Rationale and plan for vitamin D food fortification: A review and guidance paper

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Pilz, S.; März, W.; Cashman, K.D.; Kiely, M.E.; Whiting, S.J. et al.: Rationale and plan for vitamin D food fortification: A review and guidance paper. In: Frontiers in Endocrinology 9 (2018), 373. DOI: https://doi.org/10.3389/fendo.2018.00373

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Sum total of downloads: 144

Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from ≥25 to ≥50 nmol/L (≥10-≥20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 μg (400-800 international units). Most populations fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations < 30 nmol/L (12 ng/mL) and < 50 nmol/L (20 ng/mL) are present in 13.0 and 40.4% of the general population, respectively. This substantial gap between officially recommended dietary reference intakes for vitamin D and the high prevalence of vitamin D deficiency in the general population requires action from health authorities. Promotion of a healthier lifestyle with more outdoor activities and optimal nutrition are definitely warranted but will not erase vitamin D deficiency and must, in the case of sunlight exposure, be well balanced with regard to potential adverse effects such as skin cancer. Intake of vitamin D supplements is limited by relatively poor adherence (in particular in individuals with low-socioeconomic status) and potential for overdosing. Systematic vitamin D food fortification is, however, an effective approach to improve vitamin D status in the general population, and this has already been introduced by countries such as the US, Canada, India, and Finland. Recent advances in our knowledge on the safety of vitamin D treatment, the dose-response relationship of vitamin D intake and 25(OH)D levels, as well as data on the effectiveness of vitamin D fortification in countries such as Finland provide a solid basis to introduce and modify vitamin D food fortification in order to improve public health with this likewise cost-effective approach.
License of this version: CC BY 4.0 Unported
Document Type: article
Publishing status: publishedVersion
Issue Date: 2018
Appears in Collections:Naturwissenschaftliche Fakultät

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pos. country downloads
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1 image of flag of Germany Germany 107 74.31%
2 image of flag of United States United States 6 4.17%
3 image of flag of Czech Republic Czech Republic 4 2.78%
4 image of flag of China China 4 2.78%
5 image of flag of Austria Austria 4 2.78%
6 image of flag of Russian Federation Russian Federation 3 2.08%
7 image of flag of Poland Poland 2 1.39%
8 image of flag of France France 2 1.39%
9 image of flag of Switzerland Switzerland 2 1.39%
10 image of flag of Israel Israel 1 0.69%
    other countries 9 6.25%

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