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Nutritional rickets around the world: an update.

Ana L Creo1, Tom D Thacher2, John M Pettifor3

  • 1a Department of Pediatric and Adolescent Medicine , Mayo Clinic , Rochester , MN , USA.

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Nutritional rickets, caused by vitamin D or calcium deficiency, remains a global health issue. Early diagnosis and targeted supplementation are crucial for prevention and treatment.

Keywords:
CalciumChildrenGlobal healthInfantsOsteomalaciaRicketsVitamin D

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Area of Science:

  • Nutritional science
  • Pediatrics
  • Public health

Background:

  • Nutritional rickets is a growing global health concern with diverse etiologies.
  • The condition presents a spectrum, from isolated vitamin D deficiency to calcium deficiency.

Purpose of the Study:

  • To provide an updated literature review on the prevalence, causes, pathophysiology, and treatment of nutritional rickets worldwide.
  • To characterize regional differences in rickets etiology and management.

Main Methods:

  • A systematic review of global literature on nutritional rickets.
  • Extraction of key data on prevalence, causes, diagnosis, and treatment from various geographical regions.

Main Results:

  • Calcium deficiency is a primary cause in Africa and Asia; vitamin D deficiency rickets is increasing in the Americas, Europe, and the Middle East.
  • Distinct clinical presentations exist for calcium-predominant versus vitamin D-predominant rickets, with overlapping features.
  • Improved diagnostic accuracy and reporting of 25-hydroxyvitamin D (25-OHD) levels enhance understanding of rickets prevalence and causes.

Conclusions:

  • Nutritional rickets is a complex, multifactorial global problem.
  • Emphasis on community screening, diagnosis, vitamin D supplementation for infants and at-risk children, maternal vitamin D sufficiency, and dietary calcium provision is essential.
  • A spectrum of deficiency exists, requiring tailored public health interventions.