by Ian Wishart
The argument that vitamin D had special powers gained weight from another study, a randomised controlled trial of vitamin D over a four year period, which found a dramatic decrease in cancers amongst those who were given 1,110 IU (international units) of vitamin D3 each day, compared to those on a placebo.
The study followed 403 women from Nebraska, and measured them against a control group of 206 on placebo. After the trial, the vitamin D users had 77% fewer cancers than placebo users.[5]
While the debate about supplementation vs sunbathing, or even a combination of both, is ongoing, the message that vitamin D appears to lower cancer risk is clear.
Of course, as with all things, there is a trade-off between increasing sun exposure for your family’s health, and increasing the risk of skin cancer. But the numbers tell the story: In 2004, 7,900 Americans died of melanoma. On the flip side of that coin and using the above data, 45,000 Americans are believed to have died from cancers that they could have survived or avoided with greater exposure to the sun. In other words, you may be nine times more likely to die from cancer caused or aggravated by a lack of sunlight, than you are from skin cancer caused by sunlight.
A 2009 report delivered to the Canadian government estimated that if vitamin D levels were increased across the board, 37,000 fewer people would die prematurely in Canada each year as a result of avoidable disease, saving taxpayers some $14 billion annually and saving an enormous amount of family grief.[6]
Yet the extent of vitamin D deficiency is actually huge. A telltale sign is the huge rise in the number of cases of rickets – a disease thought vanquished in the early 20th century – across the world. Characterised by bone deformities, children and babies can also suffer seizures. Hospital emergency departments in London, New York, Sydney and Auckland are routinely seeing children with rickets now.
Low vitamin D levels are the cause. A study of inpatients at Boston’s Massachusetts General Hospital found 57% had vitamin D levels in the blood that were deficient.[7] Thirty one percent of Australians are in the same boat.[8] Even in Melbourne and Adelaide at the end of summer, 42% of women and 27% of men were vitamin D deficient. Given the Aussie summer sun, they shouldn’t have been.
As vitamin D researcher Cedric Garland announced to the world, getting people to spend 15 minutes a day in the sun without sunscreen could save ten lives from cancer alone, for every extra skin cancer death caused by increased sun exposure.
It was this kind of information that caused doctors the world over to sit up and think: was the message on staying sun-safe the wrong message? Had the pendulum of caution swung too far, to the point where it was causing more cancers in other areas? What exactly was the link between vitamin D and cancer mortality? Why was melanoma not nearly as fatal in New Zealand and Australia, despite the strongest UV radiation in the world?
Could it be that the sunshine vitamin held secrets essential to life, secrets only now being unlocked?
[1] “Gray area” by Ken Marcella, D.V.M,
http://www.horses-and-horse-information.com/articles/0701melanoma.shtml
[2] There are two primary forms of vitamin D. Ergocalciferol, known as vitamin D2, is obtained from food sources. Cholecalciferol, or vitamin D3, is produced when sunlight strikes your skin and converts cholesterol to a fat-soluble compound.
[3] “Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure,” Moan et al, Proceedings of the National Academy of Sciences, PNAS January 15, 2008 vol. 105 no. 2 668-673. http://www.pnas.org/content/105/2/668.long
[4] “Diagnosis and treatment of vitamin D deficiency”, Cannell et al, Journal of Expert Opinion in Pharmacotherapy, 2008, 9(1):1-12
[5] “Vitamin D and calcium supplementation reduces cancer risk,” Lappe et al, American Journal of Clinical Nutrition, 2007, 85(6):1586-91
[6] “An estimate of the economic burden and premature deaths due to vitamin D deficiency in Canada,” Grant et al, Mol. Nutr. Food Res. 2010, 54, 1172–1181, http://www.vitamindsociety.org/pdf/Grant%202010%20-%20vitamin%20D%20deficiency%20in%20Canada.pdf
[7] “Diagnosis and treatment of vitamin D deficiency,” Cannell et al, Expert Opinion in Pharmacotherapy, 2008 9(1), citing “Hypovitaminosis D in medical inpatients,” Thomas et al, New England Journal of Medicine, 1998; 338(12):777-83
[8] “Prevalence of vitamin D deficiency and its determinants in Australian adults etc,” Daly et al, Oxford Journal of Clinical Endocrinology, 2012 Jul; 77(1):26-35
CHAPTER 2
ALZHEIMER’S CURSE
“We hypothesize that good vitamin D levels might prevent or mitigate the disease”
– Associate Professor of Geriatrics Robert Przybelski, 2007
One of the early studies to show promise involved the mental deterioration of Alzheimer’s. It’s a shocking, debilitating disease, for which no cure exists. Once diagnosed, sufferers are usually dead after seven years, and only little more than two percent are alive by 14 years.
Around one in fifty people aged up to 64 suffer Alzheimer’s, jumping to around one in five people between the ages of 75 and 84, and nearly one in two people aged 85 and over. In other words, if you managed to rack up your allotted three-score years and ten, there’s nearly a fifty-fifty chance Alzheimer’s will come for you.
The disease degenerates your mind, starting slowly with a little bit of fuzziness around the edges, then gradually robbing you of short and medium term memory until you reach the final stages where you are talking with fairies, dribbling from both sides of your mouth and needing around the clock nursing and toilet care.
The spectre of Alzheimer’s haunts Baby Boomers and Gen-Xers so much that its one of the driving forces behind pleas to introduce voluntary euthanasia. “Kill me if I get Alzheimer’s,” they beg. Well, there might be a better option.
When a small observational study by University of Wisconsin researchers was published online in January 2007 showing a significant association for the first time between low levels of vitamin D in the blood of Alzheimer’s patients and poor performance on a cognitive test, people’s ears pricked up.
The study was prompted after family members of the Alzheimer’s patients reported how well they were performing and acting within weeks of being put on large doses of prescription vitamin D, said lead author Robert Przybelski, an associate professor of geriatric medicine at the University of Wisconsin.
“We hypothesize that good vitamin D levels might prevent or mitigate the disease,” Przybelski said.[1]
The study noted that neurons, like many other cells, have vitamin D receptors. It says vitamin D might enhance levels of important brain chemicals and that it also might help protect brain cells.
That was 2007. Rapidly, researchers moved into overdrive. Could vitamin D not only improve the minds of Alzheimer’s sufferers, but perhaps even help stave it off?
A Boston based study published 2008 examined more than a thousand “elders” – people aged 65 to 99 – for their performance in cognitive mental function tests, relative to their vitamin D blood serum levels.
To understand a lot of the research presented in this book, you’ll need to become familiar with different scientific descriptions of the same thing. In this case, blood serum of vitamin D, usually grouped under the name “25(OH)D”, is measured relative to its volume in blood.
So far, so good. The scientists however use two different measuring systems and you will find different studies use one or the other. One is expressed as nanograms per millilitre, or “ng/ml”. The other rival way of expressing this is nanomoles per litre, “nmol/L”, but the numbers are not identical. Multiply ng by 2.5 and you’ll get the nmol figure. For rule of thumb purposes, I’ve set out below the two different scales of blood serum vitamin D measurement. Come back to this conversion chart for further reference if you need to:[2]
Ideal Vitamin D Level Insufficient Level[3] Deficient Level Seriously Deficient Level
125 – 200 nmol/L <75 nmol/L <50 nmol/L <25 nm
ol/L
50 – 80 ng/ml <30 ng/ml <20 ng/ml <10 ng/ml
It’s worth noting that 50 ng/ml is the natural blood level of vitamin D often found in people who’ve worked outside over summer, as humans have done for millennia. Armed with that, we return to the Boston study.
Sixty-five percent of the “elders” had 25(OH)D levels below 50 nmol/L, putting them into the seriously insufficient category. Eighteen percent were listed as deficient, with less than 25 nmol/L.
Adjustments in the analysis were made for age, sex, race, body mass index, education, residence area, kidney function, seasonality, physical activity, and alcohol use. Even after all that, the elders with higher vitamin D levels scored significantly higher in tests including “trails…digit symbol…matrix reasoning…block design”.
The analysts dug deeper, adjusting for possible interference from other hormones in the system, B vitamins or multivitamin use. Despite all of that, people with the highest levels of vitamin D still emerged the winners.[4]
A European study of healthy men aged 40+ found a similar link between low vitamin D levels and slower mental skills.
“In this population-based study of European men aged ≥ 40 years we observed a significant, independent association between a slower information processing speed (as assessed by the DSST test) and lower levels of 25(OH)D. The association appeared strongest among those with a 25(OH)D level less than ~35 nmol/L.[5]
“Although the magnitude of the association between 25(OH)D and processing speed was comparatively small, if cognitive function can be improved by a simple intervention such as vitamin D supplementation, this would have potentially important implications for population health.”
In other words, if you want to keep your wits about you, vitamin D is crucial.
A 2011 study in Turkey of 125 geriatric patients found elderly people who took summer walks in the sun were 73% more capable of scoring highly in cognitive tests.[6]
By May 2011, researchers had well and truly realised they were onto something.
“There is evidence that the vast majority of hospitalised patients have vitamin D deficiency. Vitamin D deficiency is a poorly-recognised pandemic…”[7]
A lack of vitamin D, they warned, was turning out to be one of the biggest canaries in the mineshaft in the entire health system.
What scientists had found is that the human body is full of what we now know are “vitamin D receptors”, or VDRs. These are docking bays where the body is designed to receive vitamin D, docking bays which for the last century we’d evidently forgotten how to use. The less of the vitamin we obtained, the more our bodies began to break down, and the greater the cost of treating us in the health system.
The benefits of vitamin D as listed by Youssef and his team included “antimicrobial and immunomodulation effects”, which is geek-speak for germ-killing and immune system stimulation, “as well as benefits on cardiovascular health, autoimmune disease, cancer and metabolism. Vitamin D deficiency increases mortality [kills you sooner] and even a modest amount of vitamin D may enhance longevity.”
In a study published March 2012, the health files of 498 elderly women were examined in the French city of Toulouse, to determine whether their vitamin D status was an accurate predictor of how quickly they would succumb to Alzheimer’s Disease or, as they described it, “an independent predictor of the onset of dementia within seven years among women aged 75 years and older.”[8]
The sample group was assessed at the end of seven years and split into three: those with no dementia; those with Alzheimer’s Disease; those with other dementias. They had all been tested and questioned at the start of the seven year trial, and their scores (described in the literature as “baseline results”) noted down.
Of the nearly 500 women, 70 were Alzheimer’s sufferers by the end of it, and that group had the lowest vitamin D levels.
The twenty percent of women who had the highest vitamin D levels had a 77% lower risk of developing Alzheimer’s during the seven years, compared with the 80% of women with lower vitamin D, leading to an inescapable study conclusion: “Higher vitamin D dietary intake was associated with a lower risk of developing Alzheimer’s Disease among older women”.
Attention has turned to “how” and “why” questions. What is it about vitamin D that assists in warding off one of the most dreaded incurable disorders known to man? In April 2012 a British team from the University of Exeter reported:[9]
“The role of vitamin D in skeletal health is well established, but more recent findings have also linked vitamin D deficiency to a range of non-skeletal conditions such as cardiovascular disease, cancer, stroke and metabolic disorders including diabetes.
“Cognitive impairment and dementia must now be added to this list. Vitamin D receptors [VDRs] are widespread in brain tissue, and vitamin D’s biologically active form, 1,25(OH)2D3, has shown protective effects including the clearance of amyloid plaques, a hallmark of Alzheimer’s Disease.”
Noting that “the risk of cognitive impairment” was “four times greater” in people with vitamin D levels below 25 nmol/L, when compared with those at minimum adequate levels of 75 nmol/L, the study’s lead author Maya Soni goes on to link vitamin D’s effect on dementia with the seemingly related fact that people with low levels are also more likely to suffer serious brain bleeds “and fatal stroke”.
It is the “clearance of amyloid plaques, a hallmark of Alzheimer’s”, that is now one of the focal points for researchers. The next paragraph is slightly technical, but given your odds of developing Alzheimer’s down the track and turning into a household vegetable, what follows could be very important to you.
A just published study in the Journal of Alzheimer’s reports that vitamin D is able to not just neutralise, but to actually “recover” damaged brain function:
“Brain clearance of amyloid-ß (A ß42) by innate immune cells is necessary for normal brain function. Phagocytosis [eating of] soluble A ß42 by Alzheimer’s Disease (AD) macrophages is defective, recovered in all ‘Type I and Type II’ AD patients by 1∂,25(OH)2-vitamin D3 (1,25D3) and blocked by the nuclear vitamin D receptor [VDR]…”[10]
I could go on, but clearly you get the picture: “The structure-function results provide evidence that 1,25D3 activation of VDR-dependent genomic and non-genomic signalling, work in concert to recover dysregulated innate immune function in Alzheimer’s Disease.”
Another study has found that a genetic fault in one of the brain’s key vitamin D receptors is associated with a higher risk of developing Alzheimer’s. “We provide both statistical evidence and functional data suggesting VDR confers genetic risk for AD. Our findings are consistent with epidemiology studies suggesting that vitamin D insufficiency increases the risk of developing Alzheimer’s Disease.”[11]
If you want to keep your mental clock ticking, then, and lower your risks of Alzheimer’s in years to come, it appears vitamin D may be the ingredient you need. But it’s not just the middle-aged or elderly at risk from a vitamin D deficiency.
[1] “Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function,” Przybelski RJ, Binkley NC, Archives of Biochemistry & Biophysics, 2007 Apr 15;460(2):202-5. Epub 2007 Jan 8
[2] “Ideal Level” is recommended by the Vitamin D Council. The remaining levels are those defined by health agencies. Many agencies are now beginning to realise “deficiency” may actually set in where “insufficiency” currently sits. This will become obvious to you as you read some of the study results.
[3] The abbreviation < represents “less than or equal to”, for those who have long forgotten the intricacies of school maths. The opposite is ‘greater than’.
[4] “Vitamin D Is Associated With Cognitive Function in Elders Receiving Home Health Services,” Buell et al, Journals of Gerontology, J Gerontol A Biol Sci Med Sci (2009) 64A (8): 888-895. doi: 10.1093/gerona/glp0
[5] “Association Between 25-Hydroxyvitamin D Level
s And Cognitive Performance In Middle-Aged And Older European Men,” Lee et al, Journal of Neurology, Neurosurgery & Psychiatry 80, 7 (2009) 722
[6] “Predictors of clock drawing test (CDT) performance in elderly patients attending an internal medicine outpatient clinic: A pilot study on sun exposure and physical activity”, Aydin et al, Archives of Gerontology and Geriatrics, Volume 52, Issue 3, May–June 2011, Pages e226–e231
[7] “Vitamin D deficiency: implications for acute care in the elderly and in patients with chronic illness,” Youssef et al, Geriatrics & Gerontology International, Vol 11, issue 4, Oct 2011:395-407
[8] “Higher Vitamin D dietary intake is associated with lower risk of Alzheimer’s Disease: a 7-year follow-up,” Annweiler et al, Journals of Gerontology, first published online April 13, 2012, doi: 10.1093/Gerona/gls107
[9] “Vitamin D and cognitive function,” Soni et al, Scandinavian Journal of Clinical and Laboratory Investigation, April 2012, Vol. 72, No. S243:79-82
[10] “Genomic and nongenomic signalling induced by 1ℓ,25(OH)2-vitamin D3 promotes the recovery of Amyloid-ß etc,” Mizwicki et al, Journal of Alzheimer’s Disease, Vol. 29, Issue 1 2012:51-62
[11] “Vitamin D receptor and Alzheimer’s Disease: a genetic and functional study,” Wang et al, Neurobiology of Aging, Vol. 33, Issue 8:1844e1-1844e9, August 2012
CHAPTER 3
AUTISTIC SPECTRUM DISORDERS
“The apparent increase in the prevalence of autism over the last 20 years corresponds with increasing medical advice to avoid the sun”
– Dr John Cannell, Vitamin D Council, 2008
Twenty-five years ago, your chance of giving birth to an autistic-spectrum child was somewhere north of 1:1800. Today, it’s as low as 1:60. For a long time, researchers suspected the culprit was vaccination, and in particular the Measles, Mumps, Rubella (MMR) vaccine introduced for worldwide use in the 1980s. Further studies, however, have failed to find a conclusive link to the vaccine.