{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:06:58Z","timestamp":1791662818147,"version":"4.3.4"},"reference-count":91,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UNICEF Lebanon Country Office","award":["03-17-00"],"award-info":[{"award-number":["03-17-00"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Vitamin D\u2014crucial for bone health, immune function, and hormone regulation\u2014is deficient worldwide, affecting around half the population, particularly women. The study aims to determine the prevalence and risk factors of vitamin D deficiency and hypovitaminosis D in non-pregnant women in Lebanon. Methods: A national cross-sectional survey sampled households across Lebanon, covering 2803 non-pregnant women aged 15 to 49. Demographic information and dietary habits were collected, and anthropometric measurements and serum analyses, including 25-hydroxyvitamin D (25(OH)D) concentrations, were conducted. Multivariable Poisson regressions were constructed to calculate the adjusted prevalence ratio (aPR) for vitamin D deficiency and hypovitaminosis D of variables. Results: The prevalence of vitamin D deficiency (&lt;30 nmol\/L) among non-pregnant women in Lebanon was 37.9%, while 69.2% had hypovitaminosis D (&lt;50 nmol\/L). Wearing a veil (hijab) was identified as the most significant risk factor for both vitamin D deficiency (aPR = 3.76) and hypovitaminosis D (aPR = 1.47). Additionally, olive skin and dark skin were both associated with an increased prevalence of vitamin D deficiency (olive skin: aPR = 1.14; dark skin: aPR = 1.28), while only dark skin color was associated with hypovitaminosis D (aPR = 1.10). In contrast, protective factors against vitamin D deficiency and hypovitaminosis D included daily sun exposure exceeding one hour (aPR = 0.83\u20130.91) and vitamin D supplementation (aPR = 0.30\u20130.55). Anemia, folate deficiency, and vitamin B12 deficiency were significantly associated with a higher prevalence of vitamin D deficiency, hypovitaminosis D, or both. BMI was not significantly associated with vitamin D deficiency; however, women with underweight (aPR = 1.13) and obesity (aPR = 1.12) exhibited a higher prevalence of hypovitaminosis D. Conclusions: Vitamin D deficiency and hypovitaminosis D affect a significant portion of non-pregnant women in Lebanon, with veiling (hijab wearing), limited sun exposure, and lack of supplementation as primary risk factors. Future work should focus on tailoring recommendations for vitamin D supplementation, sun exposure, and food fortification to effectively address the diverse risk factors in the population.<\/jats:p>","DOI":"10.3390\/nu17050804","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T08:28:31Z","timestamp":1740558511000},"page":"804","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Sunshine Paradox: Unraveling Risk Factors for Low Vitamin D Status Among Non-Pregnant Women in Lebanon"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2693-6603","authenticated-orcid":false,"given":"Carla","family":"El-Mallah","sequence":"first","affiliation":[{"name":"GroundWork, 7036 Fl\u00e4sch, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8459-6221","authenticated-orcid":false,"given":"Amirhossein","family":"Yarparvar","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Fund, Beirut 1100, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7867-9960","authenticated-orcid":false,"given":"Valeria","family":"Galetti","sequence":"additional","affiliation":[{"name":"GroundWork, 7036 Fl\u00e4sch, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7554-1296","authenticated-orcid":false,"given":"Omar","family":"Obeid","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Sciences, Faculty of Agricultural Sciences, American University of Beirut, Beirut 1107, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Boutros","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Fund, Beirut 1100, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Safadi","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Fund, Beirut 1100, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4648-054X","authenticated-orcid":false,"given":"Razan","family":"ZeinEddine","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Sciences, Faculty of Agricultural Sciences, American University of Beirut, Beirut 1107, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour El Hoda","family":"Ezzeddine","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Fund, Beirut 1100, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Kouzeiha","sequence":"additional","affiliation":[{"name":"Mercy-USA for Aid and Development, Tripoli 1300, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Kobayter","sequence":"additional","affiliation":[{"name":"Mercy-USA for Aid and Development, Tripoli 1300, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4733-0379","authenticated-orcid":false,"given":"James P.","family":"Wirth","sequence":"additional","affiliation":[{"name":"GroundWork, 7036 Fl\u00e4sch, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirella","family":"Abi Zeid Daou","sequence":"additional","affiliation":[{"name":"World Food Programme, Beirut 1552, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Asfahani","sequence":"additional","affiliation":[{"name":"World Bank, Beirut 8577, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1834-9388","authenticated-orcid":false,"given":"Nadeen","family":"Hilal","sequence":"additional","affiliation":[{"name":"Ministry of Public Health, Beirut 1107, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3091-9750","authenticated-orcid":false,"given":"Randa","family":"Hamadeh","sequence":"additional","affiliation":[{"name":"Ministry of Public Health, Beirut 1107, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firass","family":"Abiad","sequence":"additional","affiliation":[{"name":"Ministry of Public Health, Beirut 1107, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolai","family":"Petry","sequence":"additional","affiliation":[{"name":"GroundWork, 7036 Fl\u00e4sch, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S182","DOI":"10.1111\/j.1753-4887.2008.00104.x","article-title":"Vitamin D: A D-Lightful Health Perspective","volume":"66","author":"Holick","year":"2008","journal-title":"Nutr. 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