Wednesday, June 29, 2016
Prevention of nutritional rickets in children
Multiple aspects of malnutrition threaten the world’s sustainable development goals! Like protein-energy malnutrition, micronutrient deficiencies can result in acute and chronic disease, hampering proper growth and development of children during their formative years. Consequently, numerous programmes and initiatives have been developed with an aim to eradicate nutritional deficiencies.
Nutritional rickets and osteomalacia are mostly seen in Africa, Asia, and Middle East countries. Severe vitamin D deficiency can result in hypocalcaemic seizures, hypocalcaemic dilated cardiomyopathy with heart failure, muscle weakness, growth failure, rickets, and osteomalacia. Low calcium levels can lead to pain, fractures, bone deformity, long-term disability, and increased risk of falls and death. However, calcium and vitamin D deficiency can be easily prevented and corrected through nutrient supplementation.
The challenge in eradicating such nutritional deficiencies can be easily accomplished through fortification of habitually consumed foods, such as milk, cooking oils, or other foods. Fortification strategies mainly include the selection of a proper vehicle, ideally a staple food, and support from governmental and non-governmental organisations to ensure fortified foods is being delivered to at-risk populations, such as infants and pregnant women.
The Food and Agriculture Organization states: “Food fortification is an essential element in nutrition strategies to alleviate micronutrient deficiencies. It is a dynamic area developing in response to the needs of population groups and industry. Efforts should continue to develop improved and new systems of delivering micronutrients to target populations through appropriate fortification procedures.”z
Rickets and osteomalacia are caused by vitamin D deficiency and/or dietary calcium deficiency. Consequently, rickets and osteomalacia are amenable to prevention with the aid of food fortification or nutrient supplementation. Vitamin D supplementation from birth till one year of age (400 International units [IU]/day), daily supplementation of vitamin D to pregnant women, 600 IU/day combined with folic acid and iron; and fortification of staple foods with vitamin D may alleviate the aforementioned nutrient deficiencies.
In this noble cause, as part of the Millennium Development Goals strategy, national governments; international donors; and stakeholders, such as the World Health Organization, the World Bank, United Nations Development Programme, United Nations Children's Emergency Fund, the Bill and Melinda Gates Foundation, Gavi, the Rotary Club, and others are extending their support to free the world from micronutrient deficiencies.
News Source: Högler W, Aguiar M, Kiely M, Tulchinsky T. Consensus Recommendations for Prevention of Nutritional Rickets: Food Forti-fication and Micronutrient Supplements for Global Health.