Vitamin D recommendations have been raised, but not enough

SupplementsA few weeks ago, the Institute of Medicine (IOM) surprised many of us when it announced its new dietary reference intake (DRI) for vitamin D. The consensus of the scientific community was that the previous DRI of 400 IU was insufficient, and that supplementation with at least 1000 IU would be necessary for most people to achieve vitamin D sufficiency. The IOM disagreed.

The IOM’s new recommendations:

- Recommended intake: 600 IU per day (for children and adults under age 70)

- Tolerable upper limit (amount not to be exceeded in one day): 4000 IU (raised from 2000 IU)

- Sufficient blood 25(OH)D level: 20 ng/ml

There has been a great deal of research in recent years on vitamin D’s role in a variety of human diseases. Low vitamin D status has been associated with cardiovascular disease, certain cancers, cognitive decline, depression, diabetes, pregnancy complications, autoimmune diseases, and even a 78% increase in all-cause mortality risk (<17.8 ng/ml 25(OH)D compared to >32.1 ng/ml). [1] However, because there are not yet enough randomized controlled trials to clearly and conclusively confirm the benefits of vitamin D supplementation for conditions unrelated to bone health [2], the IOM did not find the existing evidence for non-skeletal conditions sufficient enough to raise the daily recommendations any higher than 600 IU. The 600 IU figure is based solely on bone health - they did not take into account whether a greater quantity of vitamin D might be necessary to prevent non-skeletal diseases, even though there are vitamin D receptors in almost every cell of the human body.

Many experts are weighing in on – and disagreeing with – the IOM’s report, and there is general agreement among the experts on these points:

  • The increase of the tolerable upper limit to 4000 IU is a positive change.
  • The IOM’s definition of 20 ng/ml as a sufficient 25(OH)D is potentially low, and this could be dangerous for some people
  • The lack of randomized controlled trials does not mean that we should ignore the epidemiological evidence showing vitamin D’s importance for preventing non-skeletal diseases.

Compare my recommendations to those of the IOM:

Recommendations: 25(OH)D Vitamin D supplementation (adults)
Institute of Medicine >20 ng/ml 600 IU
Dr. Fuhrman 35-55 ng/ml 2000 IU*

*adjust supplementation according to 25(OH)D level

I agree that the IOM’s recommendations are inadequate. My recommendation is a safe, conservative amount of vitamin D which is supported by the literature. To learn more about why following the IOM’s guidelines may be risky, read my full commentary.

 

References:

1. Melamed, M.L., et al., 25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population. Archives of Internal Medicine, 2008. 168(15): p. 1629-1637.
2. Zhang, R. and D.P. Naughton, Vitamin D in health and disease: Current perspectives. Nutr J, 2010. 9(65).

 

Vitamin D update: Diabetes, cognitive decline, asthma, and heart attack

Vitamin D is continuing to make news.  Although previously well-known for its effects on calcium absorption and therefore bone health, vitamin D has now emerged as a contributor to many nonskeletal physiological processes, and functions have been attributed to vitamin D in the prevention of cancer, cardiovascular disease, infections, autoimmune diseases, and more. There are vitamin D receptors in almost every cell in the human body, and vitamin D regulates the expression of over 200 different genes. It is not surprising that sufficient vitamin D is crucial to the proper function of so many of our body’s tissues.1

Scientists estimate that 50% of the population of North America and Western Europe has insufficient blood vitamin D levels (as measured by 25(OH)D; sufficient is defined as greater than 30 ng/ml). Although recommended vitamin D intakes remain at only 200-400 IU per day, there is consensus among the scientific community that 2000 IU or more may be necessary for most  people to maintain sufficient blood levels.2

The newest research has found that vitamin D sufficiency is important for preventing type 2 diabetes, cognitive decline, asthma, and cardiovascular disease.

 

 

 

Type 2 diabetes

There is some evidence that vitamin D is involved in insulin secretion by pancreatic beta cells, since insulin secretion is a calcium-dependent process. Vitamin D may also prevent the development of insulin resistance by stimulating expression of the insulin receptor on the surface of cells that use glucose as fuel.3 A recent study performed at Johns Hopkins University School of Medicine on type 2 diabetics found that 91% of the patients were either deficient (less than 15 ng/ml) or insufficient (between 15 and 30 ng/ml) in vitamin D. Furthermore, there was inverse association between vitamin D levels and HbA1c, an indicator of blood glucose levels over the preceding 2-3 months, implying that vitamin D sufficiency contributes to glycemic control in diabetics.4 Vitamin D’s effects are not specific to type 2 diabetes; there is also convincing evidence that vitamin D supplementation during pregnancy and early childhood can reduce the risk of type 1 diabetes, and prospective studies on this topic are ongoing.1,5

Cognitive decline

Vitamin D receptors are present throughout the entire human brain, and genes that are regulated by vitamin D are involved in processes such as memory formation and neurotransmission.6,7 Although previous studies have been inconclusive8, this new data supports a role for vitamin D in maintaining brain health in older adults. 

Asthma

Two recent studies on asthma, one in adults and one in children, has linked vitamin D insufficiency with increased asthma severity.9 Those with 25(OH)D levels above 30 ng/ml had greater lung function, and used less medication.10 A similar study in children also found that lower vitamin D levels were associated with increased asthma severity, and that higher vitamin D levels were associated with reduced odds of hospitalization for asthma.11 Vitamin D’s anti-inflammatory actions or regulation of smooth muscle cell contraction via calcium handling may be the responsible factors. The researchers are currently conducting a trial investigating vitamin D supplementation as a therapeutic option for asthma. Vitamin D is also important for lung development in utero, so maternal supplementation with vitamin D during pregnancy is recommended.12

Cardiovascular disease

There is continually building evidence in the literature that sufficient vitamin D levels protect against cardiovascular disease. Vitamin D deficiency is extremely prevalent among heart attack sufferers – 96% of heart attack sufferers in a recent study were either insufficient (21%) or deficient (75%) in vitamin D. Those with sufficient vitamin D levels are less likely to die from heart attack or stroke.  Vitamin D insufficiency may allow for increased cholesterol uptake by inflammatory cells, which contributes to atherosclerosis.13 A newly published study recorded vitamin D levels at baseline and throughout 6 years of follow-up. At the start of the study, the average 25(OH)D level was 19.3 ng/ml (insufficient). During the trial, about half of the subjects increased their levels to the sufficient range (above 30 ng/ml), and these subjects had significantly reduced incidence of heart attack, heart failure, and coronary artery disease. Some subjects raised their 25(OH)D levels above 44 ng/ml, and they received even stronger protection against cardiovascular disease. Compared to those who reached levels above 44 ng/ml, those whose levels stayed between 10 and 19 ng/ml had a 27% increase in coronary artery disease, a 32% increase in heart failure, and a 59% increase in heart attack incidence.14

Maintaining sufficient vitamin D levels is essential to our health. 

Very few foods naturally contain vitamin D and we cannot rely on sun exposure alone because of indoor jobs, cool climates, and the risk of skin cancer that may arise from adequate amounts of sun exposure to maintain vitamin D levels.   Plus, requirements vary with genetics and skin type greatly effecting Vitamin D production in the skin.  Taking a multivitamin is not the answer because almost all  multivitamins still provide an inadequate amount of vitamin D (400 IU). Favorable levels can be confirmed with a blood test, and supplementation can be adjusted accordingly.   I recommend supplementing with an adequate amount of vitamin D in order to maintain 25(OH)D levels of 35-55 ng/ml. For some people 2000 IU will be sufficient, but others may require more.

References:

1. Hyppönen E. Vitamin D and increasing incidence of type 1 diabetes-evidence for an association? Diabetes Obes Metab. 2010 Sep;12(9):737-43.

2. University of California - Riverside (2010, July 19). More than half the world's population gets insufficient vitamin D, says biochemist. ScienceDaily. Retrieved July 28, 2010, from http://www.sciencedaily.com /releases/2010/07/100715172042.htm

3. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007 Jun;92(6):2017-29.

4. The Endocrine Society (2010, June 21). Poor control of diabetes may be linked to low vitamin D. ScienceDaily. Retrieved July 28, 2010, from http://www.sciencedaily.com /releases/2010/06/100621091209.htm

5. Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child. 2008 Jun;93(6):512-7.

6. McCann JC, Ames BN. Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? FASEB J. 2008 Apr;22(4):982-1001.

7. Llewellyn DJ, Lang IA, Langa KM, et al. Vitamin D and Risk of Cognitive Decline in Elderly Persons Arch Intern Med. 2010;170(13):1135-1141.

8. Annweiler C, Allali G, Allain P, et al. Vitamin D and cognitive performance in adults: a systematic review. Eur J Neurol. 2009 Oct;16(10):1083-9.

9. EurekAlert! Low vitamin D levels associated with more asthma symptoms and medication use. http://www.eurekalert.org/pub_releases/2010-04/njma-lvd041510.php#

Jancin B. Vitamin D Tied to Airway Hyperresponsiveness. Family Practice News. May 1, 2010.

10. Sutherland ER, Goleva E, Jackson LP, et al. Vitamin D levels, lung function, and steroid response in adult asthma. Am J Respir Crit Care Med. 2010 Apr 1;181(7):699-704.

11. Brehm JM, Celedón JC, Soto-Quiros ME, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009 May 1;179(9):765-71.

12. Litonjua AA. Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol. 2009 Jun;9(3):202-7.

13. Washington University School of Medicine (2009, August 25). Why Low Vitamin D Raises Heart Disease Risks In Diabetics. ScienceDaily. Retrieved July 28, 2010, from http://www.sciencedaily.com /releases/2009/08/090821211007.htm

14. Jancin B. CAD Events Less Likely With Normal Vitamin D. Family Practice News, May 15, 2010.

 

Pregnant women are not getting enough vitamin D

Research on vitamin D is exploding, and we are learning that sufficient blood levels of this vitamin are crucial to our health, and also that a significant proportion of the population, including pregnant women, is deficient. Vitamin D is a key factor in fetal bone growth during the third trimester. For pregnant and nursing women, vitamin D insufficiency increases the risk of preeclampsia and also puts their children at risk of impaired growth during infancy and autoimmune diseases during childhood.1

Pregnant womanDespite these dangers, vitamin D deficiency is common, affecting up to 50% of pregnant women and breastfed infants.1 Most prenatal vitamins, similar to other conventional multivitamins, contain only 400 IU vitamin D, an amount that is known throughout the scientific community to be inadequate for maintaining sufficient blood levels of vitamin D.

The National Institutes of Health considers 2000 IU to be the daily tolerable upper limit of vitamin D intake, but scientists wanted to know whether higher doses would be safe for pregnant women, and more importantly, whether using higher doses to attain sufficient blood levels of vitamin D would reduce the risk of pregnancy complications.

Researchers tested 400, 2000, and 4000 IU doses of vitamin D in pregnant women starting at 12 weeks gestation. They saw significant differences between groups in blood levels of vitamin D (25(OH)D). In healthy adults, a minimum of 30 ng/ml 25(OH)D is thought to be required for vitamin D to properly exert its many vital functions in the body.2 Consequently, I recommend that levels be maintained in the range of 35-55 ng/ml. The 400 IU group maintained 25(OH)D levels of only about 30 ng/ml, and the 2000 IU group reached 25(OH)D of 42 ng/ml by the end of their pregnancies. The 4000 IU group’s levels reached the optimal range earlier on in pregnancy and remained between 40 and 50 ng/ml for the duration of the study. Since there were no differences in any safety measures, and no adverse events were attributed to the supplements, the researchers concluded that vitamin D supplementation of up to 4000 IU is safe for pregnant women.3

The researchers then looked at pregnancy outcomes – whether the vitamin D affected pregnancy complications such as pre-term labor, pre-term birth, and infection.

The risk of these pregnancy complications overall was 50% lower in the 4000 IU group than the 400 IU group. Women who had complications on average had lower 25(OH)D levels than women who did not have complications. Importantly, neonatal serum 25(OH)D correlated with maternal 25(OH)D, confirming that the additional vitamin D helped to insure that babies were born with sufficient vitamin D levels.4

As mentioned above, I recommend that 25(OH)D levels be maintained in the range of 35-55 ng/ml. These authors recommend serum 25(OH)D levels of at least 40 ng/ml, and therefore supplementation level of 4000 IU according to their results. However, the level of supplementation necessary for individuals to reach optimal serum 25(OH)D levels may vary. Vitamin D needs of individual pregnant women should be assessed by blood test and supplementation should be adjusted accordingly. For some women that may be 2000 IU, but others may require more. I will continue to monitor these studies, and update my recommendations accordingly. 

 

References:

1. Mulligan ML et al. Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol. 2009 Oct 19. [Epub ahead of print]

2. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences.Am J Clin Nutr 2008;87(suppl):1080S– 6S.

3. Wagner CL et al. "Vitamin D supplementation during Pregnancy Part I NICHD/CTSA Randomized Clinical Trial (RCT): Safety Considerations" PAS 2010; Abstract 2630.7.

4. Wagner CL et al. "Vitamin D supplementation during Pregnancy Part 2 NICHD/CTSA Randomized Clinical Trial (RCT): Outcomes" PAS 2010; Abstract 1665.6

MedPageToday: PAS: Vitamin D Cuts Risks of Pregnancy. Michael Smith, North American Correspondent, MedPage Today May 01, 2010

http://www.medpagetoday.com/tbprint.cfm?tbid=19847

Vitamin D may protect against colon cancer

Vitamin D insufficiency is widespread, and is now thought to contribute to a variety of disease states, including osteoporosis, cardiovascular disease, diabetes, autoimmune diseases, depression, and cancers.

Vitamin D affects calcium absorption and metabolism in the bone, kidney, and intestine, but it also acts as a regulator of gene transcription in many tissues, affecting genes that control cell growth, adhesion, differentiation, proliferation, and programmed cell death. Vitamin D’s action on such genes has been shown to suppress proliferation of human colon cancer cells and tumor growth.1,2

Also, the cells of the colon, whether they are normal or cancerous, are capable of converting 25(OH)D to its active form 1,25(OH)2D. It is likely that this ability has purpose – vitamin D may have yet unidentified actions specific to the cells of the colon.

Colon

Researchers analyzed data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which has over 520,000 participants. Blood levels of vitamin D, which were measured at the start of the study, were compared between 1248 colorectal cancer patients and matched controls after diagnosis.

Circulating 25(OH)D levels of below 20 ng/ml were associated with increased risk of colorectal cancer compared with levels between 20-30 ng/ml.  When the researchers arranged the data into 5 quintiles of Vitamin D levels, they found a dose-dependent reduction in colon cancer risk; highest quintile (greater than 40 ng/ml) had 40% reduced risk compared to lowest quintile (less than 10 ng/ml). When cancers were distinguished by site, the association between Vitamin D levels and colon cancer was even stronger – the highest quintile showed a 60% risk reduction.3

This is the largest study on the subject to date, following up at least 25 previous studies since 2002. A 2009 review of these previous studies confirmed that there is indeed an inverse relationship between vitamin D levels and colorectal cancer. Even after a diagnosis of colon cancer, vitamin D levels are associated with increased survival – in colon cancer patients, higher vitamin D levels were predictive of a decreased risk of death from any cause, not only colon cancer.4

The 2009 review concluded that 25(OH)D levels of 32 ng/ml would be sufficient to achieve the protection against colorectal cancers seen in the literature, and the current study saw benefits with as low as 20 ng/ml. A minimum of 30 ng/ml 25(OH)D is thought to be required for vitamin D to properly exert its many beneficial effects.5 Accordingly, I  recommend that levels be maintained in the range of 35-55 ng/ml. 

About 50% of the U.S. population is deficient in vitamin D and cannot rely on sun exposure because of indoor jobs, skin color, and their climate. Plus, with the depletion of the ozone layer, the amount of sun most people would require to achieve these levels may result in too much skin damage and skin cancer.6 

 

 References:

1. Ingraham BA, Bragdon B, Nohe A. Molecular basis of the potential of vitamin D to prevent cancer. Curr Med Res Opin. 2008 Jan;24(1):139-49.

2. Journal of Clinical Investigation (2009, July 7). Understanding The Anticancer Effects Of Vitamin D3. ScienceDaily. Retrieved April 6, 2010, from http://www.sciencedaily.com /releases/2009/07/090706171500.htm

Emory University (2008, April 14). Vitamin D And Calcium Influence Cell Death In The Colon, Researchers Find. ScienceDaily. Retrieved April 6, 2010, from http://www.sciencedaily.com /releases/2008/04/080413161052.htm

Rockefeller University Press (2008, November 26). Vitamin D Can Alter Color Cancer Cells In Many Ways, Through One Pathway. ScienceDaily. Retrieved April 6, 2010, from http://www.sciencedaily.com /releases/2008/11/081117091614.htm

3. Jenab M, Bueno-de-Mesquita HB, Ferrari P, et al. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ. 2010 Jan 21;340:b5500.

High vitamin D levels linked to lower risk of colon cancer. ScienceDaily. Retrieved April 6, 2010, from http://www.sciencedaily.com /releases/2010/01/100122002340.htm

4. Dana-Farber Cancer Institute (2008, June 20). Vitamin D Linked To Colon Cancer Survival. ScienceDaily. Retrieved April 6, 2010, from http://www.sciencedaily.com /releases/2008/06/080619090749.htm

5. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences.Am J Clin Nutr 2008;87(suppl):1080S– 6S.

6. Terushkin V, Bender A, Psaty EL, et al. Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes. J Am Acad Dermatol. 2010 Apr 2. [Epub ahead of print]

 

Vitamin D and Omega-3 fatty acids work together to reduce coronary calcification

Heart - black & white

Coronary artery calcification is essentially the beginning of bone formation – except it’s happening in the arteries.1-2 Sound scary? It is. Calcification is associated with a 3-4 fold increased risk of death from cardiovascular disease.3 And strangely enough, those who have vascular calcification usually have low bone density or even osteoporosis4 – hard arteries and weak bones??

Previous studies had tested the effects of cholesterol-lowering drugs (statins) on the progression of arterial calcification, and they were found to be ineffective. These scientists were looking for another solution. Vitamin D deficiency is known to produce a risk of cardiovascular disease, but had not been investigated for effects on arterial calcification. Because of the protective effect of Vitamin D on both bone and cardiovascular tissues, scientists thought that Vitamin D might be a player in this complex interplay between bone precursors and blood vessel walls.

Subjects with no previous heart disease symptoms but a high coronary calcium score (CCS) were included in the study. They supplemented with omega-3 fatty acids  and sufficient Vitamin D3 to achieve greater than 50ng/ml serum levels of 25(OH) Vitamin D. The response of these subjects to these therapies varied 18 months later. About half saw a decrease in CCS, and about half experienced no change or a small increase in CCS. Also about half of the subjects experienced slowed atherosclerotic plaque growth.5

What do these results tell us? It is difficult to interpret these results because of the lack of a control (no treatment) group, but it definitely opens the door to more studies on the role of Vitamin D in coronary artery calcification. 

We also don’t know anything about the diets of the subjects of the study. A phytochemical-rich diet plus Vitamin D and omega-3 supplementation could have achieved dramatic improvements in calcium score!

For now, we can now tentatively add coronary calcification to the long list of detrimental consequences of Vitamin D deficiency. Our best protection against these consequences, in addition of course to a high nutrient diet, is a good Vitamin D supplement.

 

References:

1. Fitzpatrick LA et al. Endochondral bone formation in the heart: a possible mechanism of coronary calcification. Endocrinology. 2003 Jun;144(6):2214-9.

2. Aigner T et al. Expression of cartilage-specific markers in calcified and non-calcified

atherosclerotic lesions. Atherosclerosis. 2008 Jan;196(1):37-41. Epub 2007 Feb 28.

3. Rennenberg RJ et al. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag. 2009;5(1):185-97. Epub 2009 Apr 8.

4. Hmamouchi I et al. Low bone mineral density is related to atherosclerosis in postmenopausal Moroccan women. BMC Public Health. 2009 Oct 14;9:388.

5. Davis W et al. Effect of a combined therapeutic approach of intensive lipid management, omega-3 fatty acid supplementation, and increased serum 25 (OH) vitamin D on coronary calcium scores in asymptomatic adults. Am J Ther. 2009 Jul-Aug;16(4):326-32.

 

 

Vitamin D protects against death from heart disease and stroke

(Image credit: denn @Flickr)

heart anatomy paintingThe evidence connecting Vitamin D deficiency with chronic disease continues to mount. Vitamin D deficiency has been linked to osteoporosis, multiple cancers, musculoskeletal diseases, thyroid disease, depression, and Type II diabetes. This is especially troublesome since several studies have found that most Americans are Vitamin D deficient.

Now, a long-term study has examined the connection between blood Vitamin D levels and death from cardiovascular disease – and the results were dramatic:

Serum Vitamin D levels were measured at the beginning of the study, and subjects were followed for 26 years. The researches found that those individuals with the highest blood levels of Vitamin D were 24% less likely to die from any cardiovascular disease, and 52% less likely to die from stroke.1

This new data supports results from the Framingham Heart Study, in which subjects were followed for 5 years – even after 5 years, those with low blood levels of vitamin D had a 60% greater risk of heart disease.2

How might Vitamin D affect cardiovascular health? Vitamin D localizes to most tissues and cells in the human body and is involved in several vital processes – to name a few - insulin production, immune cell function, inflammation, and heart contractility. Vitamin D deficiency could possibly lead to a pro-inflammatory environment, which would promote cardiovascular disease.3

How can you get adequate Vitamin D? Food sources of Vitamin D are scarce, and it is almost impossible for your body to produce sufficient Vitamin D from a safe amount of sun exposure, especially if you work indoors and don’t live in the tropics. So a Vitamin D supplement is your best bet. Remember – the standard dose of Vitamin D found in most multivitamins is not enough to assure adequate blood Vitamin D levels. In order to support all of Vitamin D’s important actions in the body, additional supplementation is necessary. Be cautious of Vitamin D supplements geared toward bone health – they may also contain excessive amounts of calcium, which can result in poor absorption of other minerals. Dr. Fuhrman’s Osteo-Sun was designed to deliver adequate amounts of Vitamin D along with a low dose of calcium in order to promote bone health without causing adverse effects associated with excess calcium intake.

 

References:

1. Kilkkinen A et al. Am J Epidemiol. 2009 Oct 15;170(8):1032-9. Epub 2009 Sep 17. Vitamin D status and the risk of cardiovascular disease death.

2. Wang TJ. Circulation. 2008 Jan 29;117(4):503-11. Epub 2008 Jan 7. Vitamin D deficiency and risk of cardiovascular disease.

3. Holick MF. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1678S-88S. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease.

 

Milk Can't Measure Up to Fruits and Vegetables

Few foods elicit such strong opinions as milk and dairy products. The dairy folks want you to believe that dairy is essential and that your bones will crumble if you don’t drink milk. The anti milk people talk about all the hormones and antibiotic residue in milk and consider it the most disease-promoting of all foods. There are exaggerations and distortions of the available research on both sides.

We can’t look at all the pros and cons of dairy here, but there are some obvious conclusions. The typical American diet that is filled with processed foods and animal products is noticeably deficient in calcium and Vitamin D unless dairy is consumed or supplemented. However, dairy is not the only source of calcium, and, once you are eating a significant amount of calcium-rich plant matter, dairy products lose their status as the main source of calcium.

As you know from the evidence in my books, all animal products, including dairy, should be curtailed significantly, and those calories should be replaced with high-micronutrient, unprocessed plant foods.

When more vegetables are consumed, you get extra calcium and a cornucopia of phytochemicals that are not found in dairy. A secondary issue is that high saturated fat intake promotes heart disease and cancer. Dairy products, such as whole-milk, butter, and cheese are the foods that contribute the most saturated fat to the American diet. Any person seeking excellent health should restrict these foods in his or her diet. Skim-milk and other non-fat dairy products can be used as part of the small amount of allowable animal products consumed weekly. They are not foods that should be consumed liberally, and they should not be seen as health foods because they are not high in micronutrients and phytochemicals.

In addition to the other problems, there is evidence that the daily use of dairy can increase the risk of prostate cancer. Prostate cancer is now the single most common cancer among men in the United States. With the spread of our meat- and dairy-centered diet, it is on the rise in almost every country in the world. A meta-analysis of the best independent studies indicated that milk drinking men seem to have a 70 percent greater chance of developing cancer of the prostate.1 This evidence exists in spite of the multiple studies that show that Vitamin D deficiency also increases the risk of prostate cancer. Since milk is fortified with Vitamin D, using it must have a significant negative effect that overwhelms the benefits from the added vitamin.

Overall, milk is not health food. If you enjoy some skim-milk or non-fat yogurt, I recommend you limit it, just as you would limit other animal products. If your diet is healthful, consuming little or no dairy won’t be a problem, as long as you make sure you get adequate Vitamin D from other sources.

This is an excerpt from Dr. Fuhrman’s book Eat For Health.

1. Qin LQ, Xu JY, Wang PY, et al. Milk consumption is a risk factor for prostate cancer: meta-analysis of case-control studies. Nutr Cancer. 2004;48(1):22-27.

Image credit: Jim Frazier

Sunshine Vitamin - Vitamin D Helps Diabetics' Hearts

Not getting enough vitamin D can be harmful, just last week a report found lack of vitamin D heightens risk of metabolic syndrome and now researchers have found not getting enough vitamin D raises cholesterol.

[Researchers] obtained macrophage cells from diabetics and non-diabetics, with and without vitamin D deficiency. When the cells were exposed cells to cholesterol and low vitamin D levels, they found that low vitamin D levels in the culture dish resulted in fewer macrophages becoming foam cells.

On the other hand, when the human macrophages were placed in a vitamin D-rich environment, the uptake of cholesterol was suppressed, and they don't become foam cells, said Bernal-Mizrachi.

The researchers noted that it may be possible to delay or reverse the development of atherosclerosis in diabetics by helping them regain adequate vitamin D levels.

Recently, in a post of about children and their need for vitamin D, Dr. Fuhrman explains it get be difficult to get sufficient vitamin D from food, unless you are spending a lot time outdoors, and even then its tough.

A sufficient amount of vitamin D is difficult to obtain from dietary sources. It is possible to obtain vitamin D from direct sun exposure—without sunscreen (sunscreens block UV-B rays they in turn prevent the body from converting vitamin D). However, since the generous amount of sunshine necessary to assure sufficient vitamin D exposure is potentially harmful and because children often spend too much time indoors watching television, playing video games, or on the computer, it is advisable for all children to assure vitamin D levels with supplements, not sunshine.

To help you get your vitamin D, Dr. Fuhrman recommends his supplement Osteo-Sun, for both children and adults.

Image credit: VJ_fliks

American Children are Vitamin D Deficient

The shocking results of a recent study conducted across the U.S. revealed 7 out of 10 children have dangerously low levels of vitamin D leaving them at risk of heart disease, rickets, and weak bones.

The study analyzed data gathered in the 2001 to 2004 National Health and Nutrition Examination Survey (NHANES) of a nationally representative sample of 6,275 children aged 1 to 21.

Kids who have low vitamin D levels are at serious risk of heart disease in adulthood, find Johns Hopkins researcher Jared P. Reis, PhD, and colleagues. Reis' team analyzed data from 3,577 12- to 19-year-olds in the NHANES database.

They found that even after controlling for all kinds of factors that affect heart disease risk—obesity, exercise levels, race/ethnicity, age, gender, and socioeconomic status—low vitamin D put kids at risk of heart disease as adults.

A sufficient amount of vitamin D is difficult to obtain from dietary sources. It is possible to obtain vitamin D from direct sun exposure—without sunscreen (sunscreens block UV-B rays they in turn prevent the body from converting vitamin D). However, since the generous amount of sunshine necessary to assure sufficient vitamin D exposure is potentially harmful and because children often spend too much time indoors watching television, playing video games, or on the computer, it is advisable for all children to assure vitamin D levels with supplements, not sunshine.

The American Academy of Pediatrics (AAP) updated their guidelines in 2008 for vitamin D intake in infants, children, and teens to prevent rickets and vitamin D deficiency. Their latest guidelines increased the recommended minimum daily intake from 200 IUs to 400 IUs per day of vitamin D for all infants, children, and adolescents beginning in the first few days of life.

I suggest children require even more vitamin D then what is available through breast milk, formula and most multivitamins. My Osteo-Sun capsules are a great source of vitamin D and can easily be twisted opened and the tasteless powder mixed into children's food or drink. Each capsule provides 300 IUs of D3.

I recommend the following daily supplementation for children to ensure adequate intake of vitamin D.

Children 0 to 6 months:

  • Liquid vitamin D supplement for infant, with 4-6 capsules of Osteo-Sun daily for pregnant or breastfeeding mother as well

Children 6 to 24 months:

  • 1 capsule of Osteo-Sun opened and mixed in formula or food

Children 24 months to 6 years:

  • 2 capsules of Osteo-Sun opened and mixed in food or drink

6 years and up:

  • 3 capsules of Osteo-Sun opened and mixed in food or taken by mouth

In addition, I also recommend children 1 year and up supplement with his multivitamin, Pixie-Vites, and DHA Purity. See my vitamin advisor for details.

And to learn more about how to protect your children's health, read my book Disease-Proof Your Child:

  • An essential guide for raising children with healthy minds and bodies.
  • The how-to's for reducing occurrences of ear infections, allergies, and asthma.
  • Delicious, easy to prepare, kid-tested healthy recipes designed to please even the fussiest eaters
  • An arsenal against developing cancer, autoimmune disorders, and cardiovascular disease.

Kumar, J. Pediatrics, September 2009; vol 124, published online ahead of print. Reis, J.P. Pediatrics, September 2009; vol 124, published online ahead of print. News release, Albert Einstein College of Medicine.

Image credit: Zixii

Millions and Millions of Kids Too Low in Vitamin D

Vitamin D deficiency is no joke! A new estimate in the journal Pediatrics reports 7.6 million children, adolescents and young adults have levels of Vitamin D so low that they can be considered deficient. Another 50.8 million people have higher levels, but still too low.

The researchers and others blamed the low levels on a combination of factors, including children spending more time watching television and playing video games instead of going outside, covering up and using sunscreen when they do go outdoors, and drinking more soda and other beverages instead of consuming milk and other foods fortified with Vitamin D.

"This appears to be another result of our unhealthy lifestyles, including a sedentary society that doesn't go out in the sun much," Michal L. Melamed of the Albert Einstein College of Medicine in New York said.

The analysis and an accompanying federal study also found an association between low Vitamin D levels and increased risk for high blood pressure, high blood sugar, and a condition that increases the risk for heart disease and diabetes, known as the metabolic syndrome.

Taken together, the studies provide new evidence that low Vitamin D levels may be putting a generation of children at increased risk for heart disease and diabetes, two of the nation's biggest health problems that are also increased by the childhood obesity epidemic.

In related news, vitamin D deficiency has been linked to difficulty thinking and increases risk of dementia. To help boost vitamin D, Dr. Fuhrman has his own supplement, called Osteo–Sun, in vegan and non-vegan forms.

Via The Washington Post.

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