Posted Mar 30, 2010
For years, we’ve dutifully obeyed doctors’ orders to stay out of the sun. We’ve lived almost like vampires, venturing outdoors only in the early morning or evening hours to avoid dangerous rays. When sunlight couldn’t be avoided, we’ve slathered our skin with sunscreen — the higher the sun protection factor, the better.
Doctors say efforts to reduce our risk of skin cancer are well worth it.
However, there is a notso-little problem. The human body needs vitamin D, which it produces when skin is exposed to sunlight.
“As we’ve protected ourselves against skin cancer, we’ve protected ourselves against vitamin D,” said Dr. J. Brent Muhlestein, director of cardiovascular research at Intermountain Medical Center’s Heart Institute in Murray.
A lot of people are deficient in vitamin D and don’t know it, according to Joy Musselman, a registered dietitian at McKay-Dee Hospital. The only way to know for sure is to get a blood test.
“After we started testing for vitamin D, we found a lot of people have a deficiency,” said Dr. Nameer Qader, a family physician in Ogden. “It’s becoming more and more like an epidemic.”
Researchers at Intermountain Medical Center’s Heart Institute looked at the results of 42,000 blood tests done at the center.
“Our findings were that twothirds of everybody in Utah is low on vitamin D. It didn’t matter if they were old or young, male or female,” said Muhlestein.
Effects of low D
There aren’t a lot of obvious symptoms associated with low levels of vitamin D, Musselman said, but it’s related to a lot of different conditions.
Vitamin D has long been associated with bone health, and low levels play a role in rickets, osteoporosis and osteopenia.
“If you have a deficiency, you can have an increased risk of common cancers, such as colon cancer, breast cancer and prostate cancer,” said Musselman.
Research done in the past few years has shown that vitamin D acts as a co-factor in a lot of metabolic processes — more than 200, according to Muhlestein.
“A significant number of those are related to heart disease,” he said, among them blood pressure, management of blood sugar, and inflammation.
Last fall, Intermountain Medical Center’s research team announced results of a study of patients over the age of 50, with no prior history of cardiovascular disease, whose blood was tested during routine care.
According to the research, those with very low levels of vitamin D were 45 percent more likely to develop coronary artery disease than people who had normal levels, and twice as likely to develop heart failure. They were also 78 percent more likely to have a stroke.
The center’s research has also shown a connection between inadequate levels of vitamin D and depression.
Recommendations
> The current daily dose of vitamin D recommended by the Institute of Medicine is 200 to 400 international units, depending on age and medical conditions.
“Generally, for post-menopausal patients, it’s 400 to 800 IU,” said Qader. “If there’s a deficiency, you should have doctors recommend the dose, depending on what levels are.”
Recommended dosages and levels may be changing, based on new research.
Muhlestein and his co-researchers presented their latest research at the American College of Cardiology’s scientific session on March 15 in Atlanta.
“We decided we wanted to know at what level of vitamin D you stop having increased cardiovascular risk,” he said.
The current vitamin D level considered normal is 30 nanograms per milliliter of blood.
“We were able to basically conclude that if you want no greater increase in risk, you had to have at least a level of 43 or above,” he said. “It’s not a randomized study, but it’s strong information, and increases the evidence that treatment of vitamin D deficiency may reduce risk.”
Muhlestein says the evidence is so strong he got his own level checked.
“I found out I was low and treated it,” he said. “I don’t want to get sick.”
To reach and maintain healthy vitamin D levels, Muhlestein says most people need 1,000 to 5,000 IUs a day.
But neither Muhlestein or Qader recommend selfdosing.
“If you take way too much, it can be toxic,” said Muhlestein. “I’d say it’s worth it to test it.”
Sources
There are three main sources of vitamin D: food, supplements and exposure to the sun’s rays.
“There aren’t many foods that are high in vitamin D,” said Musselman. “Fatty fishes, like salmon, are one of the better sources of vitamin D — salmon will give you about half of your daily dose of vitamin D in a 3.5-ounce serving.”
However, she says, you’d have to eat fatty fish five to seven days a week to get enough.
Many milk products are fortified with vitamin D, including whole milk, cheese, cottage cheese and yogurt, said Qader. But it’s not a good idea to try to get enough vitamin D from these sources.
“It seems to be in a lot of things that are fatty,” said Qader.
Orange juices and cereals are also fortified, but Musselman says a serving only contains about 100 IUs.
J.J. Ochsenbein, assistant manager of Harvest Health Foods in Ogden, says more people are buying vitamin D supplements these days.
“I’d say we’ve seen probably a 500 to 600 percent increase within the last couple of years,” he said.
His relative, Steve Ochsenbein, of Down to Earth Natural Foods in Roy, says what customers are asking for has changed.
“They usually want higher potencies, like 1,000 on up to 10,000 per day,” he said.
Sun is the body’s natural way to make vitamin D, and it doesn’t take a lot of sunlight to get enough.
“During the months from March to October, you have to have between 5 and 15 minutes of direct sunlight on your arms and your legs three times a week,” said Musslelman. “Sunscreen will limit 99 percent of the vitamin D your body can get from the sun, so that’s why you have to do it without sunscreen.”
Of course, doctors don’t want you outside without sunscreen.
“Getting cancer of the skin is not as easy to deal with as taking a pill,” said Qader.
Date: Mar 23, 2010
To see more of the Standard-Examiner, or to subscribe to the newspaper, go to http://www.standard.net.
Copyright © 2010, Standard-Examiner, Ogden, Utah
Distributed by McClatchy-Tribune Information Services.
For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.