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Vitamin D Deficiency and Associated Risk Factors in Muslim Housewives of Quetta, Pakistan: A Cross-Sectional Study

Background Vitamin D (Vit-D) plays a central role in calcium homeostasis and maintains skeletal integrity. Housewives in Quetta, Pakistan are at increased risk of vitamin D deficiency (VDD). They spend a greater part of their day in cleaning, washing, cooking, managing daily groceries, and other hou...

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Published in:Curēus (Palo Alto, CA) CA), 2021-09, Vol.13 (9), p.e17643-e17643
Main Authors: Hussain, Taimoor, Eimal Latif, Abdul Habib, Malik, Sheza, Raza, Sami, Saeed, Tooba, Salman Zahid, Asjad, Nazary, Kefayatullah, Arshad, Mohammad mohsin, Khan, Rajeswari, Walizada, Khalida, Wahab, Ahsan
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creator Hussain, Taimoor
Eimal Latif, Abdul Habib
Malik, Sheza
Raza, Sami
Saeed, Tooba
Salman Zahid, Asjad
Nazary, Kefayatullah
Arshad, Mohammad mohsin
Khan, Rajeswari
Walizada, Khalida
Wahab, Ahsan
description Background Vitamin D (Vit-D) plays a central role in calcium homeostasis and maintains skeletal integrity. Housewives in Quetta, Pakistan are at increased risk of vitamin D deficiency (VDD). They spend a greater part of their day in cleaning, washing, cooking, managing daily groceries, and other household chores. Thus, little time is left for self-care and outdoor activities. They wear hijab and have very little exposure to sunlight. In addition, their diet is deficient in Vit-D-rich food items, rendering them at high risk of VDD. Fear of getting tanned, melasma, and preference for a fair complexion further limit their sun exposure. This study evaluates the prevalence of VDD in housewives and determines its various risk factors to recommend screening guidelines for VDD. Methods A cross-sectional study was performed between November 2020 and April 2021 and recruited housewives aged >18 from the outpatient department of a tertiary care hospital in Quetta. Informed consent was obtained from all participants. VDD was defined as a serum 25(OH)-D level 
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Housewives in Quetta, Pakistan are at increased risk of vitamin D deficiency (VDD). They spend a greater part of their day in cleaning, washing, cooking, managing daily groceries, and other household chores. Thus, little time is left for self-care and outdoor activities. They wear hijab and have very little exposure to sunlight. In addition, their diet is deficient in Vit-D-rich food items, rendering them at high risk of VDD. Fear of getting tanned, melasma, and preference for a fair complexion further limit their sun exposure. This study evaluates the prevalence of VDD in housewives and determines its various risk factors to recommend screening guidelines for VDD. Methods A cross-sectional study was performed between November 2020 and April 2021 and recruited housewives aged &gt;18 from the outpatient department of a tertiary care hospital in Quetta. Informed consent was obtained from all participants. VDD was defined as a serum 25(OH)-D level &lt;20 ng/mL (50 nmol/L). Sociodemographic variables and information about the dietary habits, perception, attitudes towards sunlight, and daily duration of sunlight exposure were collected. Mean and standard deviation (SD) were calculated for continuous variables and counts, and proportions were calculated for categorical variables like education, age. Univariate and multivariate logistic regression analyses were performed to determine the risk factors and associations of VDD. Data were analyzed by SAS/STAT software (version 9.4). Results Among 151 housewives, 58.9% of housewives had VDD. VDD group had a higher proportion of females aged 18-30 years and a lower proportion of graduates. The reported use of Vit-D supplements was much lower in the VDD group compared with the non-deficient group, 38.2% versus 71.0 %, P-value &lt;0.001. History of fragility fractures was reported by 10.1% of housewives in the VDD group compared to 4.8% in the non-deficient group, P-value: 0.03. Around 77.5% of housewives in the VDD group spent 15 minutes or less outdoors versus 51.6% in the non-deficient group; 55.1% of housewives in the VDD group reported that they never consumed milk versus 17.7 % in the non-deficient group, P-value &lt;0.00001. In the univariate logistic regression model, housewives with an 11-12th grade of education had 4.80-fold higher odds of VDD compared to those who had undergraduate or graduate degrees (OR: 4.80, 95 % CI: 1.07-21.45). Housewives who never consumed milk had 9.72-fold (95 % CI: 3.69-25.58) higher odds of VDD compared to those who consumed milk on daily basis. Odds of VDD were 3.61-fold (95% CI: 1.06-12.31) higher in those who never consumed fish as compared to those who ate fish at least 1-2 days/week. In multivariate logistic regression, age group 18-30 (OR: 17.07, 95% CI: 1.18-246.86), and never consuming milk (OR: 7.33, 95 % CI: 1.99-26.89) were independently associated with VDD. Conclusion VDD is highly prevalent (58.9%) in housewives of Quetta. It is the need of time to increase awareness regarding the health benefits, sources, and deficiency symptoms of Vit-D. Our study revealed VDD in housewives irrespective of education and income. Dietary supplementations were greater predictors of VDD. Daily sun exposure should be encouraged, and food items should be fortified with Vit-D. Recommendations for Vitamin D screening would be a good step, especially in Muslim housewives.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.17643</identifier><identifier>PMID: 34646691</identifier><language>eng</language><publisher>Palo Alto (CA): Cureus</publisher><subject>Endocrinology/Diabetes/Metabolism ; Epidemiology/Public Health ; Internal Medicine</subject><ispartof>Curēus (Palo Alto, CA), 2021-09, Vol.13 (9), p.e17643-e17643</ispartof><rights>Copyright © 2021, Hussain et al. 2021 Hussain et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c291t-a7fca37bf1bf3571ad8ec1fde17398ebfb0db1c37783e2af1d0e47dbca743d0c3</citedby><cites>FETCH-LOGICAL-c291t-a7fca37bf1bf3571ad8ec1fde17398ebfb0db1c37783e2af1d0e47dbca743d0c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485963/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485963/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,37013,53791,53793</link.rule.ids></links><search><creatorcontrib>Hussain, Taimoor</creatorcontrib><creatorcontrib>Eimal Latif, Abdul Habib</creatorcontrib><creatorcontrib>Malik, Sheza</creatorcontrib><creatorcontrib>Raza, Sami</creatorcontrib><creatorcontrib>Saeed, Tooba</creatorcontrib><creatorcontrib>Salman Zahid, Asjad</creatorcontrib><creatorcontrib>Nazary, Kefayatullah</creatorcontrib><creatorcontrib>Arshad, Mohammad mohsin</creatorcontrib><creatorcontrib>Khan, Rajeswari</creatorcontrib><creatorcontrib>Walizada, Khalida</creatorcontrib><creatorcontrib>Wahab, Ahsan</creatorcontrib><title>Vitamin D Deficiency and Associated Risk Factors in Muslim Housewives of Quetta, Pakistan: A Cross-Sectional Study</title><title>Curēus (Palo Alto, CA)</title><description>Background Vitamin D (Vit-D) plays a central role in calcium homeostasis and maintains skeletal integrity. Housewives in Quetta, Pakistan are at increased risk of vitamin D deficiency (VDD). They spend a greater part of their day in cleaning, washing, cooking, managing daily groceries, and other household chores. Thus, little time is left for self-care and outdoor activities. They wear hijab and have very little exposure to sunlight. In addition, their diet is deficient in Vit-D-rich food items, rendering them at high risk of VDD. Fear of getting tanned, melasma, and preference for a fair complexion further limit their sun exposure. This study evaluates the prevalence of VDD in housewives and determines its various risk factors to recommend screening guidelines for VDD. Methods A cross-sectional study was performed between November 2020 and April 2021 and recruited housewives aged &gt;18 from the outpatient department of a tertiary care hospital in Quetta. Informed consent was obtained from all participants. VDD was defined as a serum 25(OH)-D level &lt;20 ng/mL (50 nmol/L). Sociodemographic variables and information about the dietary habits, perception, attitudes towards sunlight, and daily duration of sunlight exposure were collected. Mean and standard deviation (SD) were calculated for continuous variables and counts, and proportions were calculated for categorical variables like education, age. Univariate and multivariate logistic regression analyses were performed to determine the risk factors and associations of VDD. Data were analyzed by SAS/STAT software (version 9.4). Results Among 151 housewives, 58.9% of housewives had VDD. VDD group had a higher proportion of females aged 18-30 years and a lower proportion of graduates. The reported use of Vit-D supplements was much lower in the VDD group compared with the non-deficient group, 38.2% versus 71.0 %, P-value &lt;0.001. History of fragility fractures was reported by 10.1% of housewives in the VDD group compared to 4.8% in the non-deficient group, P-value: 0.03. Around 77.5% of housewives in the VDD group spent 15 minutes or less outdoors versus 51.6% in the non-deficient group; 55.1% of housewives in the VDD group reported that they never consumed milk versus 17.7 % in the non-deficient group, P-value &lt;0.00001. In the univariate logistic regression model, housewives with an 11-12th grade of education had 4.80-fold higher odds of VDD compared to those who had undergraduate or graduate degrees (OR: 4.80, 95 % CI: 1.07-21.45). Housewives who never consumed milk had 9.72-fold (95 % CI: 3.69-25.58) higher odds of VDD compared to those who consumed milk on daily basis. Odds of VDD were 3.61-fold (95% CI: 1.06-12.31) higher in those who never consumed fish as compared to those who ate fish at least 1-2 days/week. In multivariate logistic regression, age group 18-30 (OR: 17.07, 95% CI: 1.18-246.86), and never consuming milk (OR: 7.33, 95 % CI: 1.99-26.89) were independently associated with VDD. Conclusion VDD is highly prevalent (58.9%) in housewives of Quetta. It is the need of time to increase awareness regarding the health benefits, sources, and deficiency symptoms of Vit-D. Our study revealed VDD in housewives irrespective of education and income. Dietary supplementations were greater predictors of VDD. Daily sun exposure should be encouraged, and food items should be fortified with Vit-D. Recommendations for Vitamin D screening would be a good step, especially in Muslim housewives.</description><subject>Endocrinology/Diabetes/Metabolism</subject><subject>Epidemiology/Public Health</subject><subject>Internal Medicine</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVkU1P3DAQhq0KVBDdW3-Ajz0QasdJ7PRQabWUgkTFN1drYo9blyQG29lq_z27LELlNCPNo2f06iXkM2dHUtbtVzNFnNIRl00lPpD9kjeqUFxVO__te2SW0l_GGGeyZJJ9JHuiaqqmafk-ifc-w-BHekyP0XnjcTQrCqOl85SC8ZDR0mufHugJmBxiomv215R6P9DTMCX855eYaHD0asKc4ZBewoNPGcZvdE4XMaRU3KDJPozQ05s82dUnsuugTzh7nQfk7uTH7eK0OL_4ebaYnxembHkuQDoDQnaOd07UkoNVaLizyKVoFXauY7bjRkipBJbguGVYSdsZkJWwzIgD8n3rfZy6Aa3BMUfo9WP0A8SVDuD1-8vo_-jfYalVpeq2EWvBl1dBDE8TpqwHnwz2PYy4jq7LWpWcKVVv0MMtajaJI7q3N5zpTVN625R-aUo8A5GciXA</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Hussain, Taimoor</creator><creator>Eimal Latif, Abdul Habib</creator><creator>Malik, Sheza</creator><creator>Raza, Sami</creator><creator>Saeed, Tooba</creator><creator>Salman Zahid, Asjad</creator><creator>Nazary, Kefayatullah</creator><creator>Arshad, Mohammad mohsin</creator><creator>Khan, Rajeswari</creator><creator>Walizada, Khalida</creator><creator>Wahab, Ahsan</creator><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210901</creationdate><title>Vitamin D Deficiency and Associated Risk Factors in Muslim Housewives of Quetta, Pakistan: A Cross-Sectional Study</title><author>Hussain, Taimoor ; Eimal Latif, Abdul Habib ; Malik, Sheza ; Raza, Sami ; Saeed, Tooba ; Salman Zahid, Asjad ; Nazary, Kefayatullah ; Arshad, Mohammad mohsin ; Khan, Rajeswari ; Walizada, Khalida ; Wahab, Ahsan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c291t-a7fca37bf1bf3571ad8ec1fde17398ebfb0db1c37783e2af1d0e47dbca743d0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Endocrinology/Diabetes/Metabolism</topic><topic>Epidemiology/Public Health</topic><topic>Internal Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hussain, Taimoor</creatorcontrib><creatorcontrib>Eimal Latif, Abdul Habib</creatorcontrib><creatorcontrib>Malik, Sheza</creatorcontrib><creatorcontrib>Raza, Sami</creatorcontrib><creatorcontrib>Saeed, Tooba</creatorcontrib><creatorcontrib>Salman Zahid, Asjad</creatorcontrib><creatorcontrib>Nazary, Kefayatullah</creatorcontrib><creatorcontrib>Arshad, Mohammad mohsin</creatorcontrib><creatorcontrib>Khan, Rajeswari</creatorcontrib><creatorcontrib>Walizada, Khalida</creatorcontrib><creatorcontrib>Wahab, Ahsan</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hussain, Taimoor</au><au>Eimal Latif, Abdul Habib</au><au>Malik, Sheza</au><au>Raza, Sami</au><au>Saeed, Tooba</au><au>Salman Zahid, Asjad</au><au>Nazary, Kefayatullah</au><au>Arshad, Mohammad mohsin</au><au>Khan, Rajeswari</au><au>Walizada, Khalida</au><au>Wahab, Ahsan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vitamin D Deficiency and Associated Risk Factors in Muslim Housewives of Quetta, Pakistan: A Cross-Sectional Study</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><date>2021-09-01</date><risdate>2021</risdate><volume>13</volume><issue>9</issue><spage>e17643</spage><epage>e17643</epage><pages>e17643-e17643</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Background Vitamin D (Vit-D) plays a central role in calcium homeostasis and maintains skeletal integrity. Housewives in Quetta, Pakistan are at increased risk of vitamin D deficiency (VDD). They spend a greater part of their day in cleaning, washing, cooking, managing daily groceries, and other household chores. Thus, little time is left for self-care and outdoor activities. They wear hijab and have very little exposure to sunlight. In addition, their diet is deficient in Vit-D-rich food items, rendering them at high risk of VDD. Fear of getting tanned, melasma, and preference for a fair complexion further limit their sun exposure. This study evaluates the prevalence of VDD in housewives and determines its various risk factors to recommend screening guidelines for VDD. Methods A cross-sectional study was performed between November 2020 and April 2021 and recruited housewives aged &gt;18 from the outpatient department of a tertiary care hospital in Quetta. Informed consent was obtained from all participants. VDD was defined as a serum 25(OH)-D level &lt;20 ng/mL (50 nmol/L). Sociodemographic variables and information about the dietary habits, perception, attitudes towards sunlight, and daily duration of sunlight exposure were collected. Mean and standard deviation (SD) were calculated for continuous variables and counts, and proportions were calculated for categorical variables like education, age. Univariate and multivariate logistic regression analyses were performed to determine the risk factors and associations of VDD. Data were analyzed by SAS/STAT software (version 9.4). Results Among 151 housewives, 58.9% of housewives had VDD. VDD group had a higher proportion of females aged 18-30 years and a lower proportion of graduates. The reported use of Vit-D supplements was much lower in the VDD group compared with the non-deficient group, 38.2% versus 71.0 %, P-value &lt;0.001. History of fragility fractures was reported by 10.1% of housewives in the VDD group compared to 4.8% in the non-deficient group, P-value: 0.03. Around 77.5% of housewives in the VDD group spent 15 minutes or less outdoors versus 51.6% in the non-deficient group; 55.1% of housewives in the VDD group reported that they never consumed milk versus 17.7 % in the non-deficient group, P-value &lt;0.00001. In the univariate logistic regression model, housewives with an 11-12th grade of education had 4.80-fold higher odds of VDD compared to those who had undergraduate or graduate degrees (OR: 4.80, 95 % CI: 1.07-21.45). Housewives who never consumed milk had 9.72-fold (95 % CI: 3.69-25.58) higher odds of VDD compared to those who consumed milk on daily basis. Odds of VDD were 3.61-fold (95% CI: 1.06-12.31) higher in those who never consumed fish as compared to those who ate fish at least 1-2 days/week. In multivariate logistic regression, age group 18-30 (OR: 17.07, 95% CI: 1.18-246.86), and never consuming milk (OR: 7.33, 95 % CI: 1.99-26.89) were independently associated with VDD. Conclusion VDD is highly prevalent (58.9%) in housewives of Quetta. It is the need of time to increase awareness regarding the health benefits, sources, and deficiency symptoms of Vit-D. Our study revealed VDD in housewives irrespective of education and income. Dietary supplementations were greater predictors of VDD. Daily sun exposure should be encouraged, and food items should be fortified with Vit-D. Recommendations for Vitamin D screening would be a good step, especially in Muslim housewives.</abstract><cop>Palo Alto (CA)</cop><pub>Cureus</pub><pmid>34646691</pmid><doi>10.7759/cureus.17643</doi><oa>free_for_read</oa></addata></record>
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Epidemiology/Public Health
Internal Medicine
title Vitamin D Deficiency and Associated Risk Factors in Muslim Housewives of Quetta, Pakistan: A Cross-Sectional Study
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