title: Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture.
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.
  
  
  METHODS
  Prospective, randomized crossover controlled study.
  
  
  METHODS
  Six French nursing homes or other institutions for elderly.
  
  
  METHODS
  Institutionalized women ≥ 65 years old with low vitamin D status and calcium intake below 700 mg/day.
  
  
  METHODS
  Consumption of soft plain cheese made of semi-skimmed milk which was fortified by both vitamin D3 (+1.25 µg/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.
  
  
  METHODS
  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 [corrected] 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. jean-philippe.bonjour@unige.ch
authors.forename: J-P
authors.initials: JP
authors.lastname: Bonjour
authors.forename: V
authors.initials: V
authors.lastname: Benoit
authors.forename: O
authors.initials: O
authors.lastname: Pourchaire
authors.forename: B
authors.initials: B
authors.lastname: Rousseau
authors.forename: J-C
authors.initials: JC
authors.lastname: Souberbielle
mesh_terms: D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001862:Bone Resorption / Q000097:blood / Q000178:diet therapy*; D002118:Calcium / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use*; D002136:Calcium, Dietary / Q000008:administration & dosage; D002611:Cheese; D024042:Collagen Type I / Q000097:blood; D004044:Dietary Proteins / Q000008:administration & dosage; D004334:Drug Administration Schedule; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D005527:Food, Fortified; D050723:Fractures, Bone / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D007326:Institutionalization; D018977:Micronutrients / Q000494:pharmacology / Q000627:therapeutic use; D010349:Patient Compliance; D010455:Peptides / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000178:diet therapy*
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D024042:Collagen Type I; D004044:Dietary Proteins; D018977:Micronutrients; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium