Supplemental Nightmares

I am generally skeptical of any claim (made by EITHER the alternative or modern medical camps) that Americans are deficient in any particular vitamin or nutrient. “Americans are not eating enough X,” the headlines cry! It just does not seem logical to me that in this day in age, where obesity has become an epidemic, that Americans are not ingesting enough of anything! But the up and down claims about vitamins are enough to send any rational consumer into a tailspin of confusion. One day we need to double our consumption of a particular nutrient, the next day we are told that too much of said nutrient is harmful then we are told that we weren’t deficient in the first place! This is the roller-coaster story of vitamin D.

Because the skin produces vitamin D when exposed to sunlight, it was thought to be common wisdom that anyone living in northern latitudes would need an extra boost of dietary vitamin D.  Studies done like this one on adolescent girls living in Maine (my home state) demonstrate that vitamin D levels drop in the wintertime. But there has been a lot of discussion about what constitutes vitamin D deficiency and insufficiency. A recent consensus study conducted by the Institute of Medicine’s Food and Nutrition Board panel concluded that the population of Americans and Canadians studied do not display dietary deficiencies of vitamin D, even at northern latitudes, largely because so much of our food is fortified. They also concluded that the early recommendations for vitamin D increase were largely inflated, and the 600 international units is sufficient for most age groups (popular press has covered these results).

The Institute of Medicine experts worry that taking vitamin D in large doses over a long period might harm some people. The evidence is inconclusive, but the panel points to studies hinting at higher levels of pancreatic and esophageal cancer. Panelists say there’s reason to worry about excess deposits of calcium in arteries from too much vitamin D.

Dr. Michael Holick of Boston University, who discovered the active form of vitamin D 40 years ago and is a leading proponent of high doses, isn’t backing away from his conviction that most people need at least 3,000 units a day. That’s what he takes, and what he recommends to his patients. Sometimes he prescribes 50,000 units of vitamin D a week.

Here is the crux of the argument I make when any “eat more of X” claims crops up in conversation:

Point 1:

American’s have an incredibly versatile diet. Very few of us eat the same thing for every meal, and in fact most of us have enormous variety in our weekly diets. Contrast that to the diet of a carnivore living on the savannah in Africa. Monday: antelope, Tuesday: crickets, Wednesday: antelope, Thursday: half-eaten antelope, Friday: zebra. Not a lot of variety there, and yet carnivores have been around and propagating longer than us omnivores. Our dietary versatility means that it is less likely that our diet will be completely lacking in any particular nutrient.  However, I want to point out that you could eat nothing but Corn Pops with chocolate milk and it would only take a few bowls to meet your daily vitamin D requirement.

Point 2:

Added to Point 1 is the fact that Americans are terrible at portion control. When was the last time you only ate the 5.5 chips that the package says is a single serving size? Did you know that many Red Delicious apples are larger than a single serving of fruit? Do you make your omelets with medium sized eggs or Grade A Extra Large? We are a well-fed nation, to the point that obesity is becoming more of a problem than starvation (Google “Hunger Paradox, it is fascinating). The likelihood that we are not eating enough of anything is pretty laughable.

Of course there are certain populations that truly may need extra doses of vitamins. Pregnant women, athletes, anyone who burns way more calories than they easily take in may have trouble maintaining vitamin levels. But for the large majority of the computer tapping, TV watching masses, I favor the age old adage, “’EVERYTHING IN MODERATION.” Do not eat a lot of anything in particular, do not eat too little of anything, and you are likely to maintain that nutritional sweet spot for your whole life. If you eat only fast-food hamburgers for every meal of every day, you may run into problems, throw in a bowl of Corn Pops with chocolate milk every once in a while.

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4 comments to Supplemental Nightmares

  • ponderingturtle

    This has made one thing clear to me, we need tighter quality controls on fruit.

    It also reminded me of how Oreo’s made low carb oreo’s, a few years ago during the atkins diet boom. They changed the serving size from 3 cookies to 2. That was a 33% drop in carbs right there.

  • I honestly learned about nearly all of this, but with that said, I still thought it had been helpful. Sweet work!

  • You’re right about vitamin and mineral supplements generally, but the issue with Vitamin D is rather more complex, in that it’s available in very few foods, with the exception of certain fatty fish (mackerel and salmon, in particular), and in low dosages in milk. (100 IU/cup, a small fraction of the US RDA). Otherwise we have to get it from sunlight.

    I don’t know about you, but I work indoors and rarely get exposure to direct sunlight. I also rarely eat fatty fish, and probably drink well under a cup of milk a day. That means I have no recourse for my Vitamin D intake than to take supplements.

    I doubt that my case is that unusual in the modern world, and it would only be exacerbated if I were dark skinned, or if I were over 70, since the body’s ability to produce Vitamin D from sunlight declines with age.

    The Institute of Medicine’s recent report tripled the RDA of Vitamin D for many adults (from 200 to 600 IU/day), while doubling the top range. While certainly there will be many who can achieve these RDAs with normal daily sun exposure, I think it’s rash to assume one is getting the appropriate amount if, for example, one works indoors.

    The appropriate response is to stick to limited supplements, say around 1,000 IU/day.

    Here’re some citations. From Harvard:

    And Berkeley:

    I started up what’s become a long thread about Vit. D, BTW, on the CFI Forum:

  • Lere

    PROFESSOR Frank Garland, and his brother, Cedric, recommend [...] taking 50,000 units of vitamin D per week for eight to twelve weeks followed by maintenance on 1,000 to 2,000 units a day”.
    ACCORDING Cedric F. Garland, Dr. P.H., FACE, Department of Family and Preventive Medicine and Moores Cancer Center of the University of California, San Diego (UCSD), “It is projected that raising the minimum year-around serum 25(OH)D level to 40-60 ng/ml (100-150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year, and three quarters of deaths from these diseases, in the US and Canada.”
    Plasma vitamin D and mortality in older men: a community-based prospective cohort study.
    “There was a U-shaped association between vitamin D concentrations and total mortality. An approximately 50% higher total mortality rate was observed among men in the lowest 10% (98 nmol/L [or 39 ng/ml]) of plasma 25(OH)D concentrations compared with intermediate concentrations. Both high and low concentrations of plasma 25(OH)D are associated with elevated risks of overall and cancer mortality.
    Dr. Frank C. Garland, 1950-2010
    “Tuesday, August 17 at UCSD Thornton Hospital after contending with a nearly year-long illness.“

    “African Americans … are more likely to be vitamin D deficient due to their darker skin pigmentation’s ability to block the sun’s rays”
    It is not true that melanin blocks the wavelengths which synthesize vitamin D . The value of melanin as a sunscreen (2010).
    “epidermal melanin is not a neutral density filter providing no or minimal protection for the induction of erythema at 295 and 315 nm and some protection at 305 and 365 nm”
    It does block 305nm but around that wavelength is the most damaging A UVB Wavelength Dependency for Local Suppression of Recall Immunity in Humans Demonstrates a Peak at 300 nm. also see Erythema curve. Note the relative danger curve ( yellow) peaks at around 305nm
    T the blocking of a limited spectra of vitamin D synthesizing UVB doesn’t matter the other wavelengths get through. Blood vitamin D levels in relation to genetic estimation of African ancestry “found novel evidence that the level of African ancestry [rather than skin pigmentation] may play a role in clinical vitamin D status”.
    There is a negative feedback system; evolution has has got vitamin D levels just right
    Klotho protein deficiency and aging.
    “α-Klotho protein is shown to function in the negative feedback regulation of vitamin D3 synthesis These observations indicated that abnormal vitamin D3 metabolism is the main cause of aging phenotypes.″
    Klotho was named after one of the Moirae or fates, supplementing vitamin D is indeed a fateful step.

    Many people of tropical ancestry have a optimum homeostasis of vitamin D which is below the new IoM levels, but if they’re wise they’ll not take supplements

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