Low vitamin D status associated with cognitive decline: Study

Inadequate dietary intake of vitamin D is associated with higher levels of cognitive impairment; however it remains unclear if the link is causal, according to a new study.

The study, published in Neurology, suggests that a weekly intake of less than 35 micrograms of vitamin D is associated with a greater incidence of cognitive impairment. However the researchers noted that the association could be causal in either direction, stating it is possible that low vitamin D is a result of, rather than the cause of cognitive impairment.

“The main finding of this population based study …was that the weekly dietary intake of vitamin D was significantly associated with the global cognitive performance in both linear and logistic regression models, even while considering the effects of all potential confounders,” said the researchers, led by Dr Cédric Annweiler from Angers University Hospital, France.

D and cognitive decline

Cognitive performance declines naturally as we age, but it has been suggested that vitamin D status could impact on cognitive function among older adults.

It is suggested that vitamin D binds to neuronal receptors in the brain, and develops an anti-neurodegenerative action through, anti-inflammatory and antioxidative. Many people have therefore recommended that maintaining an adequate vitamin D status is essential to avoid vitamin D deficiency– induced cognitive decline.

Data from David Llewellyn and colleagues at the University of Exeter, England, indicated that insufficient levels of vitamin D may accelerate cognitive decline . The scientists analyzed vitamin D levels from blood samples of 858 adults and found that severe vitamin D deficiency was associated with a 60 percent increase in the risk of substantial cognitive decline.

Annweiler and colleagues said the benefits of vitamin D intake in treating or preventing cognitive impairment remain unknown, adding that, to date no randomized controlled trials have explored the benefits of vitamin D supplementation to treat or prevent cognitive impairment.

But, before conducting such a trial, they said it would be of benefit to determine whether dietary, non-supplemented, intake of vitamin D could be associated with cognitive performance in older adults.

“We had the opportunity to examine the association between dietary intakes of vitamin D and global cognitive performance in a large representative community survey of older women,” said the researchers.

Study details

A total of 5,596 women, not taking vitamin D supplements were divided into 2 groups according to their baseline weekly staus: either inadequate (less than 35 micrograms per week) or recommended (more than 35 micrograms per week).

Compared to women with recommended weekly vitamin D dietary intakes, women with inadequate intakes were reported to have lower scores on the SPMSQ mental state questionnaire.

The researchers observed that inadequate intakes were more often associated with cognitive impairment, as defined by an SPMSQ score of less than 8.

“We found an association between weekly vitamin D dietary intake and SPMSQ score. Inadequate weekly vitamin D dietary intakes were also associated with cognitive impairment,” wrote the researchers.

Causation

Exactly how low dietary intakes of vitamin D and decreased cognitive performance are associated remains unclear. Annweiler and co workers noted that it is yet to be clarified whether the of association is causal, and if so, in what direction the causation may be.

They stated that it remains a possibility that low vitamin D status may be a result of poor diet, due to cognitive decline. But, emphasized that vitamin D insufficiency has been suggested as a contributing factor to hypertension, which itself is a major risk factor in the development of cerebrovascular diseases and cognitive decline.

Annweiler and colleagues added that nutrients are not consumed in isolation, “but rather as components of an overall diet, which is precisely considered as a modifiable risk factor for cognitive decline.”

Moreover, they said that as a component of diet, low vitamin D intake may be a surrogate measure for other nutritional abnormalities, which in turn may lead to cognitive decline.



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U.S. panel expresses caution on Vitamin D

Government scientists on Tuesday tripled the recommended intake of Vitamin D for most Americans. At the same time, the federal panel cautioned that most people already get enough - and should be skeptical of myriad reports that far higher amounts offer benefits for diseases ranging from cancer to diabetes.

The impact of the advice - coming after a decade of highly publicized research that has led to gradual changes in mainstream medical practice and dramatic increases in over-the-counter supplement sales - was unclear.

"Vitamin D has become a really hot topic," said Catharine Ross, a Penn State University nutrition professor, who chaired the panel. "We hope that the report will provide some reassurance to the American and Canadian public" - federal agencies in both countries were the sponsors - "that their Vitamin D status is not nearly as poor as they have been led to think . . . and is consistent with good bone health."

The conclusion that most people now get enough of the "sunshine vitamin" was perhaps the most controversial finding. Although there is no national standard for adequate levels of Vitamin D in the blood, hundreds of recent studies have found associations between low levels and the risk of various disorders.

Few of those studies were able to prove cause-and-effect, however, and the findings often conflicted. As a result, the panel set aside all claims of benefit for Vitamin D except for skeletal health, which has been known for more than a century. Most Americans, they said, get enough for their bones.

"Basically, what is going to happen here is nothing," said a disgusted-sounding Bruce W. Hollis, professor of pediatrics at the Medical University of South Carolina. Hollis, who gave expert testimony to the committee, has found significant benefits to infants whose breast-feeding mothers take 6,000 IU of Vitamin D daily - 10 times the new guideline.

Although the new recommendations of 600 IU per day for most children and adults are triple the old guideline, Hollis and other experts said that was too small to matter.

The panel also made recommendations for calcium, which works with Vitamin D to build bone. Most calcium guidelines stayed the same.

The most significant change from the past, scientists said, is in how the report defines the Vitamin D upper limit, the maximum amount that is likely to pose no risk of adverse effects to almost anyone. The limit previously was another hurdle for scientists who wanted to study supplementation in the higher amounts that they believed would make a difference.

This time, the committee not only set the limit higher, but also made clear that it was not intended to constrain research on subjects who were carefully monitored.

Michael F. Holick, a Boston University medical school professor, predicted that intense interest by the media and the public might influence makers of supplements and fortified foods to take their cues not from the new Recommended Dietary Allowance, but from the upper limit.

"I think they were, you know, being very, very conservative," said Holick, whose book, The Vitamin D Solution, describes benefits for heart disease, rheumatoid arthritis, depression, psoriasis, and several types of cancer.

"The good news is that they at least appreciated that everyone needs more Vitamin D."

Holick, who served on the panel that came up with the old recommendations, in 1997, said the committee was required to follow strict guidelines that would preclude consideration of many studies that he considers valid.

Indeed, the new report describes the difficulty of formulating the first scientifically based guidelines for a nutrient that occurs naturally in a few foods (mainly fatty fish), as a fortified element of many others (milk, orange juice, baby formula), as a common pill, and - in its most natural form - as a product of the skin triggered by sunlight.

It is largely the sunlight part that has caused widespread recent concern about deficiency, as people spend more time indoors or slathered with sunscreen, and as dark-skinned people move from latitudes with more sun to areas with less sun.

The report by the outside panel of the Institute of Medicine, part of the Academy of Sciences, does not need to be confirmed by any other body. On the other hand, for the findings to appear on labels and in federal policy, various agencies must translate its findings.

All of that is voluntary.

Ross, the panel chair, said she hoped the report would encourage doctors to "not just jump on the bandwagon" of Vitamin D deficiency.

Kara M. Nakisbendi, a gynecologist with an integrative medicine practice in Ardmore, said that the report might compel her to "not be as aggressive" in raising her patients' Vitamin D levels, but that she would still aim for essentially double what the report considered enough.

Wendy Warner, a holistic physician in Langhorne, said she, too, had seen enough research - and improvements in patients - that she intended to continue recommending amounts of Vitamin D far greater than the committee's guideline.

The panel spent considerable effort trying to determine levels of Vitamin D that would be safe over a lifetime and cautioned against taking supplements in amounts that it could not prove were OK.

Ross recalled past cases, such as hormone replacement therapy, that for years had shown promise and minimal harm, but were eventually found to be problematic.

Some nutrition researchers argue that such comparisons may be valid for pharmaceuticals, but not for nutrients, which are "essential to health," said Robert P. Heaney, a professor of medicine at Creighton University in Omaha, Neb.

He also suggested that the public had already made up its mind. Domestic sales were $425 million in 2009, 10 times those of 2001, the Nutrition Business Journal found.

And Wal-Mart, Heaney noted, recently introduced Vitamin D capsules with 5,000 IU apiece - nearly 10 times the new guideline for most Americans.

"Once Wal-Mart goes there," he said, "so goes the nation."


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New Guidelines for Vitamin D and Calcium

If you've been confused about the flip-flopping reports on the benefits and risks of vitamin D recently, you're not alone. Health officials were just as baffled about the potential benefits that supplements of vitamin D and calcium could have, as well as how much of the nutrients would be sufficient to improve health.

That's why the Institute of Medicine (IOM), an advisory group established by Congress, was charged by the U.S. and Canadian governments to gather the existing evidence on the health benefits of vitamin D and calcium, and come up with revised guidelines to help the public and the medical community determine the recommend dietary allowance, or RDA, of each nutrient. And according to the committee's analysis, North Americans are not nearly as deficient in vitamin D as we have been led to believe.

The 14-member IOM committee, made up of nutrition and other experts, issued its report on Tuesday, advising that the average adult needs about 600 IU of vitamin D daily, and about 1,000 mg of calcium each day to maintain bone health. Those 71 years or older, however, may need more vitamin D, up to 800 IU a day, to combat deteriorating bone. Because of the lack of sufficient data to date, advice on vitamin D up to this point was not considered as a recommended dietary allowance, which is based on stronger scientific evidence, but rather an adequate intake suggestion, and stood at anywhere from 200 IU to 400 IU for adults. The new recommendations are based on data from more than 1,000 studies, most of which included trials in which volunteers were randomly assigned to receive either vitamin or calcium supplements or a placebo, after which their health outcomes were compared to one another.

In addition, the report states that contrary to previous claims, most Americans are not lacking in vitamin D, and that the majority of adults are in fact well-supplied with the bone-building vitamin. The discrepancy can be traced to the lack of standardization among labs that test for blood levels of the vitamin. Different facilities establish varying thresholds for what they consider to be sufficient levels of vitamin D and that can lead to a misleading perception that more people are deficient.

After studying data on which levels of vitamin D are linked to the most benefit for preventing fractures and maintaining bone health, the IOM committee determined that a blood level of 20 nanogm/mL was sufficient for the average adult. The mistaken belief that Americans are deficient in vitamin D has led some experts to suggest that adults spend more time in the sun, since UV exposure can trigger vitamin D synthesis in the skin. But the committee cautions against that practice, since UV exposure can increase the risk of skin cancer and that risk outweighs the need to boost vitamin D production in the body.

The committee's advice also applies only to nutritional requirements to maintain skeletal health, and should not, says committee member Dr. JoAnn Manson, be interpreted to suggest benefit for any other health condition. In recent years, studies have suggested a link between vitamin D supplementation and a lower risk of heart disease, as well as prevention of cancer, Alzheimer's, diabetes and autoimmune conditions. But after a thorough review of the existing evidence for those diseases, the committee determined that the data on such supplementation and non-bone conditions was “inconsistent, inconclusive as to the cause and effect, and insufficient to inform nutritional requirements,” says Manson. Most of the data drawing these correlations did not come from rigorous clinical trials that randomly assigned subjects to a vitamin or placebo group.

That's not to say that vitamin D will not at some point prove effective in preventing or alleviating conditions other than bone-related fractures; Manson is currently recruiting for a multicenter study, the Vitamin D and Omega-3 Trial, or VITAL, that aims to do just that. VITAL will involve more than 20,000 healthy subjects who will be taking either vitamin D or a placebo and then followed over a number of years for their risk of developing cancer, stroke and heart disease.

VITAL will be the first such large-scale randomized study to analyze vitamin D supplementation in this scientifically validated way, so until those results are released, in another five years or so, the IOM committee declined to make any recommendations about vitamin D's role in anything other than promoting bone health.

The committee also established upper limits of intake per day, since some studies suggest that megadoses of the vitamin D may not provide any additional benefit, and may actually cause harm. Even when it comes to bone health, for example, a recent trial showed that high doses of vitamin D supplementation did not lower the rate of fractures and other studies showed high levels of D increased the risk of kidney stones and other renal conditions. “This perception that more is better and that everyone should jump on the bandwagon of high doses of vitamin D is of concern until we have evidence from randomized clinical trails that the benefits of such dosing outweighs the risks,” says Manson.

The advice is not likely to be the last word on vitamin D and calcium supplementation, and as new data emerges on the role that these nutrients may play in warding off disease, the guidelines may change. But in the meantime, the evidence is strong enough to support supplementing the diet with vitamin D in order to keep bones healthy. Having an RDA for vitamin D, say experts, should help to clear up some of the confusion over D.



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The vitamin D controversy

The group said most people have adequate amounts of vitamin D in their blood supplied by their diets and natural sources like sunshine, the committee says in a report that is to be released on Tuesday.

“For most people, taking extra calcium and vitamin D supplements is not indicated,” said Dr. Clifford J. Rosen, a member of the panel and an osteoporosis expert at the Maine Medical Center Research Institute.

Dr. J. Christopher Gallagher, director of the bone metabolism unit at the Creighton University School of Medicine in Omaha, Neb., agreed, adding, “The onus is on the people who propose extra calcium and vitamin D to show it is safe before they push it on people.”

Over the past few years, the idea that nearly everyone needs extra calcium and vitamin D — especially vitamin D — has swept the nation.

With calcium, adolescent girls may be the only group that is getting too little, the panel found. Older women, on the other hand, may take too much, putting themselves at risk for kidney stones. And there is evidence that excess calcium can increase the risk of heart disease, the group wrote.

As for vitamin D, some prominent doctors have said that most people need supplements or they will be at increased risk for a wide variety of illnesses, including heart disease, cancer and autoimmune diseases.

And these days more and more people know their vitamin D levels because they are being tested for it as part of routine physical exams.

“The number of vitamin D tests has exploded,” said Dennis Black, a reviewer of the report who is a professor of epidemiology and biostatistics at the University of California, San Francisco.

At the same time, vitamin D sales have soared, growing faster than those of any supplement, according to The Nutrition Business Journal. Sales rose 82 percent from 2008 to 2009, reaching $430 million. “Everyone was hoping vitamin D would be kind of a panacea,” Dr. Black said. The report, he added, might quell the craze.

“I think this will have an impact on a lot of primary care providers,” he said.

The 14-member expert committee was convened by the Institute of Medicine, an independent nonprofit scientific body, at the request of the United States and Canadian governments. It was asked to examine the available data — nearly 1,000 publications — to determine how much vitamin D and calcium people were getting, how much was needed for optimal health and how much was too much.

The two nutrients work together for bone health.

Bone health, though, is only one of the benefits that have been attributed to vitamin D, and there is not enough good evidence to support most other claims, the committee said.

Some labs have started reporting levels of less than 30 nanograms of vitamin D per milliliter of blood as a deficiency. With that as a standard, 80 percent of the population would be deemed deficient of vitamin D, Dr. Rosen said. Most people need to take supplements to reach levels above 30 nanograms per milliliter, he added.

But, the committee concluded, a level of 20 to 30 nanograms is all that is needed for bone health, and nearly everyone is in that range.

Vitamin D is being added to more and more foods, said Paul R. Thomas of the Office of Dietary Supplements at the National Institutes of Health. Not only is it in orange juice and milk, but more is being added to breakfast cereals, and it now can be found in very high doses in supplement pills. Most vitamin D pills, he said, used to contain no more than 1,000 international units of it. Now it is easy to find pills, even in places like Wal-Mart, with 5,000 international units. The committee, though, said people need only 600 international units a day.

To assess the amounts of vitamin D and calcium people are getting, the panel looked at national data on diets. Most people, they concluded, get enough calcium from the foods they eat, about 1,000 milligrams a day for most adults (1,200 for women ages 51 to 70).

Vitamin D is more complicated, the group said. In general, most people are not getting enough vitamin D from their diets, but they have enough of the vitamin in their blood, probably because they are also making it naturally after being out in the sun and storing it in their bodies.

The American Society for Bone and Mineral Research and other groups applauded the report. It is “a very balanced set of recommendations,” said Dr. Sundeep Khosla, a Mayo Clinic endocrinologist and the society’s president.

But Andrew Shao, an executive vice president at the Council for Responsible Nutrition, a trade group, said the panel was being overly cautious, especially in its recommendations about vitamin D. He said there was no convincing evidence that people were being harmed by taking supplements, and he said higher levels of vitamin D, in particular, could be beneficial.

Such claims “are not supported by the available evidence,” the committee wrote. They were based on studies that observed populations and concluded that people with lower levels of the vitamin had more of various diseases. Such studies have been misleading and most scientists agree that they cannot determine cause and effect.

It is not clear how or why the claims for high vitamin D levels started, medical experts say. First there were two studies, which turned out to be incorrect, that said people needed 30 nanograms of vitamin D per milliliter of blood, the upper end of what the committee says is a normal range. They were followed by articles and claims and books saying much higher levels — 40 to 50 nanograms or even higher — were needed.

After reviewing the data, the committee concluded that the evidence for the benefits of high levels of vitamin D was “inconsistent and/or conflicting and did not demonstrate causality.”

Evidence also suggests that high levels of vitamin D can increase the risks for fractures and the overall death rate and can raise the risk for other diseases. While those studies are not conclusive, any risk looms large when there is no demonstrable benefit. Those hints of risk are “challenging the concept that ‘more is better,’ ” the committee wrote.

That is what surprised Dr. Black. “We thought that probably higher is better,” he said.

He has changed his mind, and expects others will too: “I think this report will make people more cautious.” (NY Times)



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Vitamin D Deficiency More Prevalent In Winter.... Experts Say Get Tested.

Vitamin D is much more than a vitamin; technically it’s a hormone. Vitamin D is manufactured through exposure to direct sunlight. Once it is metabolized and absorbed, it has profound benefits in nearly every aspect of immunity.

Vitamin D deficiency increases risk for acute sickness as well as susceptibility to chronic diseases, including cancer.

It’s no coincidence that the number of coughs and colds increase in the winter when sunlight is at seasonal low in most climates. The American Journal of Public Health sites over 60 studies that implicate a protective relationship that vitamin D has over cancer. The European Journal of Clinical Nutrition reported that children with low vitamin D levels were 11 times more susceptible to respiratory infections.

The best way to know if you are vitamin D deficient is through a simple blood test. Seek a qualified practitioner who can order a serum 25-hydroxyvitamin D [25 (OH) D] test. The baseline minimum should be 30 ng/mL, although evidence is mounting to establish higher levels for optimal health and cancer prevention. The Vitamin D Council recommends enough sunlight, supplementation and/or artificial light to maintain levels between 80-100 ng/mL year round. Supplementation to increase levels of vitamin D can also be surprisingly inexpensive, especially when one looks at the cost of sick care.

Older adults require higher amounts of vitamin D due to an inability to absorb it efficiently. Research has shown that blacks may require as much as two times the sun exposure to accumulate the same amounts of vitamin D.

The American Journal of Clinical Nutrition performed a study on vitamin D supplementation that showed a decreased incidence of cancer by over 75% compared to those in the placebo group who were given a sugar pill. The best food sources of vitamin D are fatty fish, eggs, meat and mushrooms. Although most people think of vitamin D for osteoporosis prevention it also assists in reducing inflammation and improving neuromuscular function. The Vitamin D Council recommends 2000 IU per day in the summer and 5000 IU in the winter. The Canadian Cancer Society has now officially recommended vitamin D supplements to help reduce risk of cancer.



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The benefits of breastfeeding

Numerous major health organizations, including the American Academy of Pediatrics and the American Dietetic Association, strongly support breastfeeding. Their position statements urge women when possible, to exclusively breast feed their babies for the first six month of life and to continue breastfeeding with complimentary foods from six months to at least 12 months of age.

The belief is that this pattern provides optimal nutrition and health protection for the baby. It can be especially important for pre-term and low birth weight babies.

When the recommendations state "exclusively," they mean attempting breast feeding shortly after birth and not giving the infant supplemental bottles of formula, water, other liquids, or pacifiers. Doing so appears to lower the success rate of initiation and continuation of breastfeeding, and reduces the nutrition the baby receives.

Not only does breast milk contain a perfect balance of nutrients, but these nutrients are in a form that infants can better digest and absorb. This potentially means a reduced risk of digestive problems and optimal nutrient uptake. The amounts of the various nutrients are also at a level appropriate for the infant's immature kidneys and in the right proportions for growth and development needs.

Breast milk also has the unique advantage of changing composition over time. As the baby's nutritional needs change, the breast milk changes to meet those needs. The first milk (colostrum) is perfect for newborns, while the mature milk later on is appropriate for older babies. Breast milk is also bacterially safe, as well as cost and time effective.

The only additional nutrients a young infant may need are vitamin D and possibly fluoride. The American Academy of Pediatrics recommends intake of 400 IU vitamin D daily from birth to at least 18 years of age for all infants — breast or formula fed (formulas may cover some of the need but probably not the full amount).

Breast milk contains numerous substances that assist with immunity. When it comes to health, research shows that breast-fed infants tend to have fewer infections and illnesses, resulting in fewer hospitalizations and visits to a health-care provider. Examples are ear and respiratory tract infections, including pneumonia.

Breast feeding is also associated with reduced risk of infant deaths in general, childhood leukemia, and sudden infant death syndrome (SIDS). For premature infants, breastfeeding reduces the incidence of the potentially fatal necrotizing enterocolitis (NEC).

For baby, long term, breast feeding is associated with a lower lifetime risk of chronic diseases, such as type 1 and 2 diabetes, heart disease, high blood pressure, and high cholesterol. Breast fed babies also tend to have healthier body weights and are less likely to become overweight or obese as adolescents and adults.

Breast feeding may also lower the chance of food allergies and intolerances. Some studies even show a relationship to higher intelligence test scores. Orally, breast feeding helps promote proper teeth and jaw development. Some studies suggest it can even act as a mild analgesic or pain reliever. Emotionally, the act of breast feeding assists with bonding between the mother and her infant.

In addition to knowing that she is providing the best nourishment for her child, mom can also benefit from breast feeding. To start, her recovery from delivery is quicker than if she does not breast feed. Because it delays menstruation, it can also help mom to recover her iron stores from losses at delivery.

The longer women breast feed, the lower their lifetime risk of getting breast and ovarian cancers, type 2 diabetes (except for those who have had gestational diabetes) and rheumatoid arthritis. This is especially significant with breastfeeding more than 12 months all children combined. Breast feeding can also lower blood pressure in women before, during and after breastfeeding sessions.

Moms may also benefit emotionally. Studies have shown that breast feeding women tend to have a lesser chance of experiencing postpartum depression.

While breastfeeding, a woman's need for protein is 25 gm/day above pre-pregnant needs (similar to needs during pregnancy). Calcium needs are slightly higher as well (1200-1500 mg/day) with adequate vitamin D. She should also increase her fluid intake to cover milk production. For weight maintenance, her calorie needs are similar to those during pregnancy. For postpartum weight loss, a slightly lower calorie intake does not appear to negatively affect milk production, but a more restrictive diet is not recommended.

Women who take prescription or over-the-counter medications or herbal supplements should check with their pharmacist and/or health-care provider to evaluate the safety of what they are taking with regard to breastfeeding. They should also reduce their exposure to chemical contaminants, including those found in foods (such as methyl mercury, which can be high in some fish).

If a woman anticipates pregnancy followed by breastfeeding, achieving a healthy body weight before pregnancy appears to improve breastfeeding success, as obesity triggers factors that may negatively affect milk production.

For a number of reasons, new moms may not be able to achieve the recommended goal of breastfeeding for at least a year. Although this longer duration of breastfeeding is optimal, be assured that any amount of time spent breastfeeding provides benefits. The good news is that there are many resources available to help — medical professionals, lactation specialists, registered dietitians, and breastfeeding support groups.



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Learn why vitamin D is the "SUNSHINE VITAMIN"

Is 10 minutes a day exposure to the sun with no sunscreen a bad thing or a good thing?

The jury is still out among a lot of health professionals, but one thing is certain: there are many people in our country that are deficient in vitamin D, the sunshine vitamin.

Vitamin D is a fat-soluble supplement needed to maintain normal levels of calcium and phosphorus in the blood. Over the last few years, vitamin D deficiency has been blamed for a number of conditions including depression, chronic pain, kidney disease, diabetes, osteoporosis, colon and breast cancer, and cardiovascular disease.

Much research has been done and much more will be done on the vitamin D debate. Many health professional are very excited about the health benefits of vitamin D and highly recommend it to their patients.

According to an article by Brian Alexander in the American Council on Exercise’s (ACE) Fitness Matters magazine, here are some things we know about vitamin D:

Vitamin D was discovered 87 years ago by a team of scientists at John Hopkins University who cured mice with rickets by feeding them cod liver oil. Oily fish like sardines remain one the few natural food sources of vitamin D.

It was later found that certain wavelengths of ultraviolet light prompts our bodies to synthesize vitamin D, eventually making a hormone called calcitriol.

Once this was understood vitamin D was produced synthetically, and foods, mainly milk, were fortified with it.

If you are Caucasian and expose 40 percent of your skin to midday summer sun in most of the United States, you will receive a dose of roughly 1,000 IUs per minute. An international unit (IU) is an internationally accepted amount of a substance. This type of measure is used for the fat-soluble vitamins (such as vitamins A, D and E) and certain hormones, enzymes and biologicals (such as vaccines).

As we age, we gradually lose our ability to absorb vitamin D.

The darker your skin, the less vitamin D you will receive from the sun.

Where you live can affect your vitamin D levels. Those living north of Atlanta, Ga., do not get enough ultraviolet rays in the winter for their bodies to produce the vitamin D that they need. Therefore, it is important to get your level tested by you physician and let him suggest alternatives.

In the same ACE article, Boston University physician and vitamin D researcher Dr. Michael Holick said, "When I first heard the claims about vitamin D, I thought it was kind of crazy."

But Holick has become convinced of vitamin D’s effectiveness. "Heart, colon, prostrate, brain, all those cells have receptors for vitamin D, we also know it stimulates serotonin production [important in depression], and it is important in muscle function."

Other studies have been inconclusive on the positive health benefits of vitamin D. So the arguments on both sides of the debate continue.

All sides do agree on one thing: more research is needed.



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Consumers Reassured Regarding Benefits of Calcium Supplements

The New Zealand Self Medication Industry (NZSMI), the industry body representing non-prescription consumer healthcare products, said today that the benefits of calcium supplements in strengthening bones outweigh any known risks.

Tim Roper, executive director of the NZSMI, says consumers should maintain their current calcium supplements or consult their doctor if they have any concerns.

Mr Roper welcomed Medsafe's statement at the weekend that there is insufficient proof that there is a link between calcium and heart disease as suggested by a recent study highlighted in the media recently.

"The study, which concluded that calcium supplements modestly increased the risk of heart attacks, was not designed to measure a link between calcium and heart disease. It was limited in its scope and only dealt with people over 70. It's not surprising that people in this age group are more at risk of heart attacks.

"Most people in New Zealand who are taking calcium supplements are younger than the age group investigated. They are usually women under the age of 50 who are pregnant, breastfeeding or menopausal, taking calcium to strengthen bones and maintain bone density."

Mr Roper says media reports on the study also failed to mention that the study group of 70 year-olds were taking calcium supplements without the recommended addition of Vitamin D which aids absorption of calcium into the bones.

He adds that the researchers involved in this study also admit it has "some limitations...and the results may not apply to co-administered calcium and Vitamin D supplements."



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Calcium Supplements Lead to Heart Attack

Thirty percent is the susceptibility to heart attack of people taking calcium supplements.

Dr. Ian Reid of the Department of Medicine at the University of Auckland was the head of the study. Higher blood serum levels lead to hardening of the arteries of the heart. These findings are consistent even after considering gender, age and the type of supplements taken.

The study excluded patients who were taking both calcium and Vitamin D supplements. Vitamin D helps in calcium absorption.

Calcium is not only for bone health but it regulates muscle contraction, which includes heartbeat and normal blood clotting.

Dr. Ian Reid suggests taking in calcium the natural way; through food: milk, yogurt (low-fat, nonfat), cheeses, pudding, soy milk and orange juice fortified with calcium, canned salmon and sardines both with bones, tofu processed with calcium and leafy vegetables.

“Given the modest benefits of calcium supplements, a reassessment of the role of calcium supplements is warranted” the scientists behind the study wrote in the British Medical Journal.

Experts however added, “Anyone who has been advised by their doctor to take calcium supplements shouldn’t stop because of this research alone.”



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Study: Supplement Vitamin D For More Muscle, Less Fat

Vitamin D has seen a lot of popularity lately thanks to discoveries about its mood-boosting abilities. The so-called “sunshine vitamin” (the term refers to the fact that it can be absorbed via sunlight) is now being sold not only on its own but as a part of many other foods and beverages. Milk fortified with Vitamin D, for example, is a big seller. The vitamin is considered to be particularly important for those in areas such as the north east, where the sun doesn’t shine as readily as it does other areas.

But don’t think that just because you live in a warm, sunny climate that you don’t need to worry about Vitamin D. In addition to possibly contributing to your happiness, studies have indicated that Vitamin D can enhance your immune system and protect against disease. In addition, Vitamin D aids in the utilization of calcium, which helps maintain healthy bones. Research has shown that Vitamin D helps keep levels of calcium in the bloodstream at ideal levels. This benefits the function of the nervous system in addition to benefiting bone growth and maintenance (1).

And if you’re still not swayed, perhaps the latest Vitamin D discovery will convince you of the need for this vitamin. Fitness enthusiasts, or anyone generally interested in their physical fitness and appearance, will be interested to see the results of a study from the journal Nutritional Research.

In the study, researchers separated rats into two groups: one fed excessive amounts of calories thanks to a significant amount of added oil for fat content, and the other group fed a high-calorie diet driven by sugar. Each of these groups was split in half, with one half receiving a “sub-optimal” dose of Vitamin D and the other receiving 10,000 IE of Vitamin D, and a slightly higher amount of calcium than what the other half received.

The researchers were surprised to find that despite the overfeeding, the rats receiving the large dose of Vitamin D and calcium actually got thinner and more muscular. According to analysis, the rats receiving the high Vitamin D and calcium doses manufactured more of a protein that helps muscles burn fat for energy. The researchers believe that this change, as well as an increase in insulin receptors prompted by the supplements, led to the improvements in body composition (2). Obviously, this information is valuable for those dieting and those looking to gain lean muscle mass – who couldn’t use extra muscle and less fat? All it takes, according to this research, is a lot more Vitamin D and some calcium – which makes Vitamin D-fortified milk look like an ideal addition to one’s diet, as it would deliver both nutrients plus protein.



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More Possible Vitamin D Benefits

Vitamin D has been making its way into the news more frequently these days. This attention has been slow in coming but researchers seem interested in making up for lost time.

Vitamin D has long been acknowledged for its role of assisting the body in the absorption of calcium. It is essential for strong, healthy bones. But wait, there's more.

While research is in its early stages, some interesting data has been emerging. Recent studies indicate that there may be a correlation between low levels of Vitamin D and mental deterioration.

And it is possible that a correlation exists between low Vitamin D levels and the danger of loss of balance or falls, for older people.

"But vitamin D also seems to have anti-inflammatory effects that may help keep blood vessels healthy, ensuring nutrient- and oxygen-rich blood flow to brain cells, says Amie Peterson, MD, of Oregon Health & Science University in Portland."

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Cod Liver Oil: A Fabulous Source of Omega 3

Cod liver oil is not only a fabulous source of omega 3 fatty acids, important for brain purpose and cardiovascular health, but also a good source of vitamin D and A, especially important in the winter months in parts of the world where there is little sun, and vitamin D deficiency is common. If your shadow is longer than you are when you are in the sun, your body can't make vitamin D. Because there are not many foods that contain much vitamin D, and people have been frightened away from precisely those foods like lard, liver, eggs etc. due to the erroneous belief that cholesterol and saturated fat are unhealthy, cod liver oil would seem to be an excellent choice in the winter, especially since synthetic vitamin D supplements are less reliable than a food for obtaining health benefits. It should also be noted that the Inuit live in darkness for many months of the year - no sun available at all - and they traditionally relied on food sources for their vitamin D - seal blubber and lots of fatty fish. They did not emerge to have any signs of vitamin D deficiency. I would picture that because we are all biochemically different, we would all require different amounts of vitamin D and A to be healthy. There is definitely some indication of that concept based on this study of calcium absorption in Inuit children.

Based from the researches made by www.finlandiapharmacyonline.com, Cod Liver Oil store carries a broad selection of products of name-brand manufacturers; you will find here an extensive selection of Cod Liver Oil at best competitive price. Allnutri's marketplace offers a fine comparison of price, product reviews and updated offers from top rated online health stores.

Cod liver oil is one of the most effective providers of omega-3 fatty acids, and an excellent source of vitamin A and vitamin D. Cod liver oil supplements are a necessity for women and their male partners, to be taken for several months before conception, and for women during pregnancy. One hundred grams of regular cod liver oil provides 100,000 IU of vitamin A, almost three times more than beef liver.

The Benefits of Code Liver Oil

1. Helps fight and avoid widespread diseases like heart disease, cancer, diabetes, Alzheimer's and many others.
2. Known to increase energy levels and concentration
3. Increase resistance against flu and cold
4. reduces risk of depression by as much as 30%
5. Improves cardiovascular health.
6. Research studies made from 1918 to 2001 rated cod liver oil an A+.
7. Contain high amount of vitamin A, D and omega 3 fats.

Finlandia Natural Pharmacy & Health Centre has been constantly meeting over 500, 000 customers’ varying necessities worldwide for 35 years. As an answer to the great challenge of Customer Satisfaction, we would like inform you the closing of www.canadadrusuperstore.com and at the same time share with you the successful Grand Opening of the new online pharmacy, www.finlandiapharmacyonline.com.

This 2010, we are giving overwhelming treats to our valued customers by offering GREAT DISCOUNTS on Best-Selling items plus, FREE SHIPPING for orders over $99.00 for the month of February. Experience and share increased presence, mindfulness and open-heartedness with your loved ones. Don’t let expensive medications and shipping costs hinder you from getting what you want and extending generosity.

Order online for Great Discounts! For more information please visit, http://www.finlandiapharmacyonline.comor call Toll-free hotline 1-800-363-4372.



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Sunshine and Vitamin D: A Catch 22

I don't want to rub it in for those of you living in more northern locales, but I'm sitting on my back porch today enjoying a 72 degree, perfectly sunny day in mid-February. (This is one of the many reasons why I love living in Austin, TX!) But even in Austin, we've had a pretty rainy and cold winter as far as winters go. For those of you living in Minnesota, no laughing please. And that means there has not been a whole lot of sunshine, which I usually take for granted.

In medical school (almost 20 years ago now - wow, time flies), I learned that sunshine is a key catalyst for humans to convert a chemical in our bodies to vitamin D. And, vitamin D is essential for our body to absorb and utilize calcium and phosphorous - thus, it's critical for healthy bones. Only recently has research pointed to even greater health benefits, like protection from certain types of cancers, autoimmune diseases, and high blood pressure.

The sun, not our diet, used to be the easiest way to obtain vitamin D. That is, until sunblock was developed to protect us from dangerous UV rays and skin cancer - hence the Catch 22. You have to choose the lesser of two evils...skin cancer or vitamin D deficiency.

You may not realize this, but very few foods contain vitamin D naturally. Milk is actually fortified with vitamin D - it's not in there when it comes from the cow. And even then, almost no one drinks enough milk to reach her daily vitamin D requirements. (More on this below). Cod liver oil is a good source of Vitamin D, but not too many people (adults or kids) guzzle this stuff.

Well, I also graduated from medical school thinking I'd never have a vitamin D deficiency living in a sunny place like Texas - especially since I'll sit outside and enjoy the sunshine for 15 minutes everyday without sunblock on (don't tell my dermatologist). Wrong.

Since vitamin D deficiency and vitamin D's health benefits have been such a hot topic of late, I asked my family doctor to test my vitamin D level at my annual physical recently.

At first, she laughed and said, "You're going to be deficient. Everyone is."

I replied, "Humor me. If I see how bad my numbers are, I'll be more inspired to take that vitamin supplement you're going to prescribe."

Well, the joke was on me. My vitamin D level was so low, it didn't even register! I am being a good patient and taking my vitamin D replacement pills now and will be taking a supplement going forward. I'm also going to encourage my own patients (even more than I already have) to take vitamin D supplements after this little experiment.

According to the American Academy of Pediatrics, babies under one year of age who are breastfed or who drink less than 32 oz a day of formula need 400 IU of a vitamin D supplement once a day. Infant vitamin supplements like Tri-Vi-Sol or D-Vi-Sol both have 400 IU per dropperful. And, after your child's first birthday, he also needs 400 IU of vitamin D a day. There's 100 IU of vitamin D per 8 oz of cow's milk (whole or 2%). So, if your child drinks the recommended 16 oz a day from age 1-3, he still lacks 200 IU of vitamin D a day. And once your child turns 3, if he isn't drinking at least a quart (32 oz) of skim or non-fat milk a day, he also needs a vitamin D supplement.

And, since many adults are also vitamin D deficient, you might want to consider picking up 1000 IU vitamin D supplements for yourself. And, take a moment to enjoy the sunshine if you've got any where you are!


- Ari Brown, MD, FAAP



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10 superfoods to eat in 2010

The term “superfoods” gets thrown around a lot, especially this time of year. Unfortunately, it’s often attached to nutrient-rich foods that are expensive, obscure or, um, something of an acquired taste.


So our list of superfoods for 2010, developed from conversations with dietitians, kinesiologists and holistic-health experts, is more practical. Our suggestions pack a big nutrient bang per calorie and deliver health benefits you need — but you probably already like and eat many of them, like romaine lettuce, walnuts, even seaweed. (Who knew it’s not just the fish that’s good for you in sushi?)


Resolve to eat these 10 foods, and be a healthier you in 2010.

1. BLUEBERRIES

Why you should eat more: Blueberries are packed with antioxidants, which help protect the body from disease; they’re high in potassium, vitamin C and fiber, all for about 80 calories a cup. Recent studies have suggested they may help protect against heart disease, cancer (especially colon and ovarian) and age-related diseases such as Alzheimer’s. In general, the darker the berry, the more health benefits, so load up on blackberries and elderberries, too.

How to up your intake: Fresh berries can be expensive and anemic-tasting in the winter, but frozen will work just fine, especially in a smoothie or stirred into yogurt. Processing, however, strips them of many nutrients, so that blueberry muffin doesn’t count.

2. QUINOA

What it is: It looks and cooks like a grain, but it’s really the seed from a leafy plant closely related to spinach.

Why you should eat more: Quinoa is a better source of complete protein than the foods it can stand in for, like rice. It provides more iron than most grains, and high levels of potassium and B vitamins. It’s also gluten-free and easily digestible, even for those with wheat allergies.

How to up your intake: Easy to prepare; it cooks in about 15 minutes. Boost the flavour by toasting in a skillet for five minutes before cooking one part quinoa to two parts liquid. Serve as a hot cereal topped with honey and yogurt; use as a substitute for rice pilaf or pasta.

3. SEAWEED

What it is: Most seaweed eaten in this country is nori, best known as those dried, dark-green sheets used in sushi rolls.

Why you should eat more: Seaweed is rich in iodine, which many Americans don’t get enough of. Iodine affects the thyroid, which helps regulate metabolism, nerve and muscle function, and it may boost resting metabolism. Some studies suggest it may even help prevent breast cancer.

How to up your intake: Sushi rolls, of course. At Japanese restaurants, also try it tossed in a soy/sesame/rice-wine vinegar dressing as a salad, or floating in miso soup. Or choose rice crackers flecked or wrapped with seaweed, available at Asian grocers.

4. WALNUTS

Why you should eat more: Unlike other nuts, walnuts are high in omega-3 fatty acids, the kind associated with fish like salmon and sardines. These fatty acids have been shown to reduce the risks of heart disease and stroke, prevent blood clots, protect against irregular heartbeat, decrease blood pressure and enhance the immune system.

How to up your intake: Walnuts are extremely high in calories, so use moderation; sprinkle on a salad (see recipe) or toss into a trail mix with dried fruit and air-popped popcorn.

5. KEFIR

What it is: A fermented dairy product drink, it’s kind of a cross between buttermilk and yogurt. Once available only in health-food stores, it’s in many mainstream grocers, often near the soy milk.

Why you should drink more: As a dairy product, it’s high in vitamin D, essential for bone growth and development. Recent studies also suggest vitamin D may help the immune system and protect against tuberculosis, multiple sclerosis, hypertension and some forms of cancer. Also, while most yogurts contain one to three types of probiotics, which aid in digestion, kefir has 10; it also contains prebiotics, which help probiotics work better. Finally, because it’s fermented, it’s easier to digest by people who are lactose-intolerant.

How to up your intake: Use it to top oatmeal; substitute for yogurt or sour cream in recipes; eat it straight, either fruit-flavored varieties or sweetened with honey, berries and granola in a parfait.

6. APPLES

Why you should eat more: They’re not flashy, but the often-overlooked apple is high in fiber (4-5 grams per apple) and lower in sugar content on the glycemic index than fruits such as bananas or grapes, so they’ll hang around in your stomach a while longer, making you feel full longer. Chewing one can even clean your teeth. Plus, they’re so practical, you have no excuse not to substitute one for that candy bar. They’re relatively cheap, widely available and highly portable — they don’t have to be refrigerated, sliced, cooked or even peeled, and they’re sturdy enough to roll around in your gym bag all day without getting mushy.

7. CHILES

What it is: Any hot variety will do, including jalapenos, poblanos, serranos, Scotch bonnets, cayenne or habaneros.

Why you should eat more: The capsaicin in chiles, which makes them hot, also is believed to have a thermogenic effect — some studies have suggested eating them can increase your metabolism rate and help burn calories. A bonus: Chiles add a ton of flavor for little caloric cost. And because of the heat, you can’t gulp down your food; you have to enjoy it slowly, which gives your stomach time to recognize it is full.

8. LENTILS

What it is: Part of the legume family, they come in a variety of colors — white, yellow, green, red, brown — which all pack roughly the same nutritional punch.

Why you should eat more: A good, inexpensive source of protein popular in world cuisines, especially Middle Eastern and Indian, lentils also provide high levels of folic acid. This nutrient, chronically under-consumed by Americans, helps prevent anemia, may help relieve menopausal hot flashes and is an important nutrient for women who are pregnant, as it’s crucial for fetal development.

9. EGGS (organic, please)

Why you should eat more: Eggs have had a hard time shaking that bad reputation they got in the ‘80s, when cholesterol was a buzzkill. More recent research, however, has shown the complete protein and other nutrients in eggs far outweigh any risks for most people. Eggs are also considered an anti-inflammatory food, meaning they can help reduce bodily inflammation thought to lead to chronic disease including stroke, heart disease and diabetes. They also are a great source of choline, which helps brain functioning, including memory, intelligence and mood, and may help prevent heart disease.

10. ROMAINE LETTUCE

Why you should eat more: All greens are good for you, and the darker the better. They’re natural antioxidants and provide a plethora of vitamins and minerals, especially vitamins A, K, C and foliate. But unlike other greens like kale or collards, romaine needs no cooking or special preparation, is palatable to almost everyone and is available virtually everywhere — Caesar salad, anyone?

4 cups romaine lettuce, torn into bite-size pieces

6 cherry or yellow grape tomatoes (sliced in half)

4 toasted walnut halves

1 tablespoon golden seedless raisins

1 / 4 red onion, sliced thinly

2 tablespoons goat or sheep feta cheese, crumbled

1/4 avocado (cut in small cubes)

1/2 small, tart apple (Granny Smiths work great), sliced thinly or cubed

For dressing:

1/2 teaspoon honey

1 teaspoon balsamic vinegar

1 teaspoon orange juice, freshly squeezed

1 teaspoon extra-virgin olive oil

1. Place salad ingredients into a bowl and toss.

2. Mix dressing ingredients and pour over salad. Serve immediately.

Adapted from www.netnutritionist.com, Gay Riley’s Web site



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The Pill May Decrease Bone Density

Recent Study shows that Oral contraception may decrease bone density in young women.

Those taking birth control pills for more than two years, and those on the low-dose estrogen pills appear to have the greatest risk of decreased bone density in the spine and whole body, according to the researchers.

"I think the evidence is still emerging on this association, but our findings suggest that low-dose oral contraceptives with long-term use have some impact on bone density," said study author Delia Scholes, a senior investigator at the Group Health Research Institute of Group Health Cooperative in Seattle.

The findings were published in the January issue of Contraception.

What isn't entirely clear from this study of women under 30, explained Scholes, is what the long-term impact might be. Researchers don't know if the lower bone density findings are easily reversible just by stopping the use of oral contraceptives. They also weren't able to study if the lower bone density in these young women would translate to a higher fracture risk later in life.

But, "if oral contraceptives are indeed causing the approximately 5 percent lower spine bone density for oral contraceptive users versus non-users that we observed in our study, and if that impact is not reversed with oral contraceptive discontinuation or with other factors that may occur across the life span, a 5 percent lower bone density after menopause is associated with approximately 50 percent more osteoporotic fractures," said Scholes.

Almost 12 million American women are currently using oral contraception, according to background information in the study. And, the use of oral contraception is highest in women under 30, reports the study. That's important because the 20s are generally a time of peak bone mass production.

However, little is known about the effects of oral contraception on bone density. Previous studies have had conflicting results, with some showing no effect or a benefit on bone density while others suggest that oral contraceptives may inhibit bone mass accrual.

The current study was comprised of 606 woman between the ages of 14 and 30. The researchers reviewed oral contraceptive use, the duration of use and the estrogen dose in the contraception, and compared this to bone mineral density tests. The bone density test measured bone density in the hip, spine and whole body.

When the researchers compared oral contraceptive users to non-users they found that women taking oral contraception had average bone mineral density levels that were 5.9 percent less for the spine and 2.3 percent lower for the whole body. There was a trend for lower bone density in the hip as well, though this trend didn't reach statistical significance.

The researchers also noted a trend toward lower bone density in women taking oral contraceptives containing lower doses of estrogen, with the lowest readings in women taking formulations containing less than 30 micrograms of estrogen.

The researchers found no effects in the 14- to 18-year-old age group. However, Schole said it's important to note that contraceptive use was less in this age group than for the women between 19 and 30.

Scholes said the researchers suspect that the hormones in birth control pills are likely affecting normal hormone levels -- perhaps lowering normally circulating estrogen levels -- which then affects bone production.

"The studies on oral contraception and bone density have been conflicting," said Dr. Beatrice Chen, director of the Center for Family Planning Research at Magee-Women's Hospital at the University of Pittsburgh Medical Center. "Although this study adds to that information, I don't think young women should be scared into stopping birth control. Talk with your doctor about your own risk factors, and the risks and benefits of using oral contraception."

Chen said that studies on longer-term birth control, such as Depo-Provera, have shown that when the contraception is stopped, bone levels quickly return to normal.

If you're concerned about your bone health, Chen said that there are steps you can take to help prevent bone loss, including: consuming adequate calcium and vitamin D, participating in weight-bearing exercise and quitting smoking.

More information

Learn more about your bone health from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.



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Study Confirms Benefits of Vitamin D and Calcium for Bone Strength

A new study has proven that nutritional supplements such as vitamin D and calcium can prevent bone fractures, a practice many physicians have been recommending for quite some time.

Research conducted at UC Davis in Sacramento, California, revealed that individuals who take the nutritional supplements on a daily basis reduces the risk of bone fractures regardless of gender and age.

The findings represent a large effort from researchers around the world, determining the benefits of calcium and vitamin D in post-menopausal women, adult men and younger patients of both genders.

Various reports have confirmed that the supplements help post-menopausal women prevent osteoporosis, which affects roughly 8 million American women.

The researchers discovered that combining both of the supplements provides better results than when they are taken separately.

"This combination of supplements benefits both women and men of all ages, which is not something we fully expected to find," explained co-author John Robbins, a professor at UC Davis. "We now need to investigate the best dosage, duration and optimal way for people to take it."



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