An adequate vitamin D status is of major importance for bone health. And is dependent on adequate vitamin D intake and sun exposure. Fish is the only natural important dietary sources of vitamin D. Milk, some milk products and cereals are supplemented to different degrees depending on the country, with a much higher degree of fortification in the USA. On the other hand, season, latitude and time of the day, clothing and sunscreen, pigmentation of the skin and ageing are the main factors contributing to the cutaneous production of vitamin.
Vitamin D inadequacy is a common worldwide, more particularly in Europe. In Middle-Eastern countries, Lebanon, Saudi Arabia, Kuwait and Jordan .several recent studies have shown a surprisingly high incidence of vitamin D deficiency in young individuals and schoolchildren.
Despite an adequate vitamin D intake being considered an essential component of osteoporosis management the prevalence of vitamin D inadequacy in osteoporotic women is very high; vitamin D inadequacy affects 64 % of osteoporotic women worldwide
In the paper Gannage-Yared and colleagues analysed vitamin D-inadequacy risk factors among the 251 Lebanese postmenopausal osteoporotic women (from both Muslim and Christian communities). Vitamin D inadequacy prevalence (25-hydroxyvitamin D (25(OH)D)
Gannage-Yared et al 2009 Prevalence and predictors of vitamin D inadequacy
amongst Lebanese osteoporotic women Brit J Nutrition vol 101 487-491

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