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January 21, 2011

Rattled by Rickets Resurgence

http://www.jewishjournal.com/blog/item/rattled_by_rickets_resurgence/

Rickets is a childhood bone disease caused by severe vitamin D deficiency. It causes bone pain, weak bones and bone deformities in growing children. In the 1920s the link between rickets and vitamin D was discovered and within a couple of decades rickets largely disappeared from the developed world.

Until now.

A flurry of articles in the media this week (links below) reports a resurgence of rickets in England, Scotland and Ireland. One hospital in Southampton is reported to have treated 40 children with rickets last year.

That’s worrisome enough, but even more alarming is that the articles (and the physicians interviewed) seem to misdiagnose the cause. The articles all blame the recent upsurge in rickets on the northern latitudes and the increasing use of sunscreen. That’s true but that’s like blaming gravity for a plane crash. England will not be tropical any time soon and children will continue to spend most of their time indoors.

Some of the doctors in the articles recommend 20 to 30 minutes of sun exposure daily, but that seems shortsighted on two fronts. First, sun exposure increases the risk of wrinkles and skin cancer. Second, recommending sun exposure is a sign that the British doctors have forgotten their own glorious history of conquering rickets. In the 1920s when vitamin D deficiency was found to cause rickets did they have all English children sunbathe every day? No. They recommended supplementing all children’s diet with foods very high in vitamin D. This spawned countless stories of English kids being forced by their nannies to ingest cod liver oil, and it banished rickets from England for over two generations.

Although the US is farther south than England and so gets more direct sunlight, we take another measure to prevent rickets – we add vitamin D to our milk. The English amassed a global empire without a single Brit ever getting a suntan. They would do well to remember the benefits of vitamin D supplementation.

Learn more:

Los Angeles Times article: Global Health Watch: Rickets showing up in some British children

BBC article: Rickets comeback due to ‘lack of sunshine exposure’

Irish Medical Times article: Re-emergence of rickets and vitamin D deficiency

My post from December reviewing the evidence about vitamin D: The Most Recent Celebrity Vitamin: D

Tangential miscellany:

This week in 2006 I decided that what the world really needed was one more doctor writing about health-related issues. Five years and 250 posts later I hope that some of my musings have informed, interested, or amused you. I remain very grateful for all the feedback I receive about my posts and for all the links to articles you send. I’ll try not to bore you for the next five years.

Lastly, there won’t be a post next week. Posting resumes in two weeks.

Important legal mumbo jumbo:
Anything you read on the web should be used to supplement, not replace, your doctor’s advice.  Anything that I write is no exception.  I’m a doctor, but I’m not your doctor despite the fact that you read or comment on my posts.  Leaving a comment on a post is a wonderful way to enter into a discussion with other readers, but I will not respond to comments (just because of time constraints).

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