Milk, at 100 IU per glass, no longer provides enough vitamin D – Aug 2013

Impact of vitamin D fortified milk supplementation on vitamin D status of healthy school children aged 10-14 years.

Osteoporos Int. 2013 Aug;24(8):2335-43. doi: 10.1007/s00198-013-2306-9. Epub 2013 Mar 5.
Khadgawat R, Marwaha RK, Garg MK, Ramot R, Oberoi AK, Sreenivas V, Gahlot M, Mehan N, Mathur P, Gupta N.
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.

Vitamin D deficiency is a major public health problem, needing immediate attention. We studied the effect of vitamin D fortification of milk in school children. Our results show that fortification of milk is safe and effective strategy to deal with widespread vitamin D deficiency.

INTRODUCTION: Vitamin D deficiency among school children and adolescents is a well-documented major public health problem, needing immediate attention. To assess the effect of vitamin D fortified milk on serum 25 hydroxy vitamin D [S.25(OH)D] levels, we carried out a prospective double-blind randomized control trial in apparently healthy school children, aged 10-14 years.

METHODS: Of 776 subjects recruited out of 796 who consented, 713 (boys-300; girls-413) completed the study. Subjects were randomized into three groups. Group A (n = 237) received 200 ml of unfortified milk per day while group B (n = 243) and group C (n = 233) received 200 ml of milk fortified with 600 IU (15 μg) and 1,000 IU (25 μg) of vitamin D per day for 12 weeks. Serum calcium, phosphate, alkaline phosphatase, S.25(OH)D, and urinary calcium/creatinine ratio were estimated at baseline and after supplementation.

RESULTS: Hypovitaminosis D [25(OH)D < 20 ng/ml] was observed in 92.3 % subjects with mean S.25(OH)D level of 11.69 ± 5.36 ng/ml. There was no significant difference in S.25(OH)D levels among the three groups at baseline. The mean percentage change in S.25(OH)D level in groups B (137.97 %) and C (177.29 %.) were significantly greater than group A (-5.25 %). The percentage of subjects having S.25(OH)D levels >20 ng/ml following supplementation were 5.9 % in group A, 69.95 % in group B, and 81.11 % in group C in comparison to 6.32 %, 4.9 % and 12 %, respectively, at baseline.

CONCLUSION: Fortification of milk with vitamin D is an effective and safe strategy in improving S.25(OH)D levels in children aged 10-14 years.

PMID: 23460234

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8 ounce glass of full-fat milk might have 100 IU (typically vitamin D2)

To get 600 IU daily (which might achieve a Vitamin D level of 20 ng/ml)

6 glasses of full-fat milk
15 glasses of skim milk

See also VitaminDWiki

• Low fat milk provides 2.5 times less vitamin D – May 2016
• Children no longer get much vitamin D from milk - fortify at home
• Most milk did not have the 400 IU of vitamin D - 1992
• Food fortified by 440 IU increased vitamin D levels by 8 ng – meta-analysis June 2012
• Even with 400 IU of vitamin D in winter, 1 in 6 were still vitamin D deficient – RCT Aug 2013
• FDA doubles the amount of vitamin D permitted in milk – July 2016
  • Will not help much with increased use of low-fat and skimmed milk
• All items in category Fortification of vitamin D 135 items