Abstract
Objective:
To assess the impact of national fortification of fluid milks and margarines with vitamin D on dietary intake and on serum 25-hydroxyvitamin D concentration in Finnish 4-year-old children.
Design, subjects and methods:
Two cohorts of children were studied during wintertime, one before (n=82) in 2001–2002 and the other after (n=36) the initiation of fortification in 2003–2004. Dietary intake was estimated by 4-day food records and serum 25-hydroxyvitamin D concentration was analyzed by radioimmunoassay.
Results:
The mean intake of vitamin D was higher the after initiation of fortification (mean (95% confidence interval (CI)); 4.5 (3.8–5.1) μg) than before it (2.1 (95% CI 1.8–2.3) μg; P<0.001), although there were no differences in consumption of the main food sources of vitamin D between the two cohorts. The difference between the cohorts was also evident when the intake of vitamin D was adjusted for energy intake (0.78 (95% CI 0.70–0.90) and 0.37 (95% CI 0.32–0.42) μg/MJ after and before fortification, respectively, P<0.001). After fortification, the mean intake approached that recommended, but was achieved by only 30.6% of the children. Equally, the serum 25-hydroxyvitamin D concentration was higher after fortification (64.9 (95% CI 59.7–70.1) nmol/l) compared to prior it (54.7 (95% CI 51.0–58.4) nmol/l; P=0.002).
Conclusions:
The results indicate that the national fortification of fluid milks and margarines with vitamin D safely improved the vitamin D status of children. This approach, in view of the novel health effects beyond bone metabolism, encourages fortification of new food sources with vitamin D or use of vitamin D supplements particularly during wintertime.
Sponsorship:
The Academy of Finland, the Sigrid Juselius Foundation and the Juho Vainio Foundation.
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Guarantor: E Isolauri.
Contributors: TP was responsible for the collection, analysis and reporting of dietary data (from 2003-4). Kl was responsible for the collection of dietary data from 2001. KL and EI designed and supervised the study and contributed to data analysis and presentation. All the authors contributed to the writing and revision of the manuscript.
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Piirainen, T., Laitinen, K. & Isolauri, E. Impact of national fortification of fluid milks and margarines with vitamin D on dietary intake and serum 25-hydroxyvitamin D concentration in 4-year-old children. Eur J Clin Nutr 61, 123–128 (2007). https://doi.org/10.1038/sj.ejcn.1602506
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DOI: https://doi.org/10.1038/sj.ejcn.1602506
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