Tag Archives: Vitamin D

New Vitamin D Recommendations

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The nation’s top scientific advisory panel recommended that adults modestly increase their intake of vitamin D, known as the “sunshine vitamin,” from a daily dose of 200 international units (IU) to 600 IU. The panel also extended the safe upper limit for adults from 2,000 IU to 4,000 IU daily.

The Institute of Medicine (IOM) report was released November 30 in Washington, DC, after two years of study and debate. The IOM had not changed its dietary guidelines for vitamin D since 1997.

During the last 13 years, though, some studies had suggested that much higher doses of vitamin D could prevent a variety of illnesses, from bone diseases to strokes and cancer. But the IOM panel said that although more vitamin D is beneficial to bone health, other studies were inconsistent and inconclusive, and therefore taking mega doses over a long period of time might harm some people. Getting too much calcium from dietary supplements has been associated with kidney stones, the panel noted.

For Vitamin D, the IOM recommended:

  • Everyone ages 1 to 70 should take 600 IU daily.
  • Adults older than 70 should take 800 IU daily to optimize bone health.
  • The safe upper limit for infants up to 6 months is 1,000 IU daily.
  • The safe upper limit for infants 6 to 12 months is 1,500 IU daily.
  • The safe upper limit for children 1 to 3 years old is 2,500 IU daily.
  • The safe upper limit for children 4 to 8 years old is 3,000 IU daily.
  • The safe upper limit for everyone older than 8 is 4,000 IU daily.

“The good news is that the IOM recognized that the amount of vitamin D recommended in 1997 was inadequate,” said Dr. Michael Holick of Boston University, a leading expert on vitamin D and author of The Vitamin D Solution (Hudson Street Press, 2010).

Holick said the IOM levels are at 60 percent of what he recommends. “What is needed now is more randomized controlled trials to convince them,” he said.

Dr. Andrew Shao, senior vice president scientific and regulatory affairs, the Council for Responsible Nutrition (CRN), agreed with Holick that the new recommendations are “a modest step in the right direction. While the new recommendations will benefit the public overall, there is significant scientific evidence demonstrating a potential need for vitamin D intake at levels up to 2,000 IU daily for adults to maintain optimal blood levels ranging between 30 and 45ng/mL.”

The issue of vitamin D toxicity by the IOM is “curious,” said Holick, who noted the panel deemed one study as not strong enough to support the use of high levels of vitamin D to decrease the incidence of cancer, but used the same data to defend its opinion on the possibility of high levels of vitamin D increasing incidence of pancreatic and prostate cancer.

The IOM’s RDAs for calcium varied more widely by age group and gender: children ages 1 through 3 years should receive 700mg of calcium per day; children ages 4 through 8 years should receive 1,000mg per day; adolescents need 1,300mg per day; women ages 19 through 50 and men as old as 70 need 1,000mg daily; and women 51 and older and men 71 and older need 1,200mg per day. ULs for calcium ranged from 1,000 IUs in infants to 3,000 IUs in adolescents and teenagers.

Despite the committee’s findings that the majority of people in North America receive adequate levels of calcium and vitamin D, the panel said supplementation still is appropriate from some groups, including calcium for girls ages 9 to 18 years and older women.

News headlines varied greatly on their interpretations of the report. The New York Times carried on its front page an article by Gina Kolata headlined “Extra vitamin D and Calcium Aren’t Necessary, Report Says.” The same day’s Wall Street Journal headline read “Triple That Vitamin D Intake, Panel Prescribes.”

To view original article:  Vitamin Retailer January 2011

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Vitamin D Deficiency Associated With Diabetic Retinopathy!!!

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A new study has found that patients with diabetic retinopathy, especially the proliferative type, are more likely to have insufficient serum vitamin D levels than people without diabetes, suggesting a link between vitamin D deficiency and one of the leading causes of blindness in adults. The principal investigator presented the findings in a poster here at the American Academy of Ophthalmology and Middle East Africa Council of Ophthalmology 2010 Joint Meeting.

Mean levels of 25-hydroxyvitamin D in adults with type 2 diabetes were well below 30 ng/mL, the cutoff the researchers used to define vitamin D “insufficiency” (deficiency), according to the lead author, John Payne, MD, a vitreoretinal fellow at Emory Eye Center, Atlanta, Georgia. More than 75% of patients with diabetic retinopathy were deficient in vitamin D, the data show.

“Vitamin D insufficiency was much more rampant than we thought it would be,” Dr. Payne told Medscape Medical News.

In this cross-sectional study, the researchers stratified 221 subjects into 5 groups: no diabetes or retinopathy, no diabetes but another eye disease, type 2 diabetes but no retinopathy, type 2 diabetes with nonproliferative diabetic retinopathy, and type 2 diabetes with proliferative retinopathy. They excluded patients with type 1 diabetes, vitamin D intake greater than 1000 IU/day, and disorders that change the metabolism of vitamin D. To minimize differences in sun exposure, the investigators performed vitamin D testing for all subjects from December 2009 through March 2010. Testing was done at a single time point.

People with diabetes had significantly lower mean 25-hydroxyvitamin D levels than people without diabetes (22.9 vs 30.3 ng/mL; P < .001), according to the poster. People with no eye disease had the highest serum vitamin D levels (mean, 31.9 ng/mL), and those with proliferative retinopathy had the lowest levels (mean, 21.1 ng/mL).

Multivitamin Use Linked to Higher Serum Vitamin D

After performing a linear multivariate analysis to control for potential confounders, the authors found only 1 factor that remained statistically significant: daily multivitamin use. “The use of daily multivitamins was somewhat protective against the development of vitamin D insufficiency,” Dr. Payne said.

People who took a daily multivitamin that included vitamin D (n = 102) had a mean serum vitamin D level of 31.1 ng/mL; those who did not take a multivitamin (n = 119) had vitamin D levels averaging only 22.0 ng/mL (P < .001), according to the poster. Dr. Payne noted that even those who took daily multivitamins had a 44% incidence of vitamin D insufficiency. The subjects’ mean intake of vitamin D from the multivitamins was less than the recommended daily intake of 400 IU, he said.

However, Dr. Payne cautioned that they did not ask subjects about their dietary intake, other than multivitamins. Another study limitation he mentioned was that the patient population was underpowered to control for multivitamin use.

He suggested several reasons that vitamin D might protect against retinopathy, including its beneficial role in maintaining normal glucose metabolism and lowering the production of inflammatory cytokines that are upregulated in type 2 diabetes.

Does Vitamin D Slow Retinopathy Progression?

An ophthalmologist who did not participate in the study, Zac Ravage, MD, said that “it lends support to the possible role of vitamin D” in diabetic retinopathy. Dr. Ravage, assistant professor of ophthalmology at Rush Medical College, Chicago, Illinois, told Medscape Medical News that the study does not attempt to answer whether vitamin D supplementation can prevent the progression of diabetic retinopathy. Such information is necessary before ophthalmologists can prescribe multivitamins to their patients with diabetic retinopathy, he suggested.

“One study isn’t going to be a game changer, but it would certainly be grounds for more research on whether supplemental vitamin D can lower the incidence of progression of diabetic retinopathy,” Dr. Ravage said.

Dr. Payne said that a national clinical trial is needed to study this issue. “But,” he said, “it would be hard to do a placebo control because there’s so much evidence on the benefits of vitamin D.”

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Is Your Salad Organic?

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Recent news that First Lady Michelle Obama and her family intend to grow an organic vegetable garden on the South Lawn of the White House means that the entire First Family will be enjoying organic salads.

Hopefully the news will prompt increased popularity for organic salads everywhere.

Recent statistics from the United States Department of Agriculture show that the percentage of total acres devoted to organic vegetable production for three common salad vegetables, lettuce, tomatoes and carrots, ranks higher than other organic food production categories such as fruit and grains. Still, organic vegetable production remains a very small part of the total vegetable market.

In 2005, 98,870 acres of land were devoted to carrot production and 5.80% or 5,737 acres, were organic carrot production. The percentage of the organic lettuce crop came in at 3.69%, or 11,986 out of 324,500 acres planted. Organic tomatoes rounded out the list with 1.62% or 6,655 out of a total 411,840 acres planted. Figure 1 shows a similar six year trend in organic salad production statistics.

Figure 1

 

 

 

 

Except for a sudden surge and drop in organic lettuce production in 2001-2002, production of the three common salad items held steady over the first half of the decade. In sum, the numbers suggest that less than four percent of all the lunch and dinner salads consumed over this time could possibly be labeled organic.

The strengths and weaknesses of the organic salad market have straight forward supply and demand explanations. The supply side deals with growing issues. Leaf lettuce and carrots, for example, often place high on most gardeners, easiest to grow vegetables list. Large scale production does little to hurt their ease of growing. Growing most of the popular tomato varieties requires more maintenance, and large scale organic tomato production is no different (see Organic Tomato Production).

Demand for organic salad produce, as with other organic products, supports the current market. Price is one factor commonly cited as keeping a lid on demand. For example, according to the Department of Agriculture, in June 2006, a 48 pound sack of carrots conventionally grown cost $10.27. A similar 48 pound sack of organic carrots cost $18. A walk through the produce section of any grocery story backs up those statistics. Organic vegetables are double or triple the price of their non-organic counterparts.

Taking the supply and demand factors into account suggests that organic salads are not a staple of the average American diet. If they are a part of your diet, chances are you’ve grown most of the vegetables in your own garden.

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Why We Should All Eat More Organic Food!

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Organic Food is More Nutritious
  • Organic foods, especially raw or non-processed, contain higher levels of beta carotene, vitamins C, D and E, health-promoting polyphenols, cancer-fighting antioxidants, flavonoids that help ward off heart disease, essential fatty acids, and essential minerals.
  • On average, organic is 25% more nutritious in terms of vitamins and minerals than products derived from industrial agriculture. Since on the average, organic food’s shelf price is only 20% higher than chemical food, this makes it actually cheaper, gram for gram, than chemical food, even ignoring the astronomical hidden costs (damage to health, climate, environment, and government subsidies) of industrial food production.
  • Levels of antioxidants in milk from organic cattle are between 50% and 80% higher than normal milk. Organic wheat, tomatoes, potatoes, cabbage, onions and lettuce have between 20% and 40% more nutrients than non-organic foods.
  • Organic food contains qualitatively higher levels of essential minerals (such as calcium, magnesium, iron and chromium), that are severely depleted in chemical foods grown on pesticide and nitrate fertilizer-abused soil. UK and US government statistics indicate that levels of trace minerals in (non-organic) fruit and vegetables fell by up to 76% between 1940 and 1991.
Organic Food is Pure Food, Free of Chemical Additives
  • Organic food doesn’t contain food additives, flavor enhancers (like MSG), artificial sweeteners (like aspartame and high-fructose corn syrup), contaminants (like mercury) or preservatives (like sodium nitrate), that can cause health problems.
  • Eating organic has the potential to lower the incidence of autism, learning disorders, diabetes, cancer, coronary heart disease, allergies, osteoporosis, migraines, dementia, and hyperactivity.
Organic Food Is Safer
  • Organic food doesn’t contain pesticides. More than 400 chemical pesticides are routinely used in conventional farming and residues remain on non-organic food even after washing. Children are especially vulnerable to pesticide exposure. One class of pesticides, endocrine disruptors, may be responsible for early puberty and breast cancer. Pesticides are linked to asthma and cancer.
  • Organic food isn’t genetically modified. Under organic standards, genetically modified (GM) crops and ingredients are prohibited.
  • Organic animals aren’t given drugs. Organic farming standards prohibit the use of antibiotics, growth hormones and genetically modified vaccines in farm animals. Hormone-laced beef and dairy consumption is correlated with increased rates of breast, testis and prostate cancers.
  • Organic animals aren’t fed slaughterhouse waste, blood, or manure. Eating organic reduces the risks of CJD, the human version of mad cow disease, as well as Alzheimer’s.
  • Organic animals aren’t fed arsenic.
  • Organic animals aren’t fed byproducts of corn ethanol production (which increases the rate of E. coli contamination).
  • Organic crops aren’t fertilized with toxic sewage sludge or coal waste, or irrigated with E. coli contaminated sewage water.
  • Organic food isn’t irradiated. Cats fed a diet of irradiated food got multiple sclerosis within 3-4 months.
  • Organic food contains less illness-inducing bacteria. Organic chicken is free of salmonella and has a reduced incidence of campylobacter.

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Low Vitamin D Levels Linked to Obesity!!!

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New research adds to the evidence linking obesity with lower levels of vitamin D, and the finding could help explain why carrying extra pounds raises the risk for a wide range of diseases, researchers say.

The study suggests that people who are obese may be less able to convert vitamin D into its hormonally active form.

Researchers measured levels of vitamin D and its hormonally active form 1,25(OH)2D in almost 1,800 people being treated at a weight loss clinic in Norway.

Most of the people were overweight and 11% were considered morbidly obese, with a body mass index (BMI) of 40 or higher.

The more the study participants weighed, the lower their vitamin D levels tended to be, study researcher Zoya Lagunova, MD, of the Rikshospitalet-Radiumhospitalet Medical Center in Oslo, Norway, tells WebMD.

She says it makes sense that obesity is associated with lower vitamin D levels since vitamin D is a fat-soluble vitamin.

The study appears in the latest issue of the Journal of Nutrition.

“Much of the vitamin D produced in the skin or ingested is distributed in fat tissue,” she says. “So obese people may take in as much vitamin D from the sun, food, or supplements as people who are not obese, but their [blood] levels will tend to be lower.”

Vitamin D and Obesity

Along with calcium, vitamin D has long been recognized as important for bone health. But in recent years studies have suggested that the vitamin plays a part in a host of diseases, including heart disease, diabetes, and certain cancers.

Perhaps not coincidentally, obesity is a known risk factor for many of these diseases, Lagunova says.

The researchers concluded that 1,25(OH)2D levels might be a better measure of vitamin D in obese people than circulating levels of the vitamin.

But Clifford J. Rosen, MD, of the Maine Medical Center Research Institute, is unconvinced.

Rosen tells WebMD that 1,25(OH)2D is more difficult and costly to measure and is not a very good indicator of vitamin D status.

He adds that while people who are obese do tend to have lower vitamin D levels, the clinical relevance of this is unclear.

Lagunova and colleagues conclude that people who are obese may need more vitamin D in their diets or greater exposure to the sun than thinner people.

“Obese people may need more vitamin D to end up with the same levels as a person whose weight is normal,” Lagunova says.

Vitamin D: Too Much of a Good Thing?

But it is far from clear if taking large doses of vitamin D in supplement form is beneficial or even safe, regardless of a person’s body weight, says Rosen.

An osteoporosis researcher, Rosen served on an expert panel that reviewed the vitamin D research and concluded that most people get enough of the vitamin without taking supplements.

The panel, convened by the independent health policy advisory group Institute of Medicine (IOM), published its findings late last month.

The IOM committee found the evidence suggesting a role for vitamin D supplementation in the prevention of non-bone related diseases to be inconclusive. It also warned that intake of vitamin D over 4,000 IU (international units) per day increases the risk for harm to the body.

Rosen says there was no suggestion that obese people needed extra vitamin D to maintain adequate levels.

Rutgers University professor of nutritional sciences Sue A. Shapses, PhD, also served on the IOM panel. She calls the research suggesting a protective role for vitamin D against non-bone-related disease “compelling” but far from conclusive.

“We know that vitamin D deficiency is not good, but most people are not deficient,” she says. “And there are just too many unanswered questions to recommend that people take high doses of vitamin D in supplement form.”

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