Assessing Health Consequences of Vitamin D Fortification Utilizing a Societal Experiment Design: Methodological Lessons Learned from the D-Tect Project

Händel, Mina Nicole; Jacobsen, Ramunė; Thorsteinsdottir, Fanney; Keller, Alexandra; Stougaard, Maria; Jensen, Christine B.; Moos, Caroline; Duus, Katrine Sidenius; Jensen, Allan; Kesmodel, Ulrik Schiøler; Abrahamsen, Bo; Heitmann, Berit Lilienthal

doi:10.3390/ijerph18158136

Cited by 2 publications

(2 citation statements)

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“…Another way of addressing widespread vitamin D deficiency is food fortification, which is an elegant, cheap universal way and independent of issues related to supplementation (logistics, adherence, costs) ( 61 , 62 ). Data from Finland are a prime example of how food fortification could improve 25OHD levels ( 40 , 63 ).…”

Section: Discussionmentioning

confidence: 99%

Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels

et al. 2022

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ObjectivesVitamin D deficiency in neonates can have life-threatening consequences, hence the knowledge of risk factors is essential. This study aimed to explore the effect of maternal socioeconomic status (SES) on newborn 25-hydroxyvitamin D (25OHD) concentrations.DesignOver two 1-week periods (winter and summer of 2019), 3000 newborn heel prick dried blood spots (DBS) and additional data of newborns, from a regional newborn screening laboratory (52° N) in the West Midlands, UK, were gathered. Post code was replaced with lower layer super output area (LSOA). Index of Multiple Deprivation (IMD) quintiles for the corresponding LSOA was used to assess SES [quintile one (Q1): most deprived 20%, quintile five (Q5): least deprived 20%]. Each of the seven domains of deprivation were examined (income, employment, education, health, barriers to housing and services, crime and living environment). 25OHD was measured on 6mm sub-punch from DBS using quantitative liquid chromatography tandem mass spectrometry and equivalent plasma values were derived.ResultsIn total 2999 (1500 summer-born, 1499 winter-born) newborn DBS (1580 males) were analysed. Summer-born newborns had significantly higher 25OHD (IQR) concentrations [49.2 (34.3; 64.8) nmol/l] than winter-born newborns [29.1 (19.8; 40.6) nmol/l, p<0.001].25OHD levels varied significantly between the different IMD quintiles in the whole (p<0.001) and summer-born cohort (p<0.001), but not in the winter-born cohort (p=0.26), whereby Q1 had the lowest 25OHD concentrations. Among the domains of deprivation, living environment had a significant influence on 25OHD levels (β=0.07, p=0.002). In this subdomain, 25OHD levels varied significantly between quintiles in the whole (p<0.001) and summer-born cohort (mean 25OHD Q1 46.45 nmol/l, Q5 54.54 nmol/l; p<0.001) but not in the winter-born cohort (mean 25OHD Q1 31.57 nmol/l, Q5 31.72 nmol/l; p=0.16). In a regression model, living environment was still significant (p=0.018), albeit less than season of birth and ethnicity.ConclusionAmong the seven domains of deprivation, maternal living environment had the greatest effect on newborn 25OHD levels. Whilst improved living environment positively influenced vitamin D status in the summer-born babies, winter-born had low 25OHD levels irrespective of the environment. Strategies such as enhanced supplementation and food fortification with vitamin D should be considered to overcome the non-modifiable main risk factors for vitamin D deficiency.

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Section: Discussionmentioning

confidence: 99%

Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels

et al. 2022

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“…Even though the fortification of all margarine products was mandatory in Denmark from the mid-1930s up until mid-1985 (when it was banned) [12], Denmark does not have a long tradition of fortifying foods. Presently, vitamin D food fortification needs to be approved by the Danish Veterinary and Food Administration.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Food Fortification Strategies on Population-Based Dietary Intake Data Using Mixed-Integer Programming

Sengupta

Christensen

Ravn‐Haren

et al. 2023

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The dietary vitamin D intake of the Danish population is low, and food fortification is a strategy to increase intake. This paper explores the possibility of vitamin D fortification on the current population food intake in Denmark, such that the population receives adequate amounts of vitamin D without having to change current dietary patterns. A mixed-integer programming approach is used to arrive at a solution for the optimal fortification required at each food group level so that the majority of the population receive the minimum intake of average requirement (AR) and do not exceed the tolerable upper intake level (UL). The method shows a significant increase in vitamin D intake compared to the current scenario, keeping a neutral approach towards preferences of one food group over others. The method can also be fine-tuned in different scenarios where certain food group preferences are known, which can be encoded into the model in the form of constraints.

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Assessing Health Consequences of Vitamin D Fortification Utilizing a Societal Experiment Design: Methodological Lessons Learned from the D-Tect Project

Cited by 2 publications

References 34 publications

Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels

Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels

Vitamin D Food Fortification Strategies on Population-Based Dietary Intake Data Using Mixed-Integer Programming

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