ABSTRACT
BACKGROUND: Calcium-deficiency rickets is common in south-east Bangladesh and responds to calcium supplementation. AIM: To evaluate the healing effect on active rickets of a five-component nutritional advice programme aimed at doubling dietary calcium intakes. METHODS: Forty-nine children aged <10 years with mild lower limb deformities and active rickets were followed over a period of 12 months. All were provided with a five-component nutritional advice programme advocating (i) the routine addition of 1 g limestone/kg rice, (ii) consuming small fish (including bones) instead of large ones, and (iii) daily consumption of 5 g ground sesame seeds, (iv) 100 g leafy vegetables and, if possible, (v) 100 ml of milk. RESULTS: Radiographic scores improved in 90% of children. The response was positively associated with age (r=0.34, n=48, p=0.01) and severity of radiographic score at baseline (r=0.85, n=49, p<0.0001). CONCLUSIONS: Despite the lack of a statistically significant association between radiographic improvement and compliance with nutritional advice, in mild calcium-deficiency active rickets, nutritional advice may be a cost-effective treatment and possibly a valuable long-term solution to the problem.
Subject(s)
Calcium, Dietary/therapeutic use , Child Nutritional Physiological Phenomena , Developing Countries , Rickets/diet therapy , Anthropometry/methods , Bangladesh , Calcium, Dietary/administration & dosage , Child , Child, Preschool , Diet , Humans , Parents/education , Patient Compliance , Program Evaluation , Radiography , Rickets/diagnostic imaging , Treatment OutcomeABSTRACT
To understand nutritional rickets in Bangladesh better, 14 rachitic and 13 'unaffected' children were evaluated. Seventy per cent of children with active rickets had no evidence of either vitamin D deficiency or familial rickets. Rickets in Bangladesh is probably related to calcium deficiency. Abnormalities in 'unaffected' children suggest that subclinical calcium insufficiency is common.
