Vitamin D Insufficiency Among Lactating Women in Southern Ethiopia

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Serum 25(OH)D concentration and its relations with dress habits, sun seeking behavior and skin reflectance were assessed among Ethiopian lactating women (n=120). The subjects were enrolled within 2 wk of delivery in a randomized controlled vitamin D supplementation trial (NCT02210884) being implemented in Sidama Zone (7°N, 38°E), Southern Ethiopia. Baseline data from the trial, reported here, was collected from September, 2014 to January, 2015. Plasma 25(OH)D concentration was determined using the new VDSP (Vitamin D Standardization Program)certified Immunodiagnostic Systems (IDS) 25‐Hydroxy Vitamin DS EIA manual ELISA Kits. Data on demographic characteristics, dress habits and sun seeking behavior were collected using questionnaires. Skin reflectance was measured using a portable colorimeter. Mean (SD) plasma 25(OH)D concentration was 48.5(14.6) nmol/L. Values ranged from 23 nmol/L to 102 nmol/L. In more than half of the participants (55%), 25(OHD) concentrations were between 30 and <50 nmol/L, which is defined as inadequate for bone and overall health. Vitamin D deficiency (< 30 nmol/L) was observed in four (3.3 %) of the women. The 25(OH)D concentrations were adequate (≥ 50 nmol/L) in 41.7%. The majority of the participants (81%) reported taking precautions to avoid direct sunlight exposure. More than half (52.5%) of the participants reported covering their head and most of their body when they go outside. Mean (SD) 25(OH)D concentration was significantly lower among women that wore more coverings outdoors (45.4 nmol/L (11.4)) compared to women who wore less conservative clothes (52.2 nmol/L (16.6)). Furthermore, skin lightness was positively correlated with 25(OH)D concentrations. The 25(OH)D concentrations were negatively correlated with maternal weight and BMI. These findings provide additional evidence that the availability of abundant sunlight does not guarantee attainment of adequate vitamin D status. Conservative dress habits and avoidance of direct sunlight are possible factors that contributed to considerable vitamin D insufficiency in a population residing near the equator.Support or Funding InformationSupported by the Nutricia Research Foundation and the W3002 Multistate Project