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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2010 Jul 1;101(4):318–321. doi: 10.1007/BF03405294

Vitamin D Intake From Food and Supplements Among Ontario Women Based on the US Block Food Frequency Questionnaire With and Without Modification for Canadian Food Values

Laura N Anderson 112,212,, Michelle Cotterchio 112,212, Beatrice A Boucher 112,212,312, Julia A Knight 112,412, Torin Block 512
PMCID: PMC6973816  PMID: 21033546

Abstract

Objectives

To measure and compare dietary vitamin D intake among women in Ontario using a modified Block 1998 (US) food frequency questionnaire (FFQ) before and after modification for Canadian-specific vitamin D food fortification.

Methods

An age-stratified random sample of 3,471 women in Ontario (aged 25–74) was identified using random digit dialing methods. Standard US food values and a modified Canadian-specific vitamin D nutrient analysis were applied to the FFQ.

Results

Intake of vitamin D from foods (Canadian nutrient analysis) was 5.3 ± 3.4 μg/day (mean ± SD) and 45% of women reported vitamin D intake from supplements. Total vitamin D intakes met the current Adequate Intakes of 5, 10 and 15 μg/day for only 62%, 47%, and 28% of women aged <-50, 51–70 and >-71, respectively. Relatively high agreement was found between the US and Canadian nutrient analysis methods of measuring vitamin D from food (weighted kappa = 0.74, 95% CI 0.72–0.76). Intake differences (US minus Canadian) ranged from -5.0 μg/day to +2.0 μg/day (1st-99th percentile); however, the mean difference was only -0.54 μg/day (95% CI: -0.58 to -0.50).

Conclusions

Lower than recommended total vitamin D intakes were observed among our study participants which may negatively impact the health status of women. Adjustment for Canadian food fortification and the inclusion of fatty fish had little impact on the measurement of vitamin D from food.

Key words: Vitamin D, food, fortified, nutrition surveys, female, Canada, United States

Footnotes

Conflict of Interest: TB is an owner of NutritionQuest, which holds the copyright on the Block FFQ. LNA, MC, BAB and JAK have none to declare.

References

  • 1.Holick MF. Vitamin D: A D-lightful health perspective. Nutr Rev. 2008;66(10Suppl2):S182–S194. doi: 10.1111/j.1753-4887.2008.00104.x. [DOI] [PubMed] [Google Scholar]
  • 2.Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81. doi: 10.1056/NEJMra070553. [DOI] [PubMed] [Google Scholar]
  • 3.Giovannucci E. Vitamin D status and cancer incidence and mortality. Adv Exp Med Biol. 2008;624:31–42. doi: 10.1007/978-0-387-77574-6_3. [DOI] [PubMed] [Google Scholar]
  • 4.Health Canada. Canadian Nutrient File. 2007. [Google Scholar]
  • 5.Health Canada. Addition of Vitamins and Minerals to Foods. 2005. [Google Scholar]
  • 6.Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: Current status and data needs. Am J Clin Nutr. 2004;80(6Suppl):1710S–1716S. doi: 10.1093/ajcn/80.6.1710S. [DOI] [PubMed] [Google Scholar]
  • 7.Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, FoodNutrition Board, Institute of Medicine. Dietary Reference Intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington, DC: National Academy Press; 1997. [Google Scholar]
  • 8.Csizmadi I, Kahle L, Ullman R, Dawe U, Zimmerman TP, Friedenreich CM, et al. Adaptation and evaluation of the National Cancer Institute’s diet history questionnaire and nutrient database for Canadian populations. Public Health Nutr. 2007;10(1):88–96. doi: 10.1017/S1368980007184287. [DOI] [PubMed] [Google Scholar]
  • 9.Cotterchio M, Boucher BA, Kreiger N, Mills CA, Thompson LU. Dietary phytoestrogen intake—lignans and isoflavones—and breast cancer risk (Canada) Cancer Causes Control. 2008;19(3):259–72. doi: 10.1007/s10552-007-9089-2. [DOI] [PubMed] [Google Scholar]
  • 10.Boucher B, Cotterchio M, Kreiger N, Nadalin V, Block T, Block G. Validity and reliability of the Block98 food-frequency questionnaire in a sample of Canadian women. Public Health Nutr. 2006;9(1):84–93. doi: 10.1079/PHN2005763. [DOI] [PubMed] [Google Scholar]
  • 11.United States Department of Agriculture, Agricultural Research Service. USDA National Nutrient Database for Standard Reference. 2009. [Google Scholar]
  • 12.Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L. A data-based approach to diet questionnaire design and testing. Am J Epidemiol. 1986;124(3):453–69. doi: 10.1093/oxfordjournals.aje.a114416. [DOI] [PubMed] [Google Scholar]
  • 13.Block G. Invited commentary: Another perspective on food frequency questionnaires. Am J Epidemiol. 2001;154(12):1103. doi: 10.1093/aje/154.12.1103. [DOI] [PubMed] [Google Scholar]
  • 14.Moore C, Murphy MM, Keast DR, Holick MF. Vitamin D intake in the United States. J Am Diet Assoc. 2004;104(6):980–83. doi: 10.1016/j.jada.2004.03.028. [DOI] [PubMed] [Google Scholar]
  • 15.Health Canada, Statistics Canada. Canadian Community Health Survey (CCHS) Cycle 2.2, Nutrition (2004) Ottawa: Health Canada; 2008. [Google Scholar]
  • 16.Holden JM, Lemar LE, Exler J. Vitamin D in foods: Development of the US Department of Agriculture database. Am J Clin Nutr. 2008;87(4):1092S–1096S. doi: 10.1093/ajcn/87.4.1092S. [DOI] [PubMed] [Google Scholar]
  • 17.Byrdwell WC, Devries J, Exler J, Harnly JM, Holden JM, Holick MF, et al. Analyzing vitamin D in foods and supplements: Methodologic challenges. Am J Clin Nutr. 2008;88(2):554S–557S. doi: 10.1093/ajcn/88.2.554S. [DOI] [PubMed] [Google Scholar]
  • 18.Lu Z, Chen TC, Zhang A, Persons KS, Kohn N, Berkowitz R, et al. An evaluation of the vitamin D3 content in fish: Is the vitamin D content adequate to satisfy the dietary requirement for vitamin D? J Steroid Biochem Mol Biol. 2007;103(3–5):642–44. doi: 10.1016/j.jsbmb.2006.12.010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Faulkner H, Hussein A, Foran M, Szijarto L. A survey of vitamin A and D contents of fortified fluid milk in Ontario. J Dairy Sci. 2000;83(6):1210–16. doi: 10.3168/jds.S0022-0302(00)74986-1. [DOI] [PubMed] [Google Scholar]
  • 20.Chen TC, Shao A, Heath H, Holick MF. An update on the vitamin D content of fortified milk from the United States and Canada. N Engl J Med. 1993;329(20):1507. doi: 10.1056/NEJM199311113292021. [DOI] [PubMed] [Google Scholar]
  • 21.Kristal AR, Peters U, Potter JD. Is it time to abandon the food frequency questionnaire? Cancer Epidemiol Biomarkers Prev. 2005;14(12):2826–28. doi: 10.1158/1055-9965.EPI-12-ED1. [DOI] [PubMed] [Google Scholar]
  • 22.Schatzkin A, Subar AF, Moore S, Park Y, Potischman N, Thompson FE, et al. Observational epidemiologic studies of nutrition and cancer: The next generation (with better observation) Cancer Epidemiol Biomarkers Prev. 2009;18(4):1026–32. doi: 10.1158/1055-9965.EPI-08-1129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Goldbohm RA, van’ t Veer P, van den Brandt PA, van’ t Hof MA, Brants HA, Sturmans F, Hermus RJ. Reproducibility of a food frequency questionnaire and stability of dietary habits determined from five annually repeated measurements. Eur J Clin Nutr. 1995;49(6):420–29. [PubMed] [Google Scholar]
  • 24.Vieth R. What is the optimal vitamin D status for health? Prog Biophys Mol Biol. 2006;92(1):26–32. doi: 10.1016/j.pbiomolbio.2006.02.003. [DOI] [PubMed] [Google Scholar]
  • 25.Whiting SJ, Green TJ, Calvo MS. Vitamin D intakes in North America and Asia-Pacific countries are not sufficient to prevent vitamin D insufficiency. J Steroid Biochem Mol Biol. 2007;103(3–5):626–30. doi: 10.1016/j.jsbmb.2006.12.067. [DOI] [PubMed] [Google Scholar]
  • 26.Cashman KD, Hill TR, Lucey AJ, Taylor N, Seamans KM, Muldowney S, et al. Estimation of the dietary requirement for vitamin D in healthy adults. Am J Clin Nutr. 2008;88(6):1535–42. doi: 10.3945/ajcn.2008.26594. [DOI] [PubMed] [Google Scholar]
  • 27.Houghton LA, Vieth R. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr. 2006;84(4):694–97. doi: 10.1093/ajcn/84.4.694. [DOI] [PubMed] [Google Scholar]
  • 28.Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, et al. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr. 2007;85(3):649–50. doi: 10.1093/ajcn/85.3.649. [DOI] [PubMed] [Google Scholar]
  • 29.US Department of Agriculture, Human Nutrition Information Service. Provisional table on the vitamin D content of foods. Washington, DC: US Government Printing Office; 1980. [Google Scholar]
  • 30.Yetley EA, Brule D, Cheney MC, Davis CD, Esslinger KA, Fischer PW, et al. Dietary reference intakes for vitamin D: Justification for a review of the 1997 values. Am J Clin Nutr. 2009;89(3):719–27. doi: 10.3945/ajcn.2008.26903. [DOI] [PMC free article] [PubMed] [Google Scholar]

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