The Vitamin D Cure Blog

Happy Holidays and Welcome to the Vitamin D Blog/Newsletter! I will attempt to keep you up on what I feel to be the most interesting vitamin D research. I have a very busy clinic in adult and pediatric rheumatology at The Arthritis Institute of Michigan in Brighton, Michigan, so my time available to post new blogs is limited to once a week. My interests in medicine extend far beyond vitamin D and I hope to share some of that with you in future books. I also supply blog information to eVitamins.com. I receive no compensation from them, only exposure.

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com . This week I asked her for a dessert recipe. It still complies with our Paleolithic principles. So, enjoy a little something sweet for the holidays.

Pear Berry Cinnamon Nut Crisp
Fruit filling
5 to 6 cups sliced pears–peeled, (2.5 to 3 pounds)
1 to 2 cups berries of your choice, fresh or frozen
1 to 2 tablespoons fresh lemon juice
1 T. ground flaxseed
1 to 2 tablespoons sugar
Crisp Topping
¾ cup chopped nuts of your choice
¼ cup ground flaxseed
¼ teaspoon salt
2 tablespoons brown sugar
¼ teaspoon cinnamon
2 to 3 tablespoons canola or vegetable oil
Directions
Preheat the oven to 400*F

Place the fruit in a medium-sized bowl, and toss with the lemon juice. Sprinkle in the flaxseed and sugar and toss until evenly coated, then transfer the mixture to an ungreased 9- or 10-inch pie pan. Don’t clean the bowl.

Use the same bowl to make the crisp topping. Combine the dry ingredients; use your fingers, if necessary, to mix in the brown sugar. Add the oil and mix with a fork and/or your hands until uniformly moistened. Carefully crumble the topping mixture over the fruit, and pat it into place. Place the pan on a baking tray, and bake in the center of the oven for 20 minutes, or until brown on top. Cool for at least 15 minutes before serving. Serve hot, warm, or at room temperature.
Serves: 4 to 6
Prep Time: 20 minutes
Cook Time: 20 minutes to bake

Vitamin D in the News
This week past there was a series of articles published in the International Journal of Endocrinology. This article was most interesting to me. This journal is open access, so you can read the full text of these papers. There are some good reviews of information we discuss in The Vitamin D Cure.

Vitamin d levels and lipid response to atorvastatin.
Int J Endocrinol. 2010;2010:320721. Epub 2009 Aug 19.
Department Internal Medicine, Rio Hortega Universitary Hospital, C/ Dulzaina 2,
University of Valladolid, 47012 Valladolid, Spain.

Objectives: Adequate vitamin D levels are necessary for good vascular health. 1,25-dihydroxycholecalciferol activates CYP3A4, an enzyme of the cytochrome P450 system, which metabolizes atorvastatin to its main metabolites. The objective of this study was to evaluate the response of cholesterol and triglycerides to atorvastatin according to vitamin D levels. Design and Methods: Sixty-three patients with acute myocardial infarction treated with low and high doses of atorvastatin were included. Levels of total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol were measured at baseline and at 12 months of follow-up. Baseline levels of 25-hydroxyvitamin D (25-OHD) were classified as deficient (<30 nmol/L),insufficient (30-50 nmol/L), and normal (>50 nmol/L). Results: In patients with 25-OHD <30nmol/L, there were no significant changes in levels of total cholesterol (173 +/-47 mg/dL versus 164 +/- 51 mg/dL), triglycerides (151 +/- 49 mg/dL versus 177 +/-94 mg/dL), and LDL cholesterol (111 +/- 48 mg/dL versus 92 45 +/- mg/dL); hereas patients with insufficient (30-50 nmol/L) and normal vitamin D (>50 nmol/L) had a good response to atorvastatin. Conclusions: We suggest that vitamin D concentrations >30nmol/L may be required for atorvastatin to reduce lipid levels in patients with acute myocardial infarction.

Comment: In short “Statins” (Lipitor, Zocor, etc…) appear to require a minimum amount of vitamin D (25(OH)D3) substrate (>12 ng/mL or 30 nmol/L) to produce their lipid lowering effects. And, this effect was dose dependent with more dramatic lipid lowering effects at vitamin D levels above 20 ng/mL or 50 nmol/L. More interesting than their lipid lowering effects is their effect on inflammation. We now know that coronary heart disease is an inflammatory disease. Vitamin D is essential for a normal and controlled inflammatory response. We also know that low levels of vitamin D are associated with increased cardiovascular mortality and all cause mortality. Does vitamin D deficiency impair the anti-inflammatory response to statins as well?

Quality of diet and potential renal acid load as risk factors for reduced bone
density in elderly women.
Bone. 2009 Dec 11.
Area di Geriatria, Università Campus Biomedico. Roma, Italy; Fondazione Alberto
Sordi Onlus. Roma, Italy.

BACKGROUND: Bone mineral density (BMD) may be influenced by the general dietary pattern and the potential renal acid load (PRAL). METHODS: We compared the
dietary intake (estimated using the European Prospective Investigation into Cancer and nutrition questionnaire) of 497 community-living women (60 years of age and older) grouped according to tertiles of baseline total, trabecular and cortical BMD estimated using tibial peripheral quantitative computed tomography (pQCT), and of BMD variation over 6 years. RESULTS: None of the other nutrients taken into account nor PRAL was associated with total BMD, with the exception that the intake of polyunsaturated fatty acids (PUFA) was slightly higher among women with the highest total BMD. Similar results were found for trabecular BMD. Cortical BMD was associated with serum 25-OH vitamin D (38.8, 43.2, and 49.5nmol/L in the first, second, and third tertiles, respectively; P=0.042). In the longitudinal analysis, a lower BMI was associated with greater loss of total BMD, while lower serum 25-OH vitamin D at baseline was associated with smaller loss of cortical BMD. CONCLUSIONS: We found no relationship between dietary acid load and BMD. We also confirmed the role of well-recognized risk factor for osteoporosis.

Comment: This study confirms the association between vitamin D levels and both cortical and trabecular bone over time. The higher the vitamin D level was between 15 and 25 ng/mL, the higher the bone mass. This study also confirms the bone protective effect of polyunsaturated fats in the diet that is well described in animal studies. In other words, omega-3 fats make for stronger bones. There was no relationship between dietary acidosis and bone mass. This contradicts previous epidemiological data.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Dear Doctor Dowd:

Thank you for your response! … My rheumatologist gave me no hope and told me the only thing I could do to keep down the inflammation is to take Tylenol or ibuprofen around the clock for the rest of my life (and have my kidneys checked yearly). If I had a flare-up, they would give me colchicine or if it got really bad, a cortisone shot. I showed her your book and one of the case studies that sounded exactly like me and she pooh-poohed it. I had worried about ending up like my grandmother who had rheumatoid arthritis and was almost totally crippled from it.

I’ve since visited a naturopath, and–against my endocrinologist’s and regular doctor’s advice–have begun taking 5,000 IU of vitamin D. My D3 level was 28 at that time. A re-test after 1.5 months showed I had improved to 46, and for the first time in years my C-reactive protein was normal–NOT high…

My knees feel better since I got a cortisone shot and had them drained (20 ccs each) in August. The shot has worn off and some pain returned, but not to the previous levels, and no noticeable swelling. I notice less swelling in my fingers, too, and am totally off ibuprofen.

By the way, our UV level is 1 today, even though it’s clear and bright (not raining!) in Seattle.

Thanks, again.

Susan

HAPPY NEW YEAR!

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com .

Sesame Chicken & Snow Peas Rice Bowl

2 tsp. Toasted sesame oil
1 Tbsp. Fresh ginger, peeled & minced
2 tsp. Fresh lemongrass, peeled & minced (optional)
2 Garlic cloves, minced
1 pound Chicken breasts, skinless & boneless, cut into 1-in. cubes
2 cups Fresh snow peas (may substitute shelled or whole edamame (green soybeans))
2 cups Frozen bell pepper stir-fry mix
2 Tbsp. Low-sodium soy sauce
1 Tbsp. Mirin (sweet rice wine)
1 tsp. Toasted sesame oil
¼ tsp. Potato starch (may substitute cornstarch)
½ cup Green onions, cut diagonally into ¼ in. pieces
2 tsp. Dark sesame seeds
½ tsp. Sea salt
2 cups Hot cooked brown or wild rice

Preparation:

1. Heat oil in a large nonstick skillet (or wok) over medium-high heat. Add ginger, lemongrass, and garlic; sauté 1 minute until mixture becomes fragrant.

2. Add chicken; sauté 2 minutes. Add snow peas and stir-fry mix; sauté another 3 minutes.

3. In a small bowl, combine soy sauce, mirin, sesame oil and potato starch, and whisk to combine. Add to pan; cook another minute.

4. Remove from heat and stir in green onions, sesame seeds and sea salt.

5. Serve over rice.

Yield: 6 servings (2/3 cup chicken mixture and 1/3 cup rice)

Vitamin D and Diet in the News
This month’s Archives of Internal Medicine has three very important articles about vitamin D and diet that further confirm the messages in The Vitamin D Cure. Vitamin D deficiency is becoming more prevalent due to changes in our lifestyle. Supplementation is effective at reducing fractures from vitamin D deficiency. And protein is not the enemy. Lean protein is an ally especially when combined with 2-3 times as much green produce.

Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004.
The prevalence of vitamin D insufficiency appears to be rising. Comparing serum 25-hydroxyvitamin D (25[OH]D) levels from the Third National Health and Nutrition Examination Survey (NHANES III), collected during 1988 through 1994, with NHANES data collected from 2001 through 2004 (NHANES 2001-2004). The authors sought to evaluate US population trends in vitamin D insufficiency. The mean serum 25(OH)D level was 30 (95% confidence interval [CI], 29-30) ng/mL during NHANES III and decreased to 24 (23-25) ng/mL during NHANES 2001-2004. Accordingly, the prevalence of 25(OH)D levels of less than 10 ng/mL increased from 2% (95% CI, 2%-2%) to 6% (5%-8%), and 25(OH)D levels of 30 ng/mL or more decreased from 45% (43%-47%) to 23% (20%-26%). The prevalence of 25(OH)D levels of less than 10 ng/mL in non-Hispanic blacks rose from 9% during NHANES III to 29% during NHANES 2001-2004, with a corresponding decrease in the prevalence of levels of 30 ng/mL or more from 12% to 3%. National data demonstrate a marked decrease in serum 25(OH)D levels from the 1988-1994 to the 2001-2004 NHANES data collections. Racial/ethnic differences have persisted and may have important implications for known health disparities. These findings are consistent with the digitalization of our society, lack of sun exposure, and inappropriate use of sunscreen discussed in The Vitamin D Cure.

Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials.
Antifracture efficacy with supplemental vitamin D has been questioned by recent trials. Dr. Bischoff-Ferrari performed a meta-analysis on the efficacy of oral supplemental vitamin D in preventing nonvertebral and hip fractures among older individuals (≥65 years). She included 12 double-blind randomized controlled trials (RCTs) for nonvertebral fractures (n = 42 279) and 8 RCTs for hip fractures (n = 40 886) comparing oral vitamin D, with or without calcium, with calcium or placebo. Consistently, pooling trials with a higher received dose of more than 400 IU/d resolved heterogeneity. For the higher dose, the pooled RR was 0.80 (95% CI, 0.72-0.89; n = 33 265 subjects from 9 trials) for nonvertebral fractures and 0.82 (95% CI, 0.69-0.97; n = 31 872 subjects from 5 trials) for hip fractures. The higher dose reduced nonvertebral fractures in community-dwelling individuals by 29% and institutionalized older individuals by 15%, and its effect was independent of calcium supplementation. Hence, nonvertebral fracture prevention with vitamin D is dose dependent, and a higher dose should reduce fractures by at least 20% for individuals aged 65 years or older.

Meat intake and mortality: a prospective study of over half a million people.
This study was designed to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality. The study population included the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Meat intake was estimated from a food frequency questionnaire. Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality. However, higher white meat intake which included poultry and fish were associated with modest decreases in total mortality, cancer mortality, and cardiovascular disease mortality. These results confirm the results of other studies regarding the benefits of lean meats or fish intake on overall health and longevity.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

I started very painful arthritis in 1987 and was diagnosed with RA in 1991. I went into remission after 4 years of Gold shots, also diagnosed with FMS (Fibromyalgia) in 1995. Then in 2007 was diagnosed with RA again. This time the doctor checked my Vitamin D levels and found I had no Vit D at all. She ordered 50,000 units of vitamin D for 1 month checking regularly, then renewed it another month. Finally the levels have gotten back to normal. I have endured over 20 years of pain, and will always have some pain, but am way better now! I am about 80% free of pain now!
Pete….@aol.com

Dietary recommendations seem to change year after year. The food industry sends us an endless stream of choices and provides reasons for why we should choose their products. They even invent new food categories and meal times. In an effort to simplify decision making and ignore the noise, we gravitate towards the philosophy of “everything in moderation.” Each of us has a different definition for moderation and for most of us this means continuing to eating the way we always have without change regardless of health.

What if there was a universal diet; a way of eating that all of us should follow for optimal health? The fuel our body was designed to assimilate most efficiently. There is such a diet and it’s outlined in The Vitamin D Cure.

If you were to meet your Paleolithic grandfather from 20,000 BC he would spruce up nicely in a tuxedo. No he would not have hair covering his entire body. His genetic makeup would be identical to yours. Remember, this is 10 times older than the bible.

Let’s look at the composition of his diet. It is more calories that you and I consume because he was waaaay more active than we are today. About 30 percent of his calories came from protein, 35 percent from fat, and 35 percent from carbohydrates. The modern Western Diet provides 13-16 percent of calories from protein, 30 percent of calories from fat and 50 percent of calories from carbohydrates. Most Americans are not getting enough protein and healthy fat in their diet. Most Americans are consuming too many carbohydrates.

Where are all the carbohydrates coming from? Grain, in all of its forms, and corn syrup account for most of this. Grain was initially touted as a solution for diseases of the colon, such as polyps and colon cancer. Decade long studies of grain fiber supplementation however failed to show prevention of either outcome. Now grain is being touted to lower cholesterol. Summaries of this date show at most single digit percent reductions in lipids.

Why aren’t we getting enough protein and fat? In the last 20 years we have demonized protein and fat as the evils of the Western Diet despite evidence to the contrary. Vegetarians have claimed that all that ails the human race is due to eating meat and fat, similar to the dermatologist telling us to avoid the sun. Subsequently, we have all decreased our meat consumption and increased our consumption of grain. Worse yet we have substituted dairy and soy products for meat. Both of these choices provide much less protein per serving and more fat and carbohydrates. See what this does to your insulin. (Insulation from Insulin, Insulin Revisited)

The Anthropologic Rule of Thumb states: Don’t eat anything your Paleolithic grandparents would not have eaten in 20,000 BC. (Note: I didn’t say eat everything that they ate…yet.) No Paleolithic humans or any wild animals on today’s planet consume dairy, grains, or legumes and neither should we. No wild animals on this planet get hypertension, diabetes, heart disease, arthritis, autoimmune diseases, or cancer like humans do. There is a direct connection between our diets and lifestyles, and these diseases. We did not need to sequence the human genome to figure this out.

Get The Vitamin D Cure and start changing your life for the better, today.

Two very important diabetes research studies were published in the New England Journal of Medicine this week, the ACCORD and ADVANCE studies. See this editorial reviewing this research or download both studies to read the complete articles.

The message is clear. Higher insulin levels lead to increased body weight, blood pressure, lipid abnormalities, and risk for heart attacks and strokes. It does not matter whether the insulin is from insulin injections or from medications which increase insulin production or sensitivity to insulin.

In the ACCORD study there was more aggressive use of insulin in combination with drugs that make you produce more insulin or make you more sensitive to insulin (thiazolidinediones). This combination was effective at lowering glucose but increased the risk of heart attacks and death leading to early termination of the study. In the ADVANCE study less insulin and medications increasing your insulin sensitivity were used and subsequently they did not see an increased risk of heart attack or weight gain. However, in the ADVANCE study they only saw kidney protection from tight control of glucose.

To prevent diabetes and its complications you want to lower insulin levels and improve insulin sensitivity without medications. Insulin is an inducible growth hormone, meaning you can adjust the level of insulin with your food choices. Insulin sensitivity is also adjustable with diet and exercise. Polyunsaturated fats, such as omega 3 fats and intense exercise increase your sensitivity to insulin.

Your background set point for insulin sensitivity is determined during fetal development and early childhood. Malnutrition during pregnancy leading to small babies and rapid catch up growth from high calorie, high combined protein/sugar, and high saturated fat diets reduces insulin sensitivity for a lifetime. See “The Barker Theory.”

Dairy, grain, and legumes (beans) produce more insulin than protein from animal meats. See Insulation from Insulin. Combining protein with sugar increases insulin release. Chronic high insulin levels promote insulin resistance especially during pregnancy and during early childhood but also later in life.

Remember the “Yellowstone Park Rule of Thumb.” Wild animals do not eat dairy but from their mother’s breast as a yearling. Wild animals do not eat grain or legumes. Wild animals exercise every day. And, wild animals do not get high blood pressure, diabetes, and heart disease. Go Wild with The Vitamin D Cure diet.

Insulin is a member of the growth hormone family. Its primary purpose is to take up glucose, protein, and fat. Without insulin your glucose levels go up and we call this diabetes. However, the strongest stimulus for the release of insulin is NOT SUGAR or carbohydrates. PROTEIN is the most potent stimulus for the release of insulin. When you combine protein and sugar in the same meal your insulin levels go through the roof.

Insulin promotes construction of bone, fat, and muscle. The stimulating nutrient(s) and your level of activity determine what is produced. Insulin plus sugar and fat with no physical activity makes more fat. Insulin plus protein and physical activity makes muscle and bone. It’s your choice.

Insulin is an on demand construction crew and more of it is released when vitamin D levels are normal than when you are deficient. Our focus, as the construction site manager is, what are we telling insulin to make? (Fat or muscle and bone)

Here is a series of related trivia questions. What food does Mother Nature provide that fattens up newborns so they will survive that first winter? And why is this food so efficient at fattening up? Should we be eating that food as adults?

Let’s face it most of us are not physically active. The absence of physical activity is a signal to insulin for the production of fat. The more insulin you release in an inactive state the more fat you will make. If we are inactive we want lower insulin levels.

Studies in postmenopausal women show much less insulin is released in response to a meal of beef protein than in response to a gram equivalent meal of soy or cottage cheese protein. This is because soy and dairy both combine sugar/carbohydrates along with their protein. Remember, that sends insulin levels through the roof. In addition dairy brings along a load of saturated fat and salt.

How might this get us into trouble? Have you ever had a smoothie? In the book I talk about 2+2 smoothies, 2 veggies, 2 fruits blended. There is no protein in that drink and there shouldn’t be. When you have a smoothie made with fruits and then add protein powder or yogurt, you send your insulin levels to the moon. And, if you are not very physically active that insulin will convert all that sugar to fat in your belly.

If you haven’t figured out the trivia question yet, it’s breast milk. Breast milk fattens babies up because it combines a simple sugar, lactose, with protein in the form of casein. This combination sends insulin levels through the roof. Insulin, plus protein and fat along with high growth hormone levels builds bone, muscle, and fat in an active growing infant. That same dairy meal in an inactive adult with waning growth hormone levels and waning sex steroids makes fat.

The take home message sounds like a broken record, lean and green. Separate your protein from carbohydrates in meals by several hours. You can combine protein and fat or carbohydrates and fat, but DO NOT combine protein and carbs. Stay away from dairy, legumes, and grain. These foods combine protein and carbs, release tons of insulin, and insulate you from health and happiness with a belly of fat. Get the Vitamin D Cure for more information on eating right.