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Vitamin D concentrations in Asian children living in England

BMJ 1999; 318 doi: (Published 22 May 1999) Cite this as: BMJ 1999;318:1417

Limited vitamin D intake and use of sunscreens may lead to rickets

  1. Stanley Zlotkin (, Professor
  1. Department of Paediatrics and of Nutritional Sciences, Hospital for Sick Children, Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, Ontario, Canada M5G
  2. Directorate of Biochemical Medicine, Ninewells Hospital, Dundee DD1 9SY

    EDITOR—I would like to add a sixth suggestion to Wharton's five approaches to improving children's vitamin D status to prevent rickets.1 A case of rickets was recently diagnosed in a 12 month old white infant at the Hospital for Sick Children in Toronto. He had clinical, radiological, and biochemical evidence of rickets, which responded to vitamin D treatment. Vitamin D intake seemed adequate until six months after treatment began but was sporadic after that. Although the infant spent time outdoors in the summer, his skin was protected with potent sunscreens (SPF 30).

    Rickets presumably developed because of limited vitamin D intake combined with diminished skin penetration of ultraviolet radiation. I believe that …

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