For those taking dietary supplements, the report advises that benefits of high intake levels are unproven and serious risks may be present. For the population at large, the report may offer comfort by saying most Americans receive adequate calcium.
What about for grain-based foods?
The issue the industry along with researchers and public health officials has begun to explore is whether fortification with vitamin D could offer significant public health benefits. With the release of the I.O.M. report, the question remains very much open and as intriguing as ever. The comment that most Americans receive enough vitamin D is counterbalanced by the observation that “average total intake of vitamin D is below the median requirement.”
When considering fortification, the standard for consideration is not whether a majority of the public would benefit. After all, fortification of flour with folic acid is expressly targeted at a minority – women in their child-bearing years.
Fortification is merited when segments of the public could derive clearly-identified health benefits without creating significant new risks for this group or others. With the I.O.M. recommending significantly higher dietary allowances (to 600 I.U. from 200) and upper limit tolerances for vitamin D (to 4,000 from 2,000), fortification remains possible, even knowing people would consume widely varying amounts (as is the case with vitamins and minerals in enriched grains today). The I.O.M. recognized strides made in studying possible benefits from vitamin D beyond improving bone health. The study noted vitamin D “regulates several hundred genes throughout the body or as much as 5% of the human genome.” But the group goes on to caution that exactly how vitamin D functions is not clearly known.
At the bottom line, the research is promising, but considerably more work is needed.