European Society of Paediatric Endocrinology, 57th Annual Meeting
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Purpose of Review: Nutritional rickets and osteomalacia are common in dark-skinned and migrant populations. Their global incidence is rising due to changing population demographics, failing prevention policies and missing implementation strategies. The calcium deprivation spectrum has hypocalcaemic (seizures, tetany and dilated cardiomyopathy) and late hypophosphataemic (rickets, osteomalacia, muscle weakness) complications. This presentation reviews sustainable prevention strategies and identifies areas for future research.
Recent findings: The global rickets consensus recognises the equal contribution of vitamin D and dietary calcium in the causation of calcium deprivation and provides a 3-stage categorisation for sufficiency, insufficiency and deficiency. For rickets prevention, 400IU daily is recommended for all infants from birth and 600IU in pregnancy, alongside monitoring in antenatal and child health surveillance programs.
Summary: High-risk populations require lifelong supplementation and food fortification with vitamin D or calcium. Future research should identify the true prevalence of rickets and osteomalacia, their role in bone fragility and infant mortality, and best screening and public health prevention tools.
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