Intentional Use of Voluntarily Fortified Foods in Relation to Socio-Demographic and Lifestyle Factors, Including Adherence to a DASH-Style Diet, Among University Students.

Background: Voluntary food fortification is a common market-driven practice to improve nutritional value, but consumption of such products may also be associated with less healthy dietary patterns. This study aimed to identify socio-demographic and lifestyle factors, including diet quality, associated with the intentional use of voluntarily fortified foods (Intentional-VFFs) among university students. Methods: The cross-sectional study was conducted among 2123 university students in Warsaw. Data were collected through a self-administered health and lifestyle questionnaire and a 5-day food record. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to identify factors associated with Intentional-VFF use. Diet quality was assessed using a Dietary Approaches to Stop Hypertension (DASH) score. Results: Intentional-VFF use was reported by 44.3% of respondents and was significantly associated with age (each 1-year increment was associated with a 6% lower use), sex (male vs. female; OR: 0.63, 95%CI: 0.49-0.81), BMI (<18.5 vs. 18.5-24.9 kg/m2; OR: 0.63, 95%CI: 0.43-0.92), self-assessed nutritional knowledge (high vs. low; OR: 1.70, 95%CI: 1.20-2.42), excluding/including some products (yes vs. no; OR: 2.09, 95%CI: 1.55-2.83), and use of dietary supplements (OR: 1.62, 95%CI: 1.30-2.01). However, significant effect modification was observed; high nutritional knowledge was associated with Intentional-VFF use among men but not among women, whereas age was inversely associated with VFF use only among dietary supplement non-users. Intentional-VFF use was not significantly associated with the DASH score; however, each 50 g increment in vegetable consumption was associated with a 4% lower odds of VFF use (p = 0.013). Conclusions: Various factors, including sex, dietary supplement use, and nutritional knowledge, may be associated with Intentional-VFF use across different adult subgroups; however, establishing a link between their use and diet quality warrants further investigation.