Clinic Blog
17/01/2012- Nearly one third of Australian adults are suffering vitamin D deficiency according to a study involving more than 11,000 adults from around the country.
This is the first national study to evaluate the vitamin D status of Australians. Those at greatest risk for deficiency were women, the elderly, the obese, people doing less than 2.5 hours of physical activity a week, and people of non- European background.
The results highlight vitamin D deficiency as a major public health issue for Australia that requires urgent attention, said study leader Professor Robin Daly, Chair of Exercise and Ageing within the Centre for Physical Activity and Nutrition Research at Deakin University, and honorary fellow in the Department of Medicine (Northwest Academic Centre) at the University of Melbourne.
"Vitamin D deficiency is emerging as a major health problem worldwide. It is clear from the results of our study that, despite an abundance of vitamin D rich sunlight, Australians are not immune from this issue," he said.
"Low levels of vitamin D can contribute to a number of serious, potentially life-threatening, conditions such as softened bones; diseases that cause progressive muscle weakness leading to an increased risk of falls, osteoporosis, cardiovascular disease, certain types of cancer and type 2 diabetes.
"While it was reassuring that only four per cent of the population had severely deficient levels, national strategies are urgently needed to attack the high prevalence of vitamin D deficiency in Australia before the problem worsens."
For the study, the researchers measured the vitamin D levels of 11,218 adults aged 25-95 years from all six states and the Northern Territory as part of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study conducted by the Baker IDI Heart and Diabetes Institute in 1999-2000.
The study revealed:
- 31 per cent of the population were vitamin D deficient
- Nearly three quarters (73 per cent) had levels considered by many experts as below the optimal for musculoskeletal health
- The prevalence of vitamin D deficiency increased with age, especially in women; 26 per cent of women aged 25-34 years were deficient which increased to 57 per cent for those aged 75 years and over. This is an important finding as vitamin D deficiency is a key risk factor for falls and fractures in the elderly.
- People of non-European origin were 4-5 times more likely to be deficient
- Those who were obese and physically inactive were around twice as likely to be vitamin D deficient
- The prevalence of deficiency was also found to vary markedly by season and location, with deficiency more common during winter and in people residing in the southern states of Australia.
"For example, 42 per cent of women and 27 per cent of men living in the southern states were deficient during summer-autumn, which increased to 58 per cent of women and 35 per cent of men during winter-spring. Even in the northern states 31 per cent of women and 15 per cent of men were vitamin D deficient during winter-spring," Professor Daly said.
Professor Daly and his co-authors from the University of Melbourne and the Baker IDI Heart and Diabetes Institute said it was timely and appropriate to develop national strategies across the whole population and further awareness campaigns for balancing safe sun exposure and adequate vitamin D intake to ensure optimal vitamin D status year-round for all Australians.
The results are published in the journal Clinical Endocrinology.
Browse the MedicalSearch directory: Orthopaedic Devices & Supplies
Source: Deakin University
New research has reported that risk of heart failure decreases with increasing blood levels of vitamin C [1]. Persons with the lowest plasma levels of ascorbate had the highest risk of heart failure, and persons with the highest levels of vitamin C had the lowest risk of heart failure.
According to the US Centers for Disease Control (CDC) there are about 600,000 deaths from heart disease each year. [2] This is an enormous number. The definition of heart failure used by the study authors was on the basis of drugs prescribed, which would include all forms of heart disease that cause death. This agrees well with the CDC definition.
Specifically, the study found that each 20 micromole/liter (μmol/L) increase in plasma vitamin C was associated with a 9% reduction in death from heart failure. That works out to 54,000 fewer deaths from heart failure for each increase in 20 μmol/L plasma vitamin C. If everyone took high enough doses of vitamin C to reach the highest quartile (80 μmol/L), that would work out to approximately 216,000 fewer deaths per year. Just from taking vitamin C.
What is Heart Failure?
The heart muscle fails for many reasons. As we get older, it weakens and may not get enough nutrients to keep it healthy. A severe heart attack, that does not kill the patient but has caused significant damage to the heart muscle, may leave the heart in a very weakened state. Long standing or acute high blood pressure can put a massive strain on the heart and cause it to fail. An abnormal beating of the heart such as a very fast heart rate, an irregular beat or a lot of missed beats will result in a less effective pumping and eventual failure. Anemia will make the heart pump harder and faster in an attempt to deliver enough oxygen to the organs. The valves in the heart which direct blood flow are made up of an important fibrous strengthening tissue called collagen. Weakness or tearing of these valves can cause the blood to flow backwards, making the heart pump very inefficiently and eventually causing it to fail. When the heart muscle begins to fail, there is a buildup of carbon dioxide and waste products, resulting in weakening of the kidneys and liver. Eventually, fluid builds up in all the organs and the person presents with severe fatigue, shortness of breath (from fluid in the lungs) and swelling of the ankles.
Viruses and other microorganisms can attack the heart and weaken the heart muscle cells permanently by causing viral myocarditis. As the heart muscle cells get older they may require more energy to work and a greater level of protection from free radical damage. Nutrients such as magnesium, orotic acid, coenzyme Q10, acetyl L-Carnitine, and others may be required. Toxins, chemotherapeutic drugs, alcohol and deficiencies of some nutrients such as selenium may cause the heart to increase the size of its cells to compensate for the weakness. An enlargement of the heart muscle is called cardiomyopathy. These hearts are much more likely to fail.
Medical treatment of cardiac failure uses drugs that open the arteries, reduce blood pressure, and force the excessive fluid out of the body (diuretics). Drugs known as ACE Inhibitors improve quality of life and survival. Diet, fluid and salt restriction, and tolerable exercise are essential. For the most severe cases, a heart transplant may be required. However, many of these treatments have significant side effects. For example, treatment with diuretics to remove excess fluid will tend to lower the plasma vitamin C level and exacerbate the causes of cardiac failure.
How Much Vitamin C is Needed?
It takes less vitamin C than you may have thought. To achieve a plasma level of 80 μmol/L, and thereby reduce deaths by 216,000 per year, requires a daily dosage of about 500 mg of vitamin C. This is only one or two tablets per day, costing less than ten cents.
3,000 to 8,000 mg/day, in continued divided doses, can achieve a plasma level twice as high (160 μmol/L). This much C could save an additional 216,000 lives as it is an additional 80 μmol/L, assuming the relationship holds.
We can go still higher, and without intravenous administration. 1,000 mg of oral vitamin C per hour for 12 hours (12,000 mg/day) will result in a plasma level of about 240 μmol/L. A single 5,000 milligram dose might take you to a peak of 240 μmol/L, but only for about 2-4 hours after the intake. That is why the dosage needs to be spread out: better absorption, gradual excretion, higher plasma levels . . . and better results.
Conclusion:
Optimizing vitamin C intake optimizes the health of a person taking it. This includes persons with potentially life-threatening disorders. It is a simple, cheap, effective, and safe therapy. Vitamin C is no longer a "controversial" therapy. It is an ignored therapy. It is time for the medical profession to fully awaken to what this recent study confirms: higher vitamin C intakes mean less heart failure. That means that higher vitamin C intakes mean fewer deaths. 200,000 per year fewer.
With just two vitamin C tablets per day.
References:
Press Release from the Orthomolecular Medicine News Service.
1. Pfister R, Sharp SJ, Luben R, Wareham NJ, Khaw KT. (2011) Plasma vitamin C predicts incident heart failure in men and women in European Prospective Investigation into Cancer and Nutrition-Norfolk prospective study. Am Heart J. 162:246-253.
2. http://www.cdc.gov/nchs/fastats/lcod.htm
Nutritional Medicine is Orthomolecular Medicine
Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org
A recent study [1] of the effect of B vitamins on a large group of participants reported an inverse relationship between blood serum levels of vitamin B6, methionine, and folate and the risk of lung cancer. High serum levels of vitamin B6, methionine and folate were associated with a 50% or greater reduction in lung cancer risk. This exciting finding has not been widely reported in the media, but it confirms a growing body of evidence gathered over the last 40 years that B vitamins are important for preventing diseases such as cancer.
The study gathered information about the lifestyle and diet of 385,000 people in several European countries. The average age was 64 years, and most had a history of drinking alcohol daily. Blood samples were then taken from these participants, and some of those (889) that developed lung cancer were analyzed for the level of several B vitamins and related biochemicals such as methionine, an essential amino acid. These nutrients were studied because they are known to be important in the metabolism of single carbon compounds, which is necessary for the synthesis and repair of DNA in the body's tissues [2]. Thus, B vitamins are helpful in preventing defects in DNA which can cause cancer [2-4].
Specifically, a high level of either vitamin B6, or methionine, or folate reduced the risk for lung cancer. High levels of all these nutrients together produced an even lower risk. The effects were large, so the results are highly significant.
The study divided the participants into three categories, depending on whether they currently smoked, had previously smoked, or had never smoked. While smoking is the most important lifestyle factor in the risk for lung cancer, interestingly, the effects of vitamin B6, methionine, and folate were fairly constant among the three categories. That is, those with higher levels of these B vitamins had a significantly lower risk of lung cancer no matter whether they smoked or not. The report emphasizes that this result strongly suggests that the effect of these essential nutrients in lowering the risk for cancer is real and not purely a statistical correlation. And, the report reiterates that smoking is dangerous, greatly increasing the risk for lung cancer in older people after decades of insult to the lungs.
Some widely-reported health studies have suggested that B vitamins can increase the risk of cancer. The theory is that these vitamins can help to prevent cancer from their effects in strengthening DNA synthesis and repair, but that when cancer is present, the vitamins supposedly help the cancer to grow [5]. However, there is a long history of health studies, including the above mentioned study, reporting that B vitamins including folate and vitamin B6 can help to prevent many types of cancer, such as breast, prostate and colorectal cancer [1-6].
It is just amazing how the news media could have missed this, but they pretty much did. In one much-publicized study [7] it was widely claimed that "Multivitamins increase deaths in older women!" Actually, the study found that B complex vitamins were associated with a 7 percent decrease in mortality, vitamin C was associated with a 4 percent decrease in mortality, vitamin D was associated with an 8 percent decrease in mortality, and several minerals were associated with a decrease in mortality.
Essential nutrients in a well-balanced diet, including B-complex, C, D, and E vitamins, are crucial to maintaining good health into old age for a variety of reasons. Persons taking adequate levels of vitamins will live longer, with fewer heart attacks [7] and other serious diseases such as diabetes [8], multiple sclerosis [9], and dementia [10].
The question begged by the report is, what role did vitamin supplements play in the blood levels reported for these essential nutrients? Taking a multivitamin that includes B-complex vitamins will obviously increase the blood levels of these essential nutrients. However, the value of supplements was not emphasized in the report.
So we will emphasize it here. Vitamins dramatically lower lung cancer risk. Supplements provide these nutrients in abundance. Modern diets do not.
References:
1. Johansson M, Relton C, Ueland PM, et al. Serum B vitamin levels and risk of lung cancer. JAMA. 2010 Jun 16;303(23):2377-85.
2. Xu X, Chen J. One-carbon metabolism and breast cancer: an epidemiological perspective. J Genet Genomics. 2009;36: 203-214.
3. Larsson SC, Orsini N, Wolk A. Vitamin B6 and risk of colorectal cancer: a meta-analysis of prospective studies. JAMA. 2010;303:1077-1083.
4. Ames BN. Prevention of mutation, cancer, and other age-associated diseases by optimizing micronutrient intake. J Nucleic Acids. 2010 Sep 22;2010. pii: 725071.
5. Mason JB. Unraveling the complex relationship between folate and cancer risk. Biofactors. 2011 Jul;37(4):253-60.
6. Giovannucci E. Epidemiologic studies of folate and colorectal neoplasia: a review. J Nutr. 2002;132(Suppl):S2350-S2355.
7. Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr. Dietary supplements and mortality rate in older women. The Iowa Women's Health Study. Arch Intern Med 2011. 171(18):1625-1633.
8. Pfister R, Sharp SJ, Luben R, et al. Plasma vitamin C predicts incident heart failure in men and women in European Prospective Investigation into Cancer and Nutrition-Norfolk prospective study. Am Heart J. 2011 Aug;162(2):246-53.
9. Harding AH, Wareham NJ, Bingham SA, et al. Plasma vitamin C level, fruit and vegetable consumption, and the risk of new-onset type 2 diabetes mellitus: the European prospective investigation of cancer--Norfolk prospective study. Arch Intern Med. 2008 Jul 28;168(14):1493-9.
10. Solomon AJ. Multiple sclerosis and vitamin D. Neurology. 2011 Oct 25;77(17):e99-e100.
11. Selhub J, Troen A, Rosenberg IH. B vitamins and the aging brain. Nutr Rev. 2010 Dec;68 Suppl 2:S112-8.
by Robert G. Smith, PhD
Nutritional Medicine is Orthomolecular Medicine
Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org
Brilliant UK documentary on epigenetics. Watch the programs - online after this intro. And then consider having a test to your epigenetic inheritance !
Biology stands on the brink of a shift in the understanding of inheritance. The discovery of epigenetics hidden influences upon the genes could affect every aspect of our lives.
At the heart of this new field is a simple but contentious idea that genes have a 'memory'. That the lives of your grandparents the air they breathed, the food they ate, even the things they saw can directly affect you, decades later, despite your never experiencing these things yourself. And that what you do in your lifetime could in turn affect your grandchildren.
The conventional view is that DNA carries all our heritable information and that nothing an individual does in their lifetime will be biologically passed to their children. To many scientists, epigenetics amounts to a heresy, calling into question the accepted view of the DNA sequence a cornerstone on which modern biology sits.
Epigenetics adds a whole new layer to genes beyond the DNA. It proposes a control system of 'switches' that turn genes on or off and suggests that things people experience, like nutrition and stress, can control these switches and cause heritable effects in humans.
A newly released study suggests that multivitamin and nutrient supplements can increase the mortality rate in older women [1]. However, there are several concerns about the study's methods and significance.
The study was observational, in which participants filled out a survey about their eating habits and their use of supplements. It reports only a small increase in overall mortality (1%) from those taking multivitamins. This is a small effect, not much larger than would be expected by chance. Generalizing from such a small effect is not scientific.
The study actually reported that taking supplements of B-complex, vitamins C, D, E, and calcium and magnesium were associated with a lower risk of mortality. But this was not emphasized in the abstract, leading the non-specialist to think that all supplements were associated with mortality. The report did not determine the amounts of vitamin and nutrient supplements taken, nor whether they were artificial or natural. Further, most of the association with mortality came from the use of iron and copper supplements, which are known to be potentially inflammatory and toxic when taken by older people, because they tend to accumulate in the body [2,3,4]. The risk from taking iron supplements should not be generalized to imply that all vitamin and nutrient supplements are harmful.
The study lacks scientific plausibility for several reasons. It tabulated results from surveys of 38,000 older women, based on their recall of what they ate over an 18-year period. But they were only surveyed 3 times during that period, relying only on their memory of what foods and supplements they took. This factor alone causes the study to be unreliable.
Some of these women smoked (~15%) or had previously (~35%), some drank alcohol (~45%), some had high blood pressure (~40%), and many of them developed heart disease and/or cancer. Some preexisting medical conditions were taken into account by adjusting the risk factors, but this caused the study to contradict what we already know about efficacy of supplements. For example, the study reports an increase in mortality from taking vitamin D, when adjusted for several health-relevant factors. However, vitamin D has recently been clearly shown to be helpful in preventing heart disease [5] and many types of cancer [6], which are major causes of death. Furthermore, supplement users were twice as likely to be on hormone replacement therapy, which is a more plausible explanation for increased mortality than taking supplements.
The effect of doctor recommendations was not taken into account. By their own repeated admissions, medical doctors and hospital nutritionists are more likely to recommend a daily multivitamin, and only a multivitamin, for their sicker patients. The study did not take this into account. All it did was tabulate deaths and attempt to correct the numbers for some prior health conditions. The numbers reported do not reflect other factors such as developing disease, side effects of pharmaceutical prescriptions, or other possible causes for the mortality. The study only reports statistical correlations, and gives no plausible cause for a claimed increase in mortality from multivitamin supplements.
The effect of education was not taken into account. When a doctor gives advice about illnesses, well-educated people will often respond by trying to be proactive. Some will take drugs prescribed by the doctor, and some will try to eat a better diet, including supplements of vitamins and nutrients. This is suggested by the study itself: the supplement users in the survey had more education than those who did not take supplements. It seems likely, therefore, the participants who got sick were more likely to have taken supplements. Because those who got sick are also more likely to die, it stands to reason that they would also be more likely to have taken supplements. This effect is purely statistical; it does not represent an increase in risk that taking supplements of vitamins and essential nutrients will cause disease or death. This type of statistical correlation is very common in observational health studies and those who are health-conscious should not be confounded by it.
The known safety of vitamin and nutrient supplements when taken at appropriate doses was not taken into account. The participants most likely took a simple multivitamin tablet, which contains low doses. Much higher doses are also safe [4,7], implying that the low doses in common multivitamin tablets are very safe. Further, because each individual requires different amounts of vitamins and nutrients, some people must take much higher doses for best health [8].
Summary: In an observational study of older women in good health, it was said that those who died were more likely to have taken multivitamin and nutrient supplements than those who did not. The effect was small, and does not indicate any reason for disease or death. Instead, the study's methods suggest that people who have serious health conditions take vitamin and mineral supplements because they know that supplements can help. Indeed, the study showed a benefit from taking B-complex, C, D, and E vitamins, and calcium and magnesium. Therefore, if those wanting better health would take appropriate doses of supplements regularly, they would likely continue to achieve better health and longer life.
by Robert G. Smith, PhD
(Robert G. Smith is Research Associate Professor, University of Pennsylvania Department of Neuroscience. He is a member of the Institute for Neurological Sciences and the author of several dozen scientific papers and reviews.)
References:
[1] Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr (2011) Dietary supplements and mortality rate in older women. The Iowa Women's Health Study. Arch Intern Med. 171(18):1625-1633.
[2] Emery, T. F. Iron and your Health: Facts and Fallacies. Boca Raton, FL: CRC Press, 1991.
[3] Fairbanks, V. F. "Iron in Medicine and Nutrition." Chapter 10 in Modern Nutrition in Health and Disease, editors M. E. Shils, J. A. Olson, M. Shike, et al., 9th ed. Baltimore, MD: Williams & Wilkins, 1999.
[4] Hoffer, A., A. W. Saul. Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians. Laguna Beach, CA: Basic Health Publications, 2008.
[5] Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB, Clarke A, Franco OH. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010 Mar;65(3):225-36.
[6] Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91.
[7] Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010 Jul 7;5(7):e11414.
[8] Williams RJ, Deason G. (1967) Individuality in vitamin C needs. Proc Natl Acad SciUSA.57:16381641.
Also of Interest:
Orthomolecular Medicine News Service, April 29, 2010. Multivitamins Dangerous? Latest News from the World Headquarters Of Pharmaceutical Politicians, Educators and Reporters. http://orthomolecular.org/resources/omns/v06n15.shtml
To Subscribe at no charge: http://www.orthomolecular.org/subscribe.html
