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Vitamin D Report Falls Short

Friday, December 03, 2010


Once again too many overzealous newspaper editors wrote headlines that don't match their reporters' articles.  Many even went so far as to suggest in this past week's headlines that the general public doesn't need vitamin D supplements at all - based on the new recommendations from the Institute of Medicine (ION). 

Alarming headlines and broadcast sound bites attract folks who frequently don't read the actual article or follow through with their own research.  The outcome is a misinformed public.

Although the new IOM recommendation for Vitamin D intake is lower than expected by most nutrition researchers, they still tripled the current RDA of 200 IU per day to 600 per day for adults under 70 and they raised it to 800 IU per day for those over 70 years old.  It's almost impossible to consume this amount of Vitamin D from a normal diet.  This is particularly concerning since new government HHS data suggest that fewer than 11% of the general public even consumes 5 servings of fruits and vegetables a day (the new recommendation is 9-13 servings a day to reach recommended amounts of vitamins, minerals and antioxidants). 

It seems within reason to suspect that these same folks who consume five or less servings of fruits and vegetables a day (almost 90% of the U.S. population) are probably not eating two or three servings of Vitamin D rich fresh fish a week either.  Hopefully, they are getting 15 minutes of sun on enough bare skin every day to make up for dietary vitamin D deficiency.

Andrew Shao, PhD, senior vice president of scientific and regulatory affairs at the Washington, D.C.-based Council for Responsible Nutrition had this to say about the report, "This week's Institute of Medicine (IOM) conservative increase in the amount of Vitamin D required to prevent disease lags behind the mountain of research demonstrating a need for vitamin D intake at levels possibly as high as 2000 IU per day for adults."

A fourteen member expert committee was asked by the IOM to examine the available data to determine how much vitamin D and calcium people were getting, how much was needed for optimal health and how much was too much.  Vitamin D and Calcium are suggested to work together for bone health.  Vitamin D has been suggested in a number of studies to have a positive health effect on our muscles and our central nervous system. This helps to explain the decreased fall and bone fracture rates reported in many calcium/vitamin D studies.

The IOM report suggests the experts examined fewer than 1000 of the 16,983 vitamin D deficiency studies available on Pub Med from the National Library of Medicine at the National Institutes of Health.

A reasonable first thought by many nutrition science researchers: Since the IOM assignment was to look at Vitamin D / Calcium studies, did they lump Vitamin D study outcomes with negative study results from excessive amounts of junk calcium with a low absorption rate?  This might explain their connection between supplemental vitamin D / calcium studies to increased risk of heart disease.

The quality of supplemental micronutrients matter, particularly where minerals are concerned.

Most research savvy nutritional biochemists long ago recognized that bone health is only one of the benefits attributed to vitamin D intake.  Over 600 new Vitamin D studies have been added to Pub Med in 2010 alone.  It's within reason to wonder how many, if any, of the 600+ 2010 peer-reviewed studies were included in the fewer than 1000  Vitamin D & Calcium  studies the IOM committee examined.

Data from the National Health and Nutritional Examination Survey (NHANES) suggest that large segments of the population have inadequate vitamin D status.  A vast amount of peer-reviewed and published scientific research links vitamin D deficiency to increased risk for certain cancers, cardiovascular disease, osteoporosis, diabetes and other health-related issues. Despite this scientific evidence, the IOM report suggests no concrete evidence that vitamin D alone protects against cancer, heart disease, autoimmune diseases or diabetes.  

There they go again; suggesting that a single nutrient can prevent disease.  Nutrients are not like synthetic drugs; they always do their best work synergistically. 

Bruce Ames, PhD (one of the most published biochemists / molecular biologists in the world) suggested in a lecture he was invited to give to the National Institutes of Health in June of this year, "The consequence of moderate shortages of even a single micronutrient, though insufficient to cause overt clinical symptoms, will impair functions essential for long-term health.  This impairment will result in insidious damage (e.g. increased DNA damage) over time,  leading to the acceleration of age-associated diseases, including cancer."

Again, before changing recommendations or vitamin D supplementation amounts, it's important to note that the IOM increased the daily recommendation for vitamin D intake from 200 IU to 600 IU for individuals under the age of 70.  The daily recommendation for vitamin D intake for people over the age of 70 was increased to 800 IU per day for disease prevention, not for optimal health.

The IOM increased the safe upper limit (UL) daily amount of vitamin D from 2,000 IU to 4,000 IU for adults.

Michael Holick, MD, PhD , professor of medicine, physiology and biophysics at Boston University School of Medicine called the new IOM guidelines on vitamin D "a step in the right direction."  He predicts the next committee will be convinced of the non-skeletal benefits of vitamin D.  Other professors of medicine, like Robert  Heaney, MD, from Creighton University in Omaha, Neb, thinks the new IOM recommendations are way too conservative because there is plenty of evidence to support higher numbers.

Ellen Troyer, MT MA
Biosyntrx CEO / Chief Research Officer
Voting Member, Council for Responsible Nutrition



 


PEARL

As you can see from the small mixed sampling below of Vitamin D references published in peer-reviewed journals in just the past two or three months, the controversy seems to be over the optimal blood serum level of 25-hydroxyvitamin D. Nutrition science studies suggest that levels less than 30-32 ng/ml have been linked to increased risk for a variety of medical conditions including cancer, heart disease, type 2 diabetes, infectious diseases, autoimmune diseases, metabolic bone diseases and neurological disorders. The Institute of Medicine (IOM) report seems to be based on serum level of 25-hydroxyvitamin D at 20 ng/ml being adequate.

The answer is to continue carefully following this science; to have your vitamin D levels checked every year, and to discuss this issue with your health care provider.  The current practice is Vitamin D loading until optimal serum levels of 25-hydroxyvitamin D are achieved.

The good news is that the IOM increased the safe upper daily limit of Vitamin D to 4,000 IU for adults, which means that daily supplementation of 2,000 IU (the amount recommended by many well-published vitamin D researchers) is well within their stated safe range.

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References

Vitamin D, neurocognitive functioning and immunocompetence. Nimiphong H, Holick MF. Curr Opin Clin Nutr Metab Care. Nov 2010 [abstract]

Fall prevention and vitamin D in the elderly: an overview of the key rold of the non-bone effects. Annweiler C, Montero-Odasso M, et al.
J Neuroeng Rehabil. [abstract]

Vitamin D and the skin. Shahriari M, Kerr Pe, et al. Clin Dermatol. Nov. 2010. [abstract]

Role of vitamin D in cardiovascular health. Reddy Vanga S, Good M, et al. Am J, Cardio. Sep 15 2010. [abstract]

Role of vitamin D in immune responses and autoimmune diseases, with emphasis on its role in multiple sclerosis. Ahang HL, Wu J. Neurosci Bull. Dec. 2010 [abstract]

Low Vitamin d levels in Northern American Adults with the Metabolic Syndrome. Devaraj S, Jialal G, et al. Horm Metab Res. Nov. 2010. [abstract]

Vitamin D and Inflammation. Guillot X. Semerano L, et al. Joint Bone Spine Nov 8 2010. [abstract]

Optimal Use of Vitamin D when Treating Osteoporosis. van den Bergh JP. Bours SP, et al. Curr Osteoporos Rep. Nov. 2010 [abstract]

Relationship between bone mineral density changes and risk of fractures among patients receiving calcium with or without vitamin D supplementation: a meta-regression. Rabennda V, Bruyere O, et al. Osteoporosis Int. Nov 2010. [abstract]

Glycemic changes after vitamin D supplementation in patients with type 1 diabetes mellitus and vitamin D deficiency. Aljabri KS, Bokhari SA, et al. Ann Saudi Med. Nov-Dec 2010. [abstract]

A randomized controlled trial of the effects of vitamin D on muscle strength and mobility in older women with vitamin D insufficiency. Zhu K, Austin N, et al. J Am Geriatr Soc. Nov, 2010 [abstract]

Nutritional Rickets among Children in a Sun Rich Country. Bener A, Hoffman GF. Int J Pediatr Endocrinol.  Nov. 2010 [abstract]

Will vitamin D supplementation ameliorate diseases characterized by chronic inflammation and fatigue? Hoeck AD, Pall ML. Med Hypotheses Oct 2010. [abstract]