Prevalence Of Vitamin Deficiency Research Articles

92 Seasonal variation in plasma vitamin A and E concentrations in horses with or without pasture access

Vitamins A and E are essential nutrients for horses and often provided in the diet by fresh forage but become depleted when forage is cut and dried for hay and can lead to potentially fatal health problems in horses. This study evaluated seasonal changes in plasma vitamin A and E for a mature horse herd in the Upper Midwest to determine the impact of pasture access on the prevalence of vitamin deficiency. Researchers hypothesized horses on dry lot would be deficient all year while horses with pasture access would have increased vitamin A and E concentrations during the grazing season. The study took place between February and November 2022 in River Falls, Wisconsin. Twenty-seven mature horses were divided into 2 treatments based on management practices including 1) horses consuming a hay-only diet in a dry lot (n = 13) and 2) horses with pasture access in the summer (n = 14). All horses had ad libitum access to water and a vitamin and mineral mix (200 IU/kg Vitamin E; 176,320 IU/kg Vitamin A) for the duration of the study and received ad libitum cool-season grass hay round bales from September through May. Hay-only horses continued this diet from June through August while pastured horses continuously grazed cool-season grass pasture. Jugular venous blood samples were taken in February (winter), May (spring), August (summer), and November (fall) and plasma samples were sent theMichigan State Veterinary Diagnostic Lab for analysis of plasma vitamin A and E concentrations. Data were analyzed using PROC MIXED in SAS with significance set at P ≤ 0.05. Adequate vitamin A was classified as 175 to 300 ng/ml, and adequate vitamin E was classified as 2.0 to 4.0 µg/ml. Vitamin A deficiency was observed in 81% and 85% of horses in winter and spring, respectively, with an average concentration of 145 ng/ml. Pastured horses exhibited an increase in plasma vitamin A in the summer compared with dry lot horses (P ≤ 0.05), however 64% of pastured horses remained deficient. In the fall, vitamin A deficiency increased to 97% for all horses and plasma vitamin A averaged 139 ng/ml. When evaluating vitamin E, 70 to 74% of horses were deficient in the winter and spring, respectively, with an average concentration of 1.83 µg/ml. Plasma vitamin E concentrations did not change over time for dry lot horses and remained inadequate in the summer at 1.43 µg/ml (P > 0.05) while concentrations in pastured horses rose to 2.4 µg/ml (P ≤ 0.05). These results confirm recommendations to provide additional vitamin A and E to horses on a hay-only diet and demonstrates the short-lived increases in vitamin A and E for horses provided limited pasture access.

Neurological Dysfunction Associated with Vitamin Deficiencies: A Narrative Review

Vitamins are essential elements from various food sources that the nervous system requires to function correctly. Vitamin deficiency is a widespread public health problem in some populations particularly susceptible. The deficit of many different types of vitamins is associated with neurologic dysfunction. It commonly results from a complex interplay of factors related to inadequate intake, impaired absorption, increased demand, and/or increased excretion. The prevalence of vitamin deficiency is difficult to estimate precisely as it varies depending on the vitamin in question. In addition, the clinical presentation varies widely based on the type of vitamin deficiency. Specific signs or symptoms accompany the deficiency of each vitamin.

Hypothesis: Low Vitamin A and D Levels Worsen Clinical Outcomes When Children with Sickle Cell Disease Encounter Parvovirus B19.

Human parvovirus B19 causes life-threatening anemia due to transient red cell aplasia (TRCA) in individuals with sickle cell disease (SCD). Children with SCD experiencing profound anemia during TRCA often require red blood cell transfusions and hospitalization. The prevalence of vitamin deficiencies in SCD is high and deficiencies are associated with respiratory and pain symptoms, but the effects of vitamins on acute infection with parvovirus B19 remain unclear. We performed a clinical study in which 20 SCD patients hospitalized with parvovirus B19 infections (Day 0) were monitored over a 120-day time course to query relationships between vitamins A and D and clinical outcomes. There were significant negative correlations between Day 0 vitamin levels and disease consequences (e.g., red blood cell transfusion requirements, inflammatory cytokines). There were significant positive correlations (i) between Day 0 vitamins and peak virus-specific antibodies in nasal wash, and (ii) between Day 0 virus-specific serum plus nasal wash antibodies and absolute reticulocyte counts. There was a significant negative correlation between Day 0 virus-specific serum antibodies and virus loads. To explain the results, we propose circular and complex mechanisms. Low baseline vitamin levels may weaken virus-specific immune responses to permit virus amplification and reticulocyte loss; consequent damage may further reduce vitamin levels and virus-specific immunity. While the complex benefits of vitamins are not fully understood, we propose that maintenance of replete vitamin A and D levels in children with SCD will serve as prophylaxis against parvovirus B19-induced TRCA complications.

Vitamin B12 in the treatment and prevention of cognitive disorders in the elderly

Vitamin B12 (cobalamin) deficiency is a common condition in the elderly. Contrary to the established point of view, the absence of hematological changes (macrocytic anemia) does not always necessarily exclude this condition. Damage of the nervous system with the development of a complex of neurological and mental disorders is observed even at borderline levels of vitamin in blood. It is known, that vitamin deficiency is important risk factor of dementia. Cobalamin deficiency can directly lead to cognitive damage or accelerate development of dementia due to the other brain pathology - Alzheimer's disease, vascular dementia. The review provides information on the biological role of cobalamin in the human body, the prevalence of vitamin deficiency, especially in the elderly patients, and methods of its diagnosis and management. Both traditional parenteral therapy regimens and the possibility of oral intake of cobalamin in the course of deficiency correction are discussed.

Are there any links between blood statuses of vitamin B12, B9, and D with depression in the elderly population living in nursing homes? A descriptive-analytical study from Tehran-Iran

Background: Nutritional deficiency has been suggested as a cause of depression in old age. The present study was performed to evaluate statuses of vitamin B12, Folate (vitamin B9), and vitamin D and their associations with depression among the elderly population living in nursing homes in Tehran-Iran. Methods: One-hundred and seventy subjects from 17 randomly selected nursing homes (NH) (Tehran-Iran) were enrolled in the study. Depression, nutritional statuses, history of chronic diseases, dental health, the levels of exposure to sunlight, the level of satisfaction associated with food quality, and NH staff were evaluated for determining possible relations between depression with vitamin B12, Folate, and vitamin D levels. Results: In the present study Folate and vitamin D deficiencies were found in 96% and 56% of subjects. No correlations were observed between depression with vitamin B12 (P=0.47), Folate (P=0.16) and Vitamin D (P=0.24) levels. Conclusion: The results delineate the high prevalence of vitamin deficiencies among elderly nursing home residents; however, no associations were observed between depression and these nutritional factors. Further studies considering other risk factors and more nutritional micronutrients are suggested.

Vitamin A-Related Policies in Iran: Document Analysis.

Background:There are one-third of children in the world with Vitamin A deficiency. The prevalence of vitamin deficiency in children aged 15–23 months in Iran has increased 18 times and in rural areas. The present article aims to an analysis of related documents to the existing policies on this vitamin in our country.Materials and Methods:This study is a descriptive study using a quantitative content analysis approach to analyze nutritional policy documents.Results:We extracted six themes at the first stage of analysis (based on common policies in the world), which were reduced to two final themes: “Direct interventions” and “Indirect interventions.” There were also six subthemes and eight issues.Conclusions:It seems that policymaking must revise these documents and also making new policy decision with more emphasis on micronutrient.

Multiple Micronutrient Powder Reduces Vitamin E Deficiency in Brazilian Children: A Pragmatic, Controlled Clinical Trial.

Multiple micronutrient powder supplementation is a health promotion strategy, but data on its effectiveness regarding vitamin E are rare. The objective was to evaluate the impact of home fortification with powdered micronutrients on α-tocopherol concentrations, growth, and inflammation in Brazilian children aged 6–15 months. This is a pragmatic, controlled clinical trial, in which the intervention group received micronutrient powder sachets for up to 3 months. Vitamin E deficiency was considered when α-tocopherol was less than 11.6 µmol/L. The Poisson regression model was used to estimate adjusted values for prevalence ratios (PR) for the outcome variable. A total of 224 children participated in the study. The intervention group had a higher median α-tocopherol level (17.2 versus 3.6 µmol/L; p < 0.001) and an 82.0% reduction in the prevalence of vitamin deficiency (PR = 0.18; 95% CI 0.11–0.30) when compared with the control group. Consumption of multiple micronutrients in powder increases serum α-tocopherol concentrations, promotes better linear growth, and reduces morbidity in children.

Oral Hydration, Food Intake, and Nutritional Status Before and After Bariatric Surgery.

Bariatric surgery is considered to be the most effective treatment of morbid obesity. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) are the most popular procedures. We evaluated nutritional status, micro- and macronutrient intake, and oral hydration in patients before and regularly during 1year after RYGBP and SG. All patients that had been through bariatric surgery with at least 1-year post-surgery were retrospectively included in the study. All participants were evaluated once during the 2months before the surgery and at 1, 3, 6, and 12months after surgery. Clinical and biological evaluations as well as dietary investigations were performed. Fifty-seven patients were included in this study (28 RYGBP and 29 SG). Patients in the RYGBP group had significantly higher body weight (132.3 ± 22 versus 122.2 ± 22.2kg, p = 0.039) than patients in the SG group. Before surgery, total energy intake, oral hydration, and vitamin and mineral intakes were not different between the two groups. RYGBP and SG induced significant similar excess weight loss 1year after surgery, 48.6 29.8% and 57.6 27.6% of body weight respectively. Energy intake significantly decreased 1month after surgery and slightly increased from 1 to 12months without reaching baseline intake levels. Macronutrient repartition did not change during follow-up. Oral hydration significantly decreased after RYGBP (- 58%) and showed a trend to be decreased after SG (- 49%). Sixty-five percent of patients still had vitamin D deficiency 1year after surgery. Whatever the type of surgery, more than 20% had some vitamin deficiency 1month after surgery. Calories intake decreases after bariatric surgery, whatever the type of procedure. In addition, the prevalence of vitamin deficiency is high after bariatric surgery. Lastly, oral hydration is importantly decreased after bariatric surgery, especially after RYGBP.

Prevalence of vitamin deficiencies in an apparently healthy urban adult population: Assessed by subclinical status and dietary intakes.

Studies in children and pregnant women consistently showed pandemic proportions of micronutrient deficiencies in the Indian subcontinent. However, vitamin deficiencies in apparently healthy adults are seldom recognized, hence the aim of this exploratory study was to assess their subclinical vitamin status and dietary intakes. In all, 270 apparently healthy urban adults 30 to 70 y of age, from Hyderabad city, India participated in this study. Blood levels of vitamins (A, B1, B2, B6, total and active B12, D, and folate) and homocysteine were assessed. Anthropometric parameters were measured; dietary intake was obtained by food frequency questionnaire, and probability of adequacy (PA) was calculated by the estimated average requirement. Among the study population, the overall prevalence of deficiency of vitamin B2 was strikingly high (50%) followed by the vitamins B6 (46%), active B12 (46%), total B12 (37%), folate (32%), D (29%), B1 (11%), and A (6%). Hyperhomocysteinemia (HHcys) was widely prevalent (52%) in the study participants. In case of dietary intakes, PA was lowest for vitamin B12 (4%) and folate (9%) followed by vitamins A (22%), B2 (33%), B6 (30%), and B1 (59%). The mean PA of these vitamins was noticeably low (28%). The unadjusted logistic regression analysis found men and those with a deficiency of folate and total and active B12 to be at higher risk for HHcys. In the adjusted model, the risk for active B12 deficiency almost doubled. The study demonstrated a high prevalence of multiple subclinical vitamin deficiencies, dietary inadequacies, and HHcys, which are possible risk factors for disease burden among apparently healthy adults.

VITAMIN STATUS OF LAW ENFORCEMENT OFFICERSUNDER THE INFLUENCE OF COMBAT STRESS

Law enforcement officers with different levels of combat stress (men, residents of the Komi Republic, n=33, 35,0 (32,0– 39,0) years old) were examined before (November) and after (March) trips to the combat zone. The control group included agents of the Ministry of emergency situations with a low level of stress (men, residents of the Komi Republic, 32,0 (30,0–35,0) years old). In total, law enforcement officers were shown to have a wide prevalence of vitamin deficiency: about 50% of persons had hypovitaminosis for vitamins A, E, about 35% — for vitamins B1, B2 and 24% — for vitamin C. A parallel study of the control group and law enforcement officers in November showed that initially there were more persons with reduced vitamin status in law enforcement officers, especially in the level of vitamins B1 and E. In March, after the arrival of law enforcement officers from the combat zone, they found a significant decrease in the percentage of persons with hypovitaminosis for vitamins A, E, C and an increase vitamin B1 deficiency. Changes vitamin status in the control group from November to March were not so significant.

Genetic characteristics of sensitivity of vitamin D and prevalence of vitamin deficiency among patients of polyclinics

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Serum folate predicts muscle strength: a pilot cross-sectional study of the association between serum vitamin levels and muscle strength and gait measures in patients &gt;65 years old with diabetes mellitus in a primary care setting

BackgroundOld age and diabetes mellitus are risk factors for vitamin deficiencies, weakness and falls.Deficiencies of vitamin D, and possibly vitamin B12 and folate (which are associated with hyperhomocysteinaemia), contribute to sarcopenia. Determination of the physical effects of vitamin deficiencies in specific groups of people can help to guide public health policy with regard to vitamin supplementation.MethodsA pilot cross-sectional study was conducted to determine the association of levels of vitamin D, vitamin B12, folate and homocysteine with muscle strength, gait and fall history in 56 patients >65 years old with diabetes mellitus in primary care in Singapore.Hand-grip and leg-quadriceps strength measures were obtained and divided by body mass index (BMI).The timed up-and-go and Tinetti tests were used to measure gait. A history of “at least one fall in the preceding year” was obtained.ResultsVitamin B12 deficiency (<150 pmol/l) was present in 43 % of patients, folate deficiency (<13.5 mmol/l) in 20 %, hyperhomocysteinaemia (≥15.0 μmol/l) in 52 % and vitamin D deficiency (<49.9 nmol/l) in 25 %.Levels of vitamin D, vitamin B12 and homocysteine did not significantly predict muscle strength in regression analyses.Folate (B = 0.010, P < 0.01) and gender (B = 0.356, P < 0.001) predicted average grip strength corrected for BMI (F(2,53) = 17.74, P < 0.001, R 2 = 0.40)Folate (B = 0.011, P < 0.05) and gender (B = 0.367, P < 0.001) also predicted average leg quadriceps strength corrected for BMI (F(2,53) = 9.79, P < 0.001, R 2 = 0.27).Average leg strength and average leg strength corrected for BMI were both negatively associated with the risk of having fallen in the preceding year (odds ratio (OR) = 0.89, 95 % CI 0.80–0.98, P < 0.05 and OR = 0.12, 95 % CI 0.02–0.92, P < 0.05, respectively).ConclusionsThe prevalence of vitamin deficiency was very high in our sample of patients >65 years old with diabetes mellitus. Folate levels were significantly correlated with grip and leg strength (with correction for BMI). Leg strength was positively correlated with gait measures and negatively correlated with a history of falls. The role of folate in muscle weakness and falls warrants further study.

P-039 YI Prevalence of Vitamin Deficiency in IBD and Its Association with Disease Activity in a Diverse Population Presenting to Establish Care

P-039 YI Prevalence of Vitamin Deficiency in IBD and Its Association with Disease Activity in a Diverse Population Presenting to Establish Care

Vitamin A, E, and D Deficiencies in Tunisian Very Low Birth Weight Neonates: Prevalence and Risk Factors

Preterm neonates are at high risk of vitamin deficiencies, which may expose them to increased morbidity and mortality. This study aimed to determine the prevalence and risk factors for vitamin A, E, and D deficiencies in Tunisian very low birth weight (VLBW) neonates. A total of 607 VLBW and 300 term neonates were included in the study. Plasma vitamins A and E were assessed by high performance liquid chromatography and vitamin D was assessed by radioimmunoassay. Prevalence of vitamin A, E, and D deficiencies were dramatically elevated in VLBW neonates and were significantly higher than term neonates (75.9% vs. 63.3%; 71.3% vs. 55.5%; and 65.2% vs. 40.4%, respectively). In VLBW neonates, the prevalence of vitamin deficiencies was significantly higher in lower classes of gestational age and birth weight. Vitamin E deficiency was associated with pre-eclampsia [odds ratio (OR) (95% confidence interval, 95% CI), 1.56 (1.01-2.44); p<0.01] and gestational diabetes [4.01 (1.05-17.0); p<0.01]. Vitamin D deficiency was associated with twin pregnancy [OR (95% CI), 2.66 (1.33-5.35); p<0.01] and pre-eclampsia [2.89 (1.36-6.40); p<0.01]. Vitamin A, E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia.

Determinants of fat-soluble vitamin status in patients aged 65 years and over

In the elderly, malnutrition is highly prevalent and a major contributor to increased morbidity and mortality. We aimed to evaluate the fat-soluble vitamin status and potential determinants in patients >65 years of age. Serum vitamins A, D and E were determined by liquid chromatography in 166 patients. Gender, age, season, hospitalization, nutritional markers (albumin and cholesterol), acute-phase reactants (ferritin and C-reactive protein) and renal function (creatinine and glomerular filtrate) were assessed as potential determinants. Prevalence of vitamin deficiency was highly variable, ranging from 0 (vitamin E/cholesterol ratio) to 94% (for vitamin D in hospitalized patients). Vitamin status did not differ according to gender, but age, season, hospitalization, a poor nutritional status and impaired renal function, and the presence of acute-phase response significantly affected serum levels of vitamin A, E and D. In conclusion, in subjects >65 years both demographic and clinical factors determined the fat-soluble vitamin status.

No relation between vitamin D status and physical performance in the oldest old: results from the Belfrail study

vitamin D deficiency is a well-known cause of bone loss and fractures but its association, especially among the oldest old, with muscle weakness is less obvious. to investigate the relationship between 25-hydroxyvitamin D (25-OHD) and muscle performance in persons aged 80 years and older. baseline results of the Belfrail study, a prospective, population-based cohort study were used to study balance, grip strength and gait speed in relation to 25-OHD serum levels in 367 subjects. a sufficient 25-OHD serum level of 30 ng/ml or more was found in 12.8% of the population. The prevalence of vitamin deficiency (20-29 ng/ml), insufficiency (10-19 ng/ml) and severe insufficiency (<10 ng/ml) was 21.5, 33 and 32.7%, respectively. No significant relation between balance, gait speed and grip strength, and serum 25-OHD was detected neither in bivariate analysis nor after adjustment for age, gender, level of education, institutionalisation, smoking status, body mass index, co-morbidity, level of activity, season, CRP, renal function, serum calcium parathyroid hormone levels, vitamin D intake and use of loop or thiazide diuretics. in this cohort of octogenarians vitamin D deficiency was highly prevalent. We could not confirm the findings of previous studies showing an association between serum 25-OHD and physical performance in elderly.

Prevalence and Factors Associated with Vitamin D Deficiency and Hyperparathyroidism in HIV-Infected Patients Treated in Barcelona

Vitamin D deficiency is an important problem in patients with chronic conditions including those with human immunodeficiency virus (HIV) infection. The aim of this cross-sectional study was to identify the prevalence and factors associated with vitamin D deficiency and hyperparathyroidism in HIV patients attended in Barcelona. Cholecalciferol (25OH vitamin D3) and PTH levels were measured. Vitamin D insufficiency was defined as 25(OH) D < 20 ng/mL and deficiency as <12 ng/mL. Hyperparathyroidism was defined as PTH levels >65 pg/mL. Cases with chronic kidney failure, liver disease, treatments or conditions potentially affecting bone metabolism were excluded. Among the 566 patients included, 56.4% were exposed to tenofovir. Vitamin D insufficiency was found in 71.2% and 39.6% of those had deficiency. PTH was measured in 228 subjects, and 86 of them (37.7%) showed high levels. Adjusted predictors of vitamin D deficiency were nonwhite race and psychiatric comorbidity, while lipoatrophy was a protective factor. Independent risk factors of hyperparathyroidism were vitamin D < 12 ng/mL (OR: 2.14, CI 95%: 1.19–3.82, P: 0.01) and tenofovir exposure (OR: 3.55, CI 95%: 1.62–7.7, P: 0.002). High prevalence of vitamin deficiency and hyperparathyroidism was found in an area with high annual solar exposure.

The prevalence of vitamin deficiency in clinical practice is assay-dependent

Vitamin D deficiency is an important concern in clinical settings and recently, international agencies have recognised the importance of 25-OHD assays in defining vitamin D status. Thus, our aim was to assess the consistency of different vitamin D assays in clinical practice. 25-OH-vitamin D was measured in 332 patients by ultra-fast liquid chromatography (UHPLC) and two immunoassays (Liaison Total 25(OH) and ADVIA Centaur Vitamin D Total Assay). Samples from the Vitamin D External Quality Survey (DEQAS) and the Standard Reference Material SRM 972 were used for analytical quality control. All methods displayed an acceptable performance with DEQAS samples but immunoassays showed a significant bias against certified materials. Compared to UHPLC, differences were significant for both immunoassays in the deficiency interval but the systematic bias was higher for the ADVIA assay throughout the whole range of concentrations. The prevalence of vitamin D deficiency in clinical practice is assay-dependent and physicians should be aware of the uncertainty associated with vitamin D assessment.

Vitamin D status and PTH in young men: a cross‐sectional study on associations with bone mineral density, body composition and glucose metabolism

Although vitamin D and bone metabolism are closely related, few studies have addressed the effects of vitamin D status on bone in men at time of peak bone mass. The objectives of this study were to evaluate the prevalence of vitamin D inadequacy in a cross-sectional study in young men and the effects of vitamin D and parathyroid hormone (PTH) on bone mass, bone markers and metabolic function. The study population consisted of 783 men aged 20-29 years. Bone mineral density (BMD) of the total hip, femoral neck and lumbar spine was measured. dual-energy X-ray absorptiometry was used to evaluate total body fat mass (BFAT). Visceral fat mass and abdominal subcutaneous fat mass (ViFM and ScFM) were assessed using magnetic resonance imaging. A radioimmunoassay was used to measure the level of 25-hydroxy vitamin D (25OHD). The prevalence of vitamin deficiency (serum 25OHD < 50 nm) was 6·3% during summer and 43·6% during winter. Serum 25OHD was associated with BMD at all sites and inversely associated with bone-specific alkaline phosphatase and directly with carboxyterminal telopeptide of type-1-collagen. 25OHD and PTH were inversely associated with BFAT, whereas 25OHD also was inversely associated with body mass index, waist-hip ratio, ViFM and ScFM after adjustment for confounders. The associations were found only to be present in participants with insufficient levels of 25OHD. 25-Hydroxy vitamin D and PTH were inversely related to insulin resistance in vitamin-insufficient participants only. No associations between PTH or 25OHD and blood pressure were noted. The study showed a high prevalence of 25OHD deficiency in young, northern European men, which was significantly associated with decreased BMD. PTH and 25OHD were found to be inversely related to the markers of insulin resistance.

High Prevalence of Vitamin D Deficiency Among Patients with Fecal Incontinence

To the Editor, Fecal incontinence is a common problem with a prevalence ranging from 0.7 to 24% depending on the population that is being studied [1]. The functional integrity of the internal and external anal sphincters requires normal functioning of the pelvic floor muscles to maintain continence [2]. Vitamin D deficiency is associated with muscle weakness and vitamin D plays an important role in muscle strength [3]. It is not known if vitamin D deficiency is associated with fecal incontinence. We evaluated serum vitamin D (25-hyroxy-cholecalciferol) levels of ten consecutive patients with fecal incontinence attending the gastroenterology clinic at a tertiary care center. Patients with infectious diarrhea and anorectal surgery were excluded. Patients with known cause of vitamin D deficiency including chronic kidney and liver diseases were also excluded from the study. Fecal incontinence was defined as recurrent uncontrolled passage of fecal material for at least 1 month. Normal vitamin D level was defined as 30 ng per milliliter or greater. Relative vitamin D insufficiency was defined as 20–29 ng per milliliter. Levels below 20 ng per liter were defined as vitamin D deficient [4, 5]. Ten patients were found to fulfill the inclusion criteria (eight males, two females). The median age was 56.7 years (range, 30–80). Mean body mass index was 31.9 (range, 19.8–38.3). All patients except one had loose stool. The average duration of fecal incontinence was 18.3 months (range, 1–240 months). The average frequency of fecal incontinence was 10.9 episodes per month (range, 2–30 episodes per month). All patients with fecal incontinence had hypovitaminosis D (60% had vitamin deficiency and 40% with relative vitamin D insufficiency). The mean vitamin D level in patients with fecal incontinence was 17 ng per milliliter (range 5.4–22.2 ng per milliliter). Historical data demonstrate that 36–57% of people have vitamin D deficiency or relative insufficiency [5]. In conclusion, in this small cohort study all patients with fecal incontinence had vitamin D deficiency or relative insufficiency. This is significantly higher than reported prevalence of vitamin deficiency or insufficiency in the general population. A prospective cross section study is warranted to determine if patients with fecal incontinence have a higher prevalence of vitamin D deficiency compared to a control group. Further research is required to determine whether hypovitaminosis D is a risk factor or a consequence of fecal incontinence.