A Novel Approach to Optimize Vitamin D Intake in Belgium through Fortification Based on Representative Food Consumption Data.
J Nutr. 2019 Jun 17. pii: nxz119. doi: 10.1093/jn/nxz119.
Moyersoen I1,2, Devleesschauwer B1,3, Dekkers A4, Verkaik-Kloosterman J4, De Ridder K1, Vandevijvere S1, Tafforeau J1, Van Oyen H1,5, Lachat C2, Van Camp J2.
Finally, fortification started to be treated as a Science!
Have not seen anything like this before
A great first step
It still needs to consider those:
- With different eating styles
- vegetarian, meat, gluten free, lactose intolerant, fast-food, etc
- Aged 65+
- With poor guts (less Vitamin D absorbed)
- In poor health (and need even more vitamin D)
- Needing additional micronutrients – such as Magnesium and Omega-3
- Who can elect to fortify or not
- let the individual decide – provide food at same price with and without fortification
- Who want to do home fortification of a variety of food products
- Who are overweght or obese - and so need much more vitamin D
- Who have poor Vitamin D genes
- Have far less blood response to same vitamin D dose
- Have far less Vitamin D is tissue, even if Vitamin D in blood is OK
- Vitamin D home fortification- don't wait 100 years for your govt
- Getting Vitamin D into your body includes discussion of gut-friendly forms of Vitamin D
Fortification works, even if food is cooked, but govts rarely fortifiy with enough
Govts, food producers, and families can fortify:
milk, yogurt, beer, bread, cerals, cooking oil, soups, jams, jellys, snack bars, etc.
Some interesting fortification articles
- Vitamin D fortification of edible oils in India starting in 2017
- Vitamin D food fortification – many trials listed – Aug 2018
- International Conference of Vitamin D Fortification of Food (India) – Sept 2018
- Vitamin D fortification of milk helps (proven in Gemany this time) – RCT Dec 2013
- Improved health due to vitamin D fortification in Finland
- Marks and Spencer is first UK retailer to add Vitamin D to all of its breads – Dec 2019
- Vitamin D food fortification, Belgium considers 270 IU per kcal of milk or bread– June 2019
- Best thing since sliced bread (vitamin D bread was patented and baked in 1929)
- Vitamin D2 from bread yeast is 4 times less bioaccessible than D2 in milk – April 2016
- Vitamin D3 fortified bread better than supplement – RCT April 2016
- 5000 IU of vitamin D in daily bread substantially improved quality of life in nursing home – May 2014
- Cooking reduces vitamin D content by about 30 percent – Oct 2013
- Germany does not fortify ANY food with vitamin D, is considering 1000 IU from bread – Nov 2013
- 5,000 IU of vitamin D (in bread) was great – should have continued forever – Oct 2013
- 5000 IU vitamin D3 added daily to bread raised blood levels to 50 ng – 2009
Food fortification is a promising means to improve vitamin D intake of a population. Careful selection of food vehicles is needed to ensure that nearly all individuals within the population benefit from the fortification program.
The aim of the study was to develop and apply a model that simultaneously selects the optimal combination of food vehicles and defines the optimal fortification level that adequately increases vitamin D intake in the population without compromising safety.
Food consumption data from the Belgian Food Consumption Survey 2014 (n = 3200; age 3-64 y) were used. The optimization model included 63 combinations of 6 potential vehicles for food fortification, namely "bread," "breakfast cereals," "fats and oils," "fruit juices," "milk and milk beverages," and "yogurt and cream cheese." The optimization procedure was designed to minimize inadequate or excessive vitamin D intake in each of the food combinations. This allowed the relative ranking of the different combinations according to their fortification utility. The estimated average requirement and upper intake level were used as thresholds. An age-specific and population-based approach enabled the sensitivity of the population subgroups to adverse health effects to be taken into account. Feasibility, technical aspects, and healthiness of the food vehicles were used to select the optimal combination.
Multiple combinations of food vehicles significantly reduced the prevalence of inadequate vitamin D intake within the Belgian population (from 92-96% to <2%). Taking other aforementioned criteria into account, the fortification of "milk and milk beverages" and "bread" with 6.9 μg vitamin D/100 kcal was proposed as an optimal fortification scenario.
The optimization model allows identification of an effective fortification scenario to improve vitamin D intake within the Belgian population based on acceptable risks of inadequate and excessive intake. The model can be extended to other micronutrients and other populations.