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|Title: ||Prevention of Nutritional Rickets in Nigerian Children with Dietary Calcium Supplementation|
|Authors: ||Thacher, Tom D.|
Fischer, Philip R.
Isichei, Christian O.
Zoakah, Ayuba I.
Pettifor, John M.
|Keywords: ||Bone diseases|
|Issue Date: ||2012|
|Series/Report no.: ||Vol. 50;Iss.5; Pp 1074–1080|
|Abstract: ||Nutritional rickets in Nigerian children usually results from dietary calciuminsufficiency. Typical dietary calcium
intakes in African children are about 200 mg daily (approximately 20–28% of US RDAs for age).We sought to determine
if rickets could be prevented with supplemental calciumorwith an indigenous food rich in calcium.We
enrolled Nigerian children aged 12 to 18 months from three urban communities. Two communities were
assigned calcium, either as calcium carbonate (400 mg) or ground fish (529±109 mg) daily, while children in
all three communities received vitamin A (2500 IU) daily as placebo. Serum markers of mineral homeostasis
and forearm bone density (pDEXA) were measured and radiographs were obtained at enrollment and after
18 months of supplementation. The overall prevalence of radiographic rickets at baseline was 1.2% and of vitamin
D deficiency [serum 25(OH)Db12 ng/ml] 5.4%. Of 647 children enrolled, 390 completed the 18-month
follow-up. Rickets developed in 1, 1, and 2 children assigned to the calcium tablet, ground fish, and control
groups, respectively (approximate incidence 6.4/1000 children/year between 1 and 3 years of age). Children
who developed rickets in the calcium-supplemented groups had less than 50% adherence. Compared with the
group that received no calcium supplementation, the groups that received calcium had a greater increase in
areal bone density of the distal and proximal 1/3 radius and ulna over time (Pb0.04). We conclude that calcium
supplementation increased areal bone density at the radius and ulna, but a larger sample sizewould be required
to determine its effect on the incidence of rickets.|
|Appears in Collections:||Chemical Pathology|
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