Vitamin D deficiency is known to be very common in the elderly. It represents a major public health problem as it is recognised to be an important risk factor for hip fractures, which are associated with significant excess mortality, disability and economic costs. There is presently also disturbing evidence of rickets reappearing in Europe, particularly in immigrant populations. It has, in addition, been pointed out that the levels of parathyroid hormone seen in many Europeans, particularly in the winter, are high enough to indicate a degree of hyperparathyroidism, which could be associated, particularly in the rapidly growing young, with an undesirable departure from achievement of optimal bone mass.
Vitamin D fortification and/or supplementation strategies are an effective and reasonably cheap way of arresting preventable health consequences. But there are many unknowns in relation to the strategy of vitamin D fortification of food, particularly concerning the levels achieving optimal effects without toxicity.
The overall objective is to investigate whether fortification of food with vitamin D is a feasible strategy to remedy the insufficient vitamin D status of large population groups in Europe, and to determine at what level fortification should be pitched. The minimal effective dose with respect to vitamin D status, calcium metabolism and bone will be assessed in adolescent girls, elderly women and an immigrant population group. The seasonal variation of vitamin D status across Europe and the relative contributions of sun exposure and dietary habits, including food fortification and vitamin D supplementation will be evaluated in young and elderly. The technical feasibility of fortifying a low-fat food with vitamin D and the bio-availability of the incorporated vitamin will be determined, as well as the acceptability to the consumer.
This project aims -taking a long term view- at improving vitamin D status of the European population, and thus takes up many facets of general health with particular reference to bone integrity. The expected results should make it possible across Europe
- To tailor vitamin D fortification optimally with respect to population needs.
- To make use of a low-fat healthy food as fortification vehicle in accordance with European nutrition recommendations
- An important outcome is to reinforce the scientific base for recommendations on vitamin D as a nutrient.