Shakur Yaseer A, Lou Wendy, L'Abbe Mary R
Earle W. McHenry Professor, and Chair, Department of Nutritional Sciences, University of Toronto.
Can J Public Health. 2014 Apr 17;105(2):e127-32. doi: 10.17269/cjph.105.4086.
Despite mandatory fortification of milk and margarine, most Canadians have inadequate vitamin D intake and consequently poor vitamin D status, especially in the winter. Increasing vitamin D fortification is one possible strategy to address this inadequacy. The purpose of our study was to examine the modelled effect of increased vitamin D fortification on the prevalence of inadequacy and the percentage of intakes greater than the Tolerable Upper Intake Level (UL) using different fortification scenarios.
Dietary intakes (24-h recall) from the 2004 Canadian Community Health Survey 2.2 (n=34,381) were used to model increased vitamin D levels in milk and the addition of vitamin D to cheese and yogurt at various levels to meet label claims of an "excellent source" based on the recommended dietary intakes. The Software for Intake Distribution Evaluation was used to estimate the prevalence of inadequacy and intakes >UL.
Fortification of milk, yogurt and cheese at 6.75 μg (270 IU)/serving led to more than doubling of vitamin D intakes across all sex/age groups and a drop in the prevalence of dietary inadequacy from >80% to <50% in all groups. Furthermore, no intakes approached the UL under any fortification scenario in any sex/age group.
There is a pressing need to improve vitamin D status among Canadians. Increasing vitamin D fortification of dairy products, consistent with their positioning in Canada's Food Guide, can lead to increased intake without a risk of excess. This is a population-wide public health strategy that should be given consideration in Canada.
尽管牛奶和人造黄油实行了强制强化,但大多数加拿大人维生素D摄入量不足,因此维生素D状况不佳,尤其是在冬季。增加维生素D强化是解决这一不足的一种可能策略。我们研究的目的是使用不同的强化方案,研究增加维生素D强化对不足患病率以及摄入量高于可耐受最高摄入量(UL)百分比的模拟影响。
采用2004年加拿大社区健康调查2.2(n = 34,381)中的膳食摄入量(24小时回顾法),对牛奶中维生素D水平的增加以及在不同水平向奶酪和酸奶中添加维生素D进行建模,以满足基于推荐膳食摄入量的“优质来源”标签声明。使用摄入量分布评估软件来估计不足患病率和摄入量> UL的情况。
每份牛奶、酸奶和奶酪强化6.75μg(270 IU)可使所有性别/年龄组的维生素D摄入量增加一倍以上,并且所有组的膳食不足患病率从> 80%降至<50%。此外,在任何强化方案下,任何性别/年龄组的摄入量均未接近UL。
迫切需要改善加拿大人的维生素D状况。根据加拿大食品指南中乳制品的定位增加其维生素D强化量,可导致摄入量增加而无过量风险。这是一项应在加拿大考虑的全人群公共卫生策略。