Apparent efficacy of food-based calcium supplementation in preventing rickets in Bangladesh

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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level

Published on: January 19, 2024

Gerald F Combs1, Nazmul Hassan, Nancie Dellagana

  • 1Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. gerald.combs@ars.usda.gov

Biological Trace Element Research
|January 9, 2008
PubMed

Insights

Increased calcium intake effectively prevents rickets in Bangladeshi children at high risk. Even low daily calcium supplements supported normal bone development, crucial for preventing this deficiency disease.

Area of Science:

  • Pediatric Nutrition
  • Bone Metabolism
  • Public Health

Background:

  • Rickets is a significant public health concern in rickets-endemic areas.
  • Children with high plasma alkaline phosphatase (AP) activity are susceptible to developing rickets.
  • A high annual risk of rickets (21.5%) was observed in a susceptible cohort in Bangladesh.

Purpose of the Study:

  • To investigate the efficacy of increased calcium (Ca) intake in preventing rickets.
  • To assess the impact of varying calcium supplement doses on bone development in high-risk children.
  • To evaluate the role of calcium in preventing rickets in a vulnerable population.

Main Methods:

  • A 13-month double-blind clinical trial was conducted with 1-to 5-year-old children.
  • Children received daily dietary supplements providing 50 mg, 250 mg, or 500 mg Ca, or 500 mg Ca with multivitamins, iron, and zinc.
  • Participants were selected based on upper decile plasma AP activity and absence of initial rickets signs.

Main Results:

  • None of the children who completed the intervention showed signs of rickets or radiological evidence of active rickets.
  • All participants exhibited normal carpal ossification for their age post-intervention.
  • Even the lowest supplemental calcium dose (50 mg/day) demonstrated effectiveness in supporting normal bone development.

Conclusions:

  • Supplemental calcium intake is effective in preventing rickets in children at high risk.
  • Low-dose calcium supplementation can be a viable strategy for bone health in deficient populations.
  • Dietary calcium plays a crucial role in preventing rickets and ensuring normal bone development.

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