Table 3. Scoping review of food fortification trials (2000–2015) having bone health outcomes involving older adults (⩾50 years or postmenopausal women.
| Reference (country study location) | Food vehicle | Nutrients added | Subjects | Trial Length | Bone Measures | Results of Treatment | Notes |
|---|---|---|---|---|---|---|---|
| Studies comparing fortified with unfortified foods | |||||||
| Adolphi et al.44 (DEU) | Fermented milk | Calcium, inulin, casein phospho-peptides | PM women | 2 weeks | ALP DPY | Not significant | Milk reduced night-time bone turnover |
| Bonjour et al.45 (FRA) | Soft cheese | Calcium, vitamin D | Nursing home PM women | 6 weeks | TRAP5b, CTX OC, PTH P1NP IGF-1 | ↓TRAP5b ↓ CTX ↓ PTH ↑ IGF-1 | |
| Bonjour et al.46 (FRA) | Soft cheese | Calcium, vitamin D | PM women | 6 weeks | TRAP5b, CTX OC, PTH P1NP, IGF-1 | ↓TRAP5b ↑ IGF-1 | |
| Bonjour et al.47 (FRA) | Yogurt | Calcium, vitamin D | Nursing home PM women | 8 weeks | TRAP5b, CTX OC, PTH P1NP, IGF-1 | ↓TRAP5b ↓ PTH | |
| Bonjour et al.48 (GBR) | Yogurt | Calcium, vitamin D | PM women | 12 weeks | TRAP5b, CTX OC, PTH P1NP, IGF-1 | ↓TRAP5b ↓ PTH | |
| Brink et al.49 (FIN, FRA, ITA, GBR) a | Biscuits and bars | Isoflavones | Early PM women | 1 year | BMD PYD, DPD P1NP PTH, ALP | Not significant | |
| Daly et al.50, 51, 52 (AUS) | Milk | Calcium, vitamin D | Nursing home men | 2 years | BMD (DXA, QCT) | ↑ femoral neck BMD ↑ bone strength if >62-year-old | BMD effect is sustained after 18 months follow-up |
| Grieger et al.53 (AUS) | Milk | Calcium, folate, vitamin D | Nursing home women | 6 months | CTX P1NP PTH | Not significant | No additive effect of vitamin K to calcium |
| Jafari et al.54 (IRN) | Yogurt | Vitamin D | Type 2 Diabetic PM women | 12 weeks | NTX PTH | ↓ NTX | Dose of vitamin D was 2000 IU |
| Kanellakis et al.55 (GRC) | Dairy | Calcium, vitamin D,±vitamin K (K1 or K2) in 3 groups (compared to no dairy) | PM women | 1 year | BMD IGF-1 DYP, PTH | ↑ lumbar BMD with vitamin K | ↑ total body BMD with any dairy |
| Kukuljan et al.56, 57 (AUS) | Milk | Calcium, vitamin D | Older men | 18 months | BMD | Not significant | Men were vitamin D replete at start |
| Studies where control food was not unfortified product | |||||||
| Green et al.58 (NZL) | Milk (tested against apple drink) | Magnesium | PM women | 4 weeks | CTX PTH | ↓ CTX | |
| Gui et al.59 (CHN) | Soy or cow milk (compared to no milk) | Calcium | PM women | 18 months | BMD | ↑ femoral neck BMD | |
| Kruger et al.39 (NZL) | Milk (compared to fruit drink) | Calcium, vitamin D, magnesium, zinc | PM women | 4 months | CTX, P1NP OC, PTH | ↓ CTX,↓P1NP ↓ OC.↓PTH | |
| Manios et al.b; Moschonis and Maniosb; Moschonis et al.b; Tenta et al.60, 61, 62, 63, 64,b (GRC) | Dairy (compared to no milk) | Calcium, vitamin D | PM women | 1 year, then 1.5 years of increased vitamin D | BMD CTX PTH IGF-1 | ↑ total body BMD (2.5 years) ↓ PTH ↑ IGF-1 | Also compared dairy to supplemental calcium and vitamin D |
| Palacios et al.67 (ESP) | Milk | Calcium, vitamin D – compared two doses of calcium | PM women | 10 weeks | ALP P1NP PYR NTX | Higher Ca dose ↓PYR | |
| Single-arm design | |||||||
| Bonjour et al.65 (FRA) | Soft cheese | Calcium, vitamin D | Nursing home PM women | 4 weeks | TRAP5b, CTX OC, PTH P1NP IGF-1 | ↓TRAP5b ↓ CTX ↓ PTH ↑ IGF-1 | Compared pre- and post-treatment |
| Mocanu et al.66 (ROM) | Bread | Vitamin D | Nursing home | 1 year | BMD | ↑ BMD z-scores for hip, and spine | Compared pre- and post-treatment |
Abbreviations: ALP, alkaline phosphatase; AUS, Australia; BMD, bone mineral density; CAN, Canada; CHN; China; CTX, C-terminal telopeptide (s, serum); DEU, Germany; DPY, deoxypyridinoline crosslinks; ESP, Spain; FIN, Finland; FRA, France; GBR, United Kingdom; GRC, Greece; IGF-1, insulin-like growth factor-1; IRN, Iran; ITA, Italy; NTX, N-terminal telopeptide (u, urine); NZL, New Zealand; OC, osteocalcin; PM, postmenopausal; PTH, parathyroid hormone; P1NP, Procollagen Type 1N-Terminal Propeptide; PYD, pyridinoline crosslinks; ROM, Romania; TRAP5b, Tartrate-resistant acid phosphatase (TRAP) 5b.
a
Multicenter PHYTOS study.
b
Five reports from ‘The Postmenopausal Health Study'.