title: Efficacy and safety of food fortification with calcium among adults in Finland.
abstract: OBJECTIVE
  To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland.
  
  
  METHODS
  A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements.
  
  
  METHODS
  Participants of FINDIET 2002 were 25-64 years old from five areas (n = 2007). Participants of the Internet-based survey (n = 1537) were over 15 years of age from all over the country.
  
  
  RESULTS
  If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level (< 800 mg day(-1)) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, > 2500 mg day(-1)) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women.
  
  
  CONCLUSIONS
  Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population.
authors.affiliation: National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland. tero.hirvonen@ktl.fi
authors.forename: Tero
authors.initials: T
authors.lastname: Hirvonen
authors.forename: Heli
authors.initials: H
authors.lastname: Tapanainen
authors.forename: Liisa
authors.initials: L
authors.lastname: Valsta
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Hannila
authors.forename: Antti
authors.initials: A
authors.lastname: Aro
authors.forename: Pirjo
authors.initials: P
authors.lastname: Pietinen
mesh_terms: D000328:Adult; D002118:Calcium / Q000172:deficiency*; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000009:adverse effects*; D003611:Dairy Products; D004034:Diet Surveys; D004305:Dose-Response Relationship, Drug; D005260:Female; D005387:Finland / Q000453:epidemiology; D005527:Food, Fortified / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009751:Nutritional Requirements; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome
chemical_list: D002136:Calcium, Dietary; D002118:Calcium