Low plasma vitamin D in Asian toddlers in Britain

BMJ 1999;318:2-3 ( 2 January )

Editorials

Low plasma vitamin D in Asian toddlers in Britain

If in doubt give vitamins; consider iron too, and remember other vulnerable children

Papers p 28 Clinical review p 39

The first 150 words of the full text of this article appear below.

Although frank rickets is now uncommon, a steady (some think increasing) trickle of new cases remains, and many local studieshave shown high prevalences of suboptimal plasma vitamin 25-OHcholecalciferol ( $=<$ 25 nmol/l) concentrations, particularly in winter.A paper this week by Lawson and Thomas (p 28) confirms a highprevalence (20-34%) in a representative sample of 618 Asian toddlersaged 11/2-21/2 years.¹ Does this matter and what can we do aboutit?

Whether a low concentration of vitamin D itself is harmful is not known. The appearance of radiological abnormalities maydepend on other factors affecting the availability of dietarycalcium as well as vitamin D. We should be wary of chasing biochemicalnormality without evidence of clinical benefit, particularly ifsubstances which are toxic in high doses have to be used. Theoverenthusiastic use of vitamin D supplements and fortified infantfoods led to an epidemic of infant hypercalcaemia . . . [Full text of this article]

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