{"title":"强化维生素 D 的战略食品载体及其对维生素 D 状态的影响：随机对照试验的系统回顾和荟萃分析","authors":"Kevin D. Cashman, Colette M. O’Neill","doi":"10.1016/j.jsbmb.2023.106448","DOIUrl":null,"url":null,"abstract":"<p>There has been growing interest in the potential of vitamin D food fortification in Europe as a means of addressing low vitamin D status. The WHO-FAO suggest that choosing a suitable food vehicle and ensuring the combination of the food vehicle and the fortificant will be efficacious and effective are of key importance to a successful food fortification program. Our key objective was to conduct a systematic review and meta-analysis to investigate the effect of various animal- and plant-based food vehicles fortified with vitamin D (as D<sub>3</sub> or D<sub>2</sub>) on circulating 25-hydroxyvitamin D [25(OH)D] concentrations. A list of prioritized food vehicles was established and we searched PubMed, Embase, Scopus and Web of Science for randomized controlled trials (RCTs) which used these vehicles individually, and which met prespecified criteria. The searches identified 49 papers which described suitable RCTs using vitamin D-fortified bread/savoury biscuits (<em>n</em>=5), orange juice (<em>n</em>=5), UV-mushrooms (<em>n</em>=8), cheese (<em>n</em>=3), yogurt (<em>n</em>=5), fluid milk (<em>n</em>=13), powdered milk (<em>n</em>=5), eggs (<em>n</em>=2), edible oils (<em>n</em>=4), or breakfast cereal (<em>n</em>=1). No suitable RCTs were identified for rice, maize flour, butter, margarine or dairy spreads, plant-based milk or yogurt alternatives. Random-effects meta-analyses of each food vehicle individually indicated weighted mean differences (WMD) in 25(OH)D in the range ~9-35 nmol/L (3-15 RCT arms, depending on vehicle), and all statistically significant (<em>P</em><0.01-0.0001), with the exception of UV-mushrooms (<em>P</em>=0.06). Heterogeneity was variable (<em>I</em><sup>2</sup>=33-99%, depending on vehicle), but subgroup analysis based on vitamer and dose reduced it in some instances. Sub-group analysis on the basis of whether the food vehicles were from plant-based or animal-based origin showed no significant difference in WMD (15.2 versus 15.9 nmol/L, respectively; <em>P</em>=0.48). These results support the use of various animal- and plant-based food vehicles for vitamin D fortification to improve circulating 25(OH)D concentrations in populations.</p><p>This work was registered with PROSPERO as CRD42023439883.</p>","PeriodicalId":501673,"journal":{"name":"The Journal of Steroid Biochemistry and Molecular Biology","volume":"1 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Strategic food vehicles for vitamin D fortification and effects on vitamin D status: A systematic review and meta-analysis of randomized controlled trials\",\"authors\":\"Kevin D. Cashman, Colette M. O’Neill\",\"doi\":\"10.1016/j.jsbmb.2023.106448\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>There has been growing interest in the potential of vitamin D food fortification in Europe as a means of addressing low vitamin D status. The WHO-FAO suggest that choosing a suitable food vehicle and ensuring the combination of the food vehicle and the fortificant will be efficacious and effective are of key importance to a successful food fortification program. Our key objective was to conduct a systematic review and meta-analysis to investigate the effect of various animal- and plant-based food vehicles fortified with vitamin D (as D<sub>3</sub> or D<sub>2</sub>) on circulating 25-hydroxyvitamin D [25(OH)D] concentrations. A list of prioritized food vehicles was established and we searched PubMed, Embase, Scopus and Web of Science for randomized controlled trials (RCTs) which used these vehicles individually, and which met prespecified criteria. 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Sub-group analysis on the basis of whether the food vehicles were from plant-based or animal-based origin showed no significant difference in WMD (15.2 versus 15.9 nmol/L, respectively; <em>P</em>=0.48). 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引用次数: 0
摘要
在欧洲，人们越来越关注维生素 D 食品营养强化作为解决维生素 D 缺乏问题的一种手段的潜力。世卫组织-粮农组织建议，选择合适的食品载体并确保食品载体和强化剂的组合有效，是食品强化计划取得成功的关键所在。我们的主要目标是进行系统综述和荟萃分析，研究各种强化维生素 D（D3 或 D2）的动物性和植物性食品载体对循环中 25- 羟基维生素 D [25(OH)D] 浓度的影响。我们制定了一份优先考虑的食物载体清单，并在 PubMed、Embase、Scopus 和 Web of Science 上检索了单独使用这些载体且符合预设标准的随机对照试验 (RCT)。搜索发现了 49 篇论文，这些论文介绍了使用维生素 D 强化面包/美味饼干（5 篇）、橙汁（5 篇）、紫外线蘑菇（8 篇）、奶酪（3 篇）、酸奶（5 篇）、液态奶（13 篇）、奶粉（5 篇）、鸡蛋（2 篇）、食用油（4 篇）或早餐谷物（1 篇）进行的合适的 RCT。对于大米、玉米粉、黄油、人造黄油或乳制品涂抹物、植物基牛奶或酸奶替代品，未发现合适的 RCT。对每种食物的随机效应荟萃分析表明，25（OH）D的加权平均差异（WMD）在9-35 nmol/L之间（3-15个RCT研究臂，取决于食物），除紫外线蘑菇外（P=0.06），其他食物均具有统计学意义（P<0.01-0.0001）。异质性是可变的（I2=33-99%，取决于载体），但基于维生素剂和剂量的亚组分析在某些情况下降低了异质性。根据食物载体来自植物还是动物进行的分组分析表明，WMD 没有显著差异（分别为 15.2 和 15.9 nmol/L；P=0.48）。这些结果支持使用各种动物性和植物性食品载体来强化维生素 D，以提高人群循环中 25(OH)D 的浓度。
Strategic food vehicles for vitamin D fortification and effects on vitamin D status: A systematic review and meta-analysis of randomized controlled trials
There has been growing interest in the potential of vitamin D food fortification in Europe as a means of addressing low vitamin D status. The WHO-FAO suggest that choosing a suitable food vehicle and ensuring the combination of the food vehicle and the fortificant will be efficacious and effective are of key importance to a successful food fortification program. Our key objective was to conduct a systematic review and meta-analysis to investigate the effect of various animal- and plant-based food vehicles fortified with vitamin D (as D3 or D2) on circulating 25-hydroxyvitamin D [25(OH)D] concentrations. A list of prioritized food vehicles was established and we searched PubMed, Embase, Scopus and Web of Science for randomized controlled trials (RCTs) which used these vehicles individually, and which met prespecified criteria. The searches identified 49 papers which described suitable RCTs using vitamin D-fortified bread/savoury biscuits (n=5), orange juice (n=5), UV-mushrooms (n=8), cheese (n=3), yogurt (n=5), fluid milk (n=13), powdered milk (n=5), eggs (n=2), edible oils (n=4), or breakfast cereal (n=1). No suitable RCTs were identified for rice, maize flour, butter, margarine or dairy spreads, plant-based milk or yogurt alternatives. Random-effects meta-analyses of each food vehicle individually indicated weighted mean differences (WMD) in 25(OH)D in the range ~9-35 nmol/L (3-15 RCT arms, depending on vehicle), and all statistically significant (P<0.01-0.0001), with the exception of UV-mushrooms (P=0.06). Heterogeneity was variable (I2=33-99%, depending on vehicle), but subgroup analysis based on vitamer and dose reduced it in some instances. Sub-group analysis on the basis of whether the food vehicles were from plant-based or animal-based origin showed no significant difference in WMD (15.2 versus 15.9 nmol/L, respectively; P=0.48). These results support the use of various animal- and plant-based food vehicles for vitamin D fortification to improve circulating 25(OH)D concentrations in populations.
This work was registered with PROSPERO as CRD42023439883.
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