Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture

Abstract

abstract:Background: nutritional approach to the deterioration of bone integrity and increased fracture risk appears to be particularly appropriate in elderly women living in nursing homes. Objective: to investigate the beneficial effect of the consumption of soft plain cheese on bone resorption markers in institutionalized elderly women. Design: Prospective, randomized crossover controlled study. Setting: six French nursing homes or other institutions for elderly. Participants: institutionalized women ≥ 65 years old with low vitamin D status and calcium intake below 700 mg/day. Intervention: consumption of soft plain cheese made of semi-skimmed milk which was fortified by both vitamin D3 (+1.25µg/100g) and milk extracted ca, thus achieving a total ca content of 151 mg/100g as compared to about 118 mg/100g for standard fresh cheese. two servings were taken every day during the 6 weeks that preceded or followed a period of 6 weeks without soft plain cheese consumption. Measurements: the primary end point was the change in serum carboxy terminal cross-linked telopeptide of type i collagen (ctX) selected as a marker of bone resorption. Results: 29 women aged 73-94 yr were selected, 21 of them with mean age 87.2±6.1 years remained compliant. the intervention increased calcium and protein intakes by 51% (904±228 vs. 599±122 mg/d) and 33 % (74.2±17.1 vs. 55.6±12.7 g/d, mean±sD), respectively. the dietary intervention was associated with a statistically significant increase in serum levels of both 25ohD and iGF-i, while those of Pth, ctX and traP5b were significantly reduced. compliance was 93,4 %. the daily consumption of two servings of soft plain cheese was well accepted in terms of tastiness and appetite suited portion size. Conclusion: this randomized crossover controlled trial demonstrates that in elderly women living in nursing homes, the consumption of soft plain cheese increasing the supply of vitamin D, calcium and proteins, could reduce bone resorption and thereby reduce the risk of incidental fragility fractures in the long term.

Cheese as Functional Food: The Example of Parmigiano Reggiano and Grana Padano

“…Many reports relating to the intake of these nutrients have emphasised their importance in the prevention of bone loss and thus in the reduction of the risk of fractures in the elderly (94). Being a source of calcium and protein, dairy products could play a positive role on bone health (42).…”

The Role of Diet in Osteoporosis Prevention and Management

“…Two French studies have evaluated the effects of 2 daily servings of calcium-and vitamin D-fortified soft cheese providing a daily dose of 400 mg of calcium, 2.5 mcg (100 IU) of vitamin D 3, and 13.8 g of protein vs usual diet [13,14]. One of the studies was conducted in older institutionalized women mean age 87±6 years with hypovitaminosis D and calcium intake below 700 mg/day.…”

“…One of the studies was conducted in older institutionalized women mean age 87±6 years with hypovitaminosis D and calcium intake below 700 mg/day. After 6 weeks, there were significant increases in 25-hydroxyvitamin D levels, higher levels of serum insulin-like growth factor-I (IGF-I), a bone anabolic factor, and significant reductions in 2 markers of osteoclast activity and bone resorption, bone specific acid phosphatase tartrate resistant acid phosphatase isoform 5b (TRAP 5b), and serum carboxy-terminal cross-linked telopeptide of type I bone collagen (CTX) [13]. The same intervention was tested in younger women, mean age 56±3.9 years, who were, on average, within 7.5 years from menopause and had calcium intake below 650 mg/day [14].…”

Prevalence of hypovitaminosis D in institutionalized elderly

“…According to the study, the association of these with the lack of sun exposure may increase the risk of fractures by increasing bone loss and the propensity for falls. 16 In addition to this, recent studies have shown that vitamin D deficiency is related to other pathologies such as cancer, diabetes melittus 17 and cardiovascular processes, such as hypertension and atherosclerosis. 18 Observational studies demonstrate such associations, but interventional studies, for the most part, fail to demonstrate the benefit of reducing such outcomes.…”