High prevalence of rickets in infants on macrobiotic diets

Article Abstract:

Rickets in children is caused primarily by vitamin D deficiency, which limits calcium absorption and leads to bone deformities. Rickets is being reported more frequently in Western countries, particularly in families that follow the macrobiotic or other alternative diets. Caucasian infants born in 1985 in the Netherlands who were put on a macrobiotic diet by their parents were evaluated for vitamin D levels and rickets. The macrobiotic diet allowed unpolished rice, high-fiber vegetables, nuts, seeds, fruits and very rarely, fish. Meats and dairy products were avoided. Twenty-eight percent of 53 macrobiotic infants aged 10 to 20 months had physical symptoms of rickets during late summer and fall. Of the original group, 25 were examined again in early spring, at which time 55 percent had physical symptoms of rickets. Blood vitamin D was lower at this time, probably because sunlight enhances vitamin D levels and children get less sun exposure during the winter. This study strongly confirms the theory that the macrobiotic diet can be damaging to bone development in young children. This is because the diet is low in calcium and vitamin D and high in fiber; fiber reduces calcium absorption. While the study was being conducted, most macrobiotic teachers and parents following the diet were not open to providing either dairy products or vitamin D supplements to the children. The researchers proposed inclusion of fatty fish, and this was accepted and recommended by Michio Kushi, the leader of the macrobiotic philosophy. But fish alone will not provide enough vitamin D and calcium for children, so the researchers also suggested allowing one serving per day of dairy products. This idea is gaining support among followers of the macrobiotic diet. Reduction of fiber would also be beneficial; this can be done by sieving cereals and vegetables for a longer time and using less whole grain foods. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Risk factors, Vegetarianism, Rickets, Nutrition disorders in children

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Vitamin B-12 from algae appears not to be bioavailable

Article Abstract:

Persons on some vegetarian diets are at increased risk for developing vitamin B-12 deficiency, since the major food sources of this vitamin are all animal products. One study showed an increased incidence of vitamin B-12 deficiency among infants aged 10 to 20 months who were placed on a macrobiotic diet (a very restrictive vegetarian diet) that was almost free of animal products. Low blood levels of vitamin B-12 have been associated with various abnormalities of the blood. Some proponents of vegetarian diets claim that certain plant foods provide vitamin B-12, but analysis of 40 plant foods showed that most of these foods contained no vitamin B-12. Vitamin B-12 levels were high only in certain types of algae, nori and spirulina, and were contained in only small amounts in other algae, barley-malt syrup, whole-meal sourdough bread, parsley, and shiitake, or dried mushrooms. It has been suggested that children on macrobiotic diets should be supplemented with vitamin B-12 from fish or the plant sources noted above; this recommendation was evaluated. The effects of the algae, nori and spirulina, and fermented plant foods on blood parameters were assessed in vitamin B-12-deficient children. Children who consumed vitamin B-12-containing plant foods had improved blood levels of vitamin B-12 but increasing deterioration of their abnormal mean corpuscular volume (MCV), a measure of the volume of red blood cells. However, MCV improved in children who consumed vitamin B-12-containing fish. These findings suggest that vitamin B-12 contained in algae and plant foods may not be bioavailable, or accessible for the body's metabolic needs. Hence, algae and other plant foods do not appear to provide sufficient sources of vitamin B-12 for children requiring vitamin B-12 supplements. (Consumer Summary produced by Reliance Medical Information, Inc.)

Vegetarians, Diet therapy, Vegetarian children, Vitamin B12, Vitamin B12 deficiency, Algae as food, Edible algae

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Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn's disease and intestinal resection

Article Abstract:

Crohn's disease causes inflammation in the small intestine and colon, and can impair the absorption of dietary nutrients in the intestines. Vitamin D deficiency is a common nutritional problem in patients with this disease. A study was performed to compare the intestinal absorption of two different forms of vitamin D, cholecalciferol and 25-hydroxycholecalciferol, in patients with Crohn's disease who also had bowel resections. The study included 12 patients with Crohn's disease and four healthy volunteers. Patients with Crohn's disease were divided into three groups (short, intermediate and long) based on the amount of intestine that was removed during the bowel resection. Each subject was given a beverage containing one of the two forms of vitamin D. Both forms of vitamin D were labeled with tritium (radioactive hydrogen); the amount of vitamin D absorbed in the intestines was determined by measuring the amount of radioactive vitamin D in the blood. Overall, the absorption of vitamin D was less in patients with Crohn's disease than in the healthy volunteers. In the patients with Crohn's disease, more 25-hydroxycholecalciferol was absorbed than cholecalciferol. Also, the amount of vitamin D absorbed decreased as the size of the bowel resection increased. These findings indicate that vitamin D absorption is impaired in patients with Crohn's disease and that the degree of malabsorption correlates with the amount of intestine removed during bowel resection. Vitamin D supplements in the form of 25-hydroxycholecalciferol may be preferred for patients with the larger bowel resections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Surgery, Crohn's disease, Intestinal absorption

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