ABSTRACT
This chapter discusses the rickets and osteomalacia produced by nutritional deficiencies of calcium and vitamin D and by the action of antimetabolites, such as dietary phytate and fiber. Defects in mineral nutrition are capable of producing severe impairment of health. Rickets and osteomalacia are among the more common syndromes resulting from malnutrition. Twenty-five years ago, rickets was said to be a disease of the past, conquered by supplementation of the milk supplies with vitamin D. The primary function of vitamin D is to promote the absorption of calcium. The most important source of the vitamin is biosynthesis in the skin; very little is supplied by unfortified diets in developing countries. The phytate of bread is an important source of rachitogenic activity in developing countries where lightly sifted flours and omission of leaven or fermentation result in high intakes of phytate. The opinion that rickets can be equated to vitamin D deficiency persists, despite evidence that dietary rachitogens are also important.
