Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-vl2kb Total loading time: 0.235 Render date: 2021-12-01T19:48:26.058Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Meat consumption reduces the risk of nutritional rickets and osteomalacia

Published online by Cambridge University Press:  08 March 2007

Matthew G. Dunnigan
Affiliation:
University Department of Human Nutrition, Royal Infirmary, Glasgow, UK
Janet B. Henderson
Affiliation:
Department of Psychiatry, Hairmyres Hospital, East Kilbride, UK
David J. Hole*
Affiliation:
Public Health & Health Policy, Division of Community Based Sciences, University of Glasgow, UK
E. Barbara Mawer
Affiliation:
University Department of Medicine, Royal Infirmary, Manchester, UK
Jacqueline L. Berry
Affiliation:
University Department of Medicine, Royal Infirmary, Manchester, UK
*
*Corresponding author: Professor David J. Hole, fax +44 141 330 3283, email d.j.hole@clinmed.gla.ac.uk
Rights & Permissions[Opens in a new window]

Abstract

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2005

References

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.Google ScholarPubMed
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.Google Scholar
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.Google Scholar
Clements, MR, Johnson, L & Fraser, DR (1987) A new mechanism for induced vitamin D deficiency in calcium deprivation. Nature 324, 6265.CrossRefGoogle Scholar
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.Google Scholar
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.CrossRefGoogle Scholar
Dent, CE (1974) Definition of osteomalacia. Lancet i, 805.CrossRefGoogle Scholar
Dent, CE & Gupta, MM (1975) Plasma 25-hydroxyvitamin D levels during pregnancy in Caucasians and in vegetarian and non-vegetarian Asians. Lancet ii, 10571060.CrossRefGoogle Scholar
Dollery, CT, Fraser, HS, Davies, D & McIntyre, I (1977) Vitamin D status in different subgroups of British Asians. Br Med J 1, 104.Google Scholar
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.CrossRefGoogle ScholarPubMed
Dunnigan, MG & Henderson, JB (1997) An epidemiological model of privational rickets and osteomalacia. Proc Nutr Soc 56, 939956.CrossRefGoogle ScholarPubMed
Dunnigan, MG, McIntosh, WB & Ford, JA (1976) Rickets in Asian immigrants. Lancet i, 1346.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Ford, JA, Davidson, DC, McIntosh, WB, Fyfe, WM & Dunnigan, MG (1973) Neonatal rickets in Asian immigrant population. Br Med J 3, 211212.CrossRefGoogle ScholarPubMed
Fraser, DR (1995) Vitamin D. Lancet 345, 104108.CrossRefGoogle ScholarPubMed
Gopalan, C, Sastri, BR & Balasubramanian, SC (1971) Nutritive Value of Indian Foods. Hyderabad: National Institute of Nutrition.Google Scholar
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.Google Scholar
Grindulis, H, Scott, PH, Belton, NR & Wharton, BA (1986) Combined deficiency of iron and vitamin D in Asian toddlers. Arch Dis Child 61, 843848.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google ScholarPubMed
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.Google ScholarPubMed
Holmes, AM, Enoch, BA, Taylor, JL & Jones, ME (1973) Occult rickets and osteomalacia amongst the Asian immigrant population. Q J Med 42, 125149.Google Scholar
Hunt, SP, O'Riordan, JLH, Windo, J & Truswell, AS (1976) Vitamin D status in different subgroups of British Asians. Br Med J 2, 13511354.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
Karrar, ZA (1998) Vitamin D deficiency rickets in developing countries. Ann Trop Paediatr 18, Suppl., 8992.CrossRefGoogle ScholarPubMed
Lawson, DEM (1979) Dietary vitamin D. Lancet ii, 1021.CrossRefGoogle Scholar
Mellanby, E (1918) The part played by an ‘accessory factor’ in the production of experimental rickets. Proc Physiol Soc January 26, xixii.Google Scholar
Mellanby, E (1921) Experimental Rickets. Medical Research Council Special Report Series no. 61. London: HM Stationery Office.Google Scholar
Mellanby, E (1949) Rickets-producing and anti-calcifying action of phytate. J Physiol 109, 488533.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Paul, AA & Southgate, DAT (1978) McCance and Widdowson's The Composition of Foods, 4th ed. London: HM Stationery Office.Google Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Row, PM (2001) Why is rickets resurgent in the USA?. Lancet 357, 1100.CrossRefGoogle Scholar
Shaw, NJ & Pal, BR (2002) Vitamin D deficiency in UK Asian families: activating a new concern. Arch Dis Child 86, 147149.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.Google ScholarPubMed
Wharton, B & Bishop, N (2003) Rickets. Lancet 362, 13891400.CrossRefGoogle ScholarPubMed
Wills, MR, Day, RC, Phillips, JB & Bateman, EC (1972) Phytic acid and nutritional rickets in immigrants. Lancet i, 771773.CrossRefGoogle Scholar
Wilton, P (1995) Cod liver oil, vitamin D and the fight against rickets. Can Med Assoc J 153, 740741.Google Scholar
You have Access
12
Cited by

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. 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 <service> 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 <service> account. Find out more about sending content to Google Drive.

Meat consumption reduces the risk of nutritional rickets and osteomalacia
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *