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There are no population-based studies that have examined the association between vitamin D and type 1 diabetes mellitus (T1DM) and the role of lifestyle habits and dietary factors in young children in the Arabian Gulf and Middle East region. Little data on the intake of these nutrients in Mediterranean countries exist, and predictors of their subop...
Citations
... Despite the abundant sunlight in countries such as Qatar, Vitamin D deficiency is highly prevalent across the Middle East. [25][26][27][28][29] A 2012 systematic review found that deficiency rates were over 90%, but the reviews used < 75 (nmol/L) levels rather than < 50 (nmol/L) levels, which is the current approved level. 30 More recent reports specific to Qatar, which use the approved level by the Endocrine Society, suggest a deficiency rate of 71% in the population. ...
Background
Vitamin D deficiency is highly prevalent worldwide among pregnant women. Although vitamin D supplementation is effective in improving vitamin D status, the safety and optimal dosing of vitamin D supplementation during pregnancy remain less well understood.
Objective
This study aimed to investigate the prevalence of vitamin D deficiency among pregnant women and evaluate the effectiveness of vitamin D supplementation in improving vitamin D status during pregnancy.
Design
This prospective cohort study assessed the impact of a 16-week daily vitamin D supplementation 1000 IU regimen on vitamin D status among pregnant women.
Methods
A total of 365 pregnant women were recruited, and their baseline total circulating 25-hydroxy vitamin D concentrations were measured. Of these, 249 participants completed the study, which involved oral daily supplementation with 1000 IU of vitamin D and a repeat of total circulating 25-hydroxy vitamin D concentrations after 16 weeks.
Results
The study found that 57.7% of the participants had vitamin D deficiency, consistent with the rates reported in other studies. However, vitamin D supplementation at a dose of 1000 IU had a small effect size and was not clinically significant. However, 67% of participants with vitamin D deficiency remained deficient; among participants initially with vitamin D insufficiency, 30% became deficient. Moreover, 26.5% of individuals with sufficient vitamin D status at 12 weeks showed insufficient levels by 28 weeks.
Conclusion
Vitamin D deficiency is widespread among pregnant women, and vitamin D supplementation at a daily dose of 1000 IU may not adequately address this problem. Although the study has limitations, its results align with previous research and may apply to other populations with a high prevalence of vitamin D deficiency during pregnancy. Further research is necessary to determine the most effective approach for addressing prenatal vitamin D deficiency.
... among our research, we observed a higher prevalence of vit D deficiency among children who seldom consumed fish, fortified milky and had little exposure of direct sun exposure. In a similar vein, Bener et al. (2009) shown that both diabetes and non-diabetic toddlers had a notably restricted level of solar exposure [18] . Following a period of six months of intervention, it was discovered that the group taking both Ca supplements and vit D had considerably higher levels of blood pH, mg, vit D and calcium. ...
Objectives: The objective of this study is to assess the prevalence of vitamin D insufficiency in children with type 1 diabetes mellitus (T1DM) who are receiving care at the Endocrinology outpatient clinic at the Pediatrics Department of Tanta University Hospital. Additionally, the study aims to investigate the impact of vit D supplementation on the progression of T1DM. Methods: The study was conducted as a prospective randomized and cross-sectional controlled trial at the "Endocrinology Outpatient Clinic" inside the Pediatrics Department of Tanta University Hospital. The research sample was composed of one hundred fifty-two children diagnosed with T1DM. The research methodology used many tools, which encompassed: Medical records are used to collect sociodemographic data. (2) Data associated with the relationship between food consumption and solar radiation exposure. (3). this research focuses on the variables associated with its insufficiency and the levels of vit D investigation. The participants in the research were children who had low vit D levels. These children were then categorized into two separate groups. The intervention group consisted of children who received standard care along with vit D supplementation. The control group consisted of youngsters who received just regular treatment. A further assessment was conducted after six months periods, whereby the previously mentioned examinations were performed for the children in both groups. Results: Low vit. D levels were found in 78.3% of the studied children. Approximately 29.0% of them had insufficient vit. D level. Mild and moderate vit. D deficiency (VDD) were found among 25.7% and 23.7% of the studied children respectively. After receiving both vit. D and calcium (Ca) supplementations, Levels of vit. D, blood pH, Ca and Magnesium (Mg) increased, while levels of HbA1C, parathyroid hormone (PTH) and alkaline phosphatase (ALP) decreased. Conclusion: Majority of children with T1DM have low vit. D levels. Bad dietary habits and lifestyles were more observed among children with low vit. D levels. Vit. D and Ca supplementations for at least six months added to the routine insulin dose proved their effectiveness in glycemic control with increased levels of ionized Ca, blood pH and Mg level and decreased levels of PTH and ALP. Introduction Vitamin D is a fat-soluble vitamin obtained from exposure to sun, eating certain foods and supplements. Vit. D is biologically inert and must undergo two hydroxylation in the body for activation. The first hydroxylation, which occurs in the liver, converts vit. D to 25-hydroxyvit D [25(OH) D], also known as "calcidiol." The second hydroxylation occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvit D [1,25(OH)2D], also known as "calcitriol" [1]. Vit. D has many functions in the human body. It promotes Ca absorption in the gut and maintains adequate serum Ca and phosphate concentrations to enable normal bone mineralization and prevent hypocalcemic tetany. It is also need for bone growth and bone remodeling by osteoblasts and osteoclasts. Other roles of vit. D includes reduction of inflammation, this also important for glucose metabolism as it promote synthesis and secretion of insulin and increase insulin sensitivity [2] .
... Among the recognized predisposing factors are smoking, overweight or obesity, and hypovitaminosis D. The latter may stem from inadequate dietary intake or limited exposure to sunlight due to a sedentary lifestyle. 12,13 Early on, 1 study even posited that smoking might confer protective effects against SARS-CoV-2. 14 Nevertheless, multiple subsequent studies conducted by various researchers and the World Health Organization's official positions have unequivocally linked smoking to an increased likelihood of both contracting SARS-CoV-2 and experiencing severe forms of COVID-19. ...
... 8 Low serum vitamin D levels may also be associated with the habitual consumption of certain unhealthy diets. 12,13 Additionally, a sedentary lifestyle can lead to diminished serum vitamin D levels, as individuals engaged in such lifestyles often lack adequate sunlight exposure due to limited outdoor physical activity. 20 As a result, the implementation of lifestyle intervention measures, such as vitamin D-rich diets and supplements coupled with sufficient exposure to sunlight, may hold promise in the prevention of COVID-19 among at-risk populations, particularly older men. ...
Since its outbreak in December 2019 in China, COVID-19 has spread like wild fire to affect many communities of the world. The high infectivity and case fatality rates of the disease among the general population and the severely ill patients respectively drew the attention of the global community. Our review showed that socio-demographic and lifestyle-related risk factors and underlying comorbid diseases were directly and indirectly associated with increased susceptibility and severity of COVID-19. These factors included older age (⩾60 years), male gender, and ethnic minority groups (especially blacks), smoking, low serum level of vitamin D, unhealthy diet, physical inactivity (with poor exposure to sunlight), overweight/obesity, high blood pressure/hypertension, high blood cholesterol, cardiovascular diseases (like stroke and coronary heart disease), diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, and some cancers (like leukemia, lymphoma, or myeloma). The literature further revealed that the clinical progression of the majority of these associated risk factors can be modified through effective and comprehensive risk reduction through healthy living and lifestyle modification. COVID-19 preventive and treatment guidelines that give adequate attention to risk reduction and healthy lifestyle among people—either in the pre-, peri-, or post-COVID-19 stage, should be developed by public health policymakers and clinicians. This will play a significant role in the global effort to combat the pandemic, and reduce its negative impact on the life expectancy and socio-economic development of the world particularly in low- and middle-income countries (LMICs).
... 2,3 The prevalence of nutritional rickets is still alarming in developed nations. 2,[4][5][6][7] The prevalence of rickets has increased in Europe and North America, where the yearly frequency is around 3 in every 100,000 children of every age. [8][9][10][11] The physical comorbidities associated with rickets tend to stay throughout late childhood and adolescence of the child as well as pose acute life-threatening consequences that make rickets a significant health burden. ...
Background
Nutritional rickets remains a significant concern in certain countries, with increasing prevalence attributed to factors such as limited sunlight exposure and undernourishment. This study aimed to identify the factors associated with rickets due to nutritional deficiency in children from Jazan Province, southwestern Saudi Arabia.
Methods
A retrospective cross-sectional study was conducted using descriptive data from medical records at a tertiary hospital in Jazan Province. Records of patients diagnosed with rickets between January 2010 and December 2020 were analyzed. Symptomatic rickets cases from pediatric clinics were included, and diagnoses were based on biochemical and clinical tests. Risk factors were assessed using patient medical records. Data were analyzed using percentages, mean, and standard deviation.
Results
The study included 84 patients with rickets (53 females and 31 males), primarily between 11–18 years old. The mean body mass index (BMI) of the participants was 21.21. The most common risk factor was nutritional deficiencies, including vitamin D deficiency or calcium deficiency, with 75 patients reporting a family history of vitamin D deficiency. The children had limited sunlight exposure and low levels of calcium and vitamin D. Malnutrition was identified as the highest risk factor for rickets in the study population.
Conclusion
Nutritional rickets appears to be prevalent in the Jazan Province, emphasizing the need for government organizations to address this preventable disease. Adequate sun exposure and recommended dietary vitamin D intake are crucial to prevent rickets, as this study detected inadequate levels of calcium and vitamin D in children. National studies are required to further identify risk factors and develop appropriate strategies.
... among our research, we observed a higher prevalence of vit D deficiency among children who seldom consumed fish, fortified milky and had little exposure of direct sun exposure. In a similar vein, Bener et al. (2009) shown that both diabetes and non-diabetic toddlers had a notably restricted level of solar exposure [18] . Following a period of six months of intervention, it was discovered that the group taking both Ca supplements and vit D had considerably higher levels of blood pH, mg, vit D and ~ 10 ~ calcium. ...
... among our research, we observed a higher prevalence of vit D deficiency among children who seldom consumed fish, fortified milky and had little exposure of direct sun exposure. In a similar vein, Bener et al. (2009) shown that both diabetes and non-diabetic toddlers had a notably restricted level of solar exposure [18] . Following a period of six months of intervention, it was discovered that the group taking both Ca supplements and vit D had considerably higher levels of blood pH, mg, vit D and ~ 10 ~ calcium. ...
... 36 Eight publications (from 7 unique studies) reported the level of vitamin D in their study populations and satisfied our selection criteria; these were included in the review. [37][38][39][40][41][42][43][44] From the studies included, 2 reports were considered as one study 42,43 since the same population and findings were presented again (but with additional information) in the more recent report. From these 2 studies, 42,43 we examined vitamin D in healthy controls only and excluded information from those children with asthma 37 or diabetes. ...
... 36 Eight publications (from 7 unique studies) reported the level of vitamin D in their study populations and satisfied our selection criteria; these were included in the review. [37][38][39][40][41][42][43][44] From the studies included, 2 reports were considered as one study 42,43 since the same population and findings were presented again (but with additional information) in the more recent report. From these 2 studies, 42,43 we examined vitamin D in healthy controls only and excluded information from those children with asthma 37 or diabetes. ...
... [37][38][39][40][41][42][43][44] From the studies included, 2 reports were considered as one study 42,43 since the same population and findings were presented again (but with additional information) in the more recent report. From these 2 studies, 42,43 we examined vitamin D in healthy controls only and excluded information from those children with asthma 37 or diabetes. 42,43 Inter-reviewer agreement ...
Qatar has a high burden of chronic diseases including obesity, cardiovascular disease and type 2 diabetes mellitus. Low serum vitamin D levels have been implicated in the development and progression of a range of these chronic conditions. The prevalence of vitamin D insufficiency or deficiency in the general population of Qatar has still not been investigated. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of vitamin D insufficiency or deficiency in the Qatari population. A search strategy was developed for online databases (PubMed, Ovid MEDLINE, Embase and Embase Classic) between 1980 to the last week of August 2012, and bibliographies of the included studies were further searched for additional reports. Search terms used were QATAR and VITAMIN D. Studies reporting the serum levels of vitamin D in several Qatari sub-populations were identified. Weighted-average vitamin D serum levels and prevalence of low vitamin D status (<75 nmol/L) were calculated. Subgroup analysis was carried out by age. The quality of each study was evaluated according to four criteria: national representativeness, representation of males and females, the sample size, and the sampling protocol. A total of 16 relevant publications were identified, and 8 of these (reporting from 7 unique studies) met our inclusion and exclusion criteria with a total number of 1,699 Qatari subjects. The pooled sample size weighted-average vitamin D concentration (±SD) was 45.3±14.3 nmol/L (95% CI: 44.6-46.0; range 29.2-66.9 nmol/L). The weighted-average prevalence of low vitamin D status was 90.4% (95% CI: 90.1-91.0; range 83%-91%). Age was inversely correlated with vitamin D levels and directly with its insufficiency/deficiency prevalence. There have only been a few studies on the prevalence of low vitamin D in Qatar a very high prevalence of vitamin D insufficiency/deficiency in Qatar that increases with age has been suggested. The present report underlines the need to develop a nationally representative study to further evaluate vitamin D status in Qatar. Given the growing evidence of the role of vitamin D in chronic disease, this study could help develop public health strategies for disease prevention in Qatar.
... However, evidence abounds that suggest that certain lifestyle-related factors or practices tend to predispose some group of people to COVID-19 compare to others. Some of the identified predisposing factors include smoking, overweight/obesity, and hypovitaminosis D. Hypovitaminosis D may result from either poor nutrition/unhealthy diet or reduced exposure to sunlight due to a sedentary lifestyle [14,15]. ...
... It is also worth noting that since studies have shown a positive correlation between decreasing serum vitamin D levels and increasing age, male gender, and obesity [9,23], this may be some of the reason why COVID-19 is more fatal in these group of people. Low serum Vitamin D may also be related to the regular consumption of certain unhealthy diets that are low in vegetables and fruits [14,15]. A sedentary lifestyle may also indirectly lead to reduce serum level of Vitamin D. Here, the affected individuals could not get adequate exposure to sunlight due to inadequate outdoor physical activity [24]. ...
Since its outbreak in late 2019, Coronavirus Disease 2019 (COVID-19) has been ravaging the health system of most countries of the world. Although many preventive and treatment strategies have been proposed and implemented to combat the disease, these efforts seem to be insufficient, and in some cases ineffective. This is evident by the daily rising global incidence and case fatality of the COVID-19 pandemic. A situation if not mitigated early will likely crumble the global economy and tilt the world to an unprecedented global recession. This challenge demands that researchers and clinicians ask more in-depth questions about the novel coronavirus disease. Aside from age that has been confirmed to be linearly associated, what are the other possible socio-demographic and lifestyle-related risk factors that may be associated with COVID-19? What are the possible factors or comorbid conditions that may worsen clinical progression and determine the clinical outcome in confirmed COVID-19 cases? Does the pre-, peri-, or post-morbid lifestyle choices of people have an impact on COVID-19 preventive and treatment efforts? And how can we use the knowledge of the associated risk factors, comorbid conditions, and lifestyle choices of people to improve preventive efforts and clinical management of COVID-19? Answer to these questions may likely serve as an important guide for policymakers and clinicians in their design and implementation of COVID-19 targeted preventive and treatment policies and programs, especially in Low- and Middle-Income Countries (LMICs). The purpose of this article is to critically review available literature and provide evidence-based recommendations.
... 2 Prevalence of nutritional rickets in developed countries also appears to be rising. [3][4][5][6][7][8] Prevention of nutritional rickets would avoid significant morbidity, so proven effective, preventive and treatment strategies are needed. 8 Rickets has come into limelight as a public health problem in Bangladesh during the past two decades and was first brought to broad attention in 1991 by Social Assistance and Rehabilitation of the Physically Vulnerable (SARPV) NGO visiting the Chakaria region of South-Eastern Bangladesh after a devastating cyclone. ...
... [3][4][5][6][7][8] Prevention of nutritional rickets would avoid significant morbidity, so proven effective, preventive and treatment strategies are needed. 8 Rickets has come into limelight as a public health problem in Bangladesh during the past two decades and was first brought to broad attention in 1991 by Social Assistance and Rehabilitation of the Physically Vulnerable (SARPV) NGO visiting the Chakaria region of South-Eastern Bangladesh after a devastating cyclone. National rickets survey in Bangladesh, 2008 found that the prevalence of rickets in Bangladesh is 0.99%. ...
Background: Nutritional rickets has emerged as a public health problem in Bangladesh during the past two decades, with up to 8% of children being clinically affected in some areas. Insufficiency of vitamin D and dietary calcium is thought to be the underlying cause. Vitamin D administered with or without calcium is commonly regarded as the mainstay of treatment. Calcium alone or in combination with vitamin D has also been used in the treatment of nutritional rickets. So this study was done to assess the effects of vitamin D, calcium or combination of vitamin D and calcium for the treatment of nutritional rickets in Bangladeshi children. Methods: This open labeled randomized comparative study was done in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from July 1, 2010 to June 30, 2012 A total 48 rickets patient was enrolled in this study. After selection of cases patients were divided in to three groups by lottery method. Group A received single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock), Group B received calcium (750 mg per day) for 6 weeks and Group C received both calcium (750 mg per day) for 6 weeks and single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock). Response was evaluated by serum alkaline phosphatase level and using 10-point radiographic score developed by Thacher and colleagues at baseline, 6 weeks, and 12 weeks. Results: Mean age of the study participants was 35.83 months. Male to female ratio was 2:1. The radiographic score was significantly improved in first and second follow up (p<0.001) in all groups. But there was significant difference of improvement in Group C than Group A and Group B. In Group C, the percent reduction from base to first follow up was 80.05±7.04 and 90.65±3 in second follow up which showed quick improvement in combination therapy. Serum alkaline phosphatase also significantly reduced in all three groups. Conclusion: Combination use of vitamin D and calcium in the treatment of nutritional rickets is more effective than prescribing either vitamin D or calcium alone. Birdem Med J 2021; 11(1): 39-46
... After the full-text screening, 62 articles were excluded as they did not meet all of the eligible criteria listed in Fig. 1. Finally, 12 case-control studies [21][22][23][24][25][26][27][28][29][30][31][32], two nested case-control studies [33,34], one case-cohort study [28], and one cross-sectional case-control study [35] were pooled in the meta-analysis. ...
It remains debatable whether vitamin D plays any role as a risk factor for type 1 diabetes mellitus (T1DM). We have summarized the effect of circulating 25-hydroxy vitamin D [25(OH)D] concentration on the risk of developing T1DM via a dose–response meta-analysis. We undertook a database search on PubMed, Embase, and Cochrane Library from inception to January 2020. A meta-analysis based on random-effects model was applied. Subgroup analysis and meta-regression were performed to inspect the source of heterogeneity. Dose–response data were examined using the generalized least squares trend estimation method. This study was registered with the PROSPERO (ID: CRD42020166174). In total, 16 studies including 10,605 participants (3913 case patients) were included. The pooled odds ratios (OR) and 95% confidence intervals (95% CI) for the highest versus the lowest 25(OH)D concentration was 0.39 (0.27, 0.57), with a high heterogeneity (I2 = 76.7%, P < 0.001). Meta-regression analysis identified latitude (P = 0.02), adjustment for gender (P = 0.001), and 25(OH)D stratification (P < 0.001) as sources of heterogeneity. Furthermore, the nonlinear dose–response analysis determined the OR (95% CI) of T1DM to be 0.91 (0.90, 0.93) per 10 nmol/L increase in the 25(OH)D concentration. A ‘U’-shaped association was found between serum 25(OH)D concentration and risk of T1DM. The present study highlights the significant inverse association between the circulating 25(OH)D concentration and the risk of T1DM.
... T1DM prevalence/incidence is increasing worldwide (77) the rise seems much steeper in gulf countries. A study conducted to determine the association between Vitamin D status and T1DM along with other factors in the young population of the State of Qatar found out that the incidences of severe Vitamin D deficiency was considerably higher in T1DM (28.8%) compared with healthy children (17.1%) (78), similarly in the Saudi cohort 84% of the T1DM children, and 59% of the healthy children were Vitamin D deficient (79). Low serum Vitamin D status was found to be associated with high prevalence and early onset of type-1 diabetes mellitus in Kuwaiti children as well (80). ...
Vitamin D is a fat soluble secosteroid that is primarily synthesized in the skin upon exposure to Ultraviolet B (UVB) sun rays. Vitamin D is essential for the growth and development of bones and helps in reducing inflammation by strengthening muscles and the immune system. Despite the endless supply of sunlight in the Gulf Cooperation Council (GCC) countries which includes United Arab Emirates, Qatar, Kuwait, Bahrain, Saudi Arabia, and Oman, Vitamin D deficiency in the (GCC) general population at various age groups remains alarmingly high. In parallel runs the increasing prevalence of acute and chronic illnesses including, autoimmune diseases, cancer, type 1 diabetes mellitus, cardiovascular disease and Inflammatory bowel disease in the adult as well as the pediatric population of these countries. The exact association between Vitamin D deficiency and chronic disease conditions remains unclear; however, studies have focused on the mechanism of Vitamin D regulation by assessing the role of the Vitamin D associated genes/proteins such as VDR (Vitamin D receptor), VDBP (Vitamin D Binding protein), CYP27B1 as these are integral parts of the Vitamin D signaling pathway. VDR is known to regulate the expression of more than 200 genes across a wide array of tissues in the human body and may play a role in controlling the Vitamin D levels. Moreover, reduced Vitamin D level and downregulation of VDR have been linked to gut dysbiosis, highlighting an intriguing role for the gut microbiome in the Vitamin D metabolism. However, this role is not fully described yet. In this review, we aim to expand our understanding of the causes of Vitamin D deficiency in the GCC countries and explore the potential relationship between the genetic predisposition, Vitamin D levels, immune system and the gut microbiome composition. Trying to unravel this complex interaction may aid in understanding the mechanism by which Vitamin D contributes to various disease conditions and will pave the way toward new therapeutics treatments for Vitamin D deficiency and its associated outcomes.
