Vitamin D: increasing supplement use among at-risk groups

NICE guidelines [PH56] Published date:

This guideline aims to increase supplement use to prevent vitamin D  deficiency among at-risk groups including:

  • infants and children aged under 5
  • pregnant and breastfeeding women, particularly teenagers and young women
  • people over 65
  • people who have low or no exposure to the sun, for example, those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods
  • people with darker skin, for example, people of African, African-Caribbean or South Asian family origin.

Vitamin D is essential for skeletal growth and bone health. Severe deficiency can result in rickets (among children) and osteomalacia (among children and adults). Dietary sources are limited. National surveys suggest that around a fifth of adults and 8 to 24% of children may have low vitamin D status.

The main natural source of vitamin D is from sunlight on skin. However, from mid-October to the beginning of April in the UK there is no ambient ultraviolet sunlight of the appropriate wavelength. 

The Scientific Advisory Committee on Nutrition (SACN) is reviewing the dietary reference values for vitamin D intake in the UK population. NICE’s recommendations should be read in conjunction with any advice published by SACN.

This guideline is for: commissioners, managers and other professionals with public health as part of their remit, working within the NHS, local authorities and the wider public, private, voluntary and community sectors. It is also aimed at manufacturers and providers of vitamin D supplements.

Sunlight exposure: benefits and risks (including exposure to prevent vitamin D deficiency) is covered in a separate NICE guideline currently under development.

This guideline updates and replaces recommendation 3 in Maternal and child nutrition NICE guideline PH11. In addition, recommendation 1.3.2.4 in Antenatal care NICE guideline CG62 has been updated.

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