Positive impact on vitamin D related lifestyle of medical advice in pregnant Somali-born women and new mothers: a mixed method study in Swedish primary care.

Affiliation

Kalliokoski P(1), Widarsson M(2), Rodhe N(3), Löfvander M(3)(4).
Author information:
(1)Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden. [Email]
(2)School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
(3)Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden.
(4)Centre for Clinical Research, Uppsala University, Västerås, Sweden.

Abstract

BACKGROUND: A previous study showed that pregnant women/new mothers especially Somali-born and some Swedish-born had extremely low vitamin D levels and poor physical performance. Our study aimed to examine vitamin D related lifestyle, attitudes and behaviour before and after brief information about vitamin D, with special long-term focus on Somali-born women. METHODS: A cohort of 91 pregnant women/new mothers having serum hydroxyvitamin D (S-25-OHD) ≤ 50 nmol/L (n = 51 Somali-born with one third < 10 nmol/L of S-25-OHD) in primary health care in Sweden was targeted for intervention. Brief individual oral and visual information on vitamin D was given by doctors at baseline and after four and ten months. Questionnaires with ordinal scales on vitamin D related lifestyle of food, clothing, and outdoor activities were distributed on all occasions. Focus-group interviews with 15 women from the target-group were performed after two years. A Somali interpreter was available. RESULTS: Veiled clothing, indoor living, and a low intake of milk, cheese, and fatty fish were common in the target group. Consumption pattern had increased significantly among the Somali-born women at the four-month follow-up but declined to non-significant levels at the ten-month follow-up. The focus-group interviews showed improved understanding of vitamin D deficiency, symptoms and attitudes, but varying applied behaviours related to sun exposure. Sun exposure for the children and increased fish consumption was the most evident positive results. CONCLUSIONS: Vitamin D related lifestyle, attitudes and behaviour improved in a Somali-born group of pregnant women/new mothers with severe vitamin D deficiency. The preventive measures suggested in our study may have impact on public health in relation to bone and muscle strength and immunity especially in vitamin D deficiency risk groups. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02922803 . Date of registration: 28 September 2016.