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The prevalence of vitamin D deficiency — essential for human health — is high even in low latitude countries, such as Brazil, where sun exposure is greater and more frequent. Most adults also consume few foods rich in this nutrient, which further increases the chances of developing diseases related to its insufficiency (such as osteoporosis, diabetes, cardiovascular diseases and even cancer). Vitamin D deficiency is more common in women than in men and personal, sociodemographic, environmental and lifestyle factors seem to be associated with the presence of this condition.
Table of Contents
Recent analysis of vitamin D in women
In a study that was part of a multicentric research developed by the agreement between the University of São Paulo, the University of Surrey, in England and the University of Wollongong, in Australia, 101 women residing in the city of Araraquara were evaluated in a transversal way, in São Paulo, aged 35 years or older, seeking associations between 25-hydroxyvitamin D (25(OH)D) levels and some factors. Among them: level of exposure to ultraviolet radiation (UV), smoking, alcohol consumption, levels of physical activity, age, Body Mass Index (BMI), stress and postmenopausal status.
To this end, questionnaires on lifestyle, food diaries and dosimeters were carried out to measure UV radiation during four consecutive days in winter (July) 2019. There is no global consensus on the optimal levels of 25(OH)D and, in this study , a value of < 50 nmol/L was adopted as a cut-off to indicate vitamin D insufficiency. The exclusion criteria chosen were factors that could influence vitamin D metabolism, such as supplementation, treatment for osteoporosis or cancer, diabetes, hypertension and heart.
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Among the results, the value of 64 nmol/L was found as the mean serum concentration of 25(OH)D among the participants, with 16% of them being classified as having vitamin D insufficiency (< 50 nmol/L). Somewhat unexpectedly, older women had significantly higher concentrations of 25(OH)D than younger women (P=0.01), as well as higher UV radiation exposure (P=0.01) and lower BMI (P=0.01). =0.005). Levels of UV radiation exposure were significantly higher in postmenopausal women (P=0.01) and lower in those classified as having vitamin D insufficiency (P < 0.001). In addition, women in the professional category “housewives” had higher levels of exposure to UV radiation than those in the “Health and Beauty” and “Administrative” categories.
Serum levels of 25(OH)D were also higher in women without overweight or obesity, in addition to those in post-menopause (P < 0.001), and high scores on the stress questionnaire also showed an association with lower levels of 25(OH)D (P=0.001). Looking specifically at sun exposure, participants with 25(OH)D concentration levels between 25 and 50 nmol/L had significantly lower exposure to UV radiation than those with rates between 50 and 75 nmol/L.
The results of better vitamin D concentrations in older women should be looked at in light of some considerations: when corrected for UV radiation and BMI variables, age loses significance. In addition, the inclusion and exclusion criteria may have biased this association, since only “healthy” women were selected. Still, these findings are relevant as they suggest that postmenopausal vitamin D deficiency is not inevitable.
Conclusion
The association with the types of occupation of each woman, as well as behavioral and environmental factors, such as BMI and exposure to the sun, raise the importance of the physician working towards these factors in order to prevent vitamin D insufficiency, especially in women. in postmenopausal women and those with risk factors for fractures. Stress — and depression, as other studies show — also stand out here in this regard, and should be addressed and dealt with properly when identified.
Know more: The real benefits of vitamin D – Part II
Vitamin D deficiency can cause numerous health problems and its approach must be interdisciplinary, as it includes from behavioral to climatic factors. Even in tropical countries such as Brazil, physicians must pay attention to providing lifestyle guidelines, which also address the risk factors identified in this study, in order to promote health and prevent diseases.
Author:
Graduation in Medicine from the Fluminense Federal University (UFF) ⦁ Residency in Family and Community Medicine from the State University of Rio de Janeiro (UERJ) and in Health Administration (UERJ) ⦁ Master in Family Health (UFF) ⦁ Doctoral Student in Health Public Health by the National School of Public Health (ENSP/Fiocruz) ⦁ Professor of the Family Health discipline and manager of the Escola Lapa Health Center of the Faculty of Medicine of the Estácio de Sá University
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#Santana, KVS et al. Association between vitamin D status and lifestyle factors in Brazilian women: Implications of Sun Exposure Levels, Diet, and Health. The Lancet eClinicalMedicine 2022; 47: 101400. DOI: 10.1016/j.eclinm.2022.101400
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