Submitted to: International Society For Trace Elements Research In Humans
Publication Type: Abstract Only
Publication Acceptance Date: 9/7/2002
Publication Date: 10/1/2002
Citation: Combs, G.F.,Jr., Hassan, N., Hunt, C.D. 2002. Risk factors for rickets in Bangladesh. Journal of Trace Elements in Experimental Medicine. 16:114.
Technical Abstract: Rickets affects ca. 4% of the children in Cox's Bazaar District of Southest Bangladesh. Our previous study showed that affected children are not vitamin D-deficient, although they are at risk for several other nutritional deficiencies. We conduced a comprehensive, multi-round survey of the food system in 6 villages in Chakaria Thana, Cox's Bazaar District. This household (HH)-level case-control study involved 199 HHs with at least one child showing physical signs consistent with rickets, and 281 HHs in the same villages with no affected children. Rickets-affected HHs were found to have more children and fewer adults, to have less economic activity, and to have substantially more pneumonia than their neighbors. Both groups consumed diets based on mainly rice and starchy vegetables, with rice and dried fish as the major sources of Ca. Dairy products were consumed by fewer than 10% of HH's; when used, they were very important Ca sources particularly for young children. The consumption of dairy products was the only HH-level food use characteristic that was associated with increased Ca intakes of children and other HH members. Deficient Ca intakes appeared to be widespread, with children under 5 yrs consuming <160 mg Ca/d, i.e., about a third of the RDA, suggesting Ca-deficiency as a predisposing factor to the disease. However, that such deficient intakes were prevalent among all HH's suggests that other factors may be involved. Because the soils in Chakaria are known to be deficient in boron (B), a trace element required for normal bone mineralization in animals, studies were conducted to determine whether B-deficiency may also play a role in the Chakaria rickets.