A study on the prevalence, behavioural patterns, and risk factors of vitamin D deficiency in the population of southern Saudi Arabia

Main Article Content

Yousef Zahrani
Md. Zeyaullah
Mohammad Suhail Khan
S Rehan Ahmad
Abdullah M. AlShahrani
Ausaf Ahmad
Ali Mohieldin
Syed Esam Mahmood
Fatima Riaz
Nouf Abdullah Alraee
Khursheed Muzammil
Bayapa Reddy Narapureddy
Md Faruque Ahmad


Awareness, Vitamin D deficiency, Behavioral patterns, Risk factor, Saudi Arabia


Introduction: This deficiency is one of the most common nutritional deficiencies now considered a public health problem in developed and underdeveloped countries. Aim: This study aims to identify the general people in the Aseer region of southern Saudi Arabia's Awareness of vitamin D deficiency, their behaviour patterns, and their knowledge of risk factors. Methodology: This cross-sectional community study was conducted in two cities of the Aseer Region, Abha and Khamis Mushayt. By applying a Simple random sampling technique, four Malls were selected, and two malls were in each city. The sample size was calculated by taking the prevalence from the previous study and putting on the formula 4Pq/D2. Eight hundred eighty respondents participated in the study. Multiple logistic regression and chi-square tests were used to analyse the significance and relationships between the variables. Results: Most participants knew about vitamin D insufficiency and its associated risk factors. Approximately 87.95% of respondents knew the need for vitamin D for health, and 86.82% had heard of vitamin D deficiency. 94.09% of the participants were Saudi citizens, and 52.09% were female. The majority (84.77%) said that the optimal period for vitamin D exposure in the sun is in the morning. In comparison, 54.32% said that exposed body areas, including the hands, arms, face, and legs, are necessary. Nearly 52% of respondents said their doctor had told them they were vitamin D deficient. Those who knew they had a shortage exhibited a favorable attitude towards taking vitamin D and adhered to their diet. Conclusion: By promoting appropriate and sane awareness among the populace, vitamin D deficiency can be avoided. Vitamin D understanding has grown over the past ten years in Saudi Arabia. To lessen vitamin D insufficiency in the Aseer region, however, the population's behaviour needs to be reinforced.

Abstract 117 | PDF Downloads 76


1. Sinha A K, Tirtha N S, Ujwal R. Status of Vitamin D Deficiency among the Patients in a Tertiary Care Hospital. Med J East Nepa 2022;1:7-12. doi:10.3126/mjen.v1i1.45854.
2. Holick M F. The Vitamin D Deficiency Pandemic: A Forgotten Hormone Important for Health.” Public Health Rev 2010:32(1); 267–83. doi:10.1007/bf03391602.
3. Holick M F. Vitamin D: Extraskeletal Health.” Rheumatic Disease Clinics of North America 2012 ;38(1):141–60. doi:10.1016/j.rdc.2012.03.013.
4. Lujain HA, Rinad ZA, Murooj E, et al. “Awareness of Vitamin D Deficiency among the General Population in Jeddah, Saudi Arabia.” J.Nutr. Metab. 2019; 1:1–7. doi:10.1155/2019/4138187.
5. Alshamsan F M, Bassam SB, Abbas. Knowledge, Awareness, Attitudes and Sources of Vitamin D Deficiency and Sufficiency in Saudi Children. Saudi Med. J.2016;37(5):579–83. doi:10.15537/smj.2016.5.14951.
6. Alemu E, Robert V. Awareness of Vitamin D Deficiency among At-Risk Patients. BMC Res. Notes 2012; 5(1): 7-10. doi:10.1186/1756-0500-5-17.
7. Holick M F, Tai C Chen. Vitamin D Deficiency: A Worldwide Problem with Health Consequences. AJCN; 87(4):21-38. doi:10.1093/ajcn/87.4.1080s.
8. Darling A L, David J B, Kourosh R A, Susan A L. New.Vitamin D Supplement Use and Associated Demographic, Dietary and Lifestyle Factors in 8024 South Asians Aged 40–69 Years: Analysis of the UK Biobank Cohort.” Public Health Nutr. 2018; 21(14): 2678–88. doi:10.1017/s1368980018001404.
9. Aterrado S, Ono G, Kanehira-Mar S, Meier J, Swislocki A. Evaluating Vitamin D Repletion Regimens and Effects in Veteran Patients. Ann Pharmacother. 2015 Sep;49(9):969-77. doi: 10.1177/1060028015591034.
10. Sinha A, Tim D, Cheetham, Simon H P. Prevention and Treatment of Vitamin D Deficiency. Calcif Tissue Int. 2012; 92(2): 207–15. doi:10.1007/s00223-012-9663-9.
11. Alemu E, Robert V. Awareness of Vitamin D Deficiency among At-Risk Patients. BMC Res. Notes 2012;5(1). doi:10.1186/1756-0500-5-17.
12. DeLuca, Hector F. Evolution of Our Understanding of Vitamin D. Nutr. Rev.2008; 66. doi:10.1111/j.1753-4887.2008.00105.x.
13. Hoogendijk, Witte J, Paul L, et al. Depression Is Associated with Decreased 25-Hydroxyvitamin D and Increased Parathyroid Hormone Levels in Older Adults.” Arch.Gen. Psychiatry 2008; 65(5): 508. doi:10.1001/archpsyc.65.5.508.
14. Cannell, John Jacob. Autism and Vitamin D. Med. Hypo.2008; 70(4) : 750–59. doi:10.1016/j.mehy.2007.08.016.
15. Boucher, B. J. Inadequate Vitamin D Status: Does It Contribute to the Disorders Comprising Syndrome ‘X’ The BJN; 79(4): 315–27. doi:10.1079/bjn19980055.
16. Ahmed I, Atiq M, Iqbal J, Khurshid M, Whittaker P. Vitamin D deficiency rickets in breast-fed infants presenting with hypocalcaemic seizures. Acta Paediatr. 1995 Aug;84(8):941-2. doi: 10.1111/j.1651-2227.1995.tb13798.x.
17. Camadoo, Laxmi, Rebecca T, Fernando I. Maternal Vitamin D Deficiency Associated with Neonatal Hypocalcaemic Convulsions. Nutr. J.2007; 6(1). doi:10.1186/1475-2891-6-23.
18. Egan KM, Signorello LB, Munro HM, Hargreaves MK, Hollis BW, Blot WJ. Vitamin D insufficiency among African-Americans in the southeastern United States: implications for cancer disparities (United States). Cancer Causes Control. 2008 Jun;19(5):527-35. doi: 10.1007/s10552-008-9115-z.
19. Weng, Francis L, Justine S, Mary B L, Virginia A S, Babette S Z. Risk Factors for Low Serum 25-Hydroxyvitamin D Concentrations in Otherwise Healthy Children and Adolescents. AJCN 2007; 86(1) :150–58. doi:10.1093/ajcn/86.1.150.
20. Serhan E, Newton P, Ali HA, Walford S, Singh B M. Prevalence of hypovitaminosis D in Indo-Asian patients attending a rheumatology clinic. Bone 1999, 25(5):609-611.
21. Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proceed 2003, 78(12):1463-70.
22. Rashid A, Mohammed T, Stephens WP, Warrington S, Berry JL, Mawer EB. Vitamin D state of Asians living in Pakistan. Br Med J 1983, 286(6360):182-184
23. Holick MF (2007) Vitamin D deficLenc. N Engl J Med 357: 266-281. 3.
24. Andıran N, Çelik N, Akça H, Doğan G. Vitamin D deficLenc. in children and adolescents. J Clin Res Pediatr Endocrinol 2012;4: 25-29.
25. Sedrani SH, Al-Arabi K, Abanmy A, Elidrissy A. Vitamin D status of Saudis: III. Prevalence of inadequate plasma 25 hydroxyvitamin D concentrations. Saudi Med. 1992; J (13): 214-219.
26. Avagyan, D.; Neupane, S.P.; Gundersen, T.E.; Madar, A.A. Vitamin D status in pre‐ school children in rural Nepal. Public Health Nutr. 2016, 19, 470–476.
27. Wang S, Shen G, Jiang S, Xu H, Li M, Wang Z, Zhang S, Yu Y. Nutrient Status of Vitamin D among Chinese Children. Nutrients. 2017 Mar 23;9(4):319. doi:10.3390/nu9040319.
28. Al-Agha AE, Alorabi SH, NoorSaeed SM, Shalabi NM. Awareness of Vitamin D and its Deficiency in Jeddah Population, Saudi Arabia. J Comm Pub Health Nurs 2016;2: 120.
29. Al-Daghri, N. M.Vitamin D in Saudi Arabia: prevalence, distribution and disease associations. The Journal of Steroid Biochemistry and Molecular Biology 2018; 175:102-107.
30. Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM. Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int. 2011 Feb;22(2):463-75. doi: 10.1007/s00198-010-1249-7.
31. Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A. Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos. 2014; 9:190. doi: 10.1007/s11657-014-0190-3.
32. Abdelsalam M, Nagy E, Abdalbary M, et al. Prevalence and Associated Factors of Vitamin D Deficiency in High Altitude Region in Saudi Arabia: Three-Year Retrospective Study. Int Gen Med. 2023 Jul 12;16:2961-2970. doi:10.2147/IJGM.S418811.
33. Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81. doi: 10.1056/NEJMra070553. PMID: 17634462.
34. Chiu KC, Chu A, Go VLW, Saad MF. Hypovitaminosis D is associated with insulin resistance and β cell dysfunction. Am J Clin Nutr 2004; 79:820-5.
35. Al-Daghri NM. Vitamin D in Saudi Arabia: Prevalence, distribution and disease associations. J Steroid Biochem Mol Biol. 2018 Jan; 175:102-107. doi:10.1016/j.jsbmb.2016.12.017.
36. Kayastha, Pawana & Chaudhary, Robin & Basnet, Subash. Prevalence of Vitamin D Deficiency and its Awareness and Knowledge Among Parents. Journal of Nepal Paediatric Society.2021; 41: 226-232. doi:10.3126/jnps. v41i2.30657.
37. Al-Faris NA. High Prevalence of Vitamin D Deficiency among Pregnant Saudi Women Nutrients. 2016 Feb 4;8(2):77. doi: 10.3390/nu8020077.
38. Benedik E. Sources of vitamin D for humans. Int J Vitam Nutr Res. 2022 Mar;92(2):118-125. doi: 10.1024/0300-9831/a000733.
39. Karthik S, Parkar B, Balasubramanian K, “Awareness of Vitamin D and its deficiency among Burqa Clad women in Navi Mumbai, India,” Int. J. of Sci. Res 2017;6 (7): 20-25.