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Reduced-fat Gouda-type cheese enriched with vitamin D3 effectively prevents vitamin D deficiency during winter months in postmenopausal women in Greece

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Abstract

Objective

The primary aim of the present study was to examine the effectiveness of daily consumption of vitamin D3-enriched, reduced-fat Gouda-type cheese on 25-hydroxyvitamin D (25(OH)D) concentration in postmenopausal women. Health-related quality of life (HRQL) indices were examined as secondary outcomes.

Design

This is a single-blinded (i.e., to study participants), randomized, controlled food-based dietary intervention study.

Methods

A sample of 79 postmenopausal women (55–75 years old) was randomized either to a control group (CG: n = 39) or an intervention group (IG: n = 40) that consumed, as part of their usual diet, 60 g of either non-enriched or vitamin D3 enriched Gouda-type cheese, respectively, for eight consecutive weeks (i.e., from January to March 2015). Sixty grams of enriched cheese provided a daily dose of 5.7 μg of vitamin D3.

Results

There was a differential response of mean (95 % CI) serum 25(OH)D levels in the IG and CG, with the former increasing and the latter decreasing significantly over the eight weeks of the trial [i.e., by 5.1 (3.4, 6.9) nmol/L vs. −4.6 (−6.4, −2.8) nmol/L, P < 0.001, respectively]. The percentages of study participants with 25(OH)D levels <30 (deficiency) and <50 nmol/L (insufficiency) were significantly higher at follow-up in the CG compared to the IG (41.0 vs. 0 %, P < 0.001 and 74.4 vs. 47.5 %, P < 0.001, respectively). The emotional well-being scale of the HRQL score increased in the IG compared to a decrease in the CG (3.2 vs. −3.8, P = 0.028). However, none of the other seven scales of the HRQL score significantly differentiated between study groups (P > 0.1).

Conclusions

Consumption of 60 g of vitamin D3-enriched, reduced-fat Gouda-type cheese provided a daily dose of 5.7 μg of additional vitamin D3 and was effective in increasing mean serum 25(OH)D concentration and in counteracting vitamin D deficiency during winter months in postmenopausal women in Greece.

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References

  1. Taylor CL, Thomas PR, Aloia JF et al (2015) Questions about vitamin D for primary care practice: input from an NIH conference. Am J Med. doi:10.1016/j.amjmed.2015.05.025

    Google Scholar 

  2. Cashman KD, Kiely M (2011) Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. Br J Nutr 106:1617–1627. doi:10.1017/s0007114511004995

    Article  CAS  Google Scholar 

  3. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281. doi:10.1056/NEJMra070553

    Article  CAS  Google Scholar 

  4. Calvo MS, Whiting SJ, Barton CN (2005) Vitamin D intake: a global perspective of current status. J Nutr 135:310–316

    CAS  Google Scholar 

  5. Godar DE, Pope SJ, Grant WB et al (2011) Solar UV doses of adult Americans and vitamin D(3) production. Dermato-endocrinology 3:243–250. doi:10.4161/derm.3.4.15292

    Article  CAS  Google Scholar 

  6. Holick MF (2004) Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80:1678s–1688s

    CAS  Google Scholar 

  7. Lynd LR, Aziz RA, de Brito Cruz CH et al (2011) A global conversation about energy from biomass: the continental conventions of the global sustainable bioenergy project. Interface Focus 1:271–279. doi:10.1098/rsfs.2010.0047

    Article  Google Scholar 

  8. van der Wielen RP, Lowik MR, van den Berg H et al (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346:207–210

    Article  Google Scholar 

  9. Black LJ, Seamans KM, Cashman KD et al (2012) An updated systematic review and meta-analysis of the efficacy of vitamin D food fortification. J Nutr 142:1102–1108. doi:10.3945/jn.112.158014

    Article  CAS  Google Scholar 

  10. Black LJ, Walton J, Flynn A et al (2015) Small increments in vitamin D intake by irish adults over a decade show that strategic initiatives to fortify the food supply are needed. J Nutr 145:969–976. doi:10.3945/jn.114.209106

    Article  CAS  Google Scholar 

  11. Cashman KD, Kiely M (2015) Tackling inadequate vitamin D intakes within the population: fortification of dairy products with vitamin D may not be enough. Endocrine. doi:10.1007/s12020-015-0711-x

    Google Scholar 

  12. Cashman KD (2015) Vitamin D: dietary requirements and food fortification as a means of helping achieve adequate vitamin D status. J Steroid Biochem Mol Biol 148:19–26. doi:10.1016/j.jsbmb.2015.01.023

    Article  CAS  Google Scholar 

  13. O’Donnell S, Cranney A, Horsley T et al (2008) Efficacy of food fortification on serum 25-hydroxyvitamin D concentrations: systematic review. Am J Clin Nutr 88:1528–1534. doi:10.3945/ajcn.2008.26415

    Article  Google Scholar 

  14. Johnson JL, Mistry VV, Vukovich MD et al (2005) Bioavailability of vitamin D from fortified process cheese and effects on vitamin D status in the elderly. J Dairy Sci 88:2295–2301. doi:10.3168/jds.S0022-0302(05)72907-6

    Article  CAS  Google Scholar 

  15. Wagner D, Sidhom G, Whiting SJ et al (2008) The bioavailability of vitamin D from fortified cheeses and supplements is equivalent in adults. J Nutr 138:1365–1371

    CAS  Google Scholar 

  16. Bonjour JP, Benoit V, Pourchaire O et al (2009) Inhibition of markers of bone resorption by consumption of vitamin D and calcium-fortified soft plain cheese by institutionalised elderly women. Br J Nutr 102:962–966. doi:10.1017/s0007114509371743

    Article  CAS  Google Scholar 

  17. Bonjour JP, Benoit V, Pourchaire O et al (2011) Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture. J Nutr Health Aging 15:404–409

    Article  CAS  Google Scholar 

  18. Bonjour JP, Benoit V, Rousseau B et al (2012) Consumption of vitamin D-and calcium-fortified soft white cheese lowers the biochemical marker of bone resorption TRAP 5b in postmenopausal women at moderate risk of osteoporosis fracture. J Nutr 142:698–703. doi:10.3945/jn.111.153692

    Article  CAS  Google Scholar 

  19. Holroyd CR, Cooper C, Harvey NC (2011) Vitamin D and the postmenopausal population. Menopause Int 17:102–107. doi:10.1258/mi.2011.011025

    Google Scholar 

  20. Cauley JA (2013) Public health impact of osteoporosis. J Gerontol Ser A Biol Sci Med Sci 68:1243–1251. doi:10.1093/gerona/glt093

    Article  Google Scholar 

  21. Berk M, Sanders KM, Pasco JA et al (2007) Vitamin D deficiency may play a role in depression. Med Hypotheses 69:1316–1319. doi:10.1016/j.mehy.2007.04.001

    Article  CAS  Google Scholar 

  22. Kanellakis S, Moschonis G, Tenta R et al (2012) Changes in parameters of bone metabolism in postmenopausal women following a 12-month intervention period using dairy products enriched with calcium, vitamin D, and phylloquinone (vitamin K(1)) or menaquinone-7 (vitamin K (2)): the Postmenopausal Health Study II. Calcif Tissue Int 90:251–262. doi:10.1007/s00223-012-9571-z

    Article  CAS  Google Scholar 

  23. Harlow SD, Gass M, Hall JE et al (2012) Executive summary of the stages of reproductive aging workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab 97:1159–1168. doi:10.1210/jc.2011-3362

    Article  CAS  Google Scholar 

  24. World Health Organization, Geneva-Switzerland (2016) WHO Global Health Observatory Data Repository (online database). http://apps.who.int/gho/data/view.main

  25. Burild A, Frandsen HL, Poulsen M et al (2014) Quantification of physiological levels of vitamin D(3) and 25-hydroxyvitamin D(3) in porcine fat and liver in subgram sample sizes. J Sep Sci 37:2659–2663. doi:10.1002/jssc.201400548

    Article  CAS  Google Scholar 

  26. Magkos F, Manios Y, Babaroutsi E et al (2006) Development and validation of a food frequency questionnaire for assessing dietary calcium intake in the general population. Osteoporos Int 17:304–312. doi:10.1007/s00198-004-1679-1

    Article  Google Scholar 

  27. Cashman KD, Kiely M, Kinsella M et al (2013) Evaluation of vitamin D standardization program protocols for standardizing serum 25-hydroxyvitamin D data: a case study of the program’s potential for national nutrition and health surveys. Am J Clin Nutr 97:1235–1242. doi:10.3945/ajcn.112.057182

    Article  CAS  Google Scholar 

  28. Sempos CT, Vesper HW, Phinney KW et al (2012) Vitamin D status as an international issue: national surveys and the problem of standardization. Scand J Clin Lab Invest 243(Supplementum):32–40. doi:10.3109/00365513.2012.681935

    Google Scholar 

  29. Csizmadi I, Lo Siou G, Friedenreich CM et al (2011) Hours spent and energy expended in physical activity domains: results from the Tomorrow Project cohort in Alberta, Canada. Int J Behav Nutr Phys Act 8:110. doi:10.1186/1479-5868-8-110

    Article  Google Scholar 

  30. Institute of Medicine Food and Nutrition Board (2011) Dietary reference intakes for calcium and vitamin D. National Academy Press, Washington, DC

    Google Scholar 

  31. Pappa E, Kontodimopoulos N, Niakas D (2005) Validating and norming of the Greek SF-36 Health Survey. Quality Life Res 14:1433–1438

    Article  Google Scholar 

  32. Whiting SJ, Bonjour JP, Payen FD et al (2015) Moderate amounts of vitamin D3 in supplements are effective in raising serum 25-hydroxyvitamin D from low baseline levels in adults: a systematic review. Nutrients 7:2311–2323. doi:10.3390/nu7042311

    Article  CAS  Google Scholar 

  33. Borel P, Caillaud D, Cano NJ (2015) Vitamin D bioavailability: state of the art. Crit Rev Food Sci Nutr 55:1193–1205. doi:10.1080/10408398.2012.688897

    Article  CAS  Google Scholar 

  34. Gowda U, Mutowo MP, Smith BJ et al (2015) Vitamin D supplementation to reduce depression in adults: meta-analysis of randomized controlled trials. Nutrition 31:421–429. doi:10.1016/j.nut.2014.06.017

    Article  CAS  Google Scholar 

  35. Hoffmann MR, Senior PA, Mager DR (2015) Vitamin D supplementation and health-related quality of life: a systematic review of the literature. J Acad Nutr Diet 115:406–418. doi:10.1016/j.jand.2014.10.023

    Article  Google Scholar 

  36. Shaffer JA, Edmondson D, Wasson LT et al (2014) Vitamin D supplementation for depressive symptoms: a systematic review and meta-analysis of randomized controlled trials. Psychosom Med 76:190–196. doi:10.1097/PSY.0000000000000044

    Article  CAS  Google Scholar 

  37. Spedding S (2014) Vitamin D and depression: a systematic review and meta-analysis comparing studies with and without biological flaws. Nutrients 6:1501–1518. doi:10.3390/nu6041501

    Article  CAS  Google Scholar 

  38. Checa MA, Garrido A, Prat M et al (2005) A comparison of raloxifene and calcium plus vitamin D on vaginal atrophy after discontinuation of long-standing postmenopausal hormone therapy in osteoporotic women. A randomized, masked-evaluator, one-year, prospective study. Maturitas 52:70–77. doi:10.1016/j.maturitas.2004.12.006

    Article  CAS  Google Scholar 

  39. Vieth R, Kimball S, Hu A et al (2004) Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J 3:8. doi:10.1186/1475-2891-3-8

    Article  Google Scholar 

  40. Shahzad G, Bojadzievski T, Yusupov E et al (2009) Effect of vitamin D3 on quality of life. J Am Geriatr Soc 57:2365–2366

    Article  Google Scholar 

  41. Gallagher JC, Yalamanchili V, Smith LM (2013) The effect of vitamin D supplementation on serum 25(OH)D in thin and obese women. J Steroid Biochem Mol Biol 136:195–200. doi:10.1016/j.jsbmb.2012.12.003

    Article  CAS  Google Scholar 

  42. Sohl E, Heymans MW, de Jongh RT et al (2014) Prediction of vitamin D deficiency by simple patient characteristics. Am J Clin Nutr 99:1089–1095. doi:10.3945/ajcn.113.076430

    Article  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank all study group members that contributed to the study execution: Eirini Efstathopoulou, Eftychia Apostolidou, Antigoni Tsiafitsa, Athanasios Douligeris, Konstantina Maragkopoulou, Paraskeui-Evita Siatitsa, Efstathoula Argiri and Chrysanthe Papafotiou, as well as all study participants. Support of M. Roordink for the development and production of vitamin D-enriched cheese and of Jette Jacobs for the measurement of vitamin D content in the cheese is also greatly acknowledged.

Funding

This work was supported by funding received by the authors from the European Commission under its Seventh Framework Programme (FP7) ODIN (Grant Agreement No. 613977). All cheese products were produced and provided by FrieslandCampina BV. YM, GM, EvdH, MK and KDC are grant holders.

Author contributions

Y.M., E.vdH., C.S.P., M.K. and K.D.C. contributed to the study design. G.M. and C.M. were responsible for data collection, management and statistical analyses. All authors contributed to the writing and revising of the manuscript.

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Authors and Affiliations

  1. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece

    Yannis Manios, George Moschonis & Christina Mavrogianni

  2. EnviNHealth S.A., Platonos 34, Moschato, 18345, Athens, Greece

    George Moschonis

  3. FrieslandCampina, Stationsplein 4, Post Box 1551, 3800 BN, Amersfoort, the Netherlands

    EGHM van den Heuvel & Cécile M. Singh-Povel

  4. Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland

    Mairead Kiely & Kevin D. Cashman

  5. The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland

    Mairead Kiely

  6. Department of Medicine, University College Cork, Cork, Ireland

    Kevin D. Cashman

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  1. Yannis Manios
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  2. George Moschonis
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Correspondence to Yannis Manios.

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Conflict of interest

C.S.P. and E.vdH. are employees at FrieslandCampina. None of the other authors have any potential conflict of interest to declare. Any opinions, findings, conclusions or recommendations expressed in the current study are those of the authors and do not necessarily reflect the views of FrieslandCampina.

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Manios, Y., Moschonis, G., Mavrogianni, C. et al. Reduced-fat Gouda-type cheese enriched with vitamin D3 effectively prevents vitamin D deficiency during winter months in postmenopausal women in Greece. Eur J Nutr 56, 2367–2377 (2017). https://doi.org/10.1007/s00394-016-1277-y

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