Intake of Vitamins and Minerals From Voluntarily Fortified Foods and/or Dietary Supplements in School Adolescents in Central-Eastern Poland

Abstract

Background: The key issue is whether voluntarily fortified foods and vitamin/mineral supplements available on the market serve public health needs. The study aim was to estimate nutrient intakes from voluntarily fortified foods and vitamin/mineral supplements in relation to the Dietary Reference Intake (DRI) in adolescents ( n = 759) aged 13–19 who attended public secondary schools in Central-Eastern Poland. Methods: Data on the consumption of voluntarily fortified foods were collected using a semi-quantitative food frequency questionnaire containing 58 food items. Data on the use of dietary supplements were assessed via an open-ended question. The content of nutrients was estimated using the producer's labeling declaration. The distribution of nutrient intakes according to the percentage of DRI categories (<20%, 20–39.9%, 40–59.9%, 60–79.9%, 80–99.9%, 100–119%, or >120%) was estimated. Results: Consumption of voluntarily fortified foods was a common behavior in adolescents (86.7% of participants), while vitamin/mineral supplements were used by less than one-fifth of them (17.7%). The amounts of nutrient intakes from fortified foods and/or supplements were at different levels: (I) vitamins A, D, calcium, magnesium (>50% of adolescents did not exceed 20% of DRI); (II) vitamins E, B 12 , iron (>50% of respondents consumed at least 20% of DRI); (III) niacin and pantothenic acid (>50% of respondents consumed at least 40% of DRI); IV) vitamins C, B 1 , B 2 , B 6 , folate, biotin (>50% of participants consumed at least 60% of DRI). In a subgroup of respondents who used fortified foods and supplements simultaneously ( n = 126), some nutrients (i.e., vitamins C, B 1 , B 2 , B 6 , niacin, and biotin) were consumed in amounts ≥150% of DRI. Intake above the Tolerable Upper Intake Levels was observed for niacin, vitamin A, B 6 and folic acid in individual cases (up to 1.1% of respondents); a higher risk of overconsumption was associated with using vitamin/mineral supplements than voluntarily fortified foods. Conclusion: Adolescents should be educated on how to reasonably use fortified foods and dietary supplements to help to overcome the potential deficiency of nutrients without causing excessive consumption.

Contribution of voluntary fortified foods to micronutrient intake in The Netherlands

“…Comparable to the Netherlands, these were also main voluntary fortified food groups in e.g. Finland (yoghurt), Poland (non-alcoholic beverages and dairy), USA (milk and milk drinks) and Ireland (fat spreads) [21][22][23][24]. Due to different food habits, in Finland, Ireland, Poland and USA ready-to-eat-breakfast cereals is an important voluntary fortified food group, in contrast to the Netherlands [21][22][23][24].…”

“…Finland (yoghurt), Poland (non-alcoholic beverages and dairy), USA (milk and milk drinks) and Ireland (fat spreads) [21][22][23][24]. Due to different food habits, in Finland, Ireland, Poland and USA ready-to-eat-breakfast cereals is an important voluntary fortified food group, in contrast to the Netherlands [21][22][23][24]. In Ireland, 53% of the population consumes ready-to-eat-breakfast cereals, in the Netherlands, this is only on 3% of the recall days.…”

Assessment of Food Supplement Consumption in Polish Population of Adults

“…However, the constantly expanding market of supplements and their non-prescription status make them generally available for all population groups ( 13 ). Young people who consume an unbalance diet, instead of improving eating habits, use food supplements with the belief that it will reduce the risk of serious health complications ( 14 , 15 ). Adult food supplement users perceive supplements as an easy and safe way to stay healthy ( 16 , 17 ).…”

Interventions to improve calcium intake through foods in populations with low intake

“…Mandatory food fortification requires minimal behavior change and for calcium can be a cost‐effective intervention 91 . By contrast, voluntary fortification relies more on the food manufacturers and consumer demand and access to address the public health issue, and typically many options are available to the consumers 93–95 . In these cases, the equity of availability and affordability must also be considered to ensure that the most at‐risk population groups can benefit from these products, especially if the costs of food fortification are passed on to the consumer 96,97 .…”