Vitamin D-Fortified Bread Is as Effective as Supplement in Improving Vitamin D Status: A Randomized Clinical Trial.
BACKGROUND
Bread can potentially be a suitable vehicle for fortification with vitamin D.


OBJECTIVE
This study was undertaken to evaluate the following: 1) the bioavailability of vitamin D from the fortified Iranian bread and 2) the possible effects of daily consumption of the fortified bread on certain health aspects.


METHODS
This was a randomized, double-blind, placebo-controlled trial conducted over 8 weeks in 90 healthy subjects aged 20-60 years.


METHODS
Subjects were randomly allocated to one of three groups: 1) fortified bread (FP; 50 g bread fortified with 25 μg vitamin D3 plus placebo daily; n = 30); 2) supplement (SP; 50 g plain bread plus 25 μg vitamin D supplement daily; n = 30); and 3) control (CP; 50 g plain bread plus placebo daily; n = 30).


METHODS
Initial and final anthropometric and biochemical assessments were performed.


RESULTS
The within-group changes of serum 25-hydroxyvitamin D concentrations were 39.0 ± 22.6 (P < .001), 28.9 ± 31.2 (P < .001), and -9.2 ± 12.3 nmol/L in the FP, SP, and CP groups, respectively. Only in FP and SP groups, serum intact PTH concentrations decreased approximately 13.5% and 14.5%, respectively. Visceral fat also showed a significant decrement in FP (-1.05% ± 1.4%; P ≤ .001) and SP (-0.96% ± 1.7%; P = .006). Serum low-density lipoprotein cholesterol concentration showed a within-group reduction in FP (-10.4 ± 11.2 mg/dL; P < .001) and an insignificant decrement in SP (-6.6 ± 20.2 mg/dL; P = .083). Serum high-density lipoprotein increased in both vitamin D-supplemented groups (FP: 9.7 ± 7.6 vs SP: 5.7 ± 6.7 mg/dL; P < .001).


CONCLUSIONS
Vitamin D-fortified bread could be potentially effective in raising circulating 25-hydroxyvitamin D levels of the population to nearly adequate levels.
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Bahareh
B
Nikooyeh
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Tirang R
TR
Neyestani
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Maliheh
M
Zahedirad
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Mehrdad
M
Mohammadi
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
S Hedayat
SH
Hosseini
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Zahra
Z
Abdollahi
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Foroozan
F
Salehi
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Jalaledin
J
Mirzay Razaz
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Nastaran
N
Shariatzadeh
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Ali
A
Kalayi
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Neda
N
Lotfollahi
Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran.
Mohammad-Reza
MR
Maleki
D000328:Adult; D001939:Bread; D002762:Cholecalciferol / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005527:Food, Fortified; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy*
D010281:Parathyroid Hormone; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D