105 Journal of Language, Literacy and Learning in STEM Education www. grnjournal.us AMERICAN Journal of Language, Literacy and Learning in STEM Education Volume 02, Issue 05, 2024 ISSN (E): 2993-2769 Evaluation of Students’ Knowledge and Pattern towards Vitamin D Doaa A. Hamad, Khansaa A. ibadi, Wasan T. Jassim College of Nursing/ University of Kerbala, Kerbala City, Iraq Assad Abbas Khalaf College of Sciences, Department of Medical Physics, University of Warith Al-Anbiyaa, Karbala City, Iraq Abeer Jasim sahib Al-Amal College for Specialized Medical Sciences, Kerbala City, Iraq Abstract: Background: Several previous studies revealed an indicator of a high vitamin D deficiency rate in society groups, so this investigation aimed to verify the university students’ knowledge about the significance of vitamin D in their lives. Method: A questionnaire was used, including a set of questions about the information and significance of vitamin D among the 547 students of Hilla University College of different ages. Results: This study evaluated university students' knowledge of vitamin D (V-D), as it illustrated that half of the students know about vitamin D deficiency, and their percentage was 49.8%, while 74.9% of students detect that the leading V-D source is sun, and this agrees with previous studies. Interestingly, (72.6%) of the people knew the sun as the primary V-D source. The findings clearly illustrated that there is shortage knowledge among students about V-D. It was found that most of the participants knew that a Deficiency of V-D is related to diseases Bones and osteoporosis. However, they did not know that V-D is also linked to other health problems. Conclusion: More knowledge and practice regarding V-D need to be provided, which can be reduced by promoting awareness of V-D in society groups, especially university students. Keywords: Vitamin D (V-D), Knowledge, Practice, Deficiency. Introduction All the body's vitamin needs are obtained from various food sources except V-D, which is obtained through sunlight. The body manufactures V-D in the skin from a primary compound with the help of natural sunlight. (1) Deficiency of V-D is a global epidemic, yet the problem of V-D is largely unknown by most humans (2,3), whereas many of them suffer from Deficiency of V-D (4,5). This Vitamin is essential for bone health (Heaney, 2007). There are several studies indicating that V-D is beneficial in promoting musculoskeletal health (6,7 ) as well as playing a role in immune function (7; 8; 9) and prevention of heart disease, vascular disease (10), and several cancer kinds (11) and several other diseases (12; 13). Although several researchers have recently increased their interest in V-D and the rates of various health benefits associated with it, V-D deficiency remains a problem (14). The percentage of Deficiency of V-D is very high in an investigation 106 Journal of Language, Literacy and Learning in STEM Education www. grnjournal.us conducted by (15 ( in the United Arab Emirates; it included (60,979) participants from 136 countries, the findings of which indicated a deficiency in the level of V-D, which reached 50 ng/ml. Several studies have assessed the link between V-D and various health findings, but there needs to be more research focusing on young adults (16, 17). It has been observed that a significant number of young adults prefer carbonated beverages over milk, which can lead to a decrease in the consumption of essential nutrients like calcium and V-D. This, in turn, may potentially increase the risk of fractures (18). Students could shape their lifestyles during university and establish healthy patterns and behaviors (19). Several university students are keenly interested in studying nutrition, which can significantly improve their dietary habits. This is especially true for students at an ideal age to make long-term positive changes in their lives. Therefore, it is crucial to prioritize this age group as the focus for prevention and intervention programs that aim to safeguard their long-term well-being and shield them from future health complications. Methodology The investigation included a group of departments of Hilla University College. Information was taken from students through a questionnaire. In April 2021, 547 students participated in the questionnaire, which included demographic information and information about the V-D significance among students. Statistical analysis The data were analyzed statistically utilizing the Independent specimens T-Test and SPSS software version 20. A statistically significant result was defined as a P magnitude less than 0.05. Results Table (1) The students’ distribution by their demographic features n= 574 Table (1) F % six Male 379 66.0% Female 195 34.0% Total 574 100.0 Marital status Married 96 16.7% Single 470 81.9% Divorced 5 .9% Widowed 3 .5% Total 574 100.0 living Rural 157 27.4% Urban 417 72.6% Total 574 100.0 age 17-19 year 47 8.2% 20-22 year 246 42.9% 23-25 year 211 36.8% 26 more than 70 12.2% Total 574 100.0 The investigation findings illustrated that 66% of the samples were males. In comparison, the % of females who participated in the investigation was 34%. Most of the students were single, with a rate of 81.9%, while the married ones made up 16.7%, and the divorced and widowed people made up a tiny percentage of 9% and 5%, respectively. The investigation found that 72% of students live in the city, while those % live in the countryside were 27%. The ages of students ranged in different proportions according to age groups, and the highest percentage was 42% for the age group 20-22 years, then 36.8% for the age group 23-25 years. 107 Journal of Language, Literacy and Learning in STEM Education www. grnjournal.us Table (2): Assessment of Students’ Knowledge toward V-D n= 574 scale F % M.S S.D. Assessment Do you know about the deficiency of Vitamins? yes 286 49.8 1.78 1.00 0 moderate No 209 36.4 I do not know 79 13.8 Total 574 100.0 The primary vitamin source is the sun yes 430 74.9 1.63 1.17 2 moderate No 35 6.1 I do not know 109 19.0 Total 574 100.0 deficiency of vitamin Symptoms, osteoporosis yes 417 72.6 1.73 1.24 9 moderate No 27 4.7 I do not know 130 22.6 Total 574 100.0 The deficiency of Vitamins can be compensated by eating milk and its derivatives yes 281 49.0 2.15 1.32 1 moderate No 110 19.2 I do not know 183 31.9 Total 574 100.0 V-D causes depression yes 236 41.1 2.51 1.41 3 High No 74 12.9 I do not know 264 46.0 Total 574 100.0 There is a correlation between V-D and skin color yes 264 46.0 2.33 1.39 0 moderate No 84 14.6 I do not know 226 39.4 Total 574 100.0 V-D varies over time yes 191 33.3 2.64 1.36 9 High No 103 17.9 I do not know 280 48.8 Total 574 100.0 There is a correlation between heart disease and cancer and V-D yes 123 21.4 2.98 1.28 3 High No 109 19.0 I do not know 342 59.6 Total 574 100.0 F= Frequency, %= Percentage, M.S. = score mean" Cut off point (0.66), low (score mean= 1-1.66), moderate (score mean=1.67-2.33), high (score mean = 2.34 and more)", S.d. = Stander deviation. Assess=Assessment 108 Journal of Language, Literacy and Learning in STEM Education www. grnjournal.us Figure (1): Overall Assessment of Students’ Knowledge of V-D Table (3): Distribution of Students’ Patterns toward V-D scale F % M.S S.d. Assess Are you exposed to little sunlight? yes 268 46.7 1.82 .848 moderate No 143 24.9 Sometimes 163 28.4 Total 574 100.0 Do you drink milk? yes 152 26.5 2.17 .577 moderate No 367 63.9 Sometimes 55 9.6 Total 574 100.0 Do you eat eggs? yes 387 67.4 1.79 .531 moderate No 154 26.8 Sometimes 33 5.7 Total 574 100.0 Do you eat fish? yes 412 71.8 1.49 .816 low No 43 7.5 Sometimes 119 20.7 Total 574 100.0 Do you eat vegetables and fruit? yes 213 37.1 1.99 .856 moderate No 154 26.8 Sometimes 207 36.1 Total 574 100.0 Do you take nutritional supplements? yes 89 15.5 1.94 .502 moderate No 428 74.6 Sometimes 57 9.9 Total 574 100.0 Have you had a test to find out the level of Vitamin in your body? yes 85 14.8 moderate No 479 83.4 Sometimes 10 1.7 Total 574 100.0 F= Frequency, %= Percentage, M.S. = score Mean " Cut off point (0.66), low (score mean = 1-1.66), moderate (score mean = 1.67-2.33), high (score mean = 2.34 and more)", S.d. = Stander deviation. Assess=Assessment. 0 100 200 300 400 500 600 F % mean s.d Low (8-13.3) Moderate (13.4-18.6) High (18.7- above) Total 109 Journal of Language, Literacy and Learning in STEM Education www. grnjournal.us Figure (2): Overall Assessment of Students’ Patterns toward V-D Discussion This study assessed university students' knowledge and understanding of V-D as listed in Table 2. The study focused on students who knew V-D Deficiency, with a percentage of 49.8%. Additionally, 74.9% of students knew that the sun is the primary V-D source, which aligns with the inquiry's findings (22, 23). Notably, a majority (72.6%) of the participants recognized the sun as a primary V-D source, as indicated in the study conducted by Arora et al. (2016). This inquiry explored the knowledge, habits, and attitudes about V-D among Indian students [24]. This survey showed the public needs greater V-D education. This confirms past evidence that many people are unaware of V-D and associated deficits (25,26). Most participants in this survey recognized that V-D insufficiency causes bone diseases including osteoporosis. They were unaware of V-D deficiency's effects on cardiovascular disease, diabetes, and pregnancy. The results obtained match previous studies (27, 28, 29). V-D deficiency may cause cancer, chronic diseases, and skeletal system deficiencies. This study revealed that a significant majority of students (72.6%) knew the (V-D) significance for maintaining bone health. However, a minority of students (59.6%) held the belief that a deficiency in V-D is linked to various diseases, including cardiovascular cancer and depression (46%). This finding aligns with a previous investigation (30). The investigation revealed that 46.0% of the students knew of the association between (V-D) and skin discoloration. 48.8% are aware that the Vitamin undergoes age-related changes. According to research, the lack of awareness in adults and children in most Middle Eastern nations may be attributed to an indoor lifestyle, which significantly contributes to V-D deficiency (31). Most participants (51.9%) were consistently exposed to sunlight for 10-20 minutes per day, which can vary depending on factors such as time of day, skin type, season, and altitude. However, evidence supports the recommended timeframe for producing V-D without causing skin burns, which is 10 to 30 minutes between 11 a.m. and 3 a.m. M. Without sunscreen, the recommended frequency is three to five times per week throughout the relevant season (32). The data presented in Table 3 illustrates the distribution of V-D practices among students. It reveals that 46.7% of the students reported limited exposure to sunlight, despite most of them recognizing the V-D significance for their health. This avoidance may be attributed to lifestyle changes resulting from modernization and the desire to conform to the prevailing cultural norms. The study's results also showed that 26.5% of the participants consumed milk, 67.4% consumed eggs, 71.8% consumed fish, and 37% consumed fruits and vegetables. It is a significant primary V-D source, as supported by (22), which states that the majority (85.7%) of the participants in the study consume vitamin-rich foods like milk, fish, and eggs in their meals. This finding aligns 0 100 200 300 400 500 600 Frequency Percent mean s.d Low (10- 16.7) Moderate (16.8- 23.5) High (23.6- above) Total 110 Journal of Language, Literacy and Learning in STEM Education www. grnjournal.us with the investigation conducted by Alemu and Varnam in 2012.35 (and this is located). Consistent with a separate study, it was shown that around 90% of participants met their V-D needs using solar exposure, which is followed by V-D supplements (73%), dairy products (47.6%), and fats. Salmon (45.8%), followed by eggs (30.8%). These results suggest that the participants had a strong understanding and recognition of the significance of sunshine as a V-D source. However, they needed to engage in sufficient sun exposure compared to prior research. The investigation revealed that 67.9% of the students reported taking nutritional supplements. Conversely, a significant majority of students (83.4%) did not undergo a vitamin level assessment, which aligns with the findings of Karbala's investigation. Additionally, the investigation revealed a low percentage of individuals (22%) who consume nutritional supplements. According to the National Institute of Health, it is recommended that persons and women who wear long garments and head coverings for religious considerations, as well as those who engage in vocations that restrict sun exposure, consider supplementing with V-D in order to achieve their daily V-D needs (37). Furthermore, many kids had yet to undergo a V-D 83 examination. This problem may indicate a need for more understanding among the individuals being investigated about the V-D significance level testing. Public hospitals need to provide the V-D test, and the exorbitant cost at private hospitals and labs may exacerbate this issue. The present study demonstrated that a minority of participants exhibited a satisfactory degree of awareness and adherence to procedures about V-D AD, which aligns with the findings reported in the inquiry conducted by Habib et al. (38). 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