Study shows mandatory fortification shields infants from vitamin D deficiency

The majority of young children showed good vitamin D status, no child had indications of deficiency, but among some intake was too low. This is the result of a study encompassing over 1,800 infants in Sweden. Foods providing children with vitamin D also contributed to greenhouse gas emissions.

This study is the first to offer an in-depth analysis of vitamin D intake and status among infants in Sweden following an expansion of mandatory vitamin D fortification in 2018. The initiative focused on certain food groups and the aim was to ensure that more people attain sufficient vitamin D through their diet.

The study included children aged 18 months (1,074 individuals) and four years (746 individuals) whose data were obtained from the survey "Riksmaten småbarn", covering 2021-2024. The study also evaluated the climate impact of foods providing children with vitamin D.

Low intake but no deficiency

The results show that 16 percent of the 18-month-olds and 61 percent of the four-year-olds were below the average required vitamin D intake (7.5 microgram/day) through diet and vitamin D drops. No children were vitamin D deficient, and most children had sufficient levels, including 93 percent in the younger age group and 96 percent in the older age group.

The most important sources of vitamin D for 18-month-olds were vitamin D drops and fortified dairy products, porridge and cereals; and for the four-year-olds, fortified dairy products and spreads.
At the same time, dairy products contribute to diet-related greenhouse gas emissions. The foods with the highest vitamin D content relative to environmental impact were fortified spreads and fortified plant-based alternatives. This makes plant-based alternatives a climate-friendly source of vitamin D.

Climate impact can be reduced

The study, published in the Nutrition Journal, was conducted by researchers at the University of Gothenburg, Swedish Food Agency and RISE, Research Institutes of Sweden. One of the lead authors is André Hesselink, dietician and doctoral student in clinical nutrition at the University of Gothenburg:

We have enjoyed an excellent collaboration with the Swedish Food Agency, and our results show the crucial importance of fortified dairy products for vitamin D intake among young children in Sweden, especially after they stop taking vitamin D drops. In addition, the expansion of the mandatory fortification programme provides an opportunity for plant-based alternatives to play a more prominent role in the future for ensuring adequate intake of vitamin D and reducing the climate impact of our dietary habits."

André Hesselink, Study Lead Author, Doctoral Student, Clinical Nutrition, University of Gothenburg