Assessing health consequences of vitamin d fortification utilizing a societal experiment design: Methodological lessons learned from the d-tect project

Mina Nicole Händel*, Ramune Jacobsen, Fanney Thorsteinsdottir, Amélie Cléo Keller, Maria Stougaard, Camilla Bjørn Jensen, Caroline Moos, Katrine Sidenius Duus, Allan Jensen, Ulrik Schiøler Kesmodel, Bo Abrahamsen, Berit Lilienthal Heitmann

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

By utilizing historical changes in Danish legislation related to mandatory vitamin D fortification of margarine, which was implemented in the mid 1930s and abruptly abandoned in June 1985, the studies in the D-tect project investigated the effects of vitamin D on health outcomes in individuals, who during gestation were exposed or unexposed to extra vitamin D from fortified margarine. This paper reviews and narratively summarizes the analytic approaches alongside the results of the societal fortification experiment studies from the D-tect project and addresses the challenges in designing societal experiment studies and evaluating their results. The latter are discussed as lessons learned that may be useful for designers of similar studies, expected to be extensively utilized while researching the health consequences of the COVID-19 pandemic by comparing individuals born before and after the epidemic. In the D-tect project, 16 articles based on the societal fortification experiment were published analyzing 10 different outcomes and using different statistical approaches. Lessons learned included the detail of the analysis of the historical information on the exposure, availability and validity of the outcome data, variety of analytical approaches, and specifics concerning vitamin D effect evaluation, such as consideration of the influence of sunshine or season. In conclusion, the D-tect project clearly demonstrated the costeffectiveness and research potential of natural-or societal-experiment-based studies.

Original languageEnglish
Article number8136
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number15
Number of pages13
ISSN1661-7827
DOIs
Publication statusPublished - 1. Aug 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Chronic diseases
  • Pregnancy
  • Semi-ecological study
  • Vitamin D

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