Vitamin D Deficiency among Female Students in the University of Kerbala and its Association with Body Mass Index and Other Factors

Khaleel, Hazim Mohammed; Abutiheen, Ali Abdulridha Kadhim; Matloob, Ahmed Hashim; Madhi, Zaid Saad

doi:10.33091/amj.2025.160056.2238

	Vitamin D Deficiency among Female Students in the University of Kerbala and its Association with Body Mass Index and Other Factors
Al- Anbar Medical Journal
Volume 22, Issue 1, January 2026, Pages 3-9 PDF (471.19 K)
Document Type: Original articles
DOI: 10.33091/amj.2025.160056.2238
Authors
Hazim Mohammed Khaleel¹; Ali Abdulridha Kadhim Abutiheen¹; Ahmed Hashim Matloob¹; Zaid Saad Madhi^* ²
¹Department of Family and Community Medicine, College of Medicine, University of Kerbala, Kerbala, Iraq.
²Department of Radiology Techniques, College of Medical and Health Techniques, Al-Mustaqbal University, Babylon, Hilla, 51001, Iraq.
Abstract
Background: Vitamin D deficiency is common among Iraqi females and has been linked to various diseases. Although associated with lower weight, there is no evidence that it causes weight gain in young females. Objective: To determine the prevalence of Vitamin D deficiency among female university students and explore its association with obesity, sun exposure, dietary habits, and physical activity. Materials and Methods: A cross-sectional study was conducted at the University of Kerbala (April–May 2024) on 200 female students. Serum 25-hydroxyvitamin D was measured, and data were analysed using nonparametric tests and Spearman’s correlation, with significance set at a P-value < 0.05. Results: Serum 25-hydroxyvitamin D levels indicated sufficiency in 22.5% and deficiency in 64% of participants. The mean body mass index (BMI) of students was 25.38 ± 5.60 kg/m². Vitamin D levels differed significantly across colleges (P-value = 0.036), with engineering students showing the lowest values. No association was found between vitamin D and BMI (P-value > 0.05). However, sun exposure and a healthy diet were positively correlated with higher vitamin D levels (P-value < 0.05). Conclusion: Over 60% of participants had vitamin D deficiency. No significant correlation was found between high BMI and vitamin D status. Implementing educational programs promoting outdoor activity, sun exposure, and a vitamin D-rich diet is recommended.
Keywords
Vitamin D deficiency; Obesity; Female university students; Body mass index

References
[1] M. A. Majid, W. N. Hassan, and A. F. Ridha, "Prevalence of 25-Hydroxyvitamin D (Vitamin D) Deficiency in a Group of Infertile Women from Baghdad City," (in eng), Biochem Res Int, vol. 2023, p. 6597730, 2023, doi: 10.1155/2023/6597730. [2] N. F. Maroufi et al., "Association between vitamin D deficiency and prevalence of metabolic syndrome in female population: a systematic review," (in eng), Horm Mol Biol Clin Investig, vol. 41, no. 4, Sep 28 2020, doi: 10.1515/hmbci-2020-0033. [3] M. M. Shady, M. M. Youssef, M. A. Shehata, E. M. El-Din, and H. A. ElMalt, "Association of Serum 25-Hydroxyvitamin D with Life Style and Dietary Factors in Egyptian Prepubescent Children," (in eng), Open Access Maced J Med Sci, vol. 3, no. 1, pp. 80-4, Mar 15 2015, doi: 10.3889/oamjms.2015.006. [4] A. R. Martineau et al., "Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data," (in eng), Bmj, vol. 356, p. i6583, Feb 15 2017, doi: 10.1136/bmj.i6583. [5] M. Abdelsalam et al., "Prevalence and Associated Factors of Vitamin D Deficiency in High Altitude Region in Saudi Arabia: Three-Year Retrospective Study," (in eng), Int J Gen Med, vol. 16, pp. 2961-2970, 2023, doi: 10.2147/ijgm.S418811. [6] R. Vieth, "Vitamin D supplementation: cholecalciferol, calcifediol, and calcitriol," (in eng), Eur J Clin Nutr, vol. 74, no. 11, pp. 1493-1497, Nov 2020, doi: 10.1038/s41430-020-0697-1. [7] L. Vranić, I. Mikolašević, and S. Milić, "Vitamin D Deficiency: Consequence or Cause of Obesity?," (in eng), Medicina (Kaunas), vol. 55, no. 9, Aug 28 2019, doi: 10.3390/medicina55090541. [8] A. Svedlund, C. Pettersson, B. Tubic, P. Magnusson, and D. Swolin-Eide, "Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy," (in eng), Eur J Nutr, vol. 56, no. 6, pp. 2061-2067, Sep 2017, doi: 10.1007/s00394-016-1244-7. [9] M. Pereira-Santos, P. R. Costa, A. M. Assis, C. A. Santos, and D. B. Santos, "Obesity and vitamin D deficiency: a systematic review and meta-analysis," (in eng), Obes Rev, vol. 16, no. 4, pp. 341-9, Apr 2015, doi: 10.1111/obr.12239. [10] C. M. Lenders et al., "Relation of body fat indexes to vitamin D status and deficiency among obese adolescents," (in eng), Am J Clin Nutr, vol. 90, no. 3, pp. 459-67, Sep 2009, doi: 10.3945/ajcn.2008.27275. [11] P. Boonchaya-anant, M. F. Holick, and C. M. Apovian, "Serum 25-hydroxyvitamin D levels and metabolic health status in extremely obese individuals," (in eng), Obesity (Silver Spring), vol. 22, no. 12, pp. 2539-43, Dec 2014, doi: 10.1002/oby.20877. [12] M. Sosa Henríquez and M. J. Gómez de Tejada Romero, "Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency," (in eng), Nutrients, vol. 12, no. 6, May 31 2020, doi: 10.3390/nu12061617. [13] G. J. Salih and S. Abdul Sahib, "Prevalence and Associated Risk Factors of Vitamin D Deficiency Among Female Adolescents in Sulaimaniyah, Iraq: A Community-Based Cross-Sectional Study," Journal of Contemporary Medical Sciences, vol. 10, no. 5, 10/26 2024, doi: 10.22317/jcms.v10i5.1633. [14] R. V. S. Amelia Lorensia, Irene Andriana Inu, Comparison of vitamin D status and physical activity related to obesity among tertiary education students. Issue: 4, 2022, pp. 108-118. [15] L. F. de Oliveira, L. G. de Azevedo, J. da Mota Santana, L. P. C. de Sales, and M. Pereira-Santos, "Obesity and overweight decreases the effect of vitamin D supplementation in adults: systematic review and meta-analysis of randomized controlled trials," (in eng), Rev Endocr Metab Disord, vol. 21, no. 1, pp. 67-76, Mar 2020, doi: 10.1007/s11154-019-09527-7. [16] N. R. Parva et al., "Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012)," (in eng), Cureus, vol. 10, no. 6, p. e2741, Jun 5 2018, doi: 10.7759/cureus.2741. [17] D. Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin and Calcium, "The National Academies Collection: Reports funded by National Institutes of Health," in Dietary Reference Intakes for Calcium and Vitamin D, A. C. Ross, C. L. Taylor, A. L. Yaktine, and H. B. Del Valle Eds. Washington (DC): National Academies Press (US) Copyright © 2011, National Academy of Sciences., 2011. [18] "Obesity: preventing and managing the global epidemic. Report of a WHO consultation," (in eng), World Health Organ Tech Rep Ser, vol. 894, pp. i-xii, 1-253, 2000. [19] R. Likert, "A Technique for the Measurement of Attitudes," Archives of Psychology, vol. 140, 1932. [20] A. F. Alharbi et al., "Association Between Serum Vitamin D Levels and Body Mass Index Status: A Cross-Sectional Study at King Khalid Hospital, Jeddah, Saudi Arabia, From 2019 to 2020," (in eng), Cureus, vol. 15, no. 10, p. e46927, Oct 2023, doi: 10.7759/cureus.46927. [21] F. Naja et al., "The Bahraini food based dietary guidelines: a holistic perspective to health and wellbeing," (in eng), Front Public Health, vol. 11, p. 1182075, 2023, doi: 10.3389/fpubh.2023.1182075. [22] J. Robinson, "Likert Scale," in Encyclopedia of Quality of Life and Well-Being Research, A. C. Michalos Ed. Dordrecht: Springer Netherlands, 2014, pp. 3620-3621. [23] A. A. R. Al Zarooni, N. Nagelkerke, F. I. Al Marzouqi, and S. H. Al Darmaki, "Risk factors for vitamin D deficiency in Abu Dhabi Emirati population," (in eng), PLoS One, vol. 17, no. 2, p. e0264064, 2022, doi: 10.1371/journal.pone.0264064. [24] Z. Md Isa, N. R. Mohd Nordin, M. H. Mahmud, and S. Hashim, "An Update on Vitamin D Deficiency Status in Malaysia," (in eng), Nutrients, vol. 14, no. 3, Jan 27 2022, doi: 10.3390/nu14030567. [25] A. Oommen and I. H. Al-Zahrani, "Association of obesity with vitamin D deficiency and the clinical implications," International Journal of Research in Medical Sciences, vol. 3, no. 11, pp. 3262-3265, 01/16 2017, doi: 10.18203/2320-6012.ijrms20151173. [26] A. Elwafa, A. Hawad, and S. Mrami, "The Prevalence of Vitamin D Deficiency among Students of Faculty of Engineering and Technical Sciences in Brack Al-Shatti," Wadi Alshatti University Journal of Pure and Applied Sciences, vol. 2, no. 1, pp. 84-89, 03/11 2025, doi: 10.63318/. [27] S. A. Quraishi and C. A. Camargo, Jr., "Vitamin D in acute stress and critical illness," Current Opinion in Clinical Nutrition & Metabolic Care, vol. 15, no. 6, 2012. [Online]. Available: https://journals.lww.com/co-clinicalnutrition/fulltext/2012/11000/vitamin_d_in_acute_stress_and_critical_illness.16.aspx. [28] Q. E. Harmon et al., "Vitamin D and Reproductive Hormones Across the Menstrual Cycle," (in eng), Hum Reprod, vol. 35, no. 2, pp. 413-423, Feb 29 2020, doi: 10.1093/humrep/dez283. [29] Y. Zhang, S. Lin, J. Li, X. Song, G. Chen, and L. Pei, "Interaction of Passive Smoking and Diet Habits on Vitamin D Deficiency among Women of Reproductive Age in Rural Central China," (in eng), Nutrients, vol. 15, no. 1, Dec 27 2022, doi: 10.3390/nu15010126. [30] V. Hirani et al., "Vitamin D status among older community dwelling men living in a sunny country and associations with lifestyle factors: the Concord Health and Ageing in Men Project, Sydney, Australia," (in eng), J Nutr Health Aging, vol. 17, no. 7, pp. 587-93, Jul 2013, doi: 10.1007/s12603-013-0013-z.
Statistics Article View: 635 PDF Download: 400