Assessing Health Consequences of Vitamin D Fortification Utilizing a Societal Experiment Design: Methodological Lessons Learned from the D-Tect Project
Int. J. Environ. Res. Public Health 2021, 18(15), 8136; https://doi.org/10.3390/ijerph18158136
by Mina Nicole Händel 1,*,†OrcID,Ramune Jacobsen 2,†OrcID,Fanney Thorsteinsdottir 1OrcID,Amélie Cléo Keller 3,Maria Stougaard 4,Camilla Bjørn Jensen 5,Caroline Moos 1OrcID,Katrine Sidenius Duus 1OrcID,Allan Jensen 6,Ulrik Schiøler Kesmodel 7,Bo Abrahamsen 8,9,10 and Berit Lilienthal Heitmann 1,3,11OrcID
The Danish govt mandated fortifing margarine with vitamin D till 1985
Fortification works, even if food is cooked, but govts rarely fortifiy with enough
Govts, food producers, and families can fortify:
milk, yogurt, beer, bread, cereals, cooking oil, soups, jams, jellys, honey, snack bars, etc.
Some interesting fortification articles
- After years of adding vitamin D, Finland now has 35 ng levels - March 2022
- Vitamin D fortification of edible oils in India starting in 2017
- Vitamin D food fortification – many trials listed – Aug 2018
- Vitamin D fortification of beverages – Review March 2022
- International Conference of Vitamin D Fortification of Food (India) – Sept 2018
- Fortification with Vitamin D works – 16 studies of Danish experience – July 2021
VitaminDWiki Fortification pages with BREAD in title
This list is automatically updated
- Danes opposed to Vitamin D fortification, will get more COPD, diabetes, depression, lupus, leg pain, etc – Oct 2015
- Schizophrenia increased 40 percent for Spring births after Danes stopped vitamin D fortification – April 2014
- Danish study of childhood diseases vs vitamin D fortification – May 2013
By utilizing historical changes in Danish legislation related to mandatory vitamin D fortification of margarine, which was implemented in the mid 1930s and abruptly abandoned in June 1985, the studies in the D-tect project investigated the effects of vitamin D on health outcomes in individuals, who during gestation were exposed or unexposed to extra vitamin D from fortified margarine. This paper reviews and narratively summarizes the analytic approaches alongside the results of the societal fortification experiment studies from the D-tect project and addresses the challenges in designing societal experiment studies and evaluating their results. The latter are discussed as lessons learned that may be useful for designers of similar studies, expected to be extensively utilized while researching the health consequences of the COVID-19 pandemic by comparing individuals born before and after the epidemic. In the D-tect project, 16 articles based on the societal fortification experiment were published analyzing 10 different outcomes and using different statistical approaches. Lessons learned included the detail of the analysis of the historical information on the exposure, availability and validity of the outcome data, variety of analytical approaches, and specifics concerning vitamin D effect evaluation, such as consideration of the influence of sunshine or season. In conclusion, the D-tect project clearly demonstrated the cost-effectiveness and research potential of natural- or societal-experiment-based studies.
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