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NICE calls for national campaign to promote daily vitamin D supplements



NICE has called for a nationwide public health campaign to make sure people at risk of vitamin D deficiency take a daily supplement, as recommended by the Department of Health.

In draft public health guidance launched today, NICE backed the DH advice by calling for GPs to recommend a daily vitamin D supplement to at-risk groups ‘at every available opportunity’.

However, GP leaders warned that while it was important to raise awareness about the risks of vitamin D deficiency, there should be more emphasis on getting people to take in enough vitamin D through their diet or from sun exposure rather than relying on daily supplements.

NICE said the new guidance is aimed at improving implementation of current recommendations on vitamin D to prevent deficiency, which advise supplements for infants and children aged under five, pregnant and breastfeeding women, older people, those with darker skin and those have limited sun exposure.

However, the NICE advisors said the DH needed to make sure vitamin D supplements are more widely available in the right strengths, and from pharmacies as well as on prescription.

And they called for greater consistency between the DH’s recommendations and those from NICE and the Scientific Advisory Committee on Nutrition, before the awareness campaign is started.

The guidance states: ‘Public Health England should lead development of a national campaign to raise awareness of the importance of vitamin D, as soon as existing recommendations on vitamin D have been clarified and made consistent.

‘The campaign should: emphasise the importance of vitamin D for good health, emphasise the importance of a daily supplement for identified at-risk groups [and] let people know where they can get vitamin D supplements.’

NICE said GPs should avoid vitamin D testing in people who do not have symptoms of deficiency – in line with National Osteoporosis Society guidance – and simply offer supplements to those from at-risk groups.

It said: ‘Health and social care professionals should recommend a daily vitamin D supplement to people from at-risk groups at every available opportunity.’

The guidance comes despite doubts being raised about the value of vitamin D supplementation even in some at-risk groups and concerns from some commissioners that widespread prescribing of vitamin D supplements is costly and unnecessary.

Dr John Grenville, chair of Derbyshire LMC, told Pulse he would prefer more emphasis on people getting vitamin D naturally, but would welcome the awareness campaign provided people were able to access the supplements easily.

Dr Grenville said: ‘I think we should be recommending sources of vitamin D as part of a healthy diet – as we should be for everybody. And I think as a society we should possibly be thinking about supplementing foods with vitamin D as we do with vitamin B, rather than treating it as a medical problem.’

He added: ‘I would welcome it provided we have the means to deal with it – people need to know where they can get the vitamins and we need to make that as effective and cost-effective as possible.

‘We certainly don’t want to make it only available on prescription, except in the cases with a definite vitamin D deficiency and related illness, because we have enough problems with access to prescribers anyway – be those doctors, nurses or other prescribers.’

NICE Public Health Draft Guidance – Vitamin D: implementation of existing guidance to prevent deficiency