The Government launches a new initiative to promote vitamin D intake and opens a 6-week call for evidence on how to increase vitamin D uptake in England

vitamin d pill

The Department of Health and Social Care (DHSC) has launched a new initiative to promote vitamin D intake, including increasing the use of dietary supplements and fortified foods and drinks. In parallel, the new Office for Health Improvement and Disparities (OHID) has opened a 6-week public consultation on how to improve the vitamin D status of the population in England.

Around one in six adults and almost 20% of children in the UK have vitamin D levels lower than Government recommendations. This is particularly likely among older people, those who are housebound, and people from Black and South Asian communities, the Government said.

OHID’s call for evidence on how to achieve the objective ‘will kickstart a national campaign to raise awareness of the importance of vitamin D, and gather views from the public, public health experts, retailers, food manufacturers and other industry bodies on ambitious ways to improve uptake and tackle disparities’, it said.

OHID will engage with representatives from major retailers, pharmacy and health organisations, patient groups, and bodies representing people from at-risk groups to support the national awareness campaign.

Dr Tazeem Bhatia, Interim Chief Nutritionist at OHID, said: ‘I welcome this call for evidence as part of OHID’s continued drive to improve health outcomes and tackle health disparities. We want to improve the dietary health of the population and this includes supporting everyone to maintain sufficient vitamin D levels to support strong and healthy bones and muscles.’

Uptake of vitamin D is ‘extremely low’

Current advice is for all adults and children to maintain adequate vitamin D levels through diet and safe sun exposure, and for adults to consider taking a 10-mcg vitamin D supplement daily, especially between October and March when sunlight levels in the UK are not strong enough to achieve sufficient skin synthesis. Some at-risk groups are advised to consider taking a supplement throughout the year. Parents may be advised to give children daily vitamin drops, depending on their age and breastfeeding status.

However, uptake is poor, with only one in six adults overall reporting taking a daily supplement. Even where free supplements are available, estimated uptake is ‘extremely low’, the Government said. This includes eligible pregnant women and new mothers, who can receive free supplements containing folic acid, vitamin C, and vitamin D under the Healthy Start scheme, and children aged under 4 years who can also receive free supplements.

The campaign is timely. A new survey last month conducted by YouGov for the Royal Osteoporosis Society showed that among 2231 adults questioned:

  • over one-third (37%) incorrectly believed they can get enough vitamin D from the sun all year round

  • the amount of time adults spend outside in the UK has decreased by 32% since the start of the pandemic in March 2020

  • although 63% identified diet as another source of vitamin D, one-third (29%) were unable to identify vitamin D-rich food sources

  • only just over half (57%) were aware of the importance of vitamin D to bone health, compared with 86% who understand the role of calcium.

In terms of advice for clinicians, a DHSC spokesperson told Medscape UK: ‘The National Institute for Health and Care Excellence (NICE) guidance states that health professionals should not routinely test people’s vitamin D status unless: they have symptoms of deficiency; they are considered to be at particularly high risk of deficiency (e.g. they have low exposure to sunlight); there is a clinical need to do so (e.g. they have osteomalacia or have had a fall). DHSC and the NHS follow this guidance.’

GPs asked for advice should also assess the person’s dietary calcium intake and possible need for calcium supplementation, NICE states.

Vitamin D Deficiency Linked to a Range of Conditions

As well as osteoporosis, hip fractures, and falls, there is some evidence that low vitamin D levels may play a role in the risk of a range of other conditions, including multiple sclerosis, heart disease, diabetes, and cancer. However, the links remain inconclusive.

There are also reports that vitamin D deficiency is linked to severe COVID.

Karis Betts, health information manager at Cancer Research UK told Medscape UK: ‘Low levels of vitamin D can cause health problems, which supplements can help prevent. But, there is not enough evidence that taking them also reduces the risk of cancer.

‘Sadly, it’s not surprising that there are inequalities around vitamin D levels across England. This echoes wider health disparities that stretch across healthcare and especially in cancer care. Any efforts to increase vitamin D levels should prioritise the groups who are most at risk of deficiency.’

The OHID review comes ahead of the Health Disparities White Paper due to be published later this year, which will set out action to reduce health disparities between different places and communities and address their causes.

Health and Social Care Secretary Sajid Javid said: ‘We must break the link between background and prospects for a healthy life, and I am determined to level up the health of the nation and tackle disparities.

‘People from Black and Asian communities, older people, and people who have limited access to the outdoors are more likely to have lower levels of vitamin D, which is essential for bone and muscle health and improving years of life lived in good health.

‘I have launched this call for evidence to identify innovative ways we can encourage people to increase their vitamin D intake and help people live longer, healthier, and happier lives.’

Call for evidence

Respondents’ views are invited on the following specific areas:

  • addressing health disparities related to accessing and consuming vitamin D

  • improving population awareness of vitamin D

  • improving awareness among health and care professionals of vitamin D

  • improving vitamin D status through diet, including fortified foods and biofortification

  • improving vitamin D status through dietary supplements, and increasing access to and availability of dietary supplements. 

Responses are welcomed from individuals over age 16 years, professionals, organisations and business, and can be submitted via an online survey or by post or email.

The DHSC told Medscape UK: ‘The Government will publish a summary of responses shortly after the call for evidence closes on 15 May. Evidence submitted will be considered as part of a policy to improve the vitamin D status of the population, and this may lead to further consultation in the future.’

This article originally appeared on Medscape, part of the Medscape Professional Network.

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