Randomized controlled trial of the effects of vitamin D–fortified milk and bread on serum 25-hydroxyvitamin D concentrations in families in Denmark during winter: the VitmaD study

Katja H Madsen, Lone B Rasmussen, Rikke Andersen, Christian Mølgaard, Jette Jakobsen, Poul J Bjerrum, Elisabeth W Andersen, Heddie Mejborn, Inge Tetens
American Journal of Clinical Nutrition 2013, 98 (2): 374-82

BACKGROUND: Vitamin D intakes are lower than dietary recommendations in most populations, and thus, a low vitamin D status is widespread, especially during winter.

OBJECTIVE: We investigated the effects of increasing vitamin D intake to the recommended amount by fortification of milk and bread on serum 25-hydroxyvitamin D [25(OH)D] concentrations in families during winter in Denmark.

DESIGN: The study was a randomized controlled trial in 782 children and adults (4-60 y old) recruited as 201 families. Families were randomly assigned to vitamin D-fortified or nonfortified milk and bread for 6 mo starting in September. The milk and bread replaced the participants' usual consumptions of products.

RESULTS: Median (IQR) vitamin D intakes (habitual diet plus fortified products) were 9.4 mg/d (6.5, 12.3 mg/d) and 2.2 mg/d (1.5, 3.0 mg/d) in fortification and control groups, respectively. Geometric mean (IQR) serum 25(OH)D concentrations decreased from 73.1 nmol/L (61.9, 88.5 nmol/L) to 67.6 nmol/L (56.2, 79.4 nmol/L) in the fortification group and from 71.1 nmol/L (61.2, 85.9 nmol/L) to 41.7 nmol/L (29.5, 58.9 nmol/L) in the control group (both P , 0.001). The final 25(OH)D concentration was significantly higher in the fortification group than in the control group (P , 0.001). By the end of the study, ,1% of subjects in the fortification group and 25% of subjects in the control group had 25(OH)D concentrations ,30 nmol/L and 16% and 65% of subjects, respectively, had 25(OH)D concentrations ,50 nmol/L.

CONCLUSION: Vitamin D fortification of milk and bread reduces the decrease in serum 25(OH)D concentrations during winter and ensures 25(OH)D concentrations .50 nmol/L in children and adults in Denmark.

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