When I was a child, Christmas morning began promptly at 6:00am; this was far too early for my parents and grandfather to wake. To pacify my excited mind for the next hour and a half, I was allowed early entrance into the living room for a preview of what Santa had delivered and was permitted to retrieve a single toy until the family gathered for the ultimate reveal. At 7:30, my sister and I tore through the boxes and bags before attacking the stocking filled with knickknacks and candy. And always, even today, in the toe of the stocking was a single orange.
I often wondered why there was always an orange in my Christmas stocking. Afterall, it was the 1980s—oranges were available year-round in the grocery store. And just in case there was a sudden shortage of fresh oranges, my mother kept several cans of frozen orange juice concentrate in the freezer. We were never far away from a good dose of vitamin C.
Several orange theories have been proposed. I once heard the tradition began during America’s Great Depression when it was difficult to obtain fresh fruit in the winter; a juicy orange from Sunny Florida was a tasty treat and a sign that warmer weather was coming. I have also heard the tradition goes back further to a time when Northern Europeans gave the gift of a Christmas orange; only the rich could afford to spoil their children with such exotic fruit from far-away lands. Recently, I have read the tradition may go all the way back to St. Nicholas himself. Legend has it that St. Nicholas placed gold balls in the stockings of 3 young ladies to rescue them from a life of slavery; the orange is a cost-effective substitution for a ball of pure gold.
Regardless of the origin, the thought that a Christmas orange would be needed to help treat vitamin C deficiency seems unimaginable in 2020. Even in the height of COVID-19 panic, when grocery shelves were bare of meat and toilet paper, stocks of oranges and other fruit remained steady. In the December issue of Pediatrics in Review, however, Dr. Ravi et al’s Visual Diagnosis article entitled, “Petechiae, Gingival Hyperplasia, Metaphyseal Lucencies, and Refusal to Ambulate in a 5-year-old Boy,” (10.1542/pir.2018-0080) reminds us that children may suffer from vitamin C deficiency from restrictive eating. Drs. Seetharaman and Fields expand on food restrictions with “Avoidant/Restrictive Food Intake Disorder;” they provide case examples, diagnostic criteria, and treatment options.
So this Christmas, if you reach down into the stocking and pull out an orange, be sure to thank Santa. That golden ball represents an escape from slavery, a warm and sunny future, and a healthy dose of vitamin C.