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By Jackie Khor

20 September 2011

Whatever condition and disease you study, Vitamin D keeps coming up as a major factor. Vitamin D is an essential nutrient that plays multiple roles in human health.

Vitamin D in calcium metabolism and bone health is well recognized but more recently, its role in cardiovascular health, immune function, glucose metabolism, and cell differentiation and proliferation have been defined.

It is well established that vitamin D deficiency leads to rickets in developing children but more current research has also linked vitamin D deficiency with osteoporosis, osteomalacia, impaired muscle function, infection, autoimmune disorders, diabetes, and some cancers in adults. Thus, achieving optimal vitamin D status throughout life is essential to maintaining overall health.

Vitamin D is unique among other vitamins, in that very little is obtained through a normal diet. The principal source of circulating vitamin D is endogenous production in the skin following exposure to sunlight. Thus, factors that limit sun exposure and/or endogenous vitamin D synthesis greatly reduce circulating vitamin D concentrations. Some of these factors include geographic latitude, season of the year, melanin content of the skin, use of sunblock, lack of outdoor activity, age, and more. Any of these factors, among others, can lead to chronic vitamin D deficiency.

Deficiencies of vitamin D are common. It is currently estimated that more than 1 billion people worldwide and 30-to-40% of the population between 15 and 49 years of age in the United States suffer from vitamin D deficiency. Consensus is building that adequate circulating vitamin D concentrations should be greater than 30 ng/mL and optimally above 50 ng/mL (7-10). Because relatively small amounts of vitamin D are obtained through the diet and so many lifestyle factors reduce endogenous vitamin D synthesis, supplementation becomes an important avenue for achieving and maintaining optimal vitamin D status. It has been shown that 100 IU of vitamin D per day increases circulating concentrations of vitamin D by ~1 ng/mL (7-10). Thus, supplementation with advanced doses of vitamin D (2000-4000 IU/day) depending on lifestyle, are required to reverse vitamin D deficiency, boost vitamin D levels into the optimal range, and maintain them thereafter.

There are several forms of vitamin D including D1, D2 and D3. You want to take D3 (calciferol). Vitamin D3 is converted in our bodies to the active form which is dihydroxy vitamin D. Doctors and pharmaceutical corporations keep promoting dangerous, synthetic, expensive, prescription only analogs of vitamin D. These can be patented and not sold over the counter. It is important not to take too much D3 as it is oil soluble, toxic in excess, and can result in side effects. Since you can’t get any meaningful amounts in common foods, this is not a problem at all.

Remember how popular cod liver oil has been for decades now? This is really because of the vitamin D content. People often really do get dramatic results from simply taking a spoonful of cod liver oil. This is because they are getting the vitamin D they need so badly. Of course, taking a multivitamin of inexpensive 400 IU vitamin D supplement is a much more practical and tasty way to do this.

There are many reasons we suffer from so many diseases and conditions in the richest country in the world with the highest standard of living. One important and proven reason is lack of vitamin D in most people. Study after study shows people of all ages in most countries are deficient in vitamin D by blood analysis. This is especially true of the poor and the elderly. Along with your multiple vitamin just take an extra 400 IU capsule of inexpensive vitamin D when you’re not getting out in the sun regularly. No matter how well you eat you aren’t going to get any significant amount in your diet.

The science behind this is just overwhelming. People of all ages should take it. The international published science here is endless and growing. Vitamin D deficiency is a worldwide epidemic.

Health authorities worldwide have uniformly stressed the importance of diet and lifestyle as the primary means of lowering serum lipids and coronary heart disease (CHD) risk.  Combining foods with known cholesterol-lowering properties can help to reduce serum cholesterol effectively under metabolically controlled conditions.

To assess the effect of a dietary portfolio on percentage change in low-density lipoprotein cholesterol (LDL-C), Canadian researchers conducted a parallel-design study of 351 participants with
Hyperlipidemia, from 4 participating academic centers across Canada randomized between June 2007 and February 2009.

Participants received dietary advice for 6 months on either a low-saturated fat therapeutic diet (control) or a dietary portfolio that emphasized dietary incorporation of plant sterols, soy protein, viscous fibers, and nuts. Routine dietary portfolio involved 2 clinic visits over 6 months and intensive dietary portfolio involved 7 clinic visits over 6 months.

The study found that Percentage LDL-C reductions for each dietary portfolio (13%) were significantly more than the control diet (3%).  A diet rich in soy, fibre, plant sterol, and nuts did better at lowering levels of LDL than a diet low in saturated fats such as low fat dairy, suggesting that certain cholesterol-friendly foods can be more effective in lowering levels of LDL, or ‘bad cholesterol’ than foods merely low in saturated fats.

Dr. David Jenkins, the lead author concludes that “This study indicated the potential value of using recognized cholesterol-lowering foods in combination”.  Such dietary approach may have clinical application, and clinicians may consider recommending to patients.

David J. A. Jenkins et al; JAMA August 2011; Vol 306(8): 831-839

A new study from Spain discusses the heart health potential of hydroxytyrosol, an olive extract possibly effective at reducing levels of oxidized LDL cholesterol.

In a recent study, supplementing with hydroxytyrosol – a polyphenolic compound extracted from olives – correlated with higher activity levels of the enzyme arylesterase, an antioxidant biomarker, and lower levels of oxidized LDL cholesterol. Oxidized LDL is believed to be a major player in promoting atherosclerosis (the build-up of fatty plaques in arteries) and general cardiovascular disease.

Hydroxytyrosol is thought to be the main antioxidant compound in olive fruit, and it is believed to play a significant role in many of the health benefits attributed to olive oil. Previous research has linked the compound to cardiovascular benefits, typically reductions in LDL or “bad” cholesterol.  Data has also suggested the compound may boost eye health and reduce the risk of macular degeneration.

Spanish researchers reported these most recent results in the British Journal of Nutrition.  Twenty-two healthy volunteers between 20 and 45 years of age and with a BMI between 18 and
33 kg/m2 were recruited. Volunteers were randomly assigned to receive 10 to 15 grams per day of hydroxytyrosol-enriched sunflower oil or non-enriched sunflower oil for three weeks. The former provided a daily hydroxytyrosol dose of between 45 and 50 mg. After the initial three week period, volunteers had two weeks of no intervention before crossing over to receive the other intervention.

Results showed no changes in total, LDL, or HDL-cholesterol between the groups. However, consumption of the hydroxytyrosol-enriched sunflower oil produced significant reductions in oxidised LDL from 79.8 units per liter at the start of the study to 64.1 U/l after three weeks, compared to an increase from 72.7 to 86.4 U/l during the control phase. Furthermore, the activity of arylesterase increased from 235.2 to 448.9 U/l during the hydroxytyrosol phase, compared with an increase from 204.1 to 310.3 U/l during the control phase.

The researchers reported that although hydroxytyrosol-enriched sunflower oil did not significantly reduce LDL-cholesterol or increase HDL-cholesterol, it acted as a functional food by increasing
arylesterase activity and reducing oxidized LDL.  Based on these results, dietary sources of hydroxytyrosol appear to be capable of reducing certain risk factors associated with coronary artery disease.

Vazquez-Velasco M, et al. Br J Nutr; 11 May 2011; 105(10):1448-52.

Elderly and critically ill people are more likely to have lower energy intakes and lower intakes of important micronutrients.  Ensuring optimal nutrition is very important in promoting the health and well-being of older adults.

A latest study published in the July 2011 issue of Nutrition assessed the effects of micronutrient supplementation on adults recovering from critical illness. Primary outcomes included clinical endpoints (mortality, infectious complications, length of intensive care unit and of hospital stay). Secondary outcomes included descriptions of practice issues, micronutrient status, morbidity, course of the acute-phase response, and oxidative stress.

Thirty-three randomized-controlled trials were included for the primary and secondary objectives.  Fourteen trials (n = 1468) showed a statistically significant decrease in overall mortality. Six RCTs (n = 1194) indicated a statistically significant decrease in 28-d mortality. Micronutrient supplementation was not associated with a decrease in infectious complications, length of intensive care unit, or length of hospital stay. In subgroup analyses, a sensitivity analysis of combined micronutrients indicated a significant decrease in mortality. The secondary outcomes confirmed that timing, duration, and dosing of supplementation appear to be key factors to ensure optimal clinical benefit.

The study authors conclude that there is a potential benefit of micronutrient supplementation in critically ill adults by possibly being associated with a decrease in mortality.

Janicke Visser et al; July 2011 Vol 27 (7):745-758

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