Victorian disease making a comeback

Wednesday, June 15, 2011

"Kids today are glued to the tube," said Lynda Johnson, a University of Missouri Extension nutrition specialist. "Within the last 10 years or so, they've seen an increase in rickets among children."

Rickets, a crippling disease that softens bones, occurs when the body has insufficient vitamin D. It was huge problem for industrialized countries in the 1800s. Pollution, coal fires and overcrowded towns kept children from getting the sunshine they needed. Children living in Victorian slums and polluted northern cities in the United States often suffered bone deformities such as bowed legs and curved spines.

All that changed in the 1930s, when we started fortifying milk with vitamin D. However, today this bone-deforming disease is on the rise due to less activity outside and malnutrition.

A 2009 study conducted by the Albert Einstein College of Medicine found that 70 percent of United States children are low in vitamin D. Today, spewing smokestacks don't keep children from getting a healthy dose of sunshine, but rather computers, video games and TV captivate kids, leaving swing sets and playgrounds empty.

It doesn't take a lot of sun for a healthy dose of vitamin D.

"You really don't have to be outside for a long time," Johnson said. "All you have to do is expose your hands or arms to 15 to 20 minutes of sun."

Of course, use of sunscreen and darker pigmented skin will decrease vitamin D absorption. Johnson noted that children still can get adequate vitamin D from sun while wearing moderate SPF sunscreen to protect themselves.

So, how much vitamin D do individuals need? Last November, the Institute of Medicine, based in Washington, D.C., recommended 600 international units (IU) daily for everyone up to age 70 and 800 IU for those over 70. The National Institute of Health reiterates that recommendation to help people maintain overall bone health.

While not as efficient as sunshine, other sources of vitamin D include fatty fish such as salmon, tuna and mackerel. Vitamin D fortified milk and breakfast cereals and some brands of orange juice, yogurt and margarine are sources for the American diet. Read labels to learn how much vitamin D is available, Johnson said.

Still, sunshine is the best option.

"It's very, very hard to get enough vitamin D from our foods," Johnson said. "With an egg yolk you're only going to get 25 IU, and tuna will give 154 IU."

Before we understood the role of vitamin D in children's bone growth, 18th century moms used tactics that were bizarre by today's standards.

According to Sister Mary Theodora Weick, author of a 1967 history of rickets in the U.S. published in the American Journal of Clinical Nutrition, "Mothers would rub babies with snail liquor and feed them snail pottage made with snails, earthworms, ale, herbs and spices. Sometimes the baby was dipped in cold water and then warmed in a cradle. When the child began to perspire, blood was drawn from the feet."

Today, we no longer rely on snails or bloodletting. Rather, make sure your children drink plenty of milk rather than soda, and send them out frequently to play in the sunshine. As a little preventive insurance, most health experts would agree vitamin D supplements won't hurt, and may be beneficial. As with all vitamin supplements, check with a pediatrician first.

Find out more about vitamin D from the NIH at

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