A Novel Approach to Optimize Vitamin D Intake in Belgium through Fortification Based on Representative Food Consumption Data.


Journal

The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243

Informations de publication

Date de publication:
01 10 2019
Historique:
received: 18 01 2019
revised: 28 02 2019
accepted: 04 05 2019
pubmed: 18 6 2019
medline: 24 6 2020
entrez: 18 6 2019
Statut: ppublish

Résumé

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.

Sections du résumé

BACKGROUND
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.
OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Identifiants

pubmed: 31204779
pii: S0022-3166(22)16451-5
doi: 10.1093/jn/nxz119
doi:

Substances chimiques

Vitamin D 1406-16-2

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1852-1862

Informations de copyright

Copyright © American Society for Nutrition 2019.

Auteurs

Isabelle Moyersoen (I)

Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.

Brecht Devleesschauwer (B)

Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium.

Arnold Dekkers (A)

National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.

Janneke Verkaik-Kloosterman (J)

National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.

Karin De Ridder (K)

Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.

Stefanie Vandevijvere (S)

Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.

Jean Tafforeau (J)

Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.

Herman Van Oyen (H)

Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Department of Public Health and Primary Care.

Carl Lachat (C)

Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.

John Van Camp (J)

Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.

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