Vitamin D Status in Ethnic and Cultural Minorities
Authors: Ganz Marc , Zlatopolsky Mendy , Karp Avrohom , Jacobs Menachem , Kadish Yonaton , Baitelman Moshe , Miller Daniel 
Published: May 2024

Abstract
Vitamin D deficiency can cause severe health conditions such as rickets and osteomalacia. Certain ethnic groups are more at risk for vitamin D deficiency due to modest dress and long indoor hours. Therefore, we suspected that cultures and communities such as Orthodox Jews and those who wear Hijabs would be one of the ethnic minorities at risk for Vitamin D deficiency since their lifestyle includes the risk factors mentioned. This review aims to examine the current literature on vitamin D deficiency in these populations to determine if this group is indeed at risk.

Methods
Articles were individually retrieved through June and July 2022 by search in PubMed and Google Scholar. Papers were searched for by the keywords "Vitamin D Deficiency," "Jewish," "Orthodox," "Dress," and or "Hijab" excluding articles not in English. When searching these keywords in PubMed and Google Scholar, 1 page of results was generated with seven articles. All seven articles were then analyzed for relevance to the discussion of Vitamin D status and the role of Orthodox Jewish culture. All three articles were found to be relevant and were used for analysis.

Results
The studies examined the relationship between the Orthodox Jewish lifestyle and Vitamin D status. Study one found lower vitamin D levels in post-partum orthodox Jewish Mothers. Study two found differences in vitamin D deficiency in children based on age. In addition, they found a high prevalence of vitamin D deficiency in ultra-orthodox and orthodox communities. However, they did not find a significant difference between ultra-orthodox and orthodox and secular patients. Finally, study three found that among young orthodox Jewish males, those with more indoor hours and restrictive dress were more vitamin D deficient. With regards to the 4 studies conducted on those who wear Niqabs or Hijabs (who likely have different cultural factors), two studies showed that women wearing a Niqab or Hijab had a higher odds of developing Vitamin D deficiency. However, another found no such association. One study did no analysis was directly regarding modest dress.

Discussion
There is some consistency between studies that Orthodox Jews and those who wear Hijabs are at a greater risk of Vitamin D deficiency. However, each study focused on a different subgroup of the population. It is unclear what factors within these subgroups contributed to their deficiency. Additionally, there was conflicting data regarding the use of modest dress in the form of wearing Hijabs or Niqabs. More research is needed to describe the nuances of Vitamin D deficiency in these communities.

Conclusion
this research highlights the risk of vitamin D deficiency among ethnic and cultural minority groups, specifically the Orthodox Jewish community and individuals who wear hijabs. Modest dress and cultural practices can limit sunlight exposure, increasing the likelihood of deficiency. It is crucial to raise awareness, provide education, and equip healthcare professionals to address this issue. Tailored interventions and collaborative efforts can help bridge the gap between cultural practices and health requirements, ensuring the well-being of these communities.