[R.B.]

The level of vitamin D deficiency in the young generally and particularly in high risk groups is potentially creating significant current and potential future health risk issues.

The combination of a message in schools not to go into the sun, and wear sunscreen, with the added use of other lotions that my block vitamin D production, without advice on dietary sources of vitamin D and the likely need for supplementation, puts many young people at risk of vitamin D deficiency.

That risk and need for advice as to supplementation must logically be enhanced in those who wear conservative religious dress codes.





Prevalence of Vitamin D deficiency in adolescent Muslim girls attending a school in the UK which adheres to a conservative dress code

S. Lukman1, R. Syahanee2, J. L. Berry3, M. Z. Mughal1
'Royal Manchester Children's Hospital, Central Manchester University Hospitals Foundation NHS Trust, UK, 2Alder Hey Children's NHS Foundation Trust, Liverpool, UK,3 Vitamin D Research Group, Endocrine Sciences, University of Manchester, UK
Aim: To determine the prevalence of vitamin D deficiency among adolescent Muslim girls attending a school in the UK which adheres to a conservative dress code.
Methods: Fifty six (31%) out of 180 girls attending a Muslim High School for Girls [median age 13.2years, (IQR 12.5-13.8 years)] took part in this cross-sectional study. Seventy nine percent (n=45) were of South Asian origin, 3.5% were Black African origin (n=2), 1.8% was Middle Eastern origin (n=1) and 15.8% were other ethnic origin (n=9). The participant's serum concentration of calcium (Ca), phosphate (P), alkaline phosphatase (ALP), parathyroid hormone (PTH) and serum 25-hydroxyvitamin D (25OHD) were measured. Dietary intake of calcium and vitamin D were also estimated.
Results: Fifty-one out of 56(91%) (95% CI 86 to 95) girls were found to be vitamin D deficient (25OHD < 25nmol/L) and 4 out of 56 (7%) (95% CI 5 to 17) were vitamin D insufficient (25nmol/L < 25OHD < 50nmol/L). The median serum concentration of 25OHD was 12.8nmol/L, (IQR 10 to 17 nmol/L). Serum concentration of Ca, P, ALP and PTH were all within the normal limits. The median vitamin D intake was 69 i.u./day, (IQR 29 to 122 i.u./day), which is 17% of the recommended daily intake (400 i.u.). The median dietary calcium intake was 662mg (IQR 456 -860mg), which is four-fifth of the recommended daily intake (800 mg). The median serum 25OHD of subjects taken multivitamin (MV) supplements [median= 17.3nmol/L (IQR 13-26.3)] was (p<0.01) higher than that of subjects not taking MV supplements [11.3nmol/L (IQR 8.8-14)].
Conclusions: All subjects (98%) bar one had vitamin D deficiency (91%) and vitamin D insufficiency (7%). Those taking MV supplements had higher serum 25OHD concentrations, although optimum serum concentrations of >50 nmol/l were not achieved. Further studies are needed to determine the dose of vitamin D supplementation needed to optimise the vitamin D status of these groups of adolescent girls.