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Veiled from vitamin D

PHS study finds cultural and biological factors contribute to low vitamin D levels among Seattle-area Somali females

April 9, 2007
Dr. Susan Reed

Dr. Susan Reed's study found universal vitamin D insufficiency among veiled East African immigrant women. The deficiency is associated with physical and mental complaints commonly expressed by female Somali immigrants at local community health clinics.

Photo by Stephanie Cartier

Veiled East African immigrant women in the Seattle area were universally found to have insufficient levels of vitamin D in their blood, according to a study led by Dr. Susan Reed of the Public Health Sciences Division.

This study, which appears in the March edition of the Journal of Women's Health, is one of only two to report on vitamin D insufficiency among immigrants to North America and the only one to show low blood concentrations in every instance.

"We were surprised to find universal insufficiency in vitamin D," said Reed, who is also a professor in the University of Washington's departments of Obstetrics and Gynecology and Epidemiology. "We had hoped to compare symptoms among those who were vitamin D insufficient to those with adequate vitamin D levels."

Vitamin D deficiency is associated with joint, back and bone pain, muscle weakness, falling, fatigue and depression, complaints commonly expressed by female Somali immigrants at local community health clinics. Exposure to sunlight helps our bodies synthesize the vitamin. It is important for individuals with limited sun exposure to include good sources of vitamin D in their diet, such as fortified dairy and grain products and fatty fish.

Of the 75 Somali women interviewed, those with the lowest levels of vitamin D were 66 percent less likely to drink milk. Women from this predominantly Muslim country also wear long robes or dresses and head coverings, which block sunlight in a region where sunlight and daylight hours are already diminished for much of the year. A little more than 50 percent of the women were outside for at least 10 minutes every day. All were dark-skinned, another risk factor for vitamin D deficiency because melanin acts like a sunblock, prolonging the time required to generate vitamin D.

At least 700-800 international units of vitamin D is needed for prevention of fractures and falls, but not one immigrant in the study met this standard.

The project was a collaboration between the Center, UW's Center of Excellence in Women's Health, and the Refugee Women's Alliance, a local community organization.

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