You'll see a comment in this story about D and diabetes. For decades we have been recommending low dose zinc with vitamin D 3 for Type 1; this combination may help reverse it.
Many people fall short in consumption of vitamin D, studies show
By Michael Hastings, Winston-Salem Journal
August 15, 2010
Vitamin D fortifies a lot of foods, including milk, cereal and orange juice. And it's naturally found in wild-caught oily fish such as salmon and tuna.
That suggests that most people get plenty of Vitamin D.
But that's wrong.
Vitamin D deficiency is a widespread problem.
"Probably 90 percent of my patients are low," said Dr. Victoria Nnadi, a physician at Forsyth Internal Medicine Kernersville, owned by Novant Health.
Dr. Michael F. Holick, a Vitamin D expert at the Boston University School of Medicine, has been quoted as saying that Vitamin D is the most common nutritional deficiency and probably the most common medical problem in the world.
Getting adequate Vitamin D would seem easy. We need to spend only a few minutes a day in the sun.
In general, 5 to 10 minutes a day between 10 a.m. and 3 p.m. with minimal clothing is considered good. But cloud cover, sunscreen, skin pigmentation and even northern latitudes can reduce the penetration of ultraviolet-B rays.
And with sedentary lifestyles and concerns about skin cancer, many people never get enough sun to provide adequate amounts of Vitamin D.
Similarly, most people don't eat enough food with Vitamin D. Kathie Sigler, a registered dietitian with Diabetes and Nutrition Services at Forsyth Medical Center in Winston-Salem, said that someone would have to drink a quart of milk a day to get the 400 IUs (International Units) for people from birth to age 50. This the current amount recommended by the Institute of Medicine, an independent organization.
That leaves supplements as the best alternative. But experts disagree about the optimum level of Vitamin D. The National Institutes of Health currently considers 15 nanograms per millimeter of 25-hydroxyvitamin D in the blood as adequate. But last year, the Institute of Medicine started a 24-month review of current recommendations.
The 2000-2004 National Health and Nutrition Examination Survey, conducted by the federal government, acknowledged the disagreement by publishing results for three different levels of Vitamin D. The survey found that 50 percent to 78 percent of all three groups surveyed (whites, Hispanics and blacks) fell below the highest level (30 ng/ml).
The nonprofit Vitamin D Council says that the level considered good should be 50 ng/ml. And many doctors, including Nnadi, agree.
Nnadi typically sees people with chronic illnesses, and many of them have multiple illnesses. And Vitamin D affects every part of the body. It is associated with the health of bones, the heart, muscles, the immune system and the prevention of cancer.
"I often will see (Vitamin D deficiency) in people who come in all achy, with low-back pain, arm pain or pain all over," Nnadi said.
Sigler said that Vitamin D is involved with the onset of diabetes. "It helps the pancreas make insulin. It helps the cells use that insulin," she said. "If the cells can't use that insulin, if there's not enough Vitamin D there, then diabetes can develop."
Sigler also said that improved Vitamin D can help people manage the complications of diabetes. For instance, the pain of neuropathy, a burning sensation in the feet, can be eased when Vitamin D levels are improved.
Sigler also said that good Vitamin D levels can promote healing after radiation therapy and help with fatigue and mild forms of depression.
It is possible to take too much Vitamin D, but that rarely happens, Nnadi and Sigler said. The NIH currently recommends a maximum of 1,000 IU of Vitamin D for infants and 2,000 IU for anyone age 1 or older.
"I would not start taking supplements (beyond a multivitamin) without getting your blood tested and without talking to your doctor," Sigler said.
Still, studies clearly show that many of us could use more Vitamin D -- and the many health benefits it can provide.
"The take-home message," Nnadi said, "is to get the Vitamin D level checked."
Copyright © 2010, South Florida Sun-Sentinel
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