Vitamin D Serum Levels in the UK Population, including a Mathematical Approach to Evaluate the Impact of Vitamin D Fortified Ready-to-Eat Breakfast Cereals: Application of the NDNS Database

Abstract

Vitamin D status is relatively poor in the general population, potentially leading to various conditions. The present study evaluates the relationship between vitamin D status and intake in the UK population and the impact of vitamin D fortified ready-to-eat cereals (RTEC) on this status via data from the National Diet and Nutrition Survey (NDNS: 2008-2012). Four cohorts were addressed: ages 4-10 (n = 803), ages 11-18 (n = 884), ages 19-64 (n = 1655) and ages 65 and higher (n = 428). The impact of fortification by 4.2 μg vitamin D per 100 g of RTEC on vitamin D intake and status was mathematically modelled. Average vitamin D daily intake was age-dependent, ranging from ~2.6 (age range 4-18 years) to ~5.0 μg (older than 64 years). Average 25(OH)D concentration ranged from 43 to 51 nmol/L, the highest in children. The relationship between vitamin D intake and status followed an asymptotic curve with a predicted plateau concentration ranging from 52 in children to 83 nmol/L in elderly. The fortification model showed that serum concentrations increased with ~1.0 in children to ~6.5 nmol/L in the elderly. This study revealed that vitamin D intake in the UK population is low with 25(OH)D concentrations being suboptimal for general health. Fortification of breakfast cereals can contribute to improve overall vitamin D status.

Keywords: National Diet and Nutrition Survey; breakfast cereals; vitamin D; vitamin D fortification; vitamin D intake and status.

Figure 1

The association between the vitamin D in diet (μg per day) and the serum concentration of 25(OH)D (nmol/L) as observed in the NDNS database. The solid line represents the 50% relationship while the dotted lines show the 95% CI level.

Figure 2

The association between RTEC intake (g/day) and expected vitamin D intake (μg per day) after fortification of 4.2 μg of vitamin D per 100 g of RTEC applying the presented model. The solid line represents the regression line, while the dotted line represents the recommended UK SACN levels of vitamin D intake. Each symbol represents a single person.