Inhibition of markers of bone resorption by consumption of vitamin D and calcium-fortified soft plain cheese by institutionalised elderly women

Br J Nutr. 2009 Oct;102(7):962-6. doi: 10.1017/S0007114509371743. Epub 2009 May 18.

Abstract

Acceleration of bone remodelling increases the risk of fragility fractures. The objective of the present study was to explore in elderly women whether a vitamin D and Ca-fortified dairy product providing about 17-25 % of the recommended intakes in vitamin D, Ca and proteins would reduce secondary hyperparathyroidism and bone remodelling in a way that may attenuate age-related bone loss in the long term. Thirty-seven institutionalised women, aged 84.8 (sd 8.1) years, with low serum 25-hydroxyvitamin D (5.5 (sd 1.7) ng/ml) were enrolled into a multicentre open trial to consume during 1 month two servings of soft plain cheese made of semi-skimmed milk providing daily 686 kJ (164 kcal), 2.5 microg vitamin D, 302 mg Ca and 14.2 g proteins. The primary endpoint was the change in serum carboxy terminal cross-linked telopeptide of type I collagen (CTX), selected as a marker of bone resorption. Thirty-five subjects remained compliant. Mean serum changes were: 25-hydroyvitamin D, +14.5 % (P = 0.0051); parathyroid hormone (PTH), - 12.3 % (P = 0.0011); CTX, - 7.5 % (P = 0.01); tartrate-resistant acid phosphatase isoform 5b (TRAP 5b), - 9.9 % (P < 0.0001); albumin, +6.2 % (P < 0.0001); insulin-like growth factor-I (IGF-I),+16.9 % (P < 0.0001); osteocalcin, +8.3 % (P = 0.0166); amino-terminal propeptide of type 1 procollagen (P1NP),+19.3 % (P = 0.0031). The present open trial suggests that fortified soft plain cheese consumed by elderly women with vitamin D insufficiency can reduce bone resorption markers by positively influencing Ca and protein economy, as expressed by decreased PTH and increased IGF-I, respectively. The rise in the bone formation marker P1NP could be explained by a protein-mediated increase in IGF-I. Thus, such a dietary intervention might uncouple, at least transiently, bone resorption from bone formation and thereby attenuate age-related bone loss.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Bone Resorption / blood
  • Bone Resorption / prevention & control*
  • Calcium, Dietary / administration & dosage
  • Calcium, Dietary / therapeutic use*
  • Cheese / analysis*
  • Collagen Type I / blood
  • Female
  • Food, Fortified*
  • Homes for the Aged
  • Humans
  • Hyperparathyroidism, Secondary / etiology
  • Hyperparathyroidism, Secondary / prevention & control
  • Nursing Homes
  • Peptides / blood
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / diet therapy
  • Vitamins / administration & dosage*

Substances

  • Biomarkers
  • Calcium, Dietary
  • Collagen Type I
  • Peptides
  • Vitamins
  • collagen type I trimeric cross-linked peptide
  • Vitamin D
  • 25-hydroxyvitamin D