Programme no. 345-OP
The majority of African and Middle Eastern immigrants in Northern Sweden have vitamin D insufficiency.
Christer Andersson1, Marie Lindkvist2, Lena Granlund*3, Anna Ramnemark4, Eva Fhärm5, Margareta Norberg6
1Department of Public Health and Clinical Medicine, Family Medicine ,Umeå University,Umeå,Sweden, 2Department of Statistics, Umeå School of Business and Economics ,Umeå University,Umeå,Sweden, 3Department of Public Health and Clinical Medicine, Family Medicine ,Umeå University,Umeå,Sweden, 4Community Medicine and Rehabilitation, Geriatric Medicine,Umeå University,Umeå,Sweden, 5Department of Public Health and Clinical Medicine, Family Medicine ,Umeå University,Umeå,Sweden, 6Department of Public Health and Clinical Medicine, Epidemiology and Global Health ,Umeå University,Umeå,Sweden
* = Presenting author
Objectives: To evaluate vitamin D status and determinants of vitamin D deficiency in immigrants from Africa and the Middle East living in Umeå, at latitude 63˚N.
Background: Vitamin D is an important factor for regulation of the balance between calcium and phosphate in the human body. Vitamin D deficiency is related to osteomalacia and rickets in children and with osteoporosis among elderly in institutions. Vitamin D also has a critical role for muscle function, even moderate vitamin D deficiency can cause proximal myopathy with muscle weakness, pain and fatigue. Since more than 90% of the vitamin D supply is produced in the skin under exposure to UVB, lack of sunlight exposure is the most common cause of vitamin D deficiency. North of latitude 37˚N, corresponding to the Spanish Costa del Sol, there is little of any vitamin D3 produced in the skin in winter. Vitamin D deficiency has been shown to occur globally with high prevalence in some ethnic groups.
Results: Vitamin D status was insufficient or deficient in 73% of the participants. Specifically, 12% had vitamin D deficiency (25(OH)D˂25 nmol/L), and only 3.7% had optimal vitamin D status (25(OH)D 75-125 nmol/L). Mean 25(OH)D was 41.0 nmol/L, with no difference between sexes. 25(OH)D was lower and vitamin D deficiency twice as common in immigrants from Africa compared to those from the Middle East. In the multiple regression analysis, vitamin D deficiency remained significantly associated with low fatty fish intake, not travelling abroad, and wearing long-sleeved clothes in summer.
Material/Methods: Cross-sectional population-based study. Immigrants aged 25-65 years from nine countries in Africa or the Middle East (N=1,306) were invited. A total 111 men and 106 women (16.5%) completed the study. S-25-hydroxyvitamin D was measured with HPLC. Anthropometry, medical, socioeconomic and lifestyle data were registered.
Conclusion: The majority of immigrants from Africa and the Middle East who live in northern Sweden have vitamin D deficiency or insufficiency. Our results are consistent with lifestyle factors being crucial for vitamin D status irrespective of the latitude of residence; they support that sun exposure and a diet with high intake of fatty fish are most important to avoid vitamin D deficiency.
Points for discussion: A direction for further research is to examine to what extent the low 25(OH)D levels in the immigrant population are correlated to health.