A systematic review of vitamin D status and dietary intake in various Slovenian populations

Introduction Gestational diabetes (GDM) is one of the most common complications in pregnancy, with a prevalence that continues to rise. At the time of the COVID-19 epidemic, immediate reorganisation and adjustment of the system was needed. Telemedicine support was offered in order to provide high-quality treatment to pregnant women. However, the success of the treatment is unknown. We therefore aimed to evaluate COVID-19 epidemic effects on pregnancy outcomes in GDM. Methods The maternal outcomes (insulin treatment, gestational weight gain, caesarean section, hypertensive disorders) and perinatal outcomes (rates of large and small for gestational age, preterm birth and a composite child outcome) of women visiting a university hospital diabetes clinic from March to December 2020 were compared with those treated in the same period in 2019. Results Women diagnosed with GDM during the COVID-19 epidemic (n=417), were diagnosed earlier (23.9 [11.7–26.0] vs. 25.1 [21.8–26.7] gestational week), had higher fasting glucose (5.2 [5.0–5.4] vs. 5.1 [4.8–5.3] mmol/l) and earlier pharmacological therapy initiation, and had achieved lower HbA1c by the end of followup (5.1% (32.2 mmol/mol) [4.9% (30.1 mmol/mol)–5.4% (35.0 mmol/mol)] vs. 5.2% (33.3 mmol/mol) [5.0% (31.1 mmol/mol) – 5.4%·(35.5 mmol/mol)], p<0.001) compared to a year before (n=430). No significant differences in perinatal outcomes were found. Conclusions Although GDM was diagnosed at an earlier gestational age and higher fasting glucose concentration was present at the time of diagnosis, the COVID-19 epidemic did not result in worse glucose control during pregnancy or worse pregnancy outcomes in Slovenia.

Section: Discussionmentioning

confidence: 99%

Maternal and perinatal outcomes during the COVID-19 epidemic in pregnancies complicated by gestational diabetes

Munda

Indihar

Okanovič

et al. 2023

“…Vitamin D intake and status in Slovenia were assessed in 2017/2018 by Hribar et al ( 40 – 42 ). The supplementation rate in our study was increased due to the Covid-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D fortification of eggs alone and in combination with milk in women aged 44–65 years: Fortification model and economic evaluation

Vičič

Mikuš

Kugler

et al. 2023

Self Cite

Introduction For almost nine decades, the fortification of foods with vitamin D has been proven effective in preventing rickets. This study aims to build and economically evaluate a fortification model based on egg biofortification and milk (including yoghurt) fortification. Methods A cross-sectional study was carried out between 1. March and 31. May 2021. Three hundred and nineteen healthy women from the Central Slovenian region aged between 44 and 65 were recruited for the study, with 176 participants included in the final analysis. For the fortification model calculations, the vitamin D contents of unenriched milk (including yoghurt) and eggs were replaced by enriched foods containing vitamin D. The economic evaluation was done using available drug and food supplement prices. Fortification costs were calculated using vitamin D prices provided by suppliers. Results Mean vitamin D intake from food was 2.19±1.34 µg/d. With fortification Model 1 (enriched eggs), it would be: 6.49±4.45 µg/d, and with Model 2 (enriched eggs and milk): 10.53±6.49 µg/d. Without fortification, none of the participants would reach a daily vitamin D intake >10 µg. With fortification Model 1 (egg fortification), 15.3% would reach >10 µg and with Model 2 (egg and milk fortification) 46.2% would reach >10 µg. The economic comparison of the annual cost of 10 µg vitamin D/d/person was EUR 6.17 for prescription drugs, EUR 6.37 for food supplements, EUR 0.09 for direct milk fortification and EUR 0.12 for egg biofortification with vitamin D. Conclusions Egg and milk (including yoghurt) fortification could cost-effectively increase vitamin D intake in the Slovenian population of women between 44 and 65 by almost five-fold, and could significantly lower the prevalence of vitamin D deficiency. Additional research and changes to legislation are needed before this can be introduced.

“…Moreover, intake of vitamin D supplements is often limited by relatively poor adherence, especially in individuals with low-socioeconomic status (lower education, marginal groups), who are at the highest risk for vitamin D deficiency. Vitamin D deficiency is a known challenging public health issue, especially during the winter months with high incidence of viral respiratory infections ( 9 ). An effective approach to improve vitamin D status in the general population could be systematic vitamin D food fortification, since it is economical, safe and decreases deficiency risk in the entire population, including people that would not use supplements ( 55 ).…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that various population groups across Slovenia are at high risk of vitamin D insufficiency and deficiency, particularly during wintertime. All included studies reported daily intakes below the recommended level ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

“…The European Centre for Disease Prevention and Control encouraged health care professionals to take actions that are logical, based on previously known findings in related fields ( 13 ). However, in more than a year of the COVID-19 pandemic new data has become available to support the important role of vitamin D in SARS-CoV-2 infection, and some recommendations of vitamin D supplementation are already available ( 8 , 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 and vitamin D– a systematic review

Jordan

Siuka

Rotovnik

et al. 2022

Introduction The COVID-19 pandemic has strongly affected global healthcare systems. Prior epidemiological studies on different infectious diseases have shown a strong correlation between serum vitamin D levels and the incidence of certain infectious diseases. Vitamin D has an important immunomodulatory effect on innate immunity and exhibits several other mechanisms in the pathogenesis of the cytokine storm, which is one of the main contributing factors to fatality in COVID-19 patients. Methods A keyword search was conducted in the PubMed and Google Scholar research databases. The abstracts and/or full texts of selected papers were further evaluated. Articles that fulfilled the inclusion criteria were included in the systematic review. Results The 28 studies summarized in this review provide observational findings that vitamin D levels are related to the incidence, severity, and mortality rate of COVID-19 infection. The literature does not suggest that COVID-19 could be eliminated with supplementation of vitamin D, but there are implications that vitamin D deficiency might increase the risk for COVID-19 infection and severity of the disease progression. Discussion Current literature and several guidelines support the supplementation of vitamin D as a reasonable strategy for correcting and preventing vitamin D deficiency. The recommended dose for maintaining normal 25(OH)D levels by consensus is 1000 to 2000 IU vitamin D daily for at-risk teens and adults. Conclusion Vitamin D supplementation might play an important role in protecting from acute respiratory infections like the SARS CoV2, and in high-risk individuals with COVID 19 from progressing to critical clinical condition and reducing mortality.