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IOM studies boost in vitamin D requirements
American Medical News ^ | April 20, 2009 | Susan J. Landers

Posted on 04/30/2009 10:22:55 PM PDT by neverdem

Researchers suggest a huge bump in recommended daily levels as the vitamin's benefits extend to helping fight diabetes, cancer and cardiovascular disease.

Vitamin D's star is on the rise and physicians who have studied it say it's about time.

Recent research has found that higher D levels are beneficial in fighting ills ranging from colds to cancer. And, on March 26, the Institute of Medicine's Food and Nutrition Board began reviewing those studies and many others with an eye to revising the recommended dietary intake of vitamin D and its close companion in maintaining bone health -- calcium. A report is expected within two years.

Vitamin D has long been recognized as essential to promoting calcium absorption to allow for bone growth and remodeling. Now, its role in health maintenance is expanding in other directions. Some researchers say if we dramatically increase amounts either absorbed from the sun, or ingested in supplements or fortified foods, a corresponding drop could occur in many rapidly proliferating illnesses, including diabetes and cardiovascular disease.

Since sun exposure is itself considered a cancer risk and people often use sunscreen to block it, supplements and fortified foods may be the best routes. So food manufacturers also have their eyes on the IOM Board's work to see whether a boost in fortification will be allowed.

But you would have to eat a lot of fortified foods to get the amounts of D urged by its fans. For example, some physicians who study the vitamin consume 2,000 International Units daily, well beyond the 200 to 400 units per day currently recommended for older teens and adults up to age 70.

Last fall the American Academy of Pediatrics recommended infants, children and adolescents double the amount of D they ingest each day from 200 IUs to 400 IUs. New research shows the higher amount would not only prevent rickets but treat it, said the AAP recommendation.

Is "D" even a vitamin?

Still, a lot is not known about vitamin D. First, it's actually a hormone. "Vitamin D is probably one of the oldest hormones on earth," said Michael Holick, MD, PhD, professor of medicine, physiology and biophysics at Boston University Medical Center.

"Back in the 1970s we realized we could make it in our skin so it couldn't be a vitamin," he added. But Dr. Holick is OK with calling it a vitamin. "People are afraid of hormones."

Vitamin D is actually a hormone.

And the last thing he wants is for people to neglect their vitamin D. His hope is the IOM board will conclude its current Dietary Reference Intakes -- and those for calcium -- are woefully inadequate. He would like to see a minimum daily intake of 1,000 units per day for adults, with 1,500 to 2,000 units preferable.

It is difficult to get too much D, he said, noting that mankind evolved in the sun, thus ensuring adequate amounts before its rays' harmful effects were noted.

The last time the IOM set the intake limits was in 1997 and Dr. Holick was on the panel. "Even then we knew they were inadequate, but there was no literature to support a higher recommendation," he said -- a circumstance that has since changed.

David Klurfeld, PhD, who leads the Human Nutrition Program at the Dept. of Agriculture agrees. Hundreds of studies have been released on vitamin D since the last intake rates were established, he told the board.

The IOM review is being sponsored by the Agriculture Dept., the Dept. of Health and Human Services and the Dept. of Defense as well as Health Canada and the Public Health Agency of Canada.

Danielle Brule, PhD, director of research for Health Canada, told the board the amount of vitamin D people can absorb at her nation's far northern latitudes is too low. Plus, people who have darker skin have more trouble absorbing adequate amounts of sunlight to gain sufficient D.

People with darker skin have trouble absorbing adequate amounts of sunlight to gain sufficient D.

Despite the increased focus on the need for higher vitamin D levels, people are actually getting less, researchers concluded in a March 23 Archives of Internal Medicine study. They compared the vitamin D levels in blood collected from participants in the National Health and Nutrition Examination Survey between 1988 and 1994 with the D in blood levels of participants in the 2001-2004 survey.

They found the amount of 25-hydroxyvitamin D had dropped from 30 nanograms per milliliter, the amount generally considered necessary for optimal health, to 24 ng/mL.

The main reason for the drop is that people are less likely to go out in the sun, said lead author Adit Ginde, MD, MPH, assistant professor of emergency medicine at the University of Colorado School of Medicine in Denver.

He and his colleagues also concluded that current recommendations are inadequate to address the "growing epidemic of vitamin D deficiency." They advocate increasing intakes to 1,000 IUs per day or more -- especially during the winter and at higher latitudes -- and allowing for judicious sun exposure. They suggest large randomized controlled trials be conducted to evaluate the effects of the increased dose.

Meanwhile, John Whitcomb, MD, medical director for patient access at Aurora Health Care, a nonprofit Wisconsin health care system based in Milwaukee, isn't waiting for the IOM board to make its decision. He's already an enthusiastic booster of increased vitamin D uptake, recommending that people take 1,000 IUs to 2,000 IUs per day.

He called the evidence supporting this increase, "the most critical public health advance in 30 years. We can reduce diabetes, coronary artery disease and cancer. We can drive down the cost of health care in America." He has spread the word of the virtues of D supplements throughout the Aurora system and beyond. "We want everyone in the state of Wisconsin to take vitamin D during the winter."

The print version of this content appeared in the April 27, 2009 issue of American Medical News.

Discuss on Sermo Discuss on Sermo Back to top.


 ADDITIONAL INFORMATION: 

Who needs more vitamin D

The National Institutes of Health Office of Dietary Supplements compiled a list of people who may require dietary supplements to meet their daily allowance. Among them are:

Breastfed infants: Vitamin D requirements cannot be met by human milk alone. The American Academy of Pediatrics recommends that exclusively and partially breastfed infants be supplemented daily with 400 International Units of this nutrient.

People age 50 and older: This group is at increased risk for vitamin D insufficiency. As people age, their skin is less efficient in synthesizing the vitamin and the kidney is less able to convert it to its active hormone form.

People with limited sun exposure: This population includes the homebound, those living in northern latitudes and individuals who wear long robes and head coverings.

People with dark skin: Greater amounts of the pigment melanin result in darker skin and reduce the skin's ability to produce vitamin D from sunlight.

People with fat malabsorption: Vitamin D requires some dietary fat in the gut for absorption. Individuals who have a reduced ability to absorb dietary fat might require supplements. Fat malabsorption is associated with conditions including pancreatic enzyme deficiency, Crohn's disease, cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines and some forms of liver disease.

People who are obese: Individuals with a body mass index equal to or greater than 30 typically have a low concentration of the vitamin in the blood.

Source: National Institutes of Health Office of Dietary Supplements (ods.od.nih.gov/factsheets/vitamind.asp)

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Copyright 2009 American Medical Association. All rights reserved.

RELATED CONTENT  You may also be interested in:
Scurvy rare, but cases still are popping up  Sept. 22/29, 2008
Low vitamin D linked to increased risk of heart attack, death  July 14, 2008
Folate findings prompt new attention to proper amounts  Jan. 29, 2007
Problems of vitamin D deficiency are becoming more evident  May 22/29, 2006


TOPICS: Culture/Society; Government; News/Current Events
KEYWORDS: cad; diabetes; htn; vitamind

1 posted on 04/30/2009 10:22:55 PM PDT by neverdem
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To: neverdem

They just had a recent article that was the opposite if this.


2 posted on 04/30/2009 10:27:22 PM PDT by nickcarraway
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To: neverdem

Bump for health issues.


3 posted on 04/30/2009 10:39:14 PM PDT by Ciexyz (I heard Joe the Plumber speak 03-30-2009.)
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To: nickcarraway

give us more info on the opposite article...this makes sense to me...I have several friends who have recently tested deficient in Vit D and been put on supplements by their drs.


4 posted on 04/30/2009 10:40:18 PM PDT by lonestar (Obama is turning Bush's "mess" into a catastrophe.)
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To: lonestar

I will try to post it. I was dubious about it’s conclusions.


5 posted on 04/30/2009 11:09:51 PM PDT by nickcarraway
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To: nickcarraway; Myrddin; Smokin' Joe; El Gato; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; ...
They just had a recent article that was the opposite if this.

I hope you can find that, nickcarraway.

New Vitamin D Guidelines May Raise Advised Dose

Vitamin D Tied to Hypertension, Hyperglycemia (Low Vitamin D may cause high blood pressue & diabetes) It's associated with high blood pressue and type II diabetes. I needed a subtitle that dealt with the need to translate medical lingo and the constraints of space in the space for titles and subtitles.

FReepmail me if you want on or off my health and science ping list or just the diabetes ping list.

6 posted on 04/30/2009 11:50:13 PM PDT by neverdem (Xin loi minh oi)
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To: neverdem

Once again, as with folic acid and pregnancy, the authorities have discovered that what once was considered a “megadose” is actually a daily requirement.

Keep that in mind the next time you read one of those scare articles about the nonexistent “dangers” of “overdoses” of vitamins. Except for Vitamin A in some of its forms, there essentially is no such thing.


7 posted on 05/01/2009 12:04:13 AM PDT by denydenydeny ("I'm sure this goes against everything you've been taught, but right and wrong do exist"-Dr House)
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To: austinmark; FreedomCalls; IslandJeff; JRochelle; MarMema; Txsleuth; Newtoidaho; texas booster; ...

I may have not included you. Please, forgive me, if I did. Check the links in comment# 6.


8 posted on 05/01/2009 12:31:07 AM PDT by neverdem (Xin loi minh oi)
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To: neverdem

Very interesting. Thanks for finding and posting.


9 posted on 05/01/2009 12:57:50 AM PDT by Daisyjane69
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To: neverdem

This sure has come a long way from the days not so long ago, where no amount of Vit D was recommended above 400 IU for fear of vitamin D toxicity.


10 posted on 05/01/2009 4:45:06 AM PDT by metmom (Welfare was never meant to be a career choice.)
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To: neverdem

This thread is pertinent to the discussion in light of the current fears of flu.

http://www.freerepublic.com/focus/f-chat/1929828/posts

I began 2,000 units/day and my health has improved. No colds, no flu for 2 winters.


11 posted on 05/01/2009 5:12:40 AM PDT by bert (K.E. N.P. +12 . Crucify ! Crucify ! Crucify him!!)
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To: LucyT

Pinging this and post #6.


12 posted on 05/01/2009 7:42:30 AM PDT by sweetiepiezer (I have a Pal in Sarah)
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To: neverdem

Thank you so much for the ping! :)

In the last six months, my doctor advised me to begin taking 2000mg/day of Vitamin D for several reasons, and when the kids were at the pediatrician, she said the same thing (lower dose, of course). Hubby’s doctor, too.

Now we’re all taking it.


13 posted on 05/01/2009 8:56:20 AM PDT by mountainbunny (Mitt Romney: Collect the whole set!)
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To: mountainbunny
In the last six months, my doctor advised me to begin taking 2000mg/day of Vitamin D for several reasons,...

That's 2 grams a day. You probably meant 2000 International Units (IU). Here's a reference.

5 micrograms of Vitamin D = 200 IU (International Units) of Vitamin D

1,000 micrograms = 1 milligram (mg)
1,000 milligrams = 1 gram (gm)

The prefix micro means one part in 1,000,000.
The prefix milli means one part in 1,000.

14 posted on 05/01/2009 11:00:45 AM PDT by neverdem (Xin loi minh oi)
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To: neverdem

As I just mentioned on another thread, after taking 4-5,000 IU D3 all week, yesterday I contracted a bad sore throat. So it isn’t a prevent-all, but I am getting better quickly. Will probably take 2,000 IU/day from now on, due to the various benefits that are becoming apparent.


15 posted on 05/01/2009 11:07:09 AM PDT by steve86 (Acerbic by nature, not nurture)
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To: neverdem

This doesn’t surprise me. I found out three months ago at the age of twenty I had a severe Vitamin D defiency when I went to the doctor. I also found out I had higher than average cholesterol levels. A month later in my Chem class we were discussing Vitamin D and found out our body uses cholesterol to make it. I believe this explains my cholesterol levels because I had broken my foot two weeks ago, and Iive in my basement (where I don’t get any sunlight), and the broken foot was making it hard to go outside. I now walk to class if I can and try to eat dinner outside to increase my sunlight absorption, and hopefully both of these will be remedied when I go back for a test about my Vitamin D.


16 posted on 05/01/2009 11:15:01 AM PDT by Toki
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To: nickcarraway

My husband and I take 1000mg extra D each day in addition to the regular stuff and a good multi-mineral. We both are never ill and I had a bone scan Wednesday and have bone density of someone half my age...


17 posted on 05/01/2009 1:42:36 PM PDT by Arizona Carolyn
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To: Arizona Carolyn

The medical profession puts out all kinds of negative info on vitamins, they have a lot to lose, you know, like boats and things, hey, got heart issues, blockages, no sweat, go natural and recover. THERE IS NO SUCH THING AS HEART DISEASE. No bacteria, no virus, no diease, sorry.

Save your life
http://www.detailshere.com/heart.htm

55 Years Old...4 Plugged Arteries

My name is Lori and I am 55 years old. After several test and three doctors...I was told in December 2006 I had 4 blocked arteries. Three at 50% and one at 70%. I started taking a liquid arginine in December 2006...three and sometimes four times a day until February 4th, 2007. On February 5th, 2007...I went in for a heart catherization...to have a stint inserted into the artery that was 70% blocked. The Doctor Could Not Find Any Blocked Arteries! I was in surgery for 1 1/2 hrs...and when the doctor finished...he told my family he could not find the blockages they had seen in the previous CAT scan...including all the other tests! My high blood pressure of 10 years is back to normal...my Cholesterol was 220...now it’s 160 I’ve been on medication for diabetes...my last test was normal. When I asked the doctor to explain all these changes...he just shook his head. I believe the good Lord used the liquid l-arginine to help me in all of these areas. Lori Orlando, FL


18 posted on 05/01/2009 1:45:13 PM PDT by Scythian
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