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Vitamin D deficiency increasingly common (sfgate.com)
40 points by cwan on Jan 10, 2010 | hide | past | favorite | 35 comments



There's so much fun stuff to read about it for a medically untrained layperson like me. Let's see, things I remember reading from off the top of my head, but don't know how true or accurate or likely they are:

- Cholesterol is converted into Vitamin D by the sunlight, so our dietary cholesterol shunning, cholesterol lowering drug culture lowers the amount of Vit D which can be created by the sun.

- UVB is needed to make Vit D from sunlight, so our sunscreen culture makes that less likely.

- UVA counters the making of Vit D in the skin, so our office culture where people sit inside behind windows which block UVB and allow through UVA is bad for Vit D levels.

- Our margarine and other odd fats promoting culture leads to trans fat and other i-don't-remember-what abnormal fats being used in body part construction and repair, and they are more likely to oxidise and distort and weaken cells and lead to an increased risk of skin cancer from sunlight.

- Our recommended blood/cell/something levels of Vit D are less than that seen naturally in people who live in Equatorial regions.

- Not all Vit D supplements are equal, eating in a powdered tablet form will cause some to be absorbed, eating in a gel tablet form will lead to more getting through the stomach to the gut and cause more to be absorbed, eating with fatty/oily food will cause more to be absorbed and used than eating it dry, using a spray under the tongue will cause absorbtion directly into the blood stream so you can more accurately predict how much will become available for bodily use, but when created by sunlight it's self regulating. So if you don't get it via sunlight, have levels checked regularly so you don't overdose. And since you can't accurately predict how much of a tablet will be absorbed, you might need to take more than you otherwise thought to get the change in level you were planning for.

So if there is truth to these, it's not just a case of sunlight causes skin cancer, but sunlight on odd-fat-weakened skin increases chances of skin cancer which office working sunscreen wearing sun avoiders have less ability to fight off.

Sounds so simple and believable it can't be true, but also so simple and believable that even if it isn't true in the slightest I'll still remember it easily. Hrm.


Is the human body conditioned to A: stay in an office all day B: stay outside in the sun all day

If we look at the last 50 years, it seems the answer is A. However, looking at the last X thousands of years, it is not surprisingly B.

I'm from Norway, and at the moment we only enjoy a few hours of sun (unless you live in the northern parts of Norway, in which case you get NO sun at all now).

Norwegians spend most of the year inside an office, and then go to Spain (or similar) for a two weeks vacation during summer where we stay 10 hours in the sun to get tanned. Even people from Spain stay inside in the middle of the day when the sun is the strongest.

And we wonder why we get skin cancer....

My simple rule: a little bit of sunshine every day is very important and very healthy - too much is not


Also: the lightening of skin in Europe/North America may primarily a result of moving from non-equatorial regions where UVB is stronger (e.g. less melanin due to body's need to absorb more UVB).

The incidence of skin cancer has actually gone up dramatically since sunscreen has been introduced.

Vitamin D helps your body to make your own antibiotics (cathelicidin, etc).


I'm not saying you're incorrect, but how do you know that incidence of skin cancer has gone up, rather than more skin cancers being detected instead of going unnoticed?


Also with thinner ozone layer it is not much of a surprise we see more skin cancer


> UVB is needed to make Vit D from sunlight

Actually, it's UVA. To make appreciable vitamin D you have to be out in the midday sun when there's plenty of UVA, not after ~2:30pm.



My mom, a retired scientist, has been going off the importance of Vitamin D for three years now. To the point, that I have been taking 2000 mg/d for over a year now. It's easy to take and it gets my mom off my back (well, at least, for Vitamin D :) ). She's pushing me to do 4,000 mg/d. Costco sells gel tablets the cheapest. Seriously, she believes it shouldn't even be called a vitamin. She was a well-respected researcher and she regularly emails me the latest research. Think about it, how important is your health? I believe your number one asset is your ability to produce income. Health is a vital part of your ability to work and enjoy life.

read more at:   http://www.vitamindcouncil.org/   http://www.proteinpower.com/drmike/important-information/vit...


I hope you mean UI instead of mg. According to wikipedia even 2000 micrograms a day would be too high.


IU. Amazing how I don't look at the bottle.


Follow-up from sfgate's resident physician-blogger at [1], more focused on what individuals can/should do and perceptions rather than research. Takeaways: skin tone affects vitD uptake, milk is insufficient, and lab tests report results against the average rather than against the recomended so a result of "normal" isn't enough. Also, fun fact: vitamin D has a huge impact on broken bones in the elderly... because it makes you not fall over in the first place!

[1] http://www.sfgate.com/cgi-bin/blogs/gurley/detail?entry_id=5...


Some have also suggested that Vitamin D may be the link in the seasonal nature of the flu:

http://www.ncbi.nlm.nih.gov/pubmed/16959053


And yet, this RCT shows that it has no effect.

http://www.ncbi.nlm.nih.gov/pubmed/19296870


I take 4,000 UI of vitamin D3 each day (live in Canada and almost never go outside).

Gelcap format (as opposed to dry tablets - the ones that would turn to powder if you crushed them) is apparently important because vitamin D is fat-soluble and is better absorbed that way.

I get them from Carlson Laboratories. One bottle of 360 gelcaps, 2,000 UIs each is something like $20. Extremely cheap.


That's very cheap, I buy Jamieson brand chocolate chewable vitamin D tablets and they cost around $30.

I too live in Canada, work inside in a windowless area even in the summer, shift work, get up when it's dark, work in the dark and go home when it's dark, when I am home I am in the dark.

Last year CBC news mentioned how vitamin D studies showed a massive benefit, so much so I think it was one of those "stop the study now!" studies because it was so good they had to get the news out.

I have noticed a massive difference in my health, I have not been sick since increasing my intake of vitamin D, which is amazing. Anecdotal? Sure but I know my body and any crazy vitamin or powder or even healthy diet I try to maintain, nothing has had such a dramatic impact on me as vitamin D has.

I only take 1,000 IU per day since there doesn't seem to be any agreement on what is right, it certainly would depend on body mass and other factors. I'm not a believer that one is good so 20 is better, I like to know what the right amount is.


A lot of my info about Vit D comes from Dr. Davis at the Heart Scan blog:

http://heartscanblog.blogspot.com/

Check the archives, you'll find a lot of interesting stuff.

He actually does blood tests on his patients and measures if the vitamin D is actually absorbed (which is what made his recommend gelcaps to everybody instead of dry tablets). I think he himself takes 6,000 or 8,000 UI / day.

I've also set a Google Alert for "Vitamin D".


+1 anecdotal here as well. Got it recommended by a friend, and just stopped getting colds. I recently forgot taking them, and had my first cold in years.


Maybe it's time to add a new food to the list requiring Vitamin D, not just milk.

Potato chips maybe? (Semi joke.) Some food with oil anyway.


Or UVB-producing laptop screens.


!

However, there is a danger of overexposure.


Something without lactose...


After reading that, I promptly threw a package of Atlantic wild caught salmon in the refrigerate to thaw for later.

Fish happens to be be one of my favorite foods. I think I am in the minority in US. I also like beet soup (borscht), so hopefully I am getting my share of Fe as well.

A lot of people here love steaks, chicken, spaghetti, pizza, but fish or beets are secondary or fall in the "weird" foods category.

In general I think so many Americans have weight problems because the popular foods happen to be bad for them. An extreme example of this is the Native American food -- fry bread. They have been displaced from their lands, and US govt. is feeding them with lard and flour. No wonder diabetes rates are so high among that population segment.

http://diabetes.niddk.nih.gov/dm/pubs/americanindian/


BTW, most "Atlantic" salmon is farmed, not wild. There is wild Atlantic stuff, but you're probably not getting it unless the sign in the seafood department specifically says so. I've never seen it for sale myself, personally. I've heard on TV it's almost fished-out of the Atlantic too. Per Wikipedia, the amount of farmed vs. wild Atlantic salmon produced was 1,433,708 tons vs. 2,989 tons in 2007, respectively.

http://en.wikipedia.org/wiki/Salmon_in_aquaculture#Wild_vers...

"Alaskan" salmon tends to be wild-caught. It's also usually more expensive (on the East Coast), and harder to find (Whole Foods is usually you're best bet). Typically, "wild" is better for you than "farmed" salmon:

http://www.paystolivegreen.com/2009/02/wild-salmon-vs-farmed...

It has better nutritional value, including better Omega 3 to Omega 6 fat ratio, higher protein and lower fat quantity, and is usually lower in PCB's. If it's not marked as "Alaskan" or "wild", it's probably farm raised.


Ah, sorry my bad. It was Alaskan not Atlantic.



Thanks.

To summarize:

    Do eat:
      - Salmon
      - Tilapia
      - Carp
      - Perch
      - Squid
      - Sardines
      - Oysters

     Do not eat:
      - Shark
      - Swordfish
      - Tilefish
      - Mackerel


Thanks for the summary, but I think you just smudged the data... For example: Mackerel from the Gulf of Mexico (study done in 2000) does have high level of mercury, but Mackerel from the N Atlantic and Pacific studies did not. We shouldn't be jumping to simplistic conclusion like 'Do not eat Mackerel' . As always, it's more complex than that, and it pays to look at the source.


When it comes to "do not eat" it is easier to remember "do not eat mackarel" when getting to the store than "do not eat Mackarel from 2009 from Golf of Mexico". Health-wise if we don't eat some kind of Mackerel we'll be OK. In other words as far as mercury levels and safety, my "shopping" list still works. However, if you are a Mackarel fisherman you might not like my shopping list...


You could make the list much simpler still, but you'd be missing out on some good fish: "Avoid predators at all cost".


As a general rule of thumb, the higher you go up the food chain for fish, the higher the mercury content. Fish which eat plants and plankton are on the bottom of the chain and tend to have low mercury levels. Fish which eat other fish which eat other fish (shark) tend to have a higher amounts of mercury, concentrated from all the tiny bits they received from other fish eaten.


Atlantic wild caught salmon

How did you obtain wild Atlantic salmon? It's an endangered species, and fishing is not allowed! If this is really what you have, how did you get it? If it's legal, let me know, I want some too! If not, you should probably stop...


Sorry, just checked the refrigerator and it is Alaskan not Atlantic.


You are very fortunate to like fish so much - you can pretty much eat as much as you want (sensibly cooked) and it can only be good for you (I really don't like fish). My only superpower in food is loving beans/legumes (I could live off them - which is both cheap and nutritious). Well at least in my country there is no lack of vitamin D unless you live and work in a lead screened bunker and never have to go outside (Australia).


I find ridiculous doctors don't suggesting a bit more sun exposure instead to give pills: I bet there is business in action here.

I live in Sicily, here to take a lot of sun means to sit in the worst hours for a lot of time, the whole summertime, and here the sun is strong. 30 minutes of sun in the right hours should kill you? I really don't think so.

Possibly all this warnings about the sun and skin cancer had the result of killing a lot more people for lack of D vitamin.


Doctors typically have to consider how likely a patient will be to follow through with their instructions. A recommendation of popping a fairly cheap pill each morning is more likely to be followed than 30 minutes of sun. This is the same reason doctors hand out pills for high blood pressure instead of insisting that patients lose weight and cut down on Sodium. It's sad that they have to rely on pills for everything, but human nature being what it is, the pills tend to be more effective.




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