Prevalence of Rickets in Children Between Two and Fourteen Years of Age

Follis, Richard H.; Jackson, Dudley P.; Eliot, Martha M.; Park, E. A.

doi:10.1001/archpedi.1943.02010190008001

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…PARK (1950) wrote that the condition begins shortly after birth and may therefore appear during the first month of life. FOLLIS (1952) observed only two cases of slight rickets among 360 infants dying within the first two weeks of life, and none among 162 still-born infants. On the other hand, VON SYDOW et al (1956) reported a high incidence of rickets at autopsy of both foetuses and infants, though the percentage was lowest in full-term still-born infants.…”

Section: Discussionmentioning

confidence: 85%

See 1 more Smart Citation

THE PREVALENCE OF RICKETS AT AUTOPSY IN A SUBTROPICAL CLIMATE: A Pilot Study in Israel

Griffel¹,

Winter²

1958

Journal of Tropical Pediatrics

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During recent years, progress in infant welfare has reduced appreciably the incidence of rickets in the temperate zone. On the other hand, there has been a growing realisation that rickets is a relatively common condition in the tropics and subtropics. JELLIFFE (1955) in his review of infant nutrition comments that " a somewhat paradoxical situation has been reached ", and regards rickets as a debilitating and possibly deforming disorder in tropical infants, living in some urban regions, including the Eastern Mediterranean.Most surveys on the incidence of rickets in warmer climes have been based on clinical diagnosis, though biochemical and radiological studies have been made. With the exception of the report by GILLMAN and GILLMAN (1951) on coloured infants in South Africa, no information on the prevalence of histologically-proven rickets at autopsy outside the temperate zone appears to have been available during recent years. A study on the incidence of rickets in Israeli infants by the authors included clinical, biochemical and radiological examinations. A pilot survey of consecutive postmortem material has now been carried out and the results are reported in this paper.The climate of Israel is subtropical. Out of a total of 4,436 day-hours during the year, over 3,200 clear sunshine hours are recorded, and this percentage is one of the highest in the world. The hot dry Ha/nsin days lead to a loss in direct sun radiation, however. MATERIAL AND METHODSThe investigation dealt with 98 unselected consecutive postmortem examinations of infants between 2 days and 2 years of age during the years 1953-1956. The fourth right costochondral junction was examined in each case. The technique included decalcification in 7 per cent nitric acid during 24 hours, preparation of a paraffin block and staining with haematoxylin-eosin. The diagnosis of rickets, as advised by FOLLIS (1943), was based on the following points : (a) regularity and depth of the columns of preparatory cartilage, (b) amount and regularity of regional blood-vessels and (c) degree of deposition of calcium salts and the amount of osteoid tissue. Positive cases of rickets were graded as severe, moderate or slight.

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Section: Discussionmentioning

confidence: 85%

“…In the U.S.A., FOLLIS et al (1952) have reported an incidence of over 63 per cent, in 1303 autopsies, and quoted SCHMORL'S 1909 figure of 94.1 per cent. Compared with such percentages, the incidence in our pilot series is indeed small in relation to that found in the past in temperate climes.…”

Section: Discussionmentioning

confidence: 97%

THE PREVALENCE OF RICKETS AT AUTOPSY IN A SUBTROPICAL CLIMATE: A Pilot Study in Israel

Griffel¹,

Winter²

1958

Journal of Tropical Pediatrics

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“…In an autopsy series of infant deaths performed by Schmorl in Dresden, Germany (6), which is at a latitude similar to the United Kingdom, >90% of the subjects had bone growth plate and histologic findings consistent with rickets. In an American series published later, >60% of infant autopsies in Baltimore showed rachitic changes (7). This prevalence indicated that rickets was a major health issue in the late 19th and early 20th centuries (1,2,8).…”

Section: Figurementioning

confidence: 99%

Early Animal Models of Rickets and Proof of a Nutritional Deficiency Hypothesis

Chesney¹

2012

J. pediatr. gastroenterol. nutr.

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In the period between 1880 and 1930, the role of nutrition and nutritional deficiency as a cause of rickets was established based upon the results from 6 animal models of rickets. This greatly prevalent condition (60%-90% in some locales) in children of the industrialized world was an important clinical research topic. What had to be reconciled was that rickets was associated with infections, crowding, and living in northern latitudes, and cod liver oil was observed to prevent or cure the disease. Several brilliant insights opened up a new pathway to discovery using animal models of rickets. Studies in lion cubs, dogs, and rats showed the importance of cod liver oil and an antirachitic substance later termed vitamin D. They showed that fats in the diet were required, that vitamin D had a secosteroid structure and was different from vitamin A, and that ultraviolet irradiation could prevent or cure rickets. Several of these experiments had elements of serendipity in that certain dietary components and the presence or absence of sunshine or ultraviolet irradiation could critically change the course of rickets. Nonetheless, at the end of these studies, a nutritional deficiency of vitamin D resulting from a poor diet or lack of adequate sunshine was firmly established as a cause of rickets.

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“…A high childhood prevalence of vitamin D deficiencies: Forty-seven percent of children (ages 2-14) born between 1927 and 1942 had rickets-a sign of severe vitamin D deficiency [30]. Accepted Dental Remedies included in its 1944 edition a citation indicating there was "abundant evidence" that the US diet was not "fully adequate" in nutrients such as vitamin D for optimal skeletal and dental mineralization.…”

Section: The Public Health Risks Of Rejecting Vitamin D Dental Caries Prophylaxis In 1944mentioning

confidence: 99%

How a Nutritional Deficiency Became Treated with Fluoride

Hujoel

2021

Nutrients

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Ignoring evidence on causes of disease such as smoking can harm public health. This report explores how public health experts started to ignore evidence that pediatric vitamin D deficiencies are associated with dental caries. Historical analyses show that an organization of clinical specialists, the American Dental Association (ADA), initiated this view. The ADA was a world-leading organization and its governing bodies worked through political channels to make fluoride a global standard of care for a disease which at the time was viewed as an indicator of vitamin D deficiencies. The ADA scientific council was enlisted in this endeavor and authorized the statement saying that “claims for vitamin D as a factor in tooth decay are not acceptable”. This statement was ghost-written, the opposite of what the ADA scientific council had endorsed for 15 years, and the opposite of what the National Academy of Sciences concluded. Internal ADA documents are informative on the origin of this scientific conundrum; the ADA scientific council had ignored their scientific rules and was assisting ADA governing bodies in conflicts with the medical profession on advertising policies. The evidence presented here suggests that professional organizations of clinical specialists have the power to create standards of care which ignore key evidence and consequently can harm public health.

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Prevalence of Rickets in Children Between Two and Fourteen Years of Age

Cited by 10 publications

References 8 publications

THE PREVALENCE OF RICKETS AT AUTOPSY IN A SUBTROPICAL CLIMATE: A Pilot Study in Israel

THE PREVALENCE OF RICKETS AT AUTOPSY IN A SUBTROPICAL CLIMATE: A Pilot Study in Israel

Early Animal Models of Rickets and Proof of a Nutritional Deficiency Hypothesis

How a Nutritional Deficiency Became Treated with Fluoride

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