Publication - Research and analysis

Evaluation of the Healthy Start Scheme: An Evidence Review

Published: 18 Mar 2016

A review of the evidence base on the Healthy Start Scheme

Evaluation of the Healthy Start Scheme: An Evidence Review


1. Agostoni, C., Canani, R. B., Fairweather-Tait, S., Heinonen, M., Korhonen, H., Vieille, S. L.,… & Lauritzen, L. (2013). Scientific Opinion on nutrient requirements and dietary intakes of infants and young children in the European Union. EFSA Journal, 11(10), 3408.

2. Ahmed, S. F., Franey, C., McDevitt, H., Somerville, L., Butler, S., Galloway, P., ... & Wallace, A. M. (2011). Recent trends and clinical features of childhood vitamin D deficiency presenting to a children's hospital in Glasgow. Archives of disease in childhood, 96(7), 694-696.

3. Alderton, S. (2014). Do we need free vitamins for all babies and young children in the UK? Nutrition Bulletin, 39(2), 187-194.

4. Al-Gailani, S. (2014). Making birth defects 'preventable': Pre-conceptional vitamin supplements and the politics of risk reduction. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 47, 278-289.

5. Attree, P. (2006). A critical analysis of UK public health policies in relation to diet and nutrition in low-income households. Maternal and Child Nutrition, 2(2), 67-78.

6. Barbour, R. S., Macleod, M., Mires, G., & Anderson, A. S. (2012). Uptake of folic acid supplements before and during pregnancy: Focus group analysis of women's views and experiences. Journal of Human Nutrition and Dietetics: The Official Journal of the British Dietetic Association, 25(2), 140-147.

7. Baskin, R., Hill, B., Jacka, F. N., O'Neil, A., & Skouteris, H. (2015). The association between diet quality and mental health during the perinatal period. A systematic review. Appetite, 91, 41-47.

8. Bestwick, J. P., Huttly, W. J., Morris, J. K., & Wald, N. J. (2014). Prevention of neural tube defects: a cross-sectional study of the uptake of folic acid supplementation in nearly half a million women. PloS one, 9(2), e89354.

9. Blann, A. (2014). An update on vitamin D deficiency and at risk groups. Journal of family health, 25(3), 16-19.

10. Brambila-Macias, J., Shankar, B., Capacci, S., Mazzocchi, M., Perez-Cueto, F. J., Verbeke, W., & Traill, W. B. (2011). Policy interventions to promote healthy eating: a review of what works, what does not, and what is promising. Food & Nutrition Bulletin, 32(4), 365-375.

11. Breastfeeding etc. (Scotland) Act 2005.

12. British Medical Association (2009). Early life nutrition and lifelong health. London: BMA.

13. British Nutrition Foundation (2014). Milk and dairy foods. Retrieved from: [accessed 22/09/15].

14. Brug, J., Kremers, S. P., Lenthe, F. V., Ball, K., & Crawford, D. (2008). Environmental determinants of healthy eating: in need of theory and evidence. Proceedings of the Nutrition Society, 67(3), 307-316.

15. Decsi, T., & Lohner, S. (2014). Gaps in Meeting Nutrient Needs in Healthy Toddlers. Annals of Nutrition and Metabolism, 65(1), 22-28.

16. Department of Health (2012). Vitamin D - advice on supplements for at risk groups - letter from UK Chief Medical Officers. Retrieved from: [accessed: 14.10.2015].

17. Department of Health (2010). Healthy Start, Equality Impact Assessment. London: Department of Health.

18. Department of Health (1991). Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. London: HMSO.

19. Domellöf, M., Braegger, C., Campoy, C., Colomb, V., Decsi, T., Fewtrell, M., .. & van Goudoever, J. (2014). Iron requirements of infants and toddlers. Journal of pediatric gastroenterology and nutrition, 58(1), 119-129.

20. Dowler, E. (2008). Symposium on 'Intervention policies for deprived households' Policy initiatives to address low-income households' nutritional needs in the UK. Proceedings of the Nutrition Society, 67(03), 289-300.

21. Dowler, E., & Lambie-Mumford, H. (2015). How Can Households Eat in austerity? Challenges for Social Policy in the UK. Social Policy and Society, 14(3), 417- 428.

22. Emmett, P. M., Jones, L. R., & Golding, J. (2015). Pregnancy diet and associated outcomes in the Avon Longitudinal Study of Parents and Children. Nutrition reviews, 73(3), 154-174.

23. Eussen, S., Alles, M., Uijterschout, L., Brus, F., & van der Horst-Graat, J. (2015). Iron Intake and Status of Children Aged 6-36 Months in Europe: A Systematic Review. Annals of Nutrition and Metabolism, 66(2-3), 80-92.

24. Filby, A., Wood, H., Jenks, M., Taylor, M., Burley, V., Barbier, M.& Giunta, G. (2015). Examining the Cost-Effectiveness of Moving the Healthy Start Vitamin Programme from a Targeted to a Universal Offering: Cost-Effectiveness Systematic Review Final Report. Retrieved from: [accessed 05/09/2015].

25. Griffin, T. L., Jackson, D. M., McNeill, G., Aucott, L. S., & Macdiarmid, J. I. (2015). A Brief Educational Intervention Increases Knowledge of the Sugar Content of Foods and Drinks but Does Not Decrease Intakes in Scottish Children Aged 10-12 Years. Journal of nutrition education and behaviour, 47(4), 367-373.e1.

26. Griffith, R., Scholder, S. V. & Smith, S. (2015). Getting a healthy start: The effectiveness of targeted benefits for improving dietary choices. Retrieved from: [accessed: 01.09.2015].

27. Haggarty, P. (2013). Epigenetic consequences of a changing human diet. Proceedings of the Nutrition Society, 72(4), 363-371. Retrieved from: [accessed 22.09.2015].

28. Healthy Start Scheme and Welfare Food (Amendment) Regulations 2005.

29. Hyppönen, E., Hartikainen, A. L., Sovio, U., Järvelin, M. R., & Pouta, A. (2007). Does vitamin D supplementation in infancy reduce the risk of pre-eclampsia? European journal of clinical nutrition, 61(9), 1136-1139.

30. Hyppönen, E., Läärä, E., Reunanen, A., Järvelin, M. R., & Virtanen, S. M. (2001). Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. The Lancet, 358(9292), 1500-1503.

31. Jessiman, T., Cameron, A., Wiggins, M., & Lucas, P. J. (2013). A qualitative study of uptake of free vitamins in England. Archives of disease in childhood, 1-5.

32. Kaiser, L. L., & Campbell, C. G. (2014). Practice Paper of the Academy of Nutrition and Dietetics Abstract: Nutrition and Lifestyle for a Healthy Pregnancy Outcome. Journal of the Academy of Nutrition and Dietetics, 114(9), 1447.

33. Khanom, A., Hill, R. A., Morgan, K., Rapport, F. L., Lyons, R. A., & Brophy, S. (2015). Parental recommendations for population level interventions to support infant and family dietary choices: a qualitative study from the Growing up in Wales study. BMC public health, 15(1), 234.

34. Lambie-Mumford, H., Crossley, D., Jensen, E., Verbeke, M. & Dowler, E. (2014). Household food security in the UK: a review of food aid-final report. Retrieved from: [accessed 12.09.2015].

35. Leaf, A. A. (2007). Vitamins for babies and young children. Archives of disease in childhood, 92(2), 160-164.

36. Lewis, L. (2014). Tackling vitamin D deficiency in children and at-risk families. Primary Health Care, 24(4), 20-24.

37. Lioret, S., Betoko, A., Forhan, A., Charles, M. A., Heude, B., and de Lauzon-Guillain, B. (2015). Dietary Patterns Track from Infancy to Preschool Age: Cross-Sectional and Longitudinal Perspectives. The Journal of nutrition, 145(4), 775-782.

38. Lockyer, V., & Porcellato, L. (2011). Vitamin D deficiency and supplementation: are we failing to prevent the preventable? Community Practitioner, 84(3), 23-26.

39. Lucas, P.J., Jessiman, T. and Cameron, A. (2015). Healthy Start: The use of welfare food vouchers by low-income parents in England. Social Policy & Society; 14(3), 457-469.

40. Lucas, C., Charlton, K. E., & Yeatman, H. (2014). Nutrition Advice During Pregnancy: Do Women Receive it and Can Health Professionals Provide it? Maternal and child health journal, 18(10), 2465-2478.

41. Lucas, P. J., Jessiman, T., Cameron, A., Wiggins, M., & Austerberry, K. H. C. (2013). Healthy Start vouchers study: The views and experiences of parents, professionals and small retailers in England. Bristol: University of Bristol.

42. Machell, G. (2015). Considering Influences on the Policy Formation of Healthy Start: A Government-Funded Nutrition Support Program for Low-Income Women and Children in the UK. Journal of Policy Practice, 14(1), 14-34.

43. Marmot, M., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., & Geddes, I. (2010). Fair society, healthy lives: strategic review of health inequalities in England post 2010. Retrieved from: C:\Users\Dorota\Desktop\WFscheme\fair-society-healthy-lives-full-report [accessed: 22.10.2015].

44. McAndrew, F., Thompson, J., Fellows, L., Large, A., Speed, M., & Renfrew, M. J. (2012). Infant feeding survey 2010. Leeds: Health and Social Care Information Centre.

45. McFadden, A., Green, J. M., McLeish, J., McCormick, F., Williams, V., & Renfrew, M. J. (2015). Healthy Start vitamins - a missed opportunity: findings of a multimethod study. BMJ open, 5(1), e006917.

46. McFadden, A., Green, J. M., Williams, V., McLeish, J., McCormick, F., Fox-Rushby, J., & Renfrew, M. J. (2014). Can food vouchers improve nutrition and reduce health inequalities in low-income mothers and young children: a multi-method evaluation of the experiences of beneficiaries and practitioners of the Healthy Start programme in England. BMC public health, 14(1), 148.

47. McFadden, A., Fox-Rushby, J., Green, J. M., Williams, V., Pokhrel, S., McLeish, J., ... & Renfrew, M. J. (2013). Understanding the use of vouchers and vitamins. Dundee: University of Dundee.

48. McGee, E., & Shaw, N. (2013). Vitamin D supplementation: Putting recommendations into practice. Journal of Health Visiting, 1(3), 138-143.

49. McInerny, T. K. (2014). Breastfeeding, Early Brain Development, and Epigenetics-Getting Children Off to Their Best Start. Breastfeeding Medicine, 9(7), 333-334.

50. Michie, C. A., & Sanchez, N. (2011). Mothers, babies and Vitamin D: old disease, new problem. Early human development, 87(11), 711-714.

51. Moonan, M., Hanratty, B., & Whitehead, M. (2012). Which is more Effective, A Universal or Targeted Approach, to Implementing the National Healthy Start Programme? A Mixed Methods Study. Journal of Epidemiology and Community Health, 66(Suppl 1), A44-A45.

52. Moy, R. J., McGee, E., Debelle, G. D., Mather, I., & Shaw, N. J. (2012). Successful public health action to reduce the incidence of symptomatic vitamin D deficiency. Archives of disease in childhood, 97(11), 952.

53. National Institute for Health and Clinical Excellence (2015). Healthy start vitamins: special report on cost effectiveness. London: NICE.

54. National Institute for Care and Excellence (2014). Vitamin D: increasing supplement use in at-risk groups [PH56]. London: NICE. Retrieved from: [accessed: 01.10.2015].

55. National Institute for Health and Clinical Excellence (2008a). Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households [PH11]. London: NICE.

56. National Institute for Health and Clinical Excellence (2008b). Maternal and child nutrition guidance [PH11]. London: NICE.

57. Nelson, M., Erens, B., Bates, B., Church, S. and Boshier, T. (2007). Low income diet and nutrition survey. Summary of key findings. Norwich: TSO.

58. NHS Health Scotland (2015). Setting the table. Nutritional Guidance and Food Standards for early years childcare providers in Scotland. NHS Health Scotland: Edinburgh.

59. Pai, B., & Shaw, N. (2011). Understanding rickets. Paediatrics and Child Health, 21(7), 315-321.

60. Paoletti, G., Bogen, D. L., & Ritchey, A. K. (2014). Severe iron-deficiency anaemia still an issue in toddlers. Clinical pediatrics, 53(14), 1352-1358.

61. Pearce, E. N., Pino, S., He, X., Bazrafshan, H. R., Lee, S. L., & Braverman, L. E. (2004). Sources of dietary iodine: bread, cows' milk, and infant formula in the Boston area. The Journal of Clinical Endocrinology & Metabolism, 89(7), 3421-3424.

62. Public Health England (2014a). Your guide to eatwell plate helping you eat a healthier diet. Retrieved from: [accessed: 23.10.2015].

63. Public Health England (2014b). National Diet and Nutrition Survey Results from Years 1, 2, 3 and 4 (combined) of the Rolling Programme (2008/2009 - 2011/2012). London: PHE. Retrieved from: [accessed: 13.09.2015].

64. Scientific Advisory Committee on Nutrition (2015). Draft Vitamin D and Health report. Scientific consultation: 22 July to 23 September 2015. Retrieved from: [accessed 10.09.2015].

65. Scientific Advisory Committee on Nutrition (2011). The influence of maternal, fetal and child nutrition on the development of chronic disease in later life. London: TSO.

66. Scientific Advisory Committee on Nutrition (2009). Folic Acid and Colorectal Cancer Risk: Review of Recommendation for Mandatory Folic Acid Supplementation. Retrieved from: [accessed 11.10.2015].

67. Scottish Government (2015a). Review of the Distribution of Healthy Start Vitamins Through Community Pharmacies. Edinburgh: Scottish Government.

68. Scottish Government (2015b). Welfare Foods Scheme Report on Open Space Event (draft). Edinburgh: Scottish Government.

69. Scottish Government (2014). Scottish Health Survey 2013. Edinburgh: Scottish Government. Retrieved from: [accessed: 09.09.2015].

70. Scottish Government (2013a). Diet and Nutrition Survey of Infants and Young Children in Scotland. Edinburgh: Scottish Government.

71. Scottish Government (2013b). Revised Dietary Goals for Scotland. Retrieved from: [accessed: 14/10/2015].

72. Scottish Government (2011a). Improving maternal and infant nutrition: a framework for action. Edinburgh: Scottish Government.

73. Scottish Government (2011b). Reducing Antenatal Health Inequalities. Outcome Focused Evidence into Action Guidance. Scottish Government: Edinburgh.

74. Scottish Government (2011c). Obesity Route Map - Action Plan. Edinburgh: Scottish Government.

75. Scottish Government (2010a). Preventing Overweight and Obesity in Scotland. Edinburgh: Scottish Government.

76. Scottish Government (2010b). Growing Up in Scotland: Health inequalities in the early years. Edinburgh: Scottish Government.

77. Shergill-Bonner, R. (2013). Micronutrients. Paediatrics and Child Health, 23(8), 331-336.

78. Sinha, A., Cheetham, T. D., & Pearce, S. H. (2013). Prevention and treatment of vitamin D deficiency. Calcified tissue international, 92(2), 207-215.

79. Welfare Food Regulations 1996.

80. Wellings, K., Jones, K. G., Mercer, C. H., Tanton, C., Clifton, S., Datta, J., ... & Johnson, A. M. (2013). The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). The Lancet, 382(9907), 1807-1816.

81. Wen, L. M., Simpson, J. M., Rissel, C., & Baur, L. A. (2013). Maternal "junk food" diet during pregnancy as a predictor of high birthweight: Findings from the healthy beginnings trial. Birth, 40(1), 46-51.

82. Westland, S. and Crawley, H. (2012). Healthy and sustainable diets in the early years. Implications of current thinking on healthy, sustainable diets for the food and nutrient intakes of children under the age of 5 in the UK. First Steps Nutrition Trust. Retrieved from: [accessed 23.10.2015].

83. Wood, C. L., & Cheetham, T. D. (2015). Vitamin D: increasing supplement use among at-risk groups (NICE guideline PH56). Archives of disease in childhood-Education & practice.

84. Zimmermann, M. B., Jooste, P. L., & Pandav, C. S. (2008). Iodine-deficiency disorders. The Lancet, 372(9645), 1251-1262.

How to access background or source data

The data collected for this social research publication:

☒ cannot be made available by Scottish Government for further analysis as Scottish Government is not the data controller.


Email: Odette Burgess