- MONTREAL -- Rickets, a bone-wrenching
childhood condition that virtually disappeared from Canada more than a
generation ago, is making an alarming comeback, warns the Canadian Paediatric
Society.
-
- At least 84 children -- a number described as the "tip
of the iceberg" -- have been diagnosed in the past two years with
rickets, according to data released yesterday.
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- Ironically, the upsurge in cases is due principally to
two health-promoting measures: breastfeeding; and sun screen, which interferes
with the formation of vitamin D. Rickets is caused by vitamin D deficiency
and breast milk is rich in many nutrients, but not vitamin D.
-
- That is why it is recommended that all breastfed babies
be given a daily supplement of vitamin D. Breastfeeding mothers should
also take a vitamin D supplement.
-
- "Breast milk is indisputably, undeniably, unquestionably
the best fluid source for infants, and we're not disputing that,"
said Leanne Ward, a pediatric endocrinologist at the Children's Hospital
of Eastern Ontario in Ottawa.
-
- "But children who are breastfed should take a supplement
of 400 international units [IU] of vitamin D from birth until they start
drinking milk." (All milk sold in Canada is fortified with vitamin
D.)
-
- Rickets is a serious disease in which children's bones
soften and break. Vitamin D regulates the body's ability to use calcium,
which is required for building bone, and without which the skeleton literally
collapses. The first symptom of rickets is convulsions. Limb pain and broken
bones are commonplace. Left untreated, rickets causes permanent skeletal
damage.
-
- Dr. Ward said the 84 diagnosed cases are the "tip
of the iceberg" and each case is a tragedy because the condition is
easily preventable.
-
- The study, released yesterday at the Paediatric Society
annual meeting in Montreal, revealed that rickets is seen principally in
dark-skinned children, particularly black children and aboriginal children
who live in the Far North. Dark skin blocks the absorption of vitamin D
from the ultraviolet rays of the sun. The Canadian Paediatric Society recommends
that children in the North take at least 800 IU of vitamin D daily in the
winter.
-
- Charles Scriver, a biochemical geneticist at the Montreal
Children's Hospital who treated many children with the condition in the
1960s, said Canadians cannot afford to be complacent about rickets. "Some
of you are asking: 'Why all the fuss over 84 cases?' Do you want to wait
for the flood, or deal with this today?" he said.
-
- "Don't you dare say: 'It's only 84 cases.' This
is entirely preventable. There shouldn't be a single case," Dr. Scriver
said.
-
- While rickets is the most immediate result of vitamin
D deficiency, there is increasing evidence that it contributes to other
serious health conditions, such as cancer, diabetes and osteoporosis. One
study suggested that vitamin D deficiency plays a role in 13 types of cancer
and, if everyone consumed adequate amounts of the vitamin, there would
be 3,000 fewer cases of cancer in Canada annually.
-
- The new research was restricted to children under six
years of age, but Dr. Ward said vitamin D deficiency is a growing problem
among adolescents, particularly those who consume soft drinks instead of
milk. (Vitamin D can also be found in orange juice, wheat products and
dark fish, such as salmon.)
-
- "I'm seeing patients in my bone-health clinic who
have subclinical vitamin D deficiency," she said. "There is real
lack of milk ingestion underlying this problem."
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