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

Do something sexy for your special someone. Give them vitamin D. It will boost their mood, memory, muscle strength, and immune system while reducing their risk for high blood pressure, diabetes, obesity, heart disease, cancer, and death from all causes.

Recipe of the Month

Milanese-Style Chicken and Arugula Salad

Tomato-Basil Vinaigrette

• ½ C. Red Wine Vinegar
• ¼ C. Basil Leaves
• 4 Plum tomatoes cut into chunks
• 2 t. Extra-virgin olive oil
• 1 t sugar
• ½ t salt
• 4 Large garlic clove

1. Blend all ingredients in a food processor until smooth.
2. Pour ½ cup dressing into 2qt glass baking dish, reserve remaining dressing

Salad

• 4 Skinless boneless chicken breasts
• 4 Red bell peppers cut into quarters
• 1 t Extra-virgin olive oil
• 1 pkg Baby Arugula
• ¼ C Pine nuts, toasted

3. Place chicken in glass baking dish and marinate for 30 minutes
4. Preheat grill or broiler
5. Brush peppers with oil and grill along with chicken until tender and peppers are to desired texture
6. Divide arugula between four plates.
7. Slice chicken and place on arugula with thinly sliced peppers.
8. Drizzle with vinaigrette and top with pine nuts

Serves 4

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 .

Vitamin D in the News

Muscle weakness is an important symptom of vitamin D deficiency, but it has not been well studied. This study was based in a secondary school. A total of 99, 12- to 14-yr-old girls were included. Median serum 25(OH)D3 concentration was 8 ng/mL. They found a positive relationship between 25(OH)D and jump velocity (P = 0.002), jump height (P = 0.005), power (P = 0.003), Esslinger Fitness Index (P = 0.003), and force (P = 0.05). From these data they concluded that vitamin D was significantly associated with muscle power and force in adolescent girls.

Multiple sclerosis (MS) is a disease associated with genes in the tissue typing class (MHC class II) region of our genome. Population data on MS provide strong evidence that environmental factors act to influence the unusual geographical distribution of this disease. Growing evidence implicates sunlight or vitamin D as a key environmental factor in its cause. This study implicates vitamin D as a strong environmental candidate in MS by demonstrating direct functional interaction with a gene that increases susceptibility to disease (HLA DRB1). These findings support a connection between the population data and the genetic features of this disease with major practical implications for studies of disease cause and prevention.

The immune system has long been known to be influenced by essential nutrients in our diet. Vitamins A and D have been shown to have an unexpected and crucial effect on the immune response. This review discusses our current understanding of the essential roles of these nutrients in modulating a broad range of immune processes, such as white cell (T-cell) activation and proliferation, T-helper-cell differentiation, tissue-specific white blood cell homing, the production of specific antibodies and regulation of the immune response. Finally, they discuss the clinical potential of vitamins A and D for modulating immune responses and for preventing and/or treating inflammation and autoimmunity.

Vitamin D Success Story

Please share your successes at success@thevitamindcure.com , or tell your story in a book review, online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Our success story this week comes from the February issue of Fitness Magazine for which Dr. Dowd was interviewed. Check out this link.

I briefly watched the three network program aired on September 5th entitled Stand Up 2 Cancer. Hollywood sure knows how to put on a fundraiser, and raise money fast. All the money they raised goes to the Entertainment Industry Foundation. The EIF then grants money for research and education. Let’s hope there is money granted to more closely examine the role of vitamin D in cancer prevention and treatment.

Vitamin D was not mentioned once among the simple things that you can do to prevent cancer in this program. Vitamin D is probably the most potent cancer preventing/fighting molecule recognized in the last decade. And, it does not cost thousands of dollars to use. It does not have any toxic side effects like hair loss, nausea, or vomiting. And, it lowers your risk of ALL-CAUSE mortality at the same time. Maybe their whole show should have been about vitamin D?

Let’s look at the data. How about we start with the strongest data from a recent double blind placebo controlled trial examining the effects of calcium and vitamin D on the risk of developing any cancer over four years of follow up?

This study showed a 60 percent reduction in the risk of any cancer over 4 years of follow up on 1100 IU of vitamin D and 1500 mg of calcium compared to taking placebo. If you assume that some of the cancers at the start of the study were already present and you examine the data only looking at years 2 through 4 there is a 77 percent reduction in all reported cancers. There were 10 fewer reported cancers in the vitamin D group than in the placebo group in years 2-4. This study was conducted among 1179 postmenopausal women. Wow!

Dr. Edward Giovannucci from Harvard University has studied the Harvard Cohorts (Health Professions Study, Nurses Health Study, and Physicians Health Study) and the risk of cancer relative to vitamin D status. These analyses are all retrospective. They demonstrate a 30 percent reduction in the risk of breast cancer with higher vitamin D levels. They consistently show a 50 percent reduction in the risk for colon cancer. These studies show that African American men have a 32 percent greater risk of having any cancer and an 89 percent greater risk of dying from that cancer than European Americans. This was particularly true for gastrointestinal cancers for which African American mortality was 124 percent greater than European American men. These numbers were worse for African American men with additional risk factors for vitamin D deficiency (57 percent and 127 percent for having cancer and mortality from cancer respectively) Remember, African Americans have the lowest vitamin D levels in the country, some 50 percent lower than European Americans.

Dr. William Grant a former NOAA scientist has shown lower incidence and/or mortality of more than a dozen forms of cancer with higher UVB exposure including breast, prostate, colon, esophagus, stomach, rectum, lymphoma, myeloma, ovarian, and uterine cancers. Remember that UVB is required to make vitamin D from cholesterol.

Both observational data and blinded prospective placebo controlled data point to the same conclusion. Vitamin D is one of the most potent cancer fighting molecules ever discovered. It is abundantly available with a diet rich in healthy fat followed by sun exposure or by taking a supplement over the counter. And it will cost you less than 20 dollars a year. I’ll bet the Entertainment Industry Foundation could purchase enough vitamin D for half of the country to supplement 2000 IU a day for the next year with the money they raised. Now there is a study that will pay for itself.

You don’t need anymore results. You need to take action. All the information you need to optimize your diet and optimize your vitamin D level is in The Vitamin D Cure.

This week saw the publication of another study showing a 26 percent greater all-cause mortality with vitamin D levels below 17.8 ng/mL when compared to vitamin D levels above 32 ng/mL in adults older than 20 from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994). This effect seemed to be more important in women than in men.

A similar study from Austria in June found higher all-cause and cardiovascular mortality with lower vitamin D levels. The risk for death from any cause was 2.13 for vitamin D deficiency of 10 ng/mL or lower, 2.34 for vitamin D deficiency defined more conservatively as 20 ng/mL or less, 1.33 for patients with vitamin D insufficiency of 10 to 20 ng/mL, and 1.54 for vitamin D insufficiency defined more broadly as 20 to 30 ng/mL.

Additionally, a study from 2005 showed a dramatic reduction in the reports of cold and flu symptoms in patients taking 800 or 2000 IU of vitamin D a day relative to placebo. Combine this with a study from 2000 showing that chronic back pain (the leading cause of work disability) improved or resolved in the majority of patients with vitamin D supplementation and the number of missed days from work has to be many fewer.

What all this means is that you will be healthier, more productive at work, and live longer to enjoy the fruits of your labor if your vitamin D level is above 35 ng/mL year round. How much do you think this would cost? The answer is about $30 a year. And the place to start is with a copy of The Vitamin D Cure to learn how you can combine this critical nutrient with dietary changes and exercise to enhance your health even further. Don’t wait for a new President or healthcare reform. Take charge of your health now. Take the risk quiz and start the program today. How much is all this worth to you? Priceless!