Vitamin D Supplementation Among Women of Childbearing Age: Prevalence and Disparities
Gardner, Deborah Beth
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<bold>Background:</bold> Maternal vitamin D deficiency is associated with numerous adverse health conditions. However, most women of childbearing age are vitamin D deficient. 1 Although scientific and public awareness about vitamin D deficiency's role in health has increased in recent years, current data are not available to assess whether there have been concomitant increases of supplementation among women of childbearing age. <bold>Methods:</bold> We assessed prevalence and significant associations of vitamin D supplementation among childbearing-age women (16-49 years) in the most recently available National Health And Nutrition Examination Survey (NHANES) dataset (2007-2008). We examined prevalence of vitamin D supplementation in stratified demographic (age, race/ethnic), socioeconomic (education, income, food security, health insurance, years in U.S.) and health (BMI, waist circumference, exercise, diabetes, weight-loss attempts, parity/breastfeeding) subgroups to determine disparities in supplementation. Logistic regression models (both unadjusted and adjusted) were used to examine associations between Vitamin D supplementation and these variables. Sampling weights were applied to account for the complex survey design and ensure generalizability to women of childbearing age among the non-institutionalized population in the US. 2 Analyses were conducted using Stata versions 11 and 12 (College Station, TX). <bold>Results:</bold>Of 1749 women, 459 (33%) had taken supplements containing vitamin D during the past 30 days. We observed low supplementation prevalence (range 12%-27%) among teenagers, those with high body mass index (BMI), low socio-economic status (low-income, low education, ethnicity other than white, food insecurity, or no/government insurance), as well as parous women who had never breastfed, and women with no history of vigorous or moderate exercise. In the fully adjusted regression models, Mexican-American race/ethnic identity (OR: .53, 95% CI .33-.86), low food security (OR: .65, 95% CI .44-.95), no health insurance (OR .65, 95% CI .42-1.00), government/other health insurance (OR: .66, 95% CI .45-.96), and parity without breastfeeding (OR: .63, 95% CI .40-.99) were associated with lower likelihood of vitamin D supplement use compared with the reference groups. <bold>Conclusions:</bold> Disparities in vitamin D supplementation parallel and may exacerbate disparities in nutrition and health. Supplementation rates may reflect inequalities. Findings should influence public health practice and advocacy.
- Health services