Q J Med. 1990 Sep; 76(281): 923-33.

Asian osteomalacia is determined by dietary factors when exposure to ultraviolet radiation is restricted: a risk factor model.

Henderson JB, Dunnigan MG, McIntosh WB, Abdul Motaal A, Hole D.

Medical Division, Stobhill General Hospital, Glasgow.

Twenty-seven previously osteomalacic and 77 normal Asian women participated in a seven-day survey of dietary intake and daylight outdoor exposure. Individual levels of daylight outdoor exposure discriminated poorly between normal and osteomalacic women. The presence of osteomalacia was strongly related to varying degrees of vegetarianism. Lactovegetarianism (no meat, fish or egg consumption) was associated with significantly greater osteomalacic risk than ovolactovegetarianism (no meat or fish consumption). Unlike Asian rickets, high-extraction wheat cereal as chapatti was not a significant risk factor for osteomalacia in Asian women and dietary fibre was a less important risk factor than absent dietary meat, fish or egg. When exposure to ultraviolet radiation is limited, Asian osteomalacia (and Asian rickets) are determined by dietary factors.