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

Abstract

Hypovitaminosis D (vitamin D deficiency) is widespread throughout the world. The cutaneous production of vitamin D through sunlight can be limited by several factors (e.g. skin pigmentation, sunscreen usage and, increasingly, indoor lifestyle). Thus, diet has become an important strategy to increase vitamin D intake and status {blood 25‐hydroxyvitamin D [25(OH)D]}. However, there are a limited number of foods that naturally contain vitamin D, and concentrations can vary significantly between and within species. The need for vitamin D‐fortified foods (including via direct fortification and biofortification) to support the adequacy of vitamin D status is a corollary of several limitations to synthesise vitamin D from sunlight. Ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) can be found in some mushrooms and animal‐derived foods, respectively. Evidence has shown vitamin D3 is more effective than vitamin D2 at raising 25(OH)D blood concentrations. The vitamin D metabolite, 25(OH)D3, is present in animal‐derived foods (e.g. meat, eggs and fish), and several intervention trials have shown 25(OH)D3 to be more effective at raising blood 25(OH)D concentrations than vitamin D3. In addition, 25(OH)D3 supplements may prove to be preferable to vitamin D3 for patients with certain clinical conditions. However, there is limited evidence on the effects of 25(OH)D3‐fortified foods on human vitamin D status and health, both in the general population and patients with certain conditions, and long‐term randomised controlled trials are needed in this area.

Influence of Vitamin D on Islet Autoimmunity and Beta-Cell Function in Type 1 Diabetes

“…On the other hand, the low adherence to supplementation may affect the long-term efficacy of vitamin D supplements in prevention and treatment of vitamin D deficiency. In this context, food fortification has been suggested as a safe and cost-effective strategy to consume the recommended daily amount of vitamin D [217,218]. In general, food can be enriched with vitamin D through two different approaches: (i) traditional fortification, which consists of direct addition of vitamin D into food, and (ii) biofortification (or bio-addition), which refers to various strategies to indirectly increase vitamin D content of food (e.g., fortifying animal diets with vitamin D or UV light exposure of yeast and mushrooms) [218,219].…”

“…In this context, food fortification has been suggested as a safe and cost-effective strategy to consume the recommended daily amount of vitamin D [217,218]. In general, food can be enriched with vitamin D through two different approaches: (i) traditional fortification, which consists of direct addition of vitamin D into food, and (ii) biofortification (or bio-addition), which refers to various strategies to indirectly increase vitamin D content of food (e.g., fortifying animal diets with vitamin D or UV light exposure of yeast and mushrooms) [218,219]. Therefore, further investigation is warranted to assess whether vitamin D-fortified foods (e.g., bread, milk, dairy products, flour, cereals, and cooking oils, which are highly consumed worldwide) represent an effective tool to increase vitamin D daily intake and long-term treatment of vitamin D deficiency.…”

Vitamins in Cereals: A Critical Review of Content, Health Effects, Processing Losses, Bioaccessibility, Fortification, and Biofortification Strategies for Their Improvement

“…For example, the fortification of pearl millet porridge with carrots, mango, and African baobab fruit ( 48 , 49 ), the fortification of bread with moringa seed powder ( 34 , 50 ), and the fortification of cake with guava skin ( 35 ) have been reported. The direct fortification of foods with vitamin D at a level of 0.024 mg/kg is an effective strategy to increase vitamin D levels in humans ( 51 , 52 ). To fulfill the demand for vitamin E for consumption, pita bread has been fortified with either whole grain or pearl barley flour ( 36 ).…”

Update on potential of edible mushrooms: high‐value compounds, extraction strategies and bioactive properties

“…Edible mushrooms are traditionally consumed as food and medicinal products, but more recently, their demand has increased not only for their nutritional characteristics but also for their unique sensory qualities (Sun et al ., 2020) and numerous health benefits (Kumar, 2020). They are an appreciated nutritional source due to their low calorific value and their high carbohydrate content, valuable proteins, dietary fibre, minerals (high level of K and P, low Na levels and considerable amounts of some microelements as Cu, Pb and Fe; Gąsecka et al ., 2021) and vitamins, such as vitamin D (Guo et al ., 2019), low‐fat contents with high levels of polyunsaturated fatty acids (Jacinto‐Acevedo et al ., 2021) and, also, secondary metabolites such as alkaloids, phenolic compounds and betalains (Rodrigues Barbosa et al ., 2020). It should also be noted that toxic compounds were identified in species traditionally considered edible so that scientific evidence in this field is relevant in order to prevent myotoxicity effects (Nieminen & Mustonen, 2020).…”

“…In this context, two options are possible: (i) formulation of diets or products enriched with the whole mushroom biomass or (ii) formulation of novel products with the mushrooms´ isolated bioactives, which can also be used as supplements (Scherlach & Hertweck, 2021). In this sense, edible mushrooms can be processed to obtain a wide variety of food products enriched with high‐quality protein (González et al ., 2020) or fortified with vitamin D (Guo et al ., 2019). Mushrooms can also be added to increase the nutritional value, rheological, physicochemical, textural and sensory characteristics of bakery products (Salehi & Aghajanzadeh, 2020), and for meat substitution, with reduction in sodium, enhancing the healthy characteristics and maintaining sensorial properties (Pintado & Delgado‐Pando, 2020).…”