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Vitamin D status in active duty Navy military personnel: a systematic review
  1. Moisés Henriques1,2,
  2. Diogo Rodrigues1,
  3. Susana Viegas2,
  4. Florentino Serranheira2,
  5. Ema Sacadura-Leite2,3
  1. 1Portuguese Navy Research Centre (CINAV), Portuguese Navy, Almada, Portugal
  2. 2NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Centre (CHRC), NOVA University Lisbon, Lisbon, Portugal
  3. 3Occupational Health Department, Northern Lisbon University Hospital Centre, Lisbon, Portugal
  1. Correspondence to Dr Moisés Henriques, Portuguese Navy Research Centre (CINAV), Portuguese Navy, Almada, Portugal; santos.henriques{at}


Objectives Active duty Navy military personnel are prone to vitamin D deficiency due to an occupational environment detrimental to sunlight exposure. The main objective of this systematic review is to provide a worldwide overview of vitamin D status in this population.

Methods The Condition, Context, Population (CoCoPop) mnemonic was used to define the inclusion criteria (vitamin D status; all contexts; active duty Navy military personnel). Studies with recruits or veterans were excluded. Scopus, Web of Science and PubMed/Medline databases were searched from inception to 30 June 2022. Joanna Briggs Institute and Downs & Black checklists were used for quality assessment and data were synthesised in narrative and tabular formats.

Results Thirteen studies published between 1975 and 2022 and conducted in northern hemisphere Navies, including mainly young and male service members, were included. The prevalence of vitamin D deficiency was globally reported as significant. Nine studies included a total of 305 male submariners who performed 30–92 days submarine patrol and reported the effect of sunlight deprivation in the decrease of vitamin D levels.

Conclusions This new systematic review underlines the high prevalence of vitamin D deficiency in the Navy, especially in submariners, and the need to implement measures to prevent vitamin D deficiency. Serum 25(OH)D data available and the heterogeneity of the studies limited a pooled analysis. Most studies included only submariners, which may limit generalisability to all active duty Navy military personnel. Further research on this topic should be promoted.

PROSPERO registration number CRD42022287057.

  • military personnel
  • occupational health
  • health services research
  • occupational health services
  • preventive medicine

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  • Contributors MH is the guarantor. MH identified the records and removed duplicate records. MH and DR screened all records, performed data extraction and conducted the critical appraisal of all studies. ES-L acted as arbitrator when required. MH drafted the manuscript. MH, DR, SV, FS and ES-L read, provided feedback, and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.