title: Development of a model for optimal food fortification: vitamin D among adults in Finland.
abstract: BACKGROUND
  Average vitamin D intake is low in Finland. Even though almost all retail milk and margarine are fortified with vitamin D, the vitamin D intake is inadequate for a significant proportion of the population. Consequently, expanded food fortification with vitamin D would be motivated. However, there is a risk of unacceptably high intakes due to the rather narrow range of the adequate and safe intake. Therefore, a safe and efficient food fortification practice should be found for vitamin D.
  
  
  OBJECTIVE
  To develop a model for optimal food fortification and apply it to vitamin D.
  
  
  METHODS
  The FINDIET 2002 Study (48-h recall and data on supplement use (n = 2007), and 3 + 3 days' food records, n = 247) was used as the test data. The proportion of the population whose vitamin D intake is between the recommended intake (RI) and the upper tolerable intake level (UL) was plotted against the fortification level per energy for selected foods. The fortification level that maximized the proportion of the population falling between RI and UL was considered the optimal fortification level.
  
  
  RESULTS
  If only milk, butter milk, yoghurt and margarine were fortified, it would be impossible to find a fortification level by which the intake of the whole population would lie within the RI-UL range. However, if all potentially fortifiable foods were fortified with vitamin D at level 1.2-1.5 microg/100 kcal, the intake of the whole adult population would be between the currently recommended intake of 7.5 microg/d and the current tolerable upper intake level of 50 microg/day (model 1). If the RI was set to 40 microg/day and UL to 250 microg/day, the optimal fortification level would be 9.2 microg/100 kcal in the scenario where all potentially fortifiable foods were fortified (model 2). Also in this model the whole population would fall between the RI-UL range.
  
  
  CONCLUSIONS
  Our model of adding a specific level of vitamin D/100 kcal to all potentially fortifiable foods (1.2-1.5 microg/100 kcal in model 1 and 9.2 microg/100 kcal in model 2) seems to be an efficient and safe food fortification practise.
authors.affiliation: Dept. of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Mannerheimintie 166, 00300, Helsinki, Finland. tero.hirvonen@ktl.fi
authors.forename: Tero
authors.initials: T
authors.lastname: Hirvonen
authors.forename: Harri
authors.initials: H
authors.lastname: Sinkko
authors.forename: Liisa
authors.initials: L
authors.lastname: Valsta
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Hannila
authors.forename: Pirjo
authors.initials: P
authors.lastname: Pietinen
mesh_terms: D000328:Adult; D003611:Dairy Products; D004034:Diet Surveys; D004305:Dose-Response Relationship, Drug; D005260:Female; D005387:Finland / Q000453:epidemiology; D005527:Food, Fortified; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009751:Nutritional Requirements; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage* / Q000009:adverse effects*; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D014807:Vitamin D