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Published in: BMC Public Health 1/2006

Open Access 01-12-2006 | Research article

The impact of clothing style on bone mineral density among post menopausal women in Morocco: a case-control study

Authors: Fadoua Allali, Siham El Aichaoui, Bouchra Saoud, Houda Maaroufi, Redouane Abouqal, Najia Hajjaj-Hassouni

Published in: BMC Public Health | Issue 1/2006

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Abstract

Background

The clothing style is an important factor that influences vitamin D production and thus bone mineral density. We performed a case-control study in order to evaluate the effect of veil wearing (concealing clothing) on bone mineral density in Moroccan post menopausal women.

Methods

The cases were osteoporotic women whose disease was assessed by bone mineral density measurement. Each patient was matched with a non osteoporotic woman for age, and body mass index. All our patients were without secondary causes or medications that might affect bone density. The veil was defined as a concealing clothing which covered most of the body including the arms, the legs and the head. This definition is this of the usual Moroccan traditional clothing style.

Results

178 post menopausal osteoporotic patients and 178 controls were studied. The mean age of the cases and the controls was 63.2 years (SD 7) and the mean body mass index was 32.1 (SD 8). The results of crude Odds Ratios analyses indicated that wearing a veil was associated with a high risk of osteoporosis: OR 2.29 (95% CI, 1.38–3.82). Multiparity or a history of familial peripheral osteoporotic fractures had also a significant effect on increasing the osteoporosis risk (ORs: 1.87 (95% CI, 1.05–3.49) and 2.01 (95% CI, 1.20–3.38)). After a multiple regression analysis, wearing the veil and a history of familial osteoporotic fractures remained the both independent factors that increased the osteoporosis risk (ORs: 2.20 (95% CI, 1.22–3.9) and 2.19 (95% CI, 1.12–4.29) respectively).

Conclusion

our study suggested that in Moroccan post menopausal women, wearing a traditional concealing clothing covering arms, legs and head increased the risk of osteoporosis. Further studies are required to evaluate the clinical impact of the above findings and to clarify the status of vitamin D among veiled women in Morocco.
Literature
1.
go back to reference Kanis JA: Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002, 359: 1929-36. 10.1016/S0140-6736(02)08761-5.CrossRefPubMed Kanis JA: Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002, 359: 1929-36. 10.1016/S0140-6736(02)08761-5.CrossRefPubMed
2.
go back to reference Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jimenez F: Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res. 2001, 16: 1408-15. 10.1359/jbmr.2001.16.8.1408.CrossRefPubMed Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jimenez F: Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res. 2001, 16: 1408-15. 10.1359/jbmr.2001.16.8.1408.CrossRefPubMed
3.
go back to reference Meyer HE, Falch JA, Sogaard AJ, Haug E: Vitamin D deficiency and secondary hyperparathyroidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway, The Oslo Health Study. Bone. 2004, 35: 412-17. 10.1016/j.bone.2004.04.003.CrossRefPubMed Meyer HE, Falch JA, Sogaard AJ, Haug E: Vitamin D deficiency and secondary hyperparathyroidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway, The Oslo Health Study. Bone. 2004, 35: 412-17. 10.1016/j.bone.2004.04.003.CrossRefPubMed
4.
go back to reference Grant WB, Holick MF: Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005, 10: 94-111.PubMed Grant WB, Holick MF: Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005, 10: 94-111.PubMed
5.
go back to reference Brustad M, Alsaker E, Engelsen O, Aksnes L, Lund E: Vitamin D status of middle-aged women at 65–71 degrees N in relation to dietary intake and exposure to ultraviolet radiation. Public Health Nutr. 2004, 7: 327-35. 10.1079/PHN2003536.PubMed Brustad M, Alsaker E, Engelsen O, Aksnes L, Lund E: Vitamin D status of middle-aged women at 65–71 degrees N in relation to dietary intake and exposure to ultraviolet radiation. Public Health Nutr. 2004, 7: 327-35. 10.1079/PHN2003536.PubMed
6.
go back to reference Bettica P, Bevilacqua M, Vago T, Norbiato G: High prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient clinic in northern Italy for initial screening. Osteoporos Int. 1999, 9: 226-9. 10.1007/s001980050141.CrossRefPubMed Bettica P, Bevilacqua M, Vago T, Norbiato G: High prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient clinic in northern Italy for initial screening. Osteoporos Int. 1999, 9: 226-9. 10.1007/s001980050141.CrossRefPubMed
7.
go back to reference Vecino-Vecino C, Gratton M, Kremer R, Rodriguez-Manas L, Duque G: Seasonal Variance in Serum Levels of Vitamin D Determines a Compensatory Response by Parathyroid Hormone: Study in an Ambulatory Elderly Population in Quebec. Gerontology. 2006, 52: 33-39. 10.1159/000089823.CrossRefPubMed Vecino-Vecino C, Gratton M, Kremer R, Rodriguez-Manas L, Duque G: Seasonal Variance in Serum Levels of Vitamin D Determines a Compensatory Response by Parathyroid Hormone: Study in an Ambulatory Elderly Population in Quebec. Gerontology. 2006, 52: 33-39. 10.1159/000089823.CrossRefPubMed
8.
go back to reference Bhattoa HP, Bettembuk P, Ganacharya S, Balogh A: Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. Osteoporos Int. 2004, 15: 447-51. 10.1007/s00198-003-1566-1.CrossRefPubMed Bhattoa HP, Bettembuk P, Ganacharya S, Balogh A: Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. Osteoporos Int. 2004, 15: 447-51. 10.1007/s00198-003-1566-1.CrossRefPubMed
9.
go back to reference Guzel R, Kozanoglu E, Guler-Uysal F, Soyupak S, Sarpel T: Vitamin D status and bone mineral density of veiled and unveiled Turkish women. J Womens Health Gend Based Med. 2001, 10: 765-70. 10.1089/15246090152636523.CrossRefPubMed Guzel R, Kozanoglu E, Guler-Uysal F, Soyupak S, Sarpel T: Vitamin D status and bone mineral density of veiled and unveiled Turkish women. J Womens Health Gend Based Med. 2001, 10: 765-70. 10.1089/15246090152636523.CrossRefPubMed
10.
go back to reference Harinarayan CV: Prevalence of vitamin D insufficiency in postmenopausal south Indian women. Osteoporos Int. 2005, 16: 397-402. 10.1007/s00198-004-1703-5.CrossRefPubMed Harinarayan CV: Prevalence of vitamin D insufficiency in postmenopausal south Indian women. Osteoporos Int. 2005, 16: 397-402. 10.1007/s00198-004-1703-5.CrossRefPubMed
11.
go back to reference Rassouli A, Milanian I, Moslemi-Zadeh M: Determination of serum 25-hydroxyvitamin D3 levels in early postmenopausal Iranian women: relationship with bone mineral density. Bone. 2001, 29: 428-30. 10.1016/S8756-3282(01)00591-9.CrossRefPubMed Rassouli A, Milanian I, Moslemi-Zadeh M: Determination of serum 25-hydroxyvitamin D3 levels in early postmenopausal Iranian women: relationship with bone mineral density. Bone. 2001, 29: 428-30. 10.1016/S8756-3282(01)00591-9.CrossRefPubMed
12.
go back to reference Ghannam NN, Hammami MM, Bakheet SM, Khan BA: Bone mineral density of the spine and femur in healthy Saudi females: relation to vitamin D status, pregnancy, and lactation. Calcif Tissue Int. 1999, 65: 23-28. 10.1007/s002239900652.CrossRefPubMed Ghannam NN, Hammami MM, Bakheet SM, Khan BA: Bone mineral density of the spine and femur in healthy Saudi females: relation to vitamin D status, pregnancy, and lactation. Calcif Tissue Int. 1999, 65: 23-28. 10.1007/s002239900652.CrossRefPubMed
13.
go back to reference Chapuy MC, Schott AM, Garnero P, Hans D, Delmas PD, Meunier PJ: Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. EPIDOS Study Group. J Clin Endocrinol Metab. 1996, 81: 1129-33. 10.1210/jc.81.3.1129.PubMed Chapuy MC, Schott AM, Garnero P, Hans D, Delmas PD, Meunier PJ: Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. EPIDOS Study Group. J Clin Endocrinol Metab. 1996, 81: 1129-33. 10.1210/jc.81.3.1129.PubMed
14.
go back to reference Hashemipour S, Larijani B, Adibi H, Javadi E, Sedaghat M, Pajouhi M, Soltani A, Shafaei AR, Hamidi Z, Fard AR, Hossein-Nezhad A, Booya F: Vitamin D deficiency and causative factors in the population of Tehran. BMC Public Health. 2004, 4: 38-44. 10.1186/1471-2458-4-38.CrossRefPubMedPubMedCentral Hashemipour S, Larijani B, Adibi H, Javadi E, Sedaghat M, Pajouhi M, Soltani A, Shafaei AR, Hamidi Z, Fard AR, Hossein-Nezhad A, Booya F: Vitamin D deficiency and causative factors in the population of Tehran. BMC Public Health. 2004, 4: 38-44. 10.1186/1471-2458-4-38.CrossRefPubMedPubMedCentral
15.
go back to reference Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, Gokalp AS: Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. 2005, 135: 218-22.PubMed Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, Gokalp AS: Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. 2005, 135: 218-22.PubMed
16.
go back to reference Diamond TH, Levy S, Smith A, Day P: High bone turnover in Muslim women with vitamin D deficiency. Med J Aust. 2002, 177: 139-41.PubMed Diamond TH, Levy S, Smith A, Day P: High bone turnover in Muslim women with vitamin D deficiency. Med J Aust. 2002, 177: 139-41.PubMed
17.
go back to reference Alagol F, Shihadeh Y, Boztepe H: Sunlight exposure and vitamin D in Turkish women. J Endocrinol Invest. 2000, 23: 173-77.CrossRefPubMed Alagol F, Shihadeh Y, Boztepe H: Sunlight exposure and vitamin D in Turkish women. J Endocrinol Invest. 2000, 23: 173-77.CrossRefPubMed
18.
go back to reference Falch JA, Steihaug S: Vitamin D deficiency in Pakistani premenopausal women living in Norway is not associated with evidence of reduced skeletal strength. Scand J Clin Lab Invest. 2000, 60: 103-9. 10.1080/00365510050184912.CrossRefPubMed Falch JA, Steihaug S: Vitamin D deficiency in Pakistani premenopausal women living in Norway is not associated with evidence of reduced skeletal strength. Scand J Clin Lab Invest. 2000, 60: 103-9. 10.1080/00365510050184912.CrossRefPubMed
19.
go back to reference El Sonbaty R, Abdul-Ghaffar NU: Vitamin D deficiency in veiled Kuwaiti women. Eur J Clin Nutr. 1996, 50: 315-18.PubMed El Sonbaty R, Abdul-Ghaffar NU: Vitamin D deficiency in veiled Kuwaiti women. Eur J Clin Nutr. 1996, 50: 315-18.PubMed
20.
go back to reference Azizi F, Rais-Zadeh F, Mir Said Ghazi A: vitamin D deficiency in a group of Tehran Population. Research In Medicine. 2000, 4: 291-303. Azizi F, Rais-Zadeh F, Mir Said Ghazi A: vitamin D deficiency in a group of Tehran Population. Research In Medicine. 2000, 4: 291-303.
21.
go back to reference Grover SR, Morley R: Vitamin D deficiency in veiled or dark-skinned pregnant women. Med J. 2001, 175: 251-52. Grover SR, Morley R: Vitamin D deficiency in veiled or dark-skinned pregnant women. Med J. 2001, 175: 251-52.
22.
go back to reference Gannage-Yared MH, Chemali R, Yaacoub N, Halaby G: Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res. 2000, 15: 1856-62. 10.1359/jbmr.2000.15.9.1856.CrossRefPubMed Gannage-Yared MH, Chemali R, Yaacoub N, Halaby G: Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res. 2000, 15: 1856-62. 10.1359/jbmr.2000.15.9.1856.CrossRefPubMed
23.
go back to reference Sedrani SH, Elidrissy AW, Arabi KM: Sunlight and vitamin D status in normal Saudi subjects. Am J Clin Nutr. 1983, 38: 129-32.PubMed Sedrani SH, Elidrissy AW, Arabi KM: Sunlight and vitamin D status in normal Saudi subjects. Am J Clin Nutr. 1983, 38: 129-32.PubMed
24.
go back to reference Meddeb N, Sahli H, Chahed M, Abdelmoula J, Feki M, Salah H, Frini S, Kaabachi N, Belkahia Ch, Mbazaa R, Zouari B, Sellami S: Vitamin D deficiency in Tunisia. Osteoporos Int. 2005, 16: 180-83. 10.1007/s00198-004-1658-6.CrossRefPubMed Meddeb N, Sahli H, Chahed M, Abdelmoula J, Feki M, Salah H, Frini S, Kaabachi N, Belkahia Ch, Mbazaa R, Zouari B, Sellami S: Vitamin D deficiency in Tunisia. Osteoporos Int. 2005, 16: 180-83. 10.1007/s00198-004-1658-6.CrossRefPubMed
Metadata
Title
The impact of clothing style on bone mineral density among post menopausal women in Morocco: a case-control study
Authors
Fadoua Allali
Siham El Aichaoui
Bouchra Saoud
Houda Maaroufi
Redouane Abouqal
Najia Hajjaj-Hassouni
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2006
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-6-135

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