Authors: Dr. Wendy Ward, Dr. Zahra Bardai, Dr. Marie-Josée Bégin, Dr. Claudia Gagnon, Dr. Alan Low, Dr. Laëtitia Michou, Sarah Rydal, Dr. Vithika Sivabalasundaram, Dr. Shirine Usmani, Dr. Adrian Lau
Osteoporosis Canada’s Rapid Response Team
In Canada, cow’s milk has been fortified with vitamin D since the 1970s to help support the development and maintenance of healthy bones and teeth. In addition to cow’s milk, there is mandatory vitamin D fortification of margarine. Only a few foods naturally contain vitamin D such as fatty fish and egg yolk, a key reason for Canada’s mandatory vitamin D fortification of specific foods. Foods fortified with vitamin D are the main dietary source of vitamin D for Canadians (1).
Fortification of foods with vitamin D:
As of January 1, 2026, the level of vitamin D has doubled in milk and margarine (1). Plant-based beverages that are advertised as ‘fortified’ also contain the same level of vitamin D as cow’s milk (Table 1). Additionally, yogurt and kefir that are made from dairy can now be voluntarily fortified with vitamin D (2). These foods were selected, in part, as they are increasing in popularity among Canadians while also containing calcium, another bone-supporting nutrient.
From 2022 through the end of 2025 there was a transition period in which the increased level of vitamin D fortification in these foods has been occurring. Increasing the level of mandatory or voluntary vitamin D fortification in these foods is anticipated to make it easier for Canadians to attain the daily recommended intake of vitamin D, and ultimately, benefit bone health (1,2).
Table 1: Levels of vitamin D in foods that are part of the mandatory or voluntary vitamin D fortification program as of January 1, 2026
| Foods that are part of the mandatory* or voluntary** vitamin D fortification program | Level of Vitamin D per serving |
| Cow’s milk* | 200 IU or 5 µg per 250 mL (1 cup) serving |
| Fortified plant-based beverages* | 200 IU or 5 µg per 250 mL (1 cup) serving |
| Margarine* | 104 IU or 2.6 µg per 10 g serving (2 tsps) |
| Yogurt** | Plain: 200 IU or 5 µg per 100 g serving Fruit-flavoured: 152-208 IU or 3.8-5.2 µg per 100 g serving |
| Drinkable yogurt** | Plain: 208 IU or 5.2 µg per 100 mL serving Fruit-flavoured: 156-208 IU or 3.9-5.2 µg per 100 mL serving |
| Kefir** | Plain: 108 IU or 2.7 µg per 100 mL serving Fruit-flavoured: 92-108 IU or 2.3-2.7 µg per 100 mL serving |
Table adapted from references 1 and 2.
*Foods that are part of the mandatory vitamin D fortification program
**Foods that can be voluntarily fortified with vitamin D. The levels reflect the allowed level of voluntary fortification with vitamin D
What is the daily recommended level of vitamin D intake for adults?
For adults, 18 through 70 years of age, Health Canada recommends the daily level of vitamin D intake be 600 IU or 15 µg vitamin D/day and this increases to 800 IU or 20 µg vitamin D/day over age 70 years due to age-related challenges to bone health. Health Canada also recommends that individuals over age 50 take a supplement of 400 IU or 10 µg vitamin D/day as few foods contain vitamin D.
Additionally, individuals are encouraged to consume vitamin D-rich foods. Though this recommendation for supplement use existed prior to the increase in the level of vitamin D fortification, the recommendation currently stands. Moreover, the level of vitamin D obtained through food sources (both fortified and natural) in combination with the 400 IU supplement is not anticipated to exceed safe levels of vitamin D intake. Health Canada’s Tolerable Upper Intake Level for vitamin D is 4000 IU or 100 µg per day (3).
This represents the dose that is generally considered safe as a maximum daily intake. However, each person’s optimal supplementation dose needs to be personalized with their health care practitioner, depending on a person’s specific medical history and requirements.
As per the Clinical Practice Guideline for Management of Osteoporosis and Fracture Prevention in Canada: 2023 Update, it is recommended that Canadian men and women age 50 and older follow Health Canada’s guidance for vitamin D intake through foods and vitamin D supplement use to support bone health (3).
For individuals at risk of vitamin D deficiency, additional supplemental vitamin D should be provided. Risk factors for vitamin D insufficiency/deficiency are detailed in the Guideline (Appendix 1, Supplementary Table 4) (4) and include the following scenarios:
- Malabsorption syndromes (e.g. inflammatory bowel disease, celiac disease, bariatric surgery, gastrectomy)
- Reduced skin synthesis (e.g. limited sun exposure, increased skin pigmentation)
- Liver failure/cirrhosis
- Nephrotic syndrome
- Chronic kidney disease/renal failure
- Medications affecting vitamin D metabolism (e.g. anticonvulsants, glucocorticoids, antiretroviral agents, cholestyramine resins, mineral oil) and vitamin D absorption (e.g. cholestyramine resins, mineral oil)
References:
- Marketing authorization for vitamin D in milk, goat’s milk and margarine. https://gazette.gc.ca/rp-pr/p2/2022/2022-01-19/html/sor-dors278-eng.html
- Marketing authorization for vitamin D in yogurt and kefir. https://gazette.gc.ca/rp-pr/p2/2024/2024-06-05/html/sor-dors88-eng.html
- Dietary reference intakes tables: Reference values for vitamins – Canada.ca https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/dietary-reference-intakes/tables/reference-values-vitamins.html
- Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update. CMAJ Oct 2023, 195 (39) E1333-E1348. https://www.cmaj.ca/content/195/39/E1333
Scientific Advisory Council
Osteoporosis Canada’s rapid response team, made up of members of the Scientific Advisory Council, creates position statements as news breaks regarding osteoporosis. The position statements are used to inform both the healthcare professional and the patient. The Scientific Advisory Council (SAC) is made up of experts in Osteoporosis and bone metabolism and is a volunteer membership.
