1. Rickets
By: Janice Jones

2. What is Rickets?
Rickets- a disorder caused by lack of vitamin D, calcium, or phosphate, leading to softening and weakening of the bones.
Vitamin D helps the body control calcium and phosphate levels.
When Vitamin D becomes too low in blood levels, the body produces hormones that cause calcium and phosphate to leave the bones.

3. Pathology
Symptoms include: bone pain and tenderness in arms, legs, pelvis, and spine.
More severe symptoms include: dental deformities, and skeletal deformities.

4. History of Rickets
There were reports as early as the second century of rickets. During the 17th century there was an outbreak of Rickets, as recorded by Cambridge Professor Francis Glisson. It became known as the “English disease”. It then became rampant during the Industrial Revolution in United States, Europe, and the UK. It was particularly rampant among immigrants, and poverty stricken communities. It was not until 1920, Elmer McCullem, discovered it was a vitamin deficiency.

5. Rickets commonly occurs in children from infancy to 18 months.
Epidemiology
Lack of Vitamin D occurs in people who live in climates with little exposure to sunlight. Or not enough through diet due to lactose intolerance.
Rickets commonly occurs in children from infancy to 18 months.
Is common among children who are black or breastfed.

6. Epidemiology
There is a form of hereditary Rickets, the kidneys are not able to hold on to the phosphate
Renal Tubular acidosis- Kidney disorder unable to uptake phospate as well

7. Treatment
Dietary Rickets can be treated through increase uptake of Vitamin D by moderate exposure to sunlight (light therapy), increase in whole milk, whole grains, cod liver oil, and most fortified dairy products.
Surgery may be used to correct some bone deformities.
It is important that disease is detected before effects are irreversible.
RDI for Vitamin D is between IU

8. Breakfast Meal Plan Day 1 Vitamin D (IU) Day 2 Vitamin D Day 3
Glass of 2% milk with Vit A & D
104.8
Instant breakfast w/whole milk
100.0
1% milk
126.8
Yogurt, banana creme
80.0
blueberries
Wheaties
39.9
1 serving of Kix cereal
42.3
Glass of 2% with A&D
Total:
227.1
204.8
166.7

9. Lunch Menu Day 1 Vitamin D Day 2 Day 3 Energy bar 80
Ham sandwhich, whole wheat
27.5
Omelette with sausage
53.4
Tuna salad sandwich 72
Vanilla milk shake
60.6
1% milk
126.8
Glass of 2% milk
104.8
Total:
256.8
88.1
180.2

10. Dinner Menu Day 1 Vitamin D Day 2 Day 3 Thai sweet noodles 50.8
Shrimp cocktail
147.2
2% milk
104.8
Vegetables, mixed
54.7
Sourdough bread
35.2
Tuna Fish
154.6
1% Milk
126.8
Vegetables mixed
Daily total:
694.2
602.1
661

11. What Vitamin is deficient for someone with Rickets?
Questions
What Vitamin is deficient for someone with Rickets?
Vitamin D
What is the RDI for Vitamin D? IU
Vitamin D can come from what sources?
Sun, Cod liver oil, whole wheats, fortified dairy products.

12. Sources
st- practice/monograph/635/basics /epidemiology.html
s/VitaminD-HealthProfessional/
ubmedhealth/PMH /
Food Composition Table, Mcgraw & Hill
Scholarly Article- History of Rickets in US. Sister Mary Theodora Weick. The America Journal of Clinical Nutrition /11/1234.full.pdf