Modelling vitamin D food fortification among Aboriginal and Torres Strait Islander peoples in Australia

TL;DR

This study models various vitamin D food fortification strategies among Aboriginal and Torres Strait Islander peoples in Australia, showing potential to significantly increase vitamin D intake through targeted fortification of staple foods.

Contribution

It provides a novel modeling analysis of vitamin D fortification scenarios, including higher-than-permitted levels and foods not currently allowed in Australia.

Findings

Fortification could increase vitamin D intake by 3-6 μg/day.

Scenario 2c could raise median intake to 8 μg/day.

No participants exceeded the upper intake level of 80 μg/day.

Abstract

Background: Low vitamin D intake and high prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D concentration < 50 nmol/L) among Aboriginal and Torres Strait Islander peoples highlight a need for public health strategies to improve vitamin D status. As few foods contain naturally occurring vitamin D, fortification strategies may be needed to improve vitamin D intake and status among Aboriginal and Torres Strait Islander peoples. Objective: We aimed to model vitamin D food fortification scenarios among Aboriginal and Torres Strait Islander peoples. Methods: We used nationally representative food consumption data (n=4,109) and vitamin D food composition data to model four food fortification scenarios. The modelling for Scenario 1 included foods and maximum vitamin D concentrations permitted for fortification in Australia: i) dairy products and alternatives, ii) butter/margarine/oil spreads, iii) formulated beverages, and iv) selected ready-to-eat breakfast cereals. The modelling for Scenarios 2a-c included some vitamin D concentrations higher than permitted in Australia; Scenario 2c included bread, which is not permitted for vitamin D fortification in Australia. Scenario 2a: i) dairy products and alternatives, ii) butter/margarine/oil spreads, iii) formulated beverages. Scenario 2b: as per Scenario 2a plus selected ready-to-eat breakfast cereals. Scenario 2c: as per Scenario 2b plus bread. Results: Vitamin D fortification of a range of staple foods could potentially increase vitamin D intake among Aboriginal and Torres Strait Islander peoples by ~ 3-6 {\mu}g/day. Scenario 2c showed the highest potential median vitamin D intake increase to ~ 8 {\mu}g/day. Across all modelled scenarios, none of the participants had vitamin D intake above the Australian upper level of intake of 80 {\mu}g/day.