Tarasuk Valerie, Brassard Didier
Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada.
Food Nutr Res. 2021 Jun 4;65. doi: 10.29219/fnr.v65.5256. eCollection 2021.
In Canada, regulatory changes have expanded marketing opportunities for voluntarily fortified products (VFPs), with micronutrient additions permitted at levels well in excess of human requirements.
To examine how the consumption of VFPs relates to usual nutrient intakes in the Canadian population.
The 2015 Canadian Community Health Survey comprises single 24-h dietary intake recalls on a population-representative sample of 20,487 individuals aged 1 year and older, with second recalls on a subset of 7,608. The intake data included 15 food codes denoting VFP (e.g. energy drinks, fortified beverages, cereals, and bars). We assessed VFP consumption and estimated usual intake distributions for riboflavin, niacin, zinc, and vitamins A, B6, B12, and C for VFP consumers and non-consumers 14-50 years old ( = 8,442) using the National Cancer Institute method. We applied the 'shrink and add' method to estimate usual intakes among supplement users and assessed apparent benefits and risks by comparing usual intake distributions to EARs and ULs.
Only 2.4% of the population reported any consumption of VFP on the first 24-h recall. VFP consumers were overrepresented in the upper quartile of population intake distributions for niacin, riboflavin, vitamin B6, vitamin B12, and zinc. The median usual intakes of VFP consumers were 24-111% higher than the median usual intakes of non-consumers, and VFP consumers had significantly lower prevalence of inadequacy for riboflavin and vitamins A, B6, B12, and C. Irrespective of VFP consumption, usual intake distributions reached the ULs for vitamin A and zinc with the addition of supplement intakes.
Given the limited differentiation of VFP in this survey, we have likely underestimated nutrient exposure levels.
VFP consumption was associated with elevated usual nutrient intakes, but we found limited evidence that it protected consumers from nutrient inadequacies or propelled intakes above tolerable upper levels.
在加拿大，监管变化扩大了自愿强化产品（VFP）的市场机会，允许添加的微量营养素水平远远超过人体需求。
研究VFP的消费与加拿大人群通常的营养素摄入量之间的关系。
2015年加拿大社区健康调查包括对20487名1岁及以上具有人口代表性的个体进行单次24小时饮食摄入量回忆调查，对其中7608名个体进行了第二次回忆调查。摄入数据包括15种表示VFP的食品代码（如能量饮料、强化饮料、谷物和棒状食品）。我们评估了VFP的消费情况，并使用美国国家癌症研究所的方法估计了14至50岁（n = 8442）的VFP消费者和非消费者中核黄素、烟酸、锌以及维生素A、B6、B12和C的通常摄入量分布。我们应用“收缩并添加”方法来估计补充剂使用者的通常摄入量，并通过将通常摄入量分布与EAR和UL进行比较来评估明显的益处和风险。
在首次24小时回忆调查中，只有2.4%的人群报告食用过任何VFP。在烟酸、核黄素、维生素B6、维生素B12和锌的人群摄入量分布的上四分位数中，VFP消费者的占比过高。VFP消费者的通常摄入量中位数比非消费者的通常摄入量中位数高24%至111%，并且VFP消费者核黄素以及维生素A、B6、B12和C摄入不足的患病率显著较低。无论是否食用VFP，加上补充剂摄入量后，通常摄入量分布都达到了维生素A和锌的UL。
鉴于本次调查中VFP的区分有限，我们可能低估了营养素暴露水平。
食用VFP与较高的通常营养素摄入量相关，但我们发现有限的证据表明它能保护消费者避免营养素不足或将摄入量提高到可耐受的上限以上。
