Hypovitaminosis D in a sunny country: Relation to lifestyle and bone markers

Hypovitaminosis D is associated with poor dietary intake and inadequate sun shine exposure. It is common worldwide, particularly in European elderly pe ople. Information about vitamin D status in young adult populations from th e Middle East is scarce. Furthermore, the relationship between hypovitamino sis D and some lifestyle factors such as style of clothing and dwelling loc ation is not well defined. We assessed vitamin D intake and measured serum calcium, phosphorus, albumin, alkaline phosphatase, 25-hydroxyvitamin D [25 (OH)D], parathyroid hormone (PTH), osteocalcin, and urinary-free deoxypyrid inoline (DPD) in 316 Lebanese volunteers (99 men and 217 women) aged 30-50 years; 156 were recruited from rural areas and 160 from urban areas. Fifty- one women from each area were veiled. The average daily vitamin D intake wa s 100.3 +/- 67.9 IU and was found to be higher in men compared with women, in urban subjects compared with rural ones and in nonveiled women compared with veiled ones. The mean level of 25(OH)D was 9.71 +/- 7.07 ng/ml. Hypovi taminosis D [25(OH)D < 12 ng/ml] affected 72.8% of our population. It was m ore common in women than in men (83.9% vs. 48.5%). Severe hypovitaminosis D [25(OH)D < 5 ng/ml] was observed in 30.7% of our subjects and was more pre valent in women (41.5%), particularly in the veiled ones (61.8%). 25(OH)D l evels were the lowest in veiled women, and in women living in rural areas. Rural men had the highest 25(OH)D levels despite their very low vitamin D i ntake. In a multivariate model, inadequate vitamin D intake, urban dwelling , veil wearing, and high parity in women were independent predictors of hyp ovitaminosis D. 25(OB)D was related inversely to PTH and free DPD whereas o steocalcin achieved only a weak positive correlation with 25(OH)D. In the a bsence of information regarding time spent outdoors, our results show that hypovitaminosis D is common among young Lebanese people and is related most ly to low vitamin D intake. This should emphasize the need for more vitamin D in our population.