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

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 mg 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, þ14·5 % (P¼0·0051); parathyroid hormone (PTH), 212·3 % (P¼0·0011); CTX, 27·5 % (P¼0·01); tartrate-resistant acid phosphatase isoform 5b (TRAP 5b), 29·9 % (P, 0·0001); albumin, þ6·2 % (P,0·0001); insulin-like growth factor-I (IGF-I), þ 16·9 % (P, 0·0001); osteocalcin, þ8·3 % (P¼ 0·0166); amino-terminal propeptide of type 1 procollagen (P1NP), þ 19·3 % (P¼ 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.

Selected individual differences as predictors of milk product consumption in a group of perimenopausal women in the light of health hazards

“…A Swiss study confirmed that the dietary intervention, namely the administration of dairy products enriched in calcium and vitamin D, was reflected by a decreased serum level of biomarker of bone resorption 5b TRAP in postmenopausal women; this pointed to a nutrition-related decrease in the rate of bone mass involution [16,17]. Our group included 2.0% of women with confirmed osteoporosis.…”

Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture

“…Milk consumption has been shown to favorably affect bone remodeling in postmenopausal women (22,23) and in elderly (24). in an open study carried out in institutionalized vitamin D deficient women, we observed an apparent beneficial effect on bone turnover markers after 4 weeks of soft plain cheese consumption, providing about 17-25 % of the recommended daily intakes of vitamin D, calcium and proteins (25).…”

“…hip fracture incidence is particularly elevated in nursing home residents, as observed in several countries (36)(37)(38). We recently reported results of an open trial exploring whether consumption of vitamin D and calcium enriched soft plain cheese may modify bone turnover in a way expected to attenuate the rate of bone loss among institutionalized elderly women (25). the results of this exploratory study suggested that fortified soft plain cheese consumed during one month by elderly women with vitamin D insufficiency can reduce bone resorption markers, namely ctX and traP 5b, by positively influencing ca and protein economy, as expressed by decreased Pth and increased iGF-i, respectively (25).…”

“…We recently reported results of an open trial exploring whether consumption of vitamin D and calcium enriched soft plain cheese may modify bone turnover in a way expected to attenuate the rate of bone loss among institutionalized elderly women (25). the results of this exploratory study suggested that fortified soft plain cheese consumed during one month by elderly women with vitamin D insufficiency can reduce bone resorption markers, namely ctX and traP 5b, by positively influencing ca and protein economy, as expressed by decreased Pth and increased iGF-i, respectively (25). the foregoing randomized cross-over controlled study confirms that dietary intervention with the same fortified soft plain cheese during 6 weeks significantly reduced bone resorption, as expressed by the significant decrease of both specific biochemical markers, ctX and traP 5b.…”

Invited review: Dairy intake and bone health: A viewpoint from the state of the art

“…According to Bonjour et al (2009), fortified soft plain cheese consumed by elderly women with vitamin D insufficiency can decrease bone resorption markers by positively influencing calcium and protein economy, as expressed by decreased parathyroid hormone and increased IGF-I, respectively. Such a dietary intervention might uncouple, at least transiently, bone resorption from bone formation and thereby attenuate age-related bone loss.…”