Study: The vitamin D questions: How much do need and how should you get it?

[Editor-in-Chief]

The vitamin D questions: How much do need and how should you get it?

by Deon Wolpowitz, MD, PhD, and Barbara A. Gilchrest, MD

Read the 17 page report (PDF)

Warning: it is biased anti-UV and pro-supplements.

[Editor-in-Chief]

February 2, 2006



Comments on:

Wolpowitz D, Gilchrest BA. The vitamin D questions: how much do you need and how should you get it? J Am Acad Dermatol. 2006 Feb;54(2):301-17.



By William B. Grant, Ph.D.

SUNARC

San Francisco, CA 94109-2529

USA

www.sunarc.org



The abstract of the paper by Wolpowitz and Gilchrest states: “The goal of this review is to provide a detailed, balanced, and referenced discussion of the complex literature underlying the current popular interest in vit D and sun exposure for the purpose of increasing vit D photosynthesis.” However, on p. 308 we find “Selected epidemiologic data suggest an inverse correlation between solar UVB exposure and mortality from several cancers…” Thus, the balanced review of the literature promised in the abstract gives way to a selected review seen through the filter of dermatologists whose mission in life it is to save people from skin cancer.



What should be done is first, examine the evidence regarding the role of vitamin D in health and disease and determine the dose response relations such as was done recently for colorectal cancer [Gorham et al., 2005]. Second, determine the serum 25-hydroxyvitamin D levels of the population of a state or country. Third, a review of the sources of vitamin D should be conducted, including diet, solar UVB, and supplements. Fourth, establish policies to improve the population vitamin D levels in a manner that is most consistent with realizing optimal health for the lifestyle and geographic location. As is evident from the literature, solar UVB irradiance is not always available and solar UV irradiance (more the UVA than the UVB) carries with it the risk of skin cancer, many countries do not fortify enough food with vitamin D, and supplements are often hard to obtain or inconvenient to take. Thus, hard analysis and decisions are required to bring populations up to optimal vitamin D levels.



For those who are interested, here are a few recent papers on UVB, vitamin D and optimal health. Abstracts can be found at PubMed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?



Selected references supporting the UVB/vitamin D/optimal health hypothesis overlooked by Wolpowitz and Gilchrest:



Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C, Barnhill R. Sun exposure and mortality from melanoma. J Natl Cancer Inst. 2005;97:195-9.



Bodiwala D, Luscombe CJ, French ME, Liu S, Saxby MF, Jones PW, Fryer AA, Strange RC. Polymorphisms in the vitamin D receptor gene, ultraviolet radiation, and susceptibility to prostate cancer. Environ Mol Mutagen. 2004;43:121-7.



Calvo MS, Whiting SJ. Overview of the proceedings from Experimental Biology 2004 symposium: vitamin D insufficiency: a significant risk factor in chronic diseases and potential disease-specific biomarkers of vitamin D sufficiency. J Nutr. 2005 Feb;135(2):301-3.



Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: current status and data needs. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1710S-6S.



Calvo MS, Whiting SJ, Barton CN. Vitamin D intake: a global perspective of current status. J Nutr. 2005 Feb;135(2):310-6.



Cantorna MT, Mahon BD. Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Exp Biol Med (Maywood). 2004;229:1136-42.



Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, Holick MF. The role of vitamin d in cancer prevention. Am J Public Health. 2006 Feb;96(2):252-61.



Giovannucci E. The epidemiology of vitamin D and colorectal cancer: recent findings. Curr Opin Gastroenterol. 2006;22:24-29.



Goldacre MJ, Seagroatt V, Yeates D, Acheson ED. Skin cancer in people with multiple sclerosis: a record linkage study. J Epidemiol Community Health. 2004;58:142-4.



Gorham ED, Garland CF, Garland FC, Grant WB, Mohr SB, Lipkin M, Newmark HL, Giovannucci E, Wei M, Holick MF. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol. 2005 Oct;97(1-2):179-94.



Grant WB. An estimate of premature cancer mortality in the United States due to inadequate doses of solar ultraviolet-B radiation. Cancer. 2002;94:1867-1875.



Grant WB, Garland CF. A critical review of studies on vitamin D in relation to colorectal cancer. Nutr Cancer. 2004;48:115-123.



Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005 Jun;10(2):94-111.



Grant WB, Garland CF, Holick MF. Comparisons of Estimated Economic Burdens due to Insufficient Solar Ultraviolet Irradiance and Vitamin D and Excess Solar UV Irradiance for the United States. Photochem Photobiol. 2005 Nov-Dec;81(6):1276-86.



Hayes CE, Cantorna MT, DeLuca HF. Vitamin D and multiple sclerosis. Proc Soc Exp Biol Med. 1997;216:21-7.



Holick MF. Vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J. 2005 Oct;98(10):1024-7.



John EM, Schwartz GG, Koo J, Van Den Berg D, Ingles SA. Sun exposure, vitamin D receptor gene polymorphisms, and risk of advanced prostate cancer. Cancer Res. 2005;65:5470-9.



Lamprecht SA, Lipkin M. Chemoprevention of colon cancer by calcium, vitamin D and folate: molecular mechanisms. Nat Rev Cancer. 2003;3:601-614.



Moan J, Porojnicu AC, Robsahm TE, et al. Solar radiation, vitamin D and survival rate of colon cancer in Norway. J Photochem Photobiol B. 2005;78:189-193.



Mosekilde L. Vitamin D and the elderly. Clin Endocrinol (Oxf). 2005 Mar;62(3):265-81



Peterlik M, Cross HS. Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur J Clin Invest. 2005 May;35(5):290-304.



Porojnicu AC, Robsahm TE, Ree AH, et al. Season of diagnosis is a prognostic factor in Hodgkin's lymphoma: a possible role of sun-induced vitamin D. Br J Cancer. 2005;93:571-574.



Robsahm TE, Tretli S, Dahlback A, et al. Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes Control. 2004;15:149-158.



Schwartz GG. Vitamin D and the epidemiology of prostate cancer. Semin Dial. 2005;18:276-89.



van den Bemd GJ, Chang GT. Vitamin D and vitamin D analogs in cancer treatment. Curr Drug Targets. 2002;3:85-94.



van der Mei IA, Ponsonby AL, Blizzard L, Dwyer T. Regional variation in multiple sclerosis prevalence in Australia and its association with ambient ultraviolet radiation. Neuroepidemiology. 2001;20:168-74.



van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Simmons R, Taylor BV, Butzkueven H, Kilpatrick T. Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study. BMJ. 2003;327:316.



Whiting SJ, Calvo MS. Dietary recommendations for vitamin D: a critical need for functional end points to establish an estimated average requirement. J Nutr. 2005 Feb;135(2):304-9.



Whiting SJ, Calvo MS. Dietary recommendations to meet both endocrine and autocrine needs of Vitamin D. J Steroid Biochem Mol Biol. 2005 Oct;97(1-2):7-12.



Zhou W, Suk R, Liu G, Park S, Neuberg DS, Wain JC, Lynch TJ, Giovannucci E, Christiani DC. Vitamin D is associated with improved survival in early-stage non-small cell lung cancer patients. Cancer Epidemiol Biomarkers Prev. 2005 Oct;14(10):2303-9.

[Editor-in-Chief]

This is a pretty big deal and only a half dozen people looked at it.

[solarmeter®]

Gilchrest is wrong. Grant any may others are right. (imo disclaimer).

There have been countless behind-the-scenes emails on this "paper" and much more data "proving" moderate B is good... but cannot be posted due to the political ramifications. Sorry.

Time will bear out the truth. Months/years not hours unfortunately. But hang on to your hat anyway. The breezes are blowin' in the wind favorably toward UVB and vitamin D.