Correspondence
An Update on the Vitamin D Content of Fortified Milk from the United States and Canada
N Engl J Med 1993; 329:1507November 11, 1993
- Article
To the Editor:
We reported previously (April 30, 1992, issue)1 that 71 percent of 42 milk samples purchased in five Eastern states in 1991 did not contain 80 to 120 percent of the amount of vitamin D claimed on the label. These results confirmed an earlier study by the Food and Drug Administration (FDA)2. As a result of these observations, there has been increased awareness of the need to monitor the fortification of milk with vitamin D more carefully. Between May 1992 and June 1993, we therefore purchased 94 milk samples in seven Eastern states, including the same five states in which we purchased samples in 1991, and also in Illinois, Louisiana, Utah, and British Columbia, Canada. The vitamin D concentrations of the samples were analyzed as previously described1. In the United States, 80 percent of the samples contained either 20 percent less or 20 percent more than the label claimed (Table 1Table 1
Vitamin D Content of Milk Samples, as a Percentage of the Amount Stated on the Package Label.); 14 percent had undetectable amounts of vitamin D. One sample of chocolate milk from Louisiana and one sample of whole milk from Utah contained 914 percent and 382 percent, respectively, of the amount of vitamin D stated on the label. The results in milk samples purchased in British Columbia were similar; 73 percent did not contain 80 to 120 percent of the amount of vitamin D claimed. One sample of 2 percent milk had no detectable vitamin D, and one sample of whole milk contained 363 percent of the amount stated on the label. The overall distribution of vitamin D concentrations reported here is similar to those reported by the FDA in 19882 and by our laboratory in 19921. In addition, our results were confirmed in a recently published report showing a large variation in vitamin D content in commercially available milk samples3. Our survey indicates that there has been no improvement in the fortification process of milk.Underfortification of milk with vitamin D can increase the risk of rickets in children and of osteomalacia in adults, whereas overfortification can cause vitamin D intoxication and its serious consequences4. A unified national program to monitor the process of vitamin D fortification is needed to ensure that proper amounts of vitamin D are included in milk.
4 ReferencesTai C. Chen, Ph.D.
Qing Shao, M.D.
Boston University School of Medicine, Boston, MA 02118Hunter Heath, III, M.D.
University of Utah School of Medicine, Salt Lake City, UT 84132Michael F. Holick, Ph.D., M.D.
Boston University School of Medicine, Boston, MA 021181
Holick MF ,Shao Q ,Liu WW ,Chen TC . The vitamin D content of fortified milk and infant formula. N Engl J Med 1992;326:1178-1181
Full Text | Web of Science | Medline2
Tanner JT ,Smith J ,Defibaugh P , et al. Survey of vitamin content of fortified milk. J Assoc Off Anal Chem 1988;71:607-610
Medline3
Renken SA ,Warthesen JJ . Vitamin D stability in milk. J Food Sci 1993;58:552-556
CrossRef | Web of Science4
Jacobus CH ,Holick MF ,Shao Q , et al. Hypervitaminosis D associated with drinking milk. N Engl J Med 1992;326:1173-1177
Full Text | Web of Science | Medline
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Melissa K. Thomas, Marie B. Demay. (2000) VITAMIN D DEFICIENCY AND DISORDERS OF VITAMIN D METABOLISM. Endocrinology & Metabolism Clinics of North America 29:3, 611-627
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H. Faulkner, A. Hussein, M. Foran, L. Szijarto. (2000) A Survey of Vitamin A and D Contents of Fortified Fluid Milk in Ontario. Journal of Dairy Science 83:6, 1210-1216
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C Banville, J.C Vuillemard, C Lacroix. (2000) Comparison of different methods for fortifying Cheddar cheese with vitamin D. International Dairy Journal 10:5-6, 375-382
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J. Jean, C. Turcotte, R.E. Simard, I. Fliss. (1999) Production and characterization of polyclonal antibodies against cholecalciferol (vitamin D3). Journal of Immunological Methods 223:2, 155-163
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