Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women

Abstract

Summary

This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern.

Introduction

There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D.

Methods

This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51° N), aged 20–55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry.

Results

Serum 25(OH)D <25 nmol/L was highly prevalent in South Asians in the winter (81 %) and autumn (79.2 %). Deficient status (below 50 nmol/L) was common in Caucasian women. Multi-level modelling suggested that, in comparison to sun exposure (1.59, 95 %CI = 0.83–2.35), dietary intake of vitamin D had no impact on 25(OH)D levels (−0.08, 95 %CI = −1.39 to 1.23).

Conclusions

Year-round vitamin D deficiency was extremely common in South Asian women. These findings pose great health threats regarding the adverse effects of vitamin D deficiency in pregnancy and warrant urgent vitamin D public health policy and action.

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Acknowledgements

This study was funded by the Foods Standards Agency (N05064). The views expressed are those of the authors and do not necessarily reflect government policy or advice. The authors thank the following individuals for their help with subject recruitment, data collection and analysis: Mrs. S. Starkey, Dr. J. Catterick, Dr. L. Brough, Ms. P. Lee, Ms. A. Bateman and Dr. W.T.K. Lee. The authors would like to acknowledge fully their great appreciation of the following individuals who helped with subject recruitment: Mrs. Freda Smithers, Mrs. Shahnaz Bano, Mrs. Rafeea Mahoon, Mrs. Razia Killedar, Mrs. Roxanna Hanjra, Mrs. Rohini Mahendran and Ms. Judy Dudman.

Dedication

This paper is dedicated to Mr. John Pheasant, Practice Manager at Thornton Heath Medical Centre, London, who helped with the study recruitment and who sadly died in 2008.

Conflicts of interest

ALD, KHH, HMM, ARK, JLB, KH have no disclosures. SLN discloses that she is a research director of D3-TEX Ltd.

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Correspondence to A. L. Darling.

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Darling, A.L., Hart, K.H., Macdonald, H.M. et al. Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women. Osteoporos Int 24, 477–488 (2013). https://doi.org/10.1007/s00198-012-1973-2

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Keywords

  • Longitudinal cohort study
  • Premenopausal women
  • Seasonal 25-hydroxyvitamin D
  • South Asian ethnicity
  • UVB exposure
  • Vitamin D deficiency