Vitamin D intake in children aged 0-4: A comparison of cultural and motivational beliefs between native and Islamic parents

Abstract

Vitamin D is very important for children in order to strengthen bones and teeth and to prevent some types of cancer and both diabetes type I and II later in life. The Dutch Health Council therefore advices to provide children aged 0-4 with an additional 10 mcg of vitamin D on a daily basis, preferably via supplements. Great sources of vitamin D are sunlight, fatty fish, eggs and vitamin D fortified foods like infant milk and dairy for children. The importance of vitamin D is not only emphasized by The Dutch Health Council but also via child health centers and on the internet. The compliance, nevertheless, is not optimal, especially amongst Islamic children which results in an insufficient intake of vitamin D by two third of Islamic children. This study aimed at exploring religious and motivational beliefs regarding vitamin D intake. It was expected Islamic religion and a bad motivation to provide sufficient vitamin D would be important determinants of bad compliance. This thesis had an explorative-observational character and a qualitative research design was practiced. A semi-structured questionnaire was chosen to investigate the differences in beliefs. Ten native and five Islamic mothers participated in an individual interview. In order to structure the audio-taped interviews ‘free nodes’ were developed in the coding programme Nvivo. The ‘free nodes’ were based on the concepts of the theoretical framework. Examples of the ‘free nodes’ were ‘knowledge of advantages’, ‘severity of insufficient consumption’ and ‘religious beliefs’. The tree map retrieved from Nvivo showed the different beliefs per concept of the questionnaire and improved the comparison. Both groups had limited knowledge about the (natural) sources of vitamin D and most participants were not able to mention health benefits. Islamic participants used sunscreen less often than native participants did because of less fear of sunburn and skin cancer. Islamic participants indicated Islamic beliefs did not reject the provision of supplements, fortified foods or sunlight exposure to children. Both groups mentioned to provide their child(ren) with any kind of fortified food although some participants rejected the great amounts of sugar in dairy for children a preferred low-sugar dairy without added vitamin D. The main difference in beliefs regarding vitamin D intake between native and Islamic mothers is related to the high frequency of sunscreen and greater feelings of anxiety and guilt if child(ren) would be unprotected amongst the native mothers. Islamic beliefs could justify the consumption of supplements; fortified foods and exposure to sunlight in order produce vitamin D. The limited level of knowledge about the sources and effects of sufficient vitamin D intake could be a reason for improvement of the communication and information on vitamin D provided in a child health center. This investigation could be improved by a focus group interview in order to stimulate discussion and furthermore be complemented by a quantitative questionnaire to gain more information about the amounts and frequencies of vitamin D consumption and sunscreen use.