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Effect of different dress style on vitamin D level in healthy young Orthodox and ultra-Orthodox students in Israel

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Abstract

Summary

Ultra-orthodox Jewish lifestyle, which encourages modest dress and indoor scholarly activity, represents a risk factor for vitamin-D deficiency. Our study in healthy young males from higher education religious institutions located in the same geographical area showed frequent and severe vitamin D deficiency, strongly correlated with the degree of sun exposure. However, PTH level was usually normal.

Introduction

Ultra-orthodox Jewish lifestyle encourages modest dress and indoor scholarly activity. As such, it represents a risk factor for vitamin-D deficiency, a worldwide problem previously underestimated in sunny countries. Our aim was to characterize the vitamin-D status of religious Jewish males according to sun exposure and outdoor activity, and study the correlation between serum 25-hydroxyvitamin D (25(OH) D) and PTH level.

Methods

Seventy-four young adult males were recruited from three Jewish higher education institutions (Yeshiva) in Jerusalem. Yeshiva-A ultra-Orthodox students (aged 20.1 ± 0.6) wear traditional clothing, live in dormitories and stay mostly indoor. Yeshiva-B ultra-Orthodox students (aged 33.0 ± 4.2) dress similarly but have regular outdoor activities. Yeshiva-C religious students (aged 19 ± 2.0) participate in a mixed army/Yeshiva program. Weekly outdoor activity time and degree of sun exposure were estimated by questionnaire.

Results

25(OH)D was 8.9 ± 3.6, 10.2 ± 5.7 and 21.7 ± 10.4 ng/ml (mean ± SD) in Yeshiva A, B and C. 25(OH)D was correlated with degree of sun exposure (r = 0.54, p < 0.0001) and inversely correlated with PTH (r = −0.3, p = 0.01). Levels below 20 ng/ml were considered as vitamin D deficiency. PTH was normal in 87% of vitamin D-deficient subjects from Yeshiva-A and Yeshiva-C (mean age 20), compared to 52% of Yeshiva-B students (mean age 33). Bone mineral density studied in a random subset (n = 14) of vitamin D-deficient subjects showed Z-scores of −1.5 ± 1.0, −1.8 ± 0.8, −2.1 ± 0.4 in femoral neck, spine and radius.

Conclusions

Severe vitamin-D deficiency is extremely prevalent in ultra-Orthodox males. Despite rare secondary hyperparathyroidism, they represent an important previously unrecognized high-risk group for metabolic bone disease.

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References

  1. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281

    Article  PubMed  CAS  Google Scholar 

  2. Sedrani SH (1984) Low 25-hydroxyvitamin D and normal serum calcium concentrations in Saudi Arabia: Riyadh region. Ann Nutr Metab 28:181–185

    Article  PubMed  CAS  Google Scholar 

  3. Marwaha RK, Tandon N, Reddy D et al (2005) Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr 82:477–482

    PubMed  CAS  Google Scholar 

  4. El-Hajj Fuleihan G, Nabulsi M, Choucair M et al (2001) Hypovitaminosis D in healthy school children. Pediatrics 107:E53

    Article  PubMed  CAS  Google Scholar 

  5. Hochvald O, Harman-boehm I, Castel H (2004) Hypovitaminosis D among inpatients in a sunny country. Isr Med Assoc J 6(2):82–87

    Google Scholar 

  6. Valimaki VV, Alfthan H, Lehmuskallio E, Loyttyniemi E, Sahi T, Stenman UH, Suominen H, Valimaki MJ (2004) Vitamin D status as a determinant of peak bone mass in young Finnish men. J Clin Endocrinol Metab 89(1):76–80

    Article  PubMed  Google Scholar 

  7. Holick MF (2008) The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol Aspects Med 29(6):361–368

    Article  PubMed  CAS  Google Scholar 

  8. Weisman Y, Schen RJ, Eisenberg Z, Edelstein S, Harell A (1981) Inadequate status and impaired metabolism of vitamin D in the elderly. Isr J Med Sci 7:19–21

    Google Scholar 

  9. Goldray D, Mizrahi-Sasson E, Merdler C et al (1989) Vitamin D deficiency in elderly patients in a general hospital. J Am Geriatr Soc 37:589–592

    PubMed  CAS  Google Scholar 

  10. Weisman Y, Salama R, Harell A, Edelstein S (1978) Serum 24, 25dihydroxy vitamin D and 25-hydroxyvitamin D concentrations in femoral neck fractures. Br Med J 2:1196–1198

    Article  PubMed  CAS  Google Scholar 

  11. Biale Y, Shany S, Levi M, Shainkin-Kestenbaum R, Berlyne GM (1979) 25-hydroxycholecalciferol levels in Bedouin women in labor and in cord blood of their infants. Am J Clin Nutr 32:2380–2382

    PubMed  CAS  Google Scholar 

  12. Lowenthal MN, Shany S (1994) Osteomalacia among Bedouin women of the Negev. Isr J Med Sci 30:520–523

    PubMed  CAS  Google Scholar 

  13. Mukamel MN, Weisman Y, Somech R, Eisenberg Z, Landman J, Shapira I, Spirer Z, Jurgenson U (2001) Vitamin D deficiency and insufficiency in Orthodox and non-Orthodox Jewish mothers in Israel. Isr Med Assoc J 3(6):419–421

    PubMed  CAS  Google Scholar 

  14. Ginat-Israeli T, Dranitzki Z, Straus U (2003) Nutritional rickets in infants immigrating to Israel from Ethiopia. IMAJ 5(4):289–290

    Google Scholar 

  15. Taha W, Chin D, Silverberg AI, Lashiker L, Khateeb N, Anhalt H (2001) Reduced spinal bone mineral density in adolescents of an ultra-Orthodox Jewish community in Brooklyn. Pediatrics 107(5):E 79

    Article  CAS  Google Scholar 

  16. Brot C, Vestergaard P, Kolthoff N, Gram J, Hermann AP, Sorensen OH (2001) Vitamin D status and its adequacy in healthy Danish perimenopausal women: relationships to dietary intake, sun exposure and serum parathyroid hormone. Br J Nutr 86(Suppl 1):S97–S103

    Article  PubMed  CAS  Google Scholar 

  17. Sahota O, Mundey MK, San P, Godber IM, Lawson N, Hosking DJ (2004) The relationship between vitamin D and parathyroid hormone: calcium homeostasis, bone turnover, and bone mineral density in postmenopausal women with established osteoporosis. Bone 35:312–319

    Article  PubMed  CAS  Google Scholar 

  18. Vieth R, Ladak Y, Walfish PG (2003) Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. J Clin Endocrinol Metab 88:185–191

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We thank Rachel Meir and Hana Raver for their contribution to this work.

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Correspondence to A. Tsur.

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Tsur, A., Metzger, M. & Dresner-Pollak, R. Effect of different dress style on vitamin D level in healthy young Orthodox and ultra-Orthodox students in Israel. Osteoporos Int 22, 2895–2898 (2011). https://doi.org/10.1007/s00198-010-1492-y

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