Prevalence of Vitamin D Insufficiency And Clinical Associations among Veiled East African Women in Washington State

Reed, Susan D.; Laya, Mary B.; Melville, Jennifer L.; Ismail, Sirad Y.; Mitchell, Caroline; Ackerman, D

doi:10.1089/jwh.2006.0089

Cited by 21 publications

(27 citation statements)

References 27 publications

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“…Low dietary intake of vitamin D has also been noted in other similar cohorts of women who reside in western countries where vitamin D fortified foods are common [39,40,41]. Far fewer of the hijab-wearing women in our study and in other studies [2,36] consumed vitamin supplements than do secularly dressed women even though such supplements are readily available and quickly raise s-25(OH)D levels [42].…”

Section: Discussionsupporting

confidence: 76%

Vitamin D and Musculoskeletal Status in Nova Scotian Women Who Wear Concealing Clothing

Ojah

Welch

2012

Nutrients

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Bone and muscle weakness due to vitamin D deficiency is common among Muslim women who reside in sunny, equatorial countries. The purpose of this study was to determine if living in a northern maritime location additionally disadvantages women who wear concealing clothes. A cross-sectional matched pair design was used to compare women who habitually wore concealing clothing with women who dressed according to western norms. Each premenopausal hijab-wearing woman (n = 11) was matched by age, height, weight and skin tone with a western-dressed woman. Subjects were tested by hand grip dynamometry to assess muscular strength and by quantitative ultrasound at the calcaneus to assess bone status. Nutritional intake was obtained by 24 h recall. Serum 25-hydroxyvitamin D (s-25(OH)D) status was determined in seven matched pairs. The hijab group had lower s-25(OH)D than women who wore western clothes (40 ± 28 vs. 81 ± 32 nmol/L, p= 0.01). Grip strength in the right hand was lower in the hijab-wearing women (p = 0.05) but this appeared to be due to less participation in intense exercise. Bone status did not differ between groups (p= 0.9). Dietary intake of vitamin D was lower in the hijab-wearers (316 ± 353 vs. 601 ± 341 IU/day, p= 0.001). This pilot study suggests that women living in a northern maritime location appear to be at risk for vitamin D insufficiency and therefore should consider taking vitamin D supplements.

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Section: Discussionsupporting

confidence: 76%

Vitamin D and Musculoskeletal Status in Nova Scotian Women Who Wear Concealing Clothing

Ojah

Welch

2012

Nutrients

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“…In fact, to our knowledge, there is only one publication on 25(OH)D levels in African immigrants in the United States. It is an assessment of 25(OH)D levels in 71 veiled Somali women living in Seattle, Washington(7). Thus, there is no evidence-based data to guide evaluation of vitamin D status in African immigrants.…”

Section: Introductionmentioning

confidence: 99%

Biochemical and clinical deficiency is uncommon in African immigrants despite a high prevalence of low vitamin D: the Africans in America study

et al. 2015

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Purpose The Endocrine Society and Institute of Medicine (IOM) have concluded from studies in largely white populations that 25(OH)D is necessary for bone health. However, their definition of vitamin D insufficiency differs. The Endocrine Society recommends a 25(OH)D threshold of <30ng/mL. The IOM uses a lower threshold of 25(OH)D <20ng/mL. As African ancestry is associated with decreased 25(OH)D but increased bone mineral density (BMD), the applicability of these thresholds to Africans is unknown. Therefore, we examined in African immigrants the relationship of 25(OH)D to parathyroid hormone (PTH) and BMD. Methods One-hundred-eighty-six African immigrants (69% male, age 38±10 (mean±SD) range 20–64y) living in metropolitan Washington, DC were enrolled. BMD was determined from whole-body DXA scans. Decreased BMD required T-scores ≤ −1.0. The threshold for low 25(OH)D was the concentration of 25(OH)D at which PTH became suppressed. This is known as the inflection point. Biochemical deficiency required low 25(OH)D and PTH>65 pg/mL. Clinical deficiency required low 25(OH)D and T-scores ≤ −1.0. Results 25(OH)D<30ng/mL and <20ng/mL occurred in 83% and 46% of African immigrants, respectively. PTH inversely correlated with 25(OH)D (r = −0.31, P=0.002). The inflection point occurred at a 25(OH)D concentration of 20ng/mL. Biochemical and clinical deficiency occurred in only 8% and 3% of immigrants, respectively. Conclusion As PTH became suppressed at 25(OH)D of 20ng/mL, the 25(OH)D<20ng/mL threshold for insufficiency may apply to African immigrants. However, ~50% of African immigrants have 25(OH)D<20ng/mL, but only <10% had evidence of deficiency. The value of providing vitamin D supplementation to the large number of African immigrants with 25(OH)D<20 ng/mL and no detectable evidence of deficiency needs to be determined.

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“…This therefore, significantly reduces the amount of sun exposure among pregnant women and their infants and according to Holick Sunlight [33] Muslim women who cover their skin are often vitamin D deficient. Indeed, this assertion is supported by several other studies [34,35]. This practice of covering their whole bodies for religious purposes precludes this behavior being targeted for change hence the need for supplementation and fortification of target foods.…”

Section: Discussionmentioning

confidence: 77%

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2015

Journal of Nutrients

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Objectives (background): Requirement for Vitamin D is high at particular stages of the lifecycle especially during pregnancy and infancy. Severe vitamin D deficiency during pregnancy may increase the risk of rickets in childhood. While policies exist in Contribution/ OriginalityThis study contributes to the existing literature by investigating the supplementation practices of vitamin D during pregnancy and infancy among Muslim women in two countries with differing guidelines regarding Vitamin D supplementation as well as different latitudes, climatic conditions and cultures. This study is unique in this respect.

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Prevalence of Vitamin D Insufficiency And Clinical Associations among Veiled East African Women in Washington State

Abstract: Vitamin D insufficiency, as reflected by low 25(OH)D serum concentrations, was a universal finding in this group of women, suggesting the need for widespread education and intervention in this and other immigrant groups at northern latitudes.

Cited by 21 publications

References 27 publications

Vitamin D and Musculoskeletal Status in Nova Scotian Women Who Wear Concealing Clothing

Vitamin D and Musculoskeletal Status in Nova Scotian Women Who Wear Concealing Clothing

Biochemical and clinical deficiency is uncommon in African immigrants despite a high prevalence of low vitamin D: the Africans in America study

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