Vitamin D milk fortification call questioned

Posted by AFN Staff Writers on 21st June 2012

Australian Food News recently reported a call for fortification of milk with Vitamin D by nutritionist Professor Carol Newsom.

The Medical Journal of Australia (MJA) Vitamin D deficiency study has echoed Professor Newsom’s concern that Vitamin D deficiency is a significant problem in Australia, but without mention of Vitamin D fortification of milk. The MJA study only provided statistics of Vitamin D deficiency rickets in “known high-risk groups”. These high-risk groups were children of low socio-economic or refugee status.

The study identified 398 children with vitamin D deficiency. Of these children, 55% were male, and the median age was 6. The overall incidence of rickets in children under 15 in Australia was 4.9 per 100,000 per year (that is, 0.049%).

These statistics do not suggest that Vitamin D deficiency rickets is a “significant population health need”, which is one of the Food and Safety Australia New Zealand (FSANZ) criteria for a mandatory food standard imposing general fortification of a food. FSANZ has also stated that fortification of a food is required only if “it is assessed as the most effective public health strategy to address the health problem.”

Readers of Australian Food News have raised the question of whether a general fortification of milk with Vitamin D would be the most effective public health strategy. Some have suggested that a free Vitamin D supplement would be more effective, especially if cow’s milk is not a regular part of the diets of the high-risk group.

New Zealand flour fortification issue

Meanwhile, the issue of folic acid fortification is still not resolved in New Zealand. Since September 2009, it has been mandatory for most flour in Australia to be fortified with folic acid, but New Zealand did not follow the Australian lead despite the two countries sharing the same Food Standards Code. (New Zealand exempted itself from mandatory fortification of flour.)

Recently, the New Zealand Ministry of Primary Industries (MPI) has requested for submissions on options for the future of the Standard on fortifying bread with folic acid in New Zealand. Options range from mandatory fortification of breads from 30 September 2012, or providing for maintenance of voluntary fortification indefinitely.

New Zealand is consulting with baking industry representatives, health professionals, academics, government officials and groups who represent families affected by neural tube defects.