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Why is Rickets Disease Making a Comeback?
A 21st Century Warning Tale?

Rickets, a softening and weakening of bones in children typically caused by vitamin D deficiency, was common in the 19th and early 20th centuries.

sun exposure

Children, and adults, need some sun exposure to make the bone-building vitamin D.

With the introduction of vitamin D supplements, however, the disease, which can lead to bowlegs, stunted growth and improper curvature of the spine, was largely eliminated by the 1950s.

But history has a way of repeating itself, and now the crippling bone disease is making a comeback, particularly among dark-skinned kids.

"This potentially is a time-bomb," Dr. Laura Tosi, bone health chief at Children's National Medical Center in Washington told the Associated Press.

She was referring to the long-term effects of kids not building strong bones during adolescence, which could lead to osteoporosis later in life.

By the time a person reaches their 30s, their bone begins to break down faster than it's replaced. During adolescence, however, almost half of bone mass is developed.

The problem is that kids today are not receiving several crucial components to build strong bones.

1. Not Enough Vitamin D

Vitamin D helps your bones absorb calcium and phosphorus. If you don't get enough, your bones will become weakened, yet government studies suggest that a growing number of Americans are deficient in this important vitamin.

You skin makes vitamin D from sun exposure, and one of the primary reasons why people, including kids, don't get enough is because they're not spending enough time outdoors, or are wearing sunscreen when they do (which blocks vitamin D production).

"Standing outside 15 minutes a day three times a week lets the skin produce enough vitamin D most of the year," says Dr. Michael Holick of Boston University.

Because people with dark-pigmented skin require more time in the sun to produce vitamin D, they are especially at risk of vitamin D deficiency and, consequently, rickets.

Certain foods, such as milk and orange juice, are fortified with vitamin D, but some natural health experts say the form of vitamin D used for fortification is not ideal.

Foods that are naturally rich in vitamin D are fatty fish like salmon and, to a lesser degree, mushrooms, organ meets and egg yolks.

Researchers have also linked lower levels of vitamin D to breastfed infants who do not receive supplemental vitamin D. If a breastfeeding woman is low in the nutrient, then her breastmilk will be as well. So while breastfeeding is still the best choice, experts recommend supplementing babies' diets with vitamin D.

2. Too Little Exercise

Exercise is a key component of bone growth. A tennis player's dominant arm has 35 percent more bone than the non-dominant arm, according to the Associated Press, and a recent Canadian study found that postmenopausal women who got more exercise as teens had 8 percent stronger bones than their less active peers.


Getting plenty of exercise is at least as important for kids' bone health as getting enough calcium, experts say.

Yet children are increasingly spending their time watching TV and playing video games instead of being active.

The result is not only increasing rates of childhood obesity but also weaker bones in childhood and adulthood.

To help address the problem, a bone-growth guide has been established by researchers at the Cincinnati Children's Hospital. The guide will help pediatricians, who often miss the early signs of rickets, to determine if a child's bone mass is at a healthy level.

For now, you can help your child to build healthy bones by getting outside for some safe sun exposure. Experts say 15-20 minutes of sunlight a day is an ideal amount for a light-skinned person to produce health-promoting vitamin D. Darker skinned people need a bit longer.

For times when you and your children cannot get out into the sun, your health care provider can recommend a natural vitamin D supplement.

And remember, staying physically active will also help your child to build strong bones. So encourage him or her to play sports, ride a bike, or do any other activity he enjoys. Even 10 or 20 minutes of activity a few times a week has been found to improve bone strength in kids.

Recommended Reading

Calcium Better From Food, Says New Study: Here are the 26 Top Calcium Food Sources

Good Posture: The Important Health Benefits of -- and Keys to -- Good Posture

Sources December 23, 2007 October 27, 2003

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