25(OH)D₃-enriched or fortified foods are more efficient at tackling inadequate vitamin D status than vitamin D₃

Abstract

The ability to synthesise sufficient vitamin D through sunlight in human subjects can be limited. Thus, diet has become an important contributor to vitamin D intake and status; however, there are only a few foods (e.g. egg yolk, oily fish) naturally rich in vitamin D. Therefore, vitamin D-enriched foods via supplementing the animals’ diet with vitamin D or vitamin D fortification of foods have been proposed as strategies to increase vitamin D intake. Evidence that cholecalciferol (vitamin D3) and calcifediol (25(OH)D3) content of eggs, fish and milk increased in response to vitamin D3 supplementation of hens, fish or cows’ diets was identified when vitamin D-enrichment studies were reviewed. However, evidence from supplementation studies with hens showed only dietary 25(OH)D3, not vitamin D3 supplementation, resulted in a pronounced increase of 25(OH)D3 in the eggs. Furthermore, evidence from randomised controlled trials indicated that a 25(OH)D3 oral supplement could be absorbed faster and more efficiently raise serum 25(OH)D concentration compared with vitamin D3 supplementation. Moreover, evidence showed the relative effectiveness of increasing vitamin D status using 25(OH)D3 varied between 3·13 and 7·14 times that of vitamin D3, probably due to the different characteristics of the investigated subjects or study design. Therefore, vitamin D-enrichment or fortified foods using 25(OH)D3 would appear to have advantages over vitamin D3. Further well-controlled studies are needed to assess the effects of 25(OH)D3 enriched or fortified foods in the general population and clinical patients.

Food fortification and biofortification as potential strategies for prevention of vitamin D deficiency

“…Vitamin D 2 and vitamin D 3 , obtained from the diet, are absorbed with long‐chain triglycerides in the small intestine and then incorporated into chylomicrons and transported via lymph to the circulation (Guo et al . ).…”

“…However, research on 25(OH)D 3 supplementation of animals’ diets is in its infancy, with data only available for hens (Guo et al . ). Interestingly, egg enrichment studies (Mattila et al .…”

“…Of the few studies performed, most have found that the vitamin D metabolite 25(OH)D 3 given orally increases vitamin D status more efficiently than oral vitamin D 3 , although no consensus has been established for the relative potency of 25(OH)D 3 and vitamin D 3 (Jakobsen 2007). Our recent review (Guo et al 2018b) summarised the available evidence comparing 25(OH)D 3 with vitamin D 3 on serum or plasma 25(OH)D 3 concentrations Jetter et al 2014;Catalano et al 2015;Navarro-Valverde et al 2016), and concluded that the relative effectiveness of 25(OH)D 3 to vitamin D 3 ranged from 3.13 to 7.14. These variable results probably reflect differences in study designs and/or characteristics of the investigated subjects.…”

“…Our recent review (Guo et al . ) summarised the available evidence comparing 25(OH)D 3 with vitamin D 3 on serum or plasma 25(OH)D 3 concentrations (Cashman et al . ; Jetter et al .…”

“…Pre-vitamin D 3 then undergoes a temperature-dependent isomerisation to produce vitamin D 3 over approximately 3 days (Holick & Chen 2008). Vitamin D 2 and vitamin D 3 , obtained from the diet, are absorbed with long-chain triglycerides in the small intestine and then incorporated into chylomicrons and transported via lymph to the circulation (Guo et al 2018b).…”