Vitamin D RDA
FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, February 19, 2010
by William B. Grant, Ph.D.
(OMNS, Feb 19, 2010) Vitamin D has been a natural part of man's experience forever, and 90% of vitamin D is derived from solar ultraviolet-B (UVB) irradiance. The health effects of vitamin D can be and have been determined from a variety of studies including ecological, observational (case-control and cohort), and cross-sectional studies.
Vitamin D helps both to prevent and to treat chronic diseases including many types of cancer, cardiovascular disease (coronary heart disease, stroke, etc.), congestive heart failure, diabetes mellitus (types 1 and 2), osteoporosis, falls, and fractures. It is also effective against infectious diseases including both bacteria and viral infections: bacterial vaginosis, pneumonia, dental caries, periodontal disease, tuberculosis, sepsis/septicemia, Epstein-Barr virus, and influenza type A such as A/H1N1 influenza. The autoimmune diseases include asthma, type 1 diabetes mellitus, multiple sclerosis, and perhaps rheumatoid arthritis.
Pregnancy outcomes are also adversely affected by low serum D levels. 40% of primary Cesarean-section deliveries in the United States are linked to low D levels (9% of births in the United States involve primary C-section), and preeclampsia is also linked to low serum levels of D. In regards to cancer, vitamin D helps cells fit into the organs properly or commit suicide (apoptosis), and also reduces angiogenesis (new blood vessel growth) around tumors and reduces metastasis. For metabolic diseases, the mechanisms include increased insulin sensitivity and insulin production. For infectious diseases, vitamin D induces production of cathelicidin and defensins, which have antimicrobial and antiendotoxin activities.
Due to current lifestyles in the United States, most people do not spend sufficient time in the sun to produce the higher serum D levels associated with optimal health. Black-Americans are particularly vulnerable to low levels due to their darker skin, which reduces the amount of UVB that reaches the 7-dehydrocholesterol in the lower epidermis to produce previtamin D. Black-Americans have a 25% higher mortality rate than White-Americans, and this difference may be explained in terms of lower serum 25(OH)D levels. Solar UVB is an excellent source of vitamin D during about half of the year. The way to take advantage of the sun as a source of vitamin D is to expose as much of the body as possible without sunscreen near solar noon, the time when one's shadow is shorter than one's height, for 10-30 minutes depending on skin pigmentation, being careful not to turn pink or red or burn. ( http://www.doctoryourself.com/holick.html )
Supplements represent an efficient way to obtain sufficient vitamin D. African-Americans should consider taking 3000 International Units (IU) per day while White-Americans should consider taking 2000 IU/day. The current dietary guideline, approximately 400 IU/day, was based on the amount of vitamin D in a spoonful of cod liver oil, which prevented rickets.
There are few adverse effects of vitamin D. With whole-body exposure to the sun, one can make at least 10,000 IU/day in a short time. Adverse effects such as hypercalcemia have been found in general only for 20,000-40,000 IU/day for very long periods. However, those with certain diseases such as adenoma of the parathyroid gland, granulomatous diseases, lymphoma, sarcoidosis, and tuberculosis, should limit their vitamin D intake or production due to the fact that the body's innate immune system produces too much 1,25-dihydroxyvitamin D in the serum, which can raise serum calcium levels too high.
Several studies have examined how much mortality rates and economic burdens of disease could be lowered if the population had more vitamin D. These studies were for Western Europe, Canada, the Netherlands, and the United States. They generally found that mortality rates could be reduced by about 15%.
During pregnancy and lactation, women should be taking about 6000 IU/day. The current US "Adequate Intake" recommendation is a mere 200 IU/day. Bruce W. Hollis and Carol L. Wagner, Medical University of South Carolina, recently completed a randomized controlled trial vitamin D supplementation for pregnant and nursing women and found that even 2000 IU/day was inadequate, and that there were no adverse effects with 6000 IU/day.
For the text of a Vitamin D Scientists' Call to Action, please go to http://www.grassrootshealth.net .
[William B. Grant earned his PhD in physics at UC Berkeley. For 15 years he was a physicist at NASA Langley Research Center's Atmospheric Sciences Division. He has authored or coauthored over 180 papers in peer reviewed journals. Since he began his work on UVB/vitamin D and cancer in 2000, the list of vitamin D-sensitive cancers has grown from 5 to at least 16. His paper in Cancer in 2002 identified 10 additional vitamin D-sensitive cancers. Dr. Grant directs the Sunlight, Nutrition, and Health Research Center (SUNARC) http://www.sunarc.org.]
For Further Reading:
[No authors listed]. Vitamin D - monograph. Altern Med Rev. 2008 Jun;13(2):153-64. http://www.thorne.com/altmedrev/.fulltext/13/2/153.pdf
Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007 Sep;92(9):3517-22. http://jcem.endojournals.org/cgi/reprint/92/9/3517
Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev. 2008 Mar;13(1):6-20. http://www.thorne.com/altmedrev/.fulltext/13/1/6.pdf
Dietrich T, Joshipura KJ, Dawson-Hughes B, Bischoff-Ferrari HA. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr. 2004 Jul;80(1):108-13. http://www.ajcn.org/cgi/reprint/80/1/108
Dunning JM. The influence of latitude and distance from seacoast on dental disease. J Dent Res. 1953 Dec;32(6):811-29. http://jdr.sagepub.com/cgi/reprint/32/6/811
East BR. Mean annual hours of sunshine and the incidence of dental daries. Am J Public Health Nations Health. 1939 Jul;29(7):777-80. http://www.ajph.org/cgi/reprint/29/7/777
Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, Holick MF. The role of vitamin D in cancer prevention. Am J Public Health. 2006 Feb;96(2):252-61. http://www.ajph.org/cgi/reprint/96/2/252
Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS. Stampfer MJ, Willett WH. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. JNCI 2006; 98:451-9. http://jnci.oxfordjournals.org/cgi/reprint/98/7/451
Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008 Jun 9;168(11):1174-80. http://archinte.ama-assn.org/cgi/reprint/168/11/1174
Grant WB. How strong is the evidence that solar ultraviolet B and vitamin D reduce the risk of cancer? An examination using Hill's criteria for causality. Dermato-Endocrinology. 2009;1(1):17-24. http://www.landesbioscience.com/journals/dermatoendocrinology/article/7388/
Grant WB. In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B irradiance. Dermato-Endocrinology, 2009;1(4):207-14. http://www.landesbioscience.com/journals/dermatoendocrinology/archive/volume/1/issue/4/
Grant WB, Cross HS, Garland CF, Gorham ED, Moan J, Peterlik M, Porojnicu AC, Reichrath J, Zittermann A. Estimated benefit of increased vitamin D status in reducing the economic burden of disease in Western Europe. Prog Biophys Mol Biol. Prog Biophys Mol Biol. 2009 Feb-Apr;99(2-3):104-13. (posted at http://www.sunarc.org)
Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81. http://content.nejm.org/cgi/content/short/357/3/266
Hyppönen E, Power C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007 Mar;85(3):860-8. http://www.ajcn.org/cgi/reprint/85/3/860
Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91. http://www.ajcn.org/cgi/reprint/85/6/1586
Looker AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano MF, Yetley EA. Serum 25-hydroxyvitamin D status of the US population: 1988-1994 compared with 2000-2004. Am J Clin Nutr. 2008 Dec;88(6):1519-27. http://www.ajcn.org/cgi/reprint/88/6/1519
Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, Felsenfeld A, Levine B, Mehrotra R, Norris K. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2007 Jun 11;167(11):1159-65. http://archinte.ama-assn.org/cgi/reprint/167/11/1159
Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008 Aug 11;168(15):1629-37.http://archinte.ama-assn.org/cgi/reprint/168/15/1629
Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009 Mar;94(3):940-5.
Papandreou D, Malindretos P, Karabouta Z, Rousso I. Possible Health Implications and Low Vitamin D Status during Childhood and Adolescence: An Updated Mini Review. Int J Endocrinol. 2010;2010:472173. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778445/pdf/IJE2010-472173.pdf
Schwalfenberg G. Not enough vitamin D: health consequences for Canadians. Can Fam Physician, 2007;53(5):841-54. http://www.cfp.ca/cgi/reprint/53/5/841
Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, Benjamin EJ, D'Agostino RB, Wolf M, Vasan RS. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008 Jan 29;117(4):503-11. http://circ.ahajournals.org/cgi/content/full/117/4/503
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