High prevalence of rickets in infants on macrobiotic diets.

The vitamin D status of 53 Caucasian infants aged 10-20 mo on a macrobiotic diet and 57 matched control infants on omnivorous diets was studied. In late summer (August-November) physical symptoms of rickets were present in 28% of the macrobiotic group; these infants had lower average plasma 25(OH)D concentrations (34.0 +/- 15.3 nmol/L) (mean +/- SD) than did the macrobiotic infants without such symptoms (49.7 +/- 21.9 nmol/L, p less than 0.02). Follow-up of a subsample of 25 macrobiotic infants in March-April revealed physical symptoms of rickets in 55% of the macrobiotic infants. All concentrations in blood were considerably below those in the preceding summer; the average 25(OH)D concentration was 12.3 +/- 4.3 nmol/L. Further analysis indicated that the low availability of calcium in the macrobiotic diet was an independent factor in causing the high prevalence of rickets in summer. Avoidance of milk products in combination with a high fiber intake may damage bone development in young children.

Increased risk of vitamin B-12 and iron deficiency in infants on macrobiotic diets.

The blood iron, vitamin B-12, and folate status of the 1985 birth cohort of Dutch infants aged 10.1-20.4 mo fed macrobiotic diets (n = 50) and matched omnivorous control infants (n = 57) was measured. Fe deficiency (combination of Hb less than 120 g/L, ferritin less than 12 micrograms/L, and FEP greater than 1.77 mumol/L) was observed in 15% of the macrobiotic group but not in the control group (p = 0.003). Plasma vitamin B-12 concentrations in the macrobiotic group were far below those of the control group (geometrical mean: 149 and 404 pmol/L, respectively, p less than 0.001). Plasma folate concentrations were higher in the macrobiotic group (31.6 +/- 11.7 nmol/L) than in the control group (21.1 +/- 8.8 nmol/L, p less than 0.001). In the macrobiotic group mean corpuscular volume, mean corpuscular hemoglobin mass, and mean corpuscular hemoglobin concentration were higher and hematocrit and red blood cells were lower (all p less than 0.05) than in the control group. It is advised to incorporate regular servings of animal foods into the macrobiotic diet to obtain an adequate amount of vitamin B-12.

The diagnostic value of certain alkaline phosphatase isoenzyme patterns in human serum, fractions obtained by polyacrylamide disc electrophoresis.

Over 2500 pathological sera were analysed to determine alkaline phosphatase (EC 3.1.3.1) isoenzyme levels. 3% of these sera showed two or more narrow isoenzyme bands with a lower electrophoretic mobility on polyacrylamide than that of the intestine type of alkaline phosphatase and higher than that of the bile type of alkaline phosphatase (the extra-bands group). This latter group showed significantly more intestine-tupe alkaline phosphatase than a control group of 240 sera lacking extra serum bands. Significantly more of the individuals in the extra-bands group belonged to blood group O or B than did individuals of the control group. This relationship with blood groups suggests that the presence of the extra bands is genetically determined. It is concluded that the presence of these extra bands is not a specific indication for a particular disease or malignant process. The serum of seven patients showed an unusually strong alkaline phosphatase band with a relative mobility amounting to about one-third of that of the liver-type band (2nd fraction group). Specificity for a particular disease could not be established in this group either. In four patients the serum showed an alkaline phosphatase band with an electrophoretic mobility greater than that of the liver-tupe band (6th fraction group). All of these patients had liver metastases of a primary adenocarcinoma localized in the pancreas or stomach. After the demonstration of this fraction in ther serum, the course became progessively worse.