Implementation strategies for improving vitamin D status and increasing vitamin D intake in the UK: Current controversies and future perspectives. Proceedings of the 2nd Rank Prize Funds Forum on Vitamin D

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Date
2021-07-21
Authors
Buttriss, J. L.
Lanham-New, S. A.
Steenson, S.
Levy, L.
Swan, G. E.
Darling, A. L.
Cashman, Kevin D.
Allen, R. E.
Durrant, L. R.
Smith, C. P.
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Publisher
Cambridge University Press
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Abstract
A multi-disciplinary expert group met to discuss vitamin D deficiency in the UK, and strategies for improving population intakes and status. Changes to UK Government advice since the 1st Rank Forum on Vitamin D (2009) were discussed, including rationale for setting a RNI (10µg/day;400IU/day) for adults and children (4+ years). Current UK data show inadequate intakes among all age groups, and high prevalence of low vitamin D status among specific groups (e.g. pregnant women and adolescent males/females). Evidence of widespread deficiency within some minority ethnic groups, resulting in nutritional rickets (particularly among Black and South Asian infants), raised particular concern. It is too early to establish whether population vitamin D status has altered since Government recommendations changed in 2016. Vitamin D food fortification was discussed as a potential strategy to increase population intakes. Data from dose-response and dietary modelling studies indicate dairy products, bread, hens' eggs and some meats as potential fortification vehicles. Vitamin D3 appears more effective than vitamin D2 for raising serum 25-hydroxyvitamin D concentration, which has implications for choice of fortificant. Other considerations for successful fortification strategies include: i) need for 'real-world' cost information for use in modelling work; ii) supportive food legislation; iii) improved consumer and health professional understanding of vitamin D's importance; iv) clinical consequences of inadequate vitamin D status; v) consistent communication of Government advice across health/social care professions, and via the food industry. These areas urgently require further research to enable universal improvement in vitamin D intakes and status in the UK population.
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Keywords
Public health , Vitamin D3 , Vitamin D2 , 25-hydroxyvitamin D , Food fortification
Citation
Buttriss, J. L., Lanham-New, S. A., Steenson, S., Levy, L., Swan, G. E., Darling, A. L., Cashman, K. D., Allen, R. E., Durrant, L. R., Smith, C. P., Magee, P., Hill, T. R., Uday, S., Kiely, M., Delamare, G., Hoyland, A. E., Larsen, L., Street, L. N., Mathers, J. C. and Prentice, A. (2021) 'Implementation strategies for improving vitamin D status and increasing vitamin D intake in the UK: Current controversies and future perspectives. Proceedings of the 2nd Rank Prize Funds Forum on Vitamin D', British Journal of Nutrition. doi: 10.1017/S0007114521002555
Copyright
© 2021, the Authors. Published by Cambridge University Press on behalf of The Nutrition Society. This material is free to view and download for personal use only. Not for re-distribution, re-sale or use in derivative works.