Skip to main content

Bread as a Vehicle Vitamin D Fortification: Application to Nursing Home Residents

  • Chapter
  • First Online:
Handbook of Food Fortification and Health

Part of the book series: Nutrition and Health ((NH))

Abstract

Vitamin D deficiency is extremely prevalent in the older adults. Most often the first symptoms are caused by myopathy with muscle pain, fatigue, muscular weakness, and gait disturbances. More severe deficiency causes osteomalacia with deep bone pain, reduced mineralization of bone matrix and fractures. The conditions suggested to be associated with vitamin D insufficiency include total mortality, osteoporosis, muscle weakness, pain, cancer, cardiovascular disease, infections, and falls [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

1,25(OH)2D:

1,25-Dihydroxyvitamin D

25(OH)D:

25-Hydroxyvitamin D

IGF-1:

Insulin-like growth factor

IU:

International unit

QoL:

Quality of life

QUALEFFO 41:

Questionnaire especially developed for measuring quality of life in patients with vertebral deformities

RDA:

Recommended dietary allowance

UL:

Tolerable upper intake level

UVB:

Ultraviolet B rays

References

  1. Holick MF. Vitamin D: evolutionary, physiological and health perspectives. Curr Drug Targets. 2011;12:4–18.

    Article  PubMed  CAS  Google Scholar 

  2. Mocanu V, Stitt PA, Costan AR, Voroniuc O, Zbranca E, Luca V, et al. Long-term effects of giving nursing home residents bread fortified with 125 microg (5000 IU) vitamin D(3) per daily serving. Am J Clin Nutr. 2009;89:1132–7.

    Article  PubMed  CAS  Google Scholar 

  3. McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med. 1992;93:69–77.

    Article  PubMed  CAS  Google Scholar 

  4. Harris SS, Soteriades E, Coolidge JA, Mudgal S, Dawson-Hughes B. Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab. 2000;85:4125–30.

    Article  PubMed  CAS  Google Scholar 

  5. Liu BA, Gordon M, Labranche JM, Murray TM, Vieth R, Shear NH. Seasonal prevalence of vitamin D deficiency in institutionalized older adults. J Am Geriatr Soc. 1997;45:598–603.

    PubMed  CAS  Google Scholar 

  6. Drinka PJ, Krause PF, Nest LJ, Goodman BM. Determinants of vitamin D levels in nursing home residents. J Am Med Dir Assoc. 2007;8:76–9.

    Article  PubMed  Google Scholar 

  7. Kinyamu HK, Gallagher JC, Balhorn KE, Petranick KM, Rafferty KA. Serum vitamin D metabolites and calcium absorption in normal young and elderly free-living women and in women living in nursing homes. Am J Clin Nutr. 1997;65:790–7.

    PubMed  CAS  Google Scholar 

  8. Bruyere O, Decock C, Delhez M, Collette J, Reginster JY. Highest prevalence of vitamin D inadequacy in institutionalized women compared with noninstitutionalized women: a case–control study. Womens Health (Lond Engl). 2009;5:49–54.

    Article  Google Scholar 

  9. Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI. Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res. 2002;17:709–15.

    Article  PubMed  CAS  Google Scholar 

  10. Atli T, Gullu S, Uysal AR, Erdogan G. The prevalence of vitamin D deficiency and effects of ultraviolet light on vitamin D levels in elderly Turkish population. Arch Gerontol Geriatr. 2005;40:53–60.

    Article  PubMed  CAS  Google Scholar 

  11. Chel V, Wijnhoven HA, Smit JH, Ooms M, Lips P. Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents. Osteoporos Int. 2008;19:663–71.

    Article  PubMed  CAS  Google Scholar 

  12. Nashimoto M, Nakamura K, Matsuyama S, Hatakeyama M, Yamamoto M. Hypovitaminosis D and hyperparathyroidism in physically inactive elderly Japanese living in nursing homes: relationship with age, sunlight exposure and activities of daily living. Aging Clin Exp Res. 2002;14:5–12.

    PubMed  CAS  Google Scholar 

  13. Theiler R, Stahelin HB, Tyndall A, Binder K, Somorjai G, Bischoff HA. Calcidiol, calcitriol and parathyroid hormone serum concentrations in institutionalized and ambulatory elderly in Switzerland. Int J Vitam Nutr Res. 1999;69:96–105.

    Article  PubMed  CAS  Google Scholar 

  14. Zochling J, Sitoh YY, Lau TC, Cameron ID, Cumming RG, Lord SR, et al. Quantitative ultrasound of the calcaneus and falls risk in the institutionalized elderly: sex differences and relationship to vitamin D status. Osteoporos Int. 2002;13:882–7.

    Article  PubMed  CAS  Google Scholar 

  15. Fardellone P, Sebert JL, Garabedian M, Bellony R, Maamer M, Agbomson F, et al. Prevalence and biological consequences of vitamin D deficiency in elderly institutionalized subjects. Rev Rhum Engl Ed. 1995;62:576–81.

    PubMed  CAS  Google Scholar 

  16. Ovesen L, Andersen R, Jakobsen J. Geographical differences in vitamin D status, with particular reference to European countries. Proc Nutr Soc. 2003;62:813–21.

    Article  PubMed  CAS  Google Scholar 

  17. Bates CJ, Carter GD, Mishra GD, O’Shea D, Jones J, Prentice A. In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? A study of people aged 65 years and over from the British National Diet and Nutrition Survey. Osteoporos Int. 2003;14:152–9.

    PubMed  CAS  Google Scholar 

  18. Lee LT, Drake WM, Kendler DL. Intake of calcium and vitamin D in 3 Canadian long-term care facilities. J Am Diet Assoc. 2002;102:244–7.

    Article  PubMed  Google Scholar 

  19. Suominen MH, Hosia-Randell HM, Muurinen S, Peiponen A, Routasalo P, Soini H, et al. Vitamin D and calcium supplementation among aged residents in nursing homes. J Nutr Health Aging. 2007;11:433–7.

    PubMed  CAS  Google Scholar 

  20. European Commission. Report on osteoporosis in the European Community ± action on prevention. Luxembourg: Office for Official Publications of the European Communities; 1998. p. 112.

    Google Scholar 

  21. US Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academy Press; 2011.

    Google Scholar 

  22. European Commission Scientific Committee on Food. Opinion of the scientific committee on food on the tolerable upper intake level of vitamin D. 2002 December. Available from: http://ec.europa.eu/food/fs/sc/scf/out157_en.pdf.

  23. Bischoff-Ferrari H, Dawson-Hughes B. Relevance of vitamin D deficiency in adult fracture and fall prevention. In: Feldman PA, editor. Vitamin D. 3rd ed. New York: Elsevier; 2011.

    Google Scholar 

  24. Cranney A, Horsley T, O’Donnell S, Weiler H, Puil L, Ooi D, et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep). 2007;158:1–235.

    Google Scholar 

  25. Vitamin D Individual Patient Analysis of Randomized Trials (DIPART) Group. Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe. BMJ. 2010;340:b5463.

    Google Scholar 

  26. Law M, Withers H, Morris J, Anderson F. Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing. 2006;35:482–6.

    Article  PubMed  Google Scholar 

  27. Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM. Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med. 1996;124:400–6.

    Article  PubMed  CAS  Google Scholar 

  28. Holick MF. Vitamin D, deficiency. N Engl J Med. 2007;357:266–81.

    Article  PubMed  CAS  Google Scholar 

  29. Al Faraj S, Al MK. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine (Phila Pa 1976). 2003;28:177–9.

    Article  Google Scholar 

  30. van den Bergh JP, Bours SP, van Geel TA, Geusens PP. Optimal use of vitamin D when treating osteoporosis. Curr Osteoporos Rep. 2011;9:36–42.

    Article  PubMed  Google Scholar 

  31. Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003;77:204–10.

    PubMed  CAS  Google Scholar 

  32. Vieth R. The pharmacology of Vitamin D. In: Feldman PA, editor. Vitamin D. 3rd ed. New York: Elsevier; 2011.

    Google Scholar 

  33. O’Donnell S, Cranney A, Horsley T, Weiler HA, Atkinson SA, Hanley DA, et al. Efficacy of food fortification on serum 25-hydroxyvitamin D concentrations: systematic review. Am J Clin Nutr. 2008;88:1528–34.

    Article  PubMed  Google Scholar 

  34. de Jong N, Chin APMJ, de Groot LC, de Graaf C, Kok FJ, van Staveren WA. Functional biochemical and nutrient indices in frail elderly people are partly affected by dietary supplements but not by exercise. J Nutr. 1999;129:2028–36.

    PubMed  Google Scholar 

  35. Dunnigan MG, Fraser SA, McIntosh WB, Moseley H, Sumner DJ. The prevention of vitamin D deficiency in the elderly. Scott Med J. 1986;31:144–9.

    PubMed  CAS  Google Scholar 

  36. Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: current status and data needs. Am J Clin Nutr. 2004;80:1710S–6.

    PubMed  CAS  Google Scholar 

  37. Tylavsky FA, Cheng S, Lyytikainen A, Viljakainen H, Lamberg-Allardt C. Strategies to improve vitamin D status in northern European children: exploring the merits of vitamin D fortification and supplementation. J Nutr. 2006;136:1130–4.

    PubMed  CAS  Google Scholar 

  38. Natri AM, Salo P, Vikstedt T, Palssa A, Huttunen M, Karkkainen MU, et al. Bread fortified with cholecalciferol increases the serum 25-hydroxyvitamin D concentration in women as effectively as a cholecalciferol supplement. J Nutr. 2006;136:123–7.

    PubMed  CAS  Google Scholar 

  39. Costan R, Zbranca E, Gotca I, Calatoru D, Costan V, Mocanu V. [Compliance with bread fortified with vitamin D and calcium in elderly]. Rev Med Chir Soc Med Nat Iasi. 2008;112:951–4.

    PubMed  Google Scholar 

  40. Vieth R, Kimball S, Hu A, Walfish PG. 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. 2004;3:8.

    Article  PubMed  Google Scholar 

  41. Torvik K, Kaasa S, Kirkevold O, Rustoen T. Pain and quality of life among residents of Norwegian nursing homes. Pain Manag Nurs. 2010;11:35–44.

    Article  PubMed  Google Scholar 

  42. Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H. Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int. 2009;20:315–22.

    Article  PubMed  CAS  Google Scholar 

  43. Johnson Q, Mannar V, Ranum P. Vitamin and mineral fortification of wheat flour, The Micronutrient Initiative Fortification Handbook. Wesley A and Ranum P, editors, 2004 (Internet) Available from: http://www.micronutrient.org/resources/publications/Fort_handbook.pdf.

  44. Heaney RP. Barriers to optimizing vitamin D3 intake for the elderly. J Nutr. 2006;136:1123–5.

    PubMed  CAS  Google Scholar 

  45. Schwalfenberg GK, Genuis SJ. Vitamin D supplementation in a nursing home population. Mol Nutr Food Res. 2010;54:1072–6.

    PubMed  CAS  Google Scholar 

  46. Aloia JF, Patel M, Dimaano R, Li-Ng M, Talwar SA, Mikhail M, et al. Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration. Am J Clin Nutr. 2008;87:1952–8.

    PubMed  CAS  Google Scholar 

  47. Vieth R. Critique of the considerations for establishing the tolerable upper intake level for vitamin D: critical need for revision upwards. J Nutr. 2006;136:1117–22.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Veronica Mocanu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Mocanu, V., Galesanu, C., Vieth, R. (2013). Bread as a Vehicle Vitamin D Fortification: Application to Nursing Home Residents. In: Preedy, V., Srirajaskanthan, R., Patel, V. (eds) Handbook of Food Fortification and Health. Nutrition and Health. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7110-3_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7110-3_15

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4614-7109-7

  • Online ISBN: 978-1-4614-7110-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics