Current iodine intakes are well below dietary recommendations. The impact of iodine fortification of bread would be greater for pregnant and postpartum women than has been previously estimated using general population intakes, but additional strategies to increase intakes by these groups are still needed.

Background: Nearly one in four Australian adults is vitamin D deficient (serum 25-hydroxyvitamin D concentrations [25(OH)D] < 50 nmol L -1 ) and current vitamin D intakes in the Australian population are unknown. Internationally, vitamin D intakes are commonly below recommendations, although estimates generally rely on food composition data that do not include 25(OH)D. We aimed to estimate usual vitamin D intakes in the Australian population. Methods: Nationally representative food consumption data were collected for Australians aged ≥ 2 years (n = 12,153) as part of the cross-sectional 2011-2013 Australian Health Survey (AHS). New analytical vitamin D food composition data for vitamin D 3 , 25(OH)D 3 , vitamin D 2 and 25(OH)D 2 were mapped to foods and beverages that were commonly consumed by AHS participants.Usual vitamin D intakes (µg day -1 ) by sex and age group were estimated using the National Cancer Institute method. Results: Assuming a 25(OH)D bioactivity factor of 1, mean daily intakes of vitamin D ranged between 1.84 and 3.25 µg day -1 . Compared to the estimated average requirement of 10 µg day -1 recommended by the Institute of Medicine, more than 95% of people had inadequate vitamin D intakes. We estimated that no participant exceeded the Institute of Medicine's Upper Level of Intake (63-100 µg day -1 , depending on age group). Conclusions: Usual vitamin D intakes in Australia are low. This evidence, paired with the high prevalence of vitamin D deficiency in Australia, suggests that data-driven nutrition policy is required to safely increase dietary intakes of vitamin D and improve vitamin D status at the population level. K E Y W O R D S 25-hydroxyvitamin D, Australia, food, usual intakes, vitamin D Key points • We quantified usual intakes of vitamin D in the Australian population using up-to-date, comprehensive vitamin D composition data and nationally representative food consumption data.

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Background: There is compelling evidence that mandatory fortification of food with folic acid reduces the prevalence of neural tube defects (NTDs). New Zealand has had voluntary fortification in place since 1996. The NTD prevalence (~10.6 per 10,000 births) in New Zealand is higher than in countries with mandatory fortification. Furthermore, Māori women are disproportionally affected by a higher rate of NTD live births than other population groups.Objective: To determine if reductions in NTDs could be achieved with additional folic acid fortification without exposing sub-groups of the population to excessive intakes. Five fortification scenarios were assessed: status quo, enhanced voluntary (80% of packaged sliced bread) and mandatory fortification of: all bread, all bread-making wheat flour, and all wheat flour.Design: Folic acid intakes and the proportion of the population with intakes in excess of the upper level of intake (UL) were calculated using the dietary intake assessment program, Harvest. We estimated the effect of the scenarios on risk of an NTD in a simulated population of pregnant women using a stochastic model. Firstly, increases in folate status (serum folate and red blood cell folate) were calculated from the predicted increase in folic acid intake. Established models between folate status and NTD risk were used to predict NTD prevalence.Results: Enhanced voluntary fortification reduced NTDs by ~3-10%. Mandatory fortification of all bread and all bread making-flour reduced NTDs by ~10-20%; and all wheat flour by ~15-30%. Less than 1% of adults exceeded the UL in the scenarios assessed. However, 36% of children aged 5-8 years exceeded the UL in one scenario: all wheat flour (36%).Conclusion: Mandatory fortification options were the most successful at reducing NTDs. Mandatory fortification of bread or all bread-making flour could reduce NTDs and would not expose the population to excessive intakes of folic acid.