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Vitamin D levels in Finland increased 2000-2011 (supplementation and fortification) – May 2017

The positive impact of general vitamin D food fortification policy on vitamin D status in a representative adult Finnish population: evidence from an 11-y follow-up based on standardized 25-hydroxyvitamin D data.

Am J Clin Nutr. 2017 May 10. pii: ajcn151415. doi: 10.3945/ajcn.116.151415. [Epub ahead of print]
Jääskeläinen T1, Itkonen ST2, Lundqvist A1, Erkkola M2, Koskela T3, Lakkala K3, Dowling KG4, Hull GL4, Kröger H5, Karppinen J6,7, Kyllönen E6, Härkänen T1, Cashman KD4,8, Männistö S1, Lamberg-Allardt C9.
1 Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.
2 Calcium Research Unit, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
3 Finnish Meteorological Institute, Helsinki, Finland.
4 Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, and.
5 Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital and Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Joensuu, Finland.
6 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; and.
7 Finnish Institute of Occupational Health, Oulu, Finland.
8 Department of Medicine, University College Cork, Cork, Ireland.
9 Calcium Research Unit, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland; christel.lamberg-allardt at helsinki.fi.

Vitamin D Life Summary

In 11 years
% of Fins supplementing: 11 % ==> 41 %
Vitamin D levels: 19 ng ==> 26 ng
Strange: very little variance reported in the measured range: 95% apparently within 1 nmol of the mean

Total population nmol

2000 2011
<30 13.0 %0.6 %
30-40 32.0 %3.2 %
40-50 55.7 %9.1%
75-125 4.1%19.9%
>1250 % 8%
Total % 107 %33 %

Very strange that % do not total to 100%

See also Vitamin D Life

Fortification with Vitamin D category listing has 111 items

Increased use of D category listing has 38 items


Background: A systematic vitamin D fortification of fluid milk products and fat spreads was started in 2003 in Finland to improve vitamin D status.

Objective: We investigated the effects of the vitamin D fortification policy on vitamin D status in Finland between 2000 and 2011.

Design: Serum 25-hydroxyvitamin D [S-25(OH)D] concentrations of a nationally representative sample comprising 6134 and 4051 adults aged ≥30 y from the Health 2000 and Health 2011 surveys, respectively, were standardized according to the Vitamin D Standardization Program with the use of liquid chromatography-tandem mass spectrometry. Linear and logistic regression models were used to assess the change in S-25(OH)D concentrations.

Results: Between 2000 and 2011, the mean S-25(OH)D increased from 48 nmol/L (95% CI: 47, 48 nmol/L) to 65 nmol/L (95% CI: 65, 66 nmol/L) (P < 0.001). The prevalence of vitamin D supplement users increased from 11% to 41% (P < 0.001). When analyzing the effect of fortification of fluid milk products, we focused on supplement nonusers. The mean increase in S-25(OH)D in daily fluid milk consumers (n = 1017) among supplement nonusers was 20 nmol/L (95% CI: 19, 21 nmol/L), which was 6 nmol/L higher than nonconsumers (n = 229) (14 nmol/L; 95% CI: 12, 16 nmol/L) (P < 0.001). In total, 91% of nonusers who consumed fluid milk products, fat spreads, and fish based on Finnish nutrition recommendations reached S-25(OH)D concentrations >50 nmol/L in 2011.

Conclusions: The vitamin D status of the Finnish adult population has improved considerably during the time period studied. The increase is mainly explained by food fortification, especially of fluid milk products, and augmented vitamin D supplement use. Other factors, such as the difference in the ultraviolet radiation index between 2000 and 2011, may partly explain the results. When consuming vitamin D sources based on the nutritional recommendations, vitamin D status is sufficient [S-25(OH)D ≥50 nmol/L], and supplementation is generally not needed.

PMID: 28490516 DOI: 10.3945/ajcn.116.151415

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