title: Use of calcium, folate, and vitamin D₃-fortified milk for 6 months improves nutritional status but not bone mass or turnover, in a group of Australian aged care residents.
abstract: In residential care, inadequate calcium and folate intakes and low serum vitamin D (25(OH)D) concentrations are common. We assessed whether daily provision of calcium, folate, and vitamin D₃-fortified milk for 6 months improved nutritional status (serum micronutrients), bone quality (heel ultrasound), bone turnover markers (parathyroid hormone, C-terminal collagen I telopeptide, terminal propeptide of type I procollagen), and/or muscle strength and mobility in a group of Australian aged care residents. One hundred and seven residents completed the study (mean (SD) age: 79.9 (10.1) years; body weight: 68.4 (15.4) kg). The median (inter-quartile range) volume of fortified milk consumed was 160 (149) ml/day. At the end of the study, the median daily vitamin D intake increased to 10.4 (8.7) μg (P < .001), which is 70% of the adequate intake (15 μg); and calcium density (mg/MJ) was higher over the study period compared with baseline (161 ± 5 mg/MJ vs. 142 ± 4 mg/MJ, P < .001). Serum 25(OH)D concentrations increased by 23 ± 2 nmol/L (83 (107)%, P < .001), yet remained in the insufficient range (mean 45 ± 2 nmol/L). Consumption of greater than the median intake of milk (160 ml/day) (n = 54, 50%) increased serum 25(OH)D levels into the adequate range (53 ± 2 nmol/L) and reduced serum parathyroid hormone by 24% (P = .045). There was no effect on bone quality, bone turnover markers, muscle strength, or mobility. Consumption of fortified milk increased dietary vitamin D intake and raised serum 25(OH)D concentrations, but not to the level thought to reduce fracture risk. If calcium-fortified milk also was used in cooking and milk drinks, this approach could allow residents to achieve a dietary calcium intake close to recommended levels. A vitamin D supplement would be recommended to ensure adequate vitamin D status for all residents.
authors.affiliation: School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Grieger
authors.forename: Caryl A
authors.initials: CA
authors.lastname: Nowson
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology; D000818:Animals; D001315:Australia; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000097:blood; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000097:blood; D003631:Day Care, Medical; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D005527:Food, Fortified; D006801:Humans; D008297:Male; D008892:Milk / Q000737:chemistry; D009751:Nutritional Requirements; D009752:Nutritional Status
chemical_list: D015415:Biomarkers; D002136:Calcium, Dietary; D002762:Cholecalciferol; D005492:Folic Acid