Multinutrient-Fortified Juices Improve Vitamin D and Vitamin E Status in Children: A Randomized Controlled Trial

• Published in: Journal of the Academy of Nutrition and Dietetics Vol. 114; no. 5; pp. 709 - 717
• Main Authors: Economos, Christina D., Moore, Carolyn E., Hyatt, Raymond R., Kuder, Julia, Chen, Tai, Meydani, Simin Nikbin, Meydani, Mohsen, Klein, Ellen, Biancuzzo, Rachael M., Holick, Michael F.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2014; Elsevier
• Subjects: alpha-tocopherol; alpha-Tocopherol - blood; beta-carotene; Beverages; Biological and medical sciences; blood serum; Body Mass Index; Body Weight; Boston; calcium; Calcium, Dietary - administration & dosage; Calcium, Dietary - blood; Child; children; Citrus sinensis - chemistry; Double-Blind Method; Feeding. Feeding behavior; Female; Food, Fortified; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Humans; Internal Medicine; Male; Multinutrient juice; Multivariate Analysis; nationalities and ethnic groups; orange juice; parathyroid hormone; Parathyroid Hormone - blood; randomized clinical trials; Vertebrates: anatomy and physiology, studies on body, several organs or systems; vitamin A; Vitamin A - administration & dosage; Vitamin A - blood; Vitamin D; Vitamin D - administration & dosage; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin E; Vitamin E - administration & dosage; Vitamin E - blood; Vitamins - administration & dosage; Vitamins - blood; Vitamin D; Multinutrient juice; Vitamin E; Human; Randomization; Clinical trial; Metabolic diseases; Child; Retinol
• ISSN: 2212-2672
• DOI: 10.1016/j.jand.2013.07.027

Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins. To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D, E, and A could increase serum 25-hydroxyvitamin D [25(OH)D], α-tocopherol, and retinol levels. A 12-week randomized, double-blind, controlled trial. One hundred eighty participants (aged 8.04±1.42 years) were recruited at Tufts (n=70) and Boston University (n=110) during 2005-2006. Of those recruited, 176 children were randomized into three groups: CaD (700 mg calcium+200 IU vitamin D), CaDEA (700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene), or Ca (700 mg calcium). Children consumed two 240-mL glasses of CaD, CaDEA, or Ca fortified orange juice daily for 12 weeks. Serum 25(OH)D, α-tocopherol, and retinol concentrations. Changes in 25(OH)D, α-tocopherol, retinol, and parathyroid hormone concentrations were examined. Covariates included sex, age, race/ethnicity, body mass index, and baseline 25(OH)D, α-tocopherol, retinol, or parathyroid hormone levels. Multivariate models and repeated measures analysis of variance tested for group differences with pre–post measures (n=141). Baseline 25(OH)D was 68.4±27.7 nmol/L (27.4±11.10 ng/mL) ), with 21.7% of participants having inadequate 25(OH)D (<50 nmol/L [20.03 ng/mL]). The CaD group's 25(OH)D increase was greater than that of the Ca group (12.7 nmol/L [5.09 ng/mL], 95% CI 1.3 to 24.1; P=0.029). The CaDEA group's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups (3.79 μmol/L [0.16 μg/mL], 95% CI 2.5 to 5.1 and 3.09 μmol/L [0.13 μg/mL], 95% CI −1.8 to 4.3), respectively (P<0.0001). Retinol levels did not change, and body weight remained as expected for growth. Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks.