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Scientists ANSWER... YOUR Questions


CONTROVERSY--a Necessity of Scientific Endeavors?

Upcoming videos of scientists' responses in the next 2 weeks.  We will post them shortly.

Carole Baggerly Director, GrassrootsHealthSome current information, however, from Carole Baggerly, Director, GrassrootsHealth:

There have been two papers published recently (Autier, Bolland) that indicated that vitamin D was not of much use.
After a very careful review of both papers, I can tell you that
(1) most of the studies they used had very low levels of vitamin D intake (400-800 IU/day) (already demonstrated not to cause much of an effect) and,
(2) a study they referenced that was 'negative' at a high dose regarding fractures was actually at 500,000 IU in a single dose, known to be in a toxic range by vitamin D researchers

 

 

 

Listen to Carole Baggerly's interview with Dr. Cedric Garland as he responds to this Vitamin D Research Controversy.

 

Here is a short text by Dr. Cedric Garland of UCSD Moores Cancer Center about the Autier paper, Vitamin D status and ill health: a systematic review.

Dr. Cedric Garland
Dr. Cedric F. Garland
UCSD Moores Cancer Center


"This meta-analysis is nothing new and is already obsolete, since it is mainly based on old papers that used too little vitamin D to expect any effect.  A New Zealand study saying we should only supplement people with vitamin D deficiency and evidence of bone loss is equally wrong.  Virtually everyone in New Zealand, and most adults in the US, are vitamin D deficient by modern criteria, being below 32 ng/ml.  The reality is that we now know that they are deficient with regard to extraskeletal effects of 25(OH)D if their serum level is below 40 ng/ml.

These papers should be disregarded as obsolete work.  We are moving into a new era of using vitamin D3 in doses no less that 4,000 IU/day for people  aged 9 years and older (The NAS-IOM total upper level intakes [TULI's]   that are safe for daily use per NAS-IOM monograph, 2011).  Studies using less than 4000 IU/day are on the verge of obsolescence.

It does not matter much that giving 400 IU/d in the meta-analysis being cited did not achieve very much – the amount given to the subjects was less than a tenth the effective dose.  The authors of this review did not use any epidemiological research and they  appear to have paid no attention in their conclusions to the only RCT that was relevant, that of Lappe et al. in 2007.

Lapper et al. used 1100 IU/day of vitamin D3 and 1500 mg/day of calcium.  They achieved a serum level of approximately 40 ng/ml.  It  reported a 77% reduction in incidence of all invasive cancer combined, after a 1-year run-in period. The benefit was 60% less cancer without a run-in period.  These cancers included breast, colon, lung and others. The women in the Lappe et al. RCT were very compliant. The result was statistically significant.

The Lappe et al, study  and the many supportive epidemiological studies that preceded and followed it should  prove to even the most ill-informed skeptic  that vitamin D prevents most cancer. It is incredible that the authors of this review virtually disregarded all of the relevant epidemiology this randomized controlled clinical trial.

Several scientists  have informed  the editors of the journal, that published the review,  presenting their objections to the conclusions this study reached, they  were based on obsolete low-dose vitamin D studies, and that they virtually totally neglected the work of the entire science of epidemiology.

Doctors and their patients should not be discouraged by this obsolete review.  Patients aged 9 years and older can take 4,000 IU/day of vitamin D3 safely according to the National Academy of Sciences-Institute of Medicine (2011 monograph).  The benefits of such a dose will be substantial.  The scientific data already accumulated is easily strong enough to support this.   Serum 25(OH)D should be monitored regularly in any event, and serum calcium in older adults or anyone where there is a concern about hypercalcemia.   It is true that the current NAS-IOM RDA is 600-800 IU/day of vitamin D3, but higher doses seem far more logical and safer now for most people based on studies and the Lappe et al RCT of 1100 IU/day of vitamin D3.  Sale and intake of vitamin D2 should end, as there is no solid support for its efficacy against non-skeletal diseases, unlike vitamin D3.

Another supporting clinical trial would be good, but we have a great one in Lappe et al.  If we ever decide to do  another RCT we should use no less than 4000 IU/d of vitamin D3 and 1000-1250 mg/day  of calcium. Such a trial may be impossible, though, because members of the placebo group may eventually take supplements on their own, or human subjects protection committees may not allow depriving anyone of vitamin D at these doses in this emerging era of knowledge about their powerful benefits at appropriate, monitored doses in preventing very  serious diseases that we have never before been able to effectively prevent, including breast cancer, colorectal cancer, pancreatic cancer, type 1 diabetes, and much of multiple sclerosis and type 2 diabetes.  It is an exciting time for using vitamin D at no less than 4000 IU/day with regular serum 25(OH)D monitoring to prevent these fatal diseases. "


A note from Dr. Ed Gorham of UCSD's Division of Epidemiology in the Department of Family and Preventive Medicine:

Dr. Ed Gorham

 

Dr. Ed Gorham
UCSD Department of Family and Preventive Medicine

Frustration with the fact that lives are now being sacrificed on a golden cross of clinical trials compels me to respond.

The two recent reviews of flawed RCTs by Autier and Bolland have produced not surprisingly flawed conclusions.  Low dose, lack of compliance, cross-over, and poor follow-up over the long-term course a prevention trial requires often limit the utility of such findings.

Why is evidence from cohort studies, nested case-control studies (including serum studies) and ecological studies ignored?  These have found strong associations between high vitamin D status or high UVB exposure and reduced risk of many chronic diseases. To account for the inverse relationship between world-wide UVB irradiance in as many as 175 countries and reduced risk of breast cancer, colon cancer, multiple sclerosis, hypertension and diabetes, it would be necessary to postulate that just prior to diagnosis, patients in whom these conditions are soon to develop suddenly migrate to a higher latitude.

Strength of the association, consistency, reproducibility, evidence of a temporal sequence from cohort studies, and dose-response criteria using 25(OH)D as a biomarker have each been satisfied with respect to vitamin D and these outcomes. The syndromic aspect of these deficiency outcomes is typical of a deficiency condition in which a vital nutrient such as vitamin D plays a key role in so many basic physiological functions; from immune modulation in suppressing diabetes and MS, to supporting tight junctions between epithelial cells.  Tight junctions supported by vitamin D and calcium of course favor apoptosis and the normal cell cycle over the cell disjunction and dysplasia that leads to cancer.

Many epidemiologic advances have been based on observational studies. It is fortunate we didn't rely on RCTs to recognize the hazards of cigarette smoking or second-hand smoke, which were determined through case-control studies and cohort studies respectively. To his undying credit, Dr. John Snow did not resort to forcing some residents of Broadstreet to drink from that pump supplying water contaminated by cholera.  Do our ethics allow us to withhold vitamin D to only 800 IU in a placebo group such as that of VITAL? 800 IU would on average raise baseline serum vitamin D levels barely 8 ng/ml. VITAL will place half the participants at risk of what is finally becoming regarded by vitamin D experts as the vitamin D deficiency syndrome.  Likewise, the meager 2,000 IU per day given to the treatment group in Vital will still fall short of many of the benefits of vitamin D sufficiency which become apparent when patients achieve a 40-60ng/ml 25(OH)D range.  Many thanks for this opportunity to share these frustrations with which I believe you may sympathize.

 

Coming soon:
Video with Dr. Garland, Dr. Robert P. Heaney


Sponsorship of these videos is by the current participants in the D*action ProjectSubscribe today and help protect yourself and help spread the word with the videos! 
 
Additional topics and speakers added regularly!  Past webinars, videos, and any additional Q&A sessions, will be posted shortly after the session ends on our 'Videos' page.
 
 
 

RECENT VIDEOS

Vitamin K... Another Calcification Nutrient to Consider?

Dr. Booth, a leading expert in vitamin K, answers many of the questions we receive about vitamin K and its relation to vitamin D. Her presentation provides information on the forms of vitamin K, dietary intake requirements, its role in the regulation of calcification and evidence for vitamin K interactions with vitamin D. Refer to Dr. Booth's published works, Effect of Vitamin K Supplementation on Bone Loss in Elderly Men and Women and Gamma-Carboxylation of osteocalcin and insulin resistance in older men and women, for more information about this topic.  Watch the recorded video here.

 

 

'It's up to US'! with Carole Baggerly, Director GrassrootsHealth

It's up to US! to solve the vitamin D deficiency epidemic. See how GrassrootsHealth is setting up community projects to help the 'grassrootshealth' movement flourish. The primary purpose of GrassrootsHealth is to move the proven science into practice--NOW! Carole Baggerly, our director, is currently on a nationwide tour to promote action with our "Protect our Children NOW!' project and will provide some new insights about how to create community action groups without waiting for government or institutional groups. As she says, 'It's up to us. It truly is at a stage where grassroots is the natural method.' Watch the recorded webinar here.

 


Vitamin D & Kidney Stones

Interview with Dr. Cedric Garland about a soon to be published paper "25-Hydroxyvitamin D in the range of 20-100 ng/mL and Incidence of Kidney Stones," with GrassrootsHealth Epidemiologist Sharon McDonnell. Watch the recorded webinar here.

 



Nutrition and Medicine: The Troubled Relationship

Dr. Robert Heaeny, a leading expert in vitamin D & nutrition, provides some perspective on the needed shift from the medical paradigm that has disease created by external agents, e.g., microbial or toxic to a 'nutrient deficiency' paradigm, that not eating something can make someone sick. Watch the recorded webinar here.

 



Diabetes Data, Questions from Scientists

Sharon McDonnell, GrassrootsHealth Epidemiologist, discusses and shares some of the detailed questions the GrassrootsHealth scientists asked about the recent diabetes data collected, and, how answers to those questions will be used to contribute to the 'Diabetes Health Action' publication. Watch the recorded webinar here.

 



YOUR Data, YOUR Answers

Sharon McDonnell, GrassrootsHealth Epidemiologist, discusses and shares preliminary data from the GrassrootsHealth D*action study. Watch the recorded webinar here.

A variety of Vitamin D topics are covered from your survey responses and questions, including vitamin A supplementation, sun exposure, indoor tanning use and supplement types. She also shares some of the D*action demographics.

 

Vitamin D: Sun or Supplement?

An extended version of Dr. Holick's previous webinar "What does the sun do for me?" 

by Michael F. Holick, MD, Ph.D. Professor, Boston University.  Watch the recorded webinar here.

 

 

Linus Pauling Institute Interviews:  Vitamin D and Aging with Dr. John Finnell


Interviews with vitamin D researchers at the 2013 conference on Diet & Optimum Health at the Linus Pauling Institute, with GrassrootsHealth Director Carole Baggerly. Watch the recorded webinar here.
 
The topic addressed in this interview is "Vitamin D and Aging," with Dr. John Finnell, ND, MSAOM, MPH, DAOM Program Director, Clinical Research Scientist, AOMA Graduate School of Integrative Medicine in Austin, Texas. 

 

 

Linus Pauling Institute Interviews:  Vitamin D and the Brain / Vitamin D and Fertility


Interviews with vitamin D researchers at the 2013 conference on Diet & Optimum Health at the Linus Pauling Institute, with GrassrootsHealth Director Carole Baggerly. Watch the recorded webinar here.
 
Two topics will be addressed during this interview webinar.   The first interview is on Vitamin D and the Brain with a focus on Schizophrenia, with Dr. Thomas Burne, Ph.D., Queensland Brain Institute at The University of Queensland. The second is on Vitamin D and Fertility with Dr. Kelton Tremellan, MB, BS (Hons), PhD, FRANZCOG, CREI, of the School of Pharmacy and Medical Sciences, University of South Australia.
 

 

Improving Clinical Outcomes in Cystic Fibrosis with Vitamin D

by Vin Tangpricha, M.D., Ph.D., Associate Professor, Emory University School of Medicine.  Watch the recorded webinar here.
 
 

 


Linus Pauling Institute Interviews:  Vitamin D and the Immune System with Dr. Adrian Gombart


Interviews with vitamin D researchers at the 2013 conference on Diet & Optimum Health at the Linus Pauling Institute, with GrassrootsHealth Director Carole Baggerly. Watch the recorded webinar here. 
 
The topic addressed in this interview is "Vitamin D and the Immune System," with Dr. Adrian Gombart, PhD, Principal Investigator, Linus Pauling Institute and Associate Professor, Dept. of Biochemistry and Biophysics.
 
Dr. Gombart's group made the seminal discovery that vitamin D regulates the expression of a key antimicrobial protein (AMP) referred to as cathelicidin or CAMP/LL-37. Since the mid-19th century, sources of vitamin D such as sunlight and cod liver oil were routinely used to treat tuberculosis. Their findings identified an important component to understanding a key mechanism by which macrophages may combat Mycobacterium tuberculosis and other pathogens in humans.
 

 


Linus Pauling Institute Interviews:  Vitamin D and Cardiovascular Disease with Dr. Stefan Pilz


Interviews with vitamin D researchers at the 2013 conference on Diet & Optimum Health at the Linus Pauling Institute, with GrassrootsHealth Director Carole Baggerly. Watch the recorded webinar here. 
 
The topic addressed in this interview is "Vitamin D and cardiovascular disease," with Dr. Stefan Pilz, MD, PhD of the Medical University of Graz, Graz, Austria.

 


Linus Pauling Institute Interviews:  Vitamin D and Cancer Prevention with Dr. David Feldman


Interviews with vitamin D researchers at the 2013 conference on Diet & Optimum Health at the Linus Pauling Institute, with GrassrootsHealth Director Carole Baggerly.  Watch the recorded webinar here. 
 
The topic addressed in this interview is "Vitamin D and cancer prevention: Calcitriol and dietary vitamin D3 exhibit substantial anti-cancer activity in mouse models of breast cancer in lean and obese mice," with Dr. David Feldman, MD of Stanford University School of Medicine, Stanford, CA.
  

 


Vitamin D Requirements for Breastfeeding Mothers & Infants

by Bruce W. Hollis, Ph.D., Professor of Pediatrics, College of Medicine, Medical University of South Carolina.  Watch the recorded webinar here.
 
Refer to the following abstract, Results of NICHD Two-Site Maternal Vitamin D Supplementation Randomized Controlled Trial during Lactation, for additional information on this topic.
 
 

 

Interactions of Vitamin D and Calcium

by Robert P. Heaney, MD, Professor, Creighton University, Department of Medicine and Research Director of GrassrootsHealth.  Watch the recorded webinar here.
  
 

 

Vitamin D--Alzheimer's Prevention

by Mathew Mizwicki, Ph.D., Assistant Researcher, David Geffen School of Medicine, Department of Surgery-Liver and Pancreas Transplantation, UCLA.  Watch the recorded webinar here.
 
The focus of the presentation is to review the regulation of the function of blood borne cells and innate immune responses that are associated with neuro-degenerative disorders, like Alzheimer's Disease (AD), by vitamin D.  
 
 

 


Vitamin D & Pregnancy--Protect the Start

with Dr. Carol Wagner and Carole Baggerly  Watch the recorded webinar here.
 
There's no better or easier time to use vitamin D to do its preventive work than at the beginning of life.  Carol Wagner, MD, in her interview with Carole Baggerly, our director, indicates that by pregnant women taking 4000 IU/day, it was not only safe, it enabled the women to reduce the incidence of many of the common co-morbidities of pregnancy by 50%, including pre-term births!  
 
Please join us in getting the word out that we need to take action now for our children.  The interview is followed by a question and answer session with Dr. Wagner. Refer to Dr. Wagner's published research, Vitamin D Supplementation During Pregnancy: Double-Blind, Randomized Clinical Trial of Safety and Effectiveness, and, A randomized trial of vitamin D supplementation in 2 community health center networks in South Carolinafor more information on this topic.
 
 

 

Vitamin D - Prevention & Treatment of Autism

by John J. Cannell, M.D., Executive Director, Vitamin D Council.  Watch the recorded webinar here.
 
Refer to Dr. Cannell's published works, On the Aetiology of Autism, and, Autism and Vitamin D, for more information on this topic.  For a quick summary, click here.
 

 

Vitamin D linked to Gene Expression

by Michael F. Holick, MD, Ph.D. Professor, Boston University.  Watch the recorded webinar here.
 

"Our data suggest that any improvement in Vitamin D status will significantly affect expression of genes that have a wide variety of biologic functions of more than 160 pathways linked to cancer, autoimmune disorders and cardiovascular disease which have been associated with vitamin D deficiency. This study reveals for the first time molecular fingerprints that help explain the nonskeletal health benefits of vitamin D."
 

 


Vitamin D Stops Breast Cancer Cell Growth

by JoEllen Welsh, Ph.D.Empire Innovations Professor, Department of Biomedical Sciences, School of Public Health, Albany State University of New York.  Watch the recorded webinar here.
 
Refer to the abstract of Dr. Welsh's recently published work, Vitamin D and cancer: integration of cellular biology, molecular mechanisms and animal models, for more information on her topic.
 
Collectively, these in vivo and in vitro data demonstrate that vitamin D signaling impacts on common pathways that drive differentiation, alter metabolism, remodel the extracellular matrix and trigger innate immunity in mammary tissue.

 

Vitamin D Reduces Prostate Cancer-associated Lesions

by Reinhold Vieth, Ph.D., Professor of Nutritional Sciences, Laboratory Medicine and Pathobiology, University of Toronto, Canada. Watch the recorded webinar here.
 
For additional information on this topic, please refer to the following publications:
 
Summary of findings from Dr. Vieth randomized (above) clinical trial:  The cancer proliferation marker Ki-67 decreased significantly in men who took 40,000 IU/day in the weeks leading up to radical prostatectomy for localized prostate cancer. The decline in Ki-67 correlated with increasing serum and prostate levels of calcitriol, which rose in a dose-dependent manner with vitamin D, reaching the highest levels with the highest dose of vitamin D (P = .02).

Moreover, high-dose vitamin D was associated with favorable changes in expression of micro- RNA (miRNA) involved in tumor suppression.

This was early-phase clinical research, essential to justify larger studies that would aim to prove that vitamin D prolongs survival or prevents cancer ~ Reinhold Vieth, PhD. 

 

Vitamin D, Prostate Cancer and Health Disparities 

by Bruce W. Hollis, Ph.D., Professor of Pediatrics, College of Medicine, Medical University of South Carolina.  Watch the recorded webinar here.
 
Refer to Dr. Hollis' published work,  Vitamin D3 Supplementation at 4000 International Units Per Day for One Year Results in a Decrease of Positive Cores at Repeat Biopsy in Subjects with Low-Risk Prostate Cancer under Active Surveillance, for more information on this topic.  In this study, the average serum level of the 4000 IU/day group was 67 ng/ml.  The dose and level were safe.

 



Why Test Vitamin D!? 

by Robert P. Heaney, MD, Professor, Creighton University, Department of Medicine and Research Director of GrassrootsHealth.  Watch the recorded webinar here.
 
Vitamin D is a consumed co-factor in the expression of over 2,000 genes. Necessarily, therefore, low vitamin D status limits cellular response to a myriad of signals and stressors. The result is that vitamin D inadequacy increases the risk of the major chronic diseases and leads to reduced longevity. While only the most severe degrees of deficiency produce overt clinically apparent symptoms and signs, most Americans have some degree of vitamin D inadequacy. Therapeutic adequacy depends not on dose but on achieved serum level, which can only be ascertained by measurement. 25(OH)D response to therapeutic doses of vitamin D varies over a six-fold range, and is hence difficult to predict.
 
Refer to Dr. Heaney's published work, Vitamin D Supplement Doses and Serum 25-Hydroxyvitamin D in the Range Associated with Cancer Prevention, for more information on this topic.
 
 

Vitamin D & Calcium:  Fractures, kidney stones-what do we do?

by Robert P. Heaney, MD, Professor, Creighton University, Department of Medicine and Research Director of GrassrootsHealth.  Watch the recorded webinar here.
 
A recent publication of the US Preventive Services Task Force made a recommendation:  The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium for the primary prevention of fractures in non-institutionalized postmenopausal women. and, Adequate evidence indicates that supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium increases the incidence of renal stones. 

In order to put these statements into perspective and provide reasonable guidance for all of us, Dr. Robert Heaney, one of the world's experts on Vitamin D and calcium metabolism, presents an expert's response to this recommendation and answer questions. 

Refer to "Kidney Stones are NOT Caused by Vitamin D" and an article Dr. Heaney has just written in response to the USPSTF recommendation, "Vitamin D: Still a Nutrient I Would Use" for more on this topic.  
 

 


Vitamin D levels declining; MS, cancer, diabetes and more on the rise.  How to protect yourself?

by Susan J. Whiting, B.Sc., M.Sc., Ph.D., Professor of Nutrition and Dietetics, University of Saskatchewan.  Watch the recorded webinar here.
 
Written answers to additional questions can also be found here
 
 
 
by Cedric F. Garland, Dr. P.H., Professor, University of California San Diego Department of Preventive Medicine.  Watch the recorded webinar here.
 
Refer to Dr. Garland's published work, Serum 25-hydroxyvitamin D and breast cancer in the military: a case–control study utilizing pre-diagnostic serum, for more information on this topic. 
 

 


Racial & Ethnic Disparities in Infant Mortality... a vitamin D problem?

by William B. Grant, Ph.D. and Founding Director of the Sunlight, Nutrition and Health Research Center.  Watch the recorded webinar here.
 
Refer to Dr. Grant's resource list here.
 

 


What vitamin D level helps prevent upper respiratory infections? (Part 1 & Part 2)

by Carlos Camargo, M.D., Dr. PH., Professor of Medicine & Epidemiology, Harvard Medical School.  Watch the recorded webinar here.
 

 


I already take vitamin D in my prenatal... do I need more?  How safe is it for pregnancy?  (Part 1 & Part 2)

by Carol L. Wagner, M.D., Professor of Pediatrics and Neonatology, Medical University of South Carolina.  Watch the recorded webinar here.

Refer to Dr. Wagner's published work, Vitamin D Supplementation During Pregnancy: Double-Blind, Randomized Clinical Trial of Safety and Effectiveness, for more information on this topic.  The average serum level of the 4000 IU/day group was 67 ng/ml.  The dose and level were safe.

 


What does the sun do for me? (Part 1 & Part 2)

by Michael F. Holick, MD, Ph.D. Professor, Boston University.  Watch the recorded webinar here.

 

How could vitamin D prevent type 1 diabetes? 

by Cedric F. Garland, Dr. P.H., Professor, University of California San Diego Department of Preventive Medicine.  Watch the recorded webinar here.