Next review date: November 2016
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.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.