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Sunlight exposure and development of rickets in Indian toddlers

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Abstract

Objective

To study the role of sunlight exposure in determining the vitamin D status of underprivileged toddlers.

Methods

Height and weight were measured, clinical examination was performed, Food Frequency Questionnaire was administered and history of sunlight exposure was obtained in all (61) toddlers attending daytime crèche (Group B). Ionised calcium (iCa), inorganic Phosphorous (iP), alkaline phosphatase activity (ALP), serum parathyroid hormone (PTH) and 25 Hydroxy vitamin D (25OHD) were measured. Data were compared with results of a survey measuring similar parameters in 51 (of 251 eligible) toddlers from the same slum (Group A).

Results

111 children (mean age 2.6 yr (0.7), boys 56) were studied. Prevalence of hypovitaminosis D was 77% in group B toddlers (46 of 60) and 16.4% (10 of 61) had rickets, while none of the group A toddlers had 25OHD levels below 30nmol/L. Four children (7.8%) from Group A as against 24 (42.9%) from Group B, had sunshine exposure of < 30 minutes per day.

Conclusion

Underprivileged toddlers who were deprived of sunlight had a much greater incidence of hypovitaminosis D and frank rickets. The study has important public health implications and underscores the necessity for sunlight exposure in young children.

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References

  1. Das G, Crocombe S, McGrath M, Berry JL, Mughal MZ. Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child 2006; 91: 569–572.

    Article  CAS  PubMed  Google Scholar 

  2. Marwaha RK, Tandon N, Reddy DR, Aggarwal R, Singh R, Sawhney RC et al. Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr 2005; 82: 477–482.

    CAS  PubMed  Google Scholar 

  3. Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr 2005; 81: 1060–1064.

    CAS  PubMed  Google Scholar 

  4. Harinarayan CV, Ramalakshmi T, Venkataprasad U. High prevalence of low dietary calcium and low vitamin D status in healthy south Indians. Asia Pac J Clin Nutr 2004; 13: 359–364.

    CAS  PubMed  Google Scholar 

  5. Khadilkar A, Das G, Sayyad M, Sanwalka N, Bhandari D, Khadilkar V et al. Low calcium intake and hypovitaminosis D in adolescent girls. Arch Dis Child 2007; 92: 1045.

    Article  CAS  PubMed  Google Scholar 

  6. Bhatia V. Dietary calcium intake — a critical reappraisal. Indian J Med Res 2008; 127: 269–273.

    CAS  PubMed  Google Scholar 

  7. Balasubramanian K, Rajeswari J, Gulab, Govil YC, Agarwal AK, Kumar A et al. Varying role of vitaminD deficiency in the etiology of rickets in young children vs adolescents in northern India. J Trop Pediatr 2003; 49: 201–206.

    Article  CAS  PubMed  Google Scholar 

  8. Oginni LM, Sharp CA, Badru OS, Risteli J, Davie MW, Worsfold M. Radiological and biochemical resolution of nutritional rickets with calcium. Arch Dis Child 2003; 88: 812–817.

    Article  CAS  PubMed  Google Scholar 

  9. Gopalan C, Ramasastri BB, Balasubramanyam SC. Nutritive value of Indian Food. Indian Council of Medical research, National Institute of Nutrition, Hyderabad 1998.

    Google Scholar 

  10. Lund CC, Browder NC. The estimation of areas of burns. Surg Gynecol Obstetrics 1944; 79: 352–358.

    Google Scholar 

  11. WHO Multicentre Growth Reference Study Group. Assessment of differences in linear growth among populations in the WHO Multicentre Growth Reference Study. Acta Paediatr Suppl 2006; 450: 56–65.

    Google Scholar 

  12. Pettifor J M. What is the optimum 25(OH)D level for bone in children In Norman A W, Bouillion R and Thomasset M, eds. Vitamin D Endocrine System: Structural, Biological, genetic and Clinical Aspects. Riverside California; 2000.; 903–907.

  13. Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, Puliyel JM. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002; 87: 111–113.

    Article  CAS  PubMed  Google Scholar 

  14. Okonofua F, Houlder S, Bell J, Dandona P. Vitamin D nutrition in pregnant Nigerian women at term and their newborn infants. J Clin Pathol 1986; 39: 650–653.

    Article  CAS  PubMed  Google Scholar 

  15. Teotia SP, Teotia M. Nutritional bone disease in Indian population. Indian J Med Res 2008; 127; 219–228.

    CAS  PubMed  Google Scholar 

  16. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Pediatrics 2008; 122:1142–1152.

    Article  PubMed  Google Scholar 

  17. Pettifor JM. Nutritional rickets: deficiency of vitamin D, calcium, or both? Amer Clinic Nutrition 2004; 80: 1725S–1729S.

    CAS  Google Scholar 

  18. Giovannucci E, Liu Y, Willett WC. Cancer incidence and mortality and vitamin D in black and white male health professionals. Cancer Epidemiol Biomarkers Prev 2006; 15: 2467–2472.

    Article  CAS  PubMed  Google Scholar 

  19. Muhe L, Lulseged S, Mason KE, Simoes EA. Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet 1997; 21: 1801–1804.

    Article  Google Scholar 

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Authors and Affiliations

  1. Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India

    V. H. Ekbote, A. V. Khadilkar, N. Sanwalka, V. V. Khadilkar & R. Ganacharya

  2. Saint Mary’s Hospital for Women & Children, Manchester, UK

    M. Z. Mughal

  3. Ruby Hall Clinic, Poona Medical Foundation Research Center, Sassoon Road, Pune, India

    N. Hanumante

  4. Agharkar Research Institute, G G Agarkar Road, Pune, India

    S. A. Chiplonkar

  5. American Institute of Medicine, University of Seychelles, Victoria, Seychelles

    S. Kant

  6. Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune, 411 001, India

    A. V. Khadilkar

Authors
  1. V. H. Ekbote
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  2. A. V. Khadilkar
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  3. M. Z. Mughal
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  4. N. Hanumante
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  5. N. Sanwalka
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  6. V. V. Khadilkar
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  7. S. A. Chiplonkar
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  8. S. Kant
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  9. R. Ganacharya
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Correspondence to A. V. Khadilkar.

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Ekbote, V.H., Khadilkar, A.V., Mughal, M.Z. et al. Sunlight exposure and development of rickets in Indian toddlers. Indian J Pediatr 77, 61–65 (2010). https://doi.org/10.1007/s12098-009-0263-2

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  • DOI: https://doi.org/10.1007/s12098-009-0263-2

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