Rickets: Signs, reasons, and remedies
In the early 20th century, rickets, a childhood bone condition that softens bones and makes them prone to fractures, was a widespread epidemic, particularly in the United States. However, since the turn of the millennium, the prevalence of rickets has significantly decreased, thanks to successful public health measures such as the fortification of foods with vitamin D and recommendations for sun exposure.
The fortification of milk with vitamin D, introduced in the 1930s, played a crucial role in eradicating rickets, which was highly prevalent before then. This intervention, combined with medical advice to expose infants to sunlight, effectively ended the high prevalence of rickets in the U.S. and other northern countries.
Despite these advancements, rickets has not been completely eradicated and still occurs in modern populations, primarily due to factors such as vitamin D deficiency, dietary insufficiency, certain medical conditions, and lifestyle choices.
Vitamin D deficiency is a significant contributor to rickets, especially in populations living in northern latitudes, those with darker skin, or people who spend most of their time indoors. Inadequate sun exposure, poor dietary intake of vitamin D and calcium, and increased prevalence of exclusive breastfeeding without vitamin D supplementation in infants are key factors.
Rickets can also be inherited or result from some metabolic and genetic conditions. A doctor may prescribe phosphate and calcitriol supplements to reduce bowing in the legs if rickets is caused by a genetic condition.
Treatment for rickets aims to maximize the individual's intake of calcium, phosphate, and vitamin D, and usually involves prescribing vitamin D supplements. Parents should consult their child's doctor about supplements if they do not think that they are getting enough vitamin D from their diet.
Dietary changes can help prevent rickets, including consuming foods rich in vitamin D such as egg, cod liver oil, oily fish, and vitamin D-fortified foods. Sunscreen limits the skin's ability to make vitamin D, so it is not possible to safely get all the vitamin D we need just by spending time outdoors.
In adulthood, a severe vitamin D deficiency can lead to osteomalacia, which shares similar symptoms with rickets. Symptoms of rickets can persist into adulthood, and people may experience bone pain due to rickets.
Children who live in countries with low sun intensity, frequent cloud cover, or short winter days may need to take vitamin D supplements to prevent rickets. A doctor may recommend increasing sun exposure for rickets prevention, but this should be done with caution to avoid sunburn and skin damage.
Blood tests, arterial blood gas tests, X-rays, and bone biopsy may be used to diagnose rickets. Rickets can also be inherited, and genetic conditions such as Hypophosphatemic rickets can result in rickets.
In conclusion, while the prevalence of rickets has drastically declined since 2000 in the U.S., it remains present primarily due to vitamin D deficiency risks related to modern lifestyles and certain medical conditions. It is crucial for individuals, especially parents, to ensure they and their children are getting enough vitamin D to maintain healthy bones and avoid rickets.
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