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

• Published in: The American journal of clinical nutrition Vol. 98; no. 2; pp. 374 - 381
• Main Authors: Madsen, Katja H, Rasmussen, Lone B, Andersen, Rikke, Mølgaard, Christian, Jakobsen, Jette, Bjerrum, Poul J, Andersen, Elisabeth W, Mejborn, Heddie, Tetens, Inge
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.08.2013; American Society for Nutrition; American Society for Clinical Nutrition, Inc
• Subjects: Adolescent; Adult; adults; Animals; Biological and medical sciences; blood serum; Bread; breads; Child; Child, Preschool; children; clinical nutrition; Clinical trials; Denmark; Diet; dietary recommendations; Dietary Supplements; Feeding. Feeding behavior; Female; Food, Fortified; Fundamental and applied biological sciences. Psychology; Humans; Male; Middle Aged; Milk; Milk - chemistry; Nutrition; Nutrition Assessment; Patient Compliance; randomized clinical trials; Seasons; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vitamin D; Vitamin D - administration & dosage; Vitamin D - blood; vitamin status; Winter; Young Adult; Denmark; Europe; Micronutrient; Winter; Nutrition; Vitamin D; Family study; Serum; Concentration; Milk; Bread
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.113.059469

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 μg/d (6.5, 12.3 μg/d) and 2.2 μg/d (1.5, 3.0 μg/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. This trial was registered at clinicaltrials.gov as NCT01184716.