Vitamin D Fortification of Consumption Cow’s Milk: Health, Nutritional and Technological Aspects. A Multidisciplinary Lecture of the Recent Scientific Evidence

Abstract

Vitamin D is essential in assuring bone health at all stages of life, but its non-skeletal effects are also essential: This vitamin impacts the physiology of the immune system, skeletal muscles and adipose tissue, glucose metabolism, skin, cardiovascular and reproductive systems, neuro-cognitive functions and cell division. The incidence of vitamin D deficiency is widespread worldwide, at any age, in young and healthy subjects, as well as in pregnant women and the elderly population, due to several factors, including inadequate sunlight exposure, skin pigmentation and coverage, adiposity, lifestyle and low dietary intakes. To overcome this problem, the fortification of foods that are consumed on a daily basis, such as milk, is strongly advisable. This opinion paper aims to discuss, in a multidisciplinary way, the current evidence supporting the importance of vitamin D in health and disease and the role of milk as an optimal carrier of this vitamin, to promote adequate intakes, highlighting its unique physico-chemical characteristics linked to both fat globule membrane and casein micelle structure. Moreover, it addresses the impact of industrial processing and storage of consumption milk on the stability of these structures, thus in determining vitamin D bioavailability and the achievement of adequate intakes.

Knowledge, attitudes, and practices associated with Vitamin D supplementation: A cross-sectional online community survey of adults in the UK

“…In their global consensus publication, Munns CF et al make recommendations for the prevention and management of nutritional rickets; these include safe sun exposure, vitamin D supplementation, combined with the strategic fortification of normal habitual foods accompanied by adequate dietary calcium intake (5). The fortification of milk with vitamin D in the 1930s effectively eradicated rickets worldwide (43)(44)(45). However, research has also shown (46,47), that fortification alone is not enough, and that additional vitamin D supplementation is needed to achieve sufficiency status in at-risk populations.…”

Role of Vitamin D in Liver Disease and Complications of Advanced Chronic Liver Disease

“…The vitamin D from animal sources is cholecalciferol (D3), while ergocalciferol (vitamin D2) is produced in plants and fungi [ 3 , 4 , 5 ]. Except for fatty fish (such as sardines, herring, tuna, mackerel, salmon, and cod liver oil), the amount of vitamin D naturally present in food is negligible unless fortified, such as in milk [ 6 ].…”

Reasonableness of Enriching Cow’s Milk with Vitamins and Minerals

“…This phenomenon raises many concerns for the health of society. Moreover, it entails a nutritional deficiency of one of the essential nutrients supplied by this group of products, such as calcium [1][2][3][4][5][6].…”

“…According to Cashman et al [32], vitamin D deficiency is evident throughout the European population at concerningly prevalence rates, requiring action from a public health perspective. The map of vitamin D status in different countries (based on 107 studies involving more than 630,000 subjects) revealed that one out of every eight people was at risk of vitamin D deficiency (even in sunny regions) [5,32].…”

“…Milk is composed of about 87% water. It contains, on average, 3.5% protein, about 5% lactose, a variable amount of fat, from 0.5% (in skimmed milk) to 3-4% (in whole milk) and minerals (1.2%, mainly calcium and phosphorus) [3,5,6].…”