Immigrants with darker skin often need vitamin D (clinical practice guidelines)
Assessment of the quality and content of clinical practice guidelines for vitamin D and for immigrants using the AGREE II instrument: global systematic review - Oct 2024
BMJ Open. 2024 Oct 10;14(10):e080233. doi: 10.1136/bmjopen-2023-080233.
Said Yousef 1 2, Lamia Hayawi 3, Alomgir Hossain 4 5, Nazmun Nahar 5, Doug Manuel 6, Ian Colman 7, Emmanuel Papadimitropoulos 8 9, MoezAlIslam E Faris 10, Leenah Abdelrazeq 11, George A Wells 7 12
Background: Worldwide, more immigrants experience vitamin D (vitD) deficiency than non-immigrants. Recommendations in current clinical practice guidelines (CPGs) concerning vitD are inadequate to address vitD deficiency among immigrants, and there are concerns regarding the quality of guidance in these CPGs.
Objectives: This study aimed to identify and evaluate the quality of published CPGs addressing vitD and immigrants' health using the Appraisal of Guidelines for Research and Evaluation-II (AGREE II) tool and clarify the recommendations pertaining to vitD and immigrant populations in these CPGs.
Methods: We performed a systematic search to identify the most recent CPGs across various databases (Ovid MEDLINE ALL, Embase and Turning Research Into Practice), guideline repositories and grey literature. Two reviewers independently conducted study selection and data abstraction and evaluated the quality of the included guidelines using the AGREE II tool.
Results: We identified 25 relevant CPGs; 21 focused on vitD and 4 covered immigrants' health. Around one-quarter of the included CPGs were high quality (≥60% in at least four of the six domains, including 'rigour of development'). The highest mean scores among the six AGREE II domains were for 'clarity of presentation' and 'scope and purpose'. About 4.8% (1/21) of the CPGs on vitD had immigrant-related recommendations. VitD recommendations were emphasised in one out of the four immigrant health CPGs (25%). CPGs covering immigrants' health and vitD were inadequately systematically appraised. Moreover, recommendations regarding vitD were insufficient to address the growing epidemic of vitD deficiency among immigrant populations.
Conclusion: The insufficient recommendations for vitD fail to address the rising vitD deficiency among immigrants, highlighting a critical gap in healthcare provisions. Urgent national and international efforts are needed to develop comprehensive CPGs, bridging research, policy and practice disparities. Future guidelines must prioritise routine vitD screening, supplementation protocols for vulnerable immigrant groups, and culturally appropriate interventions to improve health outcomes for immigrants globally.
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14+ VitaminDWiki pages have IMMIGRANT in the title
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VitaminDWiki – Overview Dark Skin and Vitamin D contains
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VitaminDWiki – Blacks die more often than whites of many diseases (they have less vitamin D) – 2012 contains the following summary__
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Low vitamin D in dark-skinned immigrants is mainly due to clothing habits and low UVR exposure: a Danish observational study - Oct. 2021 https://doi.org/10.1007/s43630-021-00115-w
