Best Of New Vitamin D News
February 16, 2011 Written by JP [Font too small?]There are many different writing styles. Some health reporters seek out a specific niche and stick to it. Others mine a more diverse topic base from which to select material. I tend to fall between the two camps. While researching, I allow the material that I come across in my daily life to dictate what I cover. At times this gives me the luxury of presenting a broad cross-section of information. But occasionally, what I discover prompts me to revisit select topics on a regular basis. Such is the case with research involving Vitamin D. Currently, there is a tremendous amount of scientific attention being paid to this humble “sunshine” hormone/nutrient. Some of the more dramatic data makes the evening news. Much of it does not. The latter category is the subject of my column today.
A rather bold proclamation was recently presented in the Scandinavian Journal of Public Health. According to the authors of a piece entitled, “Health Benefit of Increased Serum 25(OH)D Levels from Oral Intake and Ultraviolet B Irradiance in Nordic Countries”, elevating Vitamin D levels to 105 nmol/L would likely lower all-cause mortality rates by: 17% in Denmark; 24% in Finland; 24% in Iceland; 18% in Norway and 18% in Sweden. How is this possible? The researchers involved note that there is an increased risk of autoimmune diseases, “brain diseases”, cancer, cardiovascular diseases, diabetes and infectious diseases in those with low blood levels of Vitamin D – serum 25-hydroxyvitamin D or 25(OH)D. (1)
If the prior assertions are accurate, one would expect to find numerous examples of the health benefits of Vitamin D in the medical literature. Those who look for such evidence will surely find it in abundance. I know I do. Here are several studies that strengthen the case for maintaining optimal 25(OH)D levels:
Breast Cancer: A recent French investigation involving 636 women with breast cancer and 1,272 women without looked for a correlation between Vitamin D levels and cancer incidence. Women with the highest 25(OH)D serum concentrations were found 27% less likely to have breast cancer. This was especially true for women under the age of 53 – a 40% decreased risk. Also of note is a study that appears in the October 2010 issue of the journal Chemico-Biological Interactions. In it, two groups of mice were exposed to identical levels of a cancer causing agent. However, one group’s chow was supplemented with added fish oil and Vitamin D. The laboratory animals receiving the fish oil + Vit. D demonstrated a “significant reduction in incidence, multiplicity and volume of mammary tumors”. The authors of the trial concluded that, “In view of their natural availability, non-toxicity and acceptability; combined supplementation of fish oil and Vitamin D3 might be effective for chemoprevention of mammary carcinogenesis”. (2,3)
Diabetes: The October 2010 edition of Diabetes Research and Clinical Practice reports that “women with active sun exposure habits were at a 30% lower risk of having DM (diabetes mellitus), as compared to those with non-active habits”. This finding is based on an examination of 29,518 Swedish women between the ages of 25 and 64. There was an average follow up time of 11 years. However, the question remains whether Vitamin D supplementation has a role to play in the prevention of diabetes or whether protection is conferred to those already living with DM. The latter inquiry is addressed in the current issue of the journal Diabetolgia. A total of 61 patients with DM were given a placebo; a single dose of 100,000 IUs of Vitamin D; or a single dose of 200,000 IUs of Vitamin D. Various measures of cardiovascular and diabetic health were taken at baseline and after 8 and 16 weeks. The patients receiving the supplemental Vitamin D3 exhibited lower systolic blood pressure (placebo: 146.4 mmHg; 100,000 IUs of D: 141.4 mmHg; 200,000 IUs of D: 136.8 mmHg). The higher-dosage Vitamin D group also demonstrated a decline in “B-type natriuretic peptide levels” – a cardiovascular bio-marker that may predict the risk of first-time heart events, heart failure and stroke. (4,5)
Periodontitis: It’s common knowledge that calcium and Vitamin D are essential for bone health. But what’s often overlooked is that oral health is largely influenced by the condition of the bone structure in the surrounding region. Two new publications in the Journal of Periodontology emphasize this connection. The first examined the effects of supplementing with 1,000 mg or more of calcium and 400 IUs or more of Vitamin D daily vs. no supplementation in a population of 51 dental patients. Once diet was factored in, it was estimated that the supplement group was consuming about 1,769 mg of calcium and 1,049 IUs of Vitamin D per day. The control group’s intake averaged 642 mg of calcium and 156 IUs of Vitamin D daily. Over the course of 12 months, dental health assessments were performed on all of the patients. The conclusion states that, “Calcium and Vitamin D supplementation (up to 1,000 IU daily) has a modest positive effect on periodontal health”. A separate examination reports that Vitamin D levels below 75 nmol/L contributed to the likelihood of periodontal disease in a group of 235 pregnant women – a population with a high incidence (up to 40%) of periodontitis. (6,7)
I make it a point to mention the importance of Vitamin D testing whenever I cover this topic. The disconcerting reality is that you may not achieve adequate-to-optimal Vitamin D status even if you spend time in the sun and/or supplement with D. Numerous examples of this fact exist in the scientific literature. Some publications go on to describe how and why this may be occurring. Here are several of the reasons cited: a) inadequate dosages or dosing schedules and differences in assimilation between genders; b) height and weight variations; c) “insufficient cutaneous absorption of UVB” due to air pollution; d) malabsorption and/or variable absorption of Vitamin D supplements and fortified foods; e) supplement timing. (8,9,10,11,12,13)
In closing I’ll tell you how I supplement with this inexpensive and safe nutrient. I use the natural Vitamin D3 form and take it in a soft gel capsule which contains a base of olive oil. Research indicates that consuming Vitamin D along with the largest meal of the day further enhances absorption. I also spend some time outside in the sunlight during non-peak hours. However, I make it a point to never get sunburned. Finally, I have my 25(OH)D levels tested as part of my routine, yearly physical. At a minimum, I strive for a 25(OH)D level of 60 ng/mL or over. I believe this is one of the most important blood tests that isn’t yet considered standard practice. Fortunately, many physicians are quickly becoming familiar with the importance of Vitamin D status and are willing to order the test if they’re asked to do so. Based on your results, you can easily adjust your level of sun exposure and supplementation. Doing so may very well reduce the risk of many costly and preventable maladies that might otherwise become a part of your future. (14)
Update: February 2011 – The most pressing Vitamin D news is that everyone should have their Vitamin D status assessed via a simple blood test (25-hydroxyvitamin D). There’s simply too much evidence indicating wide-spread deficiencies in various populations. And if you think that living in a sunny climate is a good enough reason not to get tested, think again. A recent analysis of adults and children living in Iran, Malaysia and the US discovered inadequate D concentrations in up to 94.7% of those tested. This was especially true in darker skinned individuals. The good news is that addressing a deficiency via inexpensive supplementation is easy and safe. Recent studies pertaining to Vitamin D have concluded that: 1) 16 weeks of Vitamin D therapy improves circulation by flow-mediated dilation in overweight African-American adults; 2) Vitamin-D enriched yogurt supports healthier blood sugar control, body fat and weight loss in type 2 diabetics; 3) breakfasts rich in calcium and Vitamin D encourage the body to burn more calories and fat throughout the day and may reduce overall caloric intake. The issue of safety was also recently addressed in a study that tested the relative toxicity of 1,600 IUs/day or 50,000 IUs/month of Vitamin D in the forms of D2 (ergocalciferol) or D3 (cholecalciferol). The results indicate that the D3 form more efficiently increased 25(OH)D concentrations. No signs of adverse reactions or toxicity were reported. This final study, conducted at the University of Wisconsin, will hopefully allay fears that some consumers and physicians still have about taking higher dosages of Vitamin D. (15,16,17,18,19,20,21)
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Diet and Weight Loss, Heart Health, Vitamin D
Posted in Dental Health, Diabetes, Nutritional Supplements
February 17th, 2011 at 12:27 pm
JP
Thanks for the update on vitamin D, the news about vitamin D seems to be increasing all the time.
Another reason for failure to bring vitamin D levels up can be due to underlying systemic inflammation from bacteria,fungi and viruses such as herpes and EBV, most or all of which, can be asymptomatic.
The immune system forms macrophages which can convert 25(OH)D to its active form 1.25(OH)2D which then down regulates the pro inflammatory cytokines caused by this inflammation.
In fighting this inflammation the vitamin D is used up and 25(OH)D levels rise very slowly(or not at all).
Another good reason to keep vitamin D levels up.
February 17th, 2011 at 1:46 pm
Thank you for adding that, Liverock. Valuable information indeed. All the more reason to test and adjust dosage accordingly.
Be well!
JP
March 25th, 2015 at 1:51 pm
Update: A powerful new study …
http://lup.sagepub.com/content/24/4-5/483.abstract
Lupus. 2015 Apr;24(4-5):483-9.
A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain.
BACKGROUND: The current mode of therapy for many patients with musculoskeletal pain is unsatisfactory.
PURPOSE: We aimed to assess the impact of adding 4000 IU of vitamin D on pain and serological parameters in patients with musculoskeletal pain.
MATERIALS AND METHODS: This was a randomized, double-blinded and placebo-controlled study assessing the effect of 4000 IU of orally given vitamin D3 (cholecalciferol) (four gel capsules of 1000 IU, (SupHerb, Israel) vs. placebo on different parameters of pain. Eighty patients were enrolled and therapy was given for 3 months. Parameters were scored at three time points: prior to intervention, at week 6 and week 12. Visual analogue scale (VAS) scores of pain perception were recorded following 6 and 12 weeks. We also measured serum levels of leukotriene B4 (LTB4), interleukin 6 (IL-6), tumor necrosis factor alpha (TNFα) and prostaglandin E2 (PGE2) by ELISA.
RESULTS: The group receiving vitamin D achieved a statistically significant larger decline of their VAS measurement throughout the study compared with the placebo group. The need for analgesic ‘rescue therapy’ was significantly lower among the vitamin D-treated group. TNFα levels decreased by 54.3% in the group treated with vitamin D and increased by 16.1% in the placebo group. PGE2 decreased by39.2% in the group treated with vitamin D and increased by 16% in the placebo group. LTB4 levels decreased in both groups by 24% (p < 0.05). CONCLUSION: Adding 4000 IU of vitamin D for patients with musculoskeletal pain may lead to a faster decline of consecutive VAS scores and to a decrease in the levels of inflammatory and pain-related cytokines. Be well! JP
May 18th, 2015 at 1:17 pm
Update 05/18/15:
http://www.annalsofepidemiology.org/article/S1047-2797%2815%2900134-9/abstract
Ann Epidemiol. 2015 Apr 18.
Higher vitamin D intake during pregnancy is associated with reduced risk of dental caries in young Japanese children.
PURPOSE: The intrauterine environment, including maternal nutrition status, may affect the development, formation, and mineralization of children’s teeth. We assessed the relationship between self-reported maternal dietary vitamin D intake during pregnancy and the risk of dental caries among young Japanese children.
METHODS: This study is based on a prospective analysis of 1210 Japanese mother-child pairs. Information on maternal intake during pregnancy was collected using a validated diet history questionnaire. Data on oral examination at 36-46 months of age were obtained from the mothers, who transcribed the information from their maternal and child health handbooks to our self-administered questionnaire. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled.
RESULTS: Compared with the lowest quartile of maternal vitamin D intake during pregnancy, adjusted odds ratios (95% confidence intervals) for quartiles 2, 3, and 4 were 1.06 (0.72-1.56), 0.53 (0.34-0.81), and 0.67 (0.44-1.02), respectively (P for trend = .01). When maternal vitamin D intake was treated as a continuous variable, the adjusted odds ratio (95% confidence interval) was 0.94 (0.89-0.995).
CONCLUSIONS: Higher maternal vitamin D intake during pregnancy may be associated with a lower risk of dental caries in children.
Be well!
JP
September 24th, 2015 at 2:19 pm
Updated 09/24/15:
http://www.ncbi.nlm.nih.gov/pubmed/26391639
J Am Coll Nutr. 2015 Sep 21:1-6.
The Effect of Vitamin D Supplementation on Glycemic Control and Lipid Profile in Patients with Type 2 Diabetes Mellitus.
AIM: The aim of this study was to evaluate the effect of vitamin D supplementation in patients with type 2 diabetes mellitus (T2DM) with regard to their glycemic control and lipid profile.
METHODS: One hundred subjects with diabetes were recruited and given 4500 IU/day of vitamin D for 2 months. 25-Hydroxyvitamin D [25(OH)D], fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), and lipid profile were measured pre- and postsupplementation.
RESULTS: There was a significant increase in the mean value of 25(OH)D level after supplementation (baseline level 16 ± 5.3 ng/ml vs. after supplement level 49.2 ± 17.7 ng/ml, p < 0.05). Both FBG and HbA1c but not lipid profile were significantly decreased after supplementation. However, the univariate general linear model between 25(OH)D percentiles and lipid profile levels showed that subjects with diabetes with high 25(OH)D levels (>61 ng/ml) had significantly lower levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) in comparison to those in the low or middle percentiles. Furthermore, participants in a higher percentile had a significantly higher level of high-density lipoprotein cholesterol (HDL-C) than those in the middle percentile. Lipid profile levels were not affected by the supplement except for triglycerides (TG) levels in females, which were significantly decreased.
CONCLUSIONS: Vitamin D supplementation may be beneficial to subjects with diabetes because it improved glycemic control. Subjects with diabetes with high 25(OH)D levels (>61 ng/ml) had better lipid profiles.
Be well!
JP
April 22nd, 2016 at 11:07 pm
Updated 04/22/16:
http://www.ncbi.nlm.nih.gov/pubmed/27097322
Int J Sport Nutr Exerc Metab. 2016 Apr 20.
Compromised Vitamin D Status Negatively Affects Muscular Strength and Power of Collegiate Athletes.
Increasing evidence indicates that compromised vitamin D status, as indicated by serum 25-hydroxyvitamin D (25-OH D), is associated with decreased muscle function. The purpose of this study was to determine the vitamin D status of collegiate athletes residing in the southern U.S. and its effects on muscular strength and anaerobic power. Collegiate athletes (n=103) from three separate NCAA athletic programs were recruited for the study. Anthropometrics, vitamin D and calcium intake, and sun exposure data were collected along with serum 25-OH D and physical performance measures (Vertical Jump Test, Shuttle Run Test, Triple Hop for Distance Test and the 1 Repetition Maximum Squat Test) to determine the influence of vitamin D status on muscular strength and anaerobic power. Approximately 68% of the study participants were vitamin D adequate (>75 nmol/L), whereas 23% were insufficient (75-50 nmol/L) and 9%, predominantly non-Caucasian athletes, were deficient (<50 nmol/L). Athletes who had lower vitamin D status had reduced performance scores (P<0.01) with odds ratios of 0.85 on the Vertical Jump Test, 0.82 on the Shuttle Run Test, 0.28 on the Triple Hop for Distance Test, and 0.23 on the 1 RM Squat Test. These findings demonstrate that even NCAA athletes living in the southern US are at risk for vitamin D insufficiency and deficiency and that maintaining adequate vitamin D status may be important for these athletes to optimize their muscular strength and power.
Be well!
JP
July 16th, 2016 at 12:34 am
Updated 07/15/16:
http://www.jdcjournal.com/article/S1056-8727(16)30220-3/abstract
J Diabetes Complications. 2016 Jun 23. pii: S1056-8727(16)30220-3.
The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial.
OBJECTIVE: This study was conducted to evaluate the effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer (DFU).
METHODS: This randomized, double-blind, placebo-controlled trial was performed among 60 patients with grade 3 DFU according to “Wagner-Meggitt’s” criteria. Participants were randomly divided into two groups (each 30 participants) and received either 50,000IU vitamin D supplements every 2weeks for 12weeks (group A) or placebo (group B). Fasting blood samples were taken at study baseline and after 12-week intervention to determine related markers.
RESULTS: After 12weeks of intervention, compared with the placebo, vitamin D supplementation resulted in a significant reduction in ulcer length (-2.1±1.1 vs. -1.1±1.1cm, P=0.001), width (-2.0±1.2 vs. -1.1±1.0cm, P=0.02) and depth (-1.0±0.5 vs. -0.5±0.5cm, P<0.001), and erythema rate (100% vs. 80%, P=0.01). In addition, in supplemented patients changes in serum insulin concentration (-3.4±9.2 vs. +2.8±9.3 μIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (-1.5±4.1 vs. +1.7±5.1, P=0.01), the quantitative insulin sensitivity check index (+0.006±0.02 vs. -0.006±0.02, P=0.03) and HbA1c (-0.6±0.6 vs. -0.1±0.5%, P=0.004) were significantly different from those of patients in the placebo group. Additionally, following supplementation with vitamin D, significant reductions in serum total- (-15.8±18.9 vs. +5.3±31.8mg/dL, P=0.003), LDL- (-17.2±19.8 vs. +2.2±28.6mg/dL, P=0.003), total-/HDL-cholesterol ratio (-1.1±0.8 vs. -0.2±1.1, P=0.001), high sensitivity C-reactive protein (hs-CRP) (-0.4±2.5 vs. +1.9±4.2μg/mL, P=0.01), erythrocyte sedimentation rate (ESR) (-34.7±32.4 vs. -18.0±26.6mm/h, P=0.03) and plasma malondialdehyde (MDA) concentrations (-0.7±0.9 vs. -0.2±0.5μmol/L, P=0.008) were seen compared with the placebo.
CONCLUSIONS: Overall, vitamin D supplementation for 12weeks among patients with DFU had beneficial effects on glucose homeostasis, total-, LDL-, total-/HDL-cholesterol, ESR, hs-CRP and MDA levels. In addition, vitamin D may have played an indirect role in wound healing due to its effect on improved glycemic control.
Be well!
JP
July 7th, 2017 at 12:01 pm
Updated 07/07/17:
https://www.ncbi.nlm.nih.gov/pubmed/28679555
Am J Clin Nutr. 2017 Jul 5.
Daily supplementation with 15 μg vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: a 12-wk randomized, placebo-controlled food-fortification trial.
Background: There are conflicting views in the literature as to whether vitamin D2 and vitamin D3 are equally effective in increasing and maintaining serum concentrations of 25-hydroxyvitamin D [25(OH)D], particularly at lower doses of vitamin D.
Objectives: We aimed to investigate whether vitamin D2 or vitamin D3 fortified in juice or food, at a relatively low dose of 15 μg/d, was effective in increasing serum total 25(OH)D and to compare their respective efficacy in South Asian and white European women over the winter months within the setting of a large randomized controlled trial.
Design: A randomized, double-blind, placebo-controlled food-fortification trial was conducted in healthy South Asian and white European women aged 20-64 y (n = 335; Surrey, United Kingdom) who consumed placebo, juice supplemented with 15 μg vitamin D2, biscuit supplemented with 15 μg vitamin D2, juice supplemented with 15 μg vitamin D3, or biscuit supplemented with 15 μg vitamin D3 daily for 12 wk. Serum 25(OH)D was measured by liquid chromatography-tandem mass spectrometry at baseline and at weeks 6 and 12 of the study.
Results: Postintervention in the 2 ethnic groups combined, both the vitamin D3 biscuit and the vitamin D3 juice groups showed a significantly greater absolute incremental change (Δ) in total 25(OH)D when compared with the vitamin D2 biscuit group [Δ (95% CI): 15.3 nmol/L (7.4, 23.3 nmol/L) (P < 0.0003) and 16.0 nmol/L (8.0, 23.9 nmol/L) ( P < 0.0001)], the vitamin D2 juice group [Δ (95% CI): 16.3 nmol/L (8.4, 24.2 nmol/L) (P < 0.0001) and 16.9 nmol/L (9.0, 24.8 nmol/L) (P < 0.0001)], and the placebo group [Δ (95% CI): 42.3 nmol/L (34.4, 50.2 nmol/L) (P < 0.0001) and 42.9 nmol/L (35.0, 50.8 nmol/L) (P < 0.0002)]. Conclusions: With the use of a daily dose of vitamin D relevant to public health recommendations (15 μg) and in vehicles relevant to food-fortification strategies, vitamin D3 was more effective than vitamin D2 in increasing serum 25(OH)D in the wintertime. Vitamin D3 may therefore be a preferential form to optimize vitamin D status within the general population. Be well! JP
November 1st, 2018 at 2:11 pm
Updated 11/1/18:
https://www.ncbi.nlm.nih.gov/pubmed/30379314
J Nutr Health Aging. 2018;22(9):1128-1132.
Effect of Vitamin D Treatment on Glucose Homeostasis and Metabolism in Lebanese Older Adults: A Randomized Controlled Trial.
BACKGROUND: A low serum 25-hydroxyvitamin D [(25(OH) D)] concentration was shown to correlate with higher fasting blood glucose (FBG) and insulin levels. Since age affect insulin sensitivity and the metabolism, we aimed in this randomized controlled trial to investigate the effect of vitamin D supplementation on glucose homeostasis and index of insulin resistance in elderly subjects living in Beirut, Lebanon.
METHODS: Participants (n= 115) deficient in vitamin D were randomly divided into two groups, a group receiving 30,000 IU cholecalciferol/week for a period of 6 months, and a placebo group. The index of insulin resistance HOMA (homeostasis model assessment) was the primary outcome. Glucose homeostasis and metabolic markers were also measured at start of treatment and at 6 months.
RESULTS: Vitamin D supplementation led to significant improvements in blood levels of [25(OH) D] (P< 0.0001), and a significant decreased of HOMA, PTH and FBG concentrations (P< 0.0001) in the intervention group compared to placebo. No significant changes were observed in HbA1c levels for both groups. Total cholesterol and LDL cholesterol concentrations have also decreased significantly in the intervention group (P< 0.0001). CONCLUSION: Short-term supplementation with cholecalciferol improved vitamin D status, and markers of insulin resistance in healthy elder population. Be well! JP
February 21st, 2019 at 7:33 pm
Updated 02/19/19:
https://onlinelibrary.wiley.com/doi/abs/10.1111/jhn.12634
J Hum Nutr Diet. 2019 Feb 18.
Vitamin D-supplemented yogurt drink reduces Candida infections in a paediatric intensive care unit: a randomised, placebo-controlled clinical trial.
BACKGROUND: The prevalence of Candida infections in paediatric intensive care units (PICUs) has dramatically increased as a result of resistance to conventional anti-fungal treatments. Because vitamin D has been shown to exhibit fungicidal activity against Candida infection in an in vitro antimicrobial screening, we aimed to investigate the effect of vitamin D on Candida infections in the PICU.
METHODS: Four hundred sixteen eligible children aged between 12 months to 5 years old admitted to the PICU, who were on broad-spectrum antibiotic therapy, participated in the study. Patients were randomly assigned to two study groups, receiving a plain yogurt drink (placebo group) or supplemented with 300 IU day-1 vitamin D (VD group). Primary outcome was defined as the incidences of Candida colonisation (Candida isolated from rectal swab) 14 days after enrollment. Secondary outcome measures were Candida growth in blood (candidaemia) and urine (candiduria).
RESULTS: The prevalence of candiduria as well as candidaemia was significantly lower in the VD-treated group (26 cases) than in the placebo group (62 cases). The mean (SD) length of PICU stay was obviously lowered in the VD group [11.8 (1.2) days] compared to the placebo group [15.2 (2.3 days)], whereas cases of patient death were similar between the two groups.
CONCLUSIONS: Supplementation of vitamin D effectively reduces infections of Candida in children who were critically ill and on broad-spectrum antibiotic treatment.
Be well!
JP