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Open Access Research

Three-year follow-up of serum 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density in nursing home residents who had received 12 months of daily bread fortification with 125 μg of vitamin D3

Veronica Mocanu1* and Reinhold Vieth23

Author Affiliations

1 Department of Pathophysiology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii str, Iasi 700115, Romania

2 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, VM, Canada

3 Department of Nutritional Sciences, University of Toronto, Toronto, RV, Canada

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Nutrition Journal 2013, 12:137  doi:10.1186/1475-2891-12-137

Published: 11 October 2013

Abstract

Background

We conducted a single-arm clinical trial in institutionalized seniors, on the effects of high-dose vitamin D3-fortified bread daily intake (clinicaltrials.gov registration NCT00789503).

Methods

At 1 and 3 years after the dietary fortification was stopped, serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone mineral density were measured in 23 of the original study subjects, aged 60-82 years who had consumed bread buns (100 g) fortified with 320 mg elemental calcium and 125 μg (5,000 IU) vitamin D3 daily for one year.

Results

At the end of the 1-year supplementation phase (receiving vitamin D3 fortified bread daily), mean (SD) serum 25(OH)D was 127.3 ± 37.8 nmol/L (baseline for this follow-up). At 1-year follow-up, the serum 25(OH)D was 64.9 ± 24.8 nmol/L (p = 0.001, vs. baseline); and at 3-year follow-up it was 28.0 ± 15.0 nmol/L (p = 0.001 vs. baseline). Serum PTH was 18.8 ± 15.6 pg/ml at baseline while at Year 3 it was 48.4 ± 18.4 pg/ml (p = 0.001 vs. baseline). Lumbar spine BMD did not change from baseline to Year 3. However, by Year 3, hip BMD had decreased (0.927 ± 0.130 g/cm2 vs. 0.907 ± 0.121 g/cm2, p = 0.024).

Conclusion

Vitamin D nutritional status exhibits a long half-life in the body, and a true steady-state plateau may not even be reached 1 year after a discontinuation in dose. Furthermore, once the need for vitamin D has been established, based on a low baseline serum 25(OH)D concentrations, the appropriate action is to maintain corrective vitamin D supplementation over the long term.

Trial registration

Clinical trial registration number: NCT00789503

Keywords:
Geriatrics; Cholecalciferol; Osteoporosis; Vitamin D deficiency; Bread fortification