Assessment of vitamin D levels, awareness among Lebanese pharmacy students, and impact of pharmacist counseling

Community pharmacy is the key to improving vitamin D levels

Introduction

Vitamin D is an essential micronutrient that participates in the body's fundamental physiological processes. The pharmacist should involve the patient in his medication adherence, leading to a change in the patient's attitude towards his medication and towards his health problem, in order to achieve the pharmacological objective set.

Methods

Quasi-experimental multicenter study design with non-probabilistic convenience sampling. A pharmacist-led intervention in health education was carried out, divided in two groups, face-to-face interview and on-line survey, and the results were evaluated 3 months later to observe if there was any change in the patient's health status or in their vitamin D levels.

Results

The study was conducted in four pharmacies through face-to-face interviews (n = 49 patients) and online surveys (n = 23). Pharmaceutical intervention improved habits of exercise (0.81 ± 1.44 days/week face-to-face interviews vs -0.09 ± 2.35 days/week online surveys (p = 0.048)). In face-to-face interviews, consumption of vitamin D-rich foods was increased (0.55 unit of tuna/week; p = 0.035 and 0.56 unit of avocado/week; p = 0.001) and was improved correct intake of vitamin D supplements (32.5% baseline to 69.8% at 3 months). The increase in 25-hydroxyvitamin D levels (11.5 ng/mL after 3 months (p = 0.021)) was correlated to salmon consumption (0.951; p = 0.013) and the improvement of quality of life was correlated to avocado consumption (1; p < 0.001).

Conclusion

There are habits that improve vitamin D production such as increased physical activity, the correct use of vitamin D supplements and the consumption of foods with high vitamin D levels. The role of the pharmacist is crucial, involving the patient in the treatment making aware of the benefits for his/her health status of increasing vitamin D levels.

Vitamin D Deficiency Is Common in Ghana despite Abundance of Sunlight: A Multicentre Comparative Cross-Sectional Study

BACKGROUND

Vitamin D is a steroid hormone important for the normal functioning of the body. It is produced through skin exposure to sunlight and from the diet. Although Ghana is located in the tropics where sunlight is abundant, factors like culture, diet, skin pigmentation, variation in the ozone layer, and geographical area influence the optimization of vitamin D concentration. It is imperative to evaluate the interplay between sunshine exposure, proinflammatory cytokines, and mediators of vitamin D metabolism and their relationship to vitamin D status in three geographical sections among apparent healthy Ghanaians.

METHODS AND RESULTS

In a cross-sectional study, a total of five hundred (500) healthy blood donors from three geographical areas in Ghana were enrolled. Their age ranged from 17 to 55 years with a mean age of 27.97 ± 8.87 years. The overall prevalence rate of vitamin D deficiency was 43.6% (218/500), with 41.2% (91/221), 45.3% (63/139), and 45.7% (64/140) of vitamin D deficiency being recorded in participants from the Northern Sector (NS), Middle Belt (MB), and Southern Sector (SS), respectively. However, there were no significant differences in the proportions of vitamin D deficiency across various geographical sectors. The median 25-hydroxyvitamin D serum levels were compared among geographical areas (NS, MB, and SS) and there were no significant differences (P=0.275) after adjusting for confounding factors. 25-Hydroxyvitamin D correlated positively with corrected ionized calcium (rs = 0.622, P ≤ 0.001) and phosphorus (rs = 0.299, P ≤ 0.001) and negatively correlated with SBP (rs = -0.092, P=0.039), vitamin D binding protein (VDBP) (rs = -0.421, P ≤ 0.001), intact parathyroid hormone (iPTH) (rs = -0.0568, rs ≤ 0.001), IFN-gamma (rs = -0.684, P ≤ 0.001), and TNF-alpha (rs = -0.600, P ≤ 0.001). After adjusting for possible confounders, not having knowledge about vitamin D foods, taking fewer vitamin D foods, and higher levels of IF-γ and IL-10 were associated with a higher risk of having vitamin D deficiency.

CONCLUSION

The prevalence of 25-hydroxyvitamin D deficiency is high among the general adult population in Ghana despite the abundance of sunlight. Increasing knowledge on vitamin D diet coupled with a daily intake of vitamin D dietary supplements is likely to reduce the risk of developing 25-hydroxyvitamin D deficiency.

The sunshine under our skin: public knowledge and practices about vitamin D deficiency in Al Ain, United Arab Emirates

This cross-sectional study among members of public showed that people generally had good knowledge and awareness about vitamin D. However, inconsistencies between awareness and attitudes were observed. Our findings reinforce the need of educating people to improve attitude and practices toward vitamin D consumption.

INTRODUCTION

Owing to its hot and dry climate, United Arab Emirates (UAE) is one of the top ranked vitamin D deficient countries. However, little is known about people's awareness surrounding this topic.

METHODS

A descriptive cross-sectional survey to assess people's knowledge, awareness, and attitude toward vitamin D deficiency was conducted in Al Ain city of UAE. A 25-item validated self-administered questionnaire was used for data collection. Differences among demographic groups were analyzed using chi-square test, and simple binary logistic regressions were used to investigate the association between vitamin D awareness and other significant risk factors.

RESULTS

More than 90% of the total 346 participants showed awareness toward vitamin D and its deficiency. Doctors were reported as the most common source of information. More than one-third of the participants claimed to have vitamin D deficiency with significantly more females than males. More than 70% of the sample considered sunlight as the best source of vitamin D and avoiding going out in sun as the major risk for vitamin D deficiency. Nearly half (43%) of the participants did not consume milk and only 24% claimed to be using vitamin D supplements. Females were found to be applying sunscreen and consuming vitamin supplements significantly more than their male counterparts. Participants aged 24-35 years, having bachelor degree and those who were tested for vitamin D, were found to score better for awareness questions.

CONCLUSIONS

Our findings demonstrate a mismatch between knowledge and awareness, and attitude implying the need of educating people to improve their attitude toward consuming vitamin D rich food and supplements.

The Prevalence of Dysphonia and Dysphagia in Patients with Vitamin D Deficiency

OBJECTIVE

To investigate the prevalence of phonatory and swallowing symptoms in patients with hypovitaminosis D.

METHODS/DESIGN

All patients presenting to the endocrinology clinic and investigated for vitamin D deficiency between January 2018 and April 2018 were asked to participate in this study. Demographic data included age, gender, allergy, and history of smoking. Patients filled Voice handicap Index (VHI-10) and Eating Assessment Tool (EAT-10).

RESULTS

A total of 136 consecutive subjects presenting to the endocrinology clinic for vitamin D testing were included: 60 with hypovitaminosis D and 76 with no hypovitaminosis D. The mean vitamin D level in the study group and controls was 13.25 ng/mL and 31.91 ng/mL, respectively. There was no significant difference in the mean score of VHI-10, nor in the mean score of EAT-10 in patients with hypovitaminosis D versus those with no hypovitaminosis D (P value >0.05).

CONCLUSION

There was no significant difference in the prevalence of phonatory and dysphagia symptoms using VHI-10 and EAT-10 questionnaires between subjects with hypovitaminosis D and those with normal serum vitamin D levels.