What is this guideline about?
This guideline aims to increase supplement use to prevent vitamin D deficiency among specific population groups, as identified in 2012 by the UK Health Departments (Vitamin D – advice on supplements for at risk groups – letter from UK Chief Medical Officers Department of Health), and in 2016 by the Scientific Advisory Committee on Nutrition's vitamin D and health report).
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 of vitamin D are limited. The main natural source is from the action of sunlight on skin. However, from October to the beginning of April in the UK there is no ambient ultraviolet sunlight of the appropriate wavelength for skin synthesis of vitamin D. National surveys suggest that around a fifth of adults and 8 to 24% of children (depending on age and gender) may have low vitamin D status. (See context for more details.)
The risks and benefits of sunlight exposure (including exposure to prevent vitamin D deficiency) are covered in a separate guideline (see related NICE guidance).
For the purpose of this guideline, a supplement refers to supplements of vitamin D, either alone or contained in multi-vitamin products (including Healthy Start supplements). It includes licensed products available only on prescription or through pharmacies and (unlicensed) food supplements available from a range of pharmacies and retail outlets.
The Scientific Advisory Committee on Nutrition (SACN) reviewed the dietary reference values for vitamin D intake in the UK population in 2016. They recommend that vitamin D supplements are made available for the entire population (4 years old or more) throughout the year. The recommendations should be read in conjunction with the SACN vitamin D and health report 2016.
Clinical judgement will be needed to determine whether NICE's recommendations in this guideline are suitable for people with conditions that increase the risk of vitamin D deficiency.
The 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. (For further details, see who should take action?) In addition, it may be of interest to members of the public.
See about this guideline for details of how the guideline was developed and its current status.