A Possible Relationship Between High-Extraction Cereal and Rickets and Osteomalacia

  • J. A. Ford
  • W. B. McIntosh
  • M. G. Dunnigan
Part of the Advances in Experimental Medicine and Biology book series (AEMB)


Rickets and osteomalacia are common among the Asian population of the united Kingdom.1,2 Rickets occurs in the neo-natal period, infancy and adolescence and osteomalacia in adult life, particularly in pregnancy. The condition is due to vitamin-D deficiency as shown by the demonstration of low levels of serum 25-hydroxychole-calciferol (25-H.C.C.) in affected patients and by their prompt theraputic response to low doses of vitamin-D.3 The reasons for the Asian population proneness to vitamin-D deficiency remain unclear. Low dietary intakes of vitamin-D, ultra-violet deprivation associated with the “purdah” way of life,4 skin pigmentation and mode of dress, a high dietary phytate intake5, and possible genetic differences in vitamin-D metabolism have all been incriminated.


Phytic Acid White Child Asian Child Dietary Phosphorus Phosphorus Excess 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dunnigan, M.G., Paton, J.P.J., Haase, S., McNicol, G.W., Gardner, M.D., and Smith, C.M.: Late rickets and osteomalacia in the Pakistani community in Glasgow. 7: 159, 1962.PubMedGoogle Scholar
  2. 2.
    Ford, J.A., Colhoun, E.M., Mcintosh, W. B., and Dunnigan, K. G.: Rickets and osteomalacia in the Glasgow Pakistani community 1961–71. Brit. med. J. ii: 677, 1972.CrossRefGoogle Scholar
  3. 3.
    Preece, M.A., McIntosh, W.B., Tomlinson, S., Ford, J.A., Dunnigan, M.G., and C’Riordan, J.L.H.: Vitamin-D deficiency among Asian immigrants to Britain. Lancet, i: 207, 1973.Google Scholar
  4. 4.
    Gupta, N.M., Round, J.M., and Stamp, T.C.B.: Spontaneous cure of vitamin-D deficiency in Asians during summer in Britain. Lancet, i: 536, 1974.Google Scholar
  5. 5.
    Wills, M.R., Day, P.C., Phillips J.B., and Batemar, E.C.: Phytic acid and nutritional rickets in immigrants. Lancet, ii: 771, 1972.CrossRefGoogle Scholar
  6. 6.
    Dunnigan, M.G., and Smith, O.M.: The aetiology of late rickets in Pakistani children in Glasgow. Report of a diet survey. Scott. med. J. 10: 1, 1965.PubMedGoogle Scholar
  7. 7.
    McCanee, R.A., and Widdowson, E.M.: The composition of foods. Spec. Rep. Ser. Med. Res. Counc. Lond., No. 235. London. H.M. Stationery Office, 1960.Google Scholar
  8. 8.
    Preece, M.A., Tomlinson, S., Pietrek, J., Robot, C.A., Ford, J.A., Dunnigan, M.G., and O’Riordan, J.L.H.: Serum 25-hydroxyvitamin-D concentration in man. Proceedings of the Fifth Parathyroid Conference, Oxford. Excerpta Medica International Congress Series Ho. 346: 448, 1974.Google Scholar
  9. 9.
    Preece, H. A., Tomlinson, S., Ribot, C. A., Pietrek, J., Korn, H. T., Davies, D.M., Ford, J.A., Dunnigan, L.G., and O’Riordan, J.L.H.: Studies of vitamin-D deficiency in man. Quart. J. Med. 44: 575, 1975.PubMedGoogle Scholar
  10. 10.
    Cooke, W.T., Asquith, P., Ruck, H., Melikian, V., and Swan, C.H.J.: Rickets, growth and alkaline phosphatase in urban adolescents. Brit. med. J. ii: 293, 1974.CrossRefGoogle Scholar
  11. 11.
    Walker, A.R.P., Fox, F.W., and Irving, J.T.: Studies in human mineral metabolism: effect of bread rich in phytate phosphorus on metabolism of certain mineral salts with special reference to calcium. Biochem. J. 42: 452, 1948.Google Scholar
  12. 12.
    Van den Berg, C.J., Hill, L.F., and Stanbury, S.W.: Inositol polyphosphates and phytic acid as inhibitors of biological calcification in the rat. Clin.Sci. 43: 377, 1972.PubMedGoogle Scholar
  13. 13.
    McCredie, D.A., Powell, H.R., and Rotenberg, S.: Diphosphonate therapy in nephrocalcinosis. Brit. J. Urol. 48: 93, 1976.PubMedCrossRefGoogle Scholar
  14. 14.
    Clark, I.: Importance of dietary calcium: phosphate ratios in skeletal calcium, magnesium and phonphate metabolism. Am. J. Physiol. 217: 865, 1969.PubMedGoogle Scholar
  15. 15.
    Reiss, E., Canterbury, J.M., Bercovitz, M.A., and Kaplan, E.L.: The role of phosphate in the secretion of parathyroid hormone in man. J. clin. Invest. 49: 2146, 1970.PubMedCrossRefGoogle Scholar
  16. 16.
    Kodicek, E.: The story of vitamin-D from vitamin to hormone. Lancet, i: 325, 1974.CrossRefGoogle Scholar
  17. 17.
    Mawer, E.B., Backhouse, J., Hill, L.F., Lumb, G.A., De Silva, P., Taylor, O.K., and Stanbury, S.W.: Vitamin-D metabolism and parathyroid function in man. Clin. Sci. 48: 548, 1975.Google Scholar
  18. 18.
    Laflamme, G.H., and Jowsey, J.: Bone and soft tissue changes with oral phosphate supplements. J. clin. Invest. 51: 2854, 1972.CrossRefGoogle Scholar
  19. 19.
    Tanaka, Y., and De Luca, E.F.: The control of 25-hydroxy-vitamin-D metabolism by inorganic phosphorus. Arch. Biochem. Biophys. 154: 566, 1973.PubMedCrossRefGoogle Scholar
  20. 20.
    Wilson, D.C.: Incidence of osteomalacia and late rickets in Northern India. Lancet, ii: 10, 1951.Google Scholar
  21. 21.
    Reinhold, J.G.: High phyt4te content of rural Iranian bread: a possible cause of human zinc deficiency. Am. J. clin. Nutr. 24: 1204, 1971.PubMedGoogle Scholar
  22. 22.
    Jessop, W.J.S.: Results of rickets surveys in Dublin. Brit. J. Nutr. 4: 289, 1950.PubMedCrossRefGoogle Scholar
  23. 23.
    Mellanby, E.: Rickets-producing and anti-calcifying action of phytate. J. Physiol. 109: 488, 1949.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1977

Authors and Affiliations

  • J. A. Ford
    • 1
  • W. B. McIntosh
    • 1
  • M. G. Dunnigan
    • 1
  1. 1.Departments of Medicine and PaediatricsStobhill General HospitalGlasgowScotland

Personalised recommendations