Socio-Demographic and Knowledge-Related Determinants of Vitamin D Supplementation in the Context of the COVID-19 Pandemic: Assessment of an Educational Intervention

  1. Katja Žmitek
  2. Maša Hribar
  3. Živa Lavriša
  4. Hristo Hristov
  5. Anita Kušar
  6. Igor Pravst

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Abstract

Vitamin D is a pro-hormone, essential for musculo-skeletal health, normal immune system, and numerous other body functions. Vitamin D deficiency is considered as a risk factor in many conditions, and there is growing evidence of its potential role in the severity of COVID-19 outcomes. However, an alarmingly high prevalence of vitamin D deficiency is reported in many regions, and vitamin D supplementation is commonly recommended, particularly during wintertime. To reduce the risk for vitamin D deficiency in the Slovenian population during the COVID-19 pandemic, we conducted mass media intervention with an educational campaign. The objective of this study was to investigate vitamin D supplementation practices in Slovenia before and during the COVID-19 pandemic, and to determine the effects of the educational intervention on supplementation practices. Two data collections were conducted using an online panel with quota sampling for age, sex, and geographical location. A pre-intervention ( N = 602, April 2020) and post-intervention ( N = 606, December 2020) sampling were done during the first and second COVID-19 lockdown, respectively. We also focused on the identification of different factors connected to vitamin D supplementation, with a particular emphasis on vitamin D-related knowledge. Study results showed significant increase in vitamin D supplementation in the population. Penetration of the supplementation increased from 33% in April to 56% in December 2020. The median daily vitamin D intake in supplement users was 25 μg, with about 95% of supplement users taking safe vitamin D levels below 100 μg/daily. Vitamin D-related knowledge (particularly about dietary sources of vitamin D, the health-related impact of vitamin D, and the prevalence of deficiency) was identified as a key independent predictor of vitamin D supplementation. Based on the study findings, we prepared recommendations to support the development of effective awareness campaigns for increasing supplementation of vitamin D.

Article activity feed

  1. Version published to 10.3389/fnut.2021.648450
  2. Version published to 10.1101/2021.04.21.21255553v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.04.21.21255553: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data analysis: All statistical analyses were done using STATA version 15.1
    STATA
    suggested: (Stata, RRID:SCR_012763)
    (StataCorp LLC, Coledge Station, TX, USA).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    While the use of an online panel could be considered as a study limitation, we should mention that considering pandemic-related restrictions, the use of an online study was the only option in practice. Both data collections were done during national lockdowns when all schools and universities were closed, non-essential workplaces in the public sector were closed and the private sector was recommended to close or restrict the number of people working; personal movement was restricted to within one’s municipality and operation of the public transport was limited. While food stores were open, non-essential stores were mostly closed. There was governmental advice in place to stay at home and to limit contact with others, while gatherings in public places were limited. We should note that, for some people, these circumstances might have limited the access of participants to vitamin D supplements during the COVID-19 pandemic. The quota sampling approach enabled a fair balance between the genders, age groups, and urban and rural areas. However, the approach used is also subject to limitations. The requirements for computer/smartphone use and internet access denied the inclusion of participants of the lowest socio-economic status. On the other hand, Slovenia has a very good internet infrastructure, and most households use computers. According to data from the Slovenian Statistical Office, more than 80% of the Slovenian population (16-74 years) is using internet (STAT, 2019). Also, ho...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  4. Version published to 10.1101/2021.04.21.21255553v1 on medRxiv