Socio-demographic and knowledge-related determinants of vitamin D supplementation in the context of the COVID-19 pandemic: assessment of an educational intervention

Abstract

Vitamin D is a pro-hormone, essential for musculo-skeletal health, normal immune system, and numerous other body functions. Vitamin D deficiency is considered a risk factor in many conditions, and there is growing evidence of its potential role in the severity of COVID-19 outcomes. However, an alarmingly high prevalence of vitamin D deficiency is reported in many regions, and vitamin D supplementation is commonly recommended, particularly during wintertime. To reduce the risk for vitamin D deficiency in the Slovenian population during the COVID-19 pandemic, we conducted mass media intervention with an educational campaign. The objective of this study was to investigate vitamin D supplementation practices in Slovenia before and during the COVID-19 pandemic, and to determine the effects of the educational intervention on supplementation practices. Two data collections were conducted using an online panel with quota sampling for age, sex, and geographical location. A pre-intervention (N=602, April 2020) and post-intervention (N=606) sampling were done during the first and second COVID-19 lockdown, respectively. We also focused on the identification of different factors connected to vitamin D supplementation, with a particular emphasis on vitamin D-related knowledge. Study results showed significant changes in vitamin D supplementation in the population. Penetration of the supplementation increased from 33% in April to 56% in December 2020. The median daily vitamin D intake in supplement users was 25 µg, with about 95% of supplement users taking safe intake levels below 100 µg/daily. Vitamin D-related knowledge (particularly about dietary sources of vitamin D, the health-related impact of vitamin D, and the prevalence of deficiency) was identified as a key independent predictor of vitamin D supplementation. Based on the study findings, we prepared recommendations, which will enable the development of effective awareness campaigns for increasing supplementation of vitamin D.

COVID-19 and vitamin D– a systematic review

“…In Slovenia, because of the COVID-19 pandemic, medical doctors and the general population were urgently advised by leading experts to supplement vitamin D in fragile, vitamin D deficient high-risk individuals and COVID-19 patients ( 10 , 11 ). At the beginning of the COVID-19 pandemic there were no data on the effects of vitamin D in SARS-CoV-2 infection; then again, there were reliable data on the beneficial effects of cholecalciferol in attenuating viral respiratory infections in people with low levels of vitamin D ( 12 ).…”

“…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 ).…”