More on Vitamin D – repost from Tending the Healthy Hearth 4/16/2010

Vitamin D has been in the news lots lately, I’m on the bandwagon to get the word out as I can attest to how much better I feel with more vitamin D and encourage others to do so. Not to belabor the point, below is a brief rundown from Dr. Ray Strand’s latest edition of Health Nuggets. If you don’t already know of Dr. Strand, cruise by his web-site listed in my “Favorite Sites” section. He’s worth knowing.

Ray D. Strand, M.D.A study reported at the American Heart Association’s Scientific Conference in Orlando reported a strong association between reduced vitamin D levels and increased risk of cardiovascular disease. Brent Muhlstein, MD and his colleagues followed over 27,000 subjects for a little over one year. Those with very low vitamin D levels were 45% more likely to develop heart disease, twice as likely to develop heart failure, 78% more likely to experience a stroke, and 77% more likely to die than those with normal levels. This is just another reason to check your vitamin D status via a 25-hydroxy vitamin D level and make sure it is greater than 60 ng/ml.

This information makes it well worth knowing your vitamin D levels. Ask your doctor to include a 25-hydroxy vitamin D level on your annual laboratory prescription. The cost-benefits are a no brainer.

For more information on vitamin D, it’s use by the DNA, risks associated with deficient supplies and disease prevention, visit #mce_temp_url#. Here is an excerpt from their site:

Risk Factors for Vitamin D Deficiency

* Exclusively breast-fed infants: Infants who are exclusively breast-fed and do not receive vitamin D supplementation are at high risk of vitamin D deficiency, particularly if they have dark skin and/or receive little sun exposure (20). Human milk generally provides 25 IU of vitamin D per liter, which is not enough for an infant if it is the sole source of vitamin D. Older infants and toddlers exclusively fed milk substitutes and weaning foods that are not vitamin D fortified are also at risk of vitamin D deficiency (19). The American Academy of Pediatrics recommends that all infants be given a vitamin D supplement of 400 IU/day (20).
* Dark skin: People with dark-colored skin synthesize less vitamin D on exposure to sunlight than those with light-colored skin (1). The risk of vitamin D deficiency is particularly high in dark-skinned people who live far from the equator. One U.S. study reported that 42% of African American women between 15 and 49 years of age were vitamin D deficient compared to 4% of White women (25).
* Aging: The elderly have reduced capacity to synthesize vitamin D in skin when exposed to UVB radiation, and the elderly are more likely to stay indoors or use sunscreen, which blocks vitamin D synthesis. Institutionalized adults who are not supplemented with vitamin D are at extremely high risk of vitamin D deficiency (26, 27).
* Covering all exposed skin or using sunscreen whenever outside: Osteomalacia has been documented in women who cover all of their skin whenever they are outside for religious or cultural reasons (28, 29). The application of sunscreen with an SPF factor of 8 reduces production of vitamin D by 95% (1).
* Fat malabsorption syndromes: Cystic fibrosis and cholestatic liver disease impair the absorption of dietary vitamin D (30).
* Inflammatory bowel disease: People with inflammatory bowel disease like Crohn’s disease appear to be at increased risk of vitamin D deficiency, especially those who have had small bowel resections (31).
* Obesity: Obesity increases the risk of vitamin D deficiency (32). Once vitamin D is synthesized in the skin or ingested, it is deposited in body fat stores, making it less bioavailable to people with large stores of body fat.

1. Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79(3):362-371. (PubMed)

Nutr. 2003;89(5):552-572. (PubMed)

19. Wharton B, Bishop N. Rickets. Lancet. 2003;362(9393):1389-1400. (PubMed)

20. Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. American Academy of Pediatrics. 2008;122(5):1142-1152. Available at: http://www.aap.org/new/VitaminDreport.pdf .

25. Nesby-O’Dell S, Scanlon KS, Cogswell ME, et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr. 2002;76(1):187-192. (PubMed)

26. Harris SS, Soteriades E, Coolidge JA, Mudgal S, Dawson-Hughes B. Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab. 2000;85(11):4125-4130. (PubMed)

27. Allain TJ, Dhesi J. Hypovitaminosis D in older adults. Gerontology. 2003;49(5):273-278. (PubMed)

28. Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr. 2003;142(2):169-173. (PubMed)

29. Glerup H, Mikkelsen K, Poulsen L, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med. 2000;247(2):260-268. (PubMed)

30. Food and Nutrition Board, Institute of Medicine. Vitamin D. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington D.C.: National Academies Press; 1999:250-287. (National Academies Press)

31. Jahnsen J, Falch JA, Mowinckel P, Aadland E. Vitamin D status, parathyroid hormone and bone mineral density in patients with inflammatory bowel disease. Scand J Gastroenterol. 2002;37(2):192-199. (PubMed)

32. Arunabh S, Pollack S, Yeh J, Aloia JF. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab. 2003;88(1):157-161. (PubMed)
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