Nutrition Journal 2013, 12:151 doi:10.1186/1475-2891-12-151
Jonathan Brown, Arne Sandmann, Anita Ignatius, Michael Amling and Florian Barvencik
Background: In Germany, vitamin D intake from food and synthesis in the skin is low, which leads to low 25(OH)D serum concentrations. In contrast to many other countries, general vitamin D food fortification is still prohibited in Germany, although the European Commission published a regulatory framework to harmonize addition of vitamins to foods. Thus the purpose of our study was to develop a vitamin D fortification model, taking into account all vitamin D sources with the goal to fulfill requirements of intake recommendations or preferable 25(OH)D serum concentrations. Finally, the aim was to assess the suitability of different carriers and associated risks.
Methods: We developed a mathematical bottom-up model of 25(OH)D serum concentrations based on data about vitamin D sources of the German population such as sunlight, food and supplements for all federal states taking seasonal and geographical variations into account. We used this model to calculate the optimal fortification levels of different vitamin D carriers in two approaches. First we calculated required fortification levels based on fixed intake recommendations from e.g. the IOM or the DGE and second based on achieving certain 25(OH)D serum concentrations.
Results: To lift 25(OH)D serum concentration in Germany to 75 nmol/L, e.g. 100 g bread has to be fortified with 11.3 mug during winter, resulting in a daily vitamin D intake of 23.7 mug.
Bread seems to be a suitable carrier for base supply. However, overdose risk with a single fortified product is higher than the risk with several fortified carriers.
Conclusions: With the model in hand, it is possible to conceive vitamin D fortification strategies for different foodstuffs and model its impact on 25(OH)D serum concentrations.
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- Vitamin D home fortification- don't wait 100 years for your govt
- Can fortify food with 1000 IU of vitamin D - Italy, March 2013 - with bread!
- Milk fortification of 1000 IU got most children above 20ng of vitamin D – March 2013 would be nice if Germany tried for more than 1000 IU
- Add vitamin D to animal feed to fortify the resulting human food – Oct 2012
- Improved health due to vitamin D fortification in Finland
- Diabetics helped with food fortified with 1000 IU vitamin D and Calcium – March 2012
- Vitamin D can fortify a variety of food and drinks – even beer – March 2012
- Overview Vitamin D Dose-Response which has many charts showing a very non-linear response
The study from Germany appears to incorrectly assume that while 1,000 IU will get people to 75 nmol that 6X that (6,000 IU) wil get people to a toxic level of 550 nnol