From the Guidelines
The most common cause of rickets is vitamin D deficiency, as supported by the most recent and highest quality study 1. Vitamin D is essential for proper calcium absorption and bone mineralization. When the body lacks sufficient vitamin D, it cannot effectively absorb calcium from the diet, leading to weakened and deformed bones characteristic of rickets. To prevent or treat vitamin D deficiency rickets:
- Ensure adequate sunlight exposure (10-30 minutes of midday sun several times a week).
- Provide vitamin D supplementation:
- For infants: 400 IU daily
- For children and adults: 600-800 IU daily
- Include vitamin D-rich foods in the diet, such as fatty fish, egg yolks, and fortified dairy products. In severe cases, higher doses of vitamin D may be prescribed under medical supervision. Additionally, ensuring adequate calcium intake through diet or supplements is crucial for bone health. Rickets is most common in infants and young children during periods of rapid growth, but can also occur in adults. Risk factors include limited sun exposure, dark skin pigmentation, exclusive breastfeeding without supplementation, and certain medical conditions affecting vitamin D metabolism, as noted in studies 2, 3, 4. However, it's worth noting that X-linked hypophosphataemia is also a significant cause of rickets, as highlighted in the 2019 study 1, which provides the most recent and highest quality evidence on the topic.
From the Research
Causes of Rickets
The most common cause of rickets is vitamin D deficiency 5, 6, 7, 8, 9. This deficiency can be due to various factors such as insufficient sunlight exposure, inadequate dietary vitamin D intake, or genetic mutations involved in vitamin D metabolism.
Factors Contributing to Vitamin D Deficiency
Several factors contribute to vitamin D deficiency, including:
- Dietary habits and lack of fortified foods 5, 8
- Atmospheric pollution and limited sunlight exposure 8
- Geographic latitude and altitude 8
- Season and time of day 8
- Religious practices that restrict sunlight exposure (clothing) 8
Treatment and Prevention
To prevent nutritional rickets, it is recommended that infants, children, and adolescents receive adequate vitamin D supplementation, either through fortified foods or supplements 5, 8, 9. The recommended daily intake of vitamin D varies, but most studies suggest at least 400 IU per day 8. In some cases, calcium supplementation may also be necessary to treat nutritional rickets 9.