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- Title
Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.
- Authors
Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi
- Abstract
<bold>Background: </bold>Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication.<bold>Evidence: </bold>A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence.<bold>Process: </bold>Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus.<bold>Results: </bold>This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts.<bold>Conclusion: </bold>Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.
- Subjects
OSTEOMALACIA; RICKETS prevention; THERAPEUTIC use of vitamin D; VITAMIN therapy; RICKETS treatment; VITAMIN D deficiency; CALCIUM; CONSENSUS (Social sciences); HEALTH policy; MOTHERS; NUTRITION policy; NUTRITIONAL requirements; VITAMIN D; VITAMINS; DIAGNOSIS; THERAPEUTICS
- Publication
Journal of Clinical Endocrinology & Metabolism, 2016, Vol 101, Issue 2, p394
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2015-2175