title: Small Increments in Vitamin D Intake by Irish Adults over a Decade Show That Strategic Initiatives to Fortify the Food Supply Are Needed.
abstract: BACKGROUND
  Food fortification could be an effective method of increasing vitamin D intakes and preventing deficiency with minimal risk of excessive dosing.
  
  
  OBJECTIVE
  Secular trends in vitamin D intakes were examined over a 10-y period.
  
  
  METHODS
  We compared vitamin D intakes among 18- to 64-y-old adults from the base diet, fortified foods, and supplements in 2 nationally representative dietary surveys in 1999 and 2009 implemented using the same methodology.
  
  
  RESULTS
  There was a slight increase in the median (IQR) intake of vitamin D from 2.9 (3.2) to 3.5 (3.7) μg/d (mean ± SD, 4.3 ± 4.0 to 5.0 ± 6.4 μg). The median (IQR) intake from the base diet was 2.3 (1.6) μg/d in 1999 and 2.1 (1.8) μg/d in 2009. In vitamin D supplement users, median (IQR) intakes were 7.6 (6.7) and 8.7 (7.2) μg/d and the prevalence of inadequacy decreased from 67% to 57% in 2009. Although the consumption of vitamin D-containing supplements was similar in the 2 surveys (17% and 16%), the use of calcium-vitamin D supplements increased from 3% to 10% among women aged 50-64 y. The prevalence of fortified food consumption was also similar at 60%, and median (IQR) vitamin D intakes in consumers were 2.9 (2.2) and 3.7 (2.9) μg/d in 1999 and 2009, respectively. Mathematical modeling of food fortification using modified vitamin D composition data showed that there is potential to increase vitamin D intakes at the lower end of the distribution, without increasing the risk of exceeding the Tolerable Upper Intake Level.
  
  
  CONCLUSIONS
  We report small increases in vitamin D intakes among Irish adults over a decade of focus on vitamin D and in the context of a voluntary fortification policy. Strategic management of vitamin D in the food supply is required to yield measurable benefits.
authors.affiliation: Vitamin D Research Group, School of Food and Nutritional Sciences.
authors.forename: Lucinda J
authors.initials: LJ
authors.lastname: Black
authors.affiliation: School of Food and Nutritional Sciences.
authors.forename: Janette
authors.initials: J
authors.lastname: Walton
authors.affiliation: School of Food and Nutritional Sciences.
authors.forename: Albert
authors.initials: A
authors.lastname: Flynn
authors.affiliation: Vitamin D Research Group, School of Food and Nutritional Sciences, Department of Medicine, and.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Cashman
authors.affiliation: Vitamin D Research Group, School of Food and Nutritional Sciences, Irish Center for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland m.kiely@ucc.ie.
authors.forename: Mairead
authors.initials: M
authors.lastname: Kiely
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet / Q000009:adverse effects / Q000208:ethnology / Q000639:trends; D004034:Diet Surveys; D019587:Dietary Supplements; D005260:Female; D005523:Food Supply; D005527:Food, Fortified; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D010349:Patient Compliance / Q000208:ethnology; D015995:Prevalence; D011446:Prospective Studies; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D035141:Voluntary Programs; D055815:Young Adult
chemical_list: D014807:Vitamin D
keywords: Irish adults; dietary modeling; vitamin D fortification; vitamin D intakes; vitamin D supplements