Abstract
To simulate the impact - effectiveness and safety - of water fortification with different concentrations of Ca using the Intake Modelling, Assessment and Planning Program. This is a secondary analysis of national or sub-national dietary intake databases. Uganda, Lao People's Democratic Republic (PDR), Bangladesh, Zambia, Argentina, USA and Italy. We found that for dietary databases assessed from low- and middle-income countries (LMIC), the strategy of fortifying water with 500 mg of Ca/l would decrease the prevalence of low Ca intake in all age groups. We also found that this strategy would be safe as no group would present a percentage of individuals exceeding the upper limit in >2 %, except women aged 19-31 years in Lao PDR, where 6·6 % of women in this group would exceed the upper limit of Ca intake. The same strategy would lead to some groups exceeding the upper limit in USA and Italy. We found that for most LMIC countries, water fortified with Ca could decrease the prevalence of Ca intake inadequacy without exceeding the upper levels of Ca intake.
Highlights
We found that for all the dietary databases assessed from low- and middleincome countries (LMIC), the strategy of fortifying water with 500 mg of Ca/l would decrease the prevalence of low Ca intake in all age groups
The current study does not take in account special groups with extreme water intake that could be put at risk of excess Ca intake with a water fortification strategy, we found that even in high-income countries (HIC), very few people consumed more than 1·5 litres of water a day
We found that for most LMIC countries, increasing Ca concentration of water to 500 mg of Ca/l would decrease the prevalence of Ca intake inadequacy without exceeding the upper level of Ca intake in any population group
Summary
We search for available national or sub-national dietary assessment databases collected through 24-h recalls or dietary records, we analysed all publicly available. This is an analysis of dietary intake databases of 24-h recalls from Uganda, Lao PDR, Bangladesh, Zambia, Argentina and USA and of self-recorded food records from Italy. We evaluated the effectiveness and safety of different Ca fortification scenarios with the aim of shifting the distribution of Ca intake so that the majority of population groups improve their Ca intake and achieve a mean intake closer to their requirement without exceeding the recommended upper limit[25].
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