Current vitamin D doses insufficient for mothers-to-be

By Stephen Daniells, 16-Sep-2009

Many mothers to be are not getting enough vitamin D, even those taking supplements at the recommended doses, says a new study from Northern Ireland.

Almost all of the women in the study had blood levels of the vitamin below 80 nmol/l, a level which is widely considered to be the cut-off for vitamin D sufficiency, showing that current recommendations may be insufficient.

Currently in the UK, pregnant women are recommended by the Food Standards Agency (FSA) to take supplements with a daily dose of 10 micrograms vitamin D. In the US and Canada, where no specific recommendations exist for pregnant women, adequate intakes are inline with the general population and set at 5 micrograms per day.

Dr Maria Barnes from the University of Ulster, Coleraine, told NutraIngredients.com that, as their study was observational, it was impossible to determine the dose of vitamin D required to improve maternal vitamin D status.

“Clearly such recommendations can only be established following a number of well designed double-blinded, randomised placebo controlled vitamin D intervention studies during pregnancy,” said Dr Barnes.

“However, from our study it is evident that general dietary supplementation given to pregnant women may be inadequate to maintain or improve vitamin D status, particularly during wintertime,” she added.

The researchers, from Queen's University, Belfast, the University of Ulster, and Belfast City Hospital report their findings in the British Journal of Nutrition.

Bigger doses needed

A wider debate is ongoing in nutrition circles regarding vitamin D intakes. Late last year the American Academy of Pediatrics (AAP) said children should be consuming 400 International Units (IUs), or 10 micrograms per day. This would mean doubling the current US recommendations. Others have recommended increasing levels to 2,000 IUs.

The US National Academy of Sciences' Institute of Medicine (IOM) said it will be reviewing its recommendations “in the not too distant future”.

According to Dr Barnes and her co-workers, children born to vitamin D-deficient mothers are at an increased risk of rickets, while maternal insufficiency may detrimentally affect bone build-up, and increase the risk of type-1 diabetes and asthma.

Study details

The researchers recruited 99 pregnant women at 12, 20 and 35 weeks of gestation, and 38 non-pregnant controls living at a latitude of 54 to 55 °N. S

Vitamin D levels, calculated using serum concentrations of 25- hydroxyvitamin D (25(OH)D), the non-active 'storage' form of the vitamin in the body, showed that 35, 44 and 16 per cent were vitamin D deficient at 12, 20 and 35 weeks of gestation. Furthermore, 96, 96 and 75 per cent were vitamin D insufficient at the same gestation stage.

While women taking supplements did have higher vitamin D levels, “vitamin D insufficiency was still evident even in the face of supplement use”, wrote Dr Barnes and her co-workers.

“To our knowledge, the present study is the first to measure vitamin D status in free-living Caucasian women with uncomplicated pregnancies, which collected samples longitudinally throughout pregnancy whilst concurrently sampling non-pregnant age-matched controls,” stated the researchers.

“Given the potential consequences of hypovitaminosis D on health outcomes, vitamin D supplementation, perhaps at higher doses than currently available, is needed to improve maternal vitamin D nutriture,” they concluded.

Data on D

Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. The former, produced in the skin on exposure to UVB radiation (290 to 320 nm), is said to be more bioactive.

While our bodies do manufacture vitamin D on exposure to sunshine, the levels in some northern countries are so weak during the winter months that our body makes no vitamin D at all, meaning that dietary supplements and fortified foods are seen by many as the best way to boost intakes of vitamin D.

Source: British Journal of Nutrition
September 2009, Volume 102, Issue 06, Pages 876-881, doi:10.1017/S0007114509297236
“Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study”
Authors: V.A. Holmes, M.S. Barnes, H.D. Alexander, P. McFaul, J.M.W. Wallace

Cancer Safety Fears Of Most Common Heartburn Treatment Rejected By Major Clinical Study

Cancer Safety Fears Of Most Common Heartburn Treatment Rejected By Major Clinical Study

I'm taking Omeprazole - a proton pump inhibitor to try and avoid the threat of esophagus cancer due to repeated flooding with stomach acid. This study confirms that the medicine does not itself cause cancer. One kind of thought this must be true but good to have a serious 2 year study make sure.

Of course my alternative healthcare provider say that it's all non-sense. The stomach needs to have a lot of acid and if the acid producing cells in the stomach lining are prevented from working then bacteria accumulate in the stomach and produce even stronger acid.

I kind of doubt this but there is always someone with a different point of view.

Full without food: Can surgery cure obesity? - health - 02 September 2009 - New Scientist

Full without food: Can surgery cure obesity? - health - 02 September 2009 - New Scientist


Over the past decade, genetic and endocrinological research has pointed to a complex set of hormones and neural signals that control food intake (New Scientist, 9 August 2003, p 38). There seem to be two systems at work: one that aims to keep body-fat stores constant over long periods of time, and another that controls food intake over the course of a day.

It is this short-term control mechanism that has been thrust into the limelight thanks to gastric bypass surgery. "Suddenly, the signalling from the gut has turned out to be much more potent than people believed - and possibly a better drug target," says Nick Finer, an endocrinologist at University College London.

Our digestive system produces both hormones that make you hungry and those that make you feel full, or sated. Ghrelin, produced by the lower part of the stomach, is a powerful promoter of hunger, while the small intestine releases a number of hormones when it senses the presence of food. These aid digestion as well as producing feelings of satiety, and include cholecystokinin, glucagon-like peptide-1 (GLP-1), oxyntomodulin and PYY.

Current thinking is that changes to the levels of any or all of these hormones could be responsible for the effects of the bypass. Shrinking the stomach seems to reduce ghrelin production, which would curtail hunger signals. A bypass also delivers nutrients to the more distant parts of the small intestine faster and in greater quantities than normal, which would stimulate the release of more satiety hormones.

The other surprising outcome from bypass surgery is its effects on type 2 diabetes, a condition in which people can no longer regulate their blood sugar. After eating, the pancreas normally releases insulin, a hormone that reduces excess glucose in the blood. In type 2 diabetes, though, the body cannot respond to insulin properly or the pancreas fails to make enough of the hormone, or sometimes both.

Type 2 diabetes is much more common in people who are overweight, and it was expected that the weight loss following a bypass would improve symptoms. But doctors have been amazed by just how quickly this happens - sometimes in a matter of hours and certainly long before any significant weight loss occurs. Many bypass patients have been able to throw away their diabetes drugs. "If you change the anatomy of the bowel, you improve diabetes like nothing else has ever done," says Francesco Rubino at Cornell University-New York Presbyterian Hospital in New York. The upshot is that bypass surgery is now being considered for diabetics of lower and lower weight - perhaps even approaching normal weight if their diabetes is severe enough.

(see "A surgical cure for diabetes?").

new glucagon and GLP-1 co-agonist eliminates obesity

Qnexa Obesity

Qnexa Obesity

VIVUS announces that obese patients on Qnexa had a weight lost averaging 14.7%.

Read full details.

What Vivus says about the trial:

• The EQUATE trial demonstrated superior weight loss with both the full-dose and mid-dose of Qnexa, as compared to the individual components and placebo.
  
• Subjects treated with full-dose and mid-dose Qnexa had an average weight loss of 9.2% and 8.5% respectively, as compared to weight loss of 1.7% reported in the placebo group (ITT LOCF p<0.0001).
  
• Average weight loss was 19.8 pounds and 18.2 pounds in the treatment arms as compared to 3.3 pounds in the placebo group.
  
• Qnexa was well tolerated with no drug-related serious adverse events in the study.

Read more.

Time to get excited about real help for serious weight loss ?

• Remember this is not really new technology because Qnexa is a combination of phentermine and topamax.
• There are side affects - lots of them.
• Qnexa is not yet available. In fact it has yet been submitted for approval by FDA.

Benefits of exercise differ by sex and race | Health | Reuters

How much health benefit you get from physical exercise might depend on your gender, and your race, new research suggests.

The work is based on data from more than 15,000 middle-aged African
American and Caucasian men and women who have been participating since
the late 1980s in the large Atherosclerosis Risk in Communities Study.

Benefits of exercise differ by sex and race | Health | Reuters


The key points:

• exercise helps promote health across the races and genders
• there are differences which are significant
• mild to moderate exercise decreased triglycerides only in white people
• increased activity reduced LDL in women but not men

Why so much variation ? No one knows. These are new results which might be contradicted by later research. This particular study used questionnaires which obviously depend upon the honest of participants.

What I've learned this month: Kidney Stones; Osteoporosis; Prostate Cancer; Calcium intake

Kidney Stones and how to prevent them forming.

I have a kidney stone but the doctor is certain that it's old and will probably never descend. I think he really meant that it will never come down but he was being careful just in case the unexpected happens.

The Mayo Clinic Health Letter, September 2009, has the happy line that "you wont soon forget the pain of first passing your first kidney stone." Then it goes on to mention there's a 50% chance that you'll pass another one within 10 years !



What to do ? Prevention strategies concentrate on reducing calcium, uric acid and maybe oxalate in the urine.

• Drink a lot of fluid - 12 cups a day (preferably water)
• Reduce meat eating to less than 8 ounces a day
• Reduce sodium in your food

Now we come to the tricky parts:

• Vitamin D, which I take to help deal with osteoporosis, can increase the risk for kidney stones, if your body is predisposed to making calcium kidney stones.
• If your stones are of the calcium oxalate type then limiting oxalate containing foods is worth thinking about. We are talking about spinach, beets, peanuts, potatoes and chocolate. Of course, all of these are also a good way of increasing calcium intake to address any osteoporosis issues.
• Getting calcium up in your diet helps reduce oxalate absorbed in the intestine because calcium bind to oxalate in the intestine and blocks oxalate absorption.
  
• I get my calcium up via Greek yogurt and calcium citrate tablets. I also think that calcium citrate is easier to absorb if one is also taking a Proton Pump Inhibitor, such as Omeprazole like me, rather than calcium carbonate.

What about Prostate Cancer and Calcium ?
Always a cheery topic !

September, 2009 edition of Nutrition Action was, as usual, stuffed full of interesting bits but the piece starting "What can men do to lower their risk of prostate cancer ? 'Avoid high milk intake' says Harvard's Walter Willett" caught the eye.

The NIH and AARP study tracked milk drinkers for 6 years. The study found no link between prostate cancer and consumption of whole milk or non-fat milk or yogurt or cheese. However the study found that men who drank at least 2 cups of skim-milk a day had a 23% higher risk of advanced prostate cancer than those who drank no skim milk. Strange in the extreme.

So how might milk increase or encourage prostate tumors ?

One theory is that it's connected to IGF-1 (Insulin-like Growth Factor). Milk increases it and it's possible that higher levels of IGF-1 is related to more aggressive prostate cancer tumors. So why milk and not yogurt or cheese ? The theory is that the fermentation leading to both cheese and yogurt denatures IGF-1. Of course it might be the calcium. Excess calcium might account for the higher prostate cancer risk.

The Health Professional Follow-up Study tracked 47,000 men for 16 years and found that those who took in more than 2,000 mg a day of calcium had a risk of fatal prostate cancer 2 1/2 higher than those who took in less than 750 mg a day of calcium.

So what have I learned so far this month ?

Dealing with Acid Reflux (GERD) with a Proton Pump Inhibitor like Omeprazole might have lead to osteoporosis. Dealing with osteoporosis with higher calcium intake might, over time, lead to prostate cancer.

Somehow the chain has to be broken. At the moment I'm getting my supplemental calcium up to around 1,200 mg a day and getting all (nearly) all my dairy intake from yogurt and cheese. Normally I don't drink milk of any kind.

What I've Learned this month: Kidney Stones;Prostate Cancer; Omega-3 fish; Lactate Threshold Training.

Kidney Stones and how to prevent them forming.

I have a kidney stone but the doctor is certain that it's old and will probably never descend. I think he really meant that it will never come down but he was being careful just in case the unexpected happens.

The Mayo Clinic Health Letter, September 2009,  has the happy line that "you wont soon forget the pain of first passing your first kidney stone." Then it goes on to mention there's a 50% chance that you'll pass another one within 10 years !

What to do ? Prevention strategies concentrate on reducing calcium, uric acid and maybe oxalate in the urine.

• Drink a lot of fluid - 12 cups a day (preferably water)
• Reduce meat eating to less than 8 ounces a day
• Reduce sodium in your food

Now we come to the tricky parts:

• Vitamin D, which I take to help deal with osteoporosis, can increase the risk for kidney stones, if your body is predisposed to making calcium kidney stones.
• If your stones are of the calcium oxalate type then limiting oxalate containing foods is worth thinking about. We are talking about spinach, beets, peanuts, potatoes and chocolate. Of course, all of these are also  a good way of increasing calcium intake to address any osteoporosis issues.
• Getting calcium up in your diet helps reduce oxalate absorbed in the intestine because calcium bind to oxalate in the intestine and blocks oxalate absorption.
  
• I get my calcium up via Greek yogurt and calcium citrate tablets. I also think that calcium citrate is easier to absorb if one is also taking a Proton Pump Inhibitor, such as Omeprazole like me, rather than calcium carbonate.
  

What about Prostate Cancer and Calcium ?
Always a cheery topic !

September, 2009 edition of Nutrition Action was, as usual, stuffed full of interesting bits but the piece starting "What can men do to lower their risk of prostate cancer ? 'Avoid high milk intake' says Harvard's Walter Willett" caught the eye.

The NIH and AARP study tracked milk drinkers for 6 years. The study found no link between prostate cancer and consumption of whole milk or non-fat milk or yogurt or cheese. However the study found that men who drank at least 2 cups of skim-milk a day had a 23% higher risk of advanced prostate cancer than those who drank no skim milk. Strange in the extreme.

So how might milk increase or encourage prostate tumors ?

One theory is that it's connected to IGF-1 (Insulin-like Growth Factor). Milk increases it and it's possible that higher levels of IGF-1 is related to more aggressive prostate cancer tumors.

So why milk and not yogurt or cheese ?

The theory is that the fermenation leading to both cheese and yogurt denatures IGF-1.

Of course it might be the calcium. Excess calcium might account for the higher prostate cancer risk. The Health Proffessional Follow-up Study tracked 47,000 men for 16 years and found that those who took in more than 2,000 mg  a day of calcium had a risk of fatal prostate cancer 2 1/2 higher than those who took in less than 750 mg a day of calcium.

So what have I learned so fat this month ? Dealing with Acid Reflux (GERD) with a Proton Pump Inhibitor like Omeprazole might have lead to osteoporosis. Dealing with osteoporosis with higher calcium intake might, over time, lead to prostate cancer.

Somehow the chain has to be broken. At the moment I'm getting my supplemental calcium up to around 1,200 mg a day and getting all (nearly) all my dairy intake from yogurt and cheese. Normaly I don't drink milk of any kind.