Partners in protecting bones

by Jeff Gelski
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A study that appeared on-line Jan. 12 in the British Medical Journal indicates vitamin D given alone may not be effective in preventing fractures, but calcium and vitamin D given together may reduce hip fractures and total fractures, and probably vertebral fractures. The study may serve as another reason for pairing vitamin D and calcium in such applications as yogurt or juice drinks.

The DiPART (vitamin D individual Patient Analysis of Randomized Trials) Group involved researchers from Copenhagen University Hospital in Copenhagen, Denmark. Researchers sourced data from seven randomized trials of vitamin D with calcium or vitamin D alone, which yielded a total of 68,517 participants ranging in age from 47 to 107. In the results, no interaction was found between fracture history and treatment response, nor was there any interaction with age, gender or hormone replacement therapy.

An editorial in the British Medical Journal written by Opinder Sahota, a professor of orthogeriatric medicine at Queen’s Medical Centre in Nottingham, United Kingdom, touched on the study.

“These findings are important because this is one of the few individual patient data analyses to show that vitamin D alone, irrespective of dose, does not reduce the risk of fracture,” Dr. Sahota wrote. “In contrast, it found that combined calcium and vitamin D reduced the overall risk of fracture, but that only low dose vitamin D with calcium reduced the risk of hip fracture.”

When contacted by Food Business News, Ram Chaudhari, senior executive vice-president and chief scientific officer for Fortitech Inc., Schenectady, N.Y., said the study had good science behind it. He said further studies may explore how other macronutrients, such as carbohydrates, in the diet affect the interaction between calcium and vitamin D.

Barbara Heidolph, technical services principal —Food Ingredients for ICL Performance Products LP, St. Louis, told Food Business News, vitamin D is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone.

“This reinforces the existing belief that calcium fortification is important to aid in the prevention of fractures,” she said of the study.

The low pH of yogurt makes it a good candidate for the addition of calcium and vitamin D, said Dr. Chaudhari, who has doctoral degrees in nutrition and food science. Because of the low pH, the vitamin D will be absorbed better. Fortitech lists a yogurt prototype with 25% of the Daily Value (DV) of vitamin D3 and 6% of the DV of calcium in its report “Reach, Strategic Nutrition for Bone & Joint Health.”

An ice cream prototype in the report features 15% of the DV of vitamin D3 and 20% of the DV for calcium. While ice cream should be considered an indulgent product, and not so much a functional food, because of its sugar and fat content, it still may serve as a practical way to deliver vitamin D and calcium, Dr. Chaudhari said.

The Fortitech report promotes the combination of vitamin D and calcium in products, stating, “While products may boast about added calcium on packaging, it needs to be better recognized that calcium works in combination with vitamin D to promote optimal bone health.”

Problems may arise in mouthfeel and chalkiness when adding calcium to semi-soft products, like yogurt, and liquid products, Ms. Heidolph said. In response, ICL Performance Products offers Cal-Sistent, a micronized tricalcium phosphate in a small particle size that is not easily detectable.

“I think there are missed opportunities on the juice side,” Ms. Heidolph said of calcium and vitamin D pairings.

While cranberry juice often is promoted for its bladder health benefits, the addition of calcium and vitamin D would add prevention of fractures as another benefit, she said.

Adding calcium and vitamin D to apple juice for children is another possibility.

“Who else needs calcium more than kids whose bones are growing?” Ms. Heidolph said.

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