Vitamin D- Is This the Miracle Vitamin

by Ian Wishart

  This jargon, in policy documents for doctors and the media, implies – whether intentionally or not – that New Zealand’s vitamin D problem isn’t all that bad. The New Zealand news media probably don’t appreciate the subtle nuances in the jargon, and simply assume that when Ministry of Health says only 10% of New Zealand children are vitamin D “deficient”, that this is based on an equivalent scale to that used overseas. Unfortunately, it is not.

  Qatari health authorities, for example, say children with “less than 20 ng/ml vitamin D were deemed deficient”, yet NZ bureaucrats call a level half that – 10 ng/ml – only “moderately deficient”.[4]

  It is as if you can pretend an epidemic does not exist by inventing your own definitions of deficiency that bear no relation at all to international best practice or the latest research data. In sunny Qatar they found 36% of children deficient in vitamin D. In cooler, cloudier New Zealand we’re told only 10% of kids are “deficient”.

  Pressure from independent media reports on vitamin D in 2005, and again in early 2008, led to New Zealand’s Ministry of Health and the Cancer Society issuing a joint position statement. Whilst acknowledging that sun exposure has benefits for vitamin D absorption, and recommending that people get sun exposure outside peak hours in summertime and during peak hours in winter, the two organisations ultimately threw their hands in the air and kicked for touch:[5]

  “Vitamin D is a hormone with receptors located in organ tissues throughout the body. Recent research suggests possible beneficial effects of exposure to solar UVR in the prevention or improvement in outcome of treatment for a number of other diseases including breast, prostate and colorectal cancer, non-Hodgkin lymphoma, diabetes, autoimmune disease (eg, multiple sclerosis) and hypertension.

  “Although vitamin D may be a contributing factor to disease risk reduction for these conditions, it is not clearly known whether there are factors, other than vitamin D, which may play an important role.

  “There is insufficient evidence to assume that vitamin D supplementation and sun exposure are equivalent in their beneficial effects. Therefore, at this time, no definitive action can be taken on these findings nor any recommendations made, as further research is required.”

  That was 2008. Most of the studies you have read about in this book were published after that. A fair and reasonable reader might well say the jury is well and truly in. So it was with some surprise that in their revised position statement of 2012 the two agencies state:[6]

  “A rapidly-growing body of evidence has identified an association between low vitamin D levels and non-skeletal health outcomes such as colorectal cancer, cardiovascular disease, auto-immune conditions and all-cause mortality, but so far there is no evidence of a causal role (Institute of Medicine 2011).

  “In the absence of convincing evidence from intervention trials, there is no basis for their inclusion in public policy at present.”[7]

  So, based on the discredited thinking of the bureaucrats at the Institute of Medicine, New Zealand is still kicking for touch. Readers can judge for themselves whether the science quoted in this book is convincing enough to justify boosting their own vitamin D levels.

  The Consensus Statement[8] still refuses to admit that its vitamin D intake recommendations are themselves “seriously deficient”.

  Most of the scientific and medical studies you’ve read have revealed a sliding scale of health benefits – the more vitamin D in the blood, the better the survival or immunity outcome. Some of the blood levels to achieve that have been as high as 80 ng/ml (200 nmol/L).

  Despite that, the Consensus report says:

  “Some international policy statements on vitamin D have defined an adequate serum 25(OH)D level as 50 nmol/L [just 20 ng/ml] and over (Institute of Medicine 2011; American Academy of Dermatology and AAD Association 2010)...

  “There is also variation in the use and definition of the terms ‘adequate’, ‘sufficient’ and ‘optimal’ due to a lack of evidence. Based on the knowledge available, it is not possible to determine an optimal status level, but aiming for a 25(OH)D level of 50 nmol/L or more seems prudent.”

  The politics behind it can be seen in the experts the Ministry of Health and the Cancer Society chose to quote in regard to “adequate” levels of vitamin D: “Institute of Medicine 2011; American Academy of Dermatology and AAD Association 2010”.

  There are thousands of scientists, doctors and medical researchers more qualified to comment on vitamin D adequacy than the Dermatology Association. The Institute of Medicine report received such a kicking from 14 vitamin D experts invited to peer review it that their criticisms were suppressed, which speaks volumes as to the IOM’s integrity and the NZ Ministry of Health’s reliance on it.

  New Zealand’s Ministry of Health would have you believe that only 4.9% of New Zealand adults are ‘deficient’ in vitamin D, and only 0.2% are ‘seriously deficient’. A further 27.1% of adults in 2008 “were below recommended levels but did not have a deficiency”.[9]

  It is not until you read the New Zealand definitions that you see how dangerous such Orwellian Newspeak can be. While this book is full of peer reviewed scientific studies listing ‘serious deficiency’ as less than 10 ng/ml, New Zealand defines serious as 5 ng/ml or less. From 5 ng/ml to 9.99 ng/ml is defined in New Zealand as “mild to moderate deficiency”. Again, in the rest of the civilised world this is all still seen as “serious deficiency”.

  From 10 ng/ml through to 20 ng/ml, New Zealand calls this “below recommended level but not deficient”. I do hope my journalistic colleagues reading this now realise how badly the New Zealand Ministry of Health has conned them. As you’ve seen in this book, levels below 20 ng/ml are regarded as “deficient” everywhere else in the world. Even New Zealand scientists are using the internationally accepted definitions.[10]

  So if we redefine the Ministry of Health propaganda, what we actually have is 5.1% of New Zealand adults who are ‘seriously deficient’, and a further 27.1% who are ‘deficient’, for a grand total of 32.2% of New Zealanders – one in three of us – who are deficient in vitamin D.

  The average level of vitamin D, for all New Zealand adults, is only 25.2 ng/ml (63 nmol/L), meaning our national average is what the rest of the world calls “insufficiency”.

  One recent study out of the US involving cancer specialists[11] defines vitamin D levels in a way that makes New Zealand’s Ministry of Health appear incompetent:

  “A widely accepted classification is deficiency at <20 ng/ml [50 nmol/L], insufficiency at 20–31 ng/ml [50-77 nmol/L], and an optimal range of ≥32 ng/ml [80 nmol/L].”[12]

  As for the claims that there are no firm scientific studies showing improvements for patients given vitamin D in controlled trials, well that’s a load of old cobblers as well. Every day, reports like this one are making the news internationally:[13]

  A new study from researchers in Boston has found that poorer lung function in asthmatic children, treated with inhaled corticosteroids, is linked with vitamin D deficiency.

  Ann Chen Wu, MD, MPH, assistant professor in the Department of Population Medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute said:

  “In our study of 1,024 children with mild to moderate persistent asthma, those who were deficient in vitamin D levels showed less improvement in pre-bronchodilator forced expiratory volume in 1 second (FEV1) after one year of treatment with inhaled corticosteroids than children with sufficient levels of vitamin D.”

  The study, which was published in American Journal of Respiratory and Critical Care Medicine, used data from the Childhood Asthma Management Program. It was a multi-center trial of asthmatic children between 5 and 12 years of age who were randomly assigned to treatment with nedocromil, budesonide (inhaled corticosteroid), or a placebo. The patients’ vitamin D levels were categorized as deficient (≤ 20 ng/ml), insufficient (20-30 ng/ml), or sufficient (> 30 ng/ml).

  Pre-bronchodilator FEV1 was increased during a treatment period of 12 month
s by 330 ml in the vitamin D insufficiency group that were treated with inhaled corticosteroids. In the vitamin D sufficiency group, kids with the same treatment saw a 290 ml increase, and in the vitamin D deficiency group only 140 ml increase.

  In other words, asthmatic children with higher vitamin D found their medication was more than twice as effective as those with low vitamin D levels. It can’t be true, of course, because the Ministry of Health and NZ Cancer Society say such intervention studies don’t exist.

  Sharp-eyed readers may have noticed that blood levels of 20 ng/ml (50 nmol/L) were deemed as “deficient” in the July 2012 Harvard study, yet that’s the level the Ministry of Health hotshots are trying to convince New Zealanders is a good target to aim for. The level found to actually be “sufficient” in the asthma study is 75 nmol/L, well above the MoH target.

  On the same day as the Harvard study, another news agency reported high vitamin D levels in breast cancer patients are linked to smaller tumours, while deficient levels of vitamin D led to larger tumours:[14]

  The benefits of vitamin D seemed particularly stronger among postmenopausal women with breast cancer. Among postmenopausal breast cancer patients, those with greater than 30 ng of vitamin D3 per mL of blood at diagnosis (75 nmol/L) were 85 percent and 57 percent more likely to survive from the disease and have disease-free interval, respectively, than those who had less than 30 ng per mL.

  The study concluded high vitamin D levels at early breast cancer diagnosis are correlated with smaller tumor sizes and better overall survival odds, and improve breast cancer-specific outcome, particularly in postmenopausal patients.

  The great thing about living in a free country is you can choose who you prefer to believe, the cancer specialists reporting in the journal Carcinogenesis, or the New Zealand Ministry of Health team telling you that 20 ng/ml of vitamin D (50 nmol/L) is perfectly fine and that even less than that is probably sufficient. Please bear in mind however that the MoH choose to receive their advice on adequate vitamin D levels from dermatologists and a sunscreen manufacturer.

  It was a dermatologist who famously said, “science has never proven that a lack of vitamin D causes cancer.”[15]

  To be fair, though, many of the excellent studies quoted in this book have been done by dermatologists, and it’s too easy to tar an entire profession over statements made by a few. British Association of Dermatologists spokeswoman Deborah Mason understands the issue well:

  “Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of vitamin D without unduly raising the risk of skin cancer. The time required to make sufficient vitamin D is typically short and less than the amount of time needed for skin to redden and burn. Regularly going outside for a matter of minutes around the middle of the day without sunscreen should be enough.

  “When it comes to sun exposure, little and often is best, and the more skin that’s exposed, the greater the chance of making sufficient vitamin D before burning.”[16]

  Speaking of sunscreen manufacturers, what of the Cancer Society, an organisation seeking millions of dollars in public donations every year? Cancer kills one in three New Zealanders, yet the needs of the many seem outweighed by the needs of the few and the powerful dermatology lobby group. It is also relevant, in my view, that the Society makes a substantial amount of money from the ‘sunscare’ business, particularly in light of massive questions about the safety and effectiveness of sunscreens.

  In the meantime, thousands of people are dying of preventable disorders, while health bosses continue to focus on a minority cancer that kills only a few people each year, despite the vast numbers who develop it.

  Perhaps what this controversial debate is really about is not skin cancer but ageing. Yes, UV radiation ages skin. In refusing to age gracefully and naturally, in maintaining our battle to retain our youth, we’re now running a serious risk of not ageing at all – not living long enough to age. Staying young. Dying pretty. But dying, nonetheless.

  The overseas, and indeed NZ, research laid out in this book has shown that New Zealand’s official Recommended Daily Intake of only 200IU of vitamin D a day is laughable, ludicrous and decades out of date. Such tiny amounts might be enough to bring rickets under control, but they will do nothing to boost your immune system or lower the risk of heart attack, stroke or cancer. They will certainly do nothing to reduce the risk of autism or numerous other diseases.

  A major New Zealand magazine nonetheless reported in April 2012 that only “very small amounts” of sun exposure are needed to gain protection, “but if you’re worried, you can top up the levels in your diet: oily fish, egg yolks, margarine – cod liver oil if you must.”[17]

  The advice is just wrong, unless of course the magazine really meant “wild-caught fatty fish, sun-dried Shitake mushrooms or reindeer meat,” the latter being in somewhat of a short supply down under. The amount of New Zealand fortified milk a person would have to drink to get the 20,000IU dose equivalent to half an hour in the sun is 500 glasses. The patient would have drowned long before reaching that target.

  “If that doesn’t suit you,” continues the cover story helpfully, “you could take over the counter supplements, although the Ministry of Health says supplements aren’t necessary for people with no specific medical issue or risk factors.”

  Once again, terrible, even deadly advice. The whole point of vitamin D is to be the preventative at the top of the cliff, rather than the last chance medication at the bottom once you’ve already developed a serious illness.

  This is the same Ministry of Health, however, that defines “deficiency” as less than 17.5 nmol/L (8 ng/ml). Contrast this statement from the latest Australian scientific study on deficiency: “Serum 25(OH)D levels of <50 nmol/L (20 ng/ml) were considered vitamin D deficient.”[18]

  New Zealand’s Ministry of Health says only 5% of New Zealanders are “deficient”. In sunny Australia they say its 31%.[19] Under my own reading of the NZ raw data against the Australian definition, 32.2% of New Zealanders are “deficient”. Who is most likely to be right, here?

  It’s also the same Ministry of Health that tells journalists “there is no scientifically validated safe level of UV exposure”, which sounds all serious and official until you wake up, pinch yourself, slap yourself for extra good measure, and realise the sun has been shining on humans since we first walked the earth, and that our bodies are designed to process UV radiation for the greater good of our health.

  If MoH wants to be pedantic, “there is no scientifically validated safe level of exposure” either to the 20,000 pieces of man-made orbital space junk hanging above our heads 24/7, but somehow we survive and death by satellite is a relatively rare misadventure.[20]

  Every breath we take brings us one step closer to death. Every move we make wears out cells and joints. I’m sure a case could be made that we should reduce taking breaths and stay locked inside a safe cocoon. Me? I prefer living.

  To say that humans should avoid the sun is, frankly, unnatural, not to mention unscientific – flying as it does in the face of millions of years of live human trial evidence to the contrary. To say it with a straight face is pure, albeit unintentional, comedy gold. Chicken Little is well and truly in charge of the hen house.

  It is probably time that New Zealand journalists attending Ministry of Health briefings on the vitamin D issue tested what they’re being fed, lest they discover it is the food traditionally used to grow those aforementioned Shitake mushrooms.

  New Zealand’s official state of denial probably has more to do with the incredible power of the dermatology lobby in New Zealand’s health system and the amount of taxpayer money that has been invested in slip, slop, slap at their urging. Cancer specialists, cardiologists, endocrinologists and GPs have largely figured this out now, and instead of fighting Wellington directly they’re simply prescribing large vitamin D supplements and some regular sun as part of routine patient care.

  Vitamin D is so cheap and available, and its bene
fits potentially so vast, that the results are likely to speak for themselves.

  [1] “Sun-shy infants developing rickets’”, NZ Doctor, 14 December 2011

  [2] Ibid

  [3] Or possibly deliberate, given that the US Institute of Medicine has pulled exactly the same stunt.

  [4] “Vitamin D deficiency as a strong predictor of asthma in children,” Bener et al, International Archives of Allergy & Immunology, 2012; 157:168-175

  [5] “Position Statement: The risks and benefits of sun exposure in New Zealand”, Cancer Society et al, August 2008

  [6] “Consensus Statement on vitamin D and sun exposure in New Zealand,” Ministry of Health and Cancer Society of New Zealand, 14 March 2012

  [7] One of the studies New Zealand authorities rely on for the “inconclusive” claim is the Women’s Health Initiative study reported at the start of the Breast Cancer chapter in this book. Because of its size, involving more than 30,000 women, research teams keep dipping into it and proclaiming there’s no link between vitamin D and cancer. But the data sample was fundamentally-flawed, in that the vitamin D dose of 400IU a day has since been shown to be too small to influence cancer. As one research team noted last year, rely on the WHI study at your peril: “The low vitamin D dose provided, limited adherence, and lack of serum 25(OH)D values should be considered when interpreting these findings.” See “The Effect of Calcium plus Vitamin D on Risk for Invasive Cancer: Results of the Women’s Health Initiative (WHI) Calcium Plus Vitamin D Randomized Clinical Trial”, Brunner et al, Nutrition and Cancer Volume 63, Issue 6, 2011

  [8] Beloved of politicians and bureaucrats, “Consensus” is a dirty word in real science. Science works by continuous progression, testing and re-testing. Anything and everything is open to challenge, if it can be proven. “Consensus” is the last refuge of charlatans, because it implies the science is settled when it never can be.