Government guidelines propose vitamin D supplements in the diet

People in the UK need to consider dietary supplementation of the essential vitamin D in their diets to compensate for the absence of that produced in the body from exposure to sunlight during the months of October to March, according to new government dietary guidelines from Public Health England (PHE).

The new dietary guidelines cover food energy and nutrients for infants, children and young people aged between one and 18 and adults aged 19 years and over and are intended to be used by the public alongside the PHE’s Eatwell Guide, which outlines a healthy diet.

Vitamin D is essential in helping the body to absorb essential elements, such as iron, magnesium, phosphate, zinc and calcium, which promotes bone growth. It is also important for other important bodily functions. Too little vitamin D results in soft bones in children (rickets) and fragile, misshapen bones in adults (osteomalacia).

Vitamin D intake

The guidelines are based on a review of vitamin D intake recommendations by the Scientific Advisory Committee on Nutrition (SACN), a committee of independent experts that advises the Food Standards Agency. In its report ‘Vitamin D and Health’, SACN published new proposals sufficient to maintain a blood vitamin D level of at least 25nmol/litre.

The recommended nutrient intake (RNI) proposed by SACN for all people aged four and above was 10µg/day, which the PHE has included in its new guidelines.

“Between late March/early April and September, the majority of people aged five 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,” said British Nutrition Foundation nutrition scientist Dr Rosalind Miller.

“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 [10µg] of vitamin D. 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 to 10 µg of vitamin D.”

Miller said that people with very little or no sunshine exposure should take a daily supplement containing 10µg of vitamin D throughout the year.

And she added: “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 10µg vitamin D throughout the year.”

As well as accommodating new recommendations for vitamin D, the PHE dietary guidelines also include ones for free sugars and dietary fibre, which are based on proposals from the Committee on Medical Aspects of Food Policy as well as from SACN, which also looked into the relationship between dietary carbohydrates, including free sugars –  those added to food and drinks – and health in its report published in 2015.

The SACN carbohydrates report contained new recommendations, including a reduction to 5% of total dietary energy from free sugars (previously 10%), something widely picked up by the popular press at the time.

However, it also proposed that people should be eating 30g of fibre (another carbohydrate) a day – much more than they currently consume. Unfortunately for nutritionists, this received far less press attention.

Average intakes of free sugars in the UK population as a whole are at least twice the 5% recommendation and three-times the 5% value in 11 to 18-year olds, according to SACN. The main sources of free sugars have been identified as soft drinks and cereal products sweetened with sugars, confectionery, table sugar and fruit juice.

SACN said that decreasing the average intake of free sugars in the population was one step that could reduce the current UK overconsumption of calories in relation to energy requirements.

Greater fibre consumption

SACN recommended that the UK’s intake – or dietary reference values (DRVs) – for fibre be raised, since fibre intake is associated with reduced risk of a number of significant chronic diseases, such as heart disease, stroke, type 2 diabetes and bowel cancer.

It proposed that DRVs for fibre be raised from the equivalent of 23-24g to 30g of fibre a day for those aged 16 years and over. For children, the recommended intakes are: 15g/day (age two to five); 20g/day (age five to 11); 25g/day (age 11 to 16).

“Dietary surveys suggest that intakes are currently well below these targets (average intakes in adults are around 18g fibre), reflecting low consumption of fibre-containing foods such as fruit, vegetables, nuts and seeds and high-fibre/wholegrain starchy foods,” said Miller. Dietary patterns will need to change if the new fibre recommendations are to be met.”