Differential effects of calcium- and vitamin D-fortified milk with FOS-inulin compared to regular milk, on bone biomarkers in Chinese pre- and postmenopausal women

PURPOSE: To compare the effects of a high-calcium vitamin D-fortified milk with added FOS-inulin versus regular milk on serum parathyroid hormone, and bone turnover markers in premenopausal (Pre-M) and postmenopausal (PM) women over 12 weeks. METHODS: Premenopausal women (n = 136, mean age 41 (±5) years) and postmenopausal women [n = 121, mean age 59 (±4) years] were recruited, and each age group randomised into two groups to take two glasses per day of control = regular milk (500 mg calcium per day) or intervention (Int) = fortified milk (1000 mg calcium for pre-M women and 1200 mg calcium for PM women, 96 mg magnesium, 2.4 mg zinc, 15 µg vitamin D, 4 g FOS-inulin per day). At baseline, week 4 and week 12 serum minerals and bone biochemical markers were measured and bone density was measured at baseline. RESULTS: Mean 25-hydroxyvitamin D [25(OH) vitamin D3] levels among groups were between 49 and 65 nmol/L at baseline, and over the 12 weeks of supplementation, the fortified milk improved vitamin D status in both Int groups. CTx-1 and PINP reduced significantly in both Pre-M and PM groups over the 12 weeks, with the changes in CTx-1 being significantly different (P < 0.035) between PM control and PM Int groups at week 12. Parathyroid hormone levels were significantly reduced in all groups over time, except for control PM group where levels increased at 12 weeks. CONCLUSION: The overall pattern of responses indicates that while both regular milk and fortified milk reduce bone resorption in young and older women, fortified milk is measurably more effective

Effects of a multinutrient-fortified milk drink combined with exercise on functional performance, muscle strength, body composition, inflammation, and oxidative stress in middle-aged women: a 4-month, double-blind, placebo-controlled, randomized trial

Background Multinutrient protein-enriched supplements are promoted to augment the effects of exercise on muscle mass and strength, but their effectiveness in middle-aged women, or whether there are any additional benefits to physical function, remains uncertain. Objectives We aimed to evaluate whether a multinutrient-fortified milk drink (MFMD) could enhance the effects of exercise on functional muscle power (stair climbing) in middle-aged women. Secondary aims were to evaluate the intervention effects on physical function, muscle strength, lean mass (LM), fat mass (FM), bone mineral content (BMC), muscle cross-sectional area (CSA), muscle density, balance, flexibility, aerobic fitness, inflammation, oxidative stress, bone and cartilage turnover, blood pressure, and blood lipids. Methods In this 4-mo, double-blind, placebo-controlled, randomized trial, 244 women (45&ndash;65 y) participated in a multimodal resistance-type exercise program 3 d/wk, with random allocation to a twice-daily MFMD containing added protein, vitamin D, calcium, milk fat globule membrane (phospholipids and other bioactives), and other micronutrients (Ex&nbsp;+&nbsp;MFMD, n&nbsp;=&nbsp;123) or an energy-matched placebo (Ex&nbsp;+&nbsp;placebo, n&nbsp;=&nbsp;121). Results A total of 216 women (89%) completed the study. After 4 mo, both groups experienced similar 3.6%&ndash;4.3% improvements in the primary outcomes of fast-pace 5- and 10-step stair ascent power. In contrast, Ex&nbsp;+&nbsp;MFMD experienced greater improvements in 5-step regular-pace stair descent time [net difference (95% CI): &minus;0.09 s (&minus;0.18, 0.00 s), P&nbsp;=&nbsp;0.045], countermovement jump height [0.5 cm (0.04, 1.0 cm), P&nbsp;=&nbsp;0.038], total body LM [0.3 kg (0.04, 0.60 kg), P&nbsp;=&nbsp;0.020], FM [&minus;0.6 kg (&minus;1.0, &minus;0.2 kg), P&nbsp;=&nbsp;0.004], BMC [0.4% (0.1%, 0.6%), P&nbsp;=&nbsp;0.020], muscle CSA [thigh: 1.8% (0.6%, 2.9%), P&nbsp;=&nbsp;0.003; lower leg: 0.9% (0.3%, 1.6%), P&nbsp;=&nbsp;0.005], balance eyes closed [3.3 s (1.1, 5.4 s), P&nbsp;=&nbsp;0.005], 2-min step performance [8 steps (3, 12 steps), P&nbsp;=&nbsp;0.003], and sit-and-reach flexibility [1.4 cm (0.6, 2.2 cm), P&nbsp;=&nbsp;0.026]. MFMD did not enhance the effects of exercise on any measures of muscle strength, gait speed, dynamic balance, reaction time, or blood lipids, and there was no effect of either intervention on blood pressure, markers of inflammation, or cartilage turnover. Ex&nbsp;+&nbsp;placebo had a greater improvement in the oxidative stress marker protein carbonyls (P&nbsp;&lt;&nbsp;0.01).Conclusions In middle-aged women, daily consumption of an MFMD did not enhance the effects of a multimodal exercise program on the primary outcome of stair climbing ascent power, but did elicit greater improvements in multiple secondary outcomes including various other measures of functional performance, LM, muscle size, FM, balance, aerobic capacity, flexibility, and bone metabolism.This trial was registered at www.anzctr.org.au as ACTRN12617000383369

Fortified Milk Supplementation Improves Vitamin D Status, Grip Strength, and Maintains Bone Density in Chinese Premenopausal Women Living in Malaysia

This study compared the effects of a high-calcium vitamin D fortified milk with added FOS-Inulin versus regular milk on serum parathyroid hormone (PTH), vitamin D status, grip strength (GS), as well as bone density in Chinese premenopausal women over 52 weeks. Premenopausal women (n = 133), mean age 41 (&#177;5.1) years were randomized into control (n = 66; regular milk at 500 mg calcium per day) or intervention (Int; n = 67; fortified milk at 1200 mg calcium, 15 μg vitamin D, and 4 g FOS-Inulin per day) groups. Assessments were at baseline, weeks 12, 24, 36, and 52 for changes in vitamin D status, levels of PTH, and GS. Bone mineral densities (BMDs) of the lumbar spine (LS), femoral neck (FN), and whole body (WB) were assessed at baseline and week 52 using GE Lunar iDEXA (GE Healthcare, Madison, WI). At baseline, WB lean mass was positively associated with LS BMD (r = 0.30, p &lt; 0.001) and FN BMD (r = 0.33, p = 0.003). Baseline 25(OH) vitamin D3 levels were 48.6 and 53.2 nmol/L (p = 0.57), respectively, and after the 12 months at 60.8 nmol/L (Int) versus 55.0 nmol/L (controls; p &lt; 0.05 for change from baseline for both groups; no difference between groups at week 52). PTH levels decreased in both groups compared to baseline (p &lt; 0.001), with no significant difference between groups. WB bone mineral content (BMC) and FN Z-score increased significantly in the Int group (p = 0.024 and p = 0.008). GS was positively associated with body weight, increasing in both groups over 52 weeks. Fortified milk improved vitamin D status, WB BMC, and Z-score of the FN, while regular milk maintained BMD. In addition, vitamin D status and GS improved