Perspective: School Meal Programs Require Higher Vitamin D Fortification Levels in Milk Products and Plant-Based Alternatives—Evidence from the National Health and Nutrition Examination Surveys (NHANES 2001–2018)

Looker, 2002, Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III, Bone, 30, 771, 10.1016/S8756-3282(02)00692-0 Whiting, 2021, Vitamin D: nutrition information brief, Adv Nutr, 12, 2037, 10.1093/advances/nmab051 Schleicher, 2016, The vitamin D status of the US population from 1988 to 2010 using standardized serum concentrations of 25-hydroxyvitamin D shows recent modest increases, Am J Clin Nutr, 104, 454, 10.3945/ajcn.115.127985 Herrick, 2019, Vitamin D status in the United States, 2011–2014, Am J Clin Nutr, 110, 150, 10.1093/ajcn/nqz037 Nesby-O’Dell, 2002, Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994, Am J Clin Nutr, 76, 187, 10.1093/ajcn/76.1.187 Calvo, 2004, Vitamin D fortification in the United States and Canada: current status and data needs, Am J Clin Nutr, 80, 1710S, 10.1093/ajcn/80.6.1710S Gutiérrez, 2011, Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey, Osteoporos Int, 22, 1745, 10.1007/s00198-010-1383-2 Malek, 2019, Race/ethnicity, enrichment/fortification, and dietary supplementation in the U.S. population, NHANES 2009–2012, Nutrients, 11, 1005, 10.3390/nu11051005 Urashima, 2010, Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren, Am J Clin Nutr, 91, 1255, 10.3945/ajcn.2009.29094 Weydert, 2014, Vitamin D in children's health, Children (Basel), 1, 208 Martineau, 2019, Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis, Health Technol Assess (Rockv), 23, 1, 10.3310/hta23020 Jolliffe, 2021, Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials, Lancet Diabetes Endocrinol, 9, 276, 10.1016/S2213-8587(21)00051-6 Mailhot, 2020, Vitamin D and immunity in infants and children, Nutrients, 12, 1233, 10.3390/nu12051233 Loeb, 2019, Effect of vitamin D supplementation to reduce respiratory infections in children and adolescents in Vietnam: a randomized controlled trial, Influenza Other Respir Viruses, 13, 176, 10.1111/irv.12615 Oktaria, 2021, Vitamin D deficiency and severity of pneumonia in Indonesian children, PLoS One, 16, e0254488, 10.1371/journal.pone.0254488 Walker, 2019, Vitamin D and otitis media, Curr Allergy Asthma Rep, 19, 33, 10.1007/s11882-019-0866-2 Szentpetpetery, 2018, Vitamin D insufficiency, plasma cytokines, and severe asthma exacerbation in school-aged children, J Allerg Clin Immunol Pract, 61, 289, 10.1016/j.jaip.2017.07.019 Litonjua, 2019, Vitamin D and childhood asthma: causation and contribution to disease activity, Curr Opin Allergy Clin Immunol, 19, 126, 10.1097/ACI.0000000000000509 Ozturk, 2019, 25-Hydroxy vitamin D levels in pediatric asthma patients and its link with asthma severity, Cureus, 11, e4302 Thorsteinsdottir, 2019, Exposure to vitamin D fortification policy in prenatal life and the risk of childhood asthma: results from the D-Tect Study, Nutrients, 11, 924, 10.3390/nu11040924 Panfili, 2021, Possible role of vitamin D in Covid-19 infection in pediatric population, J Endocrinol Invest, 44, 27, 10.1007/s40618-020-01327-0 Feketea, 2021, Vitamin D in corona virus disease 2019 (COVID-19) related multisystem inflammatory syndrome in children (MIS-C), Front Immunol, 12, 648546, 10.3389/fimmu.2021.648546 US Department of Agriculture, Agriculture Research Service, National Nutrient Database for Standard Reference Legacy Release (SR Legacy). Food Data Central, 2019. Available at: https://fdc.nal.usda.gov (accessed 30 January 2022). US Department of Agriculture, Agricultural Research Service. USDA Food and Nutrient Database for Dietary Studies 2015–2016. [Internet]. Food Surveys Research Group Home Page; 2018. Available from: www.ars.usda.gov/nea/bhnrc/fsrg (accessed 30 January 2022). Moshfegh, 2008, The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes, Am J Clin Nutr, 88, 324, 10.1093/ajcn/88.2.324 US Department of Agriculture, Agricultural Research Service. Total nutrient intakes. Percent reporting and mean amounts of selected vitamins and minerals from food and beverages and dietary supplements, by race/ethnicity, What We Eat in America, NHANES 2013–2014. [Internet]. 2017. Available from: www.ars.usda.gov/ba/bhnrc/fsrg (accessed 30 January 2022). US Department of Agriculture, Agricultural Research Service. Total nutrient intakes from foods and beverages: mean amounts consumed per individual by race/ethnicity and age, What We Eat in America, NHANES 2015–2016. [Internet]. 2018. Available from: www.ars.usda.gov/ba/bhnrc/fsrg (accessed 30 January 2022). US Department of Agriculture, Agricultural Research Service. Total nutrient intakes from foods and beverages: mean amounts consumed per individual by sex and age, What We Eat in America, NHANES 2017–2018. [Internet]. 2020. Available from: www.ars.usda.gov/ba/bhnrc/fsrg (accessed 30 January 2022). USDA, Agricultural Research Service. Usual nutrient intake from food and beverages among non-Hispanic White individuals, What We Eat in America, NHANES 2015–2018. [Internet]. 2021. Available from: http://www.ars.usda.gov/nea/bhnrc/fsrg. USDA, Agricultural Research Service. Usual nutrient intake from food and beverages among non-Hispanic Black individuals, What We Eat in America, NHANES 2015–2018. [Internet]. 2021. Available from: http://www.ars.usda.gov/nea/bhnrc/fsrg. USDA, Agricultural Research Service. Usual nutrient intake from food and beverages among Hispanic individuals, What We Eat in America, NHANES 2015–2018. [Internet]. 2021. Available from: http://www.ars.usda.gov/nea/bhnrc/fsrg. Karalius, 2014, Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006, J Pediatr Endocrinol Metab, 27, 461, 10.1515/jpem-2013-0246 Berner, 2014, Fortified foods are major contributors to nutrient intakes in diets of US children and adolescents, J Acad Nutr Diet, 114, 1009, 10.1016/j.jand.2013.10.012 Newman, 2019, Nutrients in the US diet: naturally occurring or enriched/fortified food and beverage sources, plus dietary supplements: NHANES 2009–2012, J Nutr, 149, 1404, 10.1093/jn/nxz066 Al Khalifah, 2020, The impact of vitamin D food fortification and health outcomes in children: a systematic review and meta-regression, Syst Rev, 9, 144, 10.1186/s13643-020-01360-3 Itkonen, 2018, Vitamin D fortification of fluid milk products and their contribution to vitamin D intake and vitamin D status in observational studies—a review, Nutrients, 10, 1054, 10.3390/nu10081054 Cole, 2010, 25-Hydroxyvitamin D status of healthy, low-income, minority children in Atlanta, Georgia, Pediatrics, 125, 633, 10.1542/peds.2009-1928 Carpenter, 2012, Demographic, dietary, and biochemical determinants of vitamin D status in inner-city children, Am J Clin Nutr, 95, 137, 10.3945/ajcn.111.018721 Talib, 2016, Treatment of vitamin D deficiency in predominantly Hispanic and black adolescents: a randomized clinical trial, J Pediatr, 170, 266, 10.1016/j.jpeds.2015.11.025 Fructuoso, 2021, An overview on nutritional aspects of plant-based beverages used as substitutes for cow’s milk, Nutrients, 13, 2650, 10.3390/nu13082650 Wolf, 2020, Beverage milk consumption patterns in the United States: who is substituting from dairy to plant-based beverages?, J Dairy Sci, 103, 11209, 10.3168/jds.2020-18741 Torres-Gonzalez, 2020, Association of milk consumption and vitamin D status in the US population by ethnicity: NHANES 2001–2010 analysis, Nutrients, 12, 3720, 10.3390/nu12123720 O’Neil, 2018, Food sources of energy and nutrients of public health concern and nutrients to limit with a focus on milk and other dairy foods in children 2 to 18 years of age: National Health and Nutrition Examination Survey 2011–2014, Nutrients, 10, 10.3390/nu10081050 Graham, 2009, Vitamin D status of year 3 children and supplementation through schools with fortified milk, Public Health Nutr, 12, 2329, 10.1017/S1368980008004357 Khadgawat, 2013, Impact of vitamin D fortified milk supplementation on vitamin D status of healthy school children aged 10–14 years, Osteoporos Int, 24, 2335, 10.1007/s00198-013-2306-9 Du, 2004, School-milk intervention trial enhances growth and bone mineral accretion in Chinese girls aged 10–12 years in Beijing, Br J Nutr, 92, 159, 10.1079/BJN20041118 Marwaha, 2021, Efficacy of daily supplementation of milk fortified with vitamin D2 for three months in healthy school children: a randomized placebo controlled trial, Indian Pediatr, 58, 820, 10.1007/s13312-021-2300-9 Benjeddou, 2019, Effect of multiple micronutrient fortified milk consumption on vitamin D status among school-aged children in rural region of Morocco, Appl Physiol Nutr Metab, 44, 461, 10.1139/apnm-2018-0368 Sipple, 2020, Invited review: maintaining and growing fluid milk consumption by children in school lunch programs in the United States, J Dairy Sci, 103, 7639, 10.3168/jds.2020-18216 Sipple, 2021, Child preferences and perceptions of fluid milk in school meal programs, J Dairy Sci, 104, 5303, 10.3168/jds.2020-19546 Stark, L. USDA announces updates to school meal nutrition standards to begin in 2022-2023 school year. CNN politics February 2022. Available from [Internet]: https://www.cnn.com/2022/02/04/politics/school-meal-nutrition-standards-updates/index. Nosowitz, 2022, USDA increases rates for school lunch budgets, Modern Farmer Green, 2010, Milk fortified with the current adequate intake for vitamin D (5 microg) increases serum 25-hydroxyvitamin D compared to control milk but is not sufficient to prevent a seasonal decline in young women, Asia Pac J Clin Nutr, 19, 195 Brooks, 2017, An analysis of factors associated with 25-hydroxyvitamin D levels in white and non-white Canadians, J AOAC Int, 100, 1345, 10.5740/jaoacint.17-0250 Vatanparast, 2020, Vitamin D intake from supplemental sources but not from food sources has increased in the Canadian population over time, J Nutr, 150, 526, 10.1093/jn/nxz291 Brett, 2018, Vitamin D status and immune health outcomes in a cross-sectional study and a randomized trial of healthy young children, Nutrients, 10, 680, 10.3390/nu10060680 Nguyen, 2021, School-based nutrition interventions can improve bone health in children and adolescents, Osteoporos Sarcopenia, 7, 1, 10.1016/j.afos.2021.03.004 Feskanich, 2014, Milk consumption during teenage years and risk of hip fractures in older adults, JAMA Pediatr, 168, 54, 10.1001/jamapediatrics.2013.3821 Camargo, 2012, Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia, Pediatrics, 130, e561, 10.1542/peds.2011-3029 Bartfeld, 2019, Access to the school breakfast program is associated with higher attendance and test scores among elementary school students, J Nutr, 149, 336, 10.1093/jn/nxy267 Au, 2012, Vitamin D intake and serum vitamin D in ethnically diverse urban schoolchildren, Public Health Nutr, 15, 2047, 10.1017/S1368980012003217 Sawicki, 2015, Sun-exposed skin color is associated with changes in serum 25-hydroxyvitamin D in racially/ethnically diverse children, J Nutr, 146, 751, 10.3945/jn.115.222505 Öhlund, 2017, Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial, Am J Clin Nutr, 106, 105, 10.3945/ajcn.116.147108 Switkowski, 2021, Early-life factors are associated with vitamin D status in early and mid-childhood and may differ between white and black children, J Nutr, 151, 1256, 10.1093/jn/nxaa456 US Food and Drug Administration; Department of Health and Human Services, 2016, Food labeling revision of the Nutrition and Supplement Facts label. Final rule, Fed Regist, 81, 33741 Calvo, 2013, Survey of current vitamin D food fortification practices in the United States and Canada, J Steroid Biochem Mol Biol, 136, 211, 10.1016/j.jsbmb.2012.09.034 Food and Drug Administration; Department of Health and Human Services. Food additives permitted for direct addition to food for human consumption; vitamin D2, a rule by the Food and Drug Administration on 7/18/2016. 81 Federal Register, 46578–46582. Available from [Internet]: https://www.govinfo.gov/content/pkg/FR-2016-07-18/pdf/2016-16738.pdf (accessed 13 July 2019).