Rationale and plan for vitamin D food fortification: a review and guidance paper

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dc.contributor.author Pilz, Stefan
dc.contributor.author Maerz, Winfried
dc.contributor.author Cashman, Kevin D.
dc.contributor.author Kiely, Mairead E.
dc.contributor.author Whiting, Susan J.
dc.contributor.author Holick, Michael F.
dc.contributor.author Grant, William B.
dc.contributor.author Pludowski, Pawel
dc.contributor.author Hiligsmann, Mickael
dc.contributor.author Trummer, Christian
dc.contributor.author Schwetz, Verena
dc.contributor.author Lerchbaum, Elisabeth
dc.contributor.author Pandis, Marlene
dc.contributor.author Tomaschitz, Andreas
dc.contributor.author Gruebler, Martin R.
dc.contributor.author Gaksch, Martin
dc.contributor.author Verheyen, Nicolas
dc.contributor.author Hollis, Bruce W.
dc.contributor.author Rejnmark, Lars
dc.contributor.author Karras, Spyridon N.
dc.contributor.author Hahn, Andreas
dc.contributor.author Bischoff-Ferrari, Heike A.
dc.contributor.author Reichrath, Joerg
dc.contributor.author Jorde, Rolf
dc.contributor.author Elmadfa, Ibrahim
dc.contributor.author Vieth, Reinhold
dc.contributor.author Scragg, Robert
dc.contributor.author Calvo, Mona S.
dc.contributor.author van Schoor, Natasja M.
dc.contributor.author Bouillon, Roger
dc.contributor.author Lips, Paul
dc.contributor.author Itkonen, Suvi T.
dc.contributor.author Martineau, Adrian R.
dc.contributor.author Lamberg-Allardt, Christel
dc.contributor.author Zittermann, Armin
dc.date.accessioned 2018-08-29T15:47:22Z
dc.date.available 2018-08-29T15:47:22Z
dc.date.issued 2018
dc.identifier.citation Pilz, S., März, W., Cashman, K. D., Kiely, M. E., Whiting, S. J., Holick, M. F., Grant, W. B., Pludowski, P., Hiligsmann, M., Trummer, C., Schwetz, V., Lerchbaum, E., Pandis, M., Tomaschitz, A., Grübler, M. R., Gaksch, M., Verheyen, N., Hollis, B. W., Rejnmark, L., Karras, S. N., Hahn, A., Bischoff-Ferrari, H. A., Reichrath, J., Jorde, R., Elmadfa, I., Vieth, R., Scragg, R., Calvo, M. S., van Schoor, N. M., Bouillon, R., Lips, P., Itkonen, S. T., Martineau, A. R., Lamberg-Allardt, C. and Zittermann, A. (2018) 'Rationale and plan for vitamin D food fortification: a review and guidance paper', Frontiers in Endocrinology, 9, 373 (16pp). doi: 10.3389/fendo.2018.00373 en
dc.identifier.volume 9
dc.identifier.startpage 1
dc.identifier.endpage 16
dc.identifier.issn 1664-2392
dc.identifier.uri http://hdl.handle.net/10468/6664
dc.identifier.doi 10.3389/fendo.2018.00373
dc.description.abstract Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from >= 25 to >= 50 nmol/L (>= 10->= 20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 mu g (400-800 international units). Most populations fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations < 30 nmol/L (12 ng/mL) and < 50 nmol/L (20 ng/mL) are present in 13.0 and 40.4% of the general population, respectively. This substantial gap between officially recommended dietary reference intakes for vitamin D and the high prevalence of vitamin D deficiency in the general population requires action from health authorities. Promotion of a healthier lifestyle with more outdoor activities and optimal nutrition are definitely warranted but will not erase vitamin D deficiency and must, in the case of sunlight exposure, be well balanced with regard to potential adverse effects such as skin cancer. Intake of vitamin D supplements is limited by relatively poor adherence (in particular in individuals with low-socioeconomic status) and potential for overdosing. Systematic vitamin D food fortification is, however, an effective approach to improve vitamin D status in the general population, and this has already been introduced by countries such as the US, Canada, India, and Finland. Recent advances in our knowledge on the safety of vitamin D treatment, the dose-response relationship of vitamin D intake and 25(OH)D levels, as well as data on the effectiveness of vitamin D fortification in countries such as Finland provide a solid basis to introduce and modify vitamin D food fortification in order to improve public health with this likewise cost-effective approach. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Frontiers Media S.A. en
dc.relation.uri https://www.frontiersin.org/articles/10.3389/fendo.2018.00373/full
dc.rights © 2018, the Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject Vitamin D en
dc.subject Public health en
dc.subject Food fortification en
dc.subject General population en
dc.subject Guidelines en
dc.subject Evidence en
dc.subject Recommendations en
dc.subject Policy en
dc.title Rationale and plan for vitamin D food fortification: a review and guidance paper en
dc.type Review en
dc.internal.authorcontactother Kevin D. Cashman, Food & Nutritional Sciences, University College Cork, Cork, Ireland. +353-21-490-3000 Email: k.cashman@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Frontiers in Endocrinology en
dc.internal.IRISemailaddress k.cashman@ucc.ie en
dc.identifier.articleid 373


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© 2018, the Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Except where otherwise noted, this item's license is described as © 2018, the Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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