Many young south Asian women in UK lack vitamin D, study finds

BMJ 2007; 334 doi: (Published 22 February 2007) Cite this as: BMJ 2007;334:389
  1. Roger Dobson
  1. Abergavenny

    A quarter of young south Asian women living in Britain who were tested for vitamin D may have what are described as strikingly low concentrations, a new study concludes.

    Such women have a level of deficiency that puts them at higher risk of developing osteomalacia, says the study (Bone 2007;40:200-4).

    “Our data confirm a high prevalence of hypovitaminosis D among young UK South Asian women. A significant proportion—approximately one quarter—had marked deficiency,” the authors wrote. “Public health measures to increase levels of serum 25-hydroxyvitamin D [25-(OH)D] are urgently required. In addition to preventing osteomalacia and rickets such measures may also have beneficial effects on bone mass.”

    The authors, who did tests on 78 women aged 18 to 36, say there may be a number of reasons for the low concentrations of serum 25-(OH)D they found. They say that in the United Kingdom ultraviolet light of the appropriate wavelength to synthesise serum 25-(OH)D is available only between the months of April and October. They also say that lack of sunlight exposure may be compounded when women, for cultural reasons, cover their skin while outside.

    “The problem for south Asian women is that they cover themselves up and are not exposed to sunlight. As a result they have to rely on their diet. But if you have a diet that is low in dairy and meat, which many Asian women have, you will not get what you need,” said Alan Silman, medical director of the Arthritis Research Campaign, who was one of the Manchester University team that did the study.

    Professor Silman said, “What was different about this study was that we were looking at a normal population of young women, not at patients. These were people who did not believe they had a problem, and yet they had these strikingly low levels of vitamin D.

    “The combination of covering yourself up and not exposing yourself to sunlight, and not getting vitamin D in your diet, is a kind of ‘double whammy.'

    “What is needed is dialogue between health educators and the Asian community to see whether there is a level of exposure that would be culturally acceptable but which would provide sufficient exposure. We do need some urgent action, and I think it is an issue of health education. We need a lot of education in schools to talk about the problem that if you cover up the whole time you have to make sure you have the right diet.”

    The study looked at the relation between concentrations of serum 25-(OH)D and serum parathyroid and bone mass in a sample of young women of Pakistani origin living in the greater Manchester area. Detailed examinations included blood tests. Most of the women (73, or 94%) had evidence of serum 25-(OH)D concentrations ≤15 ng/ml, while 20 (26%) had evidence of marked deficiency (≤5 ng/ml).

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