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Monday, November 06, 2006

Wrist fractures in children on the increase due to lack of sunlight

The following extract is from the newsletter of the Vitamin D Council. It relates to my concerns about the harm we are doing to our children by keeping them out of the sun, especially our Polynesian and darker-skinned citizens for whom skin cancer is a non-issue.

To work out what are your Optimum Vitamin D levels to reduce risk of heart disease, cancer and auto immune diseases, go here
Photo: Jasmine and Alama Moller, dressing appropriately according to their skin type

Dear Dr. Cannell:

I have always been very protective of my children's health. I made sure they ate right, went to bed on time, and always wore sunblock. A few weeks ago, my 16 year old computer whiz son decided to start jogging instead of playing computer games all weekend. The very first day he came home with his right foot hurting and the doctor said the x-ray showed he had broken a bone in his foot, a "stress fracture," from jogging! He didn't step on anything or twist his ankle, it just broke for no reason. The doctor told him he should drink more milk but he drinks plenty of milk. What could have caused this?

April in Duluth, Minnesota

Dear April:

Your son had what I call a "Gilchrest fracture." About 30 years ago, dermatologists like Barbara Gilchrest at Boston University, began telling Americans, including children, to stay out of the sun, lather on the sunblock, and to "drink milk" if they are concerned about vitamin D. The problem is that your son would have to drink at least 40 glasses of milk a day to get enough vitamin D if he followed her sun-avoidance advice and it sounds like he did.

Gilchrest fractures are vitamin D deficiency fractures in healthy people that occur after normal activities. Two studies have clearly linked such fractures to low vitamin D levels. A recent Finnish study found Gilchrest fractures to be almost four times more likely in young soldiers with vitamin D levels below 30 ng/ml (75 nmol/L). An earlier study of Israeli soldiers showed the same thing. The surprising thing about both studies was none of the men were obviously vitamin D deficient, indicating - once again - that current lower limits of vitamin D blood levels are set too low and that serum 25(OH)D levels should be maintained at 50 - 70 ng/ml, year around.
Ruohola JP et al. Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men. J Bone Miner Res. 2006 Sep;21(9):1483-8.
Givon U et al. Stress fractures in the Israeli defense forces from 1995 to 1996. Clin Orthop Relat Res. 2000 Apr;(373):227-32.

The rates of Gilchrest fractures, even in young people, have been steadily increasing over the last thirty years, since dermatologists have been handing out their pathological advice. For example, the incidence of fractured wrists in American kids went up 32% in boys and 56% in girls between the years 1970 and 2000.
Khosla S, et al. Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA. 2003 Sep 17;290(11):1479-85.
A study in Great Britain showed a clear latitudinal variation with the lowest fracture rates in sunnier southeast England and the highest rates in of Gilchrest fractures in Northern Ireland, Wales, and Scotland.
Cooper C, et al. Epidemiology of childhood fractures in Britain: a study using the general practice research database. J Bone Miner Res. 2004 Dec;19(12):1976-81.

The good news is that your son only suffered a broken foot by following Professor Gilchrest's advice. As you will see below, others have lost their lives.

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