Rickets and Osteomalacia

Introduction

There are many conditions in Western industrialised societies today that were unheard of, or at least very rare, just a century ago. The same conditions are still unheard of in primitive peoples who do not have the 'benefits' of our knowledge. There is a very good reason for this: They eat what Nature intended; we don't. The diseases caused by our incorrect and unnatural diets are those featured on these pages.

Rickets and Osteomalacia

Dietary causes:

Rickets

Rickets is a disease of children in which the bones do not harden and are malformed. It is caused by a deficiency of calcium and vitamin D. In the archaeological record, rickets is rare or absent in pre-agricultural human skeletons but common in industrialised societies. In the 19th and early 20th centuries, rickets was so common in the poorer parts of England, it was called "The English Disease".

Early studies showed that rickets was caused by eating wholemeal and other bran-rich breads. This was because a chemical called phytate found in the bran bound calcium in food so that it couldn't be absorbed from the gut.[1]

With the advent of better nutrition in the 1930s rickets largely disappeared, not only in England but in other industrialised countries.

However, it wasn't to last. Since the introduction of 'healthy eating' with its stress on increasing cereal intake and fibre-rich foods, rickets has returned.[2]

Lack of vitamin D is another major cause. There is very little Vitamin D in any food; our greatest source is from sunlight. Current strictures about keeping out of the sun and using a sunscreen when in it, also contribute massively to the return of rickets.[3]

Osteomalacia

Osteomalacia is the adult counterpart to rickets. In osteomalacia bones soften due to both insufficient vitamin D because women don't go into the sun enough, and to insufficient calcium in their diet. If not treated soon enough, the condition may be irreversible. Just as with rickets, regular exposure to sunlight and the avoidance of bran are effective treatments for osteomalacia.

It is no surprise that both rickets and osteomalacia are much more common in Asian immigrants to countries such as the UK. With a mainly vegetarian diet, Asians are much more likely to be calcium deficient; and their darker pigmented skin, designed to cope with sunnier climates, also dramatically reduces the amount of vitamin D they can absorb from the UK's much weaker sunlight.

Conclusion

Both adults and children should avoid fibre-rich foods, particularly from cereals and bran. It is equally important that both adults and children should sunbathe regularly during the summer months (from March to September), in the middle of the day, and without a sunscreen. Ten or 15 minutes a day may be all that is needed. If that is impractical, or if you have a dark skin, then vitamin D supplements are a must. That said, the 400 IUs of vitamin D, which is the recommended daily dose, is woefully inadequate; 4000 IUs is nearer the mark.

References

1. McCance R, Widdowson E. Mineral metabolism of healthy adults on white and brown bread dietaries. J Physiol 1942; 101: 44-85.
2. Clements MR. The problem of rickets in UK Asians. J Hum Nutr & Dietet 1989; 2: 105-16.
3. Welch TR, Bergstrom WH, Tsang RC. Vitamin D-deficient rickets: The re-emergence of a once-conquered disease. J Pediatr 2000; 137: 143-5.