Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-25T23:19:15.095Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy and safety of food fortification with calcium among adults in Finland

Published online by Cambridge University Press:  02 January 2007

Tero Hirvonen ,
Heli Tapanainen ,
Liisa Valsta ,
Marja-Leena Hannila ,
Antti Aro  and
Pirjo Pietinen
Tero Hirvonen*
Affiliation:
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
Heli Tapanainen
Affiliation:
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
Liisa Valsta
Affiliation:
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
Marja-Leena Hannila
Affiliation:
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
Antti Aro
Affiliation:
National Public Health Institute, Department of Health and Functional Capacity, Helsinki, Finland
Pirjo Pietinen
Affiliation:
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland
*
*Corresponding author: Email tero.hirvonen@ktl.fi
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland.

Design

A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements.

Setting/participants

Participants of FINDIET 2002 were 25–64 years old from five areas (n = 2007). Participants of the Internet-based survey (n = 1537) were over 15 years of age from all over the country.

Results

If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level (<800 mg day−1) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, >2500 mg day−1) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women.

Conclusions

Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population.

Keywords

FortificationRisk assessmentCalciumAdults
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 6 , September 2006 , pp. 792 - 797
Copyright
Copyright © The Authors 2006

References

1Flynn, A. The role of dietary calcium in bone health. Proceedings of the Nutrition Society 2003; 62: 851–8.CrossRefGoogle ScholarPubMed
2Cho, E, Smith-Warner, SA, Spiegelman, D, Beeson WL van den Brandt, PA, Colditz, GA, et al. Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies. Journal of the National Cancer Institute 2004; 96: 1015–22.CrossRefGoogle ScholarPubMed
3Flood, A, Peters, U, Chatterjee, N, Lacey, JV Jr, Schairer, C, Schatzkin, A. Calcium from diet and supplements is associated with reduced risk of colorectal cancer in a prospective cohort of women. Cancer Epidemiology, Biomarkers & Prevention 2005; 14: 126–32.CrossRefGoogle Scholar
4Allender, PS, Cutler, JA, Follmann, D, Cappuccio, FP, Pryer, J, Elliott, P. Dietary calcium and blood pressure: a meta-analysis of randomized clinical trials. Annals of Internal Medicine 1996; 124: 825–31.Google Scholar
5Cappuccio, FP, Elliott, P, Allender, PS, Pryer, J, Follman, DA, Cutler, JA. Epidemiologic association between dietary calcium intake and blood pressure: a meta-analysis of published data. American Journal of Epidemiology 1995; 142: 935–45.CrossRefGoogle ScholarPubMed
6Whiting, SJ, Wood, RJ. Adverse effects of high-calcium diets in humans. Nutrition Reviews 1997; 55: 1–9.CrossRefGoogle ScholarPubMed
7Dagnelie, PC, Schuurman, AG, Goldbohm, RA, Van den Brandt, PA. Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention studies. BJU International 2004; 93: 1139–50.CrossRefGoogle Scholar
8Männistö, S, Ovaskainen, M-L, Valsta, L, eds. The National FINDIET 2002 Study. Publication B3/2003. Helsinki: National Public Health Institute, 2003.Google Scholar
9Sahi, T, Launiala, K, Laitinen, H. Hypolactasia in a fixed cohort of young Finnish adults – a follow-up study. Scandinavian Journal of Gastroenterology 1983; 18: 865–70.CrossRefGoogle Scholar
10Honkanen, R, Kroger, H, Alhava, E, Turpeinen, P, Tuppurainen, M, Saarikoski, S. Lactose intolerance associated with fractures of weight-bearing bones in Finnish women aged 38–57 years. Bone 1997; 21: 473–7.Google Scholar
11Nordic Council of Ministers. Nordic Nutrition Recommendations 2004 – Integrating Nutrition and Physical Activity. Nord 2004;13. Copenhagen: Nordic Council of Ministers, 2004.Google Scholar
12Scientific Committee on Food, European Commission (EC). Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Calcium. Brussels: Scientific Committee on Food, EC, 2003.Google Scholar
13Raulio, S. Ravitsemuksellisesti täydennettyjen elintarvikkeiden käyttö ja sen taustatejijät suomalaisilla aikuisilla. Suomen Lääkarilehti. Finlands Läkartidning 2003; 58: 1685–8.Google Scholar
14Nusser, SM, Carriquiry, KW, Dodd, KW, Fuller, WA. A semiparametric transformation approach to estimating usual daily intake distribution. Journal of the American Statistical Association 1996; 91: 1440–9.CrossRefGoogle Scholar
15Iman, RL, Conover, WJ. A distribution-free approach to including rank correlation among input variables. Communications in Statistics: Simulations and Computations 1982; 11: 311–34.CrossRefGoogle Scholar
16Osler, M, Heitmann, BL. Food patterns, flour fortification, and intakes of calcium and vitamin D – a longitudinal study of Danish adults. Journal of Epidemiology and Community Health 1998; 52: 161–5.CrossRefGoogle Scholar
17Suojanen, A, Raulio, S, Ovaskainen, M-L. Liberal fortification of foods: the risks – a study relating to Finland. Journal of Epidemiology and Community Health 2002; 56: 259–64.CrossRefGoogle ScholarPubMed
18Galvin, MA, Kiely, M, Flynn, A. Impact of ready-to-eat breakfast cereal (RTEBC) consumption on adequacy of micronutrient intakes and compliance with dietary recommendations in Irish adults. Public Health Nutrition 2003; 6: 351–63.CrossRefGoogle ScholarPubMed
19Johnson-Down, L, L'Abbé MR Lee, NS, Gray-Donald, K. Appropriate calcium fortification of the food supply presents a challenge. Journal of Nutrition 2003; 133: 2232–8.CrossRefGoogle ScholarPubMed
20Hirvonen, T, Männistö S Roos, E, Pietinen, P. Increasing prevalence of underreporting does not necessarily distort dietary surveys. European Journal of Clinical Nutrition 1997; 51: 297–301.CrossRefGoogle Scholar
21Peetz-Schou, M. Nordic legislative practises and consumer attitudes towards the addition of nutrients to foods. Scandinavian Journal of Nutrition 1999; 43: 125S–8S.Google Scholar