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.
OBJECTIVE
To 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.


METHODS
A randomized double-blind controlled trial.


METHODS
A community dwelling home.


METHODS
Forty-eight women over 60 years (mean age 73.4).


METHODS
Consumption 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.


METHODS
Serum 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).


RESULTS
The 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.


CONCLUSIONS
This 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.
Jean-Philippe Bonjour, M.D. Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle Perret-Gentil 4, CH - 1211 Geneva 14, Switzerland, Phone:+4122 372 99 60, Fax:+4122 372 99 73, E-mail: jean-philippe.bonjour@unige.ch.
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D000135:Acid Phosphatase / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001862:Bone Resorption / Q000097:blood* / Q000178:diet therapy / Q000517:prevention & control; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D024042:Collagen Type I / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005527:Food, Fortified; D006620:Hip Fractures / Q000517:prevention & control; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000178:diet therapy / Q000517:prevention & control; D007527:Isoenzymes / Q000097:blood; D008875:Middle Aged; D009735:Nursing Homes; D058866:Osteoporotic Fractures / Q000517:prevention & control; D010281:Parathyroid Hormone / Q000097:blood*; D012306:Risk; D000071681:Tartrate-Resistant Acid Phosphatase; D044465:White People; D015014:Yogurt
D015415:Biomarkers; D002136:Calcium, Dietary; D024042:Collagen Type I; D007527:Isoenzymes; D010281:Parathyroid Hormone; D002762:Cholecalciferol; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase