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Effects of Adding Chymosin to Milk on Calcium Homeostasis: A Randomized, Double-Blind, Cross-Over Study

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Abstract

Calcium intake and absorption is important for bone health. In a randomized double-blind cross-over trial, we investigated effects of adding chymosin to milk on the intestinal calcium absorption as measured by renal calcium excretion and indices of calcium homeostasis. The primary outcome of the study was 24-h renal calcium excretion that is considered a proxy measure of the amount of calcium absorbed from the intestine. We studied 125 healthy men and women, aged 34 (25–45) years on two separate days. On each day, a light breakfast was served together with 500 ml of semi-skimmed milk to which either chymosin or similar placebo was added. Compared with placebo, chymosin did not affect 24-h urinary calcium, calcium/creatinine ratio, plasma parathyroid hormone, calcitonin or ionized calcium levels. However, during the first 4 h after intake of milk with chymosin, urinary calcium–creatinine ratio was significantly increased (17 %) compared with placebo. Stratification by daily calcium intake showed effect of chymosin in participant with a habitual intake above the median (>1,050 mg/day) in whom both urinary calcium and calcium/creatinine ratio were significantly increased compared with placebo. Effects did not depend on plasma 25-hydroxyvitamin D levels. Chymosin added to milk increases renal calcium excretion in the hours following intake without affecting plasma levels of calcium or calciotropic hormones. The effect most likely represents enhanced intestinal calcium absorption shortly after intake. Further studies are warranted on whether intake of milk-added chymosin may cause beneficial effects on bone. www.ClinicalTrials.gov no. NCT01370941.

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Conflict of Interest

Chymosin was delivered free of charge by Chr. Hansen Holding A/S (Hørsholm, Denmark). Semi-skimmed milk for the study was purchased commercially. Nutrichym A/S, Norway provided financial support for the study. Ulla Kristine Møller, Lars Thorbjørn Jensen, Leif Mosekilde and Lars Rejnmark declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

Each study participant gave verbal and written informed consent prior to the study.

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Authors and Affiliations

  1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000, Aarhus C, Denmark

    Ulla Kristine Møller, Leif Mosekilde & Lars Rejnmark

  2. Department of Clinical Physiology, Glostrup University Hospital, Copenhagen, Denmark

    Lars Thorbjørn Jensen

Authors
  1. Ulla Kristine Møller
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  2. Lars Thorbjørn Jensen
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  3. Leif Mosekilde
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  4. Lars Rejnmark
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Correspondence to Lars Rejnmark.

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Møller, U.K., Jensen, L.T., Mosekilde, L. et al. Effects of Adding Chymosin to Milk on Calcium Homeostasis: A Randomized, Double-Blind, Cross-Over Study. Calcif Tissue Int 96, 105–112 (2015). https://doi.org/10.1007/s00223-014-9942-8

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  • DOI: https://doi.org/10.1007/s00223-014-9942-8

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