title: Multinutrient-fortified juices improve vitamin D and vitamin E status in children: a randomized controlled trial.
abstract: BACKGROUND
  Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins.
  
  
  OBJECTIVE
  To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D, E, and A could increase serum 25-hydroxyvitamin D [25(OH)D], α-tocopherol, and retinol levels.
  
  
  METHODS
  A 12-week randomized, double-blind, controlled trial.
  
  
  METHODS
  One hundred eighty participants (aged 8.04±1.42 years) were recruited at Tufts (n=70) and Boston University (n=110) during 2005-2006. Of those recruited, 176 children were randomized into three groups: CaD (700 mg calcium+200 IU vitamin D), CaDEA (700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene), or Ca (700 mg calcium). Children consumed two 240-mL glasses of CaD, CaDEA, or Ca fortified orange juice daily for 12 weeks.
  
  
  METHODS
  Serum 25(OH)D, α-tocopherol, and retinol concentrations.
  
  
  METHODS
  Changes in 25(OH)D, α-tocopherol, retinol, and parathyroid hormone concentrations were examined. Covariates included sex, age, race/ethnicity, body mass index, and baseline 25(OH)D, α-tocopherol, retinol, or parathyroid hormone levels. Multivariate models and repeated measures analysis of variance tested for group differences with pre-post measures (n=141).
  
  
  RESULTS
  Baseline 25(OH)D was 68.4±27.7 nmol/L (27.4±11.10 ng/mL) ), with 21.7% of participants having inadequate 25(OH)D (<50 nmol/L [20.03 ng/mL]). The CaD group's 25(OH)D increase was greater than that of the Ca group (12.7 nmol/L [5.09 ng/mL], 95% CI 1.3 to 24.1; P=0.029). The CaDEA group's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups (3.79 μmol/L [0.16 μg/mL], 95% CI 2.5 to 5.1 and 3.09 μmol/L [0.13 μg/mL], 95% CI -1.8 to 4.3), respectively (P<0.0001). Retinol levels did not change, and body weight remained as expected for growth.
  
  
  CONCLUSIONS
  Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks.
authors.forename: Christina D
authors.initials: CD
authors.lastname: Economos
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Moore
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Hyatt
authors.forename: Julia
authors.initials: J
authors.lastname: Kuder
authors.forename: Tai
authors.initials: T
authors.lastname: Chen
authors.forename: Simin Nikbin
authors.initials: SN
authors.lastname: Meydani
authors.forename: Mohsen
authors.initials: M
authors.lastname: Meydani
authors.forename: Ellen
authors.initials: E
authors.lastname: Klein
authors.forename: Rachael M
authors.initials: RM
authors.lastname: Biancuzzo
authors.forename: Michael F
authors.initials: MF
authors.lastname: Holick
mesh_terms: D001628:Beverages; D015992:Body Mass Index; D001835:Body Weight; D001900:Boston; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000097:blood; D002648:Child; D032084:Citrus sinensis / Q000737:chemistry; D004311:Double-Blind Method; D005260:Female; D005527:Food, Fortified; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood; D014810:Vitamin E / Q000008:administration & dosage* / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage* / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014815:Vitamins; D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; C104450:25-hydroxyvitamin D; D024502:alpha-Tocopherol
keywords: Multinutrient juice; Vitamin D; Vitamin E