Research by Zayed University and Shaikh Khalifa Medical City hospital shows emirati university students are vitamin D deficient and depressed due to avoiding the sun.
A vision of sun-deprived individuals isn’t something you’d associate with the UAE, which experiences year-round sunshine.
However, research by Zayed University (ZU) and Shaikh Khalifa Medical City (SKMC) Hospital indicates that a large segment of the population is avoiding the sun — especially in the summer — to their detriment.
After conducting a study with almost 200 students at ZU, researchers found more than a quarter of the students were severely vitamin D deficient. Vitamin D levels, shown in the blood, for those students who participated in the summer were significantly lower than those in the winter.
Though the results were conducted with a sample group that was all female, student and Emirati, the findings are representative of the UAE population as about 50 per cent is under the age of 25, principal investigator and ZU Biochemist and Microbiologist Dr Fatme Al Anouti said.
The next step is a Dh200,000 larger scale study, funded by the Emirates Foundation, that looks at vitamin D deficiency among the general population of Abu Dhabi but with a focus on Emiratis, she said.
Also part of the study is Dr Justin Thomas at ZU’s Department of Natural Science and Public Health who explored the relationship between vitamin D deficiency and depression among the female university students at ZU.
He found that the summer students in the study also showed the most depression symptoms.
Over the years more attention has focused on vitamin D’s role in mental health problems, particularly schizophrenia and mood disorders such as major depressive and seasonal affective disorder. When it comes to vitamin D deficiency and mood disorders, studies have shown there is a higher incidence among women.
Dr Thomas said several studies have described the prevalence of vitamin D deficiency in the Gulf Arab populations and focused on the health consequences. However “no work to date has explored the psychological consequences of vitamin D deficiency or the issue of seasonal variations in deficiency and symptom severity”.
Dr Al Anouti was told of the problem when she spoke with doctors at SKMC Hospital who noticed that patients were severely deficient in vitamin D when lab tests were run. “It’s really prevalent but no one has documented this public health problem because people think this is the country of the sun. They think it’s normal for people who live in Canada to have vitamin D deficiency.”
Emiratis are particularly at risk because traditional dress does not allow the body to be exposed, Dr Al Anouti said. Complexion is also a problem as it takes longer for darker skinned people to absorb UVB rays when exposed to the sun. UVB rays from the sun convert cholesterol in skin to vitamin D.
Dr Thomas said there was a misconception that people could get their vitamin D dose while behind windows or in the car. “You need a fair amount of exposure… people can go weeks and even months in a sun rich country without substantial sun on the skin.”
He added that factors such as high levels of obesity, relatively dark skin pigmentation and the presence of dust in the atmosphere play a role in reducing the skin’s ability to synthesise vitamin D. Cultural issues such as the desire to be light skinned is also a factor in sun avoidance. Dr Thomas said some of the female students want to be light skinned while others go to tanning salons and have a modern approach.
Majority do not seek treatment
University students are not free from depression but the majority of them do not seek treatment for a number of reasons, University of Wollongong in Dubai students counsellor Talien Huisman said.
American University of Sharjah’s director of health services Dr Lubna A. Yousuf acknowledges the link between vitamin D deficiency and depression but says the most common reason for depression is homesickness, adjusting to university life and dealing with the pressures of examinations and studies.
Saleema Al Harbi, a student at Dubai Women’s College, says weather is the main reason that students avoid the sun. “I’ve heard about this from people and newspapers and I think it’s a problem if people are depressed like this.”
Although Saleema admits that she avoids the sun because she doesn’t want to be darker and it is traditional. However, not all her friends share this view and regularly visit tanning salons. Munira Mohammad, also a DWC student, says Emirati women are not avoiding the sun and it’s not because of traditional clothing either. “We do our best to take the sunlight, especially in the morning and we sit outside and open the windows.”
Doctors recommend about 10-15 minutes of direct sun exposure between 10am and 3pm every day is needed to synthesise vitamin D.
In darker skinned individuals vitamin D is produced more slowly and longer sun exposure is needed.
Obese and older people also synthesise vitamin D more slowly and require more sunlight.
Apart from sun exposure, foods such as egg, certain fish and liver will provide your vitamin D requirements. Supplements help but sunlight is best.
Depression is associated with heart disease, hypertension, diabetes, rheumatoid arthritis, cancer and low bone mineral density, all illnesses thought to be linked to vitamin D deficiency.
Urbanisation, working indoors, living in tall buildings, driving tinted cars, clothing all body parts, applying sun blocking creams on face all contribute to vitamin D deficiency.
Symptoms and signs for vitamin D deficiency include muscle pain, weak bones/fractures, low energy and fatigue, lowered immunity, symptoms of depression and mood swings, and sleep irregularities.