Obesity and Vitamin D

It has been awhile since I talked about vitamin D on this blog, so here are some new insights. Research published in May in the American Journal of Clinical Nutrition found that mother's who are vitamin D-deprived during pregnancy are more likely to have children who suffer from obesity. Of the 977 women in the study, the average serum level of 25 OHD (vitamin D) was 24.8 ng/ml which is about 50% of the optimal level of 50 ng/ml.  However, the vitamin D status of these women was actually worse than this since 35% of the women had serum 25 OHD levels below 20 ng/ml and were, therefore, clinically deficient in vitamin D. These women gave birth to infants who were low in both lean and fat body mass, but who, by age six, had higher levels of body fat than did the children whose mothers were vitamin D-sufficient during pregnancy.  The researchers checked for confounding factors, but found that maternal BMI and weight gain during pregnancy did not play a role.  They concluded that, "Lower maternal vitamin D status may be linked to programmed differences in offspring fat mass. The findings require replication but add to a growing evidence base for a role of vitamin D in the origins of adiposity."  That is, pregnant women who have inadequate levels of vitamin D may pre-dispose their children to obesity later in life.  It does not appear that the researchers checked the vitamin D levels of the children.  But if the mothers were deficient during pregnancy, the children would have been born vitamin D deficient.  And it is probable that their vitamin D status was not optimized during childhood, especially if the mothers followed the dermatological guidelines which prevent children from receiving UVB radiation exposure and thereby prevent them from making vitamin D by exposing their skin to sunlight.  [See my post on Dermatological Purdah for more on this issue.]

This research provides further support for an earlier study (2009) on weight loss at the University of Minnesota that found that obese individuals were vitamin D deficient. Dr. Sibley was running a diet study with 38 participants.  She found that those who were vitamin D-deficient had a much harder time losing body fat than did those with higher levels of vitamin D.  While she admits that her observational study does not provide clear evidence for a cause/effect relationship between obesity and vitamin D levels, it is suggestive.  The hormonal form of vitamin D affects the "...same pathway (the renin-angiotensin system) [that] also affects fat cell development and metabolism...What’s interesting about our study is we did not recruit people to be vitamin D inadequate; we recruited people who were overweight or obese for our weight-loss study. And they happened, on average, to have inadequate vitamin D levels, so it tells you how prevalent the problem is.”  


While more research needs to be done on this connection, vitamin D deprivation is a widespread problem in the United States, as is obesity.  If raising serum 25 OHD levels can increase weight loss and prevent childhood obesity, then this problem seems to have a relatively easy fix.  If you've taken the dermatologist's warnings seriously, but you still want to raise your vitamin D levels, then you will need to take supplements.  Make sure the supplements are vitamin D3, without calcium. Excess calcium intake via supplementation is a bigger problem than no calcium supplementation. To raise your levels to 50 ng/ml, you will probably need to take 2000 - 4000 IU/day.  It is a good idea to have your vitamin D levels checked before beginning supplementation, and then again after three months of supplementation.  Pregnant women need to take at least 5000 IU/day of vitamin D3.


If diet and exercise are not really doing the job in helping you to lose weight, try optimizing your vitamin D levels.  It may be just the kickstart you need to get you on the road to better health.

The Simple Key to Better Health

There are many things that you can and should be doing to make sure you are as healthy as possible. But, frankly, most of you will resist doing them for one reason or another. You won’t really change your diet because, “I can’t live without bread!”; or “Cheesy fries are SO good!”; or whatever. Maybe you will try to add a few more fruits and veggies, but give up anything you love? No way!

And what about exercise? You know you need to get more, but your life is so busy! Where can you fit it in? You could park at the back of lot so that you’d at least get a little exercise at the office or the store, but hey, “I’m running late!”; or “The bags are so heavy!”; or whatever.

Recent research has shown that adequate sleep (8 – 10 hours) is necessary to consolidate learning and to reboot our immune system which gives our bodies a chance to heal and fend off invaders. But we live in a 24/7 society. Who has time to sleep?! So much to do; so many places to be. So…not enough sleep.

We’ve become a pill-popping, easy-fix society. Normally, I am against this. But there is one case where I no longer think we have a choice; where popping the pills may be the best and simplest key to better health.

Those of you who’ve read my newsletters and blogs over the years probably know where I am headed with this.  Yes, the simple key to better health is taking more vitamin D3 pills. You can do this in, what, 30 seconds? I think you can manage to fit that into your busy schedule. And the cost is reasonable. Give up a can of soda and you’ve paid for about one week’s worth of pills [2000 IU/day].

Now, your skin is capable of making vitamin D, but… But unless you have very light skin and can spend about 10 minutes/day between 10 am and 3 pm in the sunlight, making adequate levels of vitamin D via your skin is going to be difficult. The range of skin color is large and as each shade darkens, the length of time needed to spend in the sun increases. If you have very dark skin color, you will need to spend around 6 hours in the sunlight. Unless you have an outdoor job and expose your skin without sunscreen or clothing (say, like a life guard), getting enough sun exposure is just not feasible for most of us. And the dermatologists would have a fit anyway.

In addition, making vitamin D via skin exposure to sunlight only works during April – October in northern latitudes. During the winter months, you are draining your stores so that by February, you are running on empty. The easy fix to this problem is to take vitamin D pills year round.

Some of you might think you can get enough vitamin D from food sources, but this is not the case. The best food source is fatty fish such as sardines, but that will give you only about one-quarter of what you need daily. I do eat sardines daily, but I also take a supplement. Milk is not a good source of vitamin D for multiple reasons, but primarily because it provides so little per glass compared to what your body actually needs. Skip the milk and take the pills.

Back in the early 1990s when I first began doing research on vitamin D deprivation, the literature stated that 20 ng/mL was the normal (and presumably adequate) level of 25 OHD (the baseline form of vitamin D used in your body). By the late 1990s, the optimal level was raised to 32 ng/mL. It has been going up ever since as researchers discover more and more health issues related to vitamin D deprivation. The optimal level is now at 60 ng/mL. This level is impossible to achieve with the current RDIs of 200 IU [children and young adults] or 400 IU [adults over 50] or even 800 IU [senior citizens]. The minimum daily dose recommended by most researchers in the field is now 2000 IU/day for older children and adults. During the winter months, you will need more. If you are confined inside or are a senior citizen, you will need more year-round. Vitamin D is fat soluble, so if you are overweight, your fat cells are pulling 25 OHD out of your blood stream, preventing it from doing its job. This means that you will also need to take more vitamin D year-round than may be true of someone who is slimmer.

Because vitamin D is fat soluble, pills should be taken with healthy-fat foods. For instance, I take my pills in the morning with my real egg salsa omelet. You might want to take yours with a handful tree nuts such as cashews. Current researchers do not recommend taking cod liver oil. Cod liver oil contains significant levels of vitamin A in addition to vitamin D. Vitamin A acts as an antagonist to vitamin D limiting its effectiveness. Also, excessive doses of vitamin A are harmful. Therefore, it is better to take a vitamin D pill that is not combined with vitamin A. It should also not be combined with calcium. If you and/or your doctor feel you need more calcium, it is probably because your vitamin D levels are much too low. When vitamin D is optimized, the body can function properly with around 500 mg of calcium/day. Getting too much calcium in supplements can also be harmful.

For those who want to know more, a recent book, The Sunlight Solution by Laurie Winn Carlson, PhD, provides a good source of information on the history of vitamin D deprivation and research, and on current research along with all the various health issues related to vitamin D deprivation. [Full Disclosure: Dr. Carlson devotes two pages to the discussion of my article: Health Disparities: Reframing the Problem. 2003 Medical Science Monitor 9 (3): SR9-15] After reading the book, you will probably want to spend more time in the sun and will definitely want to take more vitamin D.

Vitamin D is not a panacea. Taking a couple of pills each day will not magically change your life, nor will it solve all your health problems. However, if you are reluctant or unwilling to make the type of changes that take more effort (e.g. diet, exercise, sleep), taking vitamin D supplementation will at least give your body and your health a fighting chance. If you decide you want to learn more about these other aspects of your health, in addition to further information on vitamin D, you can order my book: Walking in Sunshine: LifeStyle Changes to Make for a Bright, Healthy Future.

'Tis the Season

It’s that time of year when we start thinking about the health and well-being of ourselves and those we love. As one year ends and another begins, we think about what we’ve accomplished, what we still want to do, and what we need to change.

To help you achieve your goals, you may wish to purchase a PDF copy of my book Walking in Sunshine: LifeStyle Changes to Make for a Bright Healthy Future at this link:
http://www.anthrohealth.net/ahbook.htm

Learn how your individual biology, behavior, and the environment in which you live interact to affect your health and well being. Discover why: adaptations matter, walking is the best exercise, sunshine is necessary, proper diet = better health, natural parenting is effective parenting, and much more.

Walking in Sunshine includes the Flexibilities appendix: color photos and directions detailing each movement in the sequence of stretches that scientific research has shown will help you prevent heart attacks, strokes, and osteoarthritis. Feel and act younger, move more gracefully, lose the achiness. Get flexible and live longer. Flexibilities can also be purchased as a separate PDF copy at this link:
http://www.anthrohealth.net/ahflexbooklet.htm

Walking in Sunshine: LifeStyle Changes to Make for a Bright Healthy Future will help you and your loved ones improve your lives. In addition, a PDF copy is environmentally green. Better your lives while helping the environment.

‘Tis the Season! May you have a wonderful life full of health and well-being.

Gut Check

Over the past few weeks there has been a lot of media coverage on the new guidelines for mammograms and breast self exams. Analysis of scientific research indicates that mammograms can do more harm than good. This is not what anti-breast cancer crusaders like the Susan G. Komen Foundation want to hear. Women are worried and confused because they have been told that they must have mammograms to detect and prevent breast cancer. Now the scientists are saying that is not the case and that, in fact, they can be counter-productive.

For every women correctly diagnosed with cancer after a mammogram there are significantly more women who endure the trauma of a false positive reading. They have no disease but undergo what turn out to be needless breast biopsies where they run the risk of a lung puncture from a poorly-performed needle biopsy. Unless a woman has a family/genetic history of breast cancer, the odds of her getting it prior to age 70 are actually quite low.

No one wants to be the one to tell the average 40-year-old woman without a family history of breast cancer to stop getting mammograms and then find out 3 years later that she developed breast cancer. But, again, the odds of her developing it are low. The cancer foundations and some health professionals appear to be operating under the “better safe than sorry” mantra while ignoring the fact that false positives can also lead to a sorry situation.

In 2002, Gerd Gigerenzer, author of Calculated Risks: How to Know When Numbers Deceive You, pointed out that the general public and many medical professionals do not really understand statistics. This lack of understanding leads them to judge inaccurately the actual risks and benefits of health screenings.

According to Gigerenzer, the vast majority of physicians who participated in the research described in his book cannot accurately determine risks and benefits when these are presented in the form of probabilities. (e.g. There is a 25% risk reduction in death from breast cancer with mammography.) Only when the results are presented in the form of natural frequencies do the risks and benefits become clear. (e.g. 1000 women got mammograms each year for 10 years and 1000 women did not. At the end of 10 years, 3 women in the first group and 4 women in the second group died of breast cancer.) If we and our physicians cannot accurately determine risks and benefits when they are presented as probabilities, we could be unnecessarily risking our health. How many of the 997 women who got mammograms each year for 10 years also had false positives during that time? How many experienced the trauma, pain, and potential negative outcomes of the additional testing required to rectify that false positive?

Rather than relying on mammograms (and other types of screenings) to safeguard their health, it would be better for women in their 40s and 50s to actively employ measures that we know can help prevent cancer. These measures include eating plenty of richly-colored fruits and vegetables; eliminating dairy and other saturated fats; getting plenty of exercise; sleeping around 8 hours each night; and taking a minimum supplement of 1000 IU/day of vitamin D3. More vitamin D supplementation may be required to get the blood levels of 25 OHD to the optimal level of 50 ng/mL.

By following these preventive measures all women, even those with a family history of breast cancer, will reduce their odds of developing the disease. And those without a family history will be able to ignore their guts and go with their brains in accepting the scientific data which states that we in the United States have been over-using mammograms. Look at the natural frequency data. Mammograms haven’t been as much help as we thought. Eat right, exercise, sleep well, and take vitamin D. That’s where the science is.

Flexibility for Life

When I was 32 I realized that I was not as flexible as I had once been. This disturbed me because at that time my grandmother was having increasing difficulty moving. Her shoulders were becoming stiff and inflexible. She needed a knee replacement. My grandmother was only 75. I loved her dearly, but I didn’t want to have the same problems with my body. From that point, I put together a series of joint movements I call Flexibilities; and I began doing them every morning when I first arose.

Over the next several weeks, I noticed that not only was I becoming more flexible, but I felt less achy and stiff when I awoke each morning. Doing the movements in the morning meant that I felt loose, alert, and ready for the day ahead. I walked a little taller with a bounce in my step.

Through the intervening years, I’ve continued to do the flexibilities each morning. On those days that for some reason I do not do the movements, I feel a little off. I’ve also found that if I do not do the flexibilities first thing in the morning, I am less likely to do them at all that day.

In addition to doing the joint movements, I do two other things to aid joint health. Each day with my breakfast (blueberries and bananas, tomato salsa omelet, and grapefruit juice) I take a vitamin D3 supplement. Vitamin D3 is vital for skeletal and muscle strength (and many other aspects of health). For lunch I eat water-packed sardines. Sardines are a super food: they are a great source of protein, calcium, vitamin D3, and omega-3 fatty acids. Omega-3 fatty acids help reduce joint inflammation (along with many other benefits).

Following this program for over two decades, I have great flexibility, no signs of osteoarthritis, and good overall health. Two research studies provide support for my anecdotal experience.

The first, published about one year ago by UC San Diego researchers, found that flexing joints prompts chondrocytes (cartilage cells) to produce a lubricating substance that keeps the joint surfaces smooth. The more the joint was flexed, the greater the percentage of chondrocytes that produced lubrication, keeping the glassy surface of the joint smooth. Joints that are not flexed produce very little lubrication resulting in an erosion of the smooth cartilage and, eventually, the pain of osteoarthritis.

The second study was published earlier this month in the American Journal of Physiology. These researchers in Texas and Japan found that an individual’s degree of flexibility could be positively correlated with that individual’s degree of arterial flexibility. That is, the most flexible adults had the best arterial condition and the lowest risk for having a heart attack or stroke. Those adults with the greatest joint stiffness were at highest risk of suffering from a heart attack or stroke.

Do you want to live a longer, healthier life? Then you need to add daily flexibilities to your routine. If you would like a PDF copy (for $3.00) of my Flexibilities booklet which includes photos and directions for each movement, click here. http://www.anthrohealth.net/ahflexbooklet.htm

Seasonal Immunity

Labor Day has passed. Students should all be back to school now. The days are getting shorter. The leaves are beginning to change color. It is time to think about how to forestall illness.

Wow. What a downer, associating Autumn with illness; but, unfortunately, that’s the way it is. What’s the connection? Sunshine, or the lack thereof. More specifically, it is the reduction of UVB radiation striking the Earth as its angle relative to the Sun limits our exposure.

Now, what does reduced exposure to UVB radiation have to do with increased levels of illness? Isn’t UVB radiation a bad thing? As regular readers of my blog and newsletter know, no, UVB radiation is actually necessary to maintaining good health.

The cells of your immune system contain Vitamin D Receptors (VDR). This means that the optimal functioning of your immune system requires optimal levels of vitamin D in your blood. If your immune system is not optimized, you are more likely to become ill. Viruses and other pathogens will have relatively free rein in your body because your defense system is sub-par.

Unprotected skin exposed to UVB radiation activates the vitamin D system, increasing blood levels of vitamin D. However, numerous factors inhibit this natural system including: over-protection of the skin (see my blog “Dermatological Purdah”); dark pigmentation at high latitudes; old age; and life spent indoors. Current estimates are that the majority of Americans have sub-optimal levels of vitamin D and are, therefore, at high risk for having a sub-optimal immune system.

If Americans aren’t getting enough vitamin D the natural way, then they will have to use supplementation. The current US recommended levels are much too low to optimize vitamin D levels. Dr. Cannell, physician and vitamin D researcher living in California, recommends that children receive 1000 IU of vitamin D3/day for each 25 lbs of weight. He takes 5000 IU/day during the winter months. The minimum recommended dose for adults, according the Canadian Cancer Society, is 1000 IU/day, year-round. Dr. Vieth, Canadian vitamin D researcher, recommends a minimum daily dose of 4000 IU/day during the winter months.

As a child, teen, and young adult, I caught pretty much every pathogen that passed by me. It wasn’t until years later, when I began my research on vitamin D, that I realized that I suffered from sub-optimal levels of vitamin D. My two big fixes for the problem were to eat sardines every day and to move to Arizona. While this did work, after several years I ended up moving back to the Midwest to be near my family. The move resulted in having to tinker some with vitamin D supplementation to achieve optimization. What appears to work for me is this: every day I eat a can of sardines. In addition to providing several hundred IU/day of vitamin D, I also get a good dose of omega-3 fatty acids, calcium, and protein. However, in the Midwest, sardines do not provide enough vitamin D. Therefore, during the summer months, I take 2000 IU/day of vitamin D3. [I just do not get out enough in the sun during the summer to optimize my vitamin D levels naturally.] In the autumn, I increase this to 3000 IU/day, then to 4000 IU/day, and finally, during the depths of winter, to 5000 IU/day. While this does not prevent every cold, I am far, far healthier than I was during my previous sojourn in the Midwest.

While this dosing schedule works for me, you will need to develop one individualized for your own set of variables. Also, if you are on any medications, you will need to discuss it with your physician. Do not wait until the leaves have all fallen to begin optimizing your vitamin D levels. It takes a few weeks to achieve optimization. If you want to have the best chance to avoid the season of colds and flu, you need to begin now. Here’s To Your Health!

Dermatological Purdah

Once again, The American Academy of Dermatology Issues (AAD) has published a statement that, “The Academy continues to recommend that individuals protect themselves from UV exposure when outdoors, such as seeking shade whenever possible, wearing sunscreen and covering up with a wide-brimmed hat, long sleeves, pants and sunglasses.” This amounts to Dermatological Purdah: do not allow any skin exposure to the sun!

Evidently, the AAD would be thrilled if we returned to the fashions of the Edwardian era. Note the stylish summer wear of these two women. No sunglasses, but even better for concerned dermatologists, they are wearing gloves and carrying a parasol. What could be better for the AAD?! Let’s return fashion to the days of Fin de Siècle. No more worries: Skin will be smooth and untanned. Why live in the 21st century when the 19th will do so much better?

The AAD does admit that following their fashion purdah restrictions will mean that vitamin D supplementation will probably be necessary. However, they think that 1000 IU/day will be adequate. Adequate? Unlikely. It is estimated that at least 80% of the US population has inadequate levels of serum vitamin D. And the vast majority isn’t following purdah restrictions. 1000 IU/day is better than nothing, of course, but if you are already at inadequate levels (and the odds are that you are), and then you follow the AAD’s advice, 1000 IU/day will be nowhere near enough to optimize your vitamin D levels. Before deciding to undertake dermatological purdah, get you 25 OHD levels checked. Anything under 50 ng/mL means that you need to take a supplement. Vitamin D3 now comes in 2000 IU/day pills.

Think it isn’t that serious? Muslim women who practice purdah in Saudi Arabia (pretty darn sunny there) have dangerously low, even undetectable, levels of serum vitamin D. Edwardian women who practiced dermatological purdah had such high rates of flattened pelvic inlets that obstetricians thought that was what a normal pelvis looked like. Childbirth is hard enough with a normal pelvic inlet. Can you imagine what it was like in Edwardian times? Do you want to return to that era? I don’t.

Sure, you need to make sure that you don’t overdo sun exposure. But get real AAD, dermatological purdah is not the answer either.

It's About Time!!

Way back in 1992, I began doing research on vitamin D deprivation. At that time, there were only a few other researchers looking at this topic. If anyone else thought of vitamin D at all, they figured it was a very minor problem resolved by drinking milk; and that it only affected bones. My research pointed to vitamin D deprivation being a widespread problem that affected multiple regions in the body beyond bones. But trying to get most of my colleagues to take this seriously was an arduous, disappointing process.

Between 1999 and 2001, I submitted grants to NIH trying to get funding to do a major research study on vitamin D deprivation among heavily-pigmented women. There was no interest in such research at that time. I wrote articles on vitamin D deprivation that have been widely cited, but still the issue wasn’t considered important enough for the NIH.

Part of the reason for this is the massive public relations campaign against sun exposure launched and carried out by dermatologists and their media friends. Yes, too much UVB exposure can be a problem; but not enough exposure is a much bigger problem. Only in the past year or so has the media finally, finally realized this. Now we are seeing articles on vitamin D deprivation and the importance of maintaining optimal levels of vitamin D if one wishes to avoid multiple health problems such as heart disease, cancer, auto-immune conditions, and, of course, keeping the skeletal system strong.

And FINALLY the NIH is going to fund a major study on vitamin D deprivation. It’s only taken almost two decades, but better late than never. This study will enroll 20,000 participants from throughout the nation. However, the group is limited to women who are 65 or older, or men who are 60 or older. Also, they need to be free of any major health problems. The study will be double blind in that participants and researchers will not know whether the participant is receiving actual vitamin D3 (2000 IU/day) or a dummy pill. The vitamin D dosage is also large enough that effects should be noticeable, unlike other recent studies where the dosage was much lower.

The study begins in January 2010 and will run for five years, so we cannot expect to read about results any time soon. However, It’s About Time! Maybe we will now see many other major research projects done on this important topic.

Just today a large cancer research study [ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/07/AR2009070702252.html ] found that even after controlling for a variety of factors, African Americans had higher rates of adverse outcomes for breast, colon, and ovarian cancers than was true of European Americans. This study evidently did not look at vitamin D levels, but, as I pointed out in one of my articles (Health Disparities: Reframing the Problem. Medical Science Monitor 2003; 9 (3): SR9-15), vitamin D deprivation is the probable factor involved in this disparity [ http://journals.indexcopernicus.com/fulltxt.php?ICID=4712 ]

Meanwhile, there is no evidence that taking 2000 IU of vitamin D3/day causes problems; and there are many studies that indicate there are important benefits. So, take your vitamin D every day and you will be ahead of the curve when the NIH study is finally analyzed and published.