Vitamin D intake of Dutch infants from the combination of (fortified) foods, infant formula, and dietary supplements

PURPOSE Due to changes in the Dutch fortification policy for vitamin D and the vitamin D supplementation advice for infants (10-μg/d for 0-4 year olds), a partially virtual scenario study was conducted to evaluate the risk of excessive vitamin D intake assigning all infants to a 100 % adherence to the supplementation advice and considering the current fortification practice. METHODS Food consumption data from the Nutrition Intake Study (2002; N = 941, 7-19 months) were combined with Dutch food composition data from 2011 to estimate vitamin D intake from (fortified) foods. For infants 0-6 months of age, the consumption volume infant formula was estimated from energy requirement and body weight. All subjects were assigned to take a daily 10 µg vitamin D supplement, according the Dutch supplementation advice for infants. Habitual vitamin D intake was estimated using the Statistical Program to Assess Dietary Exposure and compared with the tolerable upper intake levels (ULs) set by the European Food Safety Authority. RESULTS The median habitual total vitamin D intake was 16-22 µg/day for infants aged 0-6 months (increasing with age) and 13-21 µg/day for infants aged 7-19 months (decreasing with age). About 4-12 % of infants aged 7-11 months exceeded the UL. At the 99th percentile, the intake was 2-4 µg above the UL, depending on age. Infants aged 0-6 and 12-19 months did not exceed the UL. CONCLUSIONS In case of combined intake from infant formula, (fortified) foods, and supplements, vitamin D intakes above the UL are possible among some infants during a limited time period.