Vitamin D intake from food sources has declined during the past 25 years for both men and women according to research in the Journal of the American Dietetic Assocation. Women are consuming less than 1/3 of the recommended daily amount of vitamin D from foods. Men are consuming less than one half the recommended amount. This observation is not surprising given that few foods are naturally-rich in vitamin D. American food policy has fallen out of step with dietary recommendations. FDA regulations (CFR Title 21 131, 137, 139, 166, 172, and 184) limit the number of foods to which vitamin D can be added, as well as the amount per serving. Until food laws change, people need to rely upon dietary supplementation to meet their vitamin D needs.
Archive for 'August 2011'
Are you missing vitamins A, C, D and E from your diet? Probably. Although all foods contain some naturally occurring nutrients, they are usually present at low levels. Fortification enhances the nutrient content of foods. If you believe eating fresh and minimally processed foods is most ideal, you need to realize that you have to eat many different types of foods and several servings, to get the essential nutrients required by your body. Fulgoni and associates analyzed the contributions of different foods and dietary supplements to the recommended intakes of 19 micronutrients in individuals over 2y of age. Using the National Health and Nutrition Examination Survey (NHANES 2003-2006), they report (Table 1) data showing many are not consuming the recommended dietary allowance (RDA for people aged 31-50y) for the vitamins:
People who eat often are more likely to be overweight and obese. That is the finding of a 20 year study of dietary behaviors and eating occasions of American youth (2-19 years) published in Journal of Nutrition. The converse is that poor appetite is one of the factors contributing to undernutrition and poor clinical outcomes. The Longitudinal Aging Study Amsterdam defined undernutrition as a BMI <20 or self-reported involuntary weight loss <5% in the last 6 months. The message seems straight forward – eat often and gain weight, eat little and lose weight. Unfortunately, body weight is only part of the issue. People can be found all along this spectrum suffering from hidden hunger – a lack of essential micronutrients. Counting calories isn’t enough. People need to choose nutrient-dense foods, that is foods containing lots of essential vitamins and minerals in each serving.
A team of epidemiologists lead by Bertone-Johnson has taken a closer look at the role vitamin D plays in women’s mental health. Women suffer from depression at twice the rate of men, with the lifetime risk around 20%, according to Bhatia and Bhatia in a review article. Women’s depression is not only more likely to start at a younger age and have a longer duration, it is also more likely to be associated with the seasons and have a greater perceived severity. Vitamin D, the sunshine vitamin, actually acts as a hormone in the body. Vitamin D receptors are present in the brain, and it may affect levels of the hormones dopamine and norepinephrin, which are mood hormones and related to depression as reviewed by Garcion and associates. In the present study, data from the Women’s Health Initiative Observational Study, conducted in the USA, was used to look at vitamin D intakes from food and supplements and relate it to incidence of depressive symptoms according to the Burnam scale.
A group of researchers at the National Institute on Alcohol Abuse and Alcoholism lead by Captain JR Hibbeln just released a report on long chain omega-3 fatty acid intakes and risk of suicide in military personnel. For some time, depression has been associated with low levels of the omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Long chain omega-3 fatty acids are implicated in neurological conditions because they form part of cell membranes and DHA participates in the relay of cell signals between brain cells. Deficiency is also associated with decreased levels of brain hormones linked to depression. In particular, one randomized controlled trial conducted by Hallahan and associates using 2 grams per day of EPA and DHA found that supplement patients at risk of self-harm lowered risk for depression, suicide and daily stresses.
Rumors circulate in Washington DC. The FDA appears ready to act on the proposed rule to revise Reference Values and Mandatory Nutrients used in nutrition labeling. This revision is needed because several Daily Values are based upon 1968 reference intake values – almost half a century old! Since 1990, new DRIs have been published for many nutrients: B vitamins and choline (1998), vitamin C, E, Selenium and Carotenoids (2000), vitamin A, K, and many minerals (2001), and calcium and vitamin D (2011). Daily Values need updating to reflect these newer recommendations. Otherwise, scientific recommendations are being kept from consumers.
How can I help keep my child from become overweight? It is a difficult question, especially when you want to nourish them without indulging. Over one year ago, the Childhood Obesity Task Force released its action plan but this agenda serves to guide federal and state agencies and community groups. The Childhood Obesity Task Force doesn’t really help parents who are struggling to help their child be healthy. It still doesn’t answer the question, “how can I help teach my child make healthier food choices?” Part of the answer can be found in a study published in the European Journal of Clinical Nutrition. Holmes and associates reported that
Antioxidant-rich diets help reduce the risk of oxidative, stress-related diseases. Some randomized, controlled trials found that pharmacological doses of antioxidants may be harmful in smokers. New research published in the British Journal of Nutrition randomized 102 male smokers to an antioxidant-rich or control diet. Karlsen and associates found adherence to both diets to be goods. At baseline, there were no differences between the two groups in plasma antioxidant levels. The antioxidant-rich diet increased antioxidant intakes from 30 to >60 mmol/day. Following the antioxidant-rich diet, substantial increases were seen in plasma concentrations of beta-carotene, tocopherol, vitamin C, and other polyphenols. An 8% increase was measured in total plasma antioxidant activity (measured by protein-free ORAC). No potentially harmful or pro-oxidative effects were observed in individuals at risk of cardiovascular disease because of lifestyle choices
Common nutritional guidance encourages people to eat fruit and vegetables as part of a healthy diet, and one reason for this is to provide us with essential vitamin C. Although the main reason is primarily to prevent overt deficiency, higher intakes of micronutrients are often associated with other secondary health benefits. Pfister and coworkers (1) recently used data from a large-scale trial conducted in Europe to determine risk of heart failure based on blood plasma vitamin C levels. Intake estimates are commonly used in epidemiological studies due to their ease of use however their downsides include recall bias, inaccuracies inherent to food databases used for the analysis, and uncertainty about micronutrient bioavailability. Biochemical tests normally provide greater accuracy, and reflect absorbed levels of nutrients being studied. For vitamin C, plasma levels correlate with fruit and vegetable intakes, as previously studied by Block and colleagues (2).
Sun screens are recommended for a reason. Exposure of the skin to radiation, whether from the sun or tanning beds, increases the risk of skin melanoma. A study by Eide and colleagues confirms this fact. They analyzed 3,223 patients, predominantly female and over 65y of age, seeking medical attention for osteoporosis. They found people who spent the most time in the sun had a 60% increased risk of developing skin cancer. Not surprisingly, these same individuals also had higher vitamin D levels [serum 25(OH)D]. Does this mean that better vitamin D status is associated with an increased risk of skin cancer? No. It's the sun exposure, not the vitamin D level that matters. We don't say that possessing a driver's license increases your risk of having a speeding ticket. It is risk-taking behavior and total miles driven which increases car accident risk, not the drivers' license.
Recently, Eide and associates (1) reported on a large epidemiological study that investigated vitamin D levels and risk of non-melanoma skin cancer (NMSC) (2). Non-melanoma skin cancer includes Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) and is the most common form of cancer. A risk factor for BCC and SCC is exposure to sunlight, particularly for people with fair skin. Nearly half of cancers in the USA are NMSC, with levels rising in fair-skinned populations exposed to strong sunlight, such as in Australia where 80% of cancers are NMSC (3). Luckily, the outlook is good for the majority of people diagnosed with NMSC.
Growing children need calcium and vitamin D to build strong bones. Serum vitamin D levels [serum 25(OH)D] should be >50 nmol/L for maximal calcium absorption and bone health. Houghton and colleagues set out to determine if these levels could be achieved from consuming vitamin D-fortified milk for 20 weeks. Over 200 healthy New Zealand toddlers, 12-20 months of age, were randomized to one of 3 groups: 1) red meat intervention, 2) micronutrient-fortified cow’s milk, or 3) whole cow milk powder fortified with vitamin D3.
The Jakarta Post quoted WHO Director of Nutrition, Dr Francesco Branca, “We cannot solve nutrition problems in one night. If you want to prepare for the next generation, you have to act through young women. Failure to address this need would cause heavy social and economic consequences for countries.” The United Nations estimates that 600,000 children could die in the Horn of Africa in the next few months. Secretary of State Hillary Clinton announced yesterday (click here to see video and text of speech) at the International Food Policy Research Institute in Washington that an additional $17 million in aid will be sent to the Horn of Africa. Of that, $12 million will be donated directly to the starving in Somalia. This will help address the immediate crisis but long-term solutions are needed to solve hunger and nutrient inadequacies. Yesterday, Secretary Clinton spoke of activities she is leading through
Imagine being confronted by a hooligan in the midst of a riot, would your reaction be “fight or flight”? Clearly, many environmental factors will impact your decision. However, either choice requires sudden dilation and contraction of blood vessels. Cells lining arteries and veins, called endothelial cells, regulate blood flow to key areas of the body. Endothelial cells help maintain pressure, blood clotting (platelet adhesion and coagulation) and immune function. When endothelial cells don’t respond normally, it is called endothelial dysfunction, an early risk marker for cardiovascular disease (CVD). Endothelial dysfunction can be improved by exercise and diet. Newens and associates report today that healthy adults using an omega-3 fatty acid supplement
The world isn’t flat. While globalization may have leveled the playing field for many, it isn’t reaching the poor. The poorest people face starvation and are falling behind economically. Tragically, thousands of destitute face starvation in the Horn of Africa while another 10% of the populations live in a manner which sustains obesity. Income disparities are reported to be the worst in the Philippines, a member of the Association of Southeast Asian Nations (ASEAN). Despite a weak economy, US corporations continue to post strong profits. Yet, one in five Americans struggle with ‘food hardship”.
Many women seek relief from hot flushes associated with menopause. They are especially interested in alternatives to estrogen or progesterone prescriptions with known health risks. What are the options? Soy-based foods are one because they contain isoflavones, a class of phytoestrogens. Genistein is the primary isoflavone, followed by daidzein (40%) and glycitein (10%) found in soy.
Aug 7 through Aug 13 has just been designated National Health Center Week to acknowledge the important role of community health centers dedicated to providing medical checkups, education, advice and critical services. Through their programs and services, people can take steps to keep themselves and their families healthy. This is a good time to ask about vitamin D supplementation. Even through summer months, the Harvard Medical School Adviser notes that many people are surprised to learn they remain vitamin D deficient even though they are often outdoors in the sunshine. A review of 9 studies published in 2011 found only 2 with 1/3 of the population having sufficient serum vitamin D levels, the other studies reported up to 80% of the population have serum 25(OH)D levels below 50 nmol/L. The Endocrine Society published new guidelines to clinicians on evaluation, treatment and prevention of vitamin D deficiency. The Endocrine Society is recommending
Economic issues dominate the news – unemployment rates, stock markets, national debts, global economies, etc. Do economics also affect nutrition and health? A study published in Health Affairs examined the cost of eating a healthy diet. Monsivais and colleagues asked, ‘what is the cost of eating a diet which meets the 2010 Dietary Guidelines? Remember, that most Americans do not consume recommended intakes of vitamin E, magnesium, vitamin D, calcium, potassium, and dietary fiber (What We Eat in America, 2001-2002 and 2005-06). They found it does cost more to eat a healthier diet. In an interview with CBS News, Dr Monsivais said
Controversy drives reader interest. Nothing attracts attention like a clash of titans. Think of soccer championships, wrestling matches, even congressional votes on budget deficits. They culminate in a single confrontation. Winners. Losers. Science is a different game. While well-written editorials denigrating the benefits of antioxidants may be compelling but they do not represent the totality of the science, especially when justified by a single meta-analysis. Today, the American Journal of Clinical Nutrition published a study by Block and colleagues. They studied polymorphisms in a family of
We live in privileged times. At least some do. Others do not. The Aug 2 CDC Morbidity and Mortality Weekly Report states that the average life expectancy worldwide is 66 years for someone born in 2000, 25% longer than the average 48 years of life for a child born in 1955. This is good news. The article goes on to highlight the top 10 global public health achievements during the first 10 years of this decade (2001-2010). The list includes a decrease in the number of children dying before their 5th birthday annually, from 10 to 8 million. Still, 99% of all childhood deaths before 5 years occur in low-income and middle-income countries. And famines in Somalia and the situation in flood-ravaged Pakistan frustrate massive efforts by WFP and UNICEF. Without these NGOs, the situation would be worse.
This is World Breastfeeding Week. The WHO recommends exclusive breastfeeding until a baby is 6 months old, and continued breastfeeding with the introduction of complementary foods up to two years. According to the 2011 US Breastfeeding Report Card, less than 15% of American children are exclusively breastfed at 6 months. California children are the most likely to be exclusively breastfed for 6 months (25%) and Mississippi children the least (6%).