Lipidomic and Fatty Acid Biomarkers in Whole Blood Can Predict the Dietary Intake of Eicosapentaenoic and Docosahexaenoic Acids in a Danish Population.

BACKGROUND: The intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been associated with health benefits. Blood levels of these fatty acids, measured by gas chromatography (GC), are associated with their dietary intake, but the relationships with lipidomic measurements are not well defined. OBJECTIVES: This study aimed to determine the lipidomic biomarkers in whole blood that predict intakes of EPA + DHA and examine the relationship between lipidomic and GC-based n-3 polyunsaturated fatty acid (n-3 PUFA) biomarkers. METHODS: Lipidomic and fatty acid analyses were completed on 120 whole blood samples collected from Danish participants. Dietary intakes were completed using a web-based 7-d food diary. Stepwise multiple linear regression was used to identify the fatty acid and lipidomic variables that predict intakes of EPA + DHA and to determine lipidomic species that predict commonly used fatty acid biomarkers. RESULTS: Stepwise regression selected lipidomic variables with an R2 = 0.52 for predicting EPA + DHA intake compared to R2 = 0.40 for the selected fatty acid GC-based variables. More predictive models were generated when the lipidomic variables were selected for females only (R2 = 0.62, n = 68) and males only (R2 = 0.72, n = 52). Phosphatidylethanolamine plasmalogen species containing EPA or DHA tended to be the most predictive lipidomic variables. Stepwise regression also indicated that selected lipidomic variables can predict commonly used fatty acid GC-based n-3 PUFA biomarkers as the R2 values ranged from 0.84 to 0.91. CONCLUSIONS: Both fatty acid and lipidomic data can be used to predict EPA + DHA intakes, and fatty acid GC-based biomarkers can be emulated by lipidomic species. Lipidomic-based biomarkers appear to be influenced by sex differences, probably in n-3 PUFA and lipoprotein metabolism. These results improve our ability to understand the relationship between novel lipidomic data and GC fatty acid data and will increase our ability to apply lipidomic methods to fatty acid and lipid nutritional research.

Per- and poly-fluoroalkyl substances in commercial organic eggs via fishmeal in feed.

Chicken eggs can be a significant source of human PFAS exposure. A survey of PFAS in commercial eggs from larger farms across Denmark showed the absence or low contents of PFAS in free-range and barn eggs. However, organic eggs from eight farms collected in September 2022 had a similar profile of nine PFASs with a predominance of odd over even carbon length PFCAs. Farm 11-13 e.g. had egg yolk ng/g concentrations of PFOA 0.07 ± 0.02; PFNA 0.37 ± 0.04; PFDA 0.13 ± 0.00; PFUnDA 0.22 ± 0.04; PFDoDA 0.06 ± 0.02; PFTrDA 0.15 ± 0.04; PFTeDA 0.02 ± 0.02; PFHxS 0.10 ± 0.04; PFOS 2.62 ± 0.11. Normalised to PFOS, the relative sum of other PFAS showed no difference between the eight organic egg samples, but significant differences between mean individual PFASs (p = 1.4E-25), reflecting a similar profile. The PFAS found in two fishmeal samples with the same origin as the fishmeal used for the organic feed production, could account for the contents in the eggs via estimated transfer from the feed. Furthermore, the estimated transfer from concentration in feed to concentration in egg increased with the carbon length of the PFCA. Exposure (95th percentile) of ∑4PFAS (PFOA, PFNA, PFHxS, PFOS) solely from consumption of 311 g âˆ¼ 5-6 organic eggs/week was for children 4-9 years 10.4 ng/kg bw, i.e. a significant exceedance of the tolerable weekly intake of 4.4 ng/kg bw established by the European Food Safety Authority. Based on the PFAS exposures from organic egg consumption, the organic egg producers decided voluntarily to cease adding fishmeal to the feed. Since the feed-to-egg half-lives are ≤1 week for PFOA, PFOS, and PFHxS, the removal of fishmeal as a feed ingredient should eliminate PFAS after 1-2 months. This was demonstrated in analyses of ten organic egg samples collected by the authorities without PFAS in eight and with 0.1 and 0.4 ng/g ∑4PFAS in two samples.

Effect of School-Based Educational Intervention on Promoting Healthy Dietary Habits in Danish Schoolchildren: The FOODcamp Case Study.

The present study aimed to evaluate the effect of the school-based educational intervention "FOODcamp" on dietary habits among 6th-7th graders (aged 11-13 years), focusing on the food groups: fruits and vegetables, fish, meat, discretionary food, and sugar-sweetened beverages. In this cluster-based quasi-experimental controlled intervention study, 16 intervention classes (322 children) and 16 control classes (267 children) from nine schools were recruited during the school year 2019-2020. The children were asked to record their food intake for four consecutive days (Wednesday to Saturday) before (baseline) and after (follow-up) attending FOODcamp, using a validated self-administered web-based dietary record. Eligible dietary intake registrations from 124 and 118 children from the control and interventions classes, respectively, were included in the final statistical analysis. Hierarchical mixed model analysis was used to evaluate the effect of the intervention. No statistically significant effects of participating in FOODcamp were found on the average food intake of the food groups eaten regularly (vegetables, fruit, vegetables/fruit/juice combined, or meat) (p > 0.05). Among the food groups not eaten regularly (fish, discretionary foods, and sugar-sweetened beverages), a non-significant tendency to lower odds of consuming sugar-sweetened beverages from baseline to follow-up (OR = 0.512; 95% CI: 0.261-1.003; p = 0.0510) was seen among FOODcamp participants compared to control participants. In conclusion, this study found no effect of the educational intervention FOODcamp on the dietary intake of vegetables, fruit, vegetable/fruit/juice combined, meat, fish, or sugar-sweetened beverages. The intake frequency of sugar-sweetened beverages tended to decrease among FOODcamp participants.

Changes in Diet and Physical Activity among 18-65-Year-Olds after the First National COVID-19 Lockdown in Denmark.

COVID-19 lockdowns affected everyday life significantly and made it challenging to achieve or maintain a healthy lifestyle. The aim of the present study was to examine longitudinal changes in Danish adults' eating habits and physical activity (PA) assessed during and after the first national lockdown in 2020. Furthermore, changes in body weight were examined during the first lockdown period. The whole diet (semi-quantitative Food Frequency Questionnaire), sociodemographic factors, moderate-to-vigorous intensity PA (MVPA), leisure screen time, anthropometrics, change in body weight, and stress level were assessed with a self-administered web-based questionnaire among 839 18-65-year-old Danes during and 5-6 months after the lockdown. Both favorable (decreased intake of saturated fat) and unfavorable (decreased intake of whole grain and fish, and increased intake of red meat) changes were found in the diet after the lockdown, while favorable changes in MVPA (increase in couples) and leisure screen time (decrease with a combined effect of family status and education) were found for PA. More Danish adults reported to gain weight (mean 3.0 kg) than to lose weight (mean 3.5 kg) during the first lockdown period (27% vs. 15%). The study showed favorable changes in PA and mixed results regarding diet among Danish adults after the lockdown. Furthermore, the first lockdown period unfavorably impacted the body weight of many Danes.

Simultaneous determination of heterocyclic aromatic amines and N-nitrosamines in fried bacon cubes and slices using LC-(ESI/APCI)-MS/MS.

Bacon manufacturing involves several processing steps including nitrite curing, followed by cooking processes, typically frying. During these processes, harmful processing contaminants such as N-nitrosamines (NAs) and heterocyclic aromatic amines (HAAs) can be formed. Consequently, we developed and validated a multi-class method for quantification of the most frequently reported HAAs and NAs in fried bacon. Satisfactory repeatability and reproducibility with limits of quantification between 0.1 and 0.5 ng g-1 for most of the compounds were achieved. Quantification in pan-fried bacon cubes and slices revealed generally low levels of individual HAAs (≤1.5 ng g-1), except in ready-to-eat bacon (0.9-2.9 ng g-1). Differences in amounts of individual HAAs were observed in cubes and slices, most likely due to meat thickness. Among volatile NAs (VNAs), only N-nitrosopiperidine (NPIP), N-nitrosopyrolidine (NPYR), and N-nitrosodibutylamine (NDBA) were found at generally low concentrations (≤5 ng g-1). In contrast, non-volatile NAs (NVNAs) were present in all tested samples at considerably higher amounts, for example, N-nitroso-thiazolidine-4-carboxylic acid (NTCA) at 12-77 ng g-1. N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), N-nitrosodipropylamine (NDPA) were not detected in any samples. Statistical evaluation and principal component analysis revealed some differences among tested samples. Dietary exposure estimation of the Danish population to HAAs and NAs showed the highest exposure in the teenage group (10-17 years).

Vitamin D Food Fortification Strategies on Population-Based Dietary Intake Data Using Mixed-Integer Programming.

The dietary vitamin D intake of the Danish population is low, and food fortification is a strategy to increase intake. This paper explores the possibility of vitamin D fortification on the current population food intake in Denmark, such that the population receives adequate amounts of vitamin D without having to change current dietary patterns. A mixed-integer programming approach is used to arrive at a solution for the optimal fortification required at each food group level so that the majority of the population receive the minimum intake of average requirement (AR) and do not exceed the tolerable upper intake level (UL). The method shows a significant increase in vitamin D intake compared to the current scenario, keeping a neutral approach towards preferences of one food group over others. The method can also be fine-tuned in different scenarios where certain food group preferences are known, which can be encoded into the model in the form of constraints.

Validation of the 2 × 24 h recall method and a 7-d web-based food diary against doubly labelled water in Danish adults.

The European Food Safety Authority has suggested that EU countries implement the 2 × 24 h diet recall (2 × 24 h DR) method and physical activity (PA) measurements for national dietary surveys. Since 2000, Denmark has used 7 d food diaries (7 d FD) with PA questionnaires and measurements. The accuracy of the reported energy intakes (EI) from the two diet methods, pedometer-determined step counts and self-reported time spent in moderate-to-vigorous PA (MVPA) were compared with total energy expenditure measured by the doubly labelled water (TEEDLW) technique and with PA energy expenditure (PAEE), respectively. The study involved fifty-two male and sixty-eight female volunteers aged 18-60 years who were randomly assigned to start with either the 24 h DR or the web-based 7 d FD, and wore a pedometer for the first 7 d and filled in a step diary. The mean TEEDLW (11·5 MJ/d) was greater than the mean reported EI for the 7 d FD (9·5 MJ/d (P < 0·01)) but the same as the 2 × 24 h DR (11·5 MJ/d). The proportion of under-reporters was 34 % (7 d FD) and 4 % (2 × 24 h DR). Most participants preferred the 7 d DR as it was more flexible, despite altering their eating habits. Pearson's correlation between steps corrected for cycling and PAEE was r = 0·44, P < 0·01. Spearman's correlation for self-reported hours spent in MVPA and PAEE was r = 0·58, P < 0·01. The 2 × 24 h DR performs better than the existing 7 d FD method. Pedometer-determined steps and self-reported MVPA are good predictors of PAEE in adult Danes.

A Data Driven Approach to Identify Safe and Adequate Schemes for Vitamin D Fortification.

Food fortification is a strategy to increase low vitamin D intake. In order to avoid the intake of a population exceeding the upper tolerable intake level, the right choice of food groups to fortify is of crucial importance. An automated fortification tool was developed based on dietary intake data from the Danish National Survey of Dietary Habits and Physical Activity 2011-2013 (DANSDA), taking into account the energy contribution of the fortified food. The fortification of food group is a variant in the linear modelling, where the optimization ensures the lowest possible variation in deviation of the calculated intake and the target intake. The resulting tool demonstrated that the lowest limit of fortification, where the model works, is 12 µg/10 MJ, when fortification of any food group is allowed. The tool also demonstrated that, by increasing the allowed upper level of fortification from 12 µg/10 MJ up to 30 µg/10 MJ, the food groups selected for fortification and the level of fortification in those food groups may change. Specifically, fewer food groups seem to be needed as the upper level of fortification is increased. The optimized scenarios, using the food groups, including milk, cheese, cereals, fats, and juice, were tested on dietary-survey data and demonstrated that all the projected scenarios manage to lift the median vitamin D intake to the targeted intake safely. A data-driven approach was used to develop a simple, fast, and automated fortification tool to test different vitamin D food fortification strategies.

Quantifying benefits of the Danish transfat ban for coronary heart disease mortality 1991-2007: Socioeconomic analysis using the IMPACTsec model.

Denmark has experienced a remarkable reduction in CVD mortality over recent decades. The scale of the health contribution from the Danish regulation on industrially produced trans fatty acid (ITFA) has therefore long been of interest. Thus the objective was to determine health and equity benefits of the Danish regulation on ITFA content in Danish food, by quantifying the relative contributions of changes in ITFA intake, other risk factors and treatments on coronary heart disease (CHD) mortality decline from 1991 to 2007 in Denmark, stratified by socioeconomic group. To evaluate the effects of the ITFA ban (Danish Order no. 160 of March 2003) the Danish IMPACTSEC model was extended to quantify reductions in CHD deaths attributable to changes in ITFA (%E) intake between 1991-2007. Population counts were obtained from the Danish Central Office of Civil Registration, financial income from Statistics Denmark and ITFA intake from Dan-MONICA III (1991) and DANSDA (2005-2008). Participants were adults aged 25-84 years living in Denmark in 1991 and 2007, stratified by socioeconomic quintiles. The main outcome measure was CHD deaths prevented or postponed (DPP). Mean energy intake from ITFA was decimated between 1991 and 2007, falling from 1.1%E to 0.1%E in men and from 1·0%E to 0·1%E in women. Approximately 1,191 (95% CI 989-1,409) fewer CHD deaths were attributable to the ITFA reduction, representing some 11% of the overall 11,100 mortality fall observed in the period. The greatest attributable mortality falls were seen in the most deprived quintiles. Adding ITFA data to the original IMPACTsec model improved the overall model fit from 64% to 73%. In conclusion: Denmark's mandatory elimination of ITFA accounted for approximately 11% of the substantial reduction in CHD deaths observed between 1991 and 2007. The most deprived groups benefited the most, thus reducing inequalities. Adopting the Danish ITFA regulatory approach elsewhere could substantially reduce CHD mortality while improving health equity.

Cumulative dietary risk assessment of pesticides in food for the Danish population for the period 2012-2017.

The cumulative chronic dietary exposure for the Danish population were assessed using Danish food monitoring data for the period 2012-2017 and Danish food consumption data for the consumer groups children (age 1-2, age 4-6 and age 7-14 years), adults age 15-75, high consumers and consumers eating Danish produced fruit and vegetables whenever possible. Levels below the Limit of Reporting (LOR) were set to ½ LOR with correction. For risk assessment of the cumulative chronic dietary exposure we used the Hazard Index (HI) method where the Hazard Quotient (HQ) was calculated for each pesticide and summed up to a HI. The HI was calculated to be below 1 for all consumer groups; i.e. 0.36 for children age 4-6 years and 0.13 for adults, indicating that the cumulative chronic dietary pesticide exposure is unlikely to constitute a health risk for Danish consumers, even for high consumers eating 600 g or more of fruit and vegetables each day. By eating Danish produced commodities whenever possible, the HI was reduced by a factor of one third for both children and adults. 25 different commodities contributed to about 90% of the HI and to 84% of the exposure.

Estimating national and subnational nutrient intake distributions of global diets.

BACKGROUND: Access to high-quality dietary intake data is central to many nutrition, epidemiology, economic, environmental, and policy applications. When data on individual nutrient intakes are available, they have not been consistently disaggregated by sex and age groups, and their parameters and full distributions are often not publicly available. OBJECTIVES: We sought to derive usual intake distributions for as many nutrients and population subgroups as possible, use these distributions to estimate nutrient intake inadequacy, compare these distributions and evaluate the implications of their shapes on the estimation of inadequacy, and make these distributions publicly available. METHODS: We compiled dietary data sets from 31 geographically diverse countries, modeled usual intake distributions for 32 micronutrients and 21 macronutrients, and disaggregated these distributions by sex and age groups. We compared the variability and skewness of the distributions and evaluated their similarity across countries, sex, and age groups. We estimated intake inadequacy for 16 nutrients based on a harmonized set of nutrient requirements and bioavailability estimates. Last, we created an R package-nutriR-to make these distributions freely available for users to apply in their own analyses. RESULTS: Usual intake distributions were rarely symmetric and differed widely in variability and skewness across nutrients and countries. Vitamin intake distributions were more variable and skewed and exhibited less similarity among countries than other nutrients. Inadequate intakes were high and geographically concentrated, as well as generally higher for females than males. We found that the shape of usual intake distributions strongly affects estimates of the prevalence of inadequate intakes. CONCLUSIONS: The shape of nutrient intake distributions differs based on nutrient and subgroup and strongly influences estimates of nutrient intake inadequacy. This research represents an important contribution to the availability and application of dietary intake data for diverse subpopulations around the world.

Risk-Benefit Assessment of an Increase in the Iodine Fortification Level of Foods in Denmark-A Pilot Study.

Iodine deficiency is one of the most common nutritional disorders worldwide. In Denmark, the mandatory iodine fortification of salt of 13 ppm was introduced in 2000 to eradicate mild to moderate iodine deficiency and the fortification level was increased to 20 ppm in 2019. However, the optimal iodine intake is a narrow interval, and the risk of disease increases with intakes both below and above this interval. In this study, we quantified the risk-benefit balance in the Danish adult population by increasing the mandatory fortification level. We applied a risk-benefit assessment approach in which population-level iodine intakes before and after the increase in fortification were integrated with epidemiological evidence of the association between iodine nutrition status and risk of relevant diseases to estimate the number of cases caused or prevented and estimated health impact in terms of disability-adjusted life years (DALY). We estimated an overall beneficial health impact and prevention of 34.9 (95% UI: -51.6; -21.7) DALY per 100,000 adults in the population annually with the increase in fortification level. Prevention of low IQ in children due to maternal iodine deficiency was the primary contributor to overall health gain. The gain in healthy life years comes at the expense of extra cases of goiter due to iodine excess. Due to lack of data, hypo- and hyperthyroidism related to iodine status were not included. Neither were children as a population group. Because of this, as well as uncertainties inherent in the model and data used, results should be interpreted with caution. We argue that nation-specific, quantitative assessments of the public health impact of fortification programs provide transparent, evidence-based decision support. Future research should aim to enable the inclusion of all relevant health effects as well as children in the assessment.

Defining Energy-Dense, Nutrient-Poor Food and Drinks and Estimating the Amount of Discretionary Energy.

Overconsumption of energy provided by energy-dense, nutrient-poor (EDNP) food and drinks increases the risk of unhealthy weight gain and of obesity-related health outcomes. The aim of this study was to develop a nutrient profiling model for classifying EDNP food and drinks and to estimate the amount of discretionary energy for EDNP food and drinks in a recommended diet. A stepwise approach was used first to develop a nutrient profiling model for classifying EDNP food and drinks and then to estimate the amount of discretionary energy in a recommended diet using diet modeling. The nutrition profiling model comprised 24 macro- and micronutrients and energy density. The model classified 67% of 1482 foods and 73% of 161 drinks correctly as EDNP food and drinks compared with an expert-adjusted model. Sweets, chocolate, cake, cookies and biscuits, sweet and salty snacks, sugar-sweetened and artificially sweetened drinks, and alcoholic drinks were classified as EDNP food and drinks. The estimated amount of discretionary energy for EDNP food and drinks was 4-6% of the energy requirements for 4-75-year-old Danes. It seems prudent to have special attention on EDNP food and drinks in dietary guidelines and future public health initiatives to avoid overconsumption of energy.

Assessment of iodine fortification of salt in the Danish population.

PURPOSE: We assessed the effect of the current iodine fortification level (20 µg/g household salt and salt included in bread and bakery products) on inadequate and excessive intake in the general Danish population. Intake models with/without the contribution from food supplements and effects of excluding specific food groups were evaluated. METHOD: Data from the Danish National Survey of Dietary Habits and Physical Activity in 2011-13 (N = 3946, aged 4-75 years) stratified by age-group and sex were used to estimate habitual dietary iodine intakes, and compared with established dietary reference values. RESULTS: The proportion with an estimated inadequate iodine intake was ≤ 3% for males and ≤ 5% for females, except for 15-17-year-old girls, where the probable prevalence of an inadequate intake was 11%. Including the contribution from food supplements gave similar results (10%). High intakes (as defined by 95th percentile) from food sources generally did not exceed the tolerable upper intake level (UL). However, for the youngest age-groups (4-6-year-old boys/girls and 7-10-year-old boys), the 95th percentiles exceeded the UL with 11%, 4% and 7%, respectively, when food supplements were included in the estimates. Especially exclusion of dairy products and bread led to an inadequate intake for both boys and girls. CONCLUSION: The current fortification level may provide an inadequate iodine intake for some females and on the other hand lead to excessive intakes in the youngest age-groups. The study shows the importance of choosing iodine-rich alternatives when excluding major sources of iodine in the Danish diet.

Natural Vitamin D in Food: To What Degree Does 25-Hydroxyvitamin D Contribute to the Vitamin D Activity in Food?

Vitamin D3, vitamin D2, 25-hydroxyvitamin D3 [25(OH)D3], and 25-hydroxyvitamin D2 [25(OH)D2]constitute the vitamin D activity in food. In general, vitamin D activity in food depends on the food's fat content, the feed the animals have been fed, and the animal's exposure to ultraviolet B (UVB) light. There are many gaps in our knowledge of 25-hydroxyvitamin D in food, including the amount present in different types of food, and the amount we process in our daily dietary intake. We aimed to assess the vitamin D vitamers in food (eggs, milk, dairy products, chicken, veal, beef, and pork) on the Danish market using accredited analytical methods. We then combined these data with existing Danish data, as well as with the information from the Danish Dietary Survey to estimate the dietary intake of vitamin D3 and of 25(OH)D3 by Danes. We report the level of vitamin D in 10% minced pork from free-range pigs slaughtered in summer as 1.39 µg vitamin D3/100 g and 0.40 µg 25(OH)D3/100 g, which are significantly higher amounts (p < 0.001) than in early spring. The levels of vitamin D2 and 25(OH)D2 are usually <0.05 µg/100 g, though in beef they are up to 0.14 µg/100 g. 25(OH)D3 accounts for up to 100% in veal and 8% in fat from free-range pigs. In the Danish diet, the share of 25(OH)D3 is 24% for children (4-17 years) and 18% for adults (18-75 years). Changes in animal-feeding strategy in the agriculture sector could change the share of 25(OH)D3 to 11% and 12% if extra vitamin D3 is added to the feed, and the animals are exposed to sunlight or UVB lightlight. Replacing vitamin D3 by 25(OH)D3 in the feed may result in a share of 25(OH)D3 of 52% and 40%, respectively, in children and adults. These estimates are based on the assumption that vitamin D3 and 25(OH)D3 contribute equally to the vitamin D activity. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.

Dietary exposure to selected chemical contaminants in fish for the Danish population.

The exposure to selected chemical contaminants from fish has been calculated for the Danish population, both for adults (15-75 years of age) and children (4-14 years of age). The Danish mean consumption of fish is 21 g person-1 day-1 for adults and 12 g person-1 day-1 for children. Fish consumption is the main food group contributor for exposure to mercury and dioxins and dioxin-like polychlorinated biphenyls (PCDD/F and DL-PCB) for the Danish population. Comparison of the mean exposure with the TDI or TWI values shows for these substances as well as for perfluorooctane sulphuric acid (PFOS) that the exposure is below the TDI/TWI values. However, even without taking other food groups into account, PCDD/Fs and DL-PCB exposure is close to the actual TWI-value. Calculation of the Margin of Exposure (MOE) for the sum of hexabromocyclododecanes (HBCDD) and polycyclic aromatic hydrocarbons (PAHs) revealed fish consumption to be of low concern for the consumer health regarding these contaminants.

Vitamin D-fortified foods improve wintertime vitamin D status in women of Danish and Pakistani origin living in Denmark: a randomized controlled trial.

PURPOSE: Low vitamin D status is prevalent worldwide. We aim to investigate the effect of vitamin D fortification on serum 25-hydroxyvitamin D (25(OH)D) concentration in women of Danish and Pakistani origin at risk of vitamin D deficiency. METHODS: A 12-week randomized, double-blinded, placebo-controlled intervention trial during winter time, designed to provide 20 µg vitamin D3/day through fortified yoghurt, cheese, eggs and crisp bread, and assess the change in serum 25(OH)D. Participants were 143 women of Danish and Pakistani origin, living in Denmark, randomized into four groups, stratified by ethnicity. RESULTS: Mean (SD) baseline 25(OH)D concentrations among women of Danish and Pakistani origin were 49.6 (18) and 46.9 (22) nmol/L, respectively (P = 0.4). While 9% of Danish women had 25(OH)D < 30 nmol/L, the prevalence among women of Pakistani origin was 24%. Median (IQR) vitamin D intake among Danish and Pakistani women at endpoint was 32.0 (27.0, 34.4) µg/day and 24.2 (19.2, 30.8) µg/day, respectively. Endpoint serum 25(OH)D increased in fortified groups to 77.8 (14) nmol/L among Danish women and 54.7 (18) nmol/L among women of Pakistani origin (P < 0.01). At endpoint, 0% in the Danish-fortified group and 3% in the Pakistani-fortified group had 25(OH)D < 30 nmol/L, compared with 23 % and 34% in their respective control groups. CONCLUSIONS: Vitamin D fortification of four different foods for 12 weeks during winter was effective in increasing serum 25(OH)D and reducing the prevalence of very low vitamin D status among women of Danish and Pakistani origin. CLINICALTRIALS. GOV WITH IDENTIFIER: NCT02631629.

The impact of dietary habits on contaminant exposures.

This study shows that dietary habits have an impact on contaminant exposures. A tool was developed to calculate chemical exposures for different Danish population groups. First, the tool divided the individuals into quartiles using a previously developed scoring system for how well their diet complies with the Danish dietary guidelines. Then the exposure was calculated for several contaminants for both children and adults within the quartiles. Comparisons were then performed between the exposures for the lowest and highest quartiles. The individuals having a diet more in compliance with the dietary guidelines have a higher exposure to contaminants than individuals having a diet less in compliance with the dietary guidelines. Standard deviations for the mean exposure were in general large indicating that the consumption patterns can be very different within each population group. A risk characterisation for each contaminant and population group was performed by calculation of Hazard Quotients (HQs). For dioxins and dioxin-like polychlorinated biphenyls (PCDD/F + DL-PCBs), inorganic arsenic, and lead all HQs were above 1 indicating a potential risk for all groups. For hexabromocyclododecane (HBCDD) and nickel, a potential risk was identified for at least one group. For all other contaminants the HQs were well below 1 for all groups.

Modelling of adequate and safe vitamin D intake in Danish women using different fortification and supplementation scenarios to inform fortification policies.

PURPOSE: Fortification of foods with vitamin D may be a population-based solution to low vitamin D intake. We performed modelling of vitamin D from diet, fortified foods and supplements in a population of Danish women 18-50 years, a risk group of vitamin D deficiency, to inform fortification policies on safe and adequate levels. METHODS: Based on individual habitual dietary vitamin D intake of female participants from the Danish National Survey of Dietary Habits and Physical Activity (DANSDA) (n = 855), we performed graded intake modelling to predict the intake in six scenarios increasing the vitamin D intake from a habitual diet without fish to habitual diet including fish, fortified foods and supplements (40/80 µg). Four different foods were used as potential foods to fortify with vitamin D. RESULTS: The vitamin D intake was below the Average Requirement (AR) of 7.5 µg/day for 88% of the assessed women. Safe levels of intake (< 100 µg/day) were observed after adding four different fortified foods (plain yoghurt, cheese, eggs and crisp-bread) contributing with a total of 20 µg/day and a vitamin D supplement of 40 µg/day to the habitual diet. Consumption of fish, fortified foods and a vitamin D supplement of 80 µg resulted in intakes above the Tolerable Upper Intake Level (UL) < 100 µg/day. CONCLUSIONS: In a Danish female population with a low vitamin D intake, low-dose fortification of different foods with vitamin D may be an effective and safe population-based approach.