A 2-year milk intervention trial was carried out with 757 girls, aged 10 years, from nine primary schools in Beijing (April 1999 -March 2001. Schools were randomised into three groups: group 1, 238 girls consumed a carton of 330 ml milk fortified with Ca on school days over the study period; group 2, 260 girls received the same quantity of milk additionally fortified with 5 or 8 mg cholecalciferol; group 3, 259 control girls. Anthropometric and bone mineralisation measurements, as well as dietary, health and physical-activity data, were collected at baseline and after 12 and 24 months of the trial. Over the 2-year period the consumption of this milk, with or without added cholecalciferol, led to significant increases in the changes in height ($0·6 %), sitting height ($ 0·8 %), body weight ($ 2·9 %), and (size-adjusted) total-body bone mineral content ($ 1·2 %) and bone mineral density ($ 3·2 %). Those subjects receiving additional cholecalciferol compared with those receiving the milk without added 25-hydoxycholecalciferol had significantly greater increases in the change in (size-adjusted) total-body bone mineral content (2·4 v. 1·2 %) and bone mineral density (5·5 v. 3·2 %). The milk fortified with cholecalciferol significantly improved vitamin D status at the end of the trial compared with the milk alone or control groups. It is concluded that an increase in milk consumption, e.g. by means of school milk programmes, would improve bone growth during adolescence, particularly when Ca intake and vitamin D status are low.

Subclinical vitamin D deficiency was widespread among Beijing adolescent girls in winter. Low plasma 25-hydroxyvitamin D concentrations in summer, low calcium intake, and low plasma calcium concentrations in winter were the main risk factors for vitamin D deficiency in winter.

It is recommended that policies be developed to prevent vitamin D deficiency in adolescent girls. Further studies are needed to identify the mechanisms whereby vitamin D status is related to exercise and to body composition during growth.

Milk supplementation during early puberty does not have long-lasting effects on bone mineral accretion.