Continuing Medical Education

Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days

R J Green, G Samy, M S Miqdady, M El-Hodhod, O O Akinyinka, G Saleh, J Haddad, S A Alsaedi, A Y Mersal, A Edris, M Salah


Exposure to sunlight, specifically ultraviolet B (UVB), is essential for cutaneous vitamin D synthesis. Despite significant daily sunlight availability
in Africa and the Middle East, persons living in these regions are frequently vitamin D insufficient or deficient. Vitamin D insufficiency
(25-hydroxyvitamin D (25(OH)D) between 15 and 20 ng/mL (37.5 - 50 nmol/L)) has been described in various population groups, ranging from 5%
to 80%. Risk factors include traditional dress and avoidance of sunlight exposure, and multiple dietary factors as a result of specific cultural beliefs.
Vitamin D resistance due to calcium deficiency mechanisms has been described in similar population groups, which may lead to hypovitaminosis D.
Should the new diseases related to hypovitaminosis D prove to be truly associated, Africa and the Middle East will become an epicentre
for many of these conditions. Urgent attention will need to be paid to cultural dress and dietary behaviours if hypovitaminosis D is to be
taken seriously. Should such factors not be correctable, new strategies for supplementation or food fortification will have to be devised.

Authors' affiliations

R J Green, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, South Africa

G Samy, Department of Child Health and Nutrition, Institute of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt

M S Miqdady, Division of Hepatology and Nutrition, Department of Pediatric Gastroenterology, Sheikh Khalifa Medical City, United Arab Emirates; Adjunct Staff, Cleveland Clinic, USA

M El-Hodhod, Department of Pediatric Gastroenterology and Endoscopy, Faculty of Medicine, Ain Shams University, Cairo, Egypt

O O Akinyinka, Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria

G Saleh, National Nutrition Institute, Cairo, Egypt

J Haddad, Department of Pediatrics, Faculty of Medicine, Balamand University, Beirut, Lebanon

S A Alsaedi, Department of Pediatrics in ICU Section, King Abdulaziz University, Jeddah, Saudi Arabia

A Y Mersal, Department of Pediatrics, King Faisal Specialist Hospital and RC, Jeddah, Saudi Arabia

A Edris, Department of Pediatrics and Neonatology, Faculty of Medicine, Cairo University, Cairo, Egypt

M Salah, Medical Affairs and R&D Department, Wyeth Nutrition, Nestlé (Middle East), United Arab Emirates

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Vitamin D deficiency

Cite this article

South African Medical Journal 2015;105(7):603-605. DOI:10.7196/SAMJnew.7785

Article History

Date submitted: 2015-09-22
Date published: 2015-09-22

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