**4.5 Vitamin D deficiency in Middle East and Lebanon**

International Osteoporosis Foundation (IOF) study showed that almost all countries have 25(OH)D3 levels beneath 30 ng/ml, while South Asia and Middle East have levels beneath 10 ng/ml [19].

The most widely seen medical issue in Middle East and North Africa is vitamin D deficiency. This results in diseases and disorders and most widely osteomalacia. Results showed 50–90% 25(OH)D3 deficiency, and these patients have levels below 20 or 30 nmol/ml [15].

Results showed higher rates of vitamin D deficiency in Lebanon especially Beirut regions as 57.86% were deficient using a cut-off of 20 ng/ml [15].

Females are 3 times more prone to have hypovitaminosis D. An investigation on Lebanese grown-up population has demonstrated that hidden ladies had just about 3 times more incidence of extreme hypovitaminosis D than nonhidden subjects [15].

Results verified that females are at more risk to have vitamin D deficiency. Besides, hidden ladies are 3 times more at risk than nonhidden ladies [15].
