scholarly journals Knowledge and attitudes towards vitamin D food fortification

2019 ◽  
Vol 49 (3) ◽  
pp. 346-358 ◽  
Author(s):  
Beth Clark ◽  
Julie Doyle ◽  
Owen Bull ◽  
Sophie McClean ◽  
Tom Hill
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
South Asians ◽  
Middle Eastern ◽  
Sun Exposure ◽  
Food Fortification ◽  
Pilot Studies ◽  
Content Type ◽  
Far Eastern

Purpose Vitamin D deficiency is a well-recognised public health problem within the UK, with specific population groups more vulnerable to deficiency. Two pilot studies were used to explore awareness of vitamin D deficiency and attitudes towards food fortification. Design/methodology/approach A survey of 120 participants from five at-risk groups (South Asians, Blacks, Middle Eastern, Far Eastern and Caucasian older adults over 65 years) plus a group of British Caucasians who do not avoid sun exposure explored awareness of vitamin D, sun exposure knowledge and behaviour and attitudes towards food fortification. The latter group was included to provide a comparison group who were at a reduced risk of deficiency. χ2 was used to test associations between categorical variables and the study groups. The second study used three focus groups and two interviews, conducted on young South Asian females and examined knowledge and awareness of vitamin D and vitamin D-fortified foods. Findings A lack of knowledge and misconceptions were highlighted by both studies in relation to at-risk factors, including sunlight exposure (p = 0.037), dietary intakes (p = 0.0174) and darker skin pigmentation (p = 0.023), sources of vitamin D and the health benefits associated with optimal consumption. Attitudes to mandatory fortification of some foods varied significantly (p = 0.004) between the groups with acceptance rates for Blacks (68 per cent), those over 65 years (50 per cent), Middle Eastern (67 per cent) and Far Eastern (73 per cent), whereas the control (71 per cent) showed no acceptance, and South Asians gave a mixed response (48 per cent No). Focus group findings highlighted positive views towards fortification, although this was less for mandatory as opposed to voluntary fortification. Both pilot studies highlight the need for more research into this area, to create more effective public health policies. Originality/value The research presents novel insights into a topical area where there is limited research.

scholarly journals Vitamin D deficiency in western dwelling South Asian populations: an unrecognised epidemic

2020 ◽  
Vol 79 (3) ◽  
pp. 259-271 ◽  
Author(s):  
Andrea L. Darling
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
South Asian ◽  
South Asians ◽  
Sun Exposure ◽  
The United States ◽  
Bone Diseases ◽  
Public Health Action ◽  
Western Countries ◽  
Asian Populations

Vitamin D deficiency (25-hydroxyvitamin D; 25(OH)D) is at epidemic proportions in western dwelling South Asian populations, including severe deficiency (<12⋅5 nmol/l) in 27–60% of individuals, depending on season. The paper aimed to review the literature concerning vitamin D concentrations in this population group. Research from the UK and Europe suggests a high prevalence of South Asians with 25(OH)D concentration <25 nmol/l, with most having a 25(OH)D concentration of <50 nmol/l. In Canada, South Asians appear to have a slightly higher 25(OH)D concentration. There are few studies from the United States, South Africa and Australasia. Reasons for vitamin D deficiency include low vitamin D intake, relatively high adiposity, sun exposure avoidance and wearing of a covered dress style for cultural reasons. Possible health effects of deficiency include bone diseases such as rickets and hypocalcaemia in children and osteomalacia in adults. Vitamin D deficiency may also increase the risk of other chronic diseases. Increased fortification of food items relevant to South Asian groups (e.g. chapatti flour), as well as increased use of vitamin D supplements may help reduce this epidemic. Introducing culturally acceptable ways of increasing skin exposure to the sun in South Asian women may also be beneficial but further research is needed to assess the effectiveness of different approaches. There may be a need for a South Asian specific vitamin D dietary intake guideline in western countries. To conclude, vitamin D deficiency is epidemic in South Asians living in western countries and there is a clear need for urgent public health action.

scholarly journals Is Sunlight Exposure Enough to Avoid Wintertime Vitamin D Deficiency in United Kingdom Population Groups?

2018 ◽  
Vol 15 (8) ◽  
pp. 1624 ◽  
Author(s):  
Richard Kift ◽  
Lesley Rhodes ◽  
Mark Farrar ◽  
Ann Webb
Keyword(s):  
Vitamin D ◽  
United Kingdom ◽  
Vitamin D Deficiency ◽  
South Asians ◽  
Experimental Studies ◽  
Sun Exposure ◽  
Skin Type ◽  
Type I ◽  
Oral Vitamin ◽  
Working Age

Solar ultraviolet radiation (UVR) is required for cutaneous vitamin D synthesis, and experimental studies have indicated the levels of sun exposure required to avoid a vitamin D deficient status. Our objectives are to examine the sun exposure behaviours of different United Kingdom sectors and to identify if their exposure is enough to maintain winter circulating 25-hydroxyvitamin D above deficiency (>25 nmol/L). Data are from a series of human studies involving >500 volunteers and performed using the same protocols in Greater Manchester, UK (53.5° N) in healthy white Caucasian adolescents and working-age adults (skin type I–IV), healthy South Asian working-age adults (skin type V), and adults with photodermatoses (skin conditions caused or aggravated by cutaneous sun exposure). Long-term monitoring of the spectral ambient UVR of the Manchester metropolitan area facilitates data interpretation. The healthy white populations are exposed to 3% ambient UVR, contrasting with ~1% in South Asians. South Asians and those with photodermatoses wear clothing exposing smaller skin surface area, and South Asians have the lowest oral vitamin D intake of all groups. Sun exposure levels prevent winter vitamin D deficiency in 95% of healthy white adults and 83% of adolescents, while 32% of the photodermatoses group and >90% of the healthy South Asians were deficient. The latter require increased oral vitamin D, whilst their sun exposure provides a tangible contribution and might convey other health benefits.

scholarly journals Vitamin D deficiency: It's contributing factors and prevention

2019 ◽  
Vol 2 (2) ◽  
pp. 77-79
Author(s):  
Zahid Naeem
Keyword(s):  
At Risk ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Dairy Products ◽  
Periodontal Diseases ◽  
Public Awareness ◽  
Middle Eastern ◽  
Sun Exposure ◽  
Chronic Fatigue ◽  
Food Sources

Vitamin D deficiency is prevalent across the globe. The most important role of vitamin D is in strengthening the bones. Besides this, vitamin D is likely to be associated with prevention against different types of cancers and chronic diseases like cardiovascular diseases, hypertension, diabetes mellitus and stroke as well as osteoporosis. It also has role in preventing many neurological diseases like depression, chronic fatigue syndrome and neuro-degenerative diseases including Alzheimer’s disease autoimmune diseases, birth defects and periodontal diseases. Main source of vitamin D is sunlight, also called sunshine vitamin. People with old age, dark skinned and obese cannot produce sufficient amount of Vitamin D. Food sources include fatty fish, animal liver, egg yolk and dairy products, though these are poor sources. Vitamin D deficiency is endemic in Pakistan, India, Sri Lanka as well as Middle Eastern Countries. Though it’s sunny there all the year round, still the bulk of population is vitamin D deficient due to limited sun exposure in extremes of high temperature and socio religious reasons.  Similarly, population in Europe and America are also affected. Pregnant mothers and infants are more at risk. Population at risk should be screened and treated. Appropriate health policies, public awareness, and fortification of dairy products can definitely prevent as well as address this huge burden of disease.

Vitamin D deficiency among Jordanian university students and employees

2015 ◽  
Vol 45 (1) ◽  
pp. 68-82 ◽  
Author(s):  
Ala Qatatsheh ◽  
Reema Tayyem ◽  
Islam Al-Shami ◽  
Murad A. Al-Holy ◽  
Abdallah S. Al-rethaia
Keyword(s):  
Vitamin D ◽  
Health Promotion ◽  
University Students ◽  
Vitamin D Deficiency ◽  
Half Life ◽  
Daily Intake ◽  
Sun Exposure ◽  
Vitamin D Supplementation ◽  
Female Students ◽  
Content Type

Purpose – This paper aims to assess the prevalence of vitamin D deficiency among female university students and employees at the Hashemite University (HU) and, then, to identify risk factors for developing vitamin D deficiency among this population. Vitamin D deficiency remains widespread in many countries, including Jordan, and has been linked to many diseases. Design/methodology/approach – In this cross-sectional study, blood samples were taken from 320 healthy females – 160 students and 160 employees – aged between 18 and 65 years old who presented for routine checkup at the medical center of HU. Level of direct sun exposure and barriers to getting enough sunlight (dress style, skin color and sunscreen use) were questioned. Serum levels of 25-hydroxyvitamin D were measured, and the daily intakes of vitamin D, calcium and phosphorous were estimated through completing an adopted food frequency questionnaire. All required data were collected using a face-to-face interview by trained dietitians. The software package ESHA was used to determine the daily intake from the nutrients. Findings – The prevalence of vitamin D deficiency (25-OHD < 25 nmol/L) was 31.2 per cent in female students compared to 20.5 per cent in female employees. Prolonged exposure to sun was independently related to vitamin D deficiency (odds ratio = 4.55); participants exposed for 30 minutes daily were at a higher risk for vitamin D deficiency. However, estimated vitamin D intake was not affected by age and working status. Research limitations/implications – The present study has some important limitations. First, this study based on serum 25-OHD results, which alone, without biochemical parameters such as parathyroid hormone (either primary or secondary), might be linked to accelerated degradation of 25-OHD and shorter half-life. Second, the half-life of 25-OHD was not consistently available. Third, the smaller sample size of participants. Finally, the present study did not distinguish between intake of vitamin D2 and D3. This limitation caused the inability to precisely evaluate the prevalence of vitamin D deficiency in the studied population. Practical implications – This study indicates that it is crucial to create awareness concerning the daily intake of vitamin D in the community to avoid long-term complications related to vitamin D deficiency, by using urgent measures including vitamin D supplementation and fortification of some highly consumed food, milk and other dairy products. Educational endeavors about sensible sun exposure should be implemented to improve vitamin D status among this population. The findings of the present study call for action at the national level to build strategies for health promotion about vitamin D supplementation in groups at risk for low supplementation (e.g. younger female students, with previous chronic diseases and poor sun exposure), and engage these populations in strategizing for successful and demographically relevant outreach and education in their own communities along with effort to prevent obesity and diabetes as well as raising awareness through simple programs to prevent and treat vitamin D deficiency among women living in Jordan. Originality/value – The high prevalence of vitamin D deficiency among female university students in this study emphasizes the necessity of vitamin D supplementation and calls for action to build strategies for health promotion concerning vitamin D supplementation.

Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study

2015 ◽  
Vol 85 (1-2) ◽  
pp. 23-30 ◽  
Author(s):  
Aneta Aleksova ◽  
Rita Belfiore ◽  
Cosimo Carriere ◽  
Salam Kassem ◽  
Salvatore La Carrubba ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Primary Source ◽  
Sun Exposure ◽  
Female Gender ◽  
Developed Countries ◽  
Vitamin D Status ◽  
High Exposure

Abstract. Background: Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area. Methods: Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction. Results: The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003). Conclusions: We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

scholarly journals Seasonal Variation in Vitamin D in Association with Age, Inflammatory Cytokines, Anthropometric Parameters, and Lifestyle Factors in Older Adults

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Leticia Elizondo-Montemayor ◽  
Elena C. Castillo ◽  
Carlos Rodríguez-López ◽  
José R. Villarreal-Calderón ◽  
Merit Gómez-Carmona ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Seasonal Variation ◽  
Vitamin D Deficiency ◽  
High Probability ◽  
Sun Exposure ◽  
Serum Levels ◽  
Lifestyle Factors ◽  
Anthropometric Parameters ◽  
Healthy Older Adults

Vitamin D deficiency is present even in sunny regions. Ageing decreases pre-vitamin D production in the skin and is associated with altered cytokine profile. We performed a multivariate analysis considering lifestyle factors, anthropometric, and inflammatory markers according to seasonal variation in Mexican healthy older adults. The same cohort was followed during 12 months. Vitamin D deficiency/insufficiency was found in 91.3% of the subjects despite living in appropriate latitude (25°40′0″N). 25(OH)D levels remained below <30 ng/mL through all seasons. Vitamin D deficiency did not correlate to sun exposure or dietary intake. Gender was the strongest associated factor, explaining a variance of 20%. Waist circumference (WC) greater than 88 cm was a risk factor for vitamin D deficiency. Age (>74 years) combined with WC (>88 cm) and BMI (>32.7) showed a high probability (90%) of vitamin D deficiency. Remarkably, an increase in one centimeter in WC decreased 25(OH)D by 0.176 ng/mL, while an increase in one point BMI decreased 25(OH)D by 0.534 ng/mL. A cutoff point of 74 years of age determined probability of vitamin D hipovitaminosis. Vitamin D deficiency was correlated with TNF-αserum levels, possibly increasing the susceptibility of older adults to a proinflammatory state and its related diseases.

scholarly journals Vitamin D and COVID-19 infection; recent findings

2021 ◽  
Vol 7 (1) ◽  
pp. e19-e19
Author(s):  
Alireza Pouramini ◽  
Fatemeh Kafi ◽  
Shakiba Hassanzadeh
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Chronic Conditions ◽  
Public Health Problem ◽  
Global Public Health ◽  
Exact Role ◽  
Risk Of Death ◽  
Global Public Health Problem

COVID-19 infection increases the risk of death in patients with chronic conditions such as diabetes or obesity. The exact role of vitamin D in COVID-19 infection is unknown and controversial. Furthermore, the exact prevalence of vitamin D deficiency is still unknown but it affects individuals worldwide regardless of ethnicity and age. Herein, we give an overview of vitamin D deficiency as a global public health problem, the role of vitamin D in COVID-19 infection, and the proper approach to treating vitamin D deficiency.

Other risk factors and explanations

2019 ◽  
pp. 173-197
Author(s):  
Raj S. Bhopal
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Chronic Disease ◽  
Hypothesis Testing ◽  
Vitamin D Deficiency ◽  
Chronic Inflammation ◽  
Thyroid Dysfunction ◽  
South Asians ◽  
Evaluation Studies ◽  
Anatomy And Physiology

As is usual with medical and scientific puzzles, there have been numerous creative ideas to explain South Asians’ susceptibility to diabetes, CHD, and stroke that have not been developed into either fully articulated hypotheses or have rarely or never been included in hypothesis testing or evaluation studies. These include thyroid dysfunction, lactose intolerance, vitamin B12 and folate deficiency, infection, and chronic inflammation. Vitamin D deficiency has been studied intensively recently in relation to chronic disease including some work on South Asians. Cardiovascular anatomy and physiology has been explored in observational and though these explanations have little theoretical foundation but they need some consideration.

scholarly journals Future perspectives in addressing the global issue of vitamin D deficiency

2020 ◽  
Vol 79 (2) ◽  
pp. 246-251 ◽  
Author(s):  
M. M. Mendes ◽  
K. Charlton ◽  
S. Thakur ◽  
H. Ribeiro ◽  
S. A. Lanham-New
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Health Outcomes ◽  
Vitamin D Deficiency ◽  
Public Health Problem ◽  
Population Level ◽  
The Body ◽  
Global Public Health ◽  
Global Issue ◽  
Wide Range

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

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