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Caafimaad-darada dhulalka qaboobaha

Qaybta 1aad: Kaalinta caafimaad ee fitamiin D-ga iyo Cudurka Ootisam (Autism)

W/Q: Dr Axmed Cumar Cabdi (Axmedbaashi)

HORDHAC

Qoraalkan kooban kuma wada falaqaynka karno dhammaan dhibaatooyinka caafimaad ee ka jira dhulalka qabow, sidaas darteed waxaan xushay arrimaha iigula muhiimsan dhibaatooyinkaas, ahna kuwa ka dhasha fitamiin D yarida iyo cudurka Autism.

Inkastoo taariidhyahanadu sheegaan in cudurka Riketis-ka (Rickets, oo ka dhasha faatimiin D yarida) uu soo jiray, inta la xasuusto, illaa qarnigii labaad CD (AD); waxaa cudurkan loo aqoonsaday mid khatar ku ah bulshada waqooyiga Yurub xilligii warshadaha. Qarnigii 17aad, nimanka la kala yiraahdo Whistler, DeBoot iyo Glissen waxay si kala gooni ah u ogaadeen in caruur farabadan oo ku noolayd magaalooyinka dadku ku badan yahay ee ciriiriga ah ee waqooyiga Yurub uu saameeyay cudur si aada lafaha u qalqaloociya, oo lagu garto dhammaadka lafaha dhaadheer oo balaarta, lugaha iyo laf-dhabarta oo qaloocda, tabar-darro iyo jilicsanaan murqaha ah. Haddaba jiritaan cudurkan lafaha curyaamiyaa wuxuu ku sii siyaaday waqooyiga Yurub iyo waqooyiga Ameerica xilligii kacaankii warshadaha, markaasoo magaalooyin ciriiriya, hawo wasaqaysanna leh aadka loo dagay,tusaale ahaan 90% caruurta wadamada Ingiriiska iyo Netherland waxay waxaa haleelay cudurkan.

Cudurkan wuxuu kaloo si gaar ah u saameeyay dumarka xilliga uur-qaad-ka ku jiray, wuxuuna sababay in lafaha miskuhu ay maroorsamaan, taasoo keentay inuu saro u kaco rafaadka iyo dhimashada hooyada iyo ilamaha labadaba waqtiga dhalmada. Dabadeedna waxaa soo ifbaxay qaliinka-dhalidda (caesarean section), oo si aada looga isticmaalay wadanka Ingiriiska.

Sanadkii 1822-kii, Sniadecki wuxuu arkay in caruurta ku nool magaalada Waarso (Warsaw) uu hayo xanuun badan oo Riketis ah, meesha caruurta ku nool baadiyaha magaaladaas uusan hayn xanuunku. Asagoo arigtadaa ka duulaya wuxuu ku dooday in iftiinka qoraxdu yahay wax lagu dawayn karo cudurkan. 1889kii, Ururka Caafimaadka ee Ingiriiska (British Medical Society) waxay sahmiyeen qaabka uu cudurkan u dhaco (hab-dhaca) (epidemioligal survey), waxayna xaqiijeen in arigtidii hore ay sax ahayd. Laakiin nasiibdarro, kumayan guulaysan inay xaqiijiyaan in xanuunku la xiriiro la’aanta iftiinka qoraxda. Hal sano kabacdi, Palm wuxuu ku sameeyay baaritaan aad u baahsan dhammaan dhulkii hoos imaan jiray  Boqortooyadii Ingiriiska iyo waliba dhulalka bariga (sida China iyo Japan), kaasoo ku saabsan hab-dhaca cudurka rickets, wuxuuna ku ogaaday muhimadda ay leedahay isudhigga  qoraxdu. Wuxuuna ku booriyay in si wada-jir ah, oo aan lookala harin, qoraxda la isugu dhigo, talaabadaasoo ka hortag iyo daawaba u ah cudurka riketis iyo cuduro kale. Nasiibdarrose, si wanaagsan looguma baraarugin arigtiyadaas xeesha-dheer ee Sniadecki iyo Palm, waxaana ka soo wareegay 30 sano, markaasoo Huldschinski uu sharaxay in marka caruurta qabta riketis-ka loo dhigo shucaaca ka soo baxa nal ka samaysan meerkuri (mercury vapor arc lamp) ay si wanaagsan uga bogsoodaan cudurkan lafaha ku dhaca.

Horaantii waxaa caado ahaan loogu dawayn jiray cudurkan saliida kaluunka (cod liver oil), illaa laga soo gaaray 1920 markaasoo McCollum iyo saaxibadii ay ka dhexheleen vitamin D. Waxaa xigtay, in la ogaaday haddii shucaac loo dhigo cuntooyin kala duwan, in si wanaagsan loogu daawayn karo, loogana hortagi karo cudurkan, taasoo casriyaysay, dardarna galisay ka hortaga iyo dabargoyta cudurkan. 1930-nadii, waxaa lagu guulaystay xaqiijinta in vitamin D3 uu ku dhexsameeysmo jirka (maqaarka) dadka marka ay ku dhacaan shucaaca ka yimaada qoraxda (UVB).[1]

Haddaba waxaa iska cad inay qaadatay qarniyo in la fahmo jiritaanka fitamiin D, waayahanna waxaa soo ifbaxay xaqiiqooyin badan oo la xiriira fitamiinkan, kuwaasoo soo guuxayay qarni kale ka hor intaan la qabalin. Qayb ka mid ah khubarada nafaqada (nuitritionists) waxay ugu yeeraan sanadka 2008 sanadka fitamiin D, marka la eego tirada xaqiiqooyinka iyo cilmibaarista lagu guulaystay.

Dhinaca kale haddaan ka eegno dhulka soomaliyeed waxa uu dhacaa dhulbaraha oo hela qorax joogto ah, waxaana dadkiisa loo tixgaliyaa inay ka mid yihiin dadyowga ugu firfircoon, uguna caqliga badan qaaradda Africa; ayna u sii dheertay caafimaad badni, marka laga reebo cudurada ka dhasha nafaqo-darada iyo nadaafad xumada. Laakiin muuqaalkaas waxaa ku yimid isbadal marka la eego soomaalidii faraha badnayd ee u soo hijrootay dhulalka qabow ee Yurub iyo Waqooyiga Ameerika. Waxaa soo foodsaaray, ayaga iyo bulshooyinka madowba, caafimaad daro saamaysay dhammaan qaybaha kala duwan ee bulshada, min ilmo dhashay illaa waayeel. Cuduro oo ay ka midyihiin jir xanuun, daal, xanuunada maskaxda (sida depression, Schizophrenia), iyo kuwo si gaar ah u saameeyey caruurta sida Ootiisam (Autism), fahmo daro iyo karti la`aan. Waxayna ka sare mareen dadkay u yimaadeen xanuunaday caanka ku ahaayeen sida Macaanka, Dhiigkarka, Shalalka, wadna-xanuunka, Kansarka  iwm. Shaki kuma jiro in bay’addu lug ku leedahay xanuunadaas faraha badan ee dhulka qaboobuhu caanka ku yahay, lakiin xaqiiqda dhabta ah ee keenta wali la iskuma raacin, waxaa sanadihii ugu danbeeyay soo ifbaxay muhimadda fitamiin D-ga, oo loo yaqaan Fitamiinka cadceeda (Sunshine Vitamin).

Markaan dib u eegay qayb ka mid ah cilmibaarisyadii u danbeeyay ee la xiriira xanuunadaan soo sheegnay iyo sababta ay dadka madow si gaar ah ugu saameeyeen, waxaan ii soo baxday in xaqiiqda wax laga ogaaday, laakiin dadyowgan dhibani ay la`yihiin cid wax u sheegta. Sidaas darteed baan go`aansaday inaan maqaalkaan qoro oo aan ugu talagaly baraarujin iyo aqoon iswaydaarsi.

Xaqiiqooyinka aan soo bandhigi doono waa kuwo intooda badan ka dahsoon dadwaynaha, oo laga yaabo inay ku cusboonaadaan xataa dhakhaatiirta qaarkeed, maadaama ay soo ifbaxeen dhawrkii sano ee u danbeeysay.

Fitamiin D

Fitamiinkan wuxuu u jiraa qaabab kala duwan waxaana ugu muhiimsan fitamiin D2 (Ergocalciferol) iyo D3 ( Cholecalciferol), oo laga kala helo dhirta iyo xayawaanka. Fitamiin waxaa la yiraahdaa nafaqooyin (organic nuitrients) inta badan uusan jirku samaysan karin, lagmamaarmaanna u ah falgalo badan oo jirka gudihiisa ka dhaca, sidaa darteed in qofku uu quuto loo baahanyahay; laakiin fitamiin D-ga intiisa badan jirkaa lagu dhexsameeya, waxaana la isku raacay inuu yahay hoormoon (hormone), laakiin dadka aan qorax heli karin wuxuu u noqonayaa fitamiin. Fitamiinkani wuxuu muhiim u yahay sidii uu jirku uga faa’iidaysan lahaa macdanka kaalshiyamka iyo fosfooraska, iyo koritaanka lafaha, muruqyada, maskaxda (neerfayaasha) iyo difaaca jirka.

Ilaha laga helo:

Waxaa lagu sameeyaa jirka kore (maqaarka) ee qofka marka shucaaca qoraxdu ku dhacdo, ayadoo maadada kolesteroolka (cholesterol) loo badalo fitamiin D3. Wax ka yar boqolkiiba toban (10%) baa laga heli karaa cuntada. Sidaa darteed si qofku u helo fitamiin ku filan waa inuu qorax kulul u dhigaa jirkiisa (sida wajiga iyo gacmaha) ayadoon wax shucaaceeda celinkaraa uusan ku dahaarnayn sida kareemada; dadka cad waxaa ku filan sodon daqiiqo labo ilaa sadder jeer isbuucii, laakiin dadka madow waxay u baahan yihiin muddo intaa ka badan shanlaab, maadaama maadada jirkooda ku jirta ee loo yaqaan Melanin ay shucaaca qoraxda celiso. Tusaale ahaan marka qofka cadi qoraxda isu dhigo muddo 20 daqiiqo ah wuxuu jirkiisu samayn karaa 20,000 units (0.5 mg) oo fitamiin-D ah. [2]

Isha kale ee laga helaa waa cuntooyinka ay mid yihiin kaluunka (sida sardines iyo salmon), ukunta, caanaha iyo haruurka. Balse waxaa muhiim ah in cuntooyinkaasi ay ka yimaadeed meel qorax leh ama ay warshaduhu ku daraan.

Sababaha Fitamiin-D yaridda

Saddexda qaybood ee keena fatamiin D yaridda waxay kala yihiin qaadasho la’aan, dheefshiid xumo iyo jirkoo isticmaali waaya. [3]

1)    Qaadasho la’aan: tani waxay ka dhalan kartaa qorax la’aan, isticmaalka walxaha shucaaca qoraxda celiya iyo af-ka-qaadasho la’aan (cunto ahaan ama daawo ahaan). Waayadan danbe waxaa siyaaday talooyin ay dhakhaatiirtu bixinayeen oo ah in qoraxda laga fogaado iyo isticmaalka kareemada shucaaca celiya, baqdin laga qabo kansarka maqaarka darteed, taasina waxay keentay in lagu tiirsanaado fitamiin D-ga laga helo cuntada, tanoon dabooli karin baahida. Arintani waxay si siyaado ah u saamaysay wadamadii markiiba horaba qoraxdu ku yarayd sida Yurub iyo Waqooyiga Ameerika. Caruurta iyo waayeelka oo inta badan guryaha ku jira iyo dumarka xijaaban ayaa dhibku ku sii badan yahay.

2)    Dheefshiidid xumo: tanina waxay dhacdaa marka ay mindhiciradu kala bixi waayaan cuntada fitamiinka ku jira, taasoo ka dhalankarta ayagoo jiran ama deriskunoole (parasites) ka horistaaga shaqadooda. Mindhicirada iyo haragu (maqaarku) markay duqoobaana shaqadoodu aad bay hoos ugu dhacdaa, sidaa darted dadka waayeelka ahi si gaar ah ayay ugu nugul yihiin fitamiin D-yaridda.

3)    Isticmaal-karid la’aan: haddii jirku ku guulaysto inuu fitamiin D helo (qaababkaan kor ku soo sheegnay), waxaa dhicikarta in qofku ka faa’iidaysan waayo haddii uu ka jiranyahay beerka ama kalyaha, oo ah labada meelood ee lagamamaarmaan u ah qaabaynta fitamiinka D-ga si uu shaqadiisii u qabsado. Sidoo kale waxaa jira daawooyin haddi qofku qaadanayo sahlaya in fitamiinku si dhaqso ah u burburo intaan laga faa’iidaysan.

Arimaha Muhiimka ah ee Saameeya Heerka Fitamiin D-ga

·        Heerka midabka jirka (maqaarka) (kor ka eeg)

·        U banbixidda shucaaca qoraxda

·        Qaybta raashinku ku biirin karo (<10%)

·        Goobta qofku dhulka ka joogo (dhigaha)(latitude)(maxaa yeelay meelaha qaarkood si kasta oo qoraxdu u soo baxdo dhucaadeedu ma dhalinkaro fitamiin ku filan)

·        Xilli-sanadeedka lagu jiro iyo xagasha qoraxdu marayso

·        Isticmaalka shucaac-celiyaayaasha (kareemooyinka, dharka, iwm)

·        Banaan u bixidda

·        Xajmiga jirka (qofka cayilan fitamiin D-ga dhiigiisa ku wareegaya waa uu ka yaryahay dadka kale, maadama aa fitamiinku uu ku milmo baruurta)

Raadka Fitamiin D-yarida

Marka heerka fitamiinka D-ga ee dhiiigu hoos u dhaco waxay keeni kartaa ama sahli kartaa in qofku la kulmo cuduro dabadheerada (chronic) sida lafa-qalqalooc (Rickets), lafa-xombobosho (osteoporosis), murqo xanuun, daal, kansar, macaan (sonkor), timo-daadasho, cayil, dhiigkar, cudurada kalagoysyada (Rheumatoid arthritis), hargab-xiliyeedka (seasonal influenza) iyo kuwo kale.

Sidoo kale xogaha caafimaadku waxay muujinayaan in fitamiin D yarida ay weheliyaan cudurada ku dhaca habdhiska dhimirka (central nerve system) sida kuwa nafsaaniga ah (depression, schizophrenia, seasonal effective disorder) iyo kuwa kale afka qalaad lagu yiraahdo Multiple Sclerosi, Alzheimer’s  and Parkinson’s diseases. Haddaba tijaabooyin lagu sameeyay xayawaanka waxay muujiyeen in fitamiin D yaridu ay keeni karto inuu xumaado koriinka iyo shaqada habdhiska dhimirka  ee ilmaha dhasha. Isku soo duuboo, isu dheelitir la’aanta heerarka fitamiin D-ga ee jirka waxay keeni kartaa shaqo-xumo iyo cimri-degdeg ku yimaada habdhiska dhimirka.[4]  Baaritaan lagu sameeyay caruurta qabta cudurka Oostisam-ka, oo ku dhaca maskaxda (dhimirka), waxaa la xiqiijiyay in dhammaantood ay hayso fitamiin D yari, taasoo taageeraysa  aragtida ku doodaysa in cudurkani ka dhasho fitamiin D yaridda. [5]

Calaamadaha guud ee lagu garto fitamiin D yarida waxaa ka mid ah qaloocsan ku dhaca lafaha dhaadheer ee caruurta, jir- iyo lafo-xanuun, tabardaro murqaha ah, sahal u jabid, timo-daadasho iyo habiso (low mood).

OOTISAM (AUTISM)

Waa xanuun ka dhasha khalad ku yimaada koriinta maskaxda kaasoo aan ka harin ilmaha inta noloshiisa ka hadhay. Waxyaalaha lagu garto waxaa ugu muhiimsan 1) dhibaato ilmaha ka qabsata dhexgalka mujtamaca (social interaction), sida inuu fahmo jawiga ku wareegsan, 2) inuu tayo ahaan u lumiyo la xiriirka dadka sida in hadalku ka soo bixiwaayo ama si wanaagsan ereyada ugu dhawaaqi waayo, iyo 3) in ilmuhu uu ku dhago ama ku celceliyo hal arin ama xarakaat.

 Cudurkani wuxuu noqday mid aad u baahsan (epidemic), tusaale ahaan Ingiriiska 88-ddii ilmood mid ayaa qaba cudurkan.[6] Inta badan ilmaha cudurkan ku dhacaayi lama ogaado illaa ay gaaraan 3 ama 4 sano jir, markaaso ay cadaato khalalka ku jira hadalkiisa iyo dhexgalka mujtamaca. Laakiin sanadka 1aad ama 2aad saddex arimood oo muhiim ah ayaa muujin kara in ilmuhu uu cudurka qabo, waana ilmahoo u soo jeensanwaaya marka magaciisa loogu yeero, asagoo qofka hortaagan si wanaagsan u qaabili waaya iyo hadalkoo ka soo bixi waaya.

Guud ahaanse xanuunkani wajiyo badan ayuuu leeyahay, waxayna ku xirantahay heerka dhaawaca maskaxda gaaray, wuxuuna ilmuhu u dhexayn karaa mid curyaamay oo aan waxba kala garanyn iyo mid u muuqda inuu caadi yahay, laakiin fahankiisa iyo feejignaantiisu ay hooseeyso (Attention Deficit Disorder), sidaa darted baa cuduradan waxaa la isku yiraahdaa  Cudurada la xiriira Ootiisamka (Autistic Spectrum Disorder ama ASD).

Illaa iyo hadda lama tilmaamin sabab gaar ah oo cudurkan keenta, balse waxaa la malaynaa inay jirto arin la xiriirta cimilada iyo bay’adda, taasoo sahasha in ilmaha hiddo ahaan nuguli uu ay cudurka qaadaan.[7]

Goor hore sanadkii 1991-dii ayaa cilmi baare ka socda Machadka Qaranka ee Badbaada Shaqada iyo Caafimaadka ee wadanka Maraykanaka (NIOSH , CDC) wuxuu sheegay in maada Meerkuriga (Hg) ay ka mid tahay walxaha la xaqiijiyay inay dhaawacaan uurkugirta, gaarahaan xagga maskaxda, ilmaha dhashaana wuxuu yeelankaraa dabaceedo khaldan oo ay ka midyihiin qalalka, ootisamka, iskitsofareeniya, feejignaan xumo iyo kuwo kale.[8]

XIRIIRKA KA DHEXEEYA OOTISAMKA IYO BAY’ADDA

(MEERKURIGA IYO FITAMIIN D-GA)

Kaalinta Meerkuriga (Hg)

Tan iyo markii ay bilaabantay isticmaalka faraha-badan ee talaalka tobonaankii sano ee u danbeeyay waxaa barbar socday siyaadidda tirada cudurka Ootisamka. Dhinaca kalana cudurkani wuxuu ku badanyahay wadamada dhulbaraha aadka uga fog. Waa arimo su’aalo muhiim ah dhaliyay!!

Waxaa la ogyahay in inta badan talaalada ay ku jirto maadada loo yaqaan Thaaymeerasool (Thimerosal) oo loo adeegsado inay daawada ka ilaaliso bakteeriyada (preservative), taasoo markay jirka gasho isu badasha meerkuri (Hg) sun ku ah difaaca jirka iyo dhimirka (maskaxda). Baaritaano badan oo lagu sameeyay xayawaanka iyo dadkuba waxay muujiyeen in meerkuridu keeni karto cudurada la xiriira Ootiisimka ama ASD.[9]

Meerkuriga waxay kaloo ku jirtaa daawooyinka loo isticmaalo indhaha, dhagaha, cunaha iyo maqaarka, kuwa ellerjiga lagu baaro, kuwa ka hortaga dhalmada; kareemada la isku caddeeyo (bleach) iyo kuwa la isku qurxiyo; boomaatada cadayga iyo kuwa wax lagu nadiifiyo (antiseptics, disinfectants, fungicides, and herbicides); maadada loo isticmaalo buuxinta ilkaha (amalgam) iyo kuwo kale oo  badan.

Marka ay meerkuridu gasho jirka hooyada (sida badan talaal ahaan ama daawo ahaan), waxay si sahal ugu gudubtaa uurkujirta iyo maskaxdiisa koraysa, taasoo ay dhibaatayn karto haddii difaaca jirku uusan si degdeg ah isaga sifaynin. Waxaa kaloo  muhiim ah inaan ogaano in koriinka maskaxdu uusan dhamaystirmin illaa ilmuhu ka gaarayo 2 sano.

Marka ilmuhu dhasho waxaa la siiyaa talaalo badan oo ay ku jiraan maadada Thaaymerasol, taasoo ku ururta jirkiisa, gaar ahaan maskaxda. Haddaan si gaar ah u eegno wadanka Maraykanka, magaala Kalifoorniya, waxaa cudurka Ootiisam-ku siyaaday 634% intii u dhexaysay 1987 iyo 2002, taasoo aan lagu fasiri karin garashada cudurka oo wanaagsanaatay ama dadka u soo  hijrooday  oo kalaiya, balse inay jirto siyaado ku timid waxa cudurka keena (Thimerasol ??).[10] Sidoo kale xanuunada la xiriira Ootiisam-ka waxay wadanka Maraykanka ka gaareen heer lixdii caruur ahi mid kamida uu hayo.[11]

Haddaan marka dib u eegno talaalada caruurta la siiyo ee ay ku jirto Meerkuridu waxaa ka mid ah DTP (Diphtheria-Tetanus-Pertussis) (25µg Hg dhooskiiba) taasoo ilmaha la siiyo mararka da’doodu tahay 2, 4, 6, iyo 18 bilood jir; Hib (Haemophilus influenza type b) (25µg Hg dhooskiiba) waxaa la siiyaa markay 2, 4, 6, iyo 18 bilood jir yihiin; talaalka Hepatitis B (12.5µg Hg dhooskiiba) waxaana la siiyaa markay dhashaan, 2 iyo 6 bilood jirka. Sidoo kale meerkuridu waxay raaci kartaa caanaha naaska hooyada haddii hooyada la siiyaya daawo ka hortag ah, marka ay dhasho ilmo ka dhiig duwan ayada (Rh-negative mothers), daawadaasoo ay ku jirto meerkuri (10.5 illaa 50µg Hg dhooskiiba) ama ay hooyadu ilkaha loogu buuxiyey maadada Amalgam (oo meerkuri ku jirto).  Waayahanna talaalka hargab-ka (influenza) waxaa ku jira Thaaymerasool (ama Meerkuri).

Sidaa daraadeed ilmaha waxaa jirkiisa ku ururi kara meerkuri cadadkeedu gaarayo 237.5µg oo Hg ah 18-ka bilood ee u horeeya noloshiisa, taasoo aad uga sareysa heerka ku sumowga meerkurida.

Cilmi-baarayal badan ayaa ogaaday in daawaca gaara neerfayaasha iyo calaamadaha ka dhasha ku sumowga meerkurida iyo cudurka Ootisamku inay isku mid yihiin. Taasoo loo eedsaday meerkuridu inay tahay waxa keenay cudurkan. Taasina waxay keentay in wadanka Maraykanku codsado in laga saaro ama la yareeyo meerkurida ku jirta talaalada la siiyo caruurta ka yar 6 sano (preservative free vaccines).

Markaan isku soo uruurino, xogaha aan kor ku soo sheegnay waxay muujinayaan in meerkurida sida isdabajooga ah u gaaraysa  ilmaha intuu uurka ku jiro iyo dhalashada ka bacdi inay sahlayso in ilmaha hido ahaan nuguli uu cudurka ootiisam-ka qaado.

Kaalinta Fitamiin D-ga ka sifaynta jirka Macdanta culus sida Meerkurida

Ka sifaynta jirka macdanaha culus waxa inta badan u dhacdaa qaab la yiraahdo oksidhaytiif-redhakshan (oxidative-reduction) oo ay sahasho maadada la yiraahdo Glutathione. Habdhiskaas difaaca si wanaagsan uma shaqeeyo bukaanada qaba cudurka ootiisamka, waxaana la ogaaday in fitamiin D-gu muhiim u yahay habsami u socodka sifaynta macdanaha culus.

Dhinaca kalana waxaa la xaqiijiyay in dhammaan bukaanada ootiisamka uu ku yaryahay fiitamiin D-gu, jirkoodana ay ku jirto meerkuri siyaado ah. Sidaa darteed iswaafaqaddida labadaa arimood waxay muujinaysaa sababta ka danbeysa cudurkan.

Qaar ka mid ah khubarada caafimaadka ayaa ku doodaya in fitamiin D-yarida kaligeed ay ku filantahay inay keento cudurka Ootiisamaka, marka la eego cadaymaha loo hayo sida uu muhiim ugu yahay koriinka maskaxda iyo sida ay isugu egyihiin qaabka maskaxda bukaanka ootiisamka iyo xayawaano tijaabo lagu sameeyay, tusaale ahaan haddii fitamiin D-yari darani hayso hooyada jiirka, wuxuu jiirkaasi yeeshaa maskax wayn iyo godadkeeda (ventricles) oo balaarta, taasoo ay isku muuqaal yihiin caruurta Ootiisamka.[12]

Xujooyinka loo hayo in Fitamiind D-yaridu iyo Meerkuridu keeni karaan Ootiisamka

1)    Xogo kooban oo la hayo ayaa waxay muujinaayaan in cudurka Ootiisamku uu ku badanyahay dadka ku nool dhinca cirif-yada dhulka, wuuna ku yaryahay dhulalka qoraxda leh ee dhulbaraha u dhow. Baaritaan ay dhawaan samaysay xarunta xakamaynta cudurada ee Maraykanka (CDC) wuxuu muujiyay in 14 gobol oo baaritaan lagu sameeyay gobolka cudurkani ugu badan yahay inuu yahay New Jersy, oo ah gobolka labaad ee waqooyiga u xiga, gobolka ugu cudurka yarna uu yahay Alabama, oo ah kan koonfurta u xiga goboladii baaritaanka lagu sameeyay.[13] Juquraafi ahaana waxaan doodi ku jirin in dhulka dhaca loolalka sare (higher latitudes) in fitamiin D-gu ku yaryahay, qoraxdoo ka dadban awgeed, taasoo macnaheedu yahay in hooyooyinka fitamiin D-gu ku yaryahay ay khatar ugu jiraan inay dhalaan ilmo uu hayo Cudurka Ootiisamka ee Ilmaha (Infantile Autistic Disorder, IAD), kaasoo ka dhalan kara korid la’aan ku timid maskaxdooda ama hoos u dhac ku yimid difaaca hooyada intay uurka lahayd.[14]

2)    Waxaan soo sheegnay xiriirka ka dhexayn kara talaalada iyo Ootiisamka, inkastoo talaalada laga isticmaalo wadamada kulaylaha, cudurkani aad buu uga yaryahay kan wadamada qaboobaha, taana waxaa lagu fasiri karaan in qoraxdu ama fitamiin D-gu uu kaalin ku leeyahay (difaaca ah).

3)    Inkastoo warbixino is diidani ka soo baxeen baaritaanadii lagu sameeyay xiriirka ka dhexeeya xiliga ilmuhu dhashaan iyo cudurka Ootiisamka, haddana dhowr baaritaan oo muhiim ah ayaa muujinaya in ilmaha dhasha xilliga qaboobaha (winter) uu cudurku ku badan yahay, gaar ahaan   dhamaadkiisa, bisha Maarso (March) oo ah marka heerka fitamiin D-gu ugu hooseeya.[15]

4)    Cudurka Ootiisamku wuxuu ku badanyahay dadka madow eek u nool Yurub iyo Waqooyiga Ameerika, kuwaasoo dabcan ay hasyo fitamiin D-yari badan, inkastoo uu cudurkani uu dhif iyo naadir  ku yahay wadamada ay asal-ahaan ka soo jeedan. Tusaale ahaan heerka cudurkan ee magaalada Goteborg, ee Sweden, ilmaha ay dhaleen dumarka ka soo jeeda wadanka Ugaandha waxay 200 jeer ka badan yihiin dadwaynaha kale.[16],[17] Inkastoo abbaaraha 90% dadka madow eek u nool dhulka qaboobaha ay fitamiin D-yari hayso, haddana baariitaan si gaar ah loogu sameeyay durmarka uurka leh ee USA waxay muujinaysaa 45% dumarka madow ay hayso fitamiin D-yari khatar ah, meesha dumarka cadi ay yihiin oo kaliya 2%. Qaadashada fiitamiin D gaaraya 400IU ama 10µg waxweyn uma tarin, maadaama 90% dumarkaa baaritaanku lagu sameeyay ay qaadanayeen dhooskaas.[18]

5)    Cilmi baarayaashu waxay ogaadeen in heerka fitamiin D-ga ee hooyooyinka iyo bukaanada xanuunkani uu ka hooseeya dadka dhiggooda ah. Dhowr baaritaan waxay caddeeyeen in hooyooyinka madow ay ku badantahay inay dhalaan ilmo miisaankoodu hooseeyo iyo in ilmahoodu hore u dhintaan.[19] Hoosaynta miisaanka ilmaha iyo inuu dhasho waqtigii oo aan u buuxsamin waxay ka midyihiin waxyaalaha sahla (risk factors) cudurka Oostiisam-ka,[20] arimahaasina waxay ka dhalan karaan sida la ogyahay faatimiin D-yarida.[21] Maxaa yeelay waxaa la ogaaday in fitamiin D-gu yareeyo khatarta hore-u-dhalashada iyo miisaan-hoosaynta ilmaha dhashay.[22] Tusaale ahaan haddii la siiyo hooya uurka leh 1,200 yunit (IU)(30µg) maalintii oo fitamiin D ah saddexda bilood ee u danbaysa, waxay siyaadisaa miisaanka ilmaha, sidoo kale marka la siiyo 600,000 yunit (15mg) labada bilood ee 7aad iyo 8aad ee uurka waxay sii siyaadisaa miisaanka ilmaha.[23]

6)    Hayadda Xakamaynta Cudurada ee USA iyo kuwo kele waxaa sheegeen in caruurta madow ay ka tiro badan yihiin kuwa cad marka la eego xanuunka maskax-yarida aan aadka u darnayn, taasoo fasiraad looga waayay inay sababtu tahay arimo dhaqan-dhaqaale (socio-economic factors).[24]

7)    Haddii la yiraahdo fitamiin D-yarida ayaa cudurkan keenta, waxaa la is oran karaa haddaba marka qorax la helo oo heerka fitamiinku kor u kaco waa in xanuunka laga roonaadaa. Baaritaan arintaa lagu sameeyay wuxuu muujiyay ka roonaansho calaamadihii cudurka Ootiisamka marka bukaanada la geeyo meel qorax leh. Sidoo kale waxaa wanaagsanaada qaab-dhaqanka bukaanadan marka nashaad loogu sameeyo banaanada ka baxsan guryaha xilliyada qorax fiicani jirto (summer), taasoo kor u qaada heerka fitamiin D-ga ee maskaxdooda.[25]

8)    Caruurta aan jirkoodu fitamiin D-ga isticmaali Karin, hiddo-ahaan, waxaa lagu yaqaanaa murqo-jilicsanaan, firfircooni-yaraan, dib u dhac ku yimaada inuu awood buuxda helo, xasilooni-darro, korid-la’aan iyo calaamadaha kele oo ay Ootiisam-ka wadaagaan. Sidoo kale waxay calaamahaas wadaagaan cudurka loo yaqaa Riketis (Rickets) oo ka dhasha fitamiin D-yarida.

FITAMIIN D-GA IYO CUDURADA RAGAADIGA AH[26]

Waxaa jira baaritaano badan oo ku talinaya in fitamiin D-yarida ay la xiriiraan cuduro badan oo ragaadi (chronic) ah, kuwaasoo ay ka midyihiin lafo-xombobosho (osteoporosis), macaanka/sonkorta, kansarka, dhiigkarka, wadno-qabadka, shalalka, ruumotiisamada, iyo kuwo kale. Cuduradaas oo mararka qaarkood loogu yeero cudurada magaalada ama cudurada wadamada hore-u-maray maadaama ay meelahaas ku badan yihiin. Inkastoo qaab-noleleedku ka qayb qaadan karo, haddana sabab si khaas ah u keenta weli lama qeexin.

Haddaba si aan loo fahmo xiriirka ka dhexeeya fitamiin D-yarida iyo cuduradan, ayaa cilmi-baarayaal waxay daraaseeyeen heerka jiritaan (incidence rate) cudurada kansarka iyo dhiigkarka adduunka oo dhan, waxay ogaadeen in heerka jiritaanka cuduradu uu kordho markasta oo laga sii fogaado dhulbaraha, oo macnaheedu yahay cadceeda iyo fitamiin D-ga oo yaraada, taasoo tusaale u ah dhammaan cuduradaan soo sheegnay. Dhinaca kale waxaa la arkay inuu sareeyo heerka u dhimashada kansarka ee dadka madow ee Maraykanka iyo kuwa cayilani taasoo lagu fasiri karo heerka fitamiin D-ga.[27]  Sidoo kale tirada ugu badan ee cudurka macaanka-caruurta (type 1 diabetes mellitus) waxay ka jirtaa wadanka Filand, dhawaana waxaa la ogaaday inuu toban-laab ku badan caruurta asalkoodu yahay Afrikaanka, taana waxaa la mid ah wadanka Marayka, sababtana fasiraad aan fitamiin D-ga ahayn looma hayo. Daliiladaas iyo kuwo kaloo farabadan ayaan waxay gundhig u yihiin daahfurka muhimadda uu leeyahay fitamiin D-gu.

Aad bay noogu daba-dheeraanaysaa haddaan cuduradan ragaadiga ah ee laxiriira fitamiin D-ga mid mid u falanqayno, qofkii sii xiisaynaya inuu wax ka sii ogaado wuxuu macluumaad badan ka heli karaa internet-ka. Laakiin waxaa ila haboonaatay inaan halkaan ku xuso baaritaano dhawaan la sameeyay oo muujinaya in dumarka ay hayso fitamiin D-yari ay 253% ay khatar ugu jiraan in kansarka mindhicirada ku dhaca (colonic cancer), dumarka qaata 1,500mg oo Kaalshiyam ah iyo 1,100 IU oo fitamiin D ah maalintii muddo 4 sano ah fursadda inay ka badbaadaan kansarkan waxay ka badan tahay 60%.[28] Sidoo kale dumarka fitamiin D-gu ku yaryahay waxay khatar ugu jiraan kansarka naasaha 75%.[29]

Waxaa kaloo la ogaaday in xiriir muhiim ahi ka dhexeeyo fitamiin D-yarida iyo wahsiga, damanaanta (low mood) iyo hargabka; maxaa yeelay arimahaan waxaa aad u soo muuqdaan xiliyada qaboobaha ah markaasoo qoraxda iyo waxtarkeeduba yaraado, iyadoo arimahan laga roonaado marka la isticmaalo fitamiin D-ga.

Baaritaano lagu sameeyay wadanka Maraykanka oo la isugu barbardhigay xiriirka ka dhexeeya fitamiin D-ga iyo cudurada qaarkood ee dadwaynahooda, waxay muujiyeen in dadka fitamiinkoodu aadka uu hooseeyo (<15ng/ml) inay khatar ugu jiraan  dhiig-kar 30%, subaga dhiiga (sida kolesterool) oo kor u kaca 47%, macaanka (diabetes) 98% iyo cayil 129%.[30]

Haddaan si gaar ah u eegno dumarka uurka leh, waxay khatar ugu jirtaa lafaha miskaha oo qaloocsama, ilmaha uurka ku jira oo lafihiisu si wacan u kori waayaan, dhaqaaqiisa oo yaraada iyo dhiig-kar ku dhaca hooyada, arimahaas oo keeni kara in hooyada la qalo xilliga dhalmada. Waxaa kaloo ilmaha uurka ku jira ku imaan kara koriin-xumo guud.[31]

Guud ahaan dhibka ka dhashay wuxuu si aada u saameeya bulshada madow iyo muslimiinta. Tusaale ahaan wadanka Denmark 88% dumarka muslimiinta carabta waxay ka sheegtaan daal iyo jir xanuun ka dhasha fitamiin D-yari. Waliba cuduradii badnaa ee aan soo sheegnay iyo cawaaqib xumadoodu waxay ku badan tahay bulshooyinkaas.

FITAMIIN D-GA IYO CUDURADA MASKAXDA (DHIMIRKA)

Waxaa la soo jeediyay in fitamiin D-gu kaalin ku leeyahay cudurada dhimirka, taasoo lagu saleeyay arimahan soo socda:[32]

1)    Xaqiiqooyinka la xiriira hab-dhaca cudurkan (epidemiological evidence) waxay muujinayaan in xiriir ka dhexeeyo qorax la’aanta iyo cudurada dhimirka. Waxaa xaqiiqo ah in cudurada dhimirku ku badan yahay wadamada qabow, tusaale ahaan wandanka Igiriiska lixdii qof mid baa qaba.

2)    Dadka qaba cudurada dhimirka waxay u badan yihiin inay hayso fitamiin D yari [ low 25(OH)D].

3)    Inta badan cudurada dhimirka waxaa weheliya cuduro kale oo la xiriiraan fitamiin D yari.

4)    Tijaabooyin lagu sameeyay xayawaan iyo sheybaaro waxay sharaxeen qaabka fitamiin D yaridu uga qayb-qaadan karto cudurada dhimirka.

5)    Cilmi baarisyo ayaa muujiyay in fitamiin D-gu wax u taro marka la siiyo dadka qaba cudurada dhimirka.

Sidaa darteed qofkasta oo qaba cudurada dhimirka ee jooga dhulka qaboobaha waa in la ogaadaa heerka fitamiin D-giisa, korna loo soo qaado haddii uu hooseeyo, gaar ahaan dadka madow iyo kuwa aan qoraxda u soo bixin. Cudurada dhimirka ee sida gaarka loo baaray waxaa ka mid ah dammanaanta (low mood), quusta (depression), iskiisofareniya iyo waalida (mania, bipolar disorder and seasonal effective disorder).

Arinta kaloo xiisaha leh waxay tahay inay jiraan xiriir ka dhexeeya heerka fitamiin D-ga iyo garaadka qofka, taasoo la oran karo in fitamiin yaridu keeni karto garaad-yari, maxaa yeelay waxaa la arkay qaadashada fitamiin D-gu ay garaadka kobciso.[33],[34]

SOOMAALIDA, OOTIISAM-KA IYO FITAMIIN D-YARIDA

Waxaa la ogaaday in caruurta Soomaaliyeed ee ku nool magaalada Manisooto, Maraykanka, ee qabta cudurka ootiisam-ka ay ka badan yihiin kuwa kale. Baaritaan ay samaysay waaxda caafimaadka ee Maanisooto 2009-kii, oo dib loogu eegay diiwanada iskuulada muddo saddex sano ah (2005 ilaa 2008), gaar ahaan caruurta da’doou u dhexayso 3 illaa 4 sano jir, waxaa lagu ogaaday in tirada caruurta Soomeeliyeed ee heshay kaalmada la siiyo dadka qaba cudurka ootiisamka ay 7 jeer ka badan yihiin caruurta aan Soomlida ahayn.[35]

Sidoo kale wadanka Iswiidhan (Sweden), baaritaan lagu sameeya 17 ilmood oo qaba cudurka ootiisam-ka, waxaa lagu ogaaday in ilaa 4 laab ay Soomaalidu ka badan yihiin dadka kale.[36] Taas macnaheedu waxay noqon kartaa inay ka badan yihiin xataa dadyowga kale ee madow.

Haddaan dhinaca kale ka eegno, Soamaaliya oo hesha cadceed sanadkoo dhan, way adagtahay inaad ka dhex hesho dadkeeda ilmo qaba cudurka ootiisamka, xaqiiqdiina ma jiro magac ay Soomaalidu u taqaan cudurkan. Laakiin markay u hijroodeen dhulalkaa qabow waxay noqdeen bulshada ugu horeeysa saamaynta cudurkan. Tanina waxay ka yaabisay saynisyahano badan, maxaa yeelay, waxay ka hortimid arigtidii hore loo qabay oo ahayd in cudurkani intiisa badan la xiriiro hiddaha (genetic), maadaama hiddahaasi muuqan waayay markii Soomaaliya la joogay. Runtiina waxaan ku doodi karaa inay tani ahayd arinta daahfurtay in xaqiiqda cudurkan la fahmo ama si dhab ah loo eego.

Anagoo og kaalinta fitamiin D-ga iyo meerkuridu ku leeyihiin cudurka ootiisamka, in Soomaalidu u sii nuglaato cudurka waxaa sii sahlay, marka koowaad, intabadan dumarka soomaaliyeed oo xirta xijaabka iyo ayagoo guryaha ku ekaada, taasoo ah waajibaad diineed, iyo marka labaad, ka warqabid la’aanta faa’iidooyinka fitamiin D-ga, gaar ahaan marka la joogo dhulka qoraxdu ku yartay.

GUNAANAD

Doodeenaas ka dib, waxaa iska cad in fitamiin D-gu muhiim u yahay koriinka iyo shaqada jirka dadka (iyo noolaha kalaba), iyo ka hortagga cuduro badan, waana maado aan dhib-badnayn, laakiin nasiib daro, waxaa qaadasheedii caqabad ku noqoday baqdin aan muhiim ahayn oo laga qabo dhibkeeda (side effects), qoraxdii oo laga fogaaday iyo ku baraarug la’aanta faa’iidooyinkeeda.

Baaritaanadii u danbeeyay waxay banaanka soo dhigeen muuqaalka saxda ah ee hoormoon-kaan, waxayna tibaaxeen sababaha ka danbeeyn kara cuduro badan oo lala xiriiriyay bay’adda. Haddaba waa inaan ku baraarugnaa muhimadda ay leedahay arintan, oo aan waqtigu naga dhicin, kana hortagnaa cawaaqibxumada ka dhalan karta fitamiin D-yarida.

Maadaama cudurka ootiisamku ku badan yahay dadka soo-galootiga ah (immigrants), dhinaca kalana wax ka qabadkiisu u baahanyahay dhaqaale badan, wadamadaasi ma ayan siin tixgalintii loo baahnaa, waxaana la is oran karaa waxay u dhaqmayaan qaab cadowtinimo, tusaale ahaan sida ay uga warwareegayaan inay soo saaraan xaasilka baaritaanada qaab-bulshadeed (demograpgic studies), tusaale ahaan wadanka Kanada oo Soomaali badani ku dhibantahay, laakiin aan sheegsheegin.

Qeexiddii hore, oo ahayd in fitamiin D-yaridu ay tahay heerka 25(OH)D3 ee dhiiga kaasoo ka  hooseeya <15ng/ml (ama <37nmol/L), aad baan loo dhaleeceeyay, maadaama heerkaasi wax ka tari karo oo kaliya dhibkii gaari lahaa lafaha (rickets & osteomalacia), laakiin ka hortaga cudurada kale waxay u baahantahay heer ka sareeyaa intaas, kaa soo dhan  >40ng/ml (ama >80nmol/L), inkastoo khuburada qaarkood ay leeyihiin heerka ugu haboon waa abaaraha 60ng/ml (ama 120nmol/L). Haddaba in qofku joogteeyo heerka 40ng/ml, wuxuu u baahanyahay inuu qaato 75 IU/Kg oo miisaankiisa ah maalintiiba, taasoo celcelis noqonaysa 5,000 IU maalintiiba dadka waawayn. Laakiin haddii qofka ay haysay fitamiin yari daran, wuxuu u baahanyahay dhoos intaa ka badan si uu u soo kabto. Dhinaca kale, baaritaano badan waxaa ku cad haddii qofku qaato illaa 30,000 IU maalintii inaysan keenin wax dhib ah; waxyeeladuna (toxicity) waxay timaadaa marka heerka fitamiin D-ga ee dhiigu gaaro 500 nmol/L.[37]

Cawaaqib xumada ugu daran ee fitamiin D yaridu waxay haleeshaa caruurta gaar ahaan markay uurka ku jiraan, taaso dhaxalsiin karta dhaawac daa’in ah oo kagaara maskaxda, hooyaduna ayaa mas’uul ka ah haddii aritaas looga hortagi kari lahaa inay qaadato fitamiin D (sida aan rumaysnahay). Ilmaha naaska nuugaya qaabka ugu wanaagsan ee lagu siiyo fitimiinkan waa hooyada oo qaadata 5,000 IU malintiiba ama ayagoo toos loo siiyo dhoos ku habboon. Hollis iyo Wagner waxay daahfureen in caanaha hooyadu ay noqonayaan il qani ku ah fitamiin D-ga (kuna filana ilmaheeda) haddii hooyadu qaadato 4,000 IU (100µg) maalintii.[38] Sidaa daraadeed hooyooyinku waa inay qaataan dhoos sare oo fitamiin D ah xilliga uurka iyo nuujinta, si ay ugu faa’iideeyaan naftooda iyo ilmahooda.

Khubaro ku xeel-dheer hab-dhaca cudurada (epidemiologists) waxay sheegeen in hidduhu uu u gogolxaari karo balse uusan ahayn waxa keena ootiisamka, fiitamiin D yariduna ay qayb wayn ka ciyaarto. Hadii arintaasi run tahay (illaa xadna waa run e), cudurkan wuxuu noqonayaa mid ka dhashay dayacaad ka timid talo-xumo oranaysa qoraxda ha laga fogaado ayadoon la keenin wax badiil ah (aan lagu boorin in la qaato dhoos badali kara qoraxda).[39]

TALOOYIN:

1)    Qofkasta, ayadoon loo eegin da’da, oo ku nool dhulka qaboobaha ah waa inuu qaato fitamiin D gaaraya 75 IU/Kg maalintii ama 200,000 IU labadii biloodba mar.

2)    Qofkasta waa inuu isku dayaa inuu qoraxda isu dhigo, kana fogaado isticmaalka kareemada qoraxda celiya.

3)    Dumarka xijaaban ee ku nool dhulka qoraxda leh waa inay qaataan fitamiin D.

4)    Waxaad gadan kartaa fitamiin d-ga adigoon warqad dhakhtareed wadan, inta badana lagama helo dhooska saxa farmashiyayaasha, balse waxaad ka heli kartaa dukaamada gada daawooyinka dabiiciga ah (natural medicine shops), waxaana ku talin lahaa inaan gadataan VITAMIN D3 4000 IU DROPS, kaasoo qofka wayni qaadanayo 2-3 dhibcood maalintii, oo u dhiganta 4000-6000 IU, caruurtana 1-2 dhibcood maalintii, oo u dhiganta 2000-4000 IU.

5)    Hay’adaha ay leeyihiin dadka Soomaaliyeed waa inay ka qaybqaataan baaritaanka lagu hayo arimahan.

6)    Haddii aad u baahantahay warbixin dheeraad ah waxaad ka heli kartaan internet-ka, gaar ahaa casharo muuqaal ah (video) ayaa ku jira YouTube-ka, adigoo ku baaraya “vitamin D”, waxaa jira website-yo u gaar ah fitamiin D-ga sida www.vitamindcouncil.org .

7)    Wixii mulaaxado ah waxaad iigu soo diri kartaa drahmedbashi@hotmail.co.uk .

CUDURDAAR

Waxaan ka cudurdaaranayaa haddii aan khalad ka galay af-soomaaliga, maadaama in badan aan isku dayay in ereybixin samaysto, markaan waayay meel aan ugu laabto.

W/Q: Dr. Axmed Cumar Abdi (Axmedbaashi).

 

[1] Hollic M. F., Moderen Nuitrition in Health and Disease.  Chapter 18, Lippincott, Williams and Wilkins, 9th ed. 1999.

 

[2] Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 2005 Feb;135(2):317-22.
[3] Harrison's Principles of Internal Medicine: Chapter 346. Bone and Mineral Metabolism in Health and Disease; 17th  Edition 2008, page 2373-7

[4] Tuohimaa P et al. Vitamin D, nervous system and aging. Psychoneuroendocrinology. 2009 Dec;34 (1):278-86.

[5] Meguid NA, Hashish AF,Anwar M, Sidhom G: Reduced serum levels of 25-hydroxy and 1,25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med.  2010 Jun;16(6):641-5.

[6] Baird G, et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet. 2006 Jul 15;368(9531):210-5.
[7] Michael W.  Sean N., Nodir A. and John W. Arch Pediatr Adolesc Med. 2008;162(11):1026-1034.

[8] Nelson BK.  Evidence for Behavioural teratogenicity in humans. J Appl Toxicol 1991; 11: 33-7.

[9] Geier DA, King PG, Sykes LK  & Geier MR.  A comprehensive review of mercury provoked autism Indian J Med Res. 2008 October; 128:383-411

[10] Blaxill MF. Study fails to establish diagnostic substitution as a factor in increased rate of autism. Pharmacotherapy 2004; 24:12–13.

[11] Geier DA, Geier MR. A two-phased population epidemiological study of the safety of thimerosal-containing vaccines: a follow up analysis. Med Sci Monit. 2005; 11:CR160–70.

[12] Cannell JJ. Review Article: Autism and Vitamin D. Med Hypotheses. 2008;70(4):750-9.
[13] Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders--autism and developmental disabilities monitoring network, 14 sites, United States, 2002. MMWR Surveill Summ. 2007 Feb 9;56(1):12-28.

[14] Grant WB, Soles CM. Epidemiologic evidence supporting the role of maternal vitamin D deficiency as a risk factor for the development of infantile autism. Dermatoendocrinol. 2009 Jul;1(4):223-8.

[15] Stevens MC, Fein DH, Waterhouse LH. Season of birth effects in autism. J Clin Exp Neuropsychol. 2000 Jun;22(3):399-407.
[16] Gillberg C, Schaumann H, Gillberg IC. Autism in immigrants: children born in Sweden to mothers born in Uganda. J Intellect Disabil Res. 1995 Apr;39 ( Pt 2):141-4.
[17] Newschaffer CJ, et al. The Epidemiology of Autism Spectrum Disorders (*). Annu Rev Public Health. 2007 Apr 21;28:235-258.
[18] Bodnar LM, et al. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007 Feb;137(2):447-52.
[19] Shiao SY, Andrews CM, Helmreich RJ. Maternal race/ethnicity and predictors of pregnancy and infant outcomes. Biol Res Nurs. 2005 Jul;7(1):55-66.
[20] Kolevzon A, Gross R, Reichenberg A. Prenatal and perinatal risk factors for autism: a review and integration of findings. Arch Pediatr Adolesc Med. 2007 Apr;161(4):326-33.
[21] Mannion CA, Gray-Donald K, Koski KG. Association of low intake of milk and vitamin D during pregnancy with decreased birth weight. CMAJ. 2006 Apr 25;174(9):1273-7.
[22] Vahratian A, et al. Multivitamin use and the risk of preterm birth. Am J Epidemiol. 2004 Nov 1;160(9):886-92.
[23] Marya RK, Rathee S, Lata V, Mudgil S. Effects of vitamin D supplementation in pregnancy. Gynecol Obstet Invest. 1981;12(3):155-61.
[24] Yeargin-Allsopp M, Drews CD, Decoufle P, Murphy CC. Mild mental retardation in black and white children in metropolitan Atlanta: a case-control study. Am J Public Health. 1995 Mar;85(3):324-8.
[25] Hung DW, Thelander MJ. Summer camp treatment program for autistic children. Except Child. 1978 Apr;44(7):534-6.

[26] Michael FH. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis; special article. American Journal of Clinical Nutrition, 2004 March;79( 3): 362-371.

[27] Giovannucci E.The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control. 2005 Mar;16(2):83-95.

[28] Holick MF. Vitamin D and sunlight: strategies for cancer prevention and other health benefits. Clin J Am Soc Nephrol. 2008 Sep;3(5):1548-54.

[29] Hines SLJorn HKThompson KMLarson JM. Breast cancer survivors and vitamin D: a review. Nutrition. 2010 Mar;26(3):255-62.

[30] Ginde AA, Liu MC, Camargo Jr CA 2009 Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 169:626–632.
[31] Mannion CA, Gray-Donald K, Koski KG. Association of low intake of milk and vitamin D during pregnancy with decreased birth weight. CMAJ. 2006 Apr 25;174(9):1273-7.
[33] Przybelski RJ, Binkley NC. Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function. Arch Biochem Biophys. 2007 Jan 8;
[34] Schoenthaler SJ, et al. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized, double-blind placebo-controlled trial. J Altern Complement Med. 2000 Feb;6(1):19-29.
[35] Rupa Shenoy, Minnesota Public Radio: Controversial autism researcher tells local Somalis disease is solvable,  December 17, 2010.
[36] MARINA JIMÉNEZ: The Somali autism puzzle; From Tuesday's Globe and Mail; last updated Friday, Apr. 10, 2009 http://www.autismspectrumconnection.com/blogs/newsfeedas/thesomalia (cited 2/18/2011).

[37] Heany RP Vitamin D: criteria for safety and efficacy. Nutr Rev. 2008 Oct;66(10 Suppl 2):S178-81.

[38] Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1752S-8S.
[39] Cannell JJ. Review Article: Autism and Vitamin D. Med Hypotheses. 2008;70(4):750-9.

Faafin: SomaliTalk.com | April 6, 2011 | Updated: April 11, 2011

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