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Title: Would fortification of more foods with vitamin D improve vitamin D intakes and status of groups at risk of deficiency in the UK?
Author: Allen, R. E.
Awarding Body: London School of Hygiene & Tropical Medicine
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 2013
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Groups of the UK population have poor vitamin D status, particularly those with low sun exposure and/or poor dietary intake. This study looked at the impact of fortifying more foods with vitamin D in the UK on population vitamin D intakes and status. It included: • A systematic review, which found that consumption of a wide variety of foods (including milk, orange juice and bread) fortified with vitamin D can improve vitamin D status; and that national schemes have been effective at improving status of some, but not all groups of the target population. • An update of the vitamin D content of fortified foods and supplements within the National Diet and Nutrition Survey (NONS) Nutrient Databank, which increased current population vitamin D intakes by 3%. Consideration of a standard level of 'overage' applied during fortification increased population intakes by a further 3%. • A computer-based data processing exercise to simulate the effect of fortifying flour and milk with vitamin D using NONS data. At 10µg vitamin D per 100g flour, the proportion of 'at risk' groups with vitamin D intakes below the UK Reference Nutrient Intake (RNI) was reduced from a current level of 97% to 53%, without anyone exceeding the European Tolerable Upper Intake Level (UL) for vitamin D. Fortification of flour at this level improved intakes across all socio-economic groups and was found to be more effective than fortification of milk, as well as simultaneous fortification of milk and flour. Fortification therefore provides an opportunity for improving vitamin 0 intakes and status in the UK However, there remains much uncertainty surrounding vitamin D, in particular around intake and status levels required for optimum health and the analytical methods used to determine these. Further research is therefore recommended prior to introducing a national scheme to fortify with vitamin D in the UK.
Supervisor: Dangour, A. D. Sponsor: Food Standards Agency ; Department of Health
Qualification Name: Thesis (Dr.P.H.) Qualification Level: Doctoral