Abstract
Bone and muscle weakness due to vitamin D deficiency is common among Muslim women who reside in sunny, equatorial countries. The purpose of this study was to determine if living in a northern maritime location additionally disadvantages women who wear concealing clothes. A cross-sectional matched pair design was used to compare women who habitually wore concealing clothing with women who dressed according to western norms. Each premenopausal hijab-wearing woman (n = 11) was matched by age, height, weight and skin tone with a western-dressed woman. Subjects were tested by hand grip dynamometry to assess muscular strength and by quantitative ultrasound at the calcaneus to assess bone status. Nutritional intake was obtained by 24 h recall. Serum 25-hydroxyvitamin D (s-25(OH)D) status was determined in seven matched pairs. The hijab group had lower s-25(OH)D than women who wore western clothes (40 ± 28 vs. 81 ± 32 nmol/L, p= 0.01). Grip strength in the right hand was lower in the hijab-wearing women (p = 0.05) but this appeared to be due to less participation in intense exercise. Bone status did not differ between groups (p= 0.9). Dietary intake of vitamin D was lower in the hijab-wearers (316 ± 353 vs. 601 ± 341 IU/day, p= 0.001). This pilot study suggests that women living in a northern maritime location appear to be at risk for vitamin D insufficiency and therefore should consider taking vitamin D supplements.
Highlights
Women who wear concealing clothing and live in northern latitudes may be at greater risk for vitamin D deficiency due to seasonal unavailability of the ultraviolet B radiation (UVB) required for cutaneous conversion of vitamin D
Given that living year round at lower latitudes provides more opportunity for cutaneous conversion of vitamin D, the even lower vitamin D status of pre-menopausal women reported in Jordan [27], Iran [28], Saudi Arabia [29], Turkey [30] and Lebanon [31] appears to be related to the practice of wearing a hijab and other body coverings
The s-25(OH)D measured in women in coastal Canada who wore concealing clothes was lower than in secularly dressed women and several of these women were severely deficient in vitamin D
Summary
Women who wear concealing clothing and live in northern latitudes may be at greater risk for vitamin D deficiency due to seasonal unavailability of the ultraviolet B radiation (UVB) required for cutaneous conversion of vitamin D. Women who dress in northern European countries such as Norway, 60° N [1], Denmark, 56° N [2], and England, 52° N [3] are more prone to vitamin D deficiency than are women who wear western style clothing. Information regarding the vitamin D status of women who wear concealing clothing and reside in Canadian communities, which mostly lie in latitudes from 42° N to 69° N, has not been reported. Girls who grow up in conservative Islamic countries tend to be vitamin D deficient and have poor bone status [12,13,14], which can affect their capacity to reach their peak bone mass potential [15]. Bone and muscle pain reported by young immigrant Muslim women living in Switzerland was typically misattributed to other conditions [17]
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