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Successful public health action to reduce the incidence of symptomatic vitamin D deficiency
  1. Robert John Moy1,
  2. Eleanor McGee2,
  3. Geoff D Debelle3,
  4. Ian Mather4,
  5. Nicholas J Shaw1,5
  1. 1School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  2. 2Birmingham Community Health Care NHS Trust – Nutrition and Dietetics, Birmingham, UK
  3. 3Department of General Paediatrics, Birmingham Children's Hospital Foundation NHS Trust, Birmingham, UK
  4. 4Public Health Department, Solihull Primary Care Trust, Solihull, UK
  5. 5Department of Endocrinology, Birmingham Children's Hospital Foundation NHS Trust, Birmingham, UK
  1. Correspondence to Dr Nicholas J Shaw, Department of Endocrinology, Birmingham Children's Hospital Foundation NHS Trust, Steelhouse Lane, Birmingham B4 6NH, UK; nick.shaw{at}bch.nhs.uk

Abstract

Background In response to a resurgence of symptomatic cases of vitamin D deficiency in a high-risk predominantly ethnic minority population, a programme of universal rather than targeted vitamin D supplementation was begun with a public awareness campaign about the importance of vitamin D.

Objective To evaluate the effectiveness of this programme in reducing case numbers.

Methods Cases of symptomatic vitamin D deficiency in children under 5 years resident in a primary care trust catchment area presenting at local hospitals were identified through laboratory records of low vitamin D levels which were cross-checked against medical records to confirm the diagnosis. Comparisons were made of the case incidence rate, level of public knowledge and vitamin supplement uptake rate at the onset of the programme in 2005 and 4 years later.

Results The number of cases of symptomatic vitamin D deficiency in those under 5 years fell by 59% (case incidence rate falling from 120/100 000 to 49/100 000) despite the supplement uptake rate rising only to 17%. Public awareness of vitamin D deficiency rose to near universal levels.

Conclusions A programme of universal rather than targeted Healthy Start vitamin D supplementation for pregnant and lactating women and young children has led to a substantial decrease in cases of symptomatic vitamin D deficiency in a high-risk population. Supplementation was also started at a younger age than in the national programme. This approach has implications for the delivery of vitamin D supplementation programmes in similar populations.

  • Bone Metabolism
  • Nutrition

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