Fighting high blood pressure and vitamin D deficiency could be as simple as a glass of milk and a healthy dose of sunshine.
By Gloria Dawson April 8, 2010
Two new studies demonstrate some age-old advice: A glass of milk and a healthy dose of sunshine could be the best defense for your kids against high blood pressure and vitamin D deficiency. One study put out by the Albert Einstein College of Medicine and published in the most recent issue of Pediatrics found that seven in 10 kids have low levels of vitamin D. Another study published in the Archives of Pediatric and Adolescent Medicine sees a correlation in the amount of time children spend watching TV and how high their blood pressure is.
In the study focusing on vitamin D deficiency, researches analyzed data on more than 6,000 children, ages one to 21. The researchers found that 9% of the children in the study, the equivalent to 7.6 million children across the U.S., were vitamin D deficient. Another 61%, or 50.8 million children, are vitamin D insufficient. Low levels of vitamin D raise the risk of bone disease, as well as heart disease and other risk factors for heart disease such as high blood pressure.
Those most at risk for vitamin D deficiency are children who are older, female, African-American, Mexican-American, obese and those children who drank milk less than once a week, or who spent more than four hours a day watching TV, playing videogames or using computers.
Taking vitamin D supplements and drinking more milk and fish, which are high in the vitamin, are ways to combat the deficiency. Dr. Michal L. Melamed, the study leader, also suggests that, “It would be good [the parents] for them to turn off the TV and send their kids outside. Just 15 to 20 minutes a day should be enough. And unless they burn easily, don’t put sunscreen on them until they’ve been out in the sun for 10 minutes, so they get the good stuff but not sun damage.”
In another study, researches also suggest getting your kids away from the TV, this time to prevent high blood pressure. The study showed children spend on average five hours each day sedentary, and of that time 1.5 hours are spent in front of the TV. The correlation between high blood pressure and screen time did not exist for computer time, only time spent in front of the TV. The findings held true regardless of the childrens’ weight.
“Given that total objective sedentary time was not associated with elevated blood pressure, it appears that other factors, which occur during excessive screen time, should also be considered,” including unhealthy snacking, the study states. The American Academy of Pediatrics recommends no more then two hours of TV per day, which should be combined with at least 60 minutes of physical activity a day.
It would seem that outside play can help tackle high blood pressure and vitamin D deficiency in your children, not to mention fighting weight gain and boredom. Having trouble getting your kids outside? The Daily Green has teamed up with National Wildlife Federation and has come up with 30 Ways to Get Your Kid to Play Outside.
By Todd Neale, Staff Writer, MedPage Today April 28, 2010 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
PRAGUE — Among patients who have suffered a traumatic brain injury, vitamin D deficiency is associated with an increased likelihood of having chronic fatigue, Dutch researchers found.
Of 90 such patients, 80% who were fatigued had the vitamin deficiency, compared with 40% of those who were not fatigued (P<0.05), Jessica Schnieders, MD, of Rijnstate Hospital in Arnhem, the Netherlands, reported at the European Congress of Endocrinology in Prague.
Having a sleep disorder strengthened the association between vitamin D deficiency — defined as a level less than 50 nmol/L — and fatigue, Schnieders said in an interview.
“I think it’s important to get knowledge to the patients, the rehabilitation doctors, and the family doctors that they should look at vitamin D and sleep in these patients,” she said.
Schnieders said all of the patients who had a vitamin D deficiency were treated, and many said they felt better.
Although the study could not establish a causal relationship between low vitamin D levels and fatigue, treating the vitamin deficiency can benefit other areas, including bone health, she said.
Previous studies have shown that some patients with a traumatic brain injury have hormone deficiencies related to damage to the pituitary gland. Schnieders and her colleagues wanted to find out whether this, as well as other factors like vitamin D deficiency, might explain the fatigue commonly seen after traumatic brain injury.
The researchers randomly selected 100 former patients of their rehabilitation center to participate in the study, and 90 agreed (26 females and 64 males). It had been about 10 years since the traumatic brain injuries.
All filled out a fatigue questionnaire and provided information on emotional well-being, quality of life, attention, coping style, daily activity, and physical performance as assessed on a cycling test. The researchers also measured vitamin D levels.
Slightly more than half (51%) of the patients reported being severely fatigued. As expected, these patients had more anxiety and a lower quality of life.
Deficiency in at least one of the pituitary hormones was identified in 29%, growth hormone deficiency was found in 24%, and gonadal hormone deficiency was observed in 10%. None of these deficiencies was significantly related to fatigue.
In a multivariate analysis including hormone deficiencies, vitamin D deficiency, sleep problems, attention, body mass index, and gender, vitamin D deficiency was the only factor independently associated with fatigue (P<0.05).
It is unclear why sleep problems strengthened the negative effect of vitamin D deficiency on fatigue, but Schnieders said there is some evidence linking melatonin, which is involved in regulating circadian rhythms, and vitamin D.
The observational study could not prove that vitamin D deficiency was causing the fatigue.
Schnieders said another possible explanation for the findings could be that fatigued patients are more likely to remain inside and not get enough exposure to sunlight.
“But I think it has something to do with the immunological system because both sleep and vitamin D are involved in the immunological system,” she said.
Schnieders reported no conflicts of interest.
One of the most interesting medical research papers to arrive in recent memory is a 2009 study reported in the British Journal of Dermatology entitled, “Melanoma epidemic: a midsummer night’s dream?”  In it the authors make the case that melanoma is not caused by sunlight, but rather by an increasing diagnosis of benign lesions as melanoma. In other words, small spots on the skin that are harmless, and that in the past would have been classified as benign, are now being called stage-one melanoma. The authors point out that new diagnoses of stage-one melanoma have increased dramatically over the past few years, but new diagnoses of stage-two, -three and -four melanomas have not increased at all.
Some have suggested that the lack of increase in the latter stages of Melanoma is due to quick removal of the type-one melanomas, which prevents their progression to full-blown cancers. However, the authors point out that those in the study with type-two, three and four melanomas had not been previously diagnosed with type-one, and therefore could not have been “saved” by removal of type-one; the advanced cases were new presentations–people who had not been previously diagnosed with any stage of melanoma.
The case of these dermatologists—that melanoma is a “midsummer night’s dream”—is compelling. Obviously, millions of people who had nothing more than harmless lesions have been diagnosed with melanoma and have had their lesions removed surgically.
The researchers ended their analysis with this statement: “These findings should lead to a reconsideration of the treatment of ‘early’ lesions, a search for better diagnostic methods to distinguish them from truly malignant melanomas, re-evaluation of the role of ultraviolet radiation and recommendations for protection from it, as well as the need for a new direction in the search for the cause of melanoma.”
I can only say “amen” to this conclusion. However, these are not the first dermatologists to question the “epidemic” of melanoma and deny that sunlight is the cause. Dr. Bernard Ackerman, a celebrated dermatologist, wrote a monograph of several hundred pages entitled, Sunlight and the “Epidemic’ of Melanoma, Myth on Myth, in which he made the same argument about the supposed melanoma epidemic being due to incorrect diagnoses. Dr. Arthur Rhodes, another dermatologist, has also given examples of many people who have died with real melanoma that occurred on areas of the body that were never exposed to sunlight. These unfortunate people, believing that the lesions they discovered could not be melanoma because there was no sun exposure, failed to get help until it was too late.
Meanwhile, the world becomes more and more deficient in vitamin D due to the efforts of the “sunscare” movement that would have us believe that sunlight, one of God’s greatest gifts to living beings, is public enemy number one. This has resulted in incredible rates of vitamin D deficiency which have further resulted in an increase in at least 18 major cancers including breast, prostate and colon cancers. It has also resulted in increasing rates of heart disease, infections including flu, autism, and numerous other maladies that I discuss and fully document in my book. Never has there been a greater fraud than the push to scare people out of the sun to avoid a disease—melanoma—that is not an epidemic at all, and whose risk is increased by sun avoidance. Non-burning sunlight exposure is absolutely necessary for optimal human health.
Not only is the “epidemic” of melanoma a midsummer night’s dream, it has become a vitamin D-deficiency nightmare.
 N.J. Levell, C.C. Beattie,* S. Shuster and D.C. Greenberg* Melanoma epidemic: a midsummer night’s dream? British Journal of Dermatology 2009;161:630–634  Ackerman, A. Sun and the “Epidemic” of Melanoma, Myth on Myth. Ardor Scribendi, LTD, New York, 2008  Rhodes, A. Guest editorial, Melanoma’s Public Message. Skin and Allergy News 2003;34:1-4
Recent evidence has shown that pregnant mothers who were given 4,000 IU (ten times the usual dose) of vitamin D daily had only half the risk of giving birth to premature babies as those who were not supplemented.  That amount can also be produced by about 20 minutes of full- body exposure to non-burning sunlight at midday.
The importance of this information is shown in the fact that annually, half of all premature babies die in the first month after birth, according to the March of Dimes. In North America, about 500,000 premature births occur annually. If vitamin D supplementation could prevent half of these deaths, that would save the lives of 250,000 babies per year. Worldwide, the lives saved might be as many as 7 million, since approximately 13 million babies are born prematurely each year. We also know that the average cost for each premature baby in the first year of life is about $49,000. http://www.marchofdimes.com/aboutus/22684_55250.asp
Premature babies, of course, are also low-birth-weight babies in most cases, which present an additional problem. Here is one more reason for mothers to get back in the sunlight: the potential for low birth weight in their babies.
Low birth weight is associated with poor mood, anxiety, depression, high blood pressure and other problems during childhood and afterward. Recent research shows that low birth weight is related to exposure by pregnant women to winter temperatures during a critical developmental time for the fetus.  This could indicate vitamin D deficiency of the pregnant mother during “vitamin D winter,” the time of year in northern latitudes when the sun is too low in the sky to produce vitamin D. The answer, of course, is to use a tanning bed or take vitamin D3 supplements (3,000-5,000 IU) during the winter. Remember never to burn!
Those who make a living frightening people out of the sunlight are responsible for much of the vitamin D deficiency in the population of North America. Don’t expect them to change. Non-burning sunlight is a wonderful gift for health, and we must stop the insanity that is causing vitamin D deficiency. The child needs every possible advantage prior to birth, and one of the advantages is a mom with high vitamin D levels. The only source of vitamin D for the fetus is the mother’s body, and the only natural way to obtain vitamin D is exposure to sunlight.
 Hollis, B. and Wagner C. Report from an international conference on vitamin D in Bruges, Belgium.  March of Dimes statement Oct 4, 2009, based on World Health Organization (WHO) statistics.   Elter K, et al. Exposure to low outdoor temperature in the midtrimester is associated with low birth weight. Aust N Z J Obstet Gynecol 2004;44:553-7.  Murray, L. et al. Links of Season and outdoor ambient temperature: effects on birth weight. Obstet Gynecol. 2000 Nov;96(5 Pt 1):689-95. – See more at: http://www.sunlightinstitute.org/do-250000-north-american-babies-die-each-year-due-vitamin-d-deficiency#sthash.LO4THgwB.dpuf
It appears that the first case of drug-resistant TB has arrived in the US from Peru. It is nearly 100% resistant to antibiotics, and does not bode well for the country, since it could cause an immense killer epidemic. There seems to be no answer to the “superbug” that causes it. Or is there an answer? Could sunlight and its skin-produced hormone, vitamin D, provide answers to this latest health threat?
Sunlight has a long history of treatment for tuberculosis. Much of the following discussion of TB comes from Dr. Fielder’s history of heliotherapy.
As early as 1857 Madame Duhamel of France exposed children with TB to sunshine because it hastened their recovery. Many doctors of that same era used heliotherapy (sunlight treatments) with great success, and as Dr. Fielder states, “As a general rule, the experience of all the Hygienists in their use of sunbathing was so successful that all question of doubt as to its place in the Hygienic System was ensured.”
Madame Duhamel was correct about sunbathing healing tuberculosis (TB). Later on, a disillusioned physician, Dr. Rollier, gave up a promising surgical practice and moved to the mountains of the Swiss countryside to practice medicine there. However, he discovered that the people needed little help, as they were seldom sick. People were always telling him, “Where the sun is, the doctor ain’t [sic].” In fact, Dr. Rollier’s fiancée had TB and would have died without intervention. He brought her to the Alpine area, exposed her regularly to sunshine, and she completely recovered.
Dr. Rollier opened a sanatorium in 1903 that was really just an extremely large solarium (sunbathing facility) with patient living quarters. There were 2,167 patients under Dr. Rollier’s care for TB following World War One. Of these, 1,746 completely recovered their health. Only those in the most advanced stages of the disease failed to recover.
In 1895, Dr. Niels Finsen made use of the first artificial UV light in treating patients with a particularly virulent form of TB known as lupus vulgaris (a skin disease). Though the disease was considered incurable, 41 of every 100 patients under his care recovered. Finsen’s work earned the Nobel Prize in medicine in 1903.
These researchers and physicians were not alone in their observations of the therapeutic power of sunlight. In 1877 two scientists, Arthur Downes and Thomas Blunt, discovered that sunlight was bactericidal. In 1890, the German microbiologist Robert Koch (who had isolated and described the tuberculosis bacterium in 1882), showed that sunlight killed TB bacteria.
Recently, the interest in Vitamin D to thwart TB is being revisited.   and it has been shown that Black immigrants to Australia have much lower vitamin D levels than the general population and a much higher risk of TB. Moreover, the effectiveness of vitamin D was demonstrated against the TB bacteria in an experiment in which a single dose of vitamin D (100,000 IU) significantly increased immunity to the TB bacterium. The effectiveness of vitamin D against TB is determined by the production of cathelicidin, an antibacterial peptide, which we could call the “body’s natural antibiotic.”
Further corroborating vitamin D’s essential role is that people who lack vitamin D receptors (VDR) are three times more likely to contract TB as those with normal VDR. Vitamin D also inhibits the body’s inflammatory response to TB infection in the lungs.  Considering the efficacy of sunlight therapy and vitamin D in inhibiting or even curing tuberculosis, doesn’t it seem that it’s time to return to the sun? Remember that you should never burn yourself in the sunlight.
 http://www.sphere.com/nation/article/first-case-of-highly-drug-resistant…  Fielder, J. Heliotherapy: the principles & practice of sunbathing. Soil and Health Library (online) http://www.soilandhealth.org/index.html.  Hobday, R. The Healing sun. Findhorn Press 1999:132  Martineau, A. Effect of vitamin D supplementation on anti-mycobacterial immunity: a double-blind randomized placebo-controlled trial in London tuberculosis contacts. Int J Tuberculosis Lung Dis 2005;9:S173.  Martineau, A. et al. Vitamin D status of tuberculosis patients and healthy blood donors in Samara City, Russia. Int J Tuberculosis Lung Dis 2005;9:S225.  Nnoaham, K. et al. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 2008;37:113-19. Gibney, K. et al. vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa. Clin Infect Dis 2008’46:443-46. Martineau, A et al. A single dose of vitamin D enhances immunity of mycobacteria. A J Respir Crit Care Med 2007;176:208-13. Liu, P. et al. vitamin D mediated human antimicrobial activity against mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol 2007;179:2060-63. Liu, W. et al. A case-control study on the vitamin D receptor gene polymorphisms and susceptibility to pulmonary tuberculosis. Zhonghua Liu Xing Bing Xue Za Zhi 2003;24:389-92.  Selvaraj, P et al. Regulatory role of promoter and 3’ UTR variants of vitamin D receptor gene on cytokine response in pulmonary tuberculosis. J Clin Immunol 2008; January 30. Epub ahead of print. Vidyarani, M. et al. 1, 25 Hydroxyvitamin D3 modulated cytokine response in pulmonary tuberculosis. Cytokine 2007;40:128-34. – See more at: http://www.sunlightinstitute.org/will-vitamin-d-stop-new-killer-strain-drug-resistant-tuberculosis-or-sunlight-cure#sthash.PTDnd37d.dpuf
40% of Children Have Vitamin D Deficiency How to Make Sure Your Kid Isn’t One of Them
By Dan Shapley April 6, 2010
At least 40% of infants and toddlers, and 42% of teens, aren’t getting enough vitamin D, the “sunshine vitamin,” according to new research.
Vitamin D is produced when the body reacts to sunlight, and helps the body absorb calcium. Without it, people are prone to bone disease, autoimmune diseases like diabetes, multiple sclerosis and certain cancers, as the Washington Post put it — as well as increased risk for heart attacks (learn more here).
The new Boston Children’s Hospital research, on infants and toddlers, suggests that nursing mothers should be giving their children Vitamin D supplements, since human breast milk lacks the fortification given to store-bought milk.
Teens may also need supplements, researchers told the Post.
Another solution we humbly suggest? Go outside. While it is important to be careful to avoid overexposure to the sun, there’s no reason people can’t get more Vitamin D the natural way.
In our hyperconnected, hyperfearful times, we’re more apt to stay indoors plugged into a computer, video game, television or PDA than to take a walk outside, play sports, fish or otherwise get some sun. Parents are increasingly concerned about the threat of pedophiles and the like, so children are less apt to just take off for the great outdoors unsupervised.
There were already good reasons to make sure – via whatever extra effort is necessary – that children aren’t suffering from so-called nature deficit disorder. There’s the food for the soul argument, the inspiration for creativity argument, the exercise for health argument, and now there’s another: good nutrition.
It’s a poignant commentary about a society when its children lack the sunshine vitamin.
Children who took vitamin D supplements during the cold and flu season escaped seasonal flu and asthma attacks, according to a study published in the American Journal of Clinical Nutrition and reported by Reuters.
For the three-month study, done during cold and flu season, researchers from the Jikei University School of Medicine in Tokyo randomly assigned 167 children, ages 6 to 15, to take 1,200 international units (IU) of vitamin D-3 or a placebo each day.
Vitamin D-3 is more readily absorbed and more potent than vitamin D-2 (usually found in multivitamins).
Scientists noted that only 18 children taking vitamin D caught influenza A compared with 31 kids taking the placebo. Overall, the vitamin D group was 58 percent less likely to catch influenza A.
In addition, vitamin D also seemed to suppress asthma attacks in children with a history of asthma. Two children taking the supplement had asthma attacks compared with 12 children taking the placebo.
Based on the study, researchers concluded that vitamin D-3 supplements may reduce influenza A. They also suggested parents check with their pediatricians about giving their children 1,200 IU of vitamin D per day starting in September to prevent asthma and flu during the flu season.
By BJS —
Forty-three percent of patients scheduled to undergo orthopaedic surgery have insufficient levels of vitamin D and two out of five of those patients had levels low enough to place them at risk for metabolic bone disease, according to a study published this month in the October 6th issue of the Journal of Bone and Joint Surgery (JBJS).
According to the National Institutes of Health (NIH) , vitamin D helps the body absorb calcium and is essential for bone growth and bone remodeling. Without sufficient vitamin D, bones can become thin, brittle or misshapen. People can obtain vitamin D in three ways:
•by eating certain types of food (including fish, dairy products, eggs and
•receiving sun exposure; and
“Given the importance of vitamin D in musculoskeletal health and its role in bone healing following orthopaedic procedures, low levels may negatively impact patient outcomes,” said orthopaedic surgeon Joseph M. Lane, MD, study co-author and chief of the metabolic bone disease service at the Hospital for Special Surgery in New York.
All 723 patients in the study had been cleared by a specialist in internal medicine for elective surgery in one of the following orthopaedic service areas: Trauma, Foot and Ankle, Sports Medicine (only ACL and/or meniscal repair), Arthroplasty (only primary total hip and knee replacement), Hand (only distal radial or ulnar fracture) and Metabolic Bone Disease (only vertebral compression fracture).
The researchers found that, of the 723 patients studied,
•411 (57 percent) had normal Vitamin D levels,
•202 (28 percent) had insufficient levels; and
•110 (15 percent) were vitamin D deficient.
“We found that nearly half of the patients who were considered ‘healthy’ enough for surgery had significantly low levels of vitamin D, placing them at risk for poor bone healing, osteomalacia (bone and muscle weakness) or even secondary hyperparathyroidism (increased secretion of the parathyroid hormone) in the most severe cases,” said Dr. Lane, who is also a professor of orthopedic surgery at Weill Cornell Medical College in New York. “This was very disconcerting since vitamin D levels can be determined with a simple blood test and low levels can be easily treated with supplements in just a few weeks.”
When results were broken down by orthopaedic service area, researchers uncovered a surprising finding: Despite having the youngest mean population (age 45 ± 14.9 years), the Sports Medicine group of patients had the second-highest rate of vitamin D insufficiency (52 percent) — exceeded only by patients in the Trauma group (66.1 percent). The remaining groups had insufficiency levels of 40 percent (Hand), 38 percent (Arthroplasty), 34 percent (Foot and Ankle) and 18.6 percent (Metabolic Bone Disease).
The researchers noted that their results are consistent with those of similar studies investigating the prevalence of vitamin D deficiency in the general population, including identification of risk factors including obesity and dark skin tone.
“This study should serve as a wake-up call to orthopedists that vitamin D deficiency is widespread, not necessarily tied to age, sex or background and screening for it should be part of routine pre-surgical care for adults,” said Dr. Lane. “Meanwhile, patients who are planning to undergo any orthopaedic procedure can request a screening (specifically, a blood test called the 25 hydroxy Vitamin D test) or ask to be placed on a medically supervised Vitamin D supplement regimen prior to surgery.”
Study specific details: In a retrospective chart review, Dr. Lane and his colleagues measured Vitamin D levels of 723 patients who were scheduled for orthopaedic surgery between January 2007 and March 2008 and determined the prevalence of normal, insufficient and deficient levels according to the following parameters:
•Normal: equal to or greater than 32 nanograms per milliliter (ng/mL)
•Insufficient: less than 32 ng/mL
•Deficient: less than 20 ng/mL
How much Vitamin D does the skin make? Our skin makes a lot of Vitamin D when we spend time in strong sunlight. With about 5-30 minutes of sunlight exposure of head, face, hands, arms, or legs), our skin can make about 1000 IUs of Vitamin D (Vitamin D is measured in units called “International Units,” or IUs.) Vitamin D is therefore known as “the sunshine vitamin.” However, as you age you can lose your ability to manufacture Vitamin D through sunlight.
How much Vitamin D is enough? The American Academy of Orthopaedic Surgeons (AAOS) and recent research support that the body needs at least 1000 IU per day for good health — depending on age, weight, and growth. Indeed, many people need much more than 1000 IU to keep Vitamin D levels in a good range.
In general, babies (especially mothers who are breastfeeding) and small children should intake at least 400 IU of Vitamin D daily. Children over age 5, adolescents, and adults should get a minimum of 1000 IU of Vitamin D each day. Disclosure: The HSS study was supported by funding from the Cohn Foundation and the Weill-Cornell Clinical Translation Science Center (UL1RR024996-01). Dr. Lane and his co-authors received no compensation for their research.
By Irene Lane, DC Healthy Living Examiner March 4, 2010
Vitamin D deficiencies among young people are more prevalent than one would think. If you adhered to medical advice and shunned the sun for most of your adult life or maintained a strict vegetarian diet, you may be at risk for a vitamin D deficiency. Increasingly, research is revealing the importance of vitamin D as protection against a host of health problems including cardiovascular disease, cognitive impairment, asthma and cancer. Are you at risk?
Dr. Mary Wilkinson, an oncologist / hematologist who practices in Northern Virginia and who has been consistently listed in Washingtonian Magazine as a leading doctor in the Washington, D.C. area says, “The medical community is just realizing that there is a more complex interaction between vitamin D and cellular growth than what has been previously identified. Nonetheless, people who have used sunscreen liberally or have just stayed away from the sun entirely are more likely to have a vitamin D deficiency.”
What are the lifestyle and individual risks for a vitamin D deficiency? Known as the sunshine vitamin, vitamin D is produced by the body in response to sunlight and is essential for strong bones because it helps the body absorb calcium. It is also occurs naturally in a few foods — including fish, egg yolks and fish liver oils as well as in fortified dairy and grain products. But a deficiency can occur for a number of reasons including:
- Following a strict vegetarian diet since the natural sources are animal-based
- Limiting your exposure to the sun
- Having dark skin because the pigment melanin reduces ability to make vitamin D
- Inability for your kidneys to convert vitamin D into its active form
- Inability to absorb vitamin D due to Crohn’s disease, cystic fibrosis or celiac disease
- Having a body mass index of 30 or greater
What are its symptoms? Vitamin D deficiency may be characterized by muscle weakness or bone pain, increased rate of fractures, low energy and fatigue, lowered immunity, symptoms of depression and mood swings and sleep irregularities. Over time, if the deficiency is not detected, osteoporosis, depression, heart disease and stroke, colon or prostate cancer in men, breast cancer in women, diabetes, parathyroid problems, immune system malfunction and weight loss may develop. Dr. Wilkinson adds, “Since we’ve only been measuring vitamin D levels more readily in the last few years, we are unsure if the deficiency causes breast cancer, for example, or if a vitamin D deficiency is merely associated with breast cancer.”
What test confirms the deficiency? The most accurate way to measure how much vitamin D is in your body is the 25-hydroxy vitamin D blood test. In the kidneys, 25-hydroxy vitamin D changes into an active form of the vitamin that helps to control calcium and phosphate levels in the body. Those levels can be measured through the blood test. The normal range is 30.0 to 74.0 nanograms per milliliter (ng/mL). A lower level indicates a vitamin D deficiency. Dr. Wilkinson emphasizes that “being in the middle of the range is very important since we do know that cancer recurrence is associated with both low and high levels of vitamin D. In this case, being in the middle of the range is best.”
How is one treated for the deficiency? Treatment involves getting more vitamin D — through diet, prescription supplements and spending more time in the sun.
How can one prevent the deficiency?
1. Allow yourself limited (no more than 15 minutes) unprotected sun exposure 2. Eat a diet rich in nutrient-dense foods such as fatty fish, egg yolks, fortified organic milk and other dairy products, and organic meats like liver 3. Take a multivitamin that includes fish oil every day 4. Take a vitamin D supplement
By Jane E. Brody
The so-called sunshine vitamin is poised to become the nutrient of the decade, if a host of recent findings are to be believed. Vitamin D, an essential nutrient found in a limited number of foods, has long been renowned for its role in creating strong bones, which is why it is added to milk.
Now a growing legion of medical researchers have raised strong doubts about the adequacy of currently recommended levels of intake, from birth through the sunset years. The researchers maintain, based on a plethora of studies, that vitamin D levels considered adequate to prevent bone malformations like rickets in children are not optimal to counter a host of serious ailments that are now linked to low vitamin D levels.
To be sure, not all medical experts are convinced of the need for or the desirability of raising the amount of vitamin D people should receive, either through sunlight, foods, supplements or all three. The federal committee that establishes daily recommended levels of nutrients has resisted all efforts to increase vitamin D intake significantly, partly because the members are not convinced of assertions for its health-promoting potential and partly because of time-worn fears of toxicity.
This column will present the facts as currently known, but be forewarned. In the end, you will have to decide for yourself how much of this vital nutrient to consume each and every day and how to obtain it.
Where to Obtain It
Through most of human history, sunlight was the primary source of vitamin D, which is formed in skin exposed to ultraviolet B radiation (the UV light that causes sunburns). Thus, to determine how much vitamin D is needed from food and supplements, take into account factors like skin color, where you live, time of year, time spent out of doors, use of sunscreens and coverups and age.
Sun avoiders and dark-skinned people absorb less UV radiation. People in the northern two-thirds of the country make little or no vitamin D in winter, and older people make less vitamin D in their skin and are less able to convert it into the hormone that the body uses. In addition, babies fed just breast milk consume little vitamin D unless given a supplement.
In addition to fortified drinks like milk, soy milk and some juices, the limited number of vitamin D food sources include oily fish like salmon, mackerel, bluefish, catfish, sardines and tuna, as well as cod liver oil and fish oils. The amount of vitamin D in breakfast cereals is minimal at best. As for supplements, vitamin D is found in prenatal vitamins, multivitamins, calcium-vitamin D combinations and plain vitamin D. Check the label, and select brands that contain vitamin D3, or cholecalciferol. D2, or ergocalciferol, is 25 percent less effective.
Vitamin D content is listed on labels in international units (I.U.). An eight-ounce glass of milk or fortified orange juice is supposed to contain 100 I.U. Most brands of multivitamins provide 400 a day. Half a cup of canned red salmon has about 940, and three ounces of cooked catfish about 570.
Myriad Links to Health
Let’s start with the least controversial role of vitamin D — strong bones. Last year, a 15-member team of nutrition experts noted in The American Journal of Clinical Nutrition that “randomized trials using the currently recommended intakes of 400 I.U. vitamin D a day have shown no appreciable reduction in fracture risk.”
A Swiss study of women in their 80s found greater leg strength and half as many falls among those who took 800 I.U. of vitamin D a day for three months along with 1,200 milligrams of calcium, compared with women who took just calcium. Greater strength and better balance have been found in older people with high blood levels of vitamin D.
In animal studies, vitamin D has strikingly reduced tumor growth, and a large number of observational studies in people have linked low vitamin D levels to an increased risk of cancer, including cancers of the breast, rectum, ovary, prostate, stomach, bladder, esophagus, kidney, lung, pancreas and uterus, as well as Hodgkin’s lymphoma and multiple myeloma.
Researchers at Creighton University in Omaha conducted a double-blind, randomized, placebo-controlled trial (the most reliable form of clinical research) among 1,179 community-living, healthy postmenopausal women. They reported last year in The American Journal of Clinical Nutrition that over the course of four years, those taking calcium and 1,100 I.U. of vitamin D3 each day developed about 80 percent fewer cancers than those who took just calcium or a placebo.
Vitamin D seems to dampen an overactive immune system. The incidence of autoimmune diseases like Type 1 diabetes and multiple sclerosis has been linked to low levels of vitamin D. A study published on Dec. 20, 2006, in The Journal of the American Medical Association examined the risk of developing multiple sclerosis among more than seven million military recruits followed for up to 12 years. Among whites, but not blacks or Hispanics, the risk of developing M.S. increased with ever lower levels of vitamin D in their blood serum before age 20.
A study published in Neurology in 2004 found a 40 percent lower risk of M.S. in women who took at least 400 I.U. of vitamin D a day.
Likewise, a study of a national sample of non-Hispanic whites found a 75 percent lower risk of diabetes among those with the highest blood levels of vitamin D.
Vitamin D is a fat-soluble vitamin that when consumed or made in the skin can be stored in body fat. In summer, as little as five minutes of sun a day on unprotected hands and face can replete the body’s supply. Any excess can be stored for later use. But for most people during the rest of the year, the body needs dietary help.
Furthermore, the general increase in obesity has introduced a worrisome factor, the tendency for body fat to hold on to vitamin D, thus reducing its overall availability.
As for a maximum safe dose, researchers like Bruce W. Hollis, a pediatric nutritionist at the Medical University of South Carolina in Charleston, maintain that the current top level of 2,000 I.U. is based on shaky evidence indeed — a study of six patients in India. Dr. Hollis has been giving pregnant women 4,000 I.U. a day, and nursing women 6,000, with no adverse effects. Other experts, however, are concerned that high vitamin D levels (above 800 I.U.) with calcium can raise the risk of kidney stones in susceptible people.