The Assessment of Vitamin D Dietary Intake and its Associations with Attitude among Pregnant Mothers in Malaysia

Abstract

Vitamin D had many benefits to human body, deficiency of it can cause many adverse effect to health including gestational diabetes mellitus, preeclampsia, preterm birth and small for gestational age infants [1]. High intake from food sources consists of vitamin D and supplementation brought positive effect to pregnant mothers, especially when begin a proper intake during early pregnancy. Sunlight exposure, food sources and supplement intake were the three main sources of vitamin D [2]. Despite of abundance sunlight available throughout the year, vitamin D deficiency (VDD) was prevalent in Malaysia particularly among pregnant mothers. Pregnant women were at risk of VDD due to their increased vitamin D needs, poor dietary vitamin D intake, and lack of sun exposure [3]. Pregnancy was a phase of life when VDD was widespread hence making it as a major concern for pregnant and lactating women [4]. Thus, this cross-sectional study aimed to determine the association between intake of vitamin D and attitude level among pregnant mothers in Malaysia.   Out of 233 participants from sample size, a total of 200 participants logged onto the online questionnaire, completed the form given with full information on sociodemographic characteristics. 200 of the participants were incorporated into the final data analysis giving the response rate 86%. Self-administered questionnaires were used to collect sociodemographic data. Applying the Food Frequency Questionnaire (FFQ) [2], vitamin D intakes were calculated, and attitude was assessed using customised, validated questionnaires [5,6]. The findings indicated that in Malaysia, the majority of expectant mothers (80.5%) did not meet the RNI 2017 standard. Majority of participants were Malay (93%) followed by Chinese (4%), Indian (2%) and others (1%) and most of them obtained university/college education (80.5%) with moderate monthly income (RM 4,851 - RM 10,970) participated in this study. The mean dietary intake of vitamin D among pregnant mothers was 10.41 + 4.52 µg/day but did not achieve the RNI recommendation of (15µg/day). The major contributor to vitamin D intake was from fish and fish products followed by milk and milk products, eggs, others, beverages, cereal and cereal products and meat and meat products.  The findings showed there was a moderate attitude level towards vitamin D among pregnant mothers in Malaysia with the average score of 74%. Of all the participants, 23.5% revealed a good attitude level towards vitamin D. The results clearly demonstrate there was no association between dietary intake of vitamin D with attitude level (p = 0.241).   This present study found that majority of Malaysian pregnant women has not achieved their vitamin D requirement during pregnancy. According to the study, there was no association between intake of vitamin D and pregnant mothers’ attitudes, but future research should concentrate on methods to avoid VDD in expectant mothers.