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.

Abstract

Background: Following advice from The Scientific Advisory Committee for Nutrition (SACN) report outlining the updated recommendations (10μg) for vitamin D in the UK, the Scottish Government amended adult and infant vitamin D recommendations in 2017. Previously, no recommendation was set for the general population as they were not thought to be at risk of deficiency. Similarly, infant recommendations have changed from 7μg to 8.5-10μg/day. Healthy Start supplements; free to families on a low income in Scotland, have not yet been updated to meet these new recommendations. Aims: 1. To assess knowledge regarding the sources and role of vitamin D in health and knowledge of updated vitamin D recommendations and supplement use in a Scottish population (18-65 years) 2. To assess the availability and affordability of infant vitamin D supplements in Edinburgh. Methods: For the first part of this study, an online questionnaire was developed using information from NHS choices. The questionnaire consisted of ten open ended and closed questions to assess knowledge of updated vitamin D recommendations as well as sources and health roles of vitamin D and supplement use. A pilot questionnaire was carried out with nine participants for face and validity. A knowledge score (low score=<5, high score= ≥5) was then calculated from the answers. For the second part of the study, a survey was conducted in two areas of high deprivation (SIMD 10% most deprived) and two areas of low deprivation (SIMD 10% least deprived) in Edinburgh, Scotland to assess the availability and affordability of infant vitamin D supplements which meet the new recommendation of 8.5-10μg. Results: 98 participants completed the survey (male = 32% n=31, female= 68%, n=67). Only 18 (18%) participants were currently taking a supplement with just 13 (13%) aware of the new recommendation. Similarly, general vitamin D knowledge was low (low score = 71% n=70, high score = 29% n=28). There was no association between knowledge score and age (X2=2.591, p=0.473), gender (X2 =0.797, p=0.473), education (X2=1.188, p=0.414) and ethnicity (X2=0.152, p=0.738). Similarly, there was no association between supplement use and age (X2= 0.003, p=1.000), gender (X2=0.53, p=1.000), education (X2=0.093, p=0.793) ethnicity (X2=0.203, p=0.751) and knowledge score (X2=2.767, p=0.144). Accessibility to supplements was low in the most deprived areas (SIMD 10% most deprived) with only one supplement available. In contrast, seven supplements were available in the least deprived areas (SIMD 10% least deprived). Conclusion: Vitamin D knowledge scores were low in this Scottish population. There was limited knowledge of updated recommendations and supplement intake was low. Accessibility of infant vitamin D supplements is low in the most deprived areas of Edinburgh (SIMD 10% most deprived) with only one supplement available in comparison to seven available in the least deprived areas (SIMD 10% least deprived). This proves the need for widespread publication and education around vitamin D. There was no association between knowledge score and any demographic variable or supplement use. Further research is required to investigate whether knowledge is associated with vitamin D status, however results indicate the need for improved health literacy around vitamin D in Scotland. Key Words: Vitamin D, SACN, Scotland, Infant supplements, SIMD.