Milk Strike

Infant Feeding

Health experts say the best source of nutrients for a baby is breast milk. Breastfeeding has benefits for the baby and for mom. For the baby, breast milk contains the right amount of nutrients to support the infant’s growth and development. For the mom, breast milk is readily available (no mixing formula or heating bottles). Breastfeeding also provides a close bond between mom and baby.

The American Academy of Pediatrics recommends breastfeeding until a baby is at least six months old. Women who don’t breastfeed can use iron-fortified infant formula. At about four to six months, many infants can be introduced to baby cereals. Other baby foods are slowly offered starting around six months.

Milk is an important source of nutrition for children as they grow older. It provides calcium, vitamin D and minerals needed by the body. Whole milk is recommended for most children until they reach two because most children need the extra fat and calories. After two, parents can switch to low-fat or nonfat milk.

Experts warn parents should avoid giving cow’s milk until a child reaches his/her first birthday. Tyrala says cow’s milk is a great source of nutrition for calves, but not for humans. A baby’s digestive system can’t handle the extra protein in cow’s milk. Adding it too early to a child’s diet can cause liver and kidney damage and increase the risk for an allergic reaction.


Transition Troubles

Most children take the change from breast milk or formula to cow’s milk in stride. But sometimes babies become very fussy and don’t want to accept cow’s milk. Occasionally, a baby will refuse to drink cow’s milk and go on a “milk strike.”

Eileen Tyrala, M.D., Pediatrician at St. Christopher’s Hospital for Children in Philadelphia, says taste is probably the biggest obstacle for babies when parents try to transition to cow’s milk. Human milk and formulas are much sweeter than cow’s milk and there are differences in the thickness and temperature of the milks. For breastfed babies, the change to a bottle or cup can trigger a loss of bonding associated with breastfeeding.


Tyrala offers some tips for parents who are having trouble with infants on a “milk strike”:

•Offer cow’s milk in a sippy cup. This helps the baby make the association between the new drink and the different taste and texture.

•Go slowly. If the child is very resistant to the change, try just one serving of cow’s milk a day. Then gradually increase the number of servings of cow’s milk. It can take several days to two weeks for the child to reach the goal of drinking all cows’ milk.

•Dilute the familiar drink. Use three parts breast milk or formula to one part water. This will slightly alter the taste and texture of the “familiar” drink and, hopefully, enable the child to gradually accept a different drink (cow’s milk). Tyrala says it should only take a few days for a child to accept cow’s milk using this technique, so the temporary loss of calories won’t have any great affect on the infant.

•Add some low-sugar flavor. Tyrala doesn’t like the idea of adding sugar-laden flavorings to make cow’s milk as sweet as formula or breast milk. If taste appears to be an issue, she suggests adding powdered flavorings with less sugar.

•Try a substitute. Try an alternative to cow’s milk, like soy milk, rice milk or potato milk. Make sure these substitutes are pasteurized and are supplemented with calcium and vitamin D. If a child continues to refuse to drink cow’s milk, try yogurt, soft cheeses or calcium fortified orange juice.

If you have any specific questions or concerns about feeding your children, talk with your health care provider. For general information:

• American Academy of Pediatrics

• National Institute of Child Health and Human Development

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Formula for health is not in the vitamin aisle

It's estimated that 40 per cent of Canadians take vitamin and mineral supplements each day. Yet according to a report in the December issue of the Journal of the American Dietetic Association, the formula for optimal health isn't in the supplement aisle of a health-food store.

Instead, the best strategy for staying healthy and lowering your risk for heart disease, diabetes and certain cancers is to eat a wide variety of nutrient-rich foods – a practice that for many people is not a habit.

Still, the report recognizes that some people do require vitamin and mineral supplements. Knowing which ones to take – and how much – can be confusing.

The fact is, the maintenance of good health is related more to the types and amounts of foods you eat than to the amount of certain vitamins or minerals you consume. When obtained from foods, certain nutrients have been demonstrated to guard against a number of health conditions. But studies investigating the effect of supplements on health outcomes have turned up disappointing results.

Foods are complex, providing more than just a single vitamin or mineral. Plant foods such as fruits, vegetables, legumes, nuts and whole grains also contain fibre, along with hundreds of disease-fighting compounds called phytochemicals. It's thought that vitamins and minerals work in concert with other components of food to exert health benefits.

You've heard it over and over: Choose mainly whole grains, get seven to 10 daily servings of fruit and vegetables, eat beans and lentils more often, and so on. Yet a very small percentage of Canadians lives by Canada's Food Guide.

According to national survey data, Canadians of all ages don't get enough magnesium, folate or potassium from their diet. Most adults don't get enough calcium from foods. And women under 50 consume too little iron.

While it's ideal to try to meet your daily nutrient requirements from food, for some people this is hard to do. Pregnant women, nursing mothers, strict vegetarians, people with food intolerances and allergies, and elderly adults often need to fill dietary gaps with a multivitamin and mineral pill.

People with certain health conditions, or who take medications that alter their need for some vitamins or minerals, may also need to rely on supplements. And older adults, people with dark skin and those with inadequate sun exposure require extra vitamin D.

If you fall into one of the following categories, consider taking certain supplements in addition to eating plenty of nutrient-rich foods.

Women of childbearing age

Women who may become pregnant should take a multivitamin supplement that provides 0.4 to 1 milligram of folic acid, a B vitamin that reduces the risk of neural tube defects – birth defects that affect the brain and spinal cord.

Menstruating women also need 18 milligrams of iron per day, an amount that's challenging – if not impossible – to get from foods alone. Look for a multivitamin with 10 to 18 milligrams of iron. (Vegetarians need an extra 14 milligrams to account for reduced iron absorption from plant foods.)

Pregnant women

During pregnancy, women need 0.6 milligrams of folic acid from a daily supplement in addition to food sources of folate. Natural sources include spinach, lentils, asparagus, broccoli, avocados and oranges.

Pregnant women also need 27 milligrams of supplemental iron each day (vegetarian women 48 milligrams). Choose a prenatal multivitamin supplement with 0.6 to 1 milligram of folic acid and 27 milligrams of iron.

Older adults

The U.S.-based Institute of Medicine advises that people over 50 get 2.4 micrograms of vitamin B12 each day in the form found in fortified foods and supplements. That's because aging reduces ability to digest B12 from food.

Vitamin B12 helps maintain nerve function, keeps red blood cells healthy and is needed to make DNA. Evidence also suggests it may guard against heart disease and maintain cognitive function.

To get your B12, choose a multivitamin and mineral supplement. If you prefer, take a B-complex supplement that contains all eight B vitamins.

Choose a product that provides no more than 0.4 milligram of folic acid, the recommended daily intake. Recently, there's concern that higher doses may accelerate the growth of pre-cancerous cells or early cancer growths.

In healthy cells, folic acid ensures that DNA replicates normally. But cancer and pre-cancer cells synthesize new copies of DNA faster than normal cells and need folic acid to multiply.

There's no evidence that the B vitamin in foods is harmful. In fact, the evidence shows that a diet rich in natural sources of folate is good for you.

At 50, calcium requirements increase to 1,500 milligrams daily. In most cases, people need to rely on calcium supplements in addition to diet to meet daily needs.

More vitamin D

Evidence suggests that optimal vitamin-D status helps prevent certain cancers, heart attacks, multiple sclerosis, diabetes, osteoporosis and rheumatoid arthritis.

The fact that Canadians don't produce enough vitamin D in their skin from sunlight between October and March prompted the Canadian Cancer Society in June, 2007, to recommend that adults take 1,000 international units (IU ) of the vitamin daily in fall and winter.

Older adults, people with dark skin, those who don't go outdoors often, and those who wear clothing that covers most of their skin should take the supplement year-round.

Before you buy, figure out how much vitamin D you're already getting from multivitamin and calcium supplements. Choose a supplement than contains D3 instead of D2, which is less potent.

Haphazard eaters, dieters

If you don't eat well despite your best intentions, or you consume less than 1,600 calories per day, a multivitamin and mineral supplement can help make up for shortfalls. But keep in mind that supplements can't replicate the nutritional and health benefits of whole foods.

Speak to your dietitian or doctor about which supplements and what doses might be appropriate for you. If you take medications, ask about possible interactions.

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The Good Stuff - High Fat Foods You Should Keep on your Diet Menu

If one of your New Year’s resolutions is to lose weight, chances are you’re already thinking about the foods you’ll be chopping from your menu. Lasagna, chocolate chip cookies, devil’s food cake and other fat-laden treats probably top the list. But Hy-Vee dietician Sheri Caldwell says as crazy as it sounds, there are some fattening foods that you should eat when you’re on a diet. These foods provide valuable nutrients that your body needs.

So if you’re making a New Year’s resolution to lose weight, make sure you keep these foods on your plate.

Nuts

“Many people think they should avoid nuts because they are high in fat and calories,” Ms. Caldwell says. “The good news is nuts provide unsaturated fats — the kind that is better for your heart health — protein, fiber and minerals.”

They also make a great snack when the afternoon munchies hit. They’re easy to grab and go, have a pretty good shelf life and provide more nutritional value than most “snack foods.” They also can be filling enough to last a few hours.

“Add a sprinkle of nuts on salads or in trail mixes,” Ms. Caldwell suggests. “Keeping the portion to about a handful will provide the health benefits without overdoing the calories.”

Peanut butter

Peanut butter is a great source of protein, fat and other vitamins and minerals and is another quick, economical option for a meal or snack. Again, the key is moderation. A tablespoon or two of the peanuty spread is all you need, and Ms. Caldwell says the best overall choice is a peanut butter that has the oil on top and doesn’t have any added sugars and hydrogenated fats. And be sure to check the labels. A reduced-fat peanut butter may contain more sugar and sodium than regular peanut butter.

“I recommend to stir the oil into the peanut butter before using,” she says. “This makes it possible to get a thin layer instead of a thick glob of peanut butter. If you prefer a peanut butter that is a bit sweeter and does not require mixing before use, select one with the least saturated fat and sugar.”

Cheese

Besides being pretty yummy, cheese is a good source of all kinds of nutrients including calcium, potassium, vitamin D and protein, which are important for a healthy bone mass and a reduced risk for osteoporosis. Those nutrients also help regulate the body’s fluid balance and maintain healthy blood pressure.

“It is recommended for most healthy adults to consume three to four servings of dairy daily, including milk, yogurt and cheese,” Ms. Caldwell says. “To reduce fat intake, try a low-fat variety or try using less of a stronger flavored cheese.”

Pasta/bread/rice

Pasta, bread and rice often get a bad rap because many people mistakenly view them as fattening. The truth is if consumed in moderation, these carbohydrates are a great source of important nutrients like B vitamins, minerals and fiber. And if they’re whole-grain varieties they can provide a unique nutrient package that refined foods lack.

“I recommended selecting whole-grain pasta, bread and brown rice,” Ms. Caldwell says. “To find whole-grain products, look for the word “whole” on the food label and in the ingredient listing, preferably as the first ingredient. Then pair them with lean meat or peanut butter and fruits and vegetables for meals and snacks.”



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The Importance of Multivitamins

Dr. Michael Roizen knows your secret. You're not eating enough fruits and veggies.

That's why most Baby Boomers need a multivitamin, said the chairman of the Wellness Institute at the Cleveland Clinic.

When it comes to opinions about the need for multivitamins, there seems to be, ahem, one a day.

Mount Sinai School of Medicine's Dr. Victor Herbert famously fell on the side of the skeptics, declaring, "supplements help some, harm some, and do nothing for most, so the bottom line is a wash," in the book Total Nutrition: The Only Guide You'll Ever Need, first published in the mid 1990s.

Until recently many doctors sided with Herbert, telling their patients that spending money on vitamins amounted to creating expensive urine.

But as Boomers have aged, nutrition science has advanced as well.

Studies are increasingly showing large gaps between optimal nutrition and what typical Americans are taking in from food, gaps that are easily surmounted with vitamins.

Roizen has data to prove it.

Co-author of You: The Owners Manual, Roizen is also the co-creator of the Web site RealAge.com . On that Web site, people report on their health status, including diet, to learn whether their "real age" is younger or older than it should be, and to glean wellness tips.

Based on users' responses, Roizen says he's certain about most adults' need for a multivitamin.

"We've had 27 million people take the RealAge program," Roison says. "A little less than 1 percent can get the right vitamins and minerals from their diet alone. It's possible, but it isn't done commonly in America. We just don't eat right."

For once, Boomers are following their doctors' advice.

According to Nutrition Business Journal estimates, U.S. consumer sales of dietary supplements reached $25.2 billion in 2008 on 6.2 percent growth. The multivitamin category accounted for $4.7 billion of these sales in 2008, on 4.3 percent growth.

But it's not necessary to go broke buying fancy brand-name vitamins, Roisen said. He tells patients at the Cleveland Clinic that a low-cost multivitamin will meet their basic needs. Grocery store brands are usually fine, he said. They're often manufactured by the same companies as the expensive vitamins, using the same basic ingredients.

But there are some other vitamins he suggests adding to the multivitamin.

His tips:

"You want to look for a multivitamin that has less than 3,500 international units of vitamin A," he said.

Buy a pill splitter, and take part in the morning, part at night, to improve absorption, he said.

Most Boomers need extra vitamin D, in the form of D3, as well, he said. Those under age 50 need around 1,000 IUs, while those over age 50 should get 1,200 IUs.

Two hours after taking their multivitamin and extra D, he recommends taking 600 mg of calcium two times a day, plus 200 mg of magnesium two times a day.

Last, he wants most of his adult patients to take fish oil, for the omega 3 fatty acids which benefit heart, brain and vascular health. Look for ones that offer 600 mg of DHA, he said. In his books, Roizen cautions patients to stay within his guidelines, and not fall for the "if a little is good, a lot must be better" mentality.

"There is toxicity from too much of some of the vitamins and minerals, so you want to make sure you stay within the guidelines of what we write," he said.

In Boynton Beach, internist Dr. Stacey Shinder has her patients bring in their vitamins, to ensure they're taking the right amounts, and not taking anything that might interfere with their prescription drugs.

Niacin, for example, can affect liver function, she said, and high doses of that and selenium can pose problems. Fish oil and blood-thinning drugs may be a bad combination.

Shinder, part of the MD VIP concierge group, charges members $1,500 a year for the extra attention. But she doesn't just go over vitamins with her patients. She orders blood tests to assess their levels of vitamin D, iron and other nutrients.

And she wants to hear about their diet.

"I often will have patients keep food diaries for me. Especially when we have weight management issues."

While she prefers good diet to vitamins, she's realistic.

"I am more of a believer in getting people to eat more fruits and vegetables, more colors, more varieties," she said. "No vitamin is a magic pill."

Rich or poor, the advice is similar.

Sue Grammond, registered dietitian at the Palm Beach County Health Department, also encourages clients to take a multivitamin. But she tells them if money is short, it's most important to eat a variety of colorful fruits and vegetables, and go for frozen veggies if fresh are difficult to keep, she tells them.

"One of the mantras in nutrition is food first," Grammond said. "It comes with the vitamins, the fiber, the whole package when you eat the whole thing."

Dr. Roizen's vitamin advice for Boomers:

1. Take a multivitamin that contains no more than 3,500 IUs of vitamin A. Buy a pill splitter, and take half the multivitamin in the morning, half at night.

2. Take additional vitamin D3. Those under age 50 need around 1,000 IUs a day, while those over age 50 should get 1,200 IUs a day.

3. Add calcium two hours after your multivitamin. Aim for 600 mg of calcium two times a day, plus 200 mg of magnesium two times a day.

4. After checking with your doctor, take a fish oil capsule with 600 mg of DHA per day.

5. Beware mega doses of vitamins. Too much vitamin A, niacin, vitamin E, and other nutrients can cause health problems, so talk to your doctor about what you're taking.

The buzz word is phytonutrients. The claim is that hundreds of plant compounds are still unknown, and benefit the immune system, the vascular system and general health.

But can they be turned into juice, freeze-dried, pressed into a capsule, and still offer health benefits? Top brands promising whole-food benefits include Juice Plus+, Nutrilite, Dr. Mercola's Whole Food Multivitamin and GNC's Maximum Greens, among others. These supplements can be much more expensive than a multivitamin.

A 31-day supply of Nutrilite's Double X multivitamin/mineral and phytonutrient pack costs a whopping $71.41. A month's supply of Juice Plus+ is $41.75. And a month's supply of GNC's Maximum Greens Ultra Mega Green Vitapak costs $35.99.

But are they worth it?

Nutrition Professor Susan Percival thinks it's likely.

At the University of Florida's Department of Food Science and Human Nutrition, in Gainesville, she is studying the effect of several natural food compounds on immune system cells called gamma delta T cells.

The cells play a dual role, first by attacking germ invaders, then by dialing down the inflammatory response after infection has passed.

Mounting an immune attack requires just about every nutrient there is to produce armies of these immune cells, she said. Several plant compounds that are not found in multivitamins play an important role in priming the immune cells, she said.

Those compounds include catechins, found in green tea, cocoa and grapes, and anthocyanins, found in blueberries, Concord grapes and cranberries.

For research published in 2006, she enrolled 59 UF law school students in a study on Juice Plus+ capsules. She found those who got the real capsules and not the placebo had increased blood levels of nutrients and antioxidants, fewer DNA strand breaks, and an increase in circulating gamma delta T cells.

Many of the beneficial food compounds are in their pigments, the chemicals that make them colorful. Eating colorful fruits and vegetables is best, because you get the fiber, she said. But the capsules she studied had definite benefits.

"I cannot generalize to all whole food capsules except to say the ones I know take very good care to preserve much of the nutritional value that the whole fruit and vegetable had," Percival said.

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Vitamin D: key to preventing cancer and heart disease

Make sure you're drinking your milk because it gives you a strong healthy heart?

It's the latest in research about vitamin D that's linking it to everything from protecting you against heart disease to preventing cancer.

And with nearly 60 days cloudy days on average during the winter, it's no wonder so many of us are vitamin D deficient, and that's not a good thing.

Recent studies on the vitamin have found it might be more important to the body than any other, "It is represented in over 13 different organ systems in our body. Our central nervous system, our pancreas, our intestines, our muscles our bones." Dr. Mark Gostine with Michigan Pain Consultants in Grand Rapids has been studying the affects of vitamin D on the body for nearly a decade.

"What we're finding out is vitamin d has tremendous impact on multiple diseases."

Gostine says it can aid in preventing cancer and protecting you against heart disease, "Vitamin D can dampen the inflammation that leads to the hardening of the arteries and that of course can lead to heart failure."

That's a theory that's recently been supported by the American Heart Association. A recent study of nearly 28,000 patients showed that those who were deficient in vitamin D were twice as likely to have diabetes and high blood pressure.

But it's not just heart disease where doctors are discovering the benefits of vitamin D, Dr. Gostine believes it may even help in the prevention of certain cancers like breast and prostate, "The immune system is probably the common denominator here with vitamin D."

Vitamin D is actually a hormone steroid not a vitamin. So the body uses it to regulate the immune system which helps the body in the fight against cancer. "By up regulating the immune system it can help the white cells and all the immune components that are looking for the cancer trying to stamp out the cancer when it's very small when it can still be treated by the bodies immune system.", says Gostine.

So how much vitamin d should we get every day?

Dr. Gostine believes that the 400 units in your multi-vitamin aren't nearly enough because the recommended daily allowance for vitamin D supplements was based on a child's dosage in the 1940's

Dr. Gostine would like to see adults get at least 4,000 units a day or more depending on your level of deficiency.

Melissa Cooper has suffered with back pain for nearly a decade undergoing two unsuccessful surgeries before being recommended to Dr. Gostine. The first thing he did was check to see if she was vitamin d deficient, "I just couldn't believe it when they said my vitamin d level was so low."

In fact it was one of the lowest levels Dr. Gostine had ever seen and immediately placed her on 50,000 units of vitamin D a week. It took more than three months to get Melissa up to normal levels.

Once she was, she endured a third back surgery, this time it was more than successful.

A side by side comparison shows that Melissa actually grew bone in her spine.

Dr.. Gostine is a firm believer vitamin D made the difference, "I don't think there was any question that that was the reason."

Is it the next miracle vitamin? - that's yet to be determined.

But in the meantime it never hurts to soak up the sun when you get the chance.



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Deviled Eggs Recipe and 10 Health Benefits of Eggs

There are many traditional Thanksgiving Day recipes that everyone looks forward to and deviled eggs are a classic. Whether they are made with using a traditional deviled eggs recipes or one of the newer versions -- including spicy, gluten free , or even a caviar deviled eggs-- Thanksgiving Day isn't the same without this tasty appetizer. Even better? Eggs have great health benefits.

Deviled eggs are hard-boiled eggs cut in half and filled with the hard-boiled egg's yolk mixed with different ingredients. Deviled eggs are usually served cold. They are served as a side dish, appetizer or a main course, and are a common holiday or party food.

Eggs are full of protein and have so many good health benefits that consuming eggs on Thanksgiving is a great idea. Try a few new recipes or stick with the classic deviled eggs recipe for a delicious Thanksgiving Day appetizer.

Easy Deviled Eggs Recipes

Classic Deviled Eggs

Crab & Celery Deviled Eggs

Caviar Deviled Eggs

Gluten Free Deviled Eggs

Health Benefits of Eggs

1. Eggs are great for the eyes. According to one study, an egg a day may prevent macular degeneraton due to the carotenoid content, specifically lutein and zeaxanthin. Both nutrients are more readily available to our bodies from eggs than from other sources.

2. In another study, researchers found that people who eat eggs every day lower their risk of developing cataracts, also because of the lutein and zeaxanthin in eggs.

3. One egg contains 6 grams of high-quality protein and all 9 essential amino acids.

4. According to a study by the Harvard School of Public Health, there is no significant link between egg consumption and heart disease. In fact, according to one study, regular consumption of eggs may help prevent blood clots, stroke, and heart attacks.

5. They are a good source of choline. One egg yolk has about 300 micrograms of choline. Choline is an important nutrient that helps regulate the brain, nervous system, and cardiovascular system.

6. They contain the right kind of fat. One egg contains just 5 grams of fat and only 1.5 grams of that is saturated fat.

7. New research shows that, contrary to previous belief, moderate consumption of eggs does not have a negative impact on cholesterol. In fact, recent studies have shown that regular consumption of two eggs per day does not affect a person's lipid profile and may, in fact, improve it. Research suggests that it is saturated fat that raises cholesterol rather than dietary cholesterol.

8. Eggs are one of the only foods that contain naturally occurring vitamin D.

9. Eggs may prevent breast cancer. In one study, women who consumed at least 6 eggs per week lowered their risk of breast cancer by 44%.

10. Eggs promote healthy hair and nails because of their high sulphur content and wide array of vitamins and minerals. Many people find their hair growing faster after adding eggs to their diet, especially if they were previously deficient in foods containing sulphur or B12.

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Chocolate Milk Good or Bad?

Milk, filled with calcium and vitamin D, may help children grow into strong healthy adults, but many won’t touch it without adding chocolate syrup. A blog on the New Yorker Web site asked New Yorker Food Issue contributors if adding chocolate cancelled the health benefits of milk, or if it is a necessary incentive to get kids to consume nutrients.

Mimi Sheraton said the chocolate is OK because otherwise children may not get the much-needed calcium and vitamin D from the milk. She suggested using high-quality, low-sugar chocolate syrup in lowfat milk. She added chocolate may even add benefits, as recent studies have shown its ability to increase high-density lipoprotein (HDL) cholesterol and reduce inflammation.

While the other contributors gave jokes for answers (Raffi Khatchadourian spoke about genetically engineered cows that produce chocolate milk from their udders; and John Colapinto said he didn’t want his son to drink chocolate milk or even eat sandwiches because of their negative health benefits), the article brings up a good point about how a spoonful of sugar helps the medicine go down. Or, in this era of childhood obesity and kids who experience adult disease, should we skip the sugar and try to give only the medicine?

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Low vitamin D linked to high risk of premature death

People with lower blood levels of sunshine vitamin D in their blood appear to have an increased risk of death from all causes and from cardiovascular diseases, according to an Austrian study in the June 23 issue of the Archives of Internal Medicine.

The study found that people with the lowest level of vitamin D in their blood were twice as likely to die from any cause including death from heart disease during an eight-year period as those who had a high level.

Vitamin D is naturally produced in the body when the skin is exposed to sunshine. Exposure of the face and both hands for 20 minutes to strong sunshine is believed to generate enough vitamin D, while a dietary regimen is needed to have a preventative effect against certain diseases or death, particularly in dark-skinned individuals and the elderly who produce less vitamin D.

An estimated 50 to 60 percent of older people in North America and the rest of the world do not have sufficient vitamin D levels, and a similar percentage of young people have the same problem, according to the background information in the report.

Previous studies have linked blood levels of 25-hydroxyvitamin D in the blood lower than 20 to 30 nanograms per milliliter with risk of falls, fractures, cancer, immune dysfunction, cardiovascular disease and hypertension.

In the study, Harald Dobnig, M.D., an internist and endocrinologist at the Medical University of Graz, Austria, and colleagues measured 25-hydroxyvitamin D and 1, 25-dihydroxyvitamin D levels in 3,258 patients of an average age of 62 years who underwent coronary angiography testing between 1997 and 2000.

During the 7.7-year follow-up, 22.6 percent of participants died and among the dead, 62.8 percent were from cardiovascular causes.

Death rates from any cause and from the cardiovascular causes were higher in those with their blood 25-hydroxyvitamin D levels in the lower 50 percent and in the lowest one-fourth of 1, 25-dihydroxyvitamin D levels, the study found.

Low 25-hydroxyvitamin D levels were also linked with markers of inflammation such as c-reactive protein, as well as signs of oxidative damage to cells, the study found.

"Apart from the proved effects that vitamin D has on bone metabolism and neuromuscular function, appropriate serum levels (that may also be higher than in the present investigation) are associated with a decrease in mortality," the researchers concluded.

"Although not proved, it seems possible that at least part of this effect may be due to lowering of a risk profile promoting atherosclerosis [narrowing of the arteries] and preventing cardiovascular end points," the researchers said.

"Based on the findings of this study, a serum 25-hydroxyvitamin D level of 20 nanograms per milliliter or higher may be advised for maintaining general health." (Editor’s note: many other studies have suggested that 30 nanograms per milliliter are needed.)

The current study merely established an association between the serum vitamin D level and death risk and it did not prove that taking vitamin D supplements to increase its level in the body would actually reduce the risk of death from all causes although the possibility cannot be excluded either.

However, many clinical trials have already demonstrated the preventative effect of vitamin D against premature deaths from all causes including cardiovascular causes.

One study meta-analyzed data from 18 separate trials of 57,000 participants who had a dietary supplement of vitamin D at a dose ranging from 300 to 2000 International Units and found that those who took vitamin D had a 7 percent lower risk of death than those who did not.

The study was conducted by Philippe Autier, M.D., of the International Agency for Research on Cancer, Lyon, France, and Sara Gandini, Ph.D., of the European Institute of Oncology in Milan, Italy, and published in the September 10, 2007 issue of the Archives of Internal Medicine.

Overall, earlier studies showed that deficiencies in vitamin D are associated with a higher risk of death from cancers (including breast, prostate, and colon cancer), heart disease, and diabetes-illnesses, which overall are responsible for 60 to 70 percent of deaths in developed countries.

Another study conducted by Edward Giovannucci, M.D., Sc.D., at the Harvard School of Public Health and colleagues revealed that it is 2.42 times more common to find people with 15 nanograms per milliliter of blood or less (deficiency) than it is to find those with a sufficient amount (30 nanograms per milliliter). The findings were published in the June 9, 2008 issue of Archives of Internal Medicine.

The researchers came to this conclusion after they compared 454 men ages 40 to 75 who had non-fatal heart attacks or fatal heart disease during the follow-up period with 900 men who did not have a history of cardiovascular disease.

Sunshine is the basic source of vitamin D. But readers should be careful about the advice they receive from news media, a health observer affiliated with foodconsumer.org suggested. Exposure to ultraviolet rays is widely viewed as a risk for developing skin cancer, and people are often urged to use screens to block exposure to sunshine. Be aware though that vitamin D deficiency can put an individual at a higher risk of dying from other more serious types of cancers and a variety of other chronic diseases.

Other sources include fortified foods such as fortified milk and cereals, natural foods such as cod liver oil, fatty fish such as cooked salmon, mackerel, tuna, and sardines, egg yolks, liver, and supplements.

The current recommended daily allowance for vitamin D is 200 IU per day for people under 50, 400 IUs for those between 50 and 70, and 600 IUs for those over 70. Older people need higher doses. Research has found that healthy people can tolerate intake of up to 10,000 IU per day. Vitamin D experts have already complained that the current RDA is too low to have a protective effect, and have recommended that the RDA should be increased to at least 1,000 IU per day.



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Vitamin D reduces asthma severity

Although the committee charged with determining the recommended daily amount of nutrients cannot currently agree on how much vitamin D we need (New York Times), there is now plenty of research supporting its many health advantages. Dr. Mercola, author of the mercola.com site, states that some of the newest reports are indicating that low vitamin D levels in children can increase the severity of asthma.

Studies have shown that children who were hospitalized with asthma-related problems typically had low levels of vitamin D in the bloodstream. This data seems to corroborate an Australian study from 2006 which showed that exposure to sunlight reduced the severity of asthma in mice.

And, according to the Journal of Allergy and Clinical Immunology, mothers who have adequate vitamin D supplementation while pregnant can actually reduce the risk that their children will later develop asthma between the ages of 3 and 5.

Jane Brody, who refers to vitamin D as the “sunshine vitamin,” reported in a recent column that since the powers that be are still in a quandary over optimal levels of the vitamin, it’s up to the consumer to look at the some of the research and decide how much to take.

These new associations between asthma severity and vitamin D are simply verification that the “sunshine vitamin” could be coming into its own. Brody writes that vitamin D has been shown to regulate balance in older people, and has been linked to a reduction in cancers of the breast, ovary, rectum, prostate and stomach.

Currently, the recommended daily allowance of vitamin D is 400 IUs, which, according to Dr. Mercola, is ten times less than the amount necessary for optimal health.



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Try Vitamin D If You Want To Live Longer

Writing in the journal Clinical Endocrinology, scientists from the Netherlands, Austria, and the U.S. report that low blood levels of the sunshine vitamin are associated with increased risk of all-cause mortality, and mortality from heart disease, in the elderly.

The research follows hot on the heels of similar findings published in Nutrition Research and in the Archives of Internal Medicine.

The new study used data from 614 people participating in the Hoorn Study, a prospective population-based study with men and women with an average age of 69.8. Blood levels of 25(OH)D were measured at the start of the study. After an average of six years of follow-up, 51 deaths had been documented, 20 of which were due to cardiovascular health.

People with the lowest average vitamin D levels were found to be at a 124 and 378 percent increased risk of all-cause mortality and cardiovascular mortality, respectively.

Commenting on the potential mechanism, the researchers note:

“Apart from the maintenance of muscular and skeletal health, vitamin D may also protect against cancer, infections, autoimmune and vascular diseases, suggesting that vitamin D deficiency might contribute to a reduced life expectancy.”

Adults with lower blood levels of vitamin D may also be more likely to die from heart disease or stroke. Scientists in Finland compared blood levels of vitamin D, and deaths from heart disease or stroke over time in more than 6,000 people. Those with the lowest vitamin D levels had a 25 percent higher risk of dying from heart disease or stroke.

In addition, in a study of 166 women undergoing treatment for breast cancer, nearly 70 percent had low levels of vitamin D in their blood, according to a study presented at the American Society of Clinical Oncology’s Breast Cancer Symposium. The analysis showed women with late-stage disease and non-Caucasian women had even lower levels.

Said Luke Peppone, Ph.D., research assistant professor of Radiation Oncology, at Rochester’s James P. Wilmot Cancer Center:

“Vitamin D is essential to maintaining bone health and women with breast cancer have accelerated bone loss due to the nature of hormone therapy and chemotherapy. It’s important for women and their doctors to work together to boost their vitamin D intake."



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Vitamin D helps Kids improve Bone Density

Calcium and vitamin D supplements can improve bone density during a crucial growth period for young girls.

A six-month study looked at identical twin girls aged between nine and 12, who were randomly assigned to receive either the calcium and vitamin D tablets, or a matched placebo.

David Greene, lecturer in exercise science at Australian Catholic University (ACU), said results showed that the supplements improved measures of bone mineral density, bone mineral content and bone strength in these girls.

These results are particularly important as young women accumulate bone mass most rapidly during adolescence, he said.

Therefore, ideal skeletal development can only be achieved when adequate dietary intakes of calcium and vitamin D supplement physical activity during this period, according to an ANU release.

Maximising bone strength during the growing years is also essential in order to offset the effects of osteoporosis in later life.

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The Hottest Vitamin Under the Sun ( Part 3 )

New products fortified with vitamin D may help the many who are deficient. Recent studies have shown pregnant women who lived at a latitude of 54 to 55 degrees north (about as north as Central Canada) had insufficient levels, even among those who use supplements.² Mothers-to-be who have lower levels of vitamin D are more likely to give birth via cesarean section.³ And Turkish researchers encouraged pregnant women to supplement their diets with vitamin D in order to reduce the risk of their children contracting acute lower respiratory infections.⁴

Once the children are out of the womb, they may still not be getting all of their vitamin D needs. In the United States, 61 percent of children aged 1 to 21 years who completed the National Health and Nutrition Examination Survey 2001-2004 had insufficient levels of vitamin D.⁵ Only 4 percent had taken a 400 IU/d supplement of vitamin D for the past 30 days. That same study found deficiency was associated with elevated parathyroid hormone levels, higher systolic blood pressure, lower serum calcium and high-density lipoprotein (HDL) cholesterol levels.

The heart-health benefits of vitamin D don’t stop with the youth. A University of Colorado study found an inverse relationship between vitamin D levels and cardiovascular disease (CVD), as well as all-cause mortality.⁶ A review in The American Journal of the Medical Sciences states cross-sectional studies found vitamin D deficiency was associated with increased risk of CVD, including hypertension, heart failure and ischemic heart disease.⁷ And Reuters reported at a September 2009 meeting of the American Heart Association in Chicago, researchers presented study that found younger white women with vitamin D deficiencies are about three times more likely to have high blood pressure in middle age than those with normal vitamin levels.

Because vitamin D is necessary for calcium absorption into the body, vitamin D is closely associated with bone health. In fact, one Swiss study found among men and women, vitamin D status seems to be the dominant predictor of bone mineral density (BMD) relative to calcium intake.⁸ In the study, only women with vitamin D concentrations less than 50 nm seem to benefit from a higher calcium intake alone. In a later review of eight randomized controlled trials, those same researchers found supplemental vitamin D in a dose of 700 to 1,000 IU/d reduced the risk of falling among older adults by 19 percent.⁹ However, doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l did not reduce the risk of falling.

McBurney added supplementing with vitamin D is good for bone health throughout life. “Bones are remodeled every day, all our life,” he said. “So it is important to build bones when one is young, and to maintain adequate vitamin D status to maintain strong bones for life.”

The benefits of vitamin D go well beyond the heart and bones. Keeping vitamin D levels high may also protect against colon cancer,¹⁰ cold and flu,¹¹ Alzheimer’s disease,¹² multiple sclerosis,¹³ ovarian cancer¹⁴ and weight gain.¹⁵

With all the new studies finding vitamin D’s health benefits (every study referenced in this article is from 2009), the sunshine vitamin’s future is, well, sunny. “Scientists are discovering new insights into the role of vitamin D,” McBurney said. “With the unraveling of the human genome, we are living in a period of discovery unprecedented in history. The future is very exciting.”



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The Hottest Vitamin Under the Sun ( Part 2 )

U.S. dietary reference intake (DRI) guidelines established in 1997 by IOM recommend 200 IU/d of vitamin D through age 50, 400 IU/d for people ages 51 to 70 and 600 IU/d for those 71 and older. But many experts now say everyone likely needs more. For instance, in 2008, The American Academy of Pediatrics the American Academy of Pediatrics (AAP) recommended breastfed infants receive supplements of 400 IU/d of vitamin D until they are weaned and consume more than 1,000 mL/d of vitamin D-fortified formula or whole milk.¹ All non-breastfed infants ingesting less than 1,000 mL/d of vitamin D-fortified formula or milk should receive a vitamin D supplement of 400 IU/d, they said. AAP also recommends older children and adolescents should take a 400 IU vitamin D supplement daily. In response, a new IOM panel is reviewing the recommendations on vitamin D and calcium and a report is expected in spring 2010.

Huang believes FDA will follow suit. “In 2010, we believe FDA will probably increase dramatically the recommended daily allowance (RDA) for vitamin D,” he said. “This will push further growth of vitamin D sales in functional foods and nutritional products.”

Those sought-after products will include dairy items as well as new innovations, said Diane Hnat, senior technical marketing manager DSM Nutritional Products.“Historically milk, margarine and ready-to-eat (RTE) cereal have been the most popular food delivery vehicles for vitamin D,” she said. “It is also allowed under the enrichment guidelines for grain products, and has picked up momentum with its additional approval in juice drinks with calcium.”

Those who formulate with vitamin D may want to invest in tests to ensure quality. “Product stability is very important in vitamin D products,” Huang said. “We have excellent stability test results to offer our customers. Also the impurities in the vitamin D are a concern, so we have utilized HPLC testing methods to assure the purity of our vitamin D products.”

The fat-soluble nature of the vitamin can also pose a challenge. “Vitamin D is fat-soluble so water-dispersible forms are required for many applications,” Hnat said. “The encapsulants’ capability to hold up during processing of foods like RTD meal replacements or processed cheese is important.”

Garner added it is less difficult to formulate vitamin D in supplements than in liquid forms. “While vitamin D is easy to process for supplements such as tablets, it is very demanding to make it part of any liquid formulation and/or clear and stable supplements,” he said. He noted NovaSOL D from Marco Hi-Tech is a water-soluble nutrient and therefore can be used in transparent liquids.

to be continued..................

Beating the common cold, naturally

With all the H1N1 discourse and debate, the nation's focus is definitely on flu season. With so much attention given to the prevention and treatment of the flu, it seems that the other big winter illness - the common cold - is getting less attention. While the common cold is typically the gentler sickness of the two - it still allows many to go to work and school, for example, while the flu usually lays people up for a week or more - it is still a drain on us, both as individuals, and as a wider population.

To protect ourselves from getting a cold or the flu, physical barriers usually rule the day: hand-washing, not sharing cups or water bottles, or staying out of busy public places altogether are strategies that we hear about over and over again.

But what about your diet? Is there anything you can take that will make you less likely to get the cold? And once you're in the clutches of one, is there anything that can make a cold's duration shorter or its symptoms less severe? While there are numerous purported cold remedies on the market, here are the highlights of a few popular nutritional supplements and their possible benefits - or lack thereof - in preventing the common cold.

VITAMIN C

When it comes to cold prevention, who doesn't think about popping some vitamin C? After decades of recommendations based largely around the prevention of scurvy, vitamin C made its way into our collective consciousness with two-time Nobel laureate Linus Pauling's assertions that mega-dosing was a pathway to good health. Now, many of us don't think twice about popping several thousand milligrams at a time, and there is a widely held belief that taking vitamin C at the onset of a cold will hold it at bay.

But what does the research say? In 2007, the Cochrane Database of Systematic Reviews - basically, the granddaddy of evidence-based reviews on medical research - published an updated review of vitamin C and the common cold, and found that, in a nutshell, yes, vitamin C regularly can reduce the length one suffers from a cold - by 8% in adults and 14% in children, as long as it is taken regularly. But when taken after the onset of symptoms, there was no effect on the length or severity. In other words, megadosing on vitamin C after you feel your first sniffle doesn't seem to do much.

Although the general population may not benefit from taking vitamin C for a cold, there is some evidence that athletes training at a high level (marathon runners, for example), and those exposed to extreme cold temperatures can benefit from popping a few pills.

VITAMIN D

The sunshine vitamin plays a role in immune system function, and at least according to early evidence, it might help to prevent respiratory tract infections. In fact, a study published in the February edition of the journal Archives of Internal Medicine found that individuals with a lower circulating level of vitamin D had a higher likelihood of developing a respiratory tract infection.

On the other hand, a more recent study, published in the October issue of Epidemiology and Infection, found that subjects given 2000 IU of vitamin D over a 12 week period were no less likely to develop a respiratory tract infection. Since there is very limited research on the role vitamin D plays in the development of the common cold, the bottom line is that we simply don't yet know enough to be able to do anything but speculate. Having said that, since so many Canadians are vitamin D deficient by late fall or early winter - the time when cold and flu season hits full stride - taking a vitamin D supplement probably isn't a bad idea, even if it is for other health benefits than cold prevention.

GARLIC

Long used by numerous cultures for taste and health, garlic's antimicrobial and antiviral properties has earned it a reputation as a classic cold-fighter. But does the evidence agree? According to a Cochrane review published earlier this year, researchers found that there is insufficient evidence to suggest that garlic should be used to either prevent or treat the common cold. Bear in mind, however, that the issue was not so much that garlic isn't useful, but rather that there haven't been enough well-controlled trials to allow a clear conclusion to be drawn, one way or the other.

In fact, in one double-blinded trial, subjects given garlic pills containing 180 mg of allicin (the active compound in garlic) for 12 weeks developed only a third as many colds as those given a placebo (dummy pill) for the same amount of time. Since double-blinded, placebo-controlled trials are considered the gold standard for proof, the results would certainly suggest that garlic has a role to play, at least in cold prevention, but more good trials are needed.

ZINC

A known immune system modulator, there is some research to suggest that zinc can be used to manage respiratory tract infections, pneumonia, and the common cold. While there is some indication that zinc supplements might be most beneficial for children and the elderly - in other words, those with weakened or compromised immune systems - the data is inconsistent.

As for the benefits of using zinc lozenges to treat the common cold, the reviewers at Cochrane deemed the data inconclusive. Yes, there are several well-controlled trials, and some have demonstrated that zinc lozenges can, in fact, reduce the duration or the severity of the common cold, others have shown no effect. The difference could be the result of the type of zinc used and its bioavailability (the ability of the body to uptake and use a particular form of a nutrient), but the possibility of bias was also raised.

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Vitamin D Deficiency: Children Need Vitamin D

This nation has many costly health care problems, but vitamin D deficiency shouldn't be one of them.

A new analysis focusing on U.S. children ages 1 through 11 says about a fifth of youngsters that age aren't getting the minimally required level of vitamin D. Many more may fall short of the optimal dose.

The deficiency puts those children - disproportionately African-American - at risk of ailments such as rickets, a disease that can cause a weakening of growing bones and cartilage.

Rickets was thought to have been conquered in this country shortly after the turn of the 20th century, when it was discovered that sunlight and food supplements could both prevent and treat the disease. But pediatricians have seen a reappearance of rickets in the United States in recent decades.

Sunshine and vitamin D-fortified milk are two key sources of vitamin D. But as an Associated Press article published Monday noted, many children don't drink the multiple glasses of milk a day that would be needed to get the recommended dose of vitamin D.

Sunshine, with its ultraviolet light that the human body turns into vitamin D, is readily available in Florida, but not in the North.

SUPPLEMENT FOR SAFETY

The potential for damage from vitamin-D deficiency in young children is so clear that the American Academy of Pediatrics now recommends that youngsters get a 400-unit, daily supplement.

The new research supports that recommendation, said Dr. Jonathan Mansbach, lead author on the study, which was reported in the November issue of the journal Pediatrics.

Some evidence indicates that teens and adults may need much more vitamin D, well beyond what would be consumed in a good diet. This too suggests that daily supplements would be helpful.

Many questions about vitamin D levels remain unanswered. Health experts should accelerate research into the causes of deficiencies, particularly the prevalence among people of color.

No one should overlook the benefits of fresh air, sunlight and adequate milk intake. But when these are not enough, the growing sentiment among health experts is to recommend a daily supplement.

This solution - accessible, relatively cheap and easy to administer - is far preferable to the possible consequences of vitamin D deficiency.

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Vitamin D and Multiple Sclerosis

Research has come up with new developments regarding Vitamin D and Multiple Sclerosis. Let’s reduce the incidence of MS by making sure Vitamin D levels are supplemented vigorously.

You don’t hear much about multiple sclerosis — mostly because it’s a disease that continues to stump doctors and researchers. While there are a handful of treatments that can alleviate some of the symptoms, there’s no cure for it. But last month, researchers from the UK and Canada did even better. They made a discovery that may prevent it from occurring in the first place.

And the missing link is none other than vitamin D.

Researchers from the University of Oxford and the University of British Columbia examined genetic factors involved in multiple sclerosis (MS) risk. They found that one of the genes known to have the strongest effect on MS risk interacts closely with DNA and proteins that rely on vitamin D to activate them.

If your body doesn’t have enough of this essential nutrient to activate those proteins, the nearby gene may be altered. And your risk of developing MS may increase as a result.

The researchers actually believe that this vitamin D deficiency-MS risk relationship begins before we’re even born. According to the article I read about this study “They believe that vitamin D deficiency in mothers or even in a previous generation may lead to altered expression of the gene in their offspring.”

In theory, this could mean that if women get ample vitamin D throughout their lives — and during pregnancy — it could potentially wipe out MS altogether.

Granted, it is still theoretical at this point. But it certainly can’t HURT. And while vitamin D may or may not be the MS savior, it does play a critical role in many, many other aspects of your health.

Dr. Wright recommends 4,000 IU of vitamin D daily for adults and teenagers, 1,000 IU for infants and small children, and 2,000 IU for everyone in between.

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Low Vitamin D Levels Linked to Increased Risk of Death

Supplementing with the sunshine vitamin could save your life.

If you’ve been keeping up with your nutritional news, you know that you should be supplementing with vitamin D. The benefits associated with the "sunshine vitamin" are many and include reduced risk for a number of diseases. But that isn’t all: getting ample amounts of vitamin D could extend your life, according to two new studies which prove that vitamin is nothing short of a nutritional miracle.

Researchers reported in the Journal of the American Geriatrics Society that people with low vitamin D levels were three times more likely to die from heart disease and two and a half times more likely to die from any cause than those with optimal vitamin D levels. The scientists wrote: “Current dosage recommendations for vitamin D supplementation appear to be inadequate in most older adults to support [the] higher levels that are associated with optimal general health and reduced mortality.”

In addition, a multi-center study published in the August 2009 issue of Nutrition Research found that vitamin D deficiency placed women at an increased risk of death. While recent study out of China found that 94% of people between the ages of 50 and 70 were vitamin D deficient, which increased their risk of metabolic syndrome — a group of symptoms that occur together and promote the development of coronary artery disease, stroke and type 2 diabetes. Other research has linked the lack of vitamin D to osteopenia, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, infectious disease and cardiovascular disease.


The Anti-Aging Bottom Line:

These are just two of many studies highlighting the dangers of low D intake. While the RDA for the vitamin is currently just 400 IU, many experts recommend that 1,000 to 5,000 IU is what's needed to achieve optimum levels. Don't let a vitamin D deficiency put you at risk for health problems as you age. Ask your doctor to check your vitamin D levels so you can be sure you are taking enough supplemental vitamin D to keep your blood levels within a safe range.



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Vitamin D Supplements Improve Risk Factors for Diabet

Many health benefits are credited to vitamin D, and a new study from New Zealand has added another one to the list. Researchers found that supplements of the vitamin may improve insulin resistance and sensitivity, which are risk factors for diabetes.

Insulin resistance is a condition in which a person’s tissues have a reduced response to insulin, a hormone that is secreted by the pancreas to help regulate glucose levels in the body. This resistance causes the body to produce larger quantities of insulin in an attempt to maintain normal levels of glucose in the blood.

In the randomized, controlled, double-blind trial, the results of which were published in the British Journal of Nutrition, the investigators studied 81 South Asian women, ages 23 to 68 years, who had insulin resistance. Half of the women were given 100 micrograms (4,000 IU) of vitamin D3 daily; the other half were given a placebo. The treatment period lasted six months.

At the end of six months, the women who had taken vitamin D showed significant improvement in both insulin resistance and sensitivity compared with those who took placebo. The best results were seen in women who had blood levels of vitamin D in the range of 80 to 119 nanomoles per liter (nmol/L). The Vitamin D Council states that the optimal blood level of vitamin D is at least 125 nmol/L (50 ng/mL), yet most Americans have levels less than 30 ng/mL.

This study follows a recent meta-analysis that showed an association between low intakes of vitamin D, calcium, or dairy products and type 2 diabetes. The authors in the current study note that along with improving insulin resistance and sensitivity, their results indicate the importance of increasing the daily recommended intake of vitamin D. The findings of this study and others highlight the concern that the dietary recommended daily intake values (DRIs) in the United States are too low. Currently the DRIs are 200 IU for adults 19 to 50 years, 400 IU for people 51 to 70, and 600 IU for people older than 70.



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Vitamin D2 effectively treats vitamin D deficiency

A new study by researchers at Boston University School of Medicine researchers has shown that 50,000 International Units (IU) of vitamin D2, given weekly for eight weeks, effectively treats vitamin D deficiency.

Vitamin D2 is a mainstay for the prevention and treatment of vitamin D deficiency in children and adults.

Continued treatment with the same dose of vitamin D2 every other week for up to six years after the initial eight-week period prevents vitamin D deficiency from recurring with no toxicity.

Vitamin D is essential for strong bones because it helps the body absorb calcium and phosphorus from the food we eat.

Vitamin D deficiency can lead to rickets in children and the painful bone disease osteomalacia in adults. Vitamin D deficiency can also cause osteoporosis and has been linked to increased risk of cancer, heart disease, diabetes, autoimmune diseases and infectious diseases including influenza.

Of the 86 patients researchers studied, 41 patients who were vitamin D deficient received eight weeks of 50,000 IU of vitamin D2 weekly prior to starting maintenance therapy.

For those patients, the mean pre-treatment 25-hydroxyvitamin D status (25(OH)D) level was 19 ng/ml, which increased to 37 ng/ml after eight weeks of weekly therapy. These patients were then treated with 50,000 IU of vitamin D2 every other week and had a mean final 25(OH)D level of 47 ng/ml.

For the 45 patients who received only maintenance therapy of 50,000 IU of vitamin D2 every two weeks, the mean pre-treatment 25(OH)D level was 27 ng/ml and the mean final level was 47 ng/ml.

‘Vitamin D2 is effective in raising 25(OH)D levels when given in physiologic and pharmacologic doses and is a simple method to treat and prevent vitamin D deficiency,’ said senior author Michael F. Holick, PhD, MD, director of the Bone Healthcare Clinic and the Vitamin D, Skin and Bone Research Laboratory at Boston University School of Medicine.

‘While treating and preventing vitamin D deficiency, these large doses of vitamin D2 do not lead to vitamin D toxicity,’ he added.

According to Holick, this is the first study demonstrating the efficacy of a prescription therapy to prevent vitamin D deficiency long-term in routine clinical practice.

The study appears online in the journal Archives of Internal Medicine.



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Latest analysis confirms suboptimal vitamin D levels in millions of US children

Millions of children in the United States between the ages of 1 and 11 may suffer from suboptimal levels of vitamin D, according to a large nationally representative study published in the November issue of Pediatrics, accompanied by an editorial.

The study, led by Jonathan Mansbach, MD, at Children's Hospital Boston, is the most up-to-date analysis of vitamin D levels in U.S. children. It builds on the growing evidence that levels have fallen below what's considered healthy, and that black and Hispanic children are at particularly high risk.

Both the optimal amount of vitamin D supplementation and the healthy blood level of vitamin D are under heated debate in the medical community. Currently, the American Academy of Pediatrics recommends children should have vitamin D levels of at least 50 nmol/L (20 ng/ml). However, other studies in adults suggest that vitamin D levels should be at least 75 nmol/L (30 ng/ml), and possibly 100 nmol/L (40 ng/ml), to lower the risk of heart disease and specific cancers.

Mansbach and collaborators from the University of Colorado Denver and Massachusetts General Hospital used data from the National Health and Nutrition Examination Survey (NHANES) to look at vitamin D levels in a nationally representative sample of roughly 5,000 children from 2001-2006. Extrapolating to the entire U.S. population, their analysis suggests that roughly 20 percent of all children fell below the recommended 50 nmol/L. Moreover, more than two-thirds of all children had levels below 75 nmol/L, including 80 percent of Hispanic children and 92 percent of non-Hispanic black children.

"If 75 nmol/L or higher is eventually demonstrated to be the healthy normal level of vitamin D, then there is much more vitamin D deficiency in the U.S. than people realize," Mansbach says.

Mansbach and his co-authors suggest that all children take vitamin D supplements, because of the generally low levels that they found and the potential health benefits of boosting vitamin D to normal levels. Vitamin D improves bone health and prevents rickets in children, and recent studies suggest that it also may prevent a host of common childhood illnesses, including respiratory infections, childhood wheezing, and winter-related eczema.

Although sun exposure generates healthy doses of vitamin D, it can also cause skin cancer. Dermatologists and the AAP recommend wearing sunblock, but this actually blocks our skin's ability to make vitamin D. Furthermore, children with more highly pigmented skin require much more sun exposure than fair-skinned children to obtain healthy levels of vitamin D. Vitamin D can also be obtained from certain foods, like liver and fatty fish, but almost all children in the U.S. don't consume these foods in high enough quantities to match the vitamin D that could be provided by summer sunshine or vitamin D supplements.

In the study, children taking multi-vitamins that included vitamin D had higher levels overall, but this accounted for less than half of all children. Mansbach recommends that all children take vitamin D supplements, especially those living in high latitudes, where the sun is scarce in the wintertime.

"We need to perform randomized controlled trials to understand if vitamin D actually improves these wide-ranging health outcomes," Mansbach says. "At present, however, there are a lot of studies demonstrating associations between low levels of vitamin D and poor health. Therefore, we believe many U.S. children would likely benefit from more vitamin D."

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