Skip to main content
×
Home

Meat consumption reduces the risk of nutritional rickets and osteomalacia

  • Matthew G. Dunnigan (a1), Janet B. Henderson (a2), David J. Hole (a3), E. Barbara Mawer (a4) and Jacqueline L. Berry (a4)...
Abstract

Endogenous vitamin D deficiency (low serum 25(OH)D3) is a necessary but insufficient requirement for the genesis of vitamin D-deficiency rickets and osteomalacia. The magnitude of the independent contributions of dietary factors to rachitic and osteomalacic risk remains uncertain. We reanalysed two weighed dietary surveys of sixty-two cases of rickets and osteomalacia and 113 normal women and children. The independent associations of four dietary variables (vitamin D, Ca, fibre and meat intakes) and daylight outdoor exposure with rachitic and osteomalacic relative risk were estimated by multivariate logistic regression. Meat and fibre intakes showed significant negative and positive associations respectively with rachitic and osteomalacic relative risk (RR; zero meat intake: RR 29·8 (95 % CI 4·96, 181), P<0·001; fibre intake: RR 1·53 (95 % CI 1·01, 2·32), P+0·043). The negative association of meat intakes with rachitic and osteomalacic relative risk was curvilinear; relative risk did not fall further at meat intakes above 60 g daily. Daylight outdoor exposure showed a significant negative association with combined relative risk (RR 0·33 (95 % CI 0·17, 0·66), P<0·001). Operation of the meat and fibre risk factors was related to sex, age and dietary pattern (omnivore/lactovegetarian), mainly determined by religious affiliation. The mechanism by which meat reduces rachitic and osteomalacic risk is uncertain and appears independent of revised estimates of meat vitamin D content. The meat content of the omnivore Western diet may explain its high degree of protection against nutritional rickets and osteomalacia from infancy to old age in the presence of endogenous vitamin D deficiency.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Meat consumption reduces the risk of nutritional rickets and osteomalacia
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Meat consumption reduces the risk of nutritional rickets and osteomalacia
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Meat consumption reduces the risk of nutritional rickets and osteomalacia
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: Professor David J. Hole, fax +44 141 330 3283, email d.j.hole@clinmed.gla.ac.uk
References
Hide All
Awumey EM, Mitra DA, Hollis BW, Kumar R & Bell NH (1998) Vitamin D metabolism in Asian Indians in the southern United States: a clinical research center study. J Clin Endocrinol Metab 83, 169173.
Bloc BH, Grant CG, McNeil AR & Reid IR (2000) Characteristics of children with florid vitamin D deficient rickets in the Auckland region in 1998. N Z Med J 113, 374376.
Chan W, Brown J, Lee SM & Buss DH (1995) Meat, Poultry and Game. Fifth Supplement to 5th edition of McCance and Widdowson's The Composition of Foods, 152153. Cambridge/London: The Royal Society of Chemistry/Ministry of Agriculture, Fisheries and Food.
Clements MR, Johnson L & Fraser DR (1987) A new mechanism for induced vitamin D deficiency in calcium deprivation. Nature 324, 6265.
Corry Mann H (1922) Rickets. The Relative Importance of Environment and Diet as Factors of Causation: An Investigation in London. Medical Research Council Special Report Series no. 68. London: HM Stationery Office.
Dandona P, Okonofua F & Clements RV (1985) Osteomalacia presenting as pathological fractures during pregnancy in women of high socio-economic class. Br Med J 290, 837838.
Dent CE (1974) Definition of osteomalacia. Lancet i, 805.
Dent CE & Gupta MM (1975) Plasma 25-hydroxyvitamin D levels during pregnancy in Caucasians and in vegetarian and non-vegetarian Asians. Lancet ii, 10571060.
Dollery CT, Fraser HS, Davies D & McIntyre I (1977) Vitamin D status in different subgroups of British Asians. Br Med J 1, 104.
Dunnigan MG, Glekin BM, Henderson JB, McIntosh WB, Sumner D & Sutherland JR (1985) Prevention of rickets in Asian children: assessment of the Glasgow campaign. Br Med J 291, 239242.
Dunnigan MG & Henderson JB (1997) An epidemiological model of privational rickets and osteomalacia. Proc Nutr Soc 56, 939956.
Dunnigan MG, McIntosh WB & Ford JA (1976) Rickets in Asian immigrants. Lancet i, 1346.
Dunnigan MG, Paton JPJ, Haase S, McNicol GW, Gardner MD & Smith CM (1962) Late rickets and osteomalacia in the Pakistani community in Glasgow. Scot Med J 7, 159167.
Dunnigan MG & Smith CM (1965) The aetiology of late rickets in Pakistani children in Glasgow. Report of a diet survey. Scot Med J 10, 19.
Finch PJ, Ang L, Colston KW, Nisbet J & Maxwell JD (1992) Blunted seasonal variation in serum 25-hydroxyvitamin D and increased risk of osteomalacia in vegetarian London Asians. Eur J Clin Nutr 46, 509515.
Ford JA, Colhoun EM, McIntosh WB & Dunnigan MG (1972 a) Rickets and osteomalacia in the Glasgow Pakistani community, 1961–1971. Br Med J 2, 677680.
Ford JA, Colhoun EM, McIntosh WB & Dunnigan MG (1972 b) Biochemical response of late rickets and osteomalacia to a chapatti-free diet. Br Med J 3, 446447.
Ford JA, Davidson DC, McIntosh WB, Fyfe WM & Dunnigan MG (1973) Neonatal rickets in Asian immigrant population. Br Med J 3, 211212.
Fraser DR (1995) Vitamin D. Lancet 345, 104108.
Gopalan C, Sastri BR & Balasubramanian SC (1971) Nutritive Value of Indian Foods. Hyderabad: National Institute of Nutrition.
Gregory JR, Collins DL, Davies PSW, Hughes JM & Clarke PC (1995) National Diet & Nutrition Survey: Children Aged 11/2 to 41/2 years, vol. 1. Report of the Diet and Nutrition Survey. London: HM Stationery Office.
Grindulis H, Scott PH, Belton NR & Wharton BA (1986) Combined deficiency of iron and vitamin D in Asian toddlers. Arch Dis Child 61, 843848.
Hallberg L, Bjorn-Rasmussen E, Howard L & Rossander L (1979) Dietary heme iron absorption. A discussion of possible mechanisms for the absorption-promoting effect of meat and for the regulation of iron absorption. Scand J Gastroenterol 14, 769779.
Heldenberg D, Tenenbaum G & Weisman Y (1992) Effect of iron on serum 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D concentrations. Am J Clin Nutr 56, 533536.
Henderson JB, Dunnigan MG, McIntosh WB, Abdul-Motaal AA, Gettinby G & Glekin BM (1987) The importance of limited exposure to ultraviolet radiation and dietary factors in the aetiology of Asian rickets: a risk factor model. Q J Med 63, 413425.
Henderson JB, Dunnigan MG, McIntosh WB, Abdul-Motaal A & Hole D (1990) Asian osteomalacia is determined by dietary factors when exposure to ultraviolet radiation is restricted: a risk factor model. Q J Med 76, 923933.
Holmes AM, Enoch BA, Taylor JL & Jones ME (1973) Occult rickets and osteomalacia amongst the Asian immigrant population. Q J Med 42, 125149.
Hunt SP, O'Riordan JLH, Windo J & Truswell AS (1976) Vitamin D status in different subgroups of British Asians. Br Med J 2, 13511354.
Iqbal SJ, Kaddam I, Wassif W, Nichol F & Walls J (1994) Continuing clinically severe vitamin D deficiency in Asians in the UK (Leicester). Postgrad Med J 70, 708714.
Karrar ZA (1998) Vitamin D deficiency rickets in developing countries. Ann Trop Paediatr 18, Suppl., 8992.
Lawson DEM (1979) Dietary vitamin D. Lancet ii, 1021.
Mellanby E (1918) The part played by an ‘accessory factor’ in the production of experimental rickets. Proc Physiol Soc January 26, xixii.
Mellanby E (1921) Experimental Rickets. Medical Research Council Special Report Series no. 61. London: HM Stationery Office.
Mellanby E (1949) Rickets-producing and anti-calcifying action of phytate. J Physiol 109, 488533.
Mughal MZ, Salama H, Greenaway T, Laing I & Mawer EB (1999) Lesson of the week: florid rickets associated with prolonged breast feeding without vitamin D supplementation. Br Med J 318, 3940.
Paul AA & Southgate DAT (1978) McCance and Widdowson's The Composition of Foods, 4th ed. London: HM Stationery Office.
Pietrek J, Windo J, Preece MA, O'Riordan JL, Dunnigan MG, McIntosh WB & Ford JA (1976) Prevention of vitamin D deficiency in Asians. Lancet i, 11451148.
Robertson I, Ford JA, McIntosh WB & Dunnigan MG (1981) The role of cereals in the aetiology of nutritional rickets: the lesson of the Irish National Nutrition Survey 1944–8. Br J Nutr 45, 1732.
Robertson I, Glekin BM, Henderson JB, McIntosh WB, Lakhani A & Dunnigan MG (1982) Nutritional deficiencies among ethnic minorities in the United Kingdom. Proc Nutr Soc 41, 243256.
Row PM (2001) Why is rickets resurgent in the USA?. Lancet 357, 1100.
Shaw NJ & Pal BR (2002) Vitamin D deficiency in UK Asian families: activating a new concern. Arch Dis Child 86, 147149.
Stamp TCB, Walker PG, Perry W & Jenkins MB (1980) Nutritional osteomalacia and late rickets in Greater London 1974–79: clinical and metabolic studies in 45 patients. Clin Endocrin Metab 9, 81105.
Tanaka Y, Frank H & De Luca HF (1973) Relative values for antirachitic activity as assessed by a calcium transport assay in the rat. Endocrinology 92, 417422.
Weisberg P, Scanlon KS, Li R & Cogswell ME (2004) Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. Am J ClinNutr 80, 1697S1705S.
Wharton B & Bishop N (2003) Rickets. Lancet 362, 13891400.
Wills MR, Day RC, Phillips JB & Bateman EC (1972) Phytic acid and nutritional rickets in immigrants. Lancet i, 771773.
Wilton P (1995) Cod liver oil, vitamin D and the fight against rickets. Can Med Assoc J 153, 740741.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 3
Total number of PDF views: 62 *
Loading metrics...

Abstract views

Total abstract views: 218 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd November 2017. This data will be updated every 24 hours.