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Does modest dress among Arab-American women promote vitamin D deficiency?

Vitamin D is the vitamin du jour these days, with many doctors urging more sun exposure following years of campaigns advising us to cover up and use sunscreen to prevent skin cancer. Many of us, especially in cloudier areas, don’t get enough of the sunshine vitamin. The elderly and post-menopausal women are more at risk for deficiency, as are those who live in northern climes.

But today comes news that one group seems to be at particular risk, doctors report in the journal Endocrine Practice. Arab-American women who wore the hijab (a Koran-derived dress code that includes a scarf or veil over their hair and modest dress) and didn’t get enough vitamin D through their diet had half the levels of the vitamin of those who didn’t adhere as closely to the dress code. There was no difference in rates of health problems linked to vitamin D deficiency, such as bone or joint pain or breaks, or muscle weakness. The study involved 87 women in Dearborn, Mich., which has a large Arab population.

The more conservatively the women dressed, the lower their vitamin D; those who wore the hijab but ate vitamin D-rich foods such as milk or oily fish had higher levels, though not as high as the women who didn’t adhere to hijab. A measure of 30 nanograms per milliliter of blood is considered sufficient; the most conservatively dressed women in the study had levels as low as 4.5, but even those who didn’t wear the hijab and got some vitamin D in their diets had an average level of 8.5 — "and that's still low," says co-author Raymond Hobbs, a senior staff physician Henry Ford Hospital in Detroit.

"We're not trying to get anyone to take off their hijab," Hobbs tells ScientificAmerican.com, but "to do things to prevent problems that might arise" from the tradition. The vitamin was once thought to be necessary only to prevent rickets (soft bones) in childhood and osteoporosis later on, but now, vitamin D deficiency is associated with diabetes, cancer, Crohn's disease, multiple sclerosis, heart disease and infections.

The study isn’t the first to link style of dress to vitamin D deficiency, which affects an estimated 1 billion people around the world. A study published in Pediatrics in 2000 found that ultra-Orthodox Jewish children in Brooklyn who are covered up year-round in long sleeves and dresses were vitamin D deficient. Studies in sunny climes (including Saudi Arabia, the United Arab Emirates, Australia, Turkey, India, and Lebanon) where people may be covered up for religious or other reasons, also found that 30 percent to 50 percent of adults and kids were vitamin D-deficient, according to a 2007 review in the New England Journal of Medicine.

While heavy doses of vitamin D are available in supplements, the body manufacturers the most through sun exposure (admittedly in short supply in early spring in Michigan, when the study was done), Hobbs says. The vitamin naturally occurs in only a few foods, including mackerel, tuna, salmon and eggs, and it's added to milk in the U.S. To get the recommended 1,000 International Units of vitamin D a day (or no more than 2,000), you'd have to drink 20 glasses of milk daily, or eat 80 eggs, Hobbs says. Spend a few minutes in the sunshine, though, and your body will make 10,000 to 20,000 units, he says.

Image by Ranoush via Flickr

Tags: heart disease, vitamin D, diabetes, cancer, multiple sclerosis, sun, skin cancer, Crohn's disease, Arab, rickets
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  1. 1. Sharon McEachern 05:28 PM 2/16/09

    And next, consider the Saudi women who must change from wearing a veil with openings for their two eyes (not a whole of sunlight gets through those holes) to merely one-eyed veils because of a Saudi sheikh's fatwa. He apparently believes women are using eye makeup and flirting through those eye holes trying seduce men. You can read more at:

    http://www.ethicsoup.com/2008/10/yet-another-saudi-sheikhs-fatwa-women-must-wear-one-eye-veils.html

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  2. 2. dts 06:21 PM 2/16/09

    I would like to add that I personally felt very offended when I read that this religious dress was called "modest". By this the author implied that all other, non-muslim-religious dress is not modest. So, what do you call us, those who don't wear "modest" dresses? This is a kind of a writing that should not be tolerated in SciAm as well as anywhere else in civilized world. By trying to be overly PC you are offending much bigger part of your readership. Or is offending a majority is OK in your book? I strongly urge the author to change the language of this article and call prohibitive religious dress what it is, and not try to cover up the situation with euphemisms.

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  3. 3. Sid in reply to dts 06:46 PM 2/16/09

    You (dts) are being overly PC at getting offended at the use of the word "modest" in this article. Your reaction is kind of funny actually.

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  4. 4. msumurdock 07:27 PM 2/16/09

    Attn: dts
    According to Merriam-Webster "modest: (of a woman) dressing or behaving so as to avoid impropriety or indecency, esp. to avoid attracting sexual attention.

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  5. 5. scientific earthling 09:43 PM 2/16/09

    Instead of all the racial stuff I see in the comments can none of you see an opportunity here.
    Sell solariums (tanning beds) to these folk. It will be good for your economy too.
    Natural selection would have programmed women to seduce men as well as men to desire women. Oh yes every rule has exceptions.

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  6. 6. omarhaq in reply to dts 10:08 PM 2/16/09

    What's wrong with 'modest' clothing? That's actually the preferred adjective of choice of muslim women when describing the hijab or the veil.

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  7. 7. Darda 11:11 PM 2/16/09

    I am sure I read of the connection between clothing and Vit. D quite a long time ago. Imagine my surprise then when earlier this year I was diagnosed with a severe Vit. D deficiency. Even though I eat fish, eggs, and drink milk, I have become deficient simply by wearing a hat, long sleeves and longish skirts or trousers. Well, we are always advised to stay out of the sun, especially those of us who are blonde and fair skinned.

    Now, this is a rhetorical question - but WHY look for "racial" or "ethnic" reasoning in this research. Heavens, I am from Netherlands' stock and have lived a large part of my life in sunny South Australia. I am very happy we have available to us not only research in this area, but very adequate means to rectify the situation. Isn't our common humanity worthy of such care? What kind of clothes people wear is irrelevant - when I am in desert areas I wear a hat with a veil, and would happily cover up even more completely.

    Let us concentrate on the possible future effects of a lack of Vit. D and applaud researchers who give us clear information.

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  8. 8. Iahmad in reply to Darda 03:48 AM 2/17/09

    Thank you Darda for your objective stand point. Otherwise one can see the racist Islamophobes not even restraining their mental sickness on SciAm also. These Islam hating fascists have no other job but to ink their evil thoughts on any blogs related to Islam. Modesty is preached by each religion. Mary wore Hijab. Most of the religious jews christians and hindus dress modestly. However, these rscists have problem only with Muslim women wearing hijab. May God either guide them or destroy them for this world to live in peace and modesty.

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  9. 9. larkalt 09:22 AM 2/17/09

    You can get 10,000 IU of vitamin D in 15 minutes in the sun IF you are nude!
    If you're just getting sun on your face or arms or legs and you aren't wearing sunblock, you get 1,500-3000 IU.
    So the article is misleading on that.

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  10. 10. Alliebear in reply to Iahmad 12:55 PM 2/17/09

    I think, suprise, suprise the entire meaning of this article has been taken completely out of context and lost its meaning. This is simply a scientific study that points out the problem with vitamin D deficiency. I see no where in the article or in the responses where anyone attacks Islam or women who practice Islam. The only anger or accusations I see are from the one doing the accusing.

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  11. 11. scientific earthling in reply to Iahmad 07:29 PM 2/17/09

    Iahmad, your comments are worse than the racist comments I derided earlier. When you speak of Hindus, they for economic reasons let their children run stark naked till they are six.
    Islam picks up so much flack because it refuses to change its 1500 year old ethics, it denies women freedom, and does not ever compromise.
    Sorry to disappoint you but god will not destroy anyone from this world, simply because he/she does not exist.

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  12. 12. Brad Hawkins in reply to Alliebear 01:52 AM 2/22/09

    Alliebear, the subject of his comment was not the article itself, but the earlier comment by dts.
    Please read carefully before you jump to your conclusions.

    Reply | Report Abuse | Link to this
  13. 13. Brad Hawkins in reply to Alliebear 01:56 AM 2/22/09

    To Alliebear,
    lahmad's comment was referring not to the article itself, but to the comment made on the article by dts.
    Please read carefully before you jump to conclusions or you'll end up making a fool of yourself.

    Reply | Report Abuse | Link to this
  14. 14. Aisha171 02:21 PM 2/22/09

    I would like to know how Nuns fair with this? I suppose it would be the same, because of their clothing. I think the article is fine, but research could have included other women who cover up as well.

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  15. 15. hope 04:08 PM 1/2/10

    I am a woman wearing hijab. I think this article is purely objective and scientific. It talked about Muslims and jewish as well so it doesn't tend to urge anyone to take off hijab. Iarkalt the article is not misleading because it said that even unveiled women has low Vitamin D.

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  16. 16. hope 04:11 PM 1/2/10

    I am a muslim woman who wears hijab. But I dont think this article offended anyone and it's purely scientific and objective. It mentioned muslims and Jewish as well. I guess we should focus on the problem of Vitamin D deficiency rather than racial or religious stuff.

    Reply | Report Abuse | Link to this
  17. 17. reallyerica 12:58 PM 3/16/10

    If the body naturally makes 10,000-20,000 IU of vitamin D after "a few minutes in the sunshine", why is there a 2,000 IU limit on supplementation? If 20,000 daily is natural from the sun, then the amounts recommended in the article seem way too low for a woman who is completely covering herself whenever she goes outdoors.

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  18. 18. singram 07:26 AM 10/14/10

    I have read that the daily intake of vitamin D should be about 5000 IU's of vitamin D and that 10 - 20 minutes in the midday sun (when the UVB rays are their most direct) will allow your skin to create 5000 - 10000 IU's. This is somewhat more than the daily dose you have stating here but nevertheless is hugely less than it looks like anyone can eat in one day? However I believe supplements are very available and quite reasonably priced, if not cheap.
    See Dr Mercola's information about Vitamin D and the recommended does. http://www.mercola.com/article/vitamin-d-resources.htm

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  19. 19. singram 07:58 AM 10/14/10

    I have read that the daily intake of vitamin D should be about 5000 IU's of vitamin D and that 10 - 20 minutes in the midday sun (when the UVB rays are their most direct) will allow your skin to create 5000 - 10000 IU's. This is somewhat more than the daily dose you have stated here but nevertheless is hugely less than it looks like anyone can eat in one day? However I believe supplements are very available and quite reasonably priced, if not cheap.
    See Dr Mercola's information about Vitamin D and the recommended does. http://www.mercola.com/article/vitamin-d-resources.htm

    Reply | Report Abuse | Link to this
  20. 20. niftyfits 03:03 AM 11/12/10

    Hello
    We welcome all of you and want to acquaint with our new and unique collection Niftyfits.com is an online store offering various designer clothing and accessory range.
    It is a one stop shop to find all the leading designer brands for fashion clothing and accessories.
    We offer menswear collection by top-class international brands like <a href="http://www.niftyfits.com/t-hugo-boss-clothing.aspx">Hugo Boss Clothing</a> and Versace.
    Thank you.

    Reply | Report Abuse | Link to this
  21. 21. niftyfits 03:04 AM 11/12/10

    Niftyfits.com is an online store offering various designer clothing and accessory range.
    It is a one stop shop to find all the leading designer brands for fashion clothing and accessories.
    We offer menswear collection by top-class international brands like <a href="http://www.niftyfits.com/t-hugo-boss-clothing.aspx">Hugo Boss Clothing</a> and Versace.

    Reply | Report Abuse | Link to this
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