Vitamin D Fortification of Fluid Milk Products and Their Contribution to Vitamin D Intake and Vitamin D Status in Observational Studies-A Review.

Suvi Itkonen,Maijaliisa Erkkola,Christel Lamberg-Allardt

doi:10.3390/nu10081054

Abstract

Fluid milk products are systematically, either mandatorily or voluntarily, fortified with vitamin D in some countries but their overall contribution to vitamin D intake and status worldwide is not fully understood. We searched the PubMed database to evaluate the contribution of vitamin D-fortified fluid milk products (regular milk and fermented products) to vitamin D intake and serum or plasma 25-hydroxyvitamin D (25(OH)D) status in observational studies during 1993–2017. Twenty studies provided data on 25(OH)D status (n = 19,744), and 22 provided data on vitamin D intake (n = 99,023). Studies showed positive associations between the consumption of vitamin D-fortified milk and 25(OH)D status in different population groups. In countries with a national vitamin D fortification policy covering various fluid milk products (Finland, Canada, United States), milk products contributed 28–63% to vitamin D intake, while in countries without a fortification policy, or when the fortification covered only some dairy products (Sweden, Norway), the contribution was much lower or negligible. To conclude, based on the reviewed observational studies, vitamin D-fortified fluid milk products contribute to vitamin D intake and 25(OH)D status. However, their impact on vitamin D intake at the population level depends on whether vitamin D fortification is systematic and policy-based.

Highlights

Vitamin D plays an important role in bone health, being necessary for calcium absorption [1].Low vitamin D status in terms of low serum 25-hydroxyvitamin D (S-25(OH)D) concentration has been linked to the increased risk of some common chronic diseases, such as type 2 diabetes or cardiovascular disease [2]
Concerning the vitamin D status, we observed that the consumption of vitamin D-fortified milk was positively associated with 25(OH)D status in almost all studies included in this review within heterogeneous population groups, independent of country-specific vitamin D-fortification policies
This mostly positive association between vitamin D-fortified milk consumption and vitamin D status was supported by a recent standardized representative population-based study in Finland, where the vitamin D fortification policy of fluid milks, in particular, was shown to be successful in improving vitamin D status in the Finnish population [25]

Summary

Introduction

Vitamin D plays an important role in bone health, being necessary for calcium absorption [1].Low vitamin D status in terms of low serum 25-hydroxyvitamin D (S-25(OH)D) concentration has been linked to the increased risk of some common chronic diseases, such as type 2 diabetes or cardiovascular disease [2]. Radiation is too low for dermal synthesis of vitamin D [3]. As there are only a few natural vitamin. D-rich foods, such as fish, egg yolk, and some wild mushrooms [1], some countries, populations at high latitudes, have initiated national policies of fortifying certain foods with vitamin. These vitamin D-fortified products are low-fat milk, fat spreads, breakfast cereals, and certain baby foods [4,5]. To better cover different population groups with differing food habits, a wider vitamin D fortification of different products instead of concentrating on only a few staple foods has been suggested [5]

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