A health education campaign to prevent osteomalacia in Asian women in Glasgow: 1984–86

Abstract

Vitamin D deficiency is common in Asian women in Britain. Self‐supplementation with vitamin D provides effective prophylaxis. Between 1984‐86 a Health Education campaign promoted vitamin D supplementation by Asian women in Glasgow. Vitamin D supplements were provided at cost‐price in Health Board clinics and a co‐ordinator and four Asian link‐workers promoted the aims of the campaign. Despite the campaign few Asian women presently purchase vitamin D supplements. Serum 25‐OHD and calcium concentrations were significantly lower in a post‐campaing survey (1986) of Asian women than in a pre‐campaign survey (1982‐83). In contrast, the majority of Asian children in the city receive a vitamin D supplement which their mothers perceive as important for their welfare. The failure of the present campaign suggests that early detection and treatment of symptomatic osteomalacia constitutes the only means of reducing the morbidity caused by this disease.

Family screening is effective in picking up undiagnosed Asian vitamin D deficient subjects

“…There have been few follow up reports following these preventative campaigns and although Dunnigan et al. (1985) reported some success with children there was a less favourable response in adult women (Henderson et al , 1989). Leicestershire Health Authority, although aware of the potential problems from early on, has not adopted any such policy in adults.…”

“…Earlier, when vitamin D de®ciency was ®rst recognized as a problem in the Asian community various preventive policies were suggested; daily or annual supplementation (Stephens et al, 1981) and forti®cation of chapati¯our (Pietrek et al, 1976) with vitamin D. The Department of Health Working Party rejected the idea of forti®cation of other foods, though forti®cation of margarine was recommended (COMA, 1980) and is still retained (COMA, 1993). There have been few follow up reports following these preventative campaigns and although Dunnigan et al (1985) reported some success with children there was a less favourable response in adult women (Henderson et al, 1989). Leicestershire Health Authority, although aware of the potential problems from early on, has not adopted any such policy in adults.…”

An epidemiological model of privational rickets and osteomalacia

“…The provision of free vitamin D supplements in 1979 in an effort to reduce the prevalence of Asian rickets in the city is not responsible for this trend (Dunnigan et al 1985). Supplement uptake declined rapidly within a few years of the onset of the campaign and vitamin D supplements are now rarely consumed by Asian schoolchildren and women (Henderson et at. 1989).…”

Vitamin D deficiency cardiomyopathy in Scotland: a retrospective review of the last decade

“…In the UK, food is not routinely supplemented with vitamin D, although this has been successful in other countries. There was a successful supplementation programme using flour in Glasgow in the 1980s17 18; however, there is a need for robust data around modern dietary intake of children in the UK to inform an effective plan for food fortification.…”