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Community and International Nutrition

Appropriate Calcium Fortification of the Food Supply Presents a Challenge

Louise Johnson-Down, Mary R. L’Abbé^*, Nora S. Lee and Katherine Gray-Donald²

School of Dietetics and Human Nutrition, McGill University, Ste Anne de Bellevue, Canada H9X 3V9 and ^* Nutrition Research Division and Nutrition Evaluation Division, Health Canada, Ottawa, Canada K1A 0L2

²To whom correspondence and reprint requests should be addressed. E-mail: gray-donald{at}macdonald.mcgill.ca.

Fortification with calcium to increase dietary intakes of this mineral is currently under evaluation in Canada. To model the potential dietary consequences of food fortification, data from a large national survey of Canadians (n = 1543) were used. Food fortification scenarios were based on reference amounts for labeling requirements. Consumption of milk, cheese and other dairy products was associated with high calcium intakes, and there was a low prevalence of inadequacy in men < 50 y old; however, other age-sex groups had lower intakes. The aim of the fortification modeling was to determine which scenario would most effectively reduce the proportion of the population with low intakes of calcium while minimizing the proportion of individuals who exceeded the tolerable upper intake level (UL). Given the correlation between energy and calcium (r = 0.60, P < 0.01), it appeared that any fortification scenario sufficient to increase the mean intake for women to near the adequate intake led to 6–7% of the men having calcium intakes above the UL. The results suggest that fortification of widely consumed foods is not a realistic way to address the issue of low calcium intakes and illustrate the need for concern about the growing use of fortification practices.

KEY WORDS: • calcium • adequate intakes • tolerable upper intake levels • fortification

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