Availability and intake of foods with naturally occurring or added vitamin D in a setting of high vitamin D deficiency

Open Access
Cooper, Morgan Brittany
Area of Honors:
Nutritional Sciences
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Alison Diane Gernand, Thesis Supervisor
  • Rebecca L Corwin, Honors Advisor
  • vitamin D
  • pregnancy
  • Bangladesh
  • milk
  • fortification
  • nutrition
Vitamin D deficiency is common during pregnancy in Bangladesh. We aimed to examine availability and intake of foods with naturally occurring or added vitamin D in pregnant women in an urban, low-income setting and analyze their estimated contributions to total vitamin D intake. We examined baseline data from an ongoing, 5-arm, randomized controlled trial of vitamin D supplementation enrolling pregnant women at 17 to 24 weeks gestation in in Dhaka, Bangladesh (n=561; “MDIG” Trial goal n=1300, ClinicalTrials.gov: NCT01924013). A focused, semi-quantitative food frequency questionnaire was used to estimate dietary intake of foods containing vitamin D and potentially fortified with vitamin D in the past month. Further, local food markets were visited to document the availability of vitamin D fortified foods. Median (IQR) fish intake was 3 (2, 3) times per week, with only 5% of women reporting no fish intake. Fresh milk was commonly consumed but powdered milk was not. Total vitamin D intake was 86 IU to 123 IU per week. Naturally occurring sources of vitamin D, specifically fish and eggs, contributed the majority of dietary vitamin D intake. In market analysis, the only locally available, packaged foods labeled as vitamin D fortified were powdered milk and ice cream. Fresh milk, juice, yogurt, breakfast cereals, and crackers were not vitamin D fortified. Powdered milk was widely available, and further, we identified 12 different powdered milk brands in the markets. All were vitamin D fortified, yet only 3 products indicated 100 IU or more per serving (approximate amount in one serving of milk in the US). Vitamin D intake in this population was extremely low. Promoting use of powdered milk and fortifying fresh milk should be explored as practical ways to improve vitamin D intake in pregnant women in Bangladesh.