This may offer new insight into today's insulin resistance etc.
Garry F. Gordon MD,DO,MD(H)President, Gordon Research Institute
Not only can food effect genes, but the effects can cross generations ...
Type 2 Diabetes May Begin With Grandma's DietAn innovative study published online in The Journal of Physiology in Press provides the first evidence that the insulin resistance typical of type 2 diabetes can be "programmed" across two generations by poor nutrition during a grandmother's pregnancy and lactation. The study, from The University of Texas Health Science Center at SanAntonio and the Institute of Medical Sciences and Nutrition in Mexico City, showed that grandsons and granddaughters of female rats fed an inadequate diet during pregnancy and/or lactation were more likely to become obese and insulin resistant than grandchildren of females fed an adequate diet. The research dramatically extends previous findings that poor maternal nutrition during pregnancy and lactation predisposes the first generation of offspring to diabetes. The study is the first to show that the adverse effects can be passed to adult grandchildren across two generations.Peter W. Nathanielsz, M.D., Ph.D., professor and director of the newCenter for Pregnancy and Newborn Research at the Health Science Center, explains: "These new findings stretch the unwanted consequences of poor nutrition across generations. It offers us important clues about the origins of insulin resistance and type 2 diabetes. Knowledge of the origins of type 2 diabetes has the potential to improve the health of millions as well as deliver very significant economic savings."The granddaughters were more affected when their maternal grandmothers were undernourished during pregnancy. The grandsons, however, were more affected when their maternal grandmothers were undernourished during lactation. Thus, there are gender differences in the effects on the grandchildren, according to the time of exposure to a poor diet during their grandmothers' own development."Other researchers who have explored the issue have not tried to teaseout the effects of poor nutrition in pregnancy in distinction to lactation. Dr. Nathanielsz said the finding is important because it re-emphasizes the need to provide better maternal care and advice to women about good nutrition both during pregnancy and lactation.Dr. Nathanielsz, who joined the Health Science Center in 2004 from New York University Medical School, is the author of several books, including "Life in the Womb: the Origin of Health and Disease" (Promethean Press, 1999) and "The Prenatal Prescription" (HarperCollins Publishers, 2001). He is a widely quoted authority on fetal and early development. He said the finding that the diets of grandmothers can affect the health of grandchildren is "the confluence of nature and nurture -- it's one of the hottest health care stories there is."
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
Wednesday, November 30, 2005
Saturday, November 26, 2005
Paradigms and Paradoxes about Vitamin D
Reprinted from...
John Cannell, MD The Vitamin D Council
Last month, Dr. Armin Zittermann, of Ruhr University in Germany, published the best vitamin D paper of the month. He reviewed the mounting evidence that vitamin D deficiency is a major cause of heart disease.
Br J Nutr. 2005 Oct;94(4):483-92.
Before we start, let’s talk about paradigms and paradoxes. A paradigm is a set of assumptions, concepts, and practices that constitutes a way of viewing reality. The current paradigm is that heart disease is caused by a combination of genetics, hypertension, diabetes, cholesterol, smoking, obesity, inactivity, and diet. A paradox is a fact that contradicts the paradigm.
The Framingham Risk Equation is an attempt to use the most reliable risk factors in the paradigm to predict who will get heart disease. When they applied it to British men for ten years, they found 84% of the heart disease occurred in the men classified as low risk! Furthermore, 75% of the men classified as high risk were still free of heart disease ten years later. It seems the equation is missing a few variables.
BMJ. 2003 Nov 29;327(7426):1267.
There are several interesting heart disease paradoxes. How well do you know them? Good time for another quiz.
1. The French Paradox is the observation that cardiovascular disease is relatively low in France, despite high intakes of saturated fats.
A. True
B. False
True. Perhaps the best known of the cardiovascular disease paradoxes, the most common explanation is that the French love red wine and the antioxidants it contains. It was first described in 1987, before the dermatologists scared the French out of their bikinis. The rates of cardiovascular mortality in France are much lower in the South and West than in the North. One of the world’s best vitamin D researchers, Dr. Marie Chapuy, found that vitamin D levels of healthy adults in France follow that same pattern, with a mean level of 38 ngs/ml in the sunnier and drier South and West, but less than half that (17ngs/ml) in the colder, rainier, and more polluted, North.
Arch Mal Coeur Vaiss. 1987 Apr;80 Spec No:17-21.
Hypertension. 2005 Oct;46(4):645-6. Epub 2005 Sep 12.
Hypertension. 2005 Oct;46(4):645-6. Epub 2005 Sep 12.
Osteoporos Int. 1997;7(5):439-43.
2. The Israeli Paradox is the observation that cardiovascular disease is high in Israel despite a high consumption of polyunsaturated omega-6 fats.
A. True
B. False
True. According to the current paradigm, polyunsaturated fats contained in vegetable seed oils are supposed to lower the risk of heart disease. However, high consumption of these oils doesn’t appear to prevent the Israelis from dying from heart attacks. Israel does, despite its sunny weather, have a high incidence of vitamin D deficiency. Average vitamin D levels among healthy adults in Lebanon, right next door, are only 9.7 ngs/ml - dangerously low. Healthy Jewish mothers, especially orthodox ones, have low vitamin D levels. (If you are wondering how the pro-inflammatory omega-6 oils could ever help heart disease, one possibility is these oils dissociate vitamin D from its binding protein, making more free vitamin D available. Apparently, the Israelis don’t have enough vitamin D in their blood to dissociate).
Isr J Med Sci. 1996 Nov;32(11):1134-43.
Isr Med Assoc J. 2004 Feb;6(2):82-7.
J Bone Miner Res. 2000 Sep;15(9):1856-62.
Isr Med Assoc J. 2001 Jun;3(6):419-21.
J Steroid Biochem Mol Biol. 1992 Sep;42(8):855-61.
3 The Italian Paradox is the observation that a population of heavy smokers has a low incidence of cardiovascular disease.
A. True
B. False
True. The overall death rate from cardiovascular disease in Italy, a country of heavy smokers, is relatively low. Before you say it is the olive oil and wine, ask yourself where olive trees and grapevines grow – in the sun. However, at least two good studies show vitamin D levels in Europe are a paradox, the closer a European lives to the equator, the lower their vitamin D level. Nevertheless, an Italian study showed healthy Roman blood donors had robust vitamin D levels of 48 ngs/ml in the summer. Even average postmenopausal Italian women reached 36 ng/ml in the summer. Anyone who has traveled in Italy, know that most Italians love the sun. As the old Italian proverb points out: “Where the sun does not go, the doctor does.”
QJM. 2000 Jun;93(6):375-83.
Br J Nutr. 1999 Feb;81(2):133-7.
4. The Northern Ireland Paradox is the observation that a population with a very high incidence of coronary heart disease does not have high rates of the expected risk factors.
A. True
B. False
True. In fact, the age adjusted mortality for coronary artery disease was more than four times higher in Belfast than in Toulouse, France, despite almost identical coronary risk factors. There were 761 deaths per 100,000 in Belfast compared to 175 in Toulouse. This is hard to explain, given the current paradigm of heart disease. Of interest, Belfast is at 54 degrees latitude, at sea level, and has 257 rainy days per year. Toulouse is eleven degrees closer to the equator, its altitude is 500 feet closer to the sun, and Toulouse only has 74 rainy days per year. Lots more vitamin D in Toulouse!
QJM. 1995 Jul;88(7):469-77.
QJM. 1998 Oct;91(10):667-76.
Weatherbase, Belfast
Weatherbase, Toulouse
5. The Indian Paradox is the observation that a high prevalence of coronary artery disease in urban Indians is associated with low saturated fat intake.
A. True
B. False
True. Researchers found that a low saturated fat diet did not prevent heart disease in the citizens of the brass-works-polluted city of Moradabad in northern India. The authors did not mention that air pollution dramatically lowers vitamin D levels.
J Am Coll Nutr. 1998 Aug;17(4):342-50.
Arch Dis Child. 2002 Aug;87(2):111-3.
6. The Swedish Paradox is the observation that the strong association between cold weather and heart disease in Sweden is not explained by the usual risk factors.
A. True
B. False
True. Researchers tried to explain why higher annual cardiac mortality is associated with residence in colder regions of Sweden. Try as they might, the authors could not support the current paradigm for heart disease. They failed to mention that cold weather is a marker for low vitamin D levels, as outdoor activity in cold weather is both curtailed and requires extensive clothing.
Scott Med J. 1991 Dec;36(6):165-8.
The point of these six paradoxes is simple. Our current paradigm for understanding heart disease is incomplete. One or more major causes of heart disease remain unknown. One theory - the theory that vitamin D deficiency is a major cause of heart disease – may explain these paradoxes.
7. Robert Scragg, Associate Professor in Epidemiology at the University of Auckland, first proposed that vitamin D deficiency plays a role in cardiovascular disease.
A. True
B. False
True. For the last 25 years, Dr. Scragg has been trying to convince anyone who would listen that vitamin D explains many of observations about heart disease. These include the facts that heart disease is higher at higher latitudes, lower altitudes, in the winter, in African Americans, in older, inactive, and in more obese patients. Remember, vitamin D blood levels are lower at higher latitudes, lower altitudes, in the winter, in African Americans, in older, inactive, and in more obese patients. Altitude is the least known of these associations. The age adjusted mortality for heart disease in the USA showed a striking inverse correlation with altitude in 1979, before the sun scare. American populations at the highest altitude had about half the heart disease of sea level populations. Thirty-five years ago, Leaf observed that most of the long-lived populations in the world reside at high altitude.
Int J Epidemiol. 1981 Dec;10(4):337-41.
J Chronic Dis. 1979;32(1-2):157-62.
Sci Am. 1973 Sep;229(3):44-52.
8. Dr. Scragg showed that higher vitamin D levels are associated with lower risk for heart attack.
A. True
B. False
True. In 1979, the Tromso Heart Study found corrected vitamin D levels showed the same thing.
Int J Epidemiol. 1990 Sep;19(3):559-63.
Br Med J. 1979 Jul 21;2(6183):176.
9. Dr. Scragg is such a good scientist, he then published a study which seemed to disprove his theory.
A. True
B. False
True. He discovered that a single oral dose of 100,000 units of vitamin D had no effect on risk factors (serum cholesterol or blood pressure) five weeks later. This seemed to disprove his theory, but he published the data anyway, always a mark of a good scientist. We now know that 100,000 units are a small dose and that such “stoss” therapy is not physiological. Such a small single dose will raise vitamin D levels for a month or two, but then they rapidly fall towards baseline and would have little physiological effect five weeks later.
Eur J Clin Nutr. 1995 Sep;49(9):640-6.
10. Zittermann points out that vitamin D reduces vascular smooth muscle proliferation, reduces vascular calcification, decreases parathormone levels, reduces C reactive protein (CRP) and other markers of inflammation, and decreases renin, all of which should prevent or treat heart disease.
A. True
B. False
True. He discusses most of the evidence that exists, tying heart disease to vitamin D deficiency. A vitamin D theory of heart disease explains the excess cardiovascular deaths at high latitude, low altitude and during the winter. Furthermore, it explains the higher incidence of heart disease in African Americans, older, inactive, and obese individuals as these groups have significantly lower vitamin D blood levels.
Br J Nutr. 2005 Oct;94(4):483-92.
11. In 2003, Zittermann discovered that patients with congestive heart failure (CHF) have very low levels of vitamin D.
A. True
B. False
True. Furthermore, he found that a protein (NT-proANP), which is a predictor of CHF severity, was inversely associated with vitamin D levels.
J Am Coll Cardiol. 2003 Jan 1;41(1):105-12.
12. Blood cholesterol measurements are worse at higher latitudes, lower altitudes and in the winter.
A. True
B. False
True. The effects of latitude on cholesterol seen in the first study are quite remarkable. In the Greek study, total serum cholesterol for both men and women were significantly lower at higher altitude in spite of similar diets. The seasonal variations in cholesterol are well known and not explained by seasonal dietary changes.
QJM. 1996 Aug;89(8):579-89.
J Epidemiol Community Health. 2005 Apr;59(4):274-8.
J Clin Epidemiol. 1988;41(7):679-89.
Chronobiol Int. 2001 May;18(3):541-57.
13. Blood pressure is higher at higher latitudes, lower altitudes, in the winter, in African Americans, in the aged, and in the obese.
A. True
B. False
True. High blood pressure is one of the strongest predictors of heart disease. Here, six facts about hypertension can be explained by one theory: vitamin D.
Hypertension. 1997 Aug;30(2 Pt 1):150-6.
Ann Hum Biol. 2000 Jan-Feb;27(1):19-28.
Harv Health Lett. 2005 Sep;30(11):8.
14. Diabetes is more common at higher latitudes, at lower altitudes, in African Americans, in the aged and the obese. Both blood sugar and hemoglobin A1C are higher in the winter.
A. True
B. False
True. Six final facts that can be explained with one theory: vitamin D.
Eur J Epidemiol. 1991 Jan;7(1):55-63.
Nutrition. 2001 Apr;17(4):305-9.
Diabetes Res Clin Pract. 2005 Aug;69(2):169-74. Epub 2005 Jan 12.
Diabetologia. 1982 Apr;22(4):250-3.
Am J Epidemiol. 2005 Mar 15;161(6):565-74.
15. Two studies show vitamin D significantly reduces C reactive protein (CRP), which may be a better predictor of heart disease than LDL cholesterol.
A. True
B. False
True. The Belgian study found a significant effect on CRP even though their high-dose vitamin D group only got 500 units a day.
QJM. 2002 Dec;95(12):787-96.
J Clin Endocrinol Metab. 2003 Oct;88(10):4623-32.
16. The risk for total mortality is significantly lower in subjects with high vitamin D levels.
A. True
B. False
True. However, the study is in Finnish and has not been translated into English (author communication).
Seppanen R, Marniemi J, Alanen E, Impivaara O, Jarvislo J, Ronnemaa T, et al. Ravinnon ja seerumin vitamiinit ja kivennaisaineet vanhusten kuolleisuuden ennustajina. Suom Laakaril 2000;42:4255-60 [Finnish]. Reported in Nutr Metab Cardiovasc Dis. 2005 Jun;15(3):188-97.
17. It is now a proven scientific fact that vitamin D both prevents and treats heart disease.
A. True
B. False
False. Like so may other fields of vitamin D research, we lack the definitive interventional trials that would settle the point. It would be simple for the National Institutes of Health to fund a study giving physiological doses of real vitamin D (5,000 units of cholecalciferol) to heart disease patients for a year and see if CRP, proinsulin, blood pressure, cholesterol, body weight, heart attacks, or death rate decreases.
We will have to wait years for science to find out if vitamin D prevents and/or treats heart disease. While you are waiting, you have a choice. You can wait vitamin D deficient (levels less than 40 ngs/ml) or you can wait vitamin D sufficient (levels around 40-60 ngs/ml). The choice is yours - another Pascal’s Wager - this time you are betting your heart.
Also, while you wait for more studies, remember that vitamin D should be obtained daily, not monthly or weekly. It should be obtained physiologically, not in an all-then-none manner, as would happen if you took 100,000 units one day a month and nothing the other 29 days. It appears likely that high blood levels followed by low blood levels may do harm. The reason is that falling blood levels reset the enzymes maintaining intracellular levels of activated vitamin D, resulting in low intracellular levels.
Int J Cancer. 2004 Sep 1;111(3):468; author reply 469.
Vitamin D should be consumed the way the human genome consumed it during its evolution in subequatorial Africa, a steady amount every day. If you live down south, you can go in the sun for a few minutes every day. If you live up north you can sun in the warmer months and use a sunlamp or take real vitamin D (cholecalciferol) in the winter. Adults in the north could take one 5,000 unit capsule a day in late fall, winter, and early spring, less in the late spring and early fall, and none in the summer months - depending on your sunning habits. Children over 50 pounds need two of the 1,000 unit capsules every day in the colder months while children under 50 pounds need about 1,000 units in the colder months. Few people need to take oral vitamin D in the summer unless you are a sunphobe. Get enough vitamin D every day to maintain stable vitamin D blood levels (25-hydroxy-vitamin D) around 50 ngs/ml, year-around.
Last question: should patients dying from heart disease be allowed to die vitamin D deficient? According to the current paradigm, the answer is yes. At least, none of the cardiologists I know even bother to check a vitamin D level. Given the scientific literature, that’s a bit paradoxical.
Comment: Don't wait for final proof, do it...
Vitamin D3
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
John Cannell, MD The Vitamin D Council
Last month, Dr. Armin Zittermann, of Ruhr University in Germany, published the best vitamin D paper of the month. He reviewed the mounting evidence that vitamin D deficiency is a major cause of heart disease.
Br J Nutr. 2005 Oct;94(4):483-92.
Before we start, let’s talk about paradigms and paradoxes. A paradigm is a set of assumptions, concepts, and practices that constitutes a way of viewing reality. The current paradigm is that heart disease is caused by a combination of genetics, hypertension, diabetes, cholesterol, smoking, obesity, inactivity, and diet. A paradox is a fact that contradicts the paradigm.
The Framingham Risk Equation is an attempt to use the most reliable risk factors in the paradigm to predict who will get heart disease. When they applied it to British men for ten years, they found 84% of the heart disease occurred in the men classified as low risk! Furthermore, 75% of the men classified as high risk were still free of heart disease ten years later. It seems the equation is missing a few variables.
BMJ. 2003 Nov 29;327(7426):1267.
There are several interesting heart disease paradoxes. How well do you know them? Good time for another quiz.
1. The French Paradox is the observation that cardiovascular disease is relatively low in France, despite high intakes of saturated fats.
A. True
B. False
True. Perhaps the best known of the cardiovascular disease paradoxes, the most common explanation is that the French love red wine and the antioxidants it contains. It was first described in 1987, before the dermatologists scared the French out of their bikinis. The rates of cardiovascular mortality in France are much lower in the South and West than in the North. One of the world’s best vitamin D researchers, Dr. Marie Chapuy, found that vitamin D levels of healthy adults in France follow that same pattern, with a mean level of 38 ngs/ml in the sunnier and drier South and West, but less than half that (17ngs/ml) in the colder, rainier, and more polluted, North.
Arch Mal Coeur Vaiss. 1987 Apr;80 Spec No:17-21.
Hypertension. 2005 Oct;46(4):645-6. Epub 2005 Sep 12.
Hypertension. 2005 Oct;46(4):645-6. Epub 2005 Sep 12.
Osteoporos Int. 1997;7(5):439-43.
2. The Israeli Paradox is the observation that cardiovascular disease is high in Israel despite a high consumption of polyunsaturated omega-6 fats.
A. True
B. False
True. According to the current paradigm, polyunsaturated fats contained in vegetable seed oils are supposed to lower the risk of heart disease. However, high consumption of these oils doesn’t appear to prevent the Israelis from dying from heart attacks. Israel does, despite its sunny weather, have a high incidence of vitamin D deficiency. Average vitamin D levels among healthy adults in Lebanon, right next door, are only 9.7 ngs/ml - dangerously low. Healthy Jewish mothers, especially orthodox ones, have low vitamin D levels. (If you are wondering how the pro-inflammatory omega-6 oils could ever help heart disease, one possibility is these oils dissociate vitamin D from its binding protein, making more free vitamin D available. Apparently, the Israelis don’t have enough vitamin D in their blood to dissociate).
Isr J Med Sci. 1996 Nov;32(11):1134-43.
Isr Med Assoc J. 2004 Feb;6(2):82-7.
J Bone Miner Res. 2000 Sep;15(9):1856-62.
Isr Med Assoc J. 2001 Jun;3(6):419-21.
J Steroid Biochem Mol Biol. 1992 Sep;42(8):855-61.
3 The Italian Paradox is the observation that a population of heavy smokers has a low incidence of cardiovascular disease.
A. True
B. False
True. The overall death rate from cardiovascular disease in Italy, a country of heavy smokers, is relatively low. Before you say it is the olive oil and wine, ask yourself where olive trees and grapevines grow – in the sun. However, at least two good studies show vitamin D levels in Europe are a paradox, the closer a European lives to the equator, the lower their vitamin D level. Nevertheless, an Italian study showed healthy Roman blood donors had robust vitamin D levels of 48 ngs/ml in the summer. Even average postmenopausal Italian women reached 36 ng/ml in the summer. Anyone who has traveled in Italy, know that most Italians love the sun. As the old Italian proverb points out: “Where the sun does not go, the doctor does.”
QJM. 2000 Jun;93(6):375-83.
Br J Nutr. 1999 Feb;81(2):133-7.
4. The Northern Ireland Paradox is the observation that a population with a very high incidence of coronary heart disease does not have high rates of the expected risk factors.
A. True
B. False
True. In fact, the age adjusted mortality for coronary artery disease was more than four times higher in Belfast than in Toulouse, France, despite almost identical coronary risk factors. There were 761 deaths per 100,000 in Belfast compared to 175 in Toulouse. This is hard to explain, given the current paradigm of heart disease. Of interest, Belfast is at 54 degrees latitude, at sea level, and has 257 rainy days per year. Toulouse is eleven degrees closer to the equator, its altitude is 500 feet closer to the sun, and Toulouse only has 74 rainy days per year. Lots more vitamin D in Toulouse!
QJM. 1995 Jul;88(7):469-77.
QJM. 1998 Oct;91(10):667-76.
Weatherbase, Belfast
Weatherbase, Toulouse
5. The Indian Paradox is the observation that a high prevalence of coronary artery disease in urban Indians is associated with low saturated fat intake.
A. True
B. False
True. Researchers found that a low saturated fat diet did not prevent heart disease in the citizens of the brass-works-polluted city of Moradabad in northern India. The authors did not mention that air pollution dramatically lowers vitamin D levels.
J Am Coll Nutr. 1998 Aug;17(4):342-50.
Arch Dis Child. 2002 Aug;87(2):111-3.
6. The Swedish Paradox is the observation that the strong association between cold weather and heart disease in Sweden is not explained by the usual risk factors.
A. True
B. False
True. Researchers tried to explain why higher annual cardiac mortality is associated with residence in colder regions of Sweden. Try as they might, the authors could not support the current paradigm for heart disease. They failed to mention that cold weather is a marker for low vitamin D levels, as outdoor activity in cold weather is both curtailed and requires extensive clothing.
Scott Med J. 1991 Dec;36(6):165-8.
The point of these six paradoxes is simple. Our current paradigm for understanding heart disease is incomplete. One or more major causes of heart disease remain unknown. One theory - the theory that vitamin D deficiency is a major cause of heart disease – may explain these paradoxes.
7. Robert Scragg, Associate Professor in Epidemiology at the University of Auckland, first proposed that vitamin D deficiency plays a role in cardiovascular disease.
A. True
B. False
True. For the last 25 years, Dr. Scragg has been trying to convince anyone who would listen that vitamin D explains many of observations about heart disease. These include the facts that heart disease is higher at higher latitudes, lower altitudes, in the winter, in African Americans, in older, inactive, and in more obese patients. Remember, vitamin D blood levels are lower at higher latitudes, lower altitudes, in the winter, in African Americans, in older, inactive, and in more obese patients. Altitude is the least known of these associations. The age adjusted mortality for heart disease in the USA showed a striking inverse correlation with altitude in 1979, before the sun scare. American populations at the highest altitude had about half the heart disease of sea level populations. Thirty-five years ago, Leaf observed that most of the long-lived populations in the world reside at high altitude.
Int J Epidemiol. 1981 Dec;10(4):337-41.
J Chronic Dis. 1979;32(1-2):157-62.
Sci Am. 1973 Sep;229(3):44-52.
8. Dr. Scragg showed that higher vitamin D levels are associated with lower risk for heart attack.
A. True
B. False
True. In 1979, the Tromso Heart Study found corrected vitamin D levels showed the same thing.
Int J Epidemiol. 1990 Sep;19(3):559-63.
Br Med J. 1979 Jul 21;2(6183):176.
9. Dr. Scragg is such a good scientist, he then published a study which seemed to disprove his theory.
A. True
B. False
True. He discovered that a single oral dose of 100,000 units of vitamin D had no effect on risk factors (serum cholesterol or blood pressure) five weeks later. This seemed to disprove his theory, but he published the data anyway, always a mark of a good scientist. We now know that 100,000 units are a small dose and that such “stoss” therapy is not physiological. Such a small single dose will raise vitamin D levels for a month or two, but then they rapidly fall towards baseline and would have little physiological effect five weeks later.
Eur J Clin Nutr. 1995 Sep;49(9):640-6.
10. Zittermann points out that vitamin D reduces vascular smooth muscle proliferation, reduces vascular calcification, decreases parathormone levels, reduces C reactive protein (CRP) and other markers of inflammation, and decreases renin, all of which should prevent or treat heart disease.
A. True
B. False
True. He discusses most of the evidence that exists, tying heart disease to vitamin D deficiency. A vitamin D theory of heart disease explains the excess cardiovascular deaths at high latitude, low altitude and during the winter. Furthermore, it explains the higher incidence of heart disease in African Americans, older, inactive, and obese individuals as these groups have significantly lower vitamin D blood levels.
Br J Nutr. 2005 Oct;94(4):483-92.
11. In 2003, Zittermann discovered that patients with congestive heart failure (CHF) have very low levels of vitamin D.
A. True
B. False
True. Furthermore, he found that a protein (NT-proANP), which is a predictor of CHF severity, was inversely associated with vitamin D levels.
J Am Coll Cardiol. 2003 Jan 1;41(1):105-12.
12. Blood cholesterol measurements are worse at higher latitudes, lower altitudes and in the winter.
A. True
B. False
True. The effects of latitude on cholesterol seen in the first study are quite remarkable. In the Greek study, total serum cholesterol for both men and women were significantly lower at higher altitude in spite of similar diets. The seasonal variations in cholesterol are well known and not explained by seasonal dietary changes.
QJM. 1996 Aug;89(8):579-89.
J Epidemiol Community Health. 2005 Apr;59(4):274-8.
J Clin Epidemiol. 1988;41(7):679-89.
Chronobiol Int. 2001 May;18(3):541-57.
13. Blood pressure is higher at higher latitudes, lower altitudes, in the winter, in African Americans, in the aged, and in the obese.
A. True
B. False
True. High blood pressure is one of the strongest predictors of heart disease. Here, six facts about hypertension can be explained by one theory: vitamin D.
Hypertension. 1997 Aug;30(2 Pt 1):150-6.
Ann Hum Biol. 2000 Jan-Feb;27(1):19-28.
Harv Health Lett. 2005 Sep;30(11):8.
14. Diabetes is more common at higher latitudes, at lower altitudes, in African Americans, in the aged and the obese. Both blood sugar and hemoglobin A1C are higher in the winter.
A. True
B. False
True. Six final facts that can be explained with one theory: vitamin D.
Eur J Epidemiol. 1991 Jan;7(1):55-63.
Nutrition. 2001 Apr;17(4):305-9.
Diabetes Res Clin Pract. 2005 Aug;69(2):169-74. Epub 2005 Jan 12.
Diabetologia. 1982 Apr;22(4):250-3.
Am J Epidemiol. 2005 Mar 15;161(6):565-74.
15. Two studies show vitamin D significantly reduces C reactive protein (CRP), which may be a better predictor of heart disease than LDL cholesterol.
A. True
B. False
True. The Belgian study found a significant effect on CRP even though their high-dose vitamin D group only got 500 units a day.
QJM. 2002 Dec;95(12):787-96.
J Clin Endocrinol Metab. 2003 Oct;88(10):4623-32.
16. The risk for total mortality is significantly lower in subjects with high vitamin D levels.
A. True
B. False
True. However, the study is in Finnish and has not been translated into English (author communication).
Seppanen R, Marniemi J, Alanen E, Impivaara O, Jarvislo J, Ronnemaa T, et al. Ravinnon ja seerumin vitamiinit ja kivennaisaineet vanhusten kuolleisuuden ennustajina. Suom Laakaril 2000;42:4255-60 [Finnish]. Reported in Nutr Metab Cardiovasc Dis. 2005 Jun;15(3):188-97.
17. It is now a proven scientific fact that vitamin D both prevents and treats heart disease.
A. True
B. False
False. Like so may other fields of vitamin D research, we lack the definitive interventional trials that would settle the point. It would be simple for the National Institutes of Health to fund a study giving physiological doses of real vitamin D (5,000 units of cholecalciferol) to heart disease patients for a year and see if CRP, proinsulin, blood pressure, cholesterol, body weight, heart attacks, or death rate decreases.
We will have to wait years for science to find out if vitamin D prevents and/or treats heart disease. While you are waiting, you have a choice. You can wait vitamin D deficient (levels less than 40 ngs/ml) or you can wait vitamin D sufficient (levels around 40-60 ngs/ml). The choice is yours - another Pascal’s Wager - this time you are betting your heart.
Also, while you wait for more studies, remember that vitamin D should be obtained daily, not monthly or weekly. It should be obtained physiologically, not in an all-then-none manner, as would happen if you took 100,000 units one day a month and nothing the other 29 days. It appears likely that high blood levels followed by low blood levels may do harm. The reason is that falling blood levels reset the enzymes maintaining intracellular levels of activated vitamin D, resulting in low intracellular levels.
Int J Cancer. 2004 Sep 1;111(3):468; author reply 469.
Vitamin D should be consumed the way the human genome consumed it during its evolution in subequatorial Africa, a steady amount every day. If you live down south, you can go in the sun for a few minutes every day. If you live up north you can sun in the warmer months and use a sunlamp or take real vitamin D (cholecalciferol) in the winter. Adults in the north could take one 5,000 unit capsule a day in late fall, winter, and early spring, less in the late spring and early fall, and none in the summer months - depending on your sunning habits. Children over 50 pounds need two of the 1,000 unit capsules every day in the colder months while children under 50 pounds need about 1,000 units in the colder months. Few people need to take oral vitamin D in the summer unless you are a sunphobe. Get enough vitamin D every day to maintain stable vitamin D blood levels (25-hydroxy-vitamin D) around 50 ngs/ml, year-around.
Last question: should patients dying from heart disease be allowed to die vitamin D deficient? According to the current paradigm, the answer is yes. At least, none of the cardiologists I know even bother to check a vitamin D level. Given the scientific literature, that’s a bit paradoxical.
Comment: Don't wait for final proof, do it...
Vitamin D3
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
Friday, November 18, 2005
Changing diet will cut cancer deaths
Changing diet will cut cancer deaths perhaps in half:
18/11/2005- More than a third of the world's cancer deaths can be blamed on nine modifiable risk factors, including diet and obesity, shows a new study out today. The report, published in tomorrow's issue of The Lancet (vol 366, no 9499), estimates that 2.43 million, or 35 per cent of the 7 million deaths from cancer in 2001 were caused by a lifestyle that could have been changed.
The Harvard University researchers based their findings on a comprehensive review of scientific studies and other sources such as government reports.
Smoking, alcohol use, and low fruit and vegetable intake were the leading risk factors for death from cancer worldwide and in low-and-middle-income countries.
In high-income countries, smoking, alcohol use, and overweight and obesity were the most important causes of cancer.
The charity Cancer Research UK estimates that around half of all cancers in the UK could be prevented by changes to lifestyle.
Comment: While I believe this information is true, there is more that people can do besides just changing diet. Bruce N. Ames, professor of molecular and cell biology at UC Berkeley says that DNA damage from micro nutrient deficiencies is likely to be a major cause of cancer. A deficiency of any of the micro nutrients: folic acid, Vitamin B12, Vitamin B6, niacin, Vitamin C, Vitamin E, iron, or zinc, mimics radiation in damaging DNA by causing single- and double-strand breaks, oxidative lesions, or both. For example, the percentage of the US population that has a low intake (<50%>20%. A level of folate deficiency causing chromosome breaks was present in approximately 10% of the US population, and in a much higher percentage of the poor. Folate deficiency causes extensive incorporation of uracil into human DNA (4 million/cell), leading to chromosomal breaks. This mechanism is the likely cause of the increased colon cancer risk associated with low folate intake. Some evidence, and mechanistic considerations, suggest that Vitamin B12 (14% US elderly) and B6 (10% of US) deficiencies also cause high uracil and chromosome breaks. Micro nutrient deficiency may explain, in good part, why the quarter of the population that eats the fewest fruits and vegetables (five portions a day is advised) has about double the cancer rate for most types of cancer when compared to the quarter with the highest intake. For example, 80% of American children and adolescents and 68% of adults do not eat five portions a day. Common micro nutrient deficiencies are likely to damage DNA by the same mechanism as radiation and many chemicals, appear to be orders of magnitude more important, and should be compared for perspective. Remedying micro nutrient deficiencies should lead to a major improvement in health and an increase in longevity at low cost.
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
18/11/2005- More than a third of the world's cancer deaths can be blamed on nine modifiable risk factors, including diet and obesity, shows a new study out today. The report, published in tomorrow's issue of The Lancet (vol 366, no 9499), estimates that 2.43 million, or 35 per cent of the 7 million deaths from cancer in 2001 were caused by a lifestyle that could have been changed.
The Harvard University researchers based their findings on a comprehensive review of scientific studies and other sources such as government reports.
Smoking, alcohol use, and low fruit and vegetable intake were the leading risk factors for death from cancer worldwide and in low-and-middle-income countries.
In high-income countries, smoking, alcohol use, and overweight and obesity were the most important causes of cancer.
The charity Cancer Research UK estimates that around half of all cancers in the UK could be prevented by changes to lifestyle.
Comment: While I believe this information is true, there is more that people can do besides just changing diet. Bruce N. Ames, professor of molecular and cell biology at UC Berkeley says that DNA damage from micro nutrient deficiencies is likely to be a major cause of cancer. A deficiency of any of the micro nutrients: folic acid, Vitamin B12, Vitamin B6, niacin, Vitamin C, Vitamin E, iron, or zinc, mimics radiation in damaging DNA by causing single- and double-strand breaks, oxidative lesions, or both. For example, the percentage of the US population that has a low intake (<50%>20%. A level of folate deficiency causing chromosome breaks was present in approximately 10% of the US population, and in a much higher percentage of the poor. Folate deficiency causes extensive incorporation of uracil into human DNA (4 million/cell), leading to chromosomal breaks. This mechanism is the likely cause of the increased colon cancer risk associated with low folate intake. Some evidence, and mechanistic considerations, suggest that Vitamin B12 (14% US elderly) and B6 (10% of US) deficiencies also cause high uracil and chromosome breaks. Micro nutrient deficiency may explain, in good part, why the quarter of the population that eats the fewest fruits and vegetables (five portions a day is advised) has about double the cancer rate for most types of cancer when compared to the quarter with the highest intake. For example, 80% of American children and adolescents and 68% of adults do not eat five portions a day. Common micro nutrient deficiencies are likely to damage DNA by the same mechanism as radiation and many chemicals, appear to be orders of magnitude more important, and should be compared for perspective. Remedying micro nutrient deficiencies should lead to a major improvement in health and an increase in longevity at low cost.
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
Saturday, November 12, 2005
Supplementation could improve life and save Billions...
Study concludes omega-3, lutein/zeaxanthin supplement use could help seniors maintain independence, save billions... From Life Extension Foundation
Readers of Life Extension Update may recall the September 27 2004 issue which reported the conclusion of the Lewin Group that consumption of certain dietary supplements by Americans could save the U.S. billions of dollars. In a new Lewin Group report dated November 2, 2005, it was revealed that the regular intake of omega-3 fatty acids and the combination of lutein with zeaxanthin could help older individuals maintain their independence and save an estimated 5.6 billion dollars over a five year period.
The Lewin Group was commissioned by the Dietary Supplement Education Alliance (DSEA) to review research publications for validity, impact and applicability of the findings for omega-3 fatty acids and lutein and zeaxanthin as associated with producing health care savings and maintaining independence for men and women over the age of 65. Several hundred studies dating back nearly thirty years concerning omega-3 fatty acid use among older adults were reviewed, along with studies dating back fifteen years for lutein and zeaxanthin.
The impact of taking 1800 milligrams omega-3 fatty acids per day on coronary heart disease (CHD) prevention was estimated by the Lewin Group to have the potential of avoiding 384,303 hospitalizations and saving 3.1 billion dollars in hospital and physician service fees over five years. For lutein with zeaxanthin, taking 6 to 10 milligrams per day could prevent the loss of independence resulting from visual impairment due to age-related macular degeneration (AMD) of 98,219 individuals, while saving 2.5 billion dollars.
The authors observed, “As the population lives longer, reducing the level of disability caused by age-related diseases is becoming ever more important . . . Potential savings could be achieved through a reduction in hospitalizations and physician services for CHD, and a reduction in the transition to greater dependency from loss of central vision due to advanced AMD.”
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
Readers of Life Extension Update may recall the September 27 2004 issue which reported the conclusion of the Lewin Group that consumption of certain dietary supplements by Americans could save the U.S. billions of dollars. In a new Lewin Group report dated November 2, 2005, it was revealed that the regular intake of omega-3 fatty acids and the combination of lutein with zeaxanthin could help older individuals maintain their independence and save an estimated 5.6 billion dollars over a five year period.
The Lewin Group was commissioned by the Dietary Supplement Education Alliance (DSEA) to review research publications for validity, impact and applicability of the findings for omega-3 fatty acids and lutein and zeaxanthin as associated with producing health care savings and maintaining independence for men and women over the age of 65. Several hundred studies dating back nearly thirty years concerning omega-3 fatty acid use among older adults were reviewed, along with studies dating back fifteen years for lutein and zeaxanthin.
The impact of taking 1800 milligrams omega-3 fatty acids per day on coronary heart disease (CHD) prevention was estimated by the Lewin Group to have the potential of avoiding 384,303 hospitalizations and saving 3.1 billion dollars in hospital and physician service fees over five years. For lutein with zeaxanthin, taking 6 to 10 milligrams per day could prevent the loss of independence resulting from visual impairment due to age-related macular degeneration (AMD) of 98,219 individuals, while saving 2.5 billion dollars.
The authors observed, “As the population lives longer, reducing the level of disability caused by age-related diseases is becoming ever more important . . . Potential savings could be achieved through a reduction in hospitalizations and physician services for CHD, and a reduction in the transition to greater dependency from loss of central vision due to advanced AMD.”
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
Wednesday, November 09, 2005
Another study supporting the benefits of higher intakes of Vit D
Vitamin D appears more important than high calcium for bones...
09/11/2005-
Consuming more than 800 mg of calcium per day may be unnecessary for bone health if the body has enough vitamin D, say Icelandic researchers. Using food consumption records from more than 900 adults, the researchers determined that sufficient vitamin D levels can ensure an ideal level of parathyroid hormone (PTH) - a measure of calcium metabolism - even when calcium intake is less than 800 mg per day.
But consuming more than 1200 mg of calcium daily is not enough to maintain ideal PTH if the vitamin D status is insufficient.
The study is part of a growing body of work that points to the important role of vitamin D, and not just calcium alone, in bone health.
Bone health is a growing concern as the numbers affected by osteoporosis continue to rise, and an increasing elderly population suggests that these will grow further in the future. In Europe, osteoporosis causes around 1.1 million fractures each year.
In light of recent research, and predicting future health problems, some researchers have called for recommended intake of vitamin D to be raised but the adequate amounts needed in the diet are still not known.
The new study, published in today’s issue of JAMA (vol 294, no 18, pp2336-2341), underlines the need to do further work on the RDA for this vitamin.
Nevertheless, the authors, Dr Laufey Steingrimsdottir and colleagues from Landspitali-University Hospital in Reykjavik, write that "there is already sufficient evidence from numerous studies for physicians and general practitioners to emphasise to a much greater extent the importance of vitamin D status and recommend vitamin D supplements for the general public, when sun exposure and dietary sources are insufficient".
The team's findings were derived from nutrient intake data obtained from 944 healthy Icelandic adults recruited between 2001-2003.
The participants were divided into groups according to calcium intake (less than 800 mg/d, 800-1200 mg/d, and greater than1200 mg/d) and serum 25-hydroxyvitamin D level (less than 10 ng/mL, 10-18 ng/mL, and greater than 18 ng/mL). Serum 25-hydroxyvitamin D is a generally accepted indicator of vitamin D status.
After adjusting for relevant factors, the researchers found that serum intact PTH was lowest in the group with a vitamin D level of more than 18 ng/mL but highest in the group with a vitamin D level of less than 10 ng/mL.
An inverse relationship between serum 25-hydroxyvitamin D and serum PTH is well established. PTH is a major hormone maintaining normal serum concentrations of calcium and phosphate and is itself regulated through levels of calcitriol and serum calcium. An insufficiency of vitamin D or calcium is generally associated with an increase in PTH.
But the researchers also observed that in people with a calcium intake of more than 1200 mg per day, there was still a significant difference in PTH between the lowest and highest vitamin D groups.
The researchers added: "The significance of our study was demonstrated by the strong negative association between sufficient serum levels of 25-hydroxyvitamin D and PTH, with calcium intake varying from less than 800 mg/d to more than 1200 mg/d."
“Our results suggest that vitamin D sufficiency can ensure ideal serum PTH values even when the calcium intake level is less than 800 mg/d, while high calcium intake (greater than 1200 mg/d) is not sufficient to maintain ideal serum PTH, as long as vitamin D status is insufficient," they write.
The authors said that although this cross-sectional study is not sufficient to demonstrate causality, “the association between vitamin D status, calcium intake, and the interaction between these two with serum PTH levels is a strong indication of the relative importance of these nutrients”.
Vitamin D may have a calcium sparing effect, explained the researchers, and as long as vitamin D status is ensured, calcium intake levels of more than 800 mg daily may be unnecessary for maintaining calcium metabolism.
Some countries, such as the UK and Denmark, have recently begun recommending that specific groups of the population take vitamin D supplements to ensure adequate vitamin D status during periods when there is little exposure to sunshine.
But data on the market for bone health supplements shows that the vitamin is still considered to have minor importance for this application. With a mere 4 per cent share of the overall vitamins market, vitamin D comes a long way behind calcium in bone supplement sales, according to a recent Frost & Sullivan report.
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
09/11/2005-
Consuming more than 800 mg of calcium per day may be unnecessary for bone health if the body has enough vitamin D, say Icelandic researchers. Using food consumption records from more than 900 adults, the researchers determined that sufficient vitamin D levels can ensure an ideal level of parathyroid hormone (PTH) - a measure of calcium metabolism - even when calcium intake is less than 800 mg per day.
But consuming more than 1200 mg of calcium daily is not enough to maintain ideal PTH if the vitamin D status is insufficient.
The study is part of a growing body of work that points to the important role of vitamin D, and not just calcium alone, in bone health.
Bone health is a growing concern as the numbers affected by osteoporosis continue to rise, and an increasing elderly population suggests that these will grow further in the future. In Europe, osteoporosis causes around 1.1 million fractures each year.
In light of recent research, and predicting future health problems, some researchers have called for recommended intake of vitamin D to be raised but the adequate amounts needed in the diet are still not known.
The new study, published in today’s issue of JAMA (vol 294, no 18, pp2336-2341), underlines the need to do further work on the RDA for this vitamin.
Nevertheless, the authors, Dr Laufey Steingrimsdottir and colleagues from Landspitali-University Hospital in Reykjavik, write that "there is already sufficient evidence from numerous studies for physicians and general practitioners to emphasise to a much greater extent the importance of vitamin D status and recommend vitamin D supplements for the general public, when sun exposure and dietary sources are insufficient".
The team's findings were derived from nutrient intake data obtained from 944 healthy Icelandic adults recruited between 2001-2003.
The participants were divided into groups according to calcium intake (less than 800 mg/d, 800-1200 mg/d, and greater than1200 mg/d) and serum 25-hydroxyvitamin D level (less than 10 ng/mL, 10-18 ng/mL, and greater than 18 ng/mL). Serum 25-hydroxyvitamin D is a generally accepted indicator of vitamin D status.
After adjusting for relevant factors, the researchers found that serum intact PTH was lowest in the group with a vitamin D level of more than 18 ng/mL but highest in the group with a vitamin D level of less than 10 ng/mL.
An inverse relationship between serum 25-hydroxyvitamin D and serum PTH is well established. PTH is a major hormone maintaining normal serum concentrations of calcium and phosphate and is itself regulated through levels of calcitriol and serum calcium. An insufficiency of vitamin D or calcium is generally associated with an increase in PTH.
But the researchers also observed that in people with a calcium intake of more than 1200 mg per day, there was still a significant difference in PTH between the lowest and highest vitamin D groups.
The researchers added: "The significance of our study was demonstrated by the strong negative association between sufficient serum levels of 25-hydroxyvitamin D and PTH, with calcium intake varying from less than 800 mg/d to more than 1200 mg/d."
“Our results suggest that vitamin D sufficiency can ensure ideal serum PTH values even when the calcium intake level is less than 800 mg/d, while high calcium intake (greater than 1200 mg/d) is not sufficient to maintain ideal serum PTH, as long as vitamin D status is insufficient," they write.
The authors said that although this cross-sectional study is not sufficient to demonstrate causality, “the association between vitamin D status, calcium intake, and the interaction between these two with serum PTH levels is a strong indication of the relative importance of these nutrients”.
Vitamin D may have a calcium sparing effect, explained the researchers, and as long as vitamin D status is ensured, calcium intake levels of more than 800 mg daily may be unnecessary for maintaining calcium metabolism.
Some countries, such as the UK and Denmark, have recently begun recommending that specific groups of the population take vitamin D supplements to ensure adequate vitamin D status during periods when there is little exposure to sunshine.
But data on the market for bone health supplements shows that the vitamin is still considered to have minor importance for this application. With a mere 4 per cent share of the overall vitamins market, vitamin D comes a long way behind calcium in bone supplement sales, according to a recent Frost & Sullivan report.
CW
Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.
Visit our website at: www.cwiechert.com
Have your nutritional questions answered by e-mail: www.cwiechert.com/QAMAIL.html
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