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Addressing vitamin D deficiency among veiled pregnant women in Australia.

Article Excerpt
To the Editor: It is noteworthy that Sir Edward Mellamby discovered rickets while working on dogs raised exclusively indoors (without sun exposure), and that he mistakenly attributed the disease to a dietary (vitamin) deficiency rather than to a sunlight-activated steroid. (1) We now know that the dictum 'light equals vitamin D' is much closer to the truth than Mellamby's dietary experiments of 1919-1920 suggested. In Australia, as in most Western nations, the approach to the management of vitamin D among some high-risk groups, such as elderly people in residential care, dark-skinned people, and people with skin conditions where avoidance of sunlight is advised, is fairly straightforward. However, addressing vitamin D deficiency among veiled pregnant women is an issue coloured by politics, religion and culture.

Although the role of vitamin D in preventing osteomalacia and rickets are well known, it is the new findings suggesting its role in maintaining optimal muscle function, and in preventing diseases such as multiple sclerosis, diabetes and hypertension that have renewed interest in its functions as a governor of the body's health. (2,3) About 90% of vitamin D is generated from the effect of sunlight on skin. Studies in Australia and most Western countries demonstrate that veiled pregnant women are at high risk of vitamin D deficiency because of their garments' impairment of absorption of ultraviolet B light from the sun. Children born to such mothers are also at greater risk of rickets...

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