Efficacy and safety of food fortification with calcium among adults in Finland

Objective To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland. Design A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements. Setting/participants Participants of FINDIET 2002 were 25–64 years old from five areas ( n = 2007). Participants of the Internet-based survey ( n = 1537) were over 15 years of age from all over the country. Results If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level ( −1 ) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, >2500 mg day −1 ) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women. Conclusions Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population.