Background

Vitamin D deficiency is a significant public health problem. There is a resurgence of rickets1 and osteomalacia and the association between vitamin D status and many other diseases remains under close scrutiny.2 Recent surveys have suggested that over 1 billion people worldwide are vitamin D deficient3 and 50% of white adults and >90% of South Asians in the UK have insufficient vitamin D levels.4 Young people and those with darker skin or limited sunlight exposure are particularly at risk and it is unlikely that high-risk groups can meet their vitamin D requirements through diet alone. Testing for vitamin D deficiency has escalated in recent years, with significant cost implications for the NHS.5

In November 2014, the National Institute for Health and Care Excellence (NICE) published a guideline entitled Vitamin D: Increasing supplement use among at-risk groups (PH56).6 The aim of this guideline is to increase vitamin D supplement use to prevent vitamin D deficiency. The guideline focuses on the following at-risk groups:

• infants and children aged under 5 years

• pregnant and breastfeeding women, particularly teenagers and young women

• people over 65 years of age

• people who have low or no exposure to the sun, for example, those who cover their skin for cultural reasons, who are housebound or are confined indoors for long periods

• people with darker skin, for example, people of African, African-Caribbean or South Asian family origin.

The Scientific Advisory Committee on Nutrition (SACN) is currently reviewing guidelines for recommended daily intakes of vitamin D and it is advised that people should follow the NICE guidelines in conjunction with future advice published by SACN.

Previous guidelines

NICE guideline PH56 replaces recommendation 3 in NICE guideline PH11, entitled Maternal and Child Nutrition. Recommendation 1.3.2.4 in …