Food fortification or individual supplementation?Vičič, Vid (Avtor) Background: This study critically reviews the recently published “Slovenian guidelines for adequate vitamin D status (2025)”, focusing on the chapter titled Cost assessment of selected recommendations in the Slovenian guidelines for ade-quate vitamin D provision. Several methodological weaknesses were identified in the economic evaluation, which may lead to inefficient and inequitable public health decisions. Methods: A secondary analysis of the guideline’s cost-assessment methodology was performed, together with an inde-pendent cost comparison of vitamin D sources. Results and discussion: The guideline’s cost-effectiveness analysis for reducing acute respiratory infections (ARI) in older adults (>65 years) with serum 25(OH)D <25 nmol/L is based on a subgroup meta-analysis in which >80% of participants were children, making extrapolation to older adults questionable. The model also assumes unrealistically high adherence to vitamin D supplementation. In contrast, population-wide food fortification is proven effective, minimizes adherence problems, is cost-effective, and ensures equitable access. Estimated annual costs for providing 20 μg vitamin D₃ daily to the total population aged ≥1 year (2.1 million people) were: 26.1 million EUR for prescription medicines; 37.3 million EUR for prescription medicines including a yearly short physician visit; 112.1 million EUR for over-the-counter medicines; 30.4 million EUR for food supplements; and 0.4 million EUR for food fortification. Conclusions: Given its demonstrated effectiveness, low cost, and ability to reduce health inequities, population-wide food fortification represents the most realistic strategy for preventing vitamin D deficiency in the entire population.20262026-07-01 09:57:40Članek v reviji184164sl