Abstract
In 1889 Dr. John Bland-Sutton, a prominent London surgeon, was consulted about fatal rickets in over 20 successive litters of lion cubs born at the London Zoo. He evaluated the diet and found the cause of rickets to be nutritional in origin. He recommended that goat meat with crushed bones and cod-liver oil be added to the lean horsemeat diet of the cubs and their mothers. Rickets were reversed, the cubs survived, and subsequent litters thrived. Thirty years later, in classic controlled studies conducted in puppies and young rats, the definitive role of calcium, phosphate and vitamin D in prevention and therapy of rickets was elucidated. Further studies led to identifying the structural features of vitamin D.Although the Bland-Sutton diet provided calcium and phosphate from bones and vitamins A and D from cod-liver oil, some other benefits of this diet were not recognized. Taurine-conjugated bile salts, necessary for intestinal absorption of fat-soluble vitamins, were provided in the oil cold-pressed from cod liver. Unlike canine and rodent species, felines are unable to synthesize taurine, yet conjugate bile acids exclusively with taurine; hence, it must be provided in the diet. The now famous Bland-Sutton “experiment of nature,” fatal rickets in lion cubs, was cured by addition of minerals and vitamin D. Taurine-conjugated bile salts undoubtedly permitted absorption of vitamins A and D, thus preventing the occurrence of metabolic bone disease and rickets.
Highlights
The story of the discovery of the cause and prevention of rickets is exciting and represents one of the most remarkable medical accomplishments of the 20th century [1]
The prevalence of rickets in children living at northern latitudes was staggering, as high as 60% to 80% in some areas [1,2,3,4]
A body of work over a 15-year period beginning in 1917 defined the biologic properties of a “substance” in cod liver oil that was antirachitic
Summary
The story of the discovery of the cause and prevention of rickets is exciting and represents one of the most remarkable medical accomplishments of the 20th century [1]. Park and their team in Baltimore, MD, who studied rats fed restricted diets) that it was discerned that certain fats (cod-liver oil, butter and milk) could reverse the bone histologic and clinical features of rickets [2,4,9]. The message that Mellanby took away from Bland-Sutton’s work was that the curing of these lion cubs was related to the addition of fat to the diet Mellanby used these ideas to design his famous dog studies in 1919 [12,13] and demonstrated the value of dietary fat, and in particular of cod-liver oil, in the prevention and treatment of rickets. By providing codliver oil to the lion cubs, Bland-Sutton increased their dietary intake of bile acids and taurine This promoted absorption of fat-soluble vitamins [2,9]. Bland-Sutton was fortunate in his choice of dietary supplements
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