The Role of Vitamin d in Rickets

During the 19th century Vitamin D deficiency was more common until it was discovered that Vitamin D is absorbed through the skin as a result from exposure to sunlight or ultraviolet rays.  In turn, prevention of Rickets (softening/ weakening of bones usually in children) has become more feasible through this measure as this finding was published and released to the public.

Winter Months

During the colder months or winter months of the year; people are known to be more susceptible to deficiencies in Vitamin D due to lack of exposure to sunlight.  Sunlight UV helps with some of the daily Vitamin D requirements but not all of it.  ‘Complete cloud cover reduces UV energy by 50%; shade (including that produced by severe pollution) reduces it by 60%’ (ODS, 2011). Supplementation through taking Vitamin D can resolve this concern and is sometimes taken in a Calcium and vitamin D complex.

Cultural/Religious Practices: Covering the Body 

Rickets and Vitamin D deficiency is a concern at all times of the year with some societies in particular who cover themselves as part of their culture and/ or religious practices.  “Europe and Australia have reported extensively in the children of recent immigrants from India, Pakistan and Bangladesh, north Africa and the Middle East in cases of Rickets. The common features in most of these situations are increased skin pigmentation and limited sun exposure due to clothing coverage in the mother, and prolonged breast feeding of the affected infant” (Pettifor, 2008).  The practice of covering skin increases chances for people to vitamin D deficiency as a result. There is a solution to this however without compromising customs, culture and religious practices.  Vitamin D deficiency can be mitigated through taking Vitamin D supplementation most common through the form of a tablet or pill.  Mothers who are deficient in vitamin D are a particular risk to passing it their infants through breast milk.  “Breast-fed babies are at risk for developing rickets because breast milk lacks sufficient vitamin D for a growing baby’s needs” (Nazario, 2011).

Developing Societies

People in developing societies are at particular risk for Rickets due the Vitamin D deficiency along with inadequate break down of Calcium and phosphorus in the intestinal tract.  They are at a higher risk due to malnutrition and lack of foods containing Vitamin D.

Other At-risk Groups

Elderly are at risk of vitamin D deficiencies that could results in Rickets due to having insufficient Vitamin D absorption in their skin.  People who have kidney issues may be at risk due to digestive concerns and not being able to process Vitamin D sufficiently.   Those with darker skin are at higher risk as well due to the high amount of Melanin pigments that reduce skins ability to make Vitamin D.  People who are obese and have undergone bypass surgery are at higher risk of Rickets because they have a higher need of Vitamin D to be retained and processed in their body.  People who are unable to absorb fats will have higher difficulty retaining vitamin D due to it being a soluble vitamin.

Recommended Dosages

There are recommended daily amounts of Vitamin D depending gender and age groups.  Higher dosages of Vitamin D are needed for women who are pregnant.

Sources of Vitamin D

There are many foods that contain Vitamin D.  Some of the common food products that have Vitamin D include various fish such as salmon, sardines, tuna and mackerel as well as milk, yogurt, eggs, cheese and beef.  Some foods produced in the U.S. and sold in supermarkets are fortified (added) with Vitamin D such as milk and orange juice.  If you eat a balanced diet and a variety of foods you should consume sufficient Vitamin D to prevent Rickets

References

 Ali, K., Allgrove, J. & Ryan, F. (2008). Hereditary vitamin D resistant rickets (HVDRR), diagnostic and therapeutic challenges, Issue 17, Pg 34, Retrieved on March 26th, 2011 from http://www.endocrine-abstracts.org/ea/0017/ea0017p34.htm

Nazario, R. (Feb 14th, 2011).  Calcium & Rickets, Retrieved on March 26th, 2011 from http://www.livestrong.com/article/381685-calcium-rickets/#ixzz1Hhm7Uhlt

ODS (Feb 25, 2011).Vitamin D, Office of Dietary Supplements, National Institutes of Health, Retrieved on March 26th, 2011 from http://ods.od.nih.gov/factsheets/vitamind/

Pettifor, J.M. (March, 2008). Vitamin D &/or calcium deficiency rickets in infants & children: a global perspective, Indian Journal of Medical Research, Issue 127, Pg 245-249, Retrieved on March 26th, 2011 from www.icmr.nic.in/ijmr/2008/march/0305.pdf