Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture

Nutritional approach to the deterioration of bone integrity and increased fracture risk appears to be particularly appropriate in elderly women living in nursing homes. To investigate the beneficial effect of the consumption of soft plain cheese on bone resorption markers in institutionalized elderly women. Prospective, randomized crossover controlled study. Six French nursing homes or other institutions for elderly. Institutionalized women a parts per thousand yen 65 years old with low vitamin D status and calcium intake below 700 mg/day. Consumption of soft plain cheese made of semi-skimmed milk which was fortified by both vitamin D3 (+ 1.25A mu g/100g) and milk extracted Ca, thus achieving a total Ca content of 151 mg/100g as compared to about 118 mg/100g for standard fresh cheese. Two servings were taken every day during the 6 weeks that preceded or followed a period of 6 weeks without soft plain cheese consumption. The primary end point was the change in serum carboxy terminal cross-linked telopeptide of type I collagen (CTX) selected as a marker of bone resorption. 29 women aged 73-94 yr were selected, 21 of them with mean age 87.2 +/- 6.1 years remained compliant The intervention increased calcium and protein intakes by 51% (904 +/- 228 vs. 599 +/- 122 mg/d) and 33 % (74.2 +/- 17.1 vs. 55.6 +/- 12.7 g/d, mean +/- SD), respectively. The dietary intervention was associated with a statistically significant increase in serum levels of both 25OHD and IGF-I, while those of PTH, CTX and TRAP5b were significantly reduced. Compliance was 93,4 %. The daily consumption of two servings of soft plain cheese was well accepted in terms of tastiness and appetite suited portion size. This randomized crossover controlled trial demonstrates that in elderly women living in nursing homes, the consumption of soft plain cheese increasing the supply of vitamin D, calcium and proteins, could reduce bone resorption and thereby reduce the risk of incidental fragility fractures in the long term.