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 and Berit Lilienthal Heitmann
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Mina Nicole Händel: Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark
Ramune Jacobsen: Department of Pharmacy, University of Copenhagen, 2100 Copenhagen, Denmark
Fanney Thorsteinsdottir: Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark
Amélie Cléo Keller: Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
Maria Stougaard: Center for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, 1353 Copenhagen, Denmark
Camilla Bjørn Jensen: Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark
Caroline Moos: Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark
Katrine Sidenius Duus: Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark
Allan Jensen: Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
Ulrik Schiøler Kesmodel: Department of Obstetrics and Gynaecology, Aalborg University Hospital and Aalborg University, 9000 Aalborg, Denmark
Bo Abrahamsen: Open Patient Explorative Network, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
Berit Lilienthal Heitmann: Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark

IJERPH, 2021, vol. 18, issue 15, 1-13

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 cost-effectiveness and research potential of natural- or societal-experiment-based studies.

Keywords: vitamin D; pregnancy; chronic diseases; semi-ecological study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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