It was undertaken to assess the KAPs of the diverse community in the UK, including both Caucasian and minority ethnic groups and offers important insights on the current usage of vitamin D and associated issues.Ī cross-sectional online survey, incorporating iteratively designed questions, was implemented to assess attitudes and experiences regarding Vitamin D and supplementation within the respondent community. This paper reports findings from the online survey, the first phase of the FABCOM-D (Facilitators and Barriers to Community (Healthy) Vitamin D status) study. The work undertaken included a systematic review that reported a paucity of studies that address the behavioural determinants that would help attain an adequate vitamin D status in hard-to-reach communities. Lee C et al explored these aspects in depth with a Somali community in Northwest London and found that a lack of awareness, access, and a reluctance to medicalise a natural state (pregnancy) were key issues.
There is a pressing need to study the knowledge, attitudes, and practices of the wider community, in particular from Black, Asian and minority ethnic subpopulations, to gain an understanding of the facilitators of and barriers to vitamin D supplementation in men, women, and children. In a Scottish study conducted to assess the KAPs of vitamin D, around 90% of the study population was Caucasian, and many other groups traditionally considered to be at risk of vitamin D deficiency were not well represented. Previous research, including questionnaire studies, has been conducted to assess the knowledge, attitudes, and practices (KAPs) in relation to Vitamin D. People with higher body mass index (BMI) and larger waist circumferences have lower serum levels, and higher doses of vitamin D supplements may be needed. In the UK, a daily supplement of 10 micrograms per day (400 international units per day) is recommended for those aged four years and above. As calcitriol has a very short half-life in the plasma, levels of its precursor, 25(OH)D, are measured to assess vitamin D status. It is subsequently metabolised in the kidneys to calcitriol, a physiological active form of vitamin D. Vitamin D initially goes through hepatic metabolization to form 25(OH)D.
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Dietary sources are essential when sunlight containing UVB radiation is limited, as is the case during the winter months in northern latitudes or where skin exposure is restricted. Vitamin D can also be obtained from foods or dietary supplements. Upon exposure to sunlight containing sufficient ultraviolet B (UVB) radiation, vitamin D is synthesised in the skin.
The main source of vitamin D in humans is solar radiation, scattered and filtered through Earth’s atmosphere and obvious as daylight when the sun is above the horizon. Long-term health outcomes of VDD may include development of obesity, diabetes, asthma, hypertension, depression, osteoporosis with osteomalacia as an underlying condition increasing the risk of fragile bones, neurodegenerative diseases and some cancers. Vitamin D may also affect immune and cardiovascular system modulation however, studies have not yet demonstrated a clear causative effect. Chronically deficient levels in preschool children have also been associated with hypo-calcaemic seizures, and cardiomyopathy, as well as motor delay, aches, pains, and fractures. VDD also causes nutritional rickets a bone disease seen in young children which can also be due to poor dietary calcium intake and still prevalent in the UK despite public health campaigns. Adequate vitamin D levels have been associated with lower risks of pre-eclampsia and gestational diabetes. Adequate vitamin D status during pregnancy is important for foetal musculoskeletal development and general foetal growth, with a Cochrane review noting that the consequences of deficient levels during pregnancy could include lower neonate birth weight, head circumference and length. The risk of VDD is higher in pregnant women, children under five years of age, and in people without much sun exposure including frail and institutionalised individuals and ethnic groups with darker skin pigmentation (e.g. Claims in the media abound, and sales of vitamin D supplements have increased 10-fold since 2001. Over the last decade, there has been considerable interest in vitamin D and the use of vitamin D supplements to help prevent or treat a variety of medical presentations. Vitamin D deficiency (VDD), defined as a serum level of 25-hydroxy-vitamin D (25(OH)D) of less than 25 nmol/l, is a global health problem with over 1 billion people affected worldwide. Vitamin D, a fat-soluble steroid hormone precursor, is responsible for regulating calcium and phosphorous metabolism in humans and essential for musculoskeletal health.
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