Long-term effects of giving nursing home residents bread fortified with 125 μg (5000 IU) vitamin D 3 per daily serving

Abstract

Background: In older adults, a serum 25-hydroxyvitamin D [25(OH)D] concentration <75 nmol/L lowers the risk of fracture. An oral intake of 125 μg (5000 IU) vitamin D 3/d may be required to achieve this target. Objective: The objective was to characterize the safety and efficacy of fortifying bread with a biologically meaningful amount of vitamin D 3. Design: In a single-arm design, 45 nursing home residents consumed one bun daily that had been fortified with 125 μg (5000 IU) vitamin D 3 and 320 mg elemental calcium. Results: The initial mean (±SD) serum 25(OH)D concentration was 28.5±10.8 nmol/L. After 12 mo, the 25(OH)D concentration was 125.6±38.8 nmol/L, and it exceeded 74 nmol/L in 92% of the patients. At every 3-mo follow-up, serum parathyroid hormone was lower than at baseline (P=0.001). No changes in serum calcium or cases of hypercalcemia were observed at the follow-up assessments. Both mean total urinary calcium and the mean urinary calcium- creatinine ratio increased from baseline at one follow-up time point (P<0.05). Between baseline and the 12-mo visit, z scores for bone mineral density at the lumbar spine and the hip both increased significantly (P<0.001). Conclusions: Fortification of bread with much more vitamin D than used previously produced no evident adverse effects on sun-deprived nursing home residents and improved bone density measures. Fortification of bread with 5000 IU vitamin D 3/d provided reasonable assurance that vitamin D-deficient older adults attained a serum 25(OH)D concentration greater than the desirable objective of > 75 nmol/L. © 2009 American Society for Nutrition.