Fortification of yogurts with vitamin D and calcium enhances the inhibition of serum parathyroid hormone and bone resorption markers: A double blind randomized controlled trial in women over 60 living in a community dwelling home

Abstract

ObjectiveTo evaluate whether fortification of yogurts with vitamin D and calcium exerts an additional lowering effect on serum parathyroid hormone (PTH) and bone resorption markers (BRM) as compared to iso-caloric and iso-protein dairy products in aged white women at risk of fragility fractures.DesignA randomized double-blind controlled trial.SettingA community dwelling home.ParticipantsForty-eight women over 60 years (mean age 73.4).InterventionConsumption during 84 days of two 125 g servings of either vitamin D and calcium-fortified yogurts (FY) at supplemental levels of 10 µg vitamin D3/d and 520 mg/d of calcium (total=800 mg/d), or non fortified control yogurts (CY) providing 280 mg/d of calcium.MeasurementsSerum changes from baseline (D0) to D28, D56 and D84 in 25OHD, PTH and in two BRM: Tartrate-resistant-acid-phosphatase-isoform-5b (TRAP5b) and carboxy-terminal-cross-linked-telopeptide of type-I-collagen (CTX).ResultsThe 10 years risk of major and hip fractures were 13.1 and 5.0%, and 12.9 and 4.2 %, in FY and CY groups, respectively. From D0 to D84, serum 25OHD increased (mean±SE) from 34.3±2.4 to 56.3±2.4 nmol/L in FY (n=24) and from 35.0±2.5 to 41.3±3.0 nmol/L in CY (n=24), (P=0.00001). The corresponding changes in PTH were from 64.1±5.1 to 47.4±3.8 ng/L in FY and from 63.5±4.6 to 60.7±4.2 ng/L in CY (P=0.0011). After D84, TRAP5b was reduced significantly (P=0.0228) and CTX fell though not significantly (P=0.0773) in FY compared to CY.ConclusionThis trial in aged white women living in a community dwelling home at risk for osteoporotic fractures confirms that fortification of dairy products with vitamin D3 and calcium should provide a greater prevention of secondary hyperparathyroidism and accelerated bone resorption as compared to non-fortified equivalent foods.

A Vitamin D, Calcium and Leucine-Enriched Whey Protein Nutritional Supplement Improves Measures of Bone Health in Sarcopenic Non-Malnourished Older Adults: The PROVIDE Study

“…These effects are similar to the active intervention in our study that resulted in a 21% and 14% decrease of PTH and CTX, respectively. A significant decline in PTH and bone resorption markers was also observed after 84 days of vitamin D (400 IU) and calcium-fortified (800 mg) yoghurt consumption twice daily in a community-dwelling population of 57 women aged > 60 years, (mean age 73 years, BMI 30 kg/ m 2 ) living in a sheltered accommodation housing in Hull (England) [24]. Similar effects of calcium and/or vitamin D fortified milk on bone parameters have been observed in Asian populations.…”

Can foodservices in aged care homes deliver sustainable food fortification strategies? A review

“…The most common mode of delivery were soups, juices, cereals, desserts, yoghurt, cheese and bread. Mode of delivery varied across the studies, including across the day in 6 studies(Tolbert 2004;Smoliner et al 2008;Grieger and Nowson 2009;Leslie et al 2013;van Til et al 2015;Beelen et al 2017), in breakfast only by 2 studies(Bermejo et al 2008;van Wymelbeke et al 2016), in breakfast and lunch by 1 study(Castellanos et al 2009), in lunch and dinner by 3 studies(Odlund Olin et al 2003;Bonjour et al 2013;Bonjour et al 2015)…”

Serum 25-hydroxyvitamin D concentrations and selected diet components in postmenopausal women [pdf]

“…Given the low vitamin D and calcium intake in many populations, researchers focused on the possibility of fortifying certain products with these nutrients (Whiting et al, 2016). A study carried out on a group of women aged >60 years by Bonjour et al (2015) demonstrated that having two yogurts fortified with calcium (520 mg) and vitamin D (10 µg) a day for three consecutive months significantly increased serum concentration of 25(OH)D and decreased the rate of bone degradation. In a study carried out on postmenopausal women, Bonjour et al (2008) observed that a 6-week period of milk supplementation diminished bone turnover mediated by reduction in parathyroid hormone secretion.…”