An investigation into the knowledge of updated vitamin D recommendations in a Scottish population, and the availability and affordability of infant vitamin D supplements in Scotland.
Background- Vitamin D’s role in regulating calcium absorption required for mineralisation of bone tissue is well known. Yet, the prevalence of vitamin D deficiency is increasingly becoming a major public health issue worldwide, with research identifying a lack of vitamin D-related knowledge among various population groups. Following advice from the Scientific Advisory Committee on Nutrition (SACN), the Scottish Government updated their advice on vitamin D in November 2017 to 10μg/day (400IU) for adults and 8.5-10μg (340-400 IU)/day for infants from birth to one year, especially those being breastfed. Currently vitamins are available for infants from low socioeconomic background by the Healthy Start Scheme (a Government Initiative), however they do not contain the updated recommendations, and uptake of these are low. The first aim of this study was to understand knowledge of updated vitamin D recommendations; the health benefits and key sources of vitamin D and supplement use in a Scottish adult population (18-65 years). The second was to understand the affordability and availability of infant vitamin D supplements (8.5-10μg) in areas of low and high deprivation in Edinburgh. Methods- Participants were required to fill out an anonymous online survey, created on Survey Monkey, regarding vitamin D-related knowledge. A knowledge score was calculated for each participant, ranging from either 0-4 (low knowledge score) or 5-8 (high knowledge score) related to questions involving knowledge of updated recommendations, sources of vitamin D and health benefits of the vitamin. Researchers carried out a survey between areas of high (SIMD 10% most deprived) and low deprivation (SIMD 10% least deprived) in Edinburgh to assess how accessible and affordable infant vitamin D supplements (8.5-10μg) were. Results- n=98 participants took part (male n=31, female n=67). Overall 87% (n=85) were unaware of the updated vitamin D recommendations for adults. With only 13% (n=13) of participants aware. Of those 13 subjects, nine were aware of 10μg/day as the recommended requirement. Many subjects were aware of vitamin D’s role in maintaining healthy bones, teeth and muscles 94% (n=92) with less being aware of its role in the prevention of rickets (52%, n=51) and osteomalacia (45%, n=44). Many were aware of sunlight being a main source of vitamin D (95%, n=93), 57% (n=56) were aware of oily fish and 42% (n=41) aware of fortified cereals. However, 34% (n=33) thought that spinach was a source of vitamin D. Overall 71% (n=70) of subjects had a low knowledge score. Furthermore, X2 analysis noted no statistically significant association between knowledge score and demographics of the population studied including gender (X2=0.797), age (X2=2.591), education level (X2=1.188) and ethnicity (X2=0.152). No significant association existed between supplement use (n=68) and knowledge score (X2=2.767) or any of the demographics studied for gender(X2=0.53), age (X2=0.003), education level (X2=0.093) and ethnicity (X2=0.203). The second part of the study revealed that infant vitamin D supplements (8.5-10μg) are more available in the least deprived areas in Edinburgh (n=7) ranging from £3.95-£8.25, as opposed to the most deprived areas (n=1) which cost £6.45. There were fewer shops available in the most deprived areas, where supplements could be purchased. Conclusion- The results indicate that knowledge regarding vitamin D is lacking among adults (18-65 years) and highlight how the accessibility and affordability of infant vitamin D supplements (8.5-10μg) is poor in more deprived areas of Edinburgh. Further research is required to investigate whether knowledge is associated with vitamin D status; however, initial results indicate the need for improved health literacy around vitamin D in Scotland. Key Words. Vitamin D, Supplements, SACN, Knowledge, Infants, SIMD