According to national surveys in the UK, across the population approximately 1 in 5 people have low vitamin D levels (defined as serum levels below 25 nmol/L). Low vitamin D levels are associated with a higher risk of poor musculoskeletal health such as rickets, osteomalacia, falls and poor muscle strength.

The Scientific Advisory Committee on Nutrition (SACN), the committee of independent experts that advises Government on matters relating to diet, nutrition and health, reviewed the scientific literature to ascertain whether current vitamin D recommendations were still appropriate. In the resultant report, Vitamin D and Health, SACN has published new recommendations sufficient to maintain a blood vitamin D level of at least 25 nmol/L in the vast majority (97.5%) of individuals in the UK.

The Recommended Nutrient Intake (RNI) proposed by SACN for all people aged 4 and above is 10 µg/day. For infants and younger children, data are insufficient to set an RNI. Instead, as a precaution, a ‘Safe Intake’ of 8.5-10 µg/day has been set.

Public Health England (PHE), on the basis of SACN’s extensive review, has issued new advice for the general public on vitamin D,  on how these recommendations may be met in practice.

The new government recommendations on vitamin D supplements are set out in the table below with a comparison to previous recommendations.

BNF has also produced a number of articles of interest and resources on vitamin D.
These include a collaboration with our journal Nutrition Bulletin and the Journal of Human Nutrition and Dietetics for a joint virtual issue, Vitamin D – population requirements, intake and status: implications for health http://bit.ly/1nTb56p and Vital vitamin D, a look at dietary sources of vitamin D.

 

Former Department of Health Advice New Advice from 21st July 2016
  • Most people aged 5 and over should be able to get all the vitamin D they need by eating a healthy balanced diet and by getting some summer sun.

  • Between late March/early April and September, the majority of people aged 5 years and above will probably obtain sufficient vitamin D from sunlight when they are outdoors, alongside foods that naturally contain or are fortified with vitamin D. As such, they might choose not to take a vitamin D supplement during these months.
  • From October to March everyone over the age of five will need to rely on dietary sources of vitamin D. Since vitamin D is found only in a small number of foods, it might be difficult to get enough from foods that naturally contain vitamin D and/or fortified foods alone. So everyone, should consider taking a daily supplement containing 10 micrograms of vitamin D.
Special Groups
Pregnant and breastfeeding women
  • All pregnant and breastfeeding women should take a daily supplement containing 10 micrograms.
  • Between late March/early April and September, the majority of pregnant and breastfeeding women will probably obtain sufficient vitamin D from sunlight when they are outdoors, alongside foods that naturally contain or are fortified with vitamin D. As such, they might choose not to take a vitamin D supplement during these months.
  • From October to March, pregnant and breastfeeding women should consider taking a daily supplement containing 10 micrograms of vitamin D.
Infants and Young Children
  • Breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy.
  • Infants who are fed infant formula will not need vitamin drops until they are receiving less than 500 ml of infant formula a day, as these products are fortified with vitamin D.

 

  • All infants and young children aged 6 months to 5 years (receiving less than 500ml infant formula) should take a daily supplement containing vitamin D in the form of vitamin drops, to help them meet the requirement set for this age group of vitamin D per day.
  • All breastfed infants 0 – 1 years. As a precaution, it is recommended that infants from birth to one year of age, whether exclusively or partially breastfed, should be given a daily supplement containing 8.5 to10 micrograms of vitamin D.
  • Infants fed infant formula should not be given a vitamin D supplement unless they are receiving less than 500mls (about a pint) of formula a day.
  • All children aged 1 to 4 years of age should be given a daily supplement containing 10 micrograms of vitamin D.
People with very little or no sunshine exposure
  • People with very little or no sunshine exposure should take a daily supplement containing 10 micrograms of vitamin D.

 

For example

  • People who are housebound or confined indoors for long periods.
  • People who cover up their skin for cultural reasons.

 

  • People with very little or no sunshine exposure should take a daily supplement containing 10 micrograms vitamin D throughout the year.
For example
  • People who are seldom outdoors such as frail or housebound individuals and those who are confined indoors (e.g. in institutions such as care homes).
  • People who habitually wear clothes that cover most of their skin while outdoors.
People aged 65 years and over
  • People aged 65 years or over should take a daily supplement containing 10 micrograms of vitamin D.
  • No special recommendations for those aged 65 and above have been set; the new recommendations for the general population apply.
Minority ethnic groups
  • People who have darker skin, for example people of African, African-Caribbean and South Asian origin, may be at risk of vitamin D deficiency because their bodies are not able to make as much vitamin D.
  • People from minority ethnic groups with dark skin such as those of African, African-Caribbean and South Asian origin might not get enough vitamin D from sunlight in summer so they should consider taking a daily supplement containing 10 micrograms vitamin D throughout the year.
The SACN report Vitamin D and Health is available on http://bit.ly/29X9GoW
The new government advice on vitamin D is available on http://bit.ly/2aekuRe