Adequacy of vitamin D intakes in children and teenagers from the base diet, fortified foods and supplements

Objective: To describe vitamin D intakes in children and teenagers and the contribution from supplements and fortified foods in addition to the base diet. Design: Analysis of 7 d weighed food records collected during the Children's and Teens' National Nutrition Surveys in Ireland. Food composition data for vitamin D were updated from international analytical sources. Setting: Nationally representative cross-sectional dietary surveys. Subjects: Children (n 594; 5-12 years) and teenagers (n 441; 13-17 years). Results: Median vitamin D intakes were 1.9, 2.1 and 2.4 mu g/d in 5-8-, 9-12-and 13-17-year-olds, respectively. The prevalence of vitamin D-containing supplement use was 21, 16 and 15% in 5-8-, 9-12- and 13-17-year-olds and median intakes in users ranged from 6.0 to 6.7 mu g/d. The prevalence of inadequate intakes, defined as the percentage with mean daily intakes below the Estimated Average Requirement of 10 mu g/d, ranged from 88 to 96% in supplement users. Foods fortified with vitamin D, mainly breakfast cereals, fat spreads and milk, were consumed by 71, 70 and 63% of 5-8-, 9-12- and 13-17-year-olds. Nonsupplement users who consumed vitamin D-fortified foods had median intakes of 1.9-2.5 mu g/d, compared with 1.2-1.4 mu g/d in those who did not consume fortified foods. Conclusions: It is currently not possible for children consuming the habitual diet to meet the US Institute of Medicine dietary reference intake for vitamin D. In the absence of nationally representative 25-hydroxyvitamin D data in children, the implications of this observation for prevalence of vitamin D deficiency and health consequences are speculative.