Vitamin D fortified bread improves pain and physical function domains of quality of life in nursing home residents

J Med Food. 2014 May;17(5):625-31. doi: 10.1089/jmf.2012.0210.


Nursing home residents have severe vitamin D deficiency and increased risk of falls and fractures. These individuals may need 125 μg of vitamin D3 to achieve desirable 25-hydroxyvitamin D [25(OH)D] concentrations to improve overall health. We evaluated health-related quality of life (HRQoL) in 45 nursing home residents (28 women and 17 men, aged 58-89 years) with 25(OH)D concentrations <50 nM who consumed daily one bun that had been fortified with 125 μg vitamin D3. The Romanian version of Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) was applied at baseline and after 12 months. Data were analyzed using repeated measures analyses of variance (ANOVA). After one year supplementation, serum 25(OH)D reached optimal status (>75 nM) and bone health has improved significantly. Nursing home residents who consumed daily bread fortified with 125 μg vitamin D3 reported significant (P=.02 for the effect of time) improvement in HRQoL (total score of QUALEFFO-41). The interaction time x treatment was also statistically significant on pain (P=.04), daily activities (P=.02), and locomotion (P=.04). To ensure the serum concentrations of 25(OH)D recommended by medical groups for bone- and general-health in the older nursing residents, the practical experience shows that much higher amounts of vitamin D3 are required. Fortification of bread and cereals is a feasible way to improve vitamin D nutrition.

Keywords: bread fortification; nursing home resident; pain; quality of life; vertebral fracture; vitamin D deficiency; vitamin D fortification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Bone Density
  • Bread*
  • Calcium, Dietary / administration & dosage*
  • Cholecalciferol / administration & dosage*
  • Female
  • Food, Fortified*
  • Frail Elderly
  • Humans
  • Male
  • Middle Aged
  • Nursing Homes*
  • Osteoporosis / etiology
  • Osteoporosis / prevention & control
  • Osteoporotic Fractures / prevention & control
  • Pain
  • Quality of Life*
  • Surveys and Questionnaires
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / physiopathology


  • Calcium, Dietary
  • Vitamin D
  • Cholecalciferol
  • 25-hydroxyvitamin D