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Mother-child vitamin D deficiency: an international perspective
  1. Adekunle Dawodu1,
  2. Carol L Wagner2
  1. 1
    Center for Global Child Health, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, OH, USA
  2. 2
    Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
  1. Dr Adekunle Dawodu, Center for Global Child Health, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 5041, Cincinnati, OH 45229-3039, USA; adekunle.dawodu{at}

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Perspective on the paper by Dijkstra et al (see page 750)

Rickets is often considered a 19th century disease. However, despite the availability of vitamin D and demonstration of its efficacy in preventing rickets, vitamin D deficiency rickets still exists as a public health problem with significant morbidity in the Middle East15 and in many Asian countries,6 7 and has been reported with increasing prevalence in minority groups in North America810 and in immigrant populations in Europe, Australia and New Zealand.11 In many countries, there are reports of a high prevalence of subclinical vitamin D deficiency in children and adolescents12 13 and rickets may merely represent the tip of the iceberg.

With more studies, there are reports from many countries of a high prevalence of vitamin D deficiency in women of child-bearing age1420 and during pregnancy2124 and in nursing mothers,2527 with likely adverse consequences for women, the fetus and growing infants and children.21 What seemed to be a rare entity has become so common that by the end of 2006 a lot of literature had been published that linked vitamin D deficiency with long-latency diseases, with the implication that vitamin D affects all organ systems, not just calcium and bone.

In addition to rickets and other possible consequences of disturbed calcium homeostasis,12 epidemiological evidence suggests that lack of vitamin D supplements in infancy and early childhood may increase the incidence of type 1 diabetes.28 29 In adults, new evidence30 supports the role of vitamin D in maintaining innate immunity and in the prevention of certain disease states including autoimmune diseases, multiple sclerosis,31 32 systemic lupus erythematosis,33 rheumatoid arthritis,34 some forms of cancer (breast, ovarian, …

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