TY - JOUR
T1 - Assessing Health Consequences of Vitamin D Fortification Utilizing a Societal Experiment Design
T2 - Methodological Lessons Learned from the D-Tect Project
AU - Handel, Mina Nicole
AU - Jacobsen, Ramune
AU - Thorsteinsdottir, Fanney
AU - Keller, Amelie Cleo
AU - Stougaard, Maria
AU - Jensen, Camilla Bjørn
AU - Moos, Caroline
AU - Duus, Katrine Sidenius
AU - Jensen, Allan
AU - Kesmodel, Ulrik Schioler
AU - Abrahamsen, Bo
AU - Heitmann, Berit Lilienthal
PY - 2021
Y1 - 2021
N2 - 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 cost-effectiveness and research potential of natural- or societal-experiment-based studies.
AB - 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 cost-effectiveness and research potential of natural- or societal-experiment-based studies.
KW - vitamin D
KW - pregnancy
KW - chronic diseases
KW - semi-ecological study
KW - FORTIFIED MARGARINE
KW - PRENATAL EXPOSURE
KW - PUBLIC-HEALTH
KW - BODY-SIZE
KW - RISK
KW - FETAL
KW - MILK
KW - REGISTERS
KW - LIFE
U2 - 10.3390/ijerph18158136
DO - 10.3390/ijerph18158136
M3 - Review
C2 - 34360427
VL - 18
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
SN - 1661-7827
IS - 15
M1 - 8136
ER -