The positive impact of general vitamin D food fortification policy on vitamin D status in a representative adult Finnish population: evidence from an 11-y follow-up based on standardized 25-hydroxyvitamin D data

Jääskeläinen, Tuija; Itkonen, Suvi T.; Lundqvist, Annamari; Erkkola, Maijaliisa; Koskela, Tapani; Lakkala, Kaisa; Dowling, Kirsten G.; Hull, George L J; Kröger, Heikki; Karppinen, Jaro; Kyllönen, Eero; Härkänen, Tommi; Cashman, Kevin D.; Männistö, Satu; Lamberg‐Allardt, Christel

doi:10.3945/ajcn.116.151415

Cited by 188 publications

(223 citation statements)

References 31 publications

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“…In some cases, hypercalcemia was associated with drinking vitamin D-fortified milk, revealing a fortification of up to 232,565 IU instead of standard 400 IU/quart, and consequently, prohibition of milk fortification [49]. However, current evidence suggests that vitamin D fortification prevents deficiency safely and effectively [50,51]. Feeding animals might represent an additional source of vitamin D without compromising product quality.…”

Section: Toxicitymentioning

confidence: 99%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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Vitamin D testing and the use of vitamin D supplements have increased substantially in recent years. Currently, the role of vitamin D supplementation, and the optimal vitamin D dose and status, is a subject of debate, because large interventional studies have been unable to show a clear benefit (in mostly vitamin D replete populations). This may be attributed to limitations in trial design, as most studies did not meet the basic requirements of a nutrient intervention study, including vitamin D-replete populations, too small sample sizes, and inconsistent intervention methods regarding dose and metabolites. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L or 20 ng/ml) is associated with unfavorable skeletal outcomes, including fractures and bone loss. A 25(OH)D level of >50 nmol/L or 20 ng/ml is, therefore, the primary treatment goal, although some data suggest a benefit for a higher threshold. Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible. The data on a benefit for mortality and prevention of infections, at least in severely deficient individuals, appear convincing. Vitamin D is clearly not a panacea, and is most likely efficient only in deficiency. Given its rare side effects and its relatively wide safety margin, it may be an important, inexpensive, and safe adjuvant therapy for many diseases, but future large and well-designed studies should evaluate this further. A worldwide public health intervention that includes vitamin D supplementation in certain risk groups, and systematic vitamin D food fortification to avoid severe vitamin D deficiency, would appear to be important. In this narrative review, the current international literature on vitamin D deficiency, its relevance, and therapeutic options is discussed.

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Section: Toxicitymentioning

confidence: 99%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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“…(87) . Additionally the and young children (88)(89)(90)(91) . This may be due to low and/or infrequent consumption of milk and other of foodstuffs in different population groups and we await these findings (81) .…”

mentioning

confidence: 99%

Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy

et al. 2017

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“…), and the data from the Finnish Health 2011 Survey showed that mean serum 25(OH)D increased from 47.6 nmol/l in 2000 to 65.4 nmol/l in 2011 (Jaaskelainen et al . ). However, a recent review (Calvo & Whiting ) questioned the adequacy of vitamin D‐fortified foods in the US and Canada to meet the needs of all race, sex and age groups.…”

Section: Food Fortification With Vitamin Dmentioning

confidence: 97%

“…In addition, subjects who consumed vitamin Dfortified milk had higher 25(OH)D concentrations than non-consumers. Voluntary fortification of foods with vitamin D has occurred in Finland since 2003 (Pilz et al 2018), and the data from the Finnish Health 2011 Survey showed that mean serum 25(OH)D increased from 47.6 nmol/l in 2000 to 65.4 nmol/l in 2011 (Jaaskelainen et al 2017). However, a recent review (Calvo & Whiting 2013) questioned the adequacy of vitamin D-fortified foods in the US and Canada to meet the needs of all race, sex and age groups.…”

Section: Direct Fortificationmentioning

confidence: 99%

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

2019

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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.

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The positive impact of general vitamin D food fortification policy on vitamin D status in a representative adult Finnish population: evidence from an 11-y follow-up based on standardized 25-hydroxyvitamin D data

Cited by 188 publications

References 31 publications

Vitamin D deficiency 2.0: an update on the current status worldwide

Vitamin D deficiency 2.0: an update on the current status worldwide

Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy

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

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