Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review

Cashman, Kevin D.; Sheehy, Tony; O’Neill, Colette

doi:10.1007/s00394-018-1607-3

Cited by 90 publications

(83 citation statements)

References 110 publications

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“…Although several recent review papers have highlighted the global extent of vitamin D deficiency, there are significant data gaps, especially for LMICs . Representative population‐level 25(OH)D data are not available for most countries, and the surveys that do exist often present an incomplete picture of vitamin D status and its determinants (i.e., lacking complementary data related to dietary intake, UVB exposure).…”

Section: Global Prevalence Of Vitamin D Deficiencymentioning

confidence: 99%

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

Roth

Abrams

Aloia

et al. 2018

Annals of the New York Academy of Sciences

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415

340

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Vitamin D is an essential nutrient for bone health and may influence the risks of respiratory illness, adverse pregnancy outcomes, and chronic diseases of adulthood. Because many countries have a relatively low supply of foods rich in vitamin D and inadequate exposure to natural ultraviolet B (UVB) radiation from sunlight, an important proportion of the global population is at risk of vitamin D deficiency. There is general agreement that the minimum serum/plasma 25-hydroxyvitamin D concentration (25(OH)D) that protects against vitamin D deficiency-related bone disease is approximately 30 nmol/L; therefore, this threshold is suitable to define vitamin D deficiency in population surveys. However, efforts to assess the vitamin D status of populations in low- and middle-income countries have been hampered by limited availability of population-representative 25(OH)D data, particularly among population subgroups most vulnerable to the skeletal and potential extraskeletal consequences of low vitamin D status, namely exclusively breastfed infants, children, adolescents, pregnant and lactating women, and the elderly. In the absence of 25(OH)D data, identification of communities that would benefit from public health interventions to improve vitamin D status may require proxy indicators of the population risk of vitamin D deficiency, such as the prevalence of rickets or metrics of usual UVB exposure. If a high prevalence of vitamin D deficiency is identified (>20% prevalence of 25(OH)D < 30 nmol/L) or the risk for vitamin D deficiency is determined to be high based on proxy indicators (e.g., prevalence of rickets >1%), food fortification and/or targeted vitamin D supplementation policies can be implemented to reduce the burden of vitamin D deficiency-related conditions in vulnerable populations.

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Section: Global Prevalence Of Vitamin D Deficiencymentioning

confidence: 99%

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

Roth

Abrams

Aloia

et al. 2018

Annals of the New York Academy of Sciences

Self Cite

415

340

View full text Add to dashboard Cite

show abstract

“…We wish to emphasize that inadequate vitamin D intakes and vitamin D deficiency in pregnant and lactating women are very common worldwide, thus pointing to the need to improve vitamin D status [ 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 ]. A systematic review has shown that 25(OH)D concentrations below 50 and 25 nmol/L during pregnancy were reported in 64% and 9% of Americans, and 57% and 23% of Europeans [ 127 ].…”

Section: Clinical Considerationsmentioning

confidence: 99%

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

Pilz

Zittermann

Obeid

et al. 2018

IJERPH

130

110

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Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation.

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“…15 Prevalence of low serum 25(OH)D levels and inadequate exposure and intake of vitamin D has been recorded in the general population by many studies exhibiting clear regional difference in the extent of concern. 16,17 Our report involved analysis of vitamin D status for comparing the prevalence of VDD as well as VDI between two tropical countries, India and Bahrain. Though there is major difference in the socio-economic, cultural as well as diet and lifestyle factors between the two regions, abundance of sunlight which is the most important for vitamin D was the common ground.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D study: a retrospective comparison between two tropical countries: India and Bahrain

Kushawaha¹,

Sinkar²,

Iyer³

et al. 2019

Int J Community Med Public Health

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Background: Hypovitaminosis D is a very common prevalence in India as well as Middle East. Studies indicate the frequency to be anywhere between 44-96% among adults in Middle east, while in India it is estimated to range in between 50 – 94%. Our report is an attempt to study vitamin D status from two tropical countries; India and Bahrain and present status of vitamin D deficiency as well as insufficiency in a comparison summary.Methods: This retrospective study in our reference lab included data from a total of 2591 samples from Bahrain and 2596 samples from India. Serum vitamin D estimation was done by chemiluminescence immunoassay or CLIA and reported as per the classification given by the US Endocrine Society. Our reference laboratory provides diagnostic services to Bahrain and thus data from both the countries were available for analysis.Results: Our analysis detected vitamin D deficiency to be 66.2% among samples from India in comparison to 41.4% from Bahrain, and this difference was statistically significant at p<0.0001. Further, the average vitamin D levels in the cohort were detected to be higher in Bahrain samples at 24.0±11.6 ng/ml in comparison to samples from India at 18.2±14.4 ng/ml and statistically significant at p<0.0001.Conclusions: Many studies have documented the prevalence of hypovitaminosis D in a region-specific manner. Our report presents the picture of vitamin D status between two tropical countries to highlight the difference in vitamin D deficiency prevalence in two arid and semi-arid regions of the world.

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Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review

Abstract: Vitamin D deficiency is a public health issue in some, but certainly not all, LMICs. There is a clear need for targeting public health strategies for prevention of vitamin D deficiency in those LMICs with excess burden.

Cited by 90 publications

References 110 publications

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

Vitamin D study: a retrospective comparison between two tropical countries: India and Bahrain

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