Calcium and vitamin D fortified milk reduces bone turnover and improves bone density in postmenopausal women over 1 year

Eur J Nutr. 2018 Dec;57(8):2785-2794. doi: 10.1007/s00394-017-1544-6. Epub 2017 Oct 3.


Purpose: In Malaysia, hip fracture incidence is higher in Chinese women than other ethnic groups. This study compared the effects of a high-calcium vitamin D fortified milk with added FOS-inulin versus regular milk over 1 year on aspects of bone health in Chinese postmenopausal women in Malaysia.

Methods: One-hundred and twenty-one women (mean age 59 (± 4) years) were randomized into two groups: control (n = 60; regular milk, 428 mg calcium per day) or intervention (n = 61; fortified milk at 1200 mg calcium, 96 mg magnesium, 2.4 mg zinc, 15 μg vitamin D and 4 g FOS-inulin per day). At baseline, weeks 12, 24, 36 and 52, parathyroid hormone (PTH), C-Telopeptide of Type I Collagen (CTx-1), Procollagen I Intact N-Terminal propeptide (PINP) and vitamin D levels were assessed. Bone density (BMD) was measured at baseline and week 52 using a GE Lunar iDXA.

Results: Body mass index, lumbar spine and femoral neck BMD did not differ between groups at baseline. Over 52 weeks, mean plasma 25 (OH) D3 levels increased to 74.8 nmol/L (intervention group) or remained at 63.1 nmol/L (control group) (p < 0.001 between groups). PTH levels increased in the control group (p = 0.001). The intervention resulted in a significant suppression of CTx-1 and PINP at p = 0.018 and p = 0.004. Femoral neck BMD remained stable in the intervention group but decreased significantly in the controls, with a borderline treatment effect (p = 0.07).

Conclusion: Compared with regular milk, the fortified milk suppressed bone turnover markers and tended to increase femoral neck BMD.

Keywords: Bone density; Bone markers; Fortified milk; Postmenopausal women.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Body Mass Index
  • Bone Density*
  • Bone Remodeling*
  • Calcium, Dietary / administration & dosage*
  • Calcium, Dietary / blood
  • Collagen Type I / blood
  • Female
  • Femur Neck / physiology
  • Follow-Up Studies
  • Food, Fortified*
  • Humans
  • Malaysia
  • Middle Aged
  • Milk / chemistry*
  • Parathyroid Hormone / blood
  • Peptides / blood
  • Postmenopause
  • Procollagen / blood
  • Surveys and Questionnaires
  • Vitamin D / administration & dosage*
  • Vitamin D / blood


  • Calcium, Dietary
  • Collagen Type I
  • Parathyroid Hormone
  • Peptides
  • Procollagen
  • collagen type I trimeric cross-linked peptide
  • Vitamin D