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February 1979, Vol 133, No. 2 >
Article | February 1979

Risk of Nutritional Rickets Among Vegetarian Children FREE

Johanna T. Dwyer, DSc; William H. Dietz, MD; Gerald Hass, MD; Robert Suskind, MD
[+] Author Affiliations

Reprint requests to New England Medical Center Hospital, Frances Stern Nutrition Center, 185 Harrison Ave, Boston, MA 02111 (Dr Dwyer).


Am J Dis Child. 1979;133(2):134-140. doi:10.1001/archpedi.1979.02130020024004.
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Comments

• Records of the dietary intake of 52 preschool vegetarian children seen from 1974 to 1976 revealed that macrobiotic vegetarian diets provided amounts of vitamin D, calcium, and phosphorus that were marginal as well as less than the amounts provided by other vegetarian diets. Vitamin D supplements were rarely given. Two subjects had roentgenographic evidence of rickets. The medical histories of 32 children on macrobiotic diets who were examined in 1977 more frequently included prior physical and roentgenographic findings indicative of rickets, whereas those of 17 other vegetarian children did not. Children in the former group were more likely to have elevated levels of serum alkaline phosphatase. Two additional cases of rickets in children consuming a macrobiotic diet confirmed by roentgenograms were brought to our attention during the study.

(Am J Dis Child 133:134-140, 1979)

REFERENCES

1 +
Owen GM, Kram KM, Garry PJ, et al:  A study of nutritional status of preschool children in the United States: 1968-1970 . Pediatrics 53:597-646, 1974;.
2 +
US Department of Health, Education, and Welfare: Ten State Nutrition Survey, 1968-1970 , publication HSM No. 72-8134. Health Services and Mental Health Administration, Center for Disease Control, vol 3, 1972;.
3 +
US Department of Health, Education, and Welfare, Public Health Service: Preliminary Findings of the First Health and Nutrition Examination Survey United States, 1971-1972: Anthropometric and Clinical Findings , publication HRA No. 75-1229. Rockville, Md, Health Resources Administration, National Center for Health Statistics, 1975;.
4 +
Ford JA, Calhoun EM, McIntosh WB, et al:  Biochemical response of late rickets and osteomalacia to a chupatty-free diet . Br Med J 3:466-447, 1972;.
Link to Article
5 +
Stadler VG, Schmid R, Held U, et al:  Serochemical and radiological improvement of vitamin D-deficiency rickets on treatment with vitamin D in spite of a calcium-free diet . Ann Pediatr 199:215-225, 1962;.
6 +
Dent CE, Round JM, Rowe DJF, et al:  Effects of chappatis and ultraviolet irradiation on nutritional rickets in an Indian immigrant . Lancet 1:1282-1284, 1973;.
Link to Article
7 +
Cooke WT, Asquith P, Ruck N, et al:  Rickets, growth and alkaline phosphatase in urban adolescents . Br Med J 2:293-297, 1974;.
Link to Article
8 +
Erhard D:  The new vegetarians , Part 2. Nutrition Today 9:20-27, 1974;.
Link to Article
9 +
Dwyer JT, Palombo R, Thorne H, et al:  Preschoolers on alternate life-style diets: Associations between size and dietary indexes with diets limited in types of animal food . J Am Diet Assoc 72:264-270, 1978;.
10 +
Schull MW, Reed RB, Valadian I, et al:  Velocities of growth in vegetarian preschool children . Pediatrics 60:410-417, 1977;.
11 +
Recommended Dietary Allowances , ed 8. Food and Nutrition Board, National Research Council, National Academy of Sciences, 1974;.
12 +
Vaughan VC III:  Growth and development , in Vaughan VC III, McKay RJ, Nelson WE (eds): Nelson Textbook of Pediatrics , ed 10. Philadelphia, WB Saunders Co, 1975;, p 48.
13 +
Ohsawa G: Zen Macrobiotics . Los Angeles, The Ohsawa Foundation, Inc, 1965;.
14 +
 Infantile scurvy and nutritional rickets in the United States, Committee on Nutrition of the American Academy of Pediatrics . Pediatrics 29:646-647, 1962;.
15 +
Eliot MM, Park EA:  Rickets , in Piersol GM (ed): Cyclopedia of Medicine , vol 2. Philadelphia, FA Davis Co, 1935;, pp 1-59.
16 +
Gupta MM, Round JM, Stamp TCB:  Spontaneous cure of vitamin-D deficiency in Asians during summer in Britain . Lancet 1:586-588, 1974;.
Link to Article
17 +
O'Hara-May J, Widdowson EM:  Diets and living conditions of Asian boys in Coventry with and without signs of rickets . Br J Nutr 36:23-26, 1976;.
Link to Article
18 +
Morse JL:  The frequency of rickets in infancy in Boston and vicinity . JAMA 34:724-726, 1900;.
Link to Article
19 +
Kooh SW, Fraser D, Reilly BJ, et al:  Rickets due to calcium deficiency . N Engl J Med 297:1264-1266, 1977;.
Link to Article
20 +
Pettifor JM, Ross P, Wang J, et al:  Rickets in children of rural origin in South Africa: Is low dietary calcium a factor? J Pediatr 92:320-324, 1978;.
Link to Article
21 +
Margen S, Calloway DH:  Effect of high protein intake on urinary calcium, magnesium, and phosphorus . Fed Proc 27:726, 1968;.
22 +
Weick, Sister MT:  A history of rickets in the United States . Am J Clin Nutr 20:1234-1241, 1967;.
23 +
Haven HC:  The etiology of rachitis . Boston Med Surg J 114:27-28, 1886;.
Link to Article
24 +
Lovett RW:  The roentgenographic appearances in rickets . JAMA 65:2062-2067, 1915;.
Link to Article
25 +
Wyman ET, Weymuller CA:  The organization of a special clinic . JAMA 83:1479-1483, 1924;.
Link to Article
26 +
Eliot MM:  The control of rickets . JAMA 85:656-663, 1925;.
Link to Article
27 +
Albright F, Butler AM, Bloomberg E:  Rickets resistant to vitamin D therapy . Am J Dis Child 54:529-547, 1937;.
28 +
Deluca H:  Current concepts-vitamin D . N Engl J Med 281:1103-1106, 1969;.
Link to Article

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References

1 +
Owen GM, Kram KM, Garry PJ, et al:  A study of nutritional status of preschool children in the United States: 1968-1970 . Pediatrics 53:597-646, 1974;.
2 +
US Department of Health, Education, and Welfare: Ten State Nutrition Survey, 1968-1970 , publication HSM No. 72-8134. Health Services and Mental Health Administration, Center for Disease Control, vol 3, 1972;.
3 +
US Department of Health, Education, and Welfare, Public Health Service: Preliminary Findings of the First Health and Nutrition Examination Survey United States, 1971-1972: Anthropometric and Clinical Findings , publication HRA No. 75-1229. Rockville, Md, Health Resources Administration, National Center for Health Statistics, 1975;.
4 +
Ford JA, Calhoun EM, McIntosh WB, et al:  Biochemical response of late rickets and osteomalacia to a chupatty-free diet . Br Med J 3:466-447, 1972;.
Link to Article
5 +
Stadler VG, Schmid R, Held U, et al:  Serochemical and radiological improvement of vitamin D-deficiency rickets on treatment with vitamin D in spite of a calcium-free diet . Ann Pediatr 199:215-225, 1962;.
6 +
Dent CE, Round JM, Rowe DJF, et al:  Effects of chappatis and ultraviolet irradiation on nutritional rickets in an Indian immigrant . Lancet 1:1282-1284, 1973;.
Link to Article
7 +
Cooke WT, Asquith P, Ruck N, et al:  Rickets, growth and alkaline phosphatase in urban adolescents . Br Med J 2:293-297, 1974;.
Link to Article
8 +
Erhard D:  The new vegetarians , Part 2. Nutrition Today 9:20-27, 1974;.
Link to Article
9 +
Dwyer JT, Palombo R, Thorne H, et al:  Preschoolers on alternate life-style diets: Associations between size and dietary indexes with diets limited in types of animal food . J Am Diet Assoc 72:264-270, 1978;.
10 +
Schull MW, Reed RB, Valadian I, et al:  Velocities of growth in vegetarian preschool children . Pediatrics 60:410-417, 1977;.
11 +
Recommended Dietary Allowances , ed 8. Food and Nutrition Board, National Research Council, National Academy of Sciences, 1974;.
12 +
Vaughan VC III:  Growth and development , in Vaughan VC III, McKay RJ, Nelson WE (eds): Nelson Textbook of Pediatrics , ed 10. Philadelphia, WB Saunders Co, 1975;, p 48.
13 +
Ohsawa G: Zen Macrobiotics . Los Angeles, The Ohsawa Foundation, Inc, 1965;.
14 +
 Infantile scurvy and nutritional rickets in the United States, Committee on Nutrition of the American Academy of Pediatrics . Pediatrics 29:646-647, 1962;.
15 +
Eliot MM, Park EA:  Rickets , in Piersol GM (ed): Cyclopedia of Medicine , vol 2. Philadelphia, FA Davis Co, 1935;, pp 1-59.
16 +
Gupta MM, Round JM, Stamp TCB:  Spontaneous cure of vitamin-D deficiency in Asians during summer in Britain . Lancet 1:586-588, 1974;.
Link to Article
17 +
O'Hara-May J, Widdowson EM:  Diets and living conditions of Asian boys in Coventry with and without signs of rickets . Br J Nutr 36:23-26, 1976;.
Link to Article
18 +
Morse JL:  The frequency of rickets in infancy in Boston and vicinity . JAMA 34:724-726, 1900;.
Link to Article
19 +
Kooh SW, Fraser D, Reilly BJ, et al:  Rickets due to calcium deficiency . N Engl J Med 297:1264-1266, 1977;.
Link to Article
20 +
Pettifor JM, Ross P, Wang J, et al:  Rickets in children of rural origin in South Africa: Is low dietary calcium a factor? J Pediatr 92:320-324, 1978;.
Link to Article
21 +
Margen S, Calloway DH:  Effect of high protein intake on urinary calcium, magnesium, and phosphorus . Fed Proc 27:726, 1968;.
22 +
Weick, Sister MT:  A history of rickets in the United States . Am J Clin Nutr 20:1234-1241, 1967;.
23 +
Haven HC:  The etiology of rachitis . Boston Med Surg J 114:27-28, 1886;.
Link to Article
24 +
Lovett RW:  The roentgenographic appearances in rickets . JAMA 65:2062-2067, 1915;.
Link to Article
25 +
Wyman ET, Weymuller CA:  The organization of a special clinic . JAMA 83:1479-1483, 1924;.
Link to Article
26 +
Eliot MM:  The control of rickets . JAMA 85:656-663, 1925;.
Link to Article
27 +
Albright F, Butler AM, Bloomberg E:  Rickets resistant to vitamin D therapy . Am J Dis Child 54:529-547, 1937;.
28 +
Deluca H:  Current concepts-vitamin D . N Engl J Med 281:1103-1106, 1969;.
Link to Article

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