Rickets
Table:
Rickets

X-ray of a two-year-old with rickets, with a marked bowing of the femurs and decreased bone density
Pronunciation

/ˈrɪkɪts/

Specialty	Pediatrics
Symptoms	Bowed legs, stunted growth, bone pain, large forehead, trouble sleeping[1][2]
Complications	Bone fractures, muscle spasms, abnormally curved spine, intellectual disability[2]
Usual onset	Childhood[2]
Causes	Diet without enough vitamin D or calcium, dark skin, too little sun exposure, exclusive breastfeeding without supplementation, celiac disease, certain genetic conditions[1][2][3]
Diagnostic method	Blood tests, X-rays[1]
Differential diagnosis	Fanconi syndrome, scurvy, Lowe syndrome, osteomalacia[2]
Prevention	Vitamin D supplements for exclusively-breastfed babies[4]
Treatment	Vitamin D and calcium[1]
Frequency	Relatively common (Middle East, Africa, Asia)[3]

From the table, identify if the claim is entailed, neutral, or refuted. Conclude with JSON {"answer": "YOUR ANSWER"} — nothing else.

Claim: Rickets are rare East of the Atlantic.

answer: refuted