Vitamin Studies Spell Confusion for Patients
If it’s Monday, it must be bad news about multivitamin day — or was that Wednesday? No, Wednesday was good news about vitamin D, not so good news about vitamin E — if you’re confused, join the club.
A recent American Medical association paper suggested that vitamins are a threat rather than an advantage to peoples lives.[1]
The Alliance for Natural Health have undertaken a quick analysis of the paper and sum up the findings:
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B Vitamins Beat Depression
This month’s (August) American Journal of Clinical Nutrition presents a longitudinal study supporting the use of B vitamins in the management of mental health.
In Nutritional Therapy practice when we are faced with patients who seem to be struggling with depression and are finding recovery hard as well as trying to prevent recurrence after resolving their current symptoms we often think – B Vitamins
But what is the evidence for this apparently normal recommendation – is there anything of substance that supports the therapeutic use of these water soluble vitamins.
To date most studies have been conducted using a cross sectional approach[1],[2] (a class of research methods that involve observation of some subset of a population of items all at the same time, in which, groups can be compared at different ages with respect of independent variables) rather than the preferred prospective style investigations (an analytic study designed to determine the relationship between a condition and a characteristic shared by some members of a group). A prospective study may involve many variables or only two; it may seek to demonstrate a relationship that is an association or one that is causal. Prospective studies produce a direct measure of risk called the relative risk.
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Vegas, Pregnancy, Immunity and Allergy Prevention!
The saying is ‘what happens in Vegas stays in Vegas’, or if you are English ‘what happens in Blackpool….’ but the same cannot be said about what happens in utero, as increasing evidence supports the understanding that the maternal nutritional environment and early feeding affects the health of the foetus beyond infancy and into adulthood.[1],[2] An article in Nature’s Mucosal Immunology this month explores some of the key events in foetal and neonatal immune management.[3] It stimulated a revisit to the area of what to consider for parents to be and mums of young children when they ask ‘is there anything I can do to prevent or reduce the risk of allergy or atopy in my child’.
The first moments, weeks and months of life can determine the health outcomes of an individual over the duration of their lifetime and this knowledge represents a significant choice for prospective parents. Fortunately the remarkable adaptability of the immune and central nervous system means that there are numerous opportunities in the early years of life to positively influence health outcomes even if the early stages were less than optimal.
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Vitamin D Halves Asthma Hospitalisation Risk
There seems no end to the illnesses this secasteroid is capable of influencing, although it should be of no real surprise that Vit D deficiency is linked to the respiratory condition asthma. The reason….mucosal tissues such as those found in the lung are rich with immune receptors that are intimately tied into the Vit D receptor family. Vitamin D up regulates a specific gene that produces over 200 anti-microbial peptides, some of which work like a broad-spectrum antibiotic.
Because of its beneficial role in respiratory tract infections and immune system modulation, it has been hypothesised that vitamin D status might affect the risks for exacerbations.[1] This paper shows show that children with initial circulating vitamin D levels of 30 ng/mL or less (vitamin D insufficiency) have a 50% greater risk for severe exacerbation over the course of a 4-year clinical trial of asthma treatment than children with circulating vitamin D levels of 30 ng/mL or greater (vitamin D sufficiency) at the start of the trial.
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More Evidence to Support Vit D as an Anti Viral Compound
Last year I wrote a number of posts relating to mechanisms related to mucosal immune defences, in particular the innate immune defences and how we as Nutritional Therapists may advise our patients of evidence based strategies. This paper out in the open access journal Plos One adds further validity to the vitamin D recommendations I proposed.
Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections.[1]
This paper in PLOS Biology describes how almost 200 adults had their serum 25-hydroxyvitamin D levels measured, without knowing what was been investigated.
One hundred ninety-eight participants, 85 men and 113 women, with an age range of 20–88, were enrolled in the study.
The researcher found that people with fair skin, lean body mass and who supplemented with vitamin D had the highest levels of 25-hydroxyvitamin D. People who achieved 38ng/ml or higher 25-hydroxyvitamin D level had a remarkable 50% reduction in the risk of developing acute respiratory tract infections and a significant reduction in the number of days ill (p<0.0001).
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Sun or Supplements – The Vit D Controversy
Vitamin D is increasingly understood to be an essential component of many aspects of human health and although technically not a “vitamin,” vitamin D is in a class by itself. Its metabolic product, calcitriol, is actually a secosteroid (A compound derived from a steroid in which there has been a ring cleavage) hormone that binds to over 2000 gene receptors (about 10% of the human genome) in the human body. There are 3 recognised ways for adults to ensure adequate levels of vitamin D:
These are:
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Do Diets Leave You Micronutrient Deficient?
The shortage of essential micronutrients in the human diet has been linked to multiple health and disease related problems. Dr Bruce Ames has described how the micronutrient triage theory can account for disease induction and more rapid levels of poor quality aging. I have written about the expensive urine myth and how the failure to recognise the differing demands placed by cells at different times can lead to altered and compromised health function.
This paper looks at the nutritional intake of people following a weight loss diet.[1] Based on the USA figures, the authors say that about 1/3 of the population are following some sort of weight loss orientated nutritional programme. The study looked to see if 27 micronutrients could be ingested in sufficient quantities whilst following 4 well known diets to meet minimum RDA levels as determined by the USA regulatory body the FDA.
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Multi Vitamin/Mineral Supplement Promotes Weight Loss in Women
Multi Vitamins are considered by many to be little more than colourful contributors to urine flow that reflect a gullible individuals need to add capital to the water course. I have addressed the major complications with this facile comment in a previous commentary.
A paper out in the March 2010 International Journal of Obesity[1] throws added weight to the triage theory of Prof Bruce Ames,[2] when additional nutrients were added to the dietary intake of obese Chinese females. It is already understood that obesity contributes to reduced bioavailability of minerals and vitamins and certainly contributes to reduced blood concentrations.
The team of researchers based at Harbin Medical University in China recruited 96 Chinese women with an average body mass index of 28kg/m2 and aged between 18-55 for the 6 month study.
Three groups were randomly set up, with one getting a multivimin, the next calcium only (162mg) and the last placebo. The results were compelling; the multivimin group had reduced body weight, body mass index, fat mass, total cholesterol and LDL cholesterol. On the positive side, they had an increased level of resting energy expenditure and HDL levels also increased. They also found reduced waist size and better breathing.
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Lifestyle Changes Better Than Drugs for Diabetes Prevention
A series of papers out in the New England Journal of medicine on March the 14th 2010 have failed to add any substantive weight to the use of medication in the prevention of diabetes and cardiovascular disease. [1],[2],[3]
The continued expansion of the western global waistline and incidence of diabetes has provided fertile opportunity for a wide range of clinical trials designed to uncover strategies for incidence of diabetes reduction.[4] There is no surprise in the discovery that making significant changes to people’s lifestyles, eating less and being more active, the primary causes of weight gain, also have a consistent reduction in type II diabetes risk. The real success has also been in the associated benefits in reduction of related cardiovascular disease risk[5] and raising of mood.[6]
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Vit D Deficiency = Fat Legs For Young Women!
It’s hard to ignore, it really appears there is a genuine epidemic (occurrence of a disease or disorder in a population at a frequency higher than that expected in a given time period) in progress, and its not H1N1 Flu.
An excellently developed study published in the March 2010 Journal of Clinical Endocrinology and Metabolism found a depressingly high 59% of study subjects had too little Vitamin D in their blood (</=29 ng/ml).[1] Nearly a quarter of the group had serious deficiencies (less than 20 ng/ml) of this important vitamin. Even the sufficient (>/=30 ng/ml) was only 41% and if we were to apply the generally regarded 50ng/ml as the base line for sufficiency, the numbers would decline even further. Since Vitamin D insufficiency is linked to increased body fat, decreased muscle strength and a range of disorders, this is a serious health issue.
The 90 young women in this group aged between 16-22yrs of age had an increased level of fatty tissue when their Vit D levels were low. Abnormal levels of Vitamin D are associated with a whole spectrum of diseases, including cancer, osteoporosis and diabetes, as well as cardiovascular and autoimmune disorders.
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The immune system is prone to the same grave misfortunes as any defense system handling weapons: collateral damage that comes with the destruction of the enemy on one’s own territory and friendly fire due to mistaken identity. Whereas the collateral damage is the price we pay for clearance of infections, autoimmunity is a pathological process. Nevertheless, the effector mechanisms involved in both processes are the same. Whether environment can be a cause, a trigger or an amplifier of an autoimmune disease are questions that are being intensively investigated.
