Department of Public Health Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary.
Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary.
Nutrients. 2023 Aug 26;15(17):3742. doi: 10.3390/nu15173742.
Vitamin D deficiency is a global public health concern with significant implications for bone health and chronic disease prevention. Our aim was to summarize the evidence from Cochrane and other systematic reviews evaluating the benefits or harms of vitamin D fortification of staple foods for household use. In April 2023, we systematically searched Ovid MEDLINE, Embase, Epistemonikos and the Cochrane Database of Systematic Reviews for systematic reviews investigating the effects of vitamin D fortification of food in general populations of any age. We used Cochrane methodology and assessed the methodological quality of included studies using AMSTAR (A MeaSurement Tool to Assess Systematic Reviews). We assessed the degree of overlap among reviews. All outcomes included in systematic reviews were assessed. The protocol is registered in PROSPERO (registration number: CRD42023420991). We included 27 systematic reviews out of 5028 records for analysis. Overall, 11 out of 12 systematic reviews calculating pooled estimates reported a significant increase in serum 25(OH)D concentrations. The mean change in serum 25(OH)D concentrations per additional 100 units of vitamin D ranged from 0.7 to 10.8 nmol/L. Fortification of food with vitamin D showed a reduction in the prevalence of vitamin D deficiency based on high-certainty evidence. Parathormone (PTH) levels were described to decrease, bone mineral density to increase, while the effects on other bone turnover markers were inconsistent. Fortification did not significantly impact most anthropometric parameters, but it seemed to positively influence lipid profiles. In summary, fortification of food with vitamin D results in a reduction of vitamin D deficiency and might increase serum 25(OH)D concentrations, to varying extents depending on the fortified vehicle and population characteristics. Additionally, fortification may have a positive impact on bone turnover and lipid metabolism but may only have a limited effect on anthropometric parameters.
维生素 D 缺乏是一个全球性的公共卫生问题，对骨骼健康和慢性病预防有重大影响。我们的目的是总结 Cochrane 及其他系统评价评估家庭使用主食强化维生素 D 的益处或危害的证据。2023 年 4 月，我们系统地检索了 Ovid MEDLINE、Embase、Epistemonikos 和 Cochrane 系统评价数据库，以寻找针对任何年龄段一般人群的食物强化维生素 D 的系统评价。我们使用 Cochrane 方法，并使用 AMSTAR（系统评价测量工具）评估纳入研究的方法学质量。我们评估了综述之间的重叠程度。评估了系统综述中包含的所有结局。该方案已在 PROSPERO（注册号：CRD42023420991）中注册。我们纳入了 5028 项记录中的 27 项系统评价进行分析。总体而言，12 项计算汇总估计值的系统评价中有 11 项报告血清 25(OH)D 浓度显著升高。每增加 100 单位维生素 D，血清 25(OH)D 浓度的平均变化范围为 0.7 至 10.8 nmol/L。基于高质量证据表明，食物强化维生素 D 可降低维生素 D 缺乏的流行率。甲状旁腺激素（PTH）水平降低，骨密度增加，而其他骨转换标志物的影响则不一致。强化并未显著影响大多数人体测量参数，但似乎对脂质谱有积极影响。总之，食物强化维生素 D 可降低维生素 D 缺乏的发生率，并可能在不同程度上增加血清 25(OH)D 浓度，具体取决于强化载体和人群特征。此外，强化可能对骨转换和脂质代谢有积极影响，但对人体测量参数的影响可能有限。
