The roles of vitamin D and dietary calcium in nutritional rickets

Abstract

The etiology and pathogenesis of nutritional rickets are becoming progressively clearer. Vitamin D deficiency has generally been considered the major or only player in the pathogenesis of nutritional rickets. However, recent research into calcium deficiency has now provided clinicians with reasons to investigate and manage patients with nutritional rickets more appropriately.The important question when assessing cases of nutritional rickets is: “Is it calcium or vitamin D deficiency or both that play a major role in the pathogenesis of the disease?”The case presentation in this review highlights the risk factors, clinical presentation and pathophysiology of nutritional rickets in a young South African black child from a semi-urban area in Johannesburg, a city with abundant sunshine throughout the year.

Controversies in medicine: the role of calcium and vitamin D supplements in adults

“… Communities with high intakes of dairy products have assumed that these high calcium intakes are desirable, but it should be noted that bone health is not in any way inferior in Asian and African communities where calcium intakes have traditionally been below 300 mg/day. Nevertheless, in children with calcium intakes of about 100 mg/day, failure of skeletal mineralisation and rickets may develop, so there is a minimum dietary requirement for calcium. Based on these imperfect data, we consider that calcium intakes of more than 500 mg/day are compatible with good skeletal health in adults of all ages, and intakes of more than 250–300 mg/day may be adequate for many individuals.…”

Vitamin D deficiency in Western Australia

“…Rickets can be classified into nutritional and non‐nutritional. Nutritional rickets has been a global public health concern and vitamin D deficiency is known to be the leading cause which shown to be more common than either isolated calcium or phosphorus deficiency . It is rarely seen in Australia and patient was referred for leg length discrepancy rather than possible assessment for rickets .…”

Rapid Determination of Vitamins D2 and D3 in Dairy Products by High‑Performance Liquid Chromatography after Solid Phase Extraction Based on Polystyrene/Polypyrrole Composite Nanofibers

“…1,2 It can result in soft, thin and brittle bones, a common disease known as rickets in children. 3 Vitamin D has two physiologically significant forms: D 2 and D 3 . 4 However, vitamin D is one of the few vitamins whose extensive intake can be toxic (hypercalcemia).…”