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Those at high-risk of being Vitamin D deficient will require about 1.5X more vitamin D to restore their levels
Those who are at risk due to being obese need about 2X more vitamin D to restore their levels
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Low vitamin D in prisoners around the world - meta-analysis June 2023
Prevalence of Vitamin-D deficiency and insufficiency among prisoners across the globe: A systematic review and meta-analysis
J Forensic Leg Med . 2023 Jun 16;97:102549. doi: 10.1016/j.jflm.2023.102549 PDF is behind a paywall
Snehasish Tripathy 1, Sapna Negi 2, Dilip Kumar 3, Muhammad Aaqib Shamim 4
Background and aim: Inadequate nutrition is linked to a wide range of detrimental chronic and infectious illness outcomes among the prison populations. However, there is a paucity of thorough analysis of the prevalence of vitamin D deficiency among jail inmates. Consequently, in order to bridge this gap, we conducted a thorough research to ascertain the incidence of vitamin D deficiency among prisoners worldwide.
Method: Six computer-based literature indexes were thoroughly searched for topic focused publications. The I2 test was used to determine heterogeneity among the studies. The overall effect was assessed using a random-effects model with a 95% confidence interval. We used metafor package in R version 4.2.1 for the analysis of data.
Result: Out of 612 studies, 4 studies were included for analysis. The estimated pooled prevalence of vitamin D deficiency was 55% among prisoners. On the other hand, 29.41% were found to have insufficient vitamin D levels.
Conclusion: Despite the scant available research, vitamin D deficiency is prevalent among prisoners. Regular vitamin D status evaluations using reliable health tests, dietary inspection and supplementation are crucial.
Introduction
Vitamin D refers to a class of seco-steroid substances, specifically vitamin D2 and D3, which are prohormones having skeletal and extra-skeletal activities. Vitamin D2 and D3 are both hydroxylated in the liver and kidneys to produce the biologically active form of vitamin D called calcitriol, which keeps plasma calcium and phosphate concentrations stable and thus supports bone health.1 Humans can get vitamin D from solar exposure, dietary sources, and supplementation. Oily fish and cod liver oil naturally contain vitamin D3 and is also synthesized endogenously in the skin. UVB radiation is necessary for the synthesis of vitamin D3 in the skin. The Institute of Medicine currently recommends for 600 IU/d of vitamin D as healthy intake of Vitamin D in person below 70 years of age group.2
Poor nutrition and lack of exposure to sunlight results in vitamin D deficiency in the body.3. According to a narrative review based on data from national representative surveys, the prevalence of Vitamin D deficiency (serum 25(OH)D levels below 25/30 nmol/L) ranges from 5% to 18% depending on the FAO world region, with relatively low levels in South America, Oceania, and North America, but moderate levels in Europe, Asia, and Africa, and vitamin D insufficiency (<50 nmol/L) with a prevalence of 24%–49% (4. The aged, obese, nursing home residents, and hospitalised patients have the highest rates of vitamin D deficiency.5 Besides that, people who are confined or restricted to places like prisons, where they are subjected to an insufficient pattern of nutritional intake and are secluded from the outside world with little to no sunlight, may have at high risk of vitamin D deficiency. Recent research on prisoners in the United Kingdom and the United States reveal low vitamin D and other nutrient intake. In a cross-sectional study, Nwosu et al.(2022) discovered that 33% of prisoners had vitamin D deficiency and 34% had vitamin D insufficiency.1 Similarly, Jacob et al. (2015) revealed that 90% of prisoners housed at the facility for more than a year showed deficiencies.2
Vitamin D deficiency among adults have been linked to bone fragility resulting in osteoporosis, and bone fractures.5 However, recent research has linked a lack of vitamin D to a multitude of illnesses and conditions, including depression, diabetes, cancer, cardiovascular disease, communicable diseases, immune dysfunction, metabolic dysregulation, and disorders of mental health.6 Consequently, there is a chance that long-term vitamin D deficiency will result in serious consequences.
The United Nations has recognized adequate nutrition as a fundamental human right; nevertheless, compliance with suggested nutritional recommendations by prison systems is not regulated by federal laws and is primarily dependent on the discretion of prison or prison officials. Accordingly, this inadequate nutrition is linked to a wide range of detrimental chronic and infectious illness outcomes that are prevalent in prison populations, including overweight, obesity, and communicable diseases like tuberculosis and mental health problems like depression.2,7, 8, 9
Although numerous research has pointed out the issue of inadequate nutritional intake among prisoners,10,11 there is a paucity of thorough analysis of the prevalence of vitamin D deficiency among jail inmates. Consequently, in order to bridge this gap, we conducted a thorough research with the objective to ascertain the incidence of vitamin D deficiency among prisoners worldwide. This will serve as the preliminary stage in laying the foundation for interventions to address with the detrimental outcomes of vitamin D deficiency-related bone illnesses on prisoners, their families, and the government healthcare expenditures.1
Section snippets
Search strategies and selection criteria
Six computer-based literature indexes (PubMed, Scopus, Epistemonikos, Embase, ScienceDirect, and ProQuest) were thoroughly searched for publications related to vitamin D deficiency and prisoners. Initially, 201 articles from PubMed, 119 articles from Scopus, 85 articles from Epistemonikos, 83 articles from Embase, 63 articles from science direct, 61 articles from ProQuest were discovered.
The search terms applied were (“Vitamin D″ OR “Vitamin D deficiency” OR “vitamin D insufficiency” OR …
Study selection and quality appraisal
From the electronic search across six databases, we retrieved a total of 612 studies. After the removal of duplicates, 540 studies were left, of which, 523 were excluded as these were found irrelevant based on title and abstract reading. Hence, as shown in Fig. 1, 17 studies were identified potentially relevant. On full text reading, only 04 met the inclusion criteria of the study. Among these, two were conducted in USA whereas one was conducted in Italy and 1 in Australia. All the studies were …
Synthesis of results and publication bias
As shown in Fig. 2, the included studies collectively gave information about vitamin D status among 881prisoners. On performing meta-analysis of the eligible studies, amongst the 881 included patients, 404 and 280 patients had Vitamin D deficiency and insufficiency respectively. Heterogeneity is high for both the analyses (deficiency: I2 = 96.8%, p < 0.001; insufficiency: I2 = 85.9%, p < 0.001). Because of this high heterogeneity, we used a random-effects model for the meta-analysis.17 The…
Risk factors associated with vitamin D deficiency and insufficiency among inmates
Vitamin D insufficiency and age, gender, season, or length of incarceration have not been found to be significantly correlated by studies.1, 2, 3,15 However, inmates' BMI and vitamin D levels were shown to be significantly correlated, according to 3.3 According to Doyle et al., smoking and dark skin color are significantly associated with Vitamin D deficiency.15 Similar to this,11 reported that dark skinned inmates were four times more likely than white inmates to be vitamin D deficient. Only…
Discussion
Prisoners' vitamin D inadequacy and insufficiency continue to be a neglected growing concern. To the finest of our knowledge, our meta-analysis is the first to assess the prevalence of Vitamin D insufficiency and deficiency among prisoners by utilising data from studies that were published across the globe. According to this review, the estimated pooled prevalence of vitamin D deficiency was 55%. On the other hand, 29.41% were found to have insufficient vitamin D levels. Published cut-offs are…
Conclusion
Despite the scant available research, vitamin D deficiency is prevalent among prisoners. Those who have been imprisoned in high security, are dark skinned and obese are at a much higher danger. To ensure that prisoners are healthy, regular vitamin D status evaluations using reliable health tests, dietary inspection and supplementation are crucial. Moreover, more extensive primary research, particularly in developing countries, must be conducted to acquire a clear picture of this phenomenon….
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Presse medicale (Paris, France (2013)
J. O'Grady et al. Tuberculosis in prisons in sub-Saharan Africa – the need for improved health services, surveillance and control
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The vitamin D status of prison inmates PLoS One (2014)
M.D. Leo et al. Vitamin D status of inmates: the experience of penitentiaries prisons in the province of Salerno in Southern Italy
La Clinica Terapeutica (2022)
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Geriatric 8 and Vulnerable Elders Survey-13 predict length of hospital stay and postoperative complications in Japanese patients undergoing urological surgery
Journal of Geriatric Oncology, Volume 14, Issue 6, 2023, Article 101558
Quality of death certification based on the documented underlying cause of death: A retrospective study
Journal of Forensic and Legal Medicine, Volume 97, 2023, Article 102547
Driving under the influence of zopiclone: Elimination between two consecutive blood samples
Forensic Science International, Volume 349, 2023, Article 111764
Physical violence against women in southern Tunisia: Epidemiology and risk factors
Journal of Forensic and Legal Medicine, Volume 94, 2023, Article 102482
A rare case of sudden death due to endomyocardial fibrosis in Italy: A differential diagnosis with other causes of restrictive cardiomyopathy
Journal of Forensic and Legal Medicine, Volume 93, 2023, Article 102462
Iconographie d’une persistance de la vascularisation fœtale
Journal Français d'Ophtalmologie, Volume 46, Issue 6, 2023, pp. 693-695
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