Research: ECONOMOS and COLLEAGUES,

Listed in Issue 240

Abstract

ECONOMOS and COLLEAGUES, USA, conducted a randomized, double-blind controlled trial to determine whether children consuming orange juice fortified with calcium and combinations of vitamins D, E, and A could increase serum 25-hydroxyvitamin D [25(OH)D], α-tocopherol, and retinol levels.

Background

Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins.

Methodology

To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D, E, and A could increase serum 25-hydroxyvitamin D [25(OH)D], α-tocopherol, and retinol levels. Design: A 12-week randomized, double-blind, controlled trial. Participants/Setting: One hundred eighty participants (aged 8.04±1.42 years) were recruited at Tufts (n=70) and Boston University (n=110) during 2005-2006. Of those recruited, 176 children were randomized into three groups: CaD (700 mg calcium+200 IU vitamin D), CaDEA (700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene), or Ca (700 mg calcium). Children consumed two 240-mL glasses of CaD, CaDEA, or Ca fortified orange juice daily for 12 weeks. Main Outcome Measures: Serum 25(OH)D, α-tocopherol, and retinol concentrations. Statistical Analyses: Changes in 25(OH)D, α-tocopherol, retinol, and parathyroid hormone concentrations were examined. Covariates included sex, age, race/ethnicity, body mass index, and baseline 25(OH)D, α-tocopherol, retinol, or parathyroid hormone levels. Multivariate models and repeated measures analysis of variance tested for group differences with pre-post measures (n=141).

Results

Baseline 25(OH)D was 68.4±27.7 nmol/L (27.4±11.10 ng/mL) ), with 21.7% of participants having inadequate 25(OH)D (<50 nmol/L [20.03 ng/mL]). The CaD group's 25(OH)D increase was greater than that of the Ca group (12.7 nmol/L [5.09 ng/mL], 95% CI 1.3 to 24.1; P=0.029). The CaDEA group's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups (3.79 μmol/L [0.16 μg/mL], 95% CI 2.5 to 5.1 and 3.09 μmol/L [0.13 μg/mL], 95% CI -1.8 to 4.3), respectively (P<0.0001). Retinol levels did not change, and body weight remained as expected for growth.

Conclusion

Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks.

References

Economos CD, Moore CE, Hyatt RR, Kuder J, Chen T, Meydani SN, Meydani M, Klein E, Biancuzzo RM, Holick MF. Multinutrient-fortified juices improve vitamin D and vitamin E status in children: a randomized controlled trial. J Acad Nutr Diet. 114(5):709-17. May 2014. doi: 10.1016/j.jand.2013.07.027. Epub Oct 18 2013.

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