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Vegan Girl, 12, has "spine of 80-year-old" - 10/06/2008
 
Shock as Vegan Diet Girl, 12, Diagnosed with Rickets
1. Headlines from the Sunday Times (8 June 2008) and the Glasgow Daily Record (9 June 2008) tell the sad tale of "a girl of 12 brought up by her parents on a strict vegan" diet who "has been admitted to hospital with a degenerative bone condition said to have left her with the spine of an 80-year-old." The story has been circulated worldwide.

2. Doctors are "under pressure" to report the couple, from Glasgow, to police and social workers amid concerns her health and welfare "may have been neglected in pursuit of their beliefs." The youngster, who has been fed on a strict meat- and dairy-free diet from birth, is being treated at the city's Royal Hospital for Sick Children. She is said to have "a severe form of rickets" and to have suffered a number of fractured bones. The condition "is caused by a lack of vitamin D, which is needed to absorb calcium and is found in liver, oily fish and dairy produce."

3. Dr Faisal Ahmed, the consultant treating the child, said that he believed the dangers of forcing children to follow a strict vegan diet needed to be highlighted. "Something like this needs publicity," he said, but he refused to blame the parents, who are understood to be well-known figures in Glasgow's vegan community: "We shouldn't name and shame. Mum feels guilty about the whole thing and feels bad about it."

4. Jonathan Sher, head of policy at Children in Scotland, said: "If the consequence of parental behavior is physical, mental or emotional harm to a child, then the child protection system should become involved." Bill Aitken, justice spokesman for the Scottish Conservatives, added: "If the youngster is coming to clinical harm, something must be done."

5. Professor Tom Sanders, head of nutrition and dietetics at King's College London, who has had much experience with vegans and their diets, warned that "while most vegan parents give their children vitamin and mineral supplements, there was a core of hardliners putting their children's health at risk. Some of them think we're still monkeys that can live on fruit and nuts." Greater Glasgow and Clyde NHS board declined to comment. A spokesman for Glasgow city council said the matter had not been referred to its social work department.

6. Similar sad events have been recorded in the UK and USA and appear to be on the increase. Some have resulted in charges of murder or manslaughter, but parents have usually been dealt with patiently and leniently by the courts. In 2001, for instance, Hazmik and Garabet Manuelyan, British vegans from Staines, near London, were finally sentenced to three years' community rehabilitation after they admitted starving daughter Arenai, 10 months, to death. She had been fed nothing but breast milk, raw fruit, vegetables and nuts. In these tragic cases the social services have the unpleasant challenges in taking the ailing children into care. Prof Sanders and a Trustee of VEGA have some experience in trying to reconcile exhausted hospital dieticians and parents in prolonged deliberations over children whose prospects are damned even before they are born. Florid rickets prompts most of the strife. Nowadays, it is rare in the UK - so rare that some GPs are unlikely to see a case during a lifetime's work in the NHS.

7. Present concerns over vitamin D levels and dietary sources accentuate advice and warnings to people with aversions of many kinds - be they "ethical", genetically determined, or sufferers from malabsorption syndromes. The challenges are acute at different ages and in different conditions of health and prosperity - a cheap flight southwards at wintry half-term might do the family a power of good, even at the cost of a heavy carbon footprint., Tests, screening, and review of data from surveys, as well as the availability of fortification, supplementation and welfare, need constant attention, not only in the prevention of rickets but also of other osteopenias and musculoskeletal disorders such as osteoporosis. (We note the practice in the 1920s and 30s of sending sufferers of TB to sanatoriums where the nursing consisted of fresh air and sunshine: the benefit might have been greater than they thought in those days. Now dermatologists' warnings on sunburn and recourse to heavy application of sunblocks or paint-on tans may unduly counteract the benefits of open air).

8. VEGA's commentaries and consultation with the Food Standards Agency, Department of Health, medical authorities, primary care in the NHS, and manufacturers of pharmaceuticals, and supplements try to achieve readily available information and purchase of fortified foods and medicaments that do not offend the scruples of special interests such as vegans. Tesco's calcium and vitamin D tablets, for instance, fit the bill at the moment for such a purpose; Boots' comparable product has additional magnesium, and vitamin K, but is otherwise spoilt for vegetarians, Jews, and Muslims by gelatine included in the formulation. Prescribed products are likely to be similarly questionable; at least the labelling makes clear in an honest way where, say, vegans can make compromises without shifty blind-eye oversights. These considerations, which extend to injections, prompt us to seek help from the Royal Pharmaceutical Society to avert refusals of essential medication when objectionable formulations can be developed.

9. VEGA is constantly seeking and compiling research material for plant-derived sources of vitamin D activity and for participation in various contemporary projects. Much of this effort is reported on our website and in our VEGA news and reviews, and it is included in our database. Reports of the 12-year-old vegan girl in Glasgow who has developed rickets and embarrassed doctors, police, and social workers - not to mention the parents' appalling woe - suggest that the Vegan Society's cited guide Feeding Your Vegan Infant with Confidence needs urgent revision in the light of tragedies reported in recent years in the UK and USA (where the lines of latitude run south of those for the UK). It is also important to note the significance of "vitamin D" implicated in functions other than bone metabolism, eg on the immune system and cancer, and in connexion with the parathyroid gland. Further attention needs to be paid to catch-up growth and "growing pains" in developmental origins of adult health and disease (DOHaD).

10. Incidences of tragic diet-induced and deficiency disorders put strains on the social and medical services and the competence of primary care. Would polyclinics prevent or manage such crises better? Do the medics, social services and police observe the niceties due to the parents' confidences, and do advisers with no direct training, experience, or knowledge of such matters, such as NGOs and politicians, act prudently and sensitively? Would a feckless mother who fed her already obese daughter lots of junk foods and fizzy drinks, only for the youngster to be harmed severely by such bad practice and example, be treated with the same courtesies as errant vegan parents? These are questions that increasingly challenge the Food Standards Agency, Department of Health and Social Services, and doctors' and nurses' organizations - and research by European teams engaged in linking the essentials of farming, food, health, and land in the wellbeing of all livestock.  
 
 

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