Gaps in Vitamin D Intake and Status in Moroccan Women.

BACKGROUND

Vitamin D is essential for women's health, yet deficiency is widespread among Moroccan premenopausal women.

OBJECTIVES

This study examined vitamin D intake, dietary sources, determinants, and predictors of serum 25-hydroxyvitamin D [25(OH)D3] in 355 women aged 18-49 years in Meknes, Morocco.

METHODS

Intake and sun exposure were assessed with validated questionnaires, and serum 25(OH)D3 was measured by chemiluminescence immunoassay. Multivariable and penalized regression (LASSO) were applied to deseasonalized values.

RESULTS

Median intake was 2.89 µg/day, and fewer than 20% of participants met the 5 µg/day recommendation. Fish (48%), dairy (24.39%), and meat (9.40%) were the main sources. Intake varied by age and residence: women aged 18-25 had significantly lower intakes (p = 0.027), while rural women consumed less than urban women (2.73 vs. 3.18 µg/day, p = 0.014), with inadequacy in 67.70% vs. 32.30% (p = 0.018). In adjusted regression, quartiles Q2-Q4 (1.76-16.60 µg/day) were associated with ~+3 ng/mL higher serum 25(OH)D compared to Q1 (0.20-1.76 µg/day, p < 0.05). Increments plateaued beyond Q2, and deficiency (<20 ng/mL) persisted in all quartiles (>59%, including 64% in Q4), reflecting limited sun exposure and high adiposity. Sun exposure was a strong positive predictor (β = 0.35, p < 0.001), while BMI was inversely associated (β = -0.37, p < 0.001). In LASSO, only sun exposure remained, explaining ~3% of variance.

CONCLUSION

In this population, improving sun exposure (≥20 min/day) should be prioritized, alongside increasing vitamin D intake through richer food sources and fortification, while also addressing obesity, with a focus on women at risk of deficiency.