Annual vitamin D deficiency screening for dark-skinned or veiled groups

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Annual screening for vitamin D deficiency and routine vitamin D supplementation in at-risk populations, such as dark-skinned or veiled groups, is recommended by Australian researchers.

The research study published in The Medical Journal of Australia.

North African refugees and Muslim Australians who wear veils have been warned they may not be getting enough vitamin D. Dark-skinned and veiled infants, children and adults should be screened annually for vitamin D deficiency, and vitamin D supplementation should be provided.

Despite being readily preventable and treatable, simple vitamin D deficiency-related rickets and osteomalacia have made a global resurgence. Known risk factors for vitamin D deficiency include dark skin pigmentation, cultural practices such as veiling and covering, insufficient exposure to sunlight, and exclusive breastfeeding beyond 6?12 months for at-risk groups.

Although simple vitamin D deficiency is often asymptomatic, adults may present with bone pain, myalgia, myopathy, increased risk of falls, osteoporosis and hip fractures. Infants with vitamin D deficiency usually have mothers who are also vitamin D deficient. Children may present with hypocalcaemic seizures, rickets, bowed limbs, fractures and motor delay. Furthermore, vitamin D is not only a calciotropic hormone, it may also have an important role in cell growth and immunomodulatory effects.

In Australia, most vitamin D is obtained through exposure to ultraviolet B (UVB) radiation in sunlight. There are adult exposure recommendations to prevent vitamin D deficiency, but because 95% of skin cancers and 99% of melanomas in Australia are due to sun exposure, it is difficult to make similar recommendations for children.

To describe the natural history of vitamin D deficiency in an at-risk population of African migrants living in Sydney, researchers collected data from 149 participants in the study. As part of a health-screening program, serum concentrations of 25(OH)D, parathyroid hormone (PTH), calcium, phosphate (PO4) and alkaline phosphatase (ALP) were measured.

Despite a significant increase in 25(OH)D serum concentration over the study period, most participants (87%) remained 25(OH)D deficient at the end of summer. “Our results support the current consensus that recommends annual screening for vitamin D deficiency and routine vitamin D supplementation in at-risk populations, such as dark-skinned or veiled groups”, concluded researcher.

Source: Medical Journal of Australia, Australia

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