FROM:
http://www.niichro.com/Child/child2.html
Vitamin D and Calcium:
Rickets still exists in some Aboriginal communities.
Dr. Moffatt reported that deficiencies in vitamin D
and calcium are very prevalent in Manitoba and announced
that rickets still exists.
Rickets is a bone disease of children that is caused by a lack of vitamin D.
Symptoms include poor growth of skull bones, delayed teething, deformed
chest, potbelly, bow legs, and swollen wrists and ankles. Giving a concentrated supply of vitamin D in addition to an adequate diet is a standard treatment for rickets. Calcium supplements may also be prescribed to help restore the normal calcium. Any deformities usually disappear if the condition is treated in the early stages. 6
In 1986, 48 rickets cases were reported in Manitoba over a 15-year period. Forty of these were from Aboriginal communities with almost half coming from the Island Lake area. In the 1990s, studies of calcium intake of northern populations showed an intake of 50 per cent or less of the recommended amounts. These findings are not surprising because dairy products, which are a good source of calcium, are not widely used and not very available there.
Dietary calcium is needed during growth for bone development
and for maintenance of skeletal integrity later in life to prevent
osteoporosis, which is the loss of normal bone density, mass
and strength, leading to increased porousness and vulnerability
to fracture.7
The community of Garden Hill in the Island Lake area has a
particular problem with rickets. In the 1980s, a survey in two
of the communities in this area showed that the majority of children had vitamin D levels well below the normal range.
In 1993-94, the incidence appears to have been in a range of
85 per 1,000. Dr. Moffatt concluded that this is a community whose members have very low vitamin D stores in the body.
Treating rickets:
To treat the problem of rickets, "Stoss Therapy" was
introduced in Garden Hill, in which mothers were given
100,000 units of vitamin D at the diagnosis of pregnancy.
Babies were given 100,000 units at the age of 1 month
and again at 4 months. The result of that program actually
has been the virtual elimination of rickets from this community.
The only cases seen have been in children whose mothers either missed the program or refused to take part in it. As a result, since
1995 there haven't been rickets cases in this community, since 1995. To determine community and risk factors that might be responsive to change, three Manitoba Aboriginal communities were recently looked at and compared:
Garden Hill (high incidence of rickets)
St. Theresa Point (lower incidence)
Norway House (no rickets cases)
Surprisingly, the percentage of women in Norway House
with blood levels of vitamin D below accepted standards
was almost 80 per cent. This was in the summer, when the level
should have been the highest due to increased exposure
to sunlight.
The body produces Vitamin D, the sunshine vitamin,
when exposed to the sun's ultraviolet light.8
Dr. Moffatt thinks that what is probably happening in these
two communities, one with high incidence and the other
with none, is common to other northern communities:
high geographic latitude with decreased exposure to sunlight
and therefore few external sources of vitamin D and calcium.
He speculated, "The curve is shifted just enough in Norway
House to avoid seeing rickets. The breastfeeding rates are
lower in that community and that is almost certainly a risk
factor as well." He added that in many other northern
communities, there might be vitamin D deficiency in many people,
including pregnant women who may be passing on very
low supplies to their infants.
Consequences of low vitamin D levels:
The following have been linked to vitamin D deficiency:
Osteoporosis results in the long term, because of the
small bone masses accumulated prior to birth and early in childhood.
Vitamin D may play a role in resistance to infection.
There is potential of baby bottle tooth decay.
There is scientific evidence that decreased insulin production may exist in the presence of low vitamin D stores.
Some cancers have been potentially associated with vitamin D definciency.
In regard to baby bottle tooth decay, a low level of calcium
in the blood can cause both tetany and poor tooth development. At birth, even a short period of calcium deficiency, called
hypocalcemia, can affect the development of tooth enamel.
Hypocalcemia is a condition in which abnormally low amounts of calcium in the blood. It is extremely serious in newborn babies; particularly those fed on cow's milk. In babies, hypocalcemia causes vomiting and breathing problems. In severe hypocalcemia, the patient may suffer a seizure, or tetany, with muscular spasms of the hands, feet and jaw. 9
There is a high rate of tooth decay in northern Aboriginal communities. Noting that educational programs have not been very successful in reducing this problem, Dr. Moffatt stressed the need for a method of prevention.
He believes that the problem is related to deficiencies of
vitamin D and calcium and that improvement will be seen
with better nutrition. He concluded that such deficiencies
in these communities are probably widespread.