Nutritional rickets: Historic overview and plan for worldwide eradication

Area of Science:

• Pediatrics
• Endocrinology
• Nutritional Science

Background:

• Rickets, historically documented since Roman times, was prevalent in 17th-century Europe.
• The causes of rickets, involving sunlight exposure and dietary factors, were identified in the 1920s with the discovery of vitamin D.
• Vitamin D supplementation significantly reduced nutritional rickets in Europe and North America.

Observation:

• Despite past successes, nutritional rickets persists globally, particularly in Asian and Middle Eastern countries due to vitamin D deficiency.
• Calcium deficiency rickets is prevalent in some African and Asian nations.
• Individuals with darker skin, including immigrants and refugees in temperate climates, are also at risk.

Findings:

• The complex vitamin D endocrine system's chemistry, metabolism, and activity have been elucidated over a century.
• Nutritional rickets stems from deficiencies in vitamin D, calcium, or both.
• Effective prevention and treatment strategies for nutritional rickets are well-established.

Implications:

• A global memorandum proposes an implementation program to eradicate nutritional rickets by 2030, modeled after successful public health initiatives.
• International collaboration is key to convincing the World Health Organization and member states to support this eradication effort.
• Eradicating nutritional rickets by 2030 is a feasible public health goal with established interventions.