Prevalence of vitamin D insufficiency and clinical associations among veiled east African women in Washington State

Aims: Cultural and biological factors place immigrant women from equatorial Africa at increased risk of vitamin D insufficiency. This could in part explain the high prevalence of fatigue, musculoskeletal complaints, and depressive symptoms in this population. Methods: In a cross-sectional study of East African immigrant women in Washington State, 25-hydroxyvitamin D ( 25( OH) D) serum concentrations and multiple measures of physical and psychological symptoms were assessed. Mean serum 25( OH) D serum concentrations and chi-square were used to assess differences between groups. Multiple logistic regression was used to explore differences in the symptoms of subjects with varying degrees of vitamin D deficiency/ insufficiency. Results: Of the 75 women interviewed and who completed surveys, 25( OH) D serum samples were available in 71 subjects. All were found to have low 25( OH) D; 9 (12.3%) had <= 8 ng/mL, 29 (40.9%) had 8.1 - 15 ng/mL, and 33 (44.9%) had 15.1 - 30 ng/mL. After controlling for age, women with 25(OH) D < 15 ng/mL were 66% less likely to drink milk than women with 25(OH) D >= 15 ng/mL ( adjusted odds ratio [aOR] = 0.33, 95% confidence interval [CI] 0.11 - 0.99). Musculoskeletal complaints, depressive symptoms, and fatigue did not correlate with the severity of 25(OH) D insufficiency. Conclusions: Vitamin D insufficiency, as reflected by low 25(OH) D serum concentrations, was a universal finding in this group of women, suggesting the need for widespread education and intervention in this and other immigrant groups at northern latitudes.