Knowledge, attitude and practice regarding vitamin D deficiency among female students in Saudi Arabia: a qualitative exploration.

Background: Vitamin D deficiency is associated with numerous chronic diseases including cancer, heart disease and diabetes type 1 and 2. It is currently estimated that one billion people suffer from vitamin D deficiency worldwide. A major cause is lack of sun exposure, and this is evident even in countries at mid and low latitudes. Although a high prevalence has been found in Saudi Arabia, little is known to date about the reasons for this and, consequently about, reduction methodologies. The study’s aim was to investigate the knowledge, attitude and practice (KAP) towards vitamin D deficiency, sun exposure, supplementation and fortification in a sample of female Saudi Arabian students. Methods: A focus group and eight in depth one‐to‐one semi‐structured interviews were conducted and analysed using thematic analysis. Results: Participants were limited in their knowledge about vitamin D and vitamin D deficiency. They reported limited sun exposure due to intense heat, cultural reasons for covering the body, and an infrastructure that makes sun exposure difficult. Conclusion: Important barriers for the prevention of vitamin D deficiency in Saudi Arabia were highlighted. Recommendations for more research in specific areas including the prevalence of vitamin D deficiency and recommended daily allowances of supplementation are made. Governmental actions including increasing awareness of the importance of vitamin D and guidelines on how to obtain it are necessary. Creating areas where women, particularly those of lower socio‐economic status, can enjoy sun exposure as well as fortifying more foods would go some way towards tackling this problem