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Effects of school milk intervention on cortical bone accretion and indicators relevant to bone metabolism in Chinese girls aged 10–12 y in Beijing^1,2,3

From the Faculty of Veterinary Science (KZ, XD, HG, and DRF) and the School of Public Health (TAD), University of Sydney, Sydney, Australia; the Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Westmead, Australia (CTC and BB); and the Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China (QZ)

Background: We previously reported that increased milk consumption enhances growth and bone mineral accretion in Chinese girls aged 10–12 y.

Objective: Our objective was to evaluate the effects of milk supplementation on cortical bone accretion and to study the physiologic mechanisms underlying the observed changes in bone.

Design: Chinese girls aged 10 y were randomly assigned into calcium-fortified milk (Ca milk), calcium and vitamin D–fortified milk (CaD milk), and control groups according to their schools in a 24-mo school milk intervention trial. Periosteal and medullary diameters of metacarpal bone were measured at baseline and 24 mo in the Ca milk (n = 177), CaD milk (n = 210), and control (n = 219) groups. Insulin-like growth factor I (IGF-I), parathyroid hormone (PTH), bone alkaline phosphatase (BAP), osteocalcin, and deoxypyridinoline concentrations were measured at baseline and at 12 and 24 mo in the Ca milk (n = 43), CaD milk (n = 44), and control (n = 41) groups.

Results: After adjustment for pubertal status and clustering by school, 24-mo supplementation led to greater increases in periosteal diameter (1.2%) and cortical thickness (5.7%) and to smaller gains in medullary diameter (6.7%) than did the control (P < 0.05). The CaD milk group had lower serum BAP at 12 mo (19.9%) and lower serum PTH at 12 (46.2%) and 24 (16.4%) mo than did the control group (P < 0.05). The effect of milk supplementation on increasing IGF-I concentrations at 24 mo (16.7–23.3%) was significant in individual analyses but not after adjustment for clustering by school.

Conclusions: Milk supplementation showed positive effects on periosteal and endosteal apposition of cortical bone.

Key Words: Fortified milk • Chinese girls • cortical bone accretion • bone alkaline phosphatase • insulin-like growth factor I

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