Nutritional rickets in Rastafarian children

Abstract

Nutritional rickets in Asian children living in the United Kingdom has been the subject of much discussion during the past 20 years and increasingly in the past decade. We diagnosed nutritional rickets in four black Rastafarian children and believe we have identified another population at risk. All four children were born in the United Kingdom of black Rastafarian parents of West Indian origin. They were breast fed until the second half of the first year of life, when they were weaned onto an essentially vegetarian diet known as I-tal. None of the children received vitamin supplements during infancy and none completed a full course of immunisations. The Rastafarians do not constitute a homogeneous group and details of the diet vary. They eat very little, if any, meat, milk, fats, or oils, most of the food being vegetable in origin. For Rastafarians in Jamaica fish is an important part of the diet, providing they have scales and are less thatn 12 in (30 cm) long. In our patients, however, fish seemed to be forbidden. Full dietary assessments were performed in cases 1 and 3. The mean daily intakes of vitamin D were estimated to be 2.2 μg in case 1 and 2.78 μg in case 2 compared with a daily recommended intake of 10 μg. Daily calcium intakes were 660 mg in case 1 and 696 mg in case 3, recommended daily intake 600 mg. The diets were also low in iron; indeed, all our patients had low serum iron concentrations, though their haemoglobin concentrations were within normal ranges.