My Health Theory du Jour

Glenn links to an article and blog post about Vitamin D deficiency being linked to high blood pressure.

Last week the NY Times wrote about whether Vitamin D could improve athletic performance:

Vitamin D is an often overlooked element in athletic achievement, a “sleeper nutrient,” says John Anderson, a professor emeritus of nutrition at the University of North Carolina and one of the authors of a review article published online in May about Vitamin D and athletic performance. Vitamin D once was thought to be primarily involved in bone development. But a growing body of research suggests that it’s vital in multiple different bodily functions, including allowing body cells to utilize calcium (which is essential for cell metabolism), muscle fibers to develop and grow normally, and the immune system to function properly. “Almost every cell in the body has receptors” for Vitamin D, Anderson says. “It can up-regulate and down-regulate hundreds, maybe even thousands of genes,” Larson-Meyer says. “We’re only at the start of understanding how important it is.”

However, getting Vitamin D by way of sunshine is not so easy in these skin-cancer conscious days, and the normal diet is not so helpful either:

Meanwhile, dietary sources of Vitamin D are meager. Cod-liver oil provides a whopping dose. But a glass of fortified milk provides a fraction of what scientists now think we need per day. (A major study published online in the journal Pediatrics last month concluded that more than 60 percent of American children, or almost 51 million kids, have “insufficient” levels of Vitamin D and another 9 percent, or 7.6 million children, are clinically “deficient,” a serious condition. Cases of childhood rickets, a bone disease caused by lack of Vitamin D, have been rising in the U.S. in recent years.)

So, my guess - although we may be OK at establishing a minimal level of Vitamin D to avoid rickets we have no idea what the optimal level is.  However, I will tell you right now that although most of us are at risk for Vitamin D deficiency, an obvious high-risk group for Vitamin D deficiency is dark-skinned city dwellers in the North living on a poor person's diet [More below - see DEFICIENT}.  What are the health implications?  I don't know, but I would start with the list of childhood diseases whose incidence is rising - hypertension, diabetes and obesity spring to mind.

The next part of the guess - a major effort to promote Vitamin D could be as powerful as the campaign to get the lead out of paint, gasoline, and households.

I need to re-read this Scientific American article, which talks about Vitamin D and the immune system.  A bit on that is also here.

DEFICIENT:  From this article:

Although no minimum vitamin D level ideal for health has been established, there is a general consensus that people ought to have at least 30 nanograms per milliliter of blood — sometimes described as about 80 nanomoles per liter (SN: 10/16/04, p. 248). In this NHANES data set, only about 45 percent of the population had that minimum. So the researchers separated the NHANES participants into three groups: those with 30 or more ng/ml, those with gross deficiency (less than 10 ng/ml of vitamin D) and those in between.

..

Also disturbing, Ginde points out that the NHANES data he analyzed had been collected about 15 years ago, when almost twice as many people as today had vitamin D levels above 30 ng/ml.

So if 45% of us were above the minimal threshold 15 years ago, roughly 22% are above the threshold today.  I claim the impact of that is widely misunderestimated.

And let me throw this stray thought out - what if the most important part of the "Mediterranean diet" is the sunshine?

CONTINUING TO SCRATCH THE SURFACE:  Vitamin D is the "It" vitamin as of June 2009 (I am soo like, last quarter); 40% of Boston toddlers had "sub-optimal" levels in June 2008 (I'll bet "optimal" is sub-optimal, too; time will tell); As of June 2009, global deficiency is widespread.  And apparently some of my guesses have already been researched:

ScienceDaily (July 10, 2007) — Many otherwise healthy children and adolescents have low vitamin D levels, which may put them at risk for bone diseases such as rickets. African American children, children above age nine and with low dietary vitamin D intake were the most likely to have low levels of vitamin D in their blood, according to researchers from The Children's Hospital of Philadelphia.

A study in the current issue of the American Journal of Clinical Nutrition measured blood levels of vitamin D in 382 healthy children between six years and 21 years of age living in the northeastern U.S. Researchers assessed dietary and supplemental vitamin D intake, as well as body mass, and found that more than half of the children had low blood levels of vitamin D. Of the subjects, 55 percent of the children had inadequate vitamin D blood levels and 68 percent overall had low blood levels of the vitamin in the wintertime.

...In addition to musculoskeletal effects, vitamin D is important for immune function, and low blood levels of the vitamin may contribute to diseases such as hypertension, cancer, multiple sclerosis and type 1 diabetes. Decreased blood levels of vitamin D have also been linked to obesity.

Further study is needed to determine the appropriate blood levels of vitamin D in children, said Dr. Zemel, who added that a review of the current recommendations for vitamin D intake is needed.

Hmm - common sense triumphant!  Later I will air my theories about the earth - flat or round?!?

Comments

[Melinda Romanoff]

But think of the Cod!!

If you think the Grand Banks are overfished now, wait'll the trendistas get ahold of this.

[Check with your doctor before going wild.]

Trouble ahead; Vit D is one of the few vitamins that you can get too much of, also A and E.
================================

[Ann]

The Anchoress has some sound advice: (tweet)

The Anchoress screw this, let's get drunk! Let's be like the soviets before Perestroika. Lets bang our shoes on our desks and drink vodka

The only good news this week has been "bad" news. :)

[centralcal]

Vitamin D? Yawn! Hello, Tom, your competitors are off on another tack . . .

Edwards, St. Elizabeth, Rielle, and Andrew - kind of a sordid Bob and Carol and Ted and Alice thingy. Oh, I date myself.

[centralcal]

Yes! Ann and the Anchoress have it exactly right!

[clarice]

I ate all my cod liver oil as a kid and even my sister's when mom wasn't looking because i actually liked it.Every kid in America had it every morning. And that is not a bad thing.

[centralcal]

Mel! You out there? I gotta run, but hey man - you like your music and well, I found some I really like too. (LUN - Carla Bruni)

Wonder what it would be like to have HER as a first lady instead of bulldoggy?

[PapayaSF]

So, my guess - although we may be OK at establishing a minimal level of Vitamin D to avoid rickets we have no idea what the optimal level is.

Indeed, this is largely true for all vitamins and nutrients. The RDAs are set to prevent known deficiencies, not because their optimum levels have been determined.

[MeTooThen]

Interesting this.

In our practice, we started checking Vit D levels on many of our patients and in the context of many different disease states.

And yes, very few of our patients have "normal" Vit D levels (25 hydroxy).

This has been very surprising to us but has been consistent across gender, age, and underlying medical conditions.

I'm not sure yet what to make out of this, but we do recommended and most often implement supplementation.

As for hypervitaminosis, I haven't seen that yet.

Still, I think it's reasonable, prudent, and not at all excessive to have your levels checked and then talk with your doc about the pros and cons of supplementation.

Just sayin'.

[bgates]

Wonder what it would be like to have HER as a first lady

Awful. She's a leftist idiot too, so the only change would be the press wouldn't have to make themselves look so ridiculous in praising her.

Besides - does Barry deserve anyone in the world besides Michelle?

[ben]

"I ate all my cod liver oil as a kid and even my sister's when mom wasn't looking because i actually liked it.Every kid in America had it every morning. And that is not a bad thing."

My mom chased me around with bottle and spoon in hand, but my kids actually liked it because now you can have it in orange or strawberry flavor. If it becomes popular, there will be many more flavors probably.

[Sara (Pal2Pal)]

We got ours from bottles with those eye droppers. We'd stand in the kitchen with our mouths open like little birds. I liked it though.

[Charlie (Colorado)]

Trouble ahead; Vit D is one of the few vitamins that you can get too much of, also A and E.

Well, yes, but something like 5 × the traditional upper limit, or 10,000IU/day is apparently safe and well-tolerated.

Vitamin E is controversial: the only negative effects directly reported have been at very high doses; the other studies, suggesting higher cardiac mortality, are metastudies of otherwise sick populations.

[Charlie (Colorado)]

MeToo, are you seeing any (anechdotal, I realize) beneficial effects of supplementation?

[Charlie (Colorado)]

A guy at Commentary agrees Chicago doesn't have the Olympics nailed.

[MeTooThen]

Charlie,

Good question.

Too early to tell, and we aren't even sure what to look for or measure.

That, and there so many variables so it's hard to even know what's doing what.

Still, it seems like a good idea (FWIW)

[Dave (in MA)]

The dairy down the road from me (great ice cream stand) was inadvertently adding 500X too much Vitamin D to their milk, and it ended up killing a customer.

[From memory, though; I didn't check.]

Charlie, it's the water solubility business. ADEK cannot just wash out of the kidneys if they are in excess. They are dangerous in overdose, those four.
================================

[Syl]

I think Tom's on to something. Especially the sunshine in the Mediterranian Diet...well that and olive oil. Of course the 'official' take is always the PC view that it's fresh veggies, fruit, little or no meat, yada yada. I mean the answer is ALWAYS the same no matter what the study is about.

I get no D that I'm aware of but I crave cheese. I don't get out much, but if it's a sunny day I CRAVE the sun and spread my arms and stand there like a vulture. :)

(Joe then pretends he doesn't know me.)

I did pick up some D capsules but forget to take them. Calcium, too, for my little Scandihoovian bones.

But I could live on olives. mmmm mmmm mmmm

[daddy]

Happy October 1st, start of The new Fiscal Year!

Border Patrol Director of Media Relations Lloyd Easterling confirmed this week that his agency is planning for ">http://www.cnsnews.com/news/article/54514"> a net decrease of 384 agents on the U.S.-Mexico border in fiscal 2010, which begins on October 1.

Sure, "three persons “linked to terrorism” and 530 aliens from “special interest countries” were intercepted at Border Patrol checkpoints last year," but just think of the cost savings.

And who knows what other cost savings Michelle and Oprah might announce from Air Force 2 in Copenhagen today. I sure don't, but these 2 related headlines at the link seem like good starts at saving taxpayer dollars:

"Feds Have Built Only 32 Miles of 700 Mile Double-Border Fence Originally Mandated by Congress"

"The U.S. Won’t Secure a Single Additional Mile of Border in 2010"

[AL]

Vitamin D my ass. Its deficiency is marginal overall.

The #1 problem is Na/K disbalance. It is well researched from the end of 19 century that drinking water and diet should supply plenty of minerals, like Na, K, Ca, to replenish what our body rejects with perspiration and urination.

Now, Ca is somehow replenished with food (diary, mostly), Na is replenished by table salt, but K is terribly deficient, and we drink tremendous amount of sugary orange juice and coke to get some.

The ideal ratio of Na/K intake is 4/1. It is quite easy to achieve by blending readily available dietary salt (50-100% of KCl) with regular table salt.

The result is amazing. In couple of weeks you will stop drinking coke and any other sugary drinks.

[PeterUK]

"Besides - does Barry deserve anyone in the world besides Michelle?"

Ye,Rosie O'Donnell.

[sylvia]

Yes I saw an article on that in Reuters health recently. The scary part was that that article implied it could take 20 years for the deficiency to show up. It said a woman who didn't have good Vit D in her 20's would be more likely to have high blood pressure at 40. So does it take 20 years to reverse, or can you even reverse it?

And yes I agree Tom that it was an interesting thought that the sun might be the most important part of the Med diet. If you looked at mortality stats, the French and Italians outlive the US the Germans and the UK, so sunlight could be one of the main components.

[Michael Chaney]

Getting Vitamin D via sunlight *is* simple. 15 minutes of exposure = 10,000IU - 20,000IU, depending on your skin tone. That's 5-10 2,000IU pills.

We're very efficient at making the stuff, and that much exposure isn't going to cause cancer.

[James]

Hi Tom,

I believe that studies on dark skin people who live rural life near the equator have blood Vitamin D levels around 60 ng/ml.

I also believe that white lifeguards in california have Vitamin D levels around 90 ng/ml.

I would bet that optimal is somewhere around that level.

James

[Seerak]

For me, the biggest data point on Vitamin D deficiency is flu season's correspondence with hours of daylight.

Sylvia: one data point that I have heard from Vitamin D advocates (can't find a cite for the moment, alas) is that the ability to synthesize Vitamin D from sunlight falls off significantly by age 40... if it's this change that drives the blood pressure increase, it implies that it is reversible via supplementation.

As for the Mediterranean diet, my money's on the red wine ;)

[Brian]

I'm not buying the sunshine argument. Why? Perpignan, the southernmost French city on the Med, is at about the same latitude as Boston. The rest of France is north of that. Rome is at about the same latitude as Providence, RI. The amount of sunshine isn't the important factor, it's the angle of incidence. At those latitudes, you can sit in the sunshine nude for hours, and not produce enough vitamin D in the winter months due to atmospheric UV absorption.

[Pamela]

I live near the Arctic Circle. I began taking vitamin D3 2 800 IUs a day about a month ago. Let's see how I cope with winter this year as opposed to the winters before. I hope this makes a difference. I am from California and was outside playing most of the time, got lots of sun, never worried about it till now. I get about 45 minutes of sun a day if I am lucky in winter.

[Roux]

I'm going to get some sun this afternoon. I'll be drinking a cold beer on my riding lawnmower....

FYI... Burkas a problem in the UK. From this article.

In the predominantly Muslim enclaves of Derby near my childhood home, you now see women hidden behind the full-length robe, their faces completely shielded from view. In London, I see an increasing number of young girls, aged four and five, being made to wear the hijab to school.

Shockingly, the Dickensian bone disease rickets has reemerged in the British Muslim community because women are not getting enough vital vitamin D from sunlight because they are being consigned to life under a shroud.

Read more: http://www.dailymail.co.uk/debate/article-1195052/Why-I-British-Muslim-woman-want-burkha-banned-streets.html#ixzz0Si3ROLTK

[Mikey NTH]

I drink about two gallons of milk a week. I hope I am getting enough.

[willis]

"I drink about two gallons of milk a week. I hope I am getting enough."

You may not be. Milk is fortified with vitiman D2, not the more absorbable form, D3.

[JorgXMcKie]

If you want anecdotal evidence, I got your anecdote right here.

For the past 8-9 years, I've had at least 1 really horrible cold per semester. (I teach at a state U and average about 125 students/semester.) I put it down to exposure and one of those building built in the late '60s with really crappy HVAC.

18 months ago, after reading a lot of the studies, I started taking first a 2000 tab, then 2, 2000 tabs of D. (On top of a one-a-day with 250.) Last year I had zero colds. None. This year I've had a very mild one (symptoms mild, lasted about 3 days).

In addition, this past June I realized that I feel better overall than I have in at least 10 years. It took around 6+ months before the colds went away, and about a year before I began to feel really good. I'm 60+.

Finally, about 2 months ago, I realized that I'm no longer getting up in the middle of the night to urinate. Seriously. It had gotten to where I was up once a night and sometimes twice in eight hours. Now, maybe once a week I get up after about 6 hours of sleep.

All anecdotal, but the only change in my life has been the Vitamin D. I feel like Homer Simpson. If this is a placebo effect, "Gimme some more of those placebos."

And, truthfully, by the time it began to work, I had all but forgotten that I was taking the extra D. It's just something I do in the morning while making coffee.

Oh. And my blood D reading (finally got one) was just above 90.

[peterike]

I've always wondered. If you're exposed to sunlight through a glass window, do you still synthesize Vitamin D?

[Ed]

After a camera capsule perforated my intestine and required 14 abdominal operations to overcome sepsis of my organs last year, my various doctors have kept me on among other things, 50,000 IU of D every 3rd day, occasionally going to every other day... Of course, I lost over 50 pounds during the hospitalization and developed osteoporosis, arthritis and multiple organ failures then, too. My four varied specialists and my internist insist that these large doses of D are vital to my new chemistry. We'll see...

[sylvia]

One thing I think we might need to start doing more is eat more organ meat. It might not sound tasty but there are so many nutrients in liver and gizzards etc. See the LUN. Most of the top souces of nutrients are the organs. That's what our primitive ancestors ate and maybe what we should do.

[bc]

OTOH, here:
http://trevormarshall.com/BioEssays-Feb08-Marshall-Preprint.pdf
Is a counter argument to D3 supplementation. D3 is not a vitamin, it is an inactive pre-cursor to a potent hormone, 1,25, dihydroxyl D3. We maintain about 1000 times more precursor D3 than we convert to the hormone, plus or minus. The conversion is done under very tight feedback control in both liver and kidneys. Even Rickets is not treated with D3, it is treated with calcium supplements.

[Linda Michaels]

What does everyone expect with all of the stupid fear of sunlight and the droids staying inside all day? Get off your duff, go outside and do some yardwork. Just like radon ... open the damned window.

[clarice]

Linda, you're a gal after my own heart.

(So's the great Florence King who said, "If whiskey and salt won't cure it, the hell with it."

[pol]

Taking Megadoses of Vitamin D also may help prevent influenza:

http://www.medicalnewstoday.com/articles/51913.php

[Molon Labe]

"We maintain about 1000 times more precursor D3 than we convert to the hormone, plus or minus."

How can that be true when supplementation with D3 has been shown to increase 1,25-Dihydroxyvitamin D concentration?

[sylvia]

Interesting article on the evolution of man. It seems that the apes may have evolved from us. LUN

[willem]

Ed. Have somebody pull an hsCRP and a plasma VitC so that data can be factored into your therapy. With inflammatory pressure that high, you may have slipped into subclinical hypoascorbemia. If so, your healing response will be significantly compromised. Ascorbate is crucial to collagen production and healing. It's also a profound anti-inflammatory, likely complimentary to your need for VitD.

[mrakes]

Last year, I was having a number of health problems (fatigue, muscle pain, joint pain, etc. along with some possible indicators of diabetes...). Went in to the doctor to get tested for the diabetes and instead learned I had extremely low Vit D levels. I was skeptical, but took the supplements proscribed. To my surprise, I began to feel significantly better in a short time. Since then, I have been learning all sorts of things about the benefits of vit D.

One thing you didn't mention in the article was the growing evidence of low Vit D level's role in depression. Apparently, low levels are often correlated with higher incidents of depression. This link is very clear in the case of Seasonal Affective Disorder (or cases of seasonal depression). Also helps explain why artificial, vitamin D producing sun lamps help combat the symptoms of this disorder. It's interesting and would be worth checking your levels if you experience it.

[FeFe]

Vitamin D "vital" ... "to utilize calcium..."
-- I think the lack of D is from a lack of calcium as the calcium uses the D before it can be utilized by the body.
-- Growing children should have 1200 mg of calcium and rarely do these days.
-- Milk in plastic containers depletes the vitamins from store lighting. Only buy milk in cartons. It will also last longer.

[jb]

I have always thought that sunlight is the most important factor in the so-called Mediterranean diet. Of all the 'European' populations Australians have the longest life expectancy.

[Brian]

"I have always thought that sunlight is the most important factor in the so-called Mediterranean diet."

Impossible. From Harvard: "Except during the short summer months, people who live at latitudes above 37 degrees north or below 37 degrees south of the equator don’t get enough UVB energy from the sun to make all the vitamin D they need."

http://www.health.harvard.edu/newsweek/vitamin-d-and-your-health.htm

Only the very southern tips of Spain, Sicily, and Greece are south of 37. The rest of Europe is north of it and falls into the "don't get enough UVB energy from the sun" category. So sunlight can't be the most important factor in the Mediterranean diet.

And if we want to keep pushing the Vitamin D - Mediterranean link... the people there are generally darker pigmented than northern Europeans, so they are at a relative disadvantage in the natural production of Vitamin D.

It's not the sun. Period.

[peterike]

It's not the sun. Period.

Though the Yurps do like to take their six weeks of vacation, travel south and sit on a beach in the sun all day wearing next to nothing.

Hmmmm... I'm sensing a new book. The Six Weeks Sitting Topless and Thonged In The Blazing Sun Mediterranean Diet...