Vitamin Information Center

Vitamin K2 helps reduce fractures

A recently concluded study by the Archives of Internal Medicine points to the importance of including 45 mg per day of vitamin K2 in your daily diet to decrease the risk of vertebral fractures by 60 percent, hip fractures by 71 percent and all nonvertebral fractures by 81 percent.
There are various forms of vitamin K, but only 45 mg per day of MK-4 has been shown in clinical trials to decrease fracture risk better than bisphosphonate medications. This amount of vitamin K2 does not interfere with healthy coagulation and is safe to take with osteoporosis medications.

According to the National Osteoporosis Foundation, about one in two women and one in four men over age 50 will have an osteoporosis-related fracture in their remaining lifetime.

Elements of marijuana beneficial
Ohio State University scientists have found that specific elements of marijuana can be good for the aging brain by reducing inflammation and possibly even stimulating the formation of new brain cells.

The research suggests that the development of a legal drug that contains certain properties similar to those in marijuana might help prevent or delay the onset of Alzheimer’s disease. Though the exact cause of Alzheimer’s remains unknown, chronic inflammation in the brain is believed to contribute to memory impairment.

Any new drug’s properties would resemble those of tetrahydrocannabinol, or THC, the main psychoactive substance in the cannabis plant, but would not share its high-producing effects. THC joins nicotine, alcohol and caffeine as agents that, in moderation, have shown some protection against inflammation in the brain that might translate to better memory late in life.

Benefits of weight-loss surgery seen for pregnant women
Obese women who have weight-loss surgery before becoming pregnant have a lower risk of pregnancy-related health problems and their children are less likely to be born with complications, according to a new RAND Corporation study.

The women had a significantly lower risk of gestational diabetes and high blood pressure than obese women who did not have surgery, according to the study published in the Nov. 19 edition of the Journal of the American Medical Association.

In addition, these women’s babies were less likely to be born prematurely, be born underweight or be born overweight than children born to obese women, according to the study.

The incidence of bariatric surgery increased eight fold in the United States from 1998 to 2005, with women aged 18 to 45 accounting for 83 percent of the procedures. More than 150,000 women of child-bearing age underwent bariatric surgery from 2002 to 2005.

FROM WIRE REPORTS

A lack of vitamin D has been found in some studies to play an unrecognized role in death among people suffering from a variety of medical problems, including heart disease and cancer.

Now researchers say they have evidence that even in the general population, having too little of the vitamin appears to be associated with a higher risk of death.

Writing in the Archives of Internal Medicine, researchers say they looked at the vitamin D levels and death rates of more than 13,000 people during a period of more than six years.

Those who fell in the lowest quarter of vitamin D levels had a 26 percent higher risk of death from all causes than those in the top quarter, according to the study, which was led by Michal L. Melamed of the Albert Einstein College of Medicine.

About 41 percent of men and 53 percent of women in the U.S. have levels of the vitamin that are considered too low.

Breakthrough likely to help people with Type 2 diabetes

Two groups of researchers in Japan have identified a gene that is directly linked to the occurrence of diabetes, a discovery likely to help in the early identification of people who may be susceptible to the disease.

A group of researchers from the Institute of Physical and Chemical Research and another from the International Medical Center of Japan separately studied individual diabetic cases involving Japanese patients.

Their findings were published in the online edition of the U.S. medical journal Nature Genetics. The researchers found a link between a gene known as KCNQ1 and the onset of Type 2 diabetes — the variant affecting 90 percent of Japan’s 8.2 million diabetic patients.

The prevalence of Type 2 diabetes is attributed to a lack of physical exercise, excessive eating and genetics.

Having too little vitamin D in the body might raise the risk of premature death, a study by Johns Hopkins researchers shows.

It follows other recent studies showing that low amounts of vitamin D are linked to certain cancers, diabetes, and bone and immune system problems, but this is the first research to connect vitamin D deficiency to a higher risk of death, said the study’s co- author Erin Michos, an assistant professor of cardiology at Johns Hopkins School of Medicine in Baltimore.

The study appears in this week’s Archives of Internal Medicine.

Michos and her colleagues analyzed data from a large government observational survey of more than 13,000 people who represented a realistic, diverse swath of U.S. adults ages 20 or older. Participants’ vitamin D amounts were determined through blood tests from 1988 through 1994.

By 2000, Michos said, 1,807 deaths had occurred, including 777 from cardiovascular disease.

The researchers divided the total population into four groups based on their amounts of vitamin D. One group included people with the least vitamin D, 17.8 ng/mL (nanograms/milliliter) or less.

A normal vitamin D test result for both children and adults is 30 ng/mL or more. Less than 20 ng/mL is considered deficient, and results between 20 and 30 ng/mL are labeled insufficient, said Catherine Gordon, director of the bone health program at Children’s Hospital Boston.

In the study, Michos said, people who had low vitamin D — 17.8 ng/mL or less — were 26 percent more likely to be dead at the end of the study than those with more.

Michos now suspects that low vitamin D is related to heart disease deaths, but that theory has to be tested in further studies, she said.

Originally published by USA TODAY.

(c) 2008 Tulsa World. Provided by ProQuest LLC. All rights Reserved.

Source: Tulsa World

Last week, we reported that high consumption of sugar-sweetened drinks seems to increase the risk for type 2 diabetes among African-American women. In the most recent issue of the Archives of Internal Medicine, investigators from England reported that high levels of vitamin C in the blood are associated with a substantially decreased risk of diabetes.

The researchers studied a population of people, ranging from age 40 to age 75, who completed food questionnaires. The study population was followed for 12 years - in that time, 735 cases of diabetes were identified among 21,831 health individuals. After analyzing the information from the food questionnaires, the researchers found that individuals with high vitamin C levels in the blood were substantially less likely to develop diabetes. They found that higher fruit and vegetable intake was also associated with a significantly decreased risk of diabetes.

These findings highlight a potentially important public health message - promoting a diet rich in fruits and vegetables could help in the prevention of diabetes.

Low vitamin D levels are associated with a higher risk of death, according to a report released on August 11, 2008 in the Archives of Internal Medicine, one of the JAMA/Archives journals.

Vitamin D is a group of prohormones that play important roles in calcium metabolism, bone formation, parathyroid function, and the immune system. Presently, the ideal bood levels of 25-hydroxyvitamin D (25[OH]D) has been suggested as 30 nanograms per milliliter or higher. In the United States, approximately 41% of men and 53% of women have levels lower than 28 nanograms per milliliter.

There are many potential health problems that could contribute to death in individuals with low vitamin D levels, including an effect on blood pressure, insulin response, or risk of obesity and diabetes.

To investigate the potential implications of this deficiency, Michal L. Melamed, M.D., M.H.S., of the Albert Einstein College of Medicine, Bronx, N.Y., and colleagues examined 13,331 individuals in the Third National Health and Nutritional Examination Survey (NHANES III), a large cohort study performed by the Centers for Disease Control and Prevention (CDC). These individuals were examined for Vitamin D levels between 1988 and 1994, and tracked through 2000, with a median 8.7 years of follow-up.

In this period, 1,806 participants died. When divided into groups based on vitamin D levels, the group maintaining the lowest level, defined as less than 17.8 nanograms per milliliter, showed a 26% increased risk of death from any cause in comparison with the group with the highest levels of vitamin D. This was not associated with cardiovascular disease or cancer alone.

The authors conclude that “the lowest 25(OH)D quartile (less than 17.8 nanograms per milliliter) is associated with a higher risk of all-cause mortality in the general U.S. population.” They continue: “Further observational studies are needed to confirm these findings and establish the mechanisms underlying these observations. If confirmed, randomized clinical trials will be needed to determine whether vitamin D supplementation at higher doses could have any potential benefit in reducing future mortality risk in those with 25(OH)D deficiency.”

25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population
Michal L. Melamed, MD, MHS; Erin D. Michos, MD, MHS; Wendy Post, MD, MS; Brad Astor, PhD
Arch Intern Med. 2008;168(15):1629-1637
Click Here For Abstract

Written by Anna Sophia McKenney
Copyright: Medical News Today

Hardly a week goes by, it seems, without a press release regarding a new vitamin D study appearing in my email box.

For example:

“Men with Low Vitamin D May Have Increased Risk of Heart Attack”
“Study Links Vitamin D to Colon Cancer Survival”
“Vitamin D Inadequacy May Exacerbate Chronic Pain”
“Low Vitamin D Levels May Worsen Osteoarthritis of the Knee”
“Low Levels of Vitamin D Associated with Depression in Older Adults”
“Study Links Vitamin D, Type 1 Diabetes”
“Vitamin D Linked to Reduced Mortality Rate in Chronic Kidney Disease”

Then, last Friday, came the uber-vitamin D press release:

“Low Vitamin D Levels Pose Large Threat to Health”

That study, published this week in the Archives of Internal Medicine, found a 26 percent increase in risk of early death from any cause among people with inadequate levels of vitamin D.

What’s going on? Why this sudden (or so it seems) interest in the “sunshine vitamin”? (The nickname comes from the fact that the vitamin is produced in the skin from sunlight.) And what are health consumers – especially here in Minnesota, where the low angle of the winter sun makes it difficult to sustain adequate vitamin D levels – to make of it all?

Old interest, new connections
Despite the current flurry of studies, research into vitamin D’s multipronged impact on human health “is not all that new,” said Kurt Kennel, M.D., an assistant professor of medicine at the Mayo Clinic in Rochester. Scientists have known since the 1970s that vitamin D’s effect on the body went beyond regulating calcium and helping to build strong bones.

Much of the past research, however, was confined to the laboratory. In recent years, thanks to better ways of assaying (or measuring) vitamin D in the body, scientists have been able to give it a more clinical face, linking it to the risk of developing different diseases.

In addition, aging baby boomers have developed a deep and personal interest in the bone-weakening disease osteoporosis.

“That put vitamin D on the map,” said Kennel.

A misnomer
To understand vitamin D’s ubiquitous role in the body, we need to stop thinking of it as a traditional vitamin.

“If we named it today, we’d call it a hormone,” said Kennel.

Like insulin, adrenaline, estrogen and other hormones, vitamin D is produced by a body organ (in this case, the skin). It’s then carried through the body by a fluid (blood) to other organs and tissues (the heart, brain, breasts, kidneys, muscles, and so on). At each of these destinations, vitamin D adeptly attaches itself to receptors on the DNA of genes in the cells’ nuclei.

As we’re now learning, the resulting effects appear to be remarkably beneficial, possibly protecting against heart disease, kidney disease, diabetes, osteoporosis, multiple sclerosis, certain types of cancers (including breast, lung and colon) and other major illnesses and conditions.

The latest study
In the newly published study – considered the most compelling evidence of vitamin D’s overall health benefits to date – a team of John Hopkins researchers analyzed vitamin D levels in more than 13,000 men and women aged 20 and older who participated in a large ongoing health survey conducted by the Centers for Disease Control and Prevention. The data was collected between 1988 and 1994.

To ensure comparable results, vitamin D levels were surveyed during the summer among participants living in northern states and during the winter among those in southern states.

All participants were tracked until Dec. 31, 2000, by which time 1,806 had died. Those whose vitamin D levels had been the lowest (less than 17.8 nanograms per milliliter of blood) had a 26 percent increased rate of death from any cause compared to those with the highest vitamin D levels (above 50 nanograms per milliliter).

Cardiovascular disease seemed to be the major factor in these deaths, although the study wasn’t able to determine with scientific certainty a cause-effect relationship between low vitamin D levels and heart attacks and strokes.

“In the past few months, several other papers have confirmed that low vitamin D levels are associated with increased risk of heart attacks and strokes,” said Erin Michos, M.D., one of the study’s lead investigators.

In fact, earlier this year, Michos and her team showed an 80 percent increased risk of peripheral artery disease among people with vitamin D deficiency.

It may not be long before vitamin D deficiency is added to the long list of risk factors for heart disease, she said.

What’s a consumer to do?
Vitamin D deficiency is, by some accounts, reaching epidemic proportions. A review article published in The New England Journal of Medicine last year reported that up to 50 percent of children and adults in the United States have insufficient levels (less than 20 nanograms per milliliter).

“Vitamin D deficiency is getting a lot more common because we’re getting more obese and sedentary, and we’re spending less time in the sun,” said Michos.

People who are over the age of 50, who have dark skin, or who wear clothing that covers most of their skin are also at increased risk. (The last two reasons, said Kennel, are partly why Minnesota’s Somali immigrants have higher-than-average rates of vitamin D deficiency.)

Both Kennel and Michos recommend that people boost their vitamin D levels by eating salmon, mackerel and other fatty fish and fortified dairy products. (Years ago, vitamin D used to be added to beer, but, alas, no longer.) You can also take cod-liver oil (yes, just as your great-grandparents did) and/or vitamin supplements.

Federal guidelines currently recommend that adults get 200 to 600 international units (IU) of vitamin D daily. Those recommendations are currently under review, said Kennel, and will most likely be upped.

The National Osteoporosis Society already recommends 800 to 1,000 IU to people aged 50 and older. And the Canadian Cancer Society, citing Canada’s northern latitude, recommends that adults living there take 1,000 IU of vitamin D daily during fall and winter.

Currently, most experts put the safe upper limit of vitamin D from supplementary sources at 2,000 IU per day. But that number, too, may be increased.

Out in the noonday sun
The best way to get vitamin D, of course, is to spend time in the sun. In a single 10-minute midday outing, your skin will produce about 10,000 IU.

Fortunately, your skin won’t let you overdose on vitamin D from the sun. But spending unprotected time in the sun increases your risk of skin cancer, which has also reached epidemic proportions in the United States.

“Unfortunately, the time of the day the dermatologist wants you to be out – the morning and the evening – is the worst time for your body to make vitamin D,” said Kennel.

If you think you’re at increased risk for vitamin D deficiency, talk with your physician about having your blood levels of the vitamin checked. You’ll then have a better idea of whether you need supplements.

And remember: Although the recent findings about vitamin D are intriguing and promising, the benefits are not yet proven.

Studies of other nutrients and hormones – vitamin E, vitamin A, and estrogen, to name a few – were also found to benefit the heart in observational studies. But when it came time for the clinical trials, not only did they fail to prevent heart disease, they actually increased the risk.

Stay tuned.

An abundance of vitamin C in the diet may help lower a person’s risk of developing type 2 diabetes, new research suggests.

In a study of middle-aged and older men and women, those with the highest blood levels of vitamin C were significantly less likely to develop diabetes over 12 years than those with the lowest levels, researchers found.

Fruits and vegetables are the main source of vitamin C in Western diets, and blood levels of vitamin C are good markers of fruit and vegetable intake, Dr. Nita G. Forouhi, at the Institute of Metabolic Science at Addenbrooke’s Hospital, Cambridge, England, and colleagues note.

The current findings “re-endorse the public health message of the beneficial effect of increasing total fruit and vegetable intake,” the investigators wrote in Archives of Internal Medicine.

Forouhi’s team followed 21,831 healthy men and women who were 40 to 75 years old for the development of type 2 diabetes. At study entry, all participants provided detailed health and lifestyle information, as well as blood samples, which investigators used to determine vitamin C levels.

Over the course of the study, 423 men and 312 women developed type 2 diabetes, an overall rate of 3.2 percent.

According to the investigators, the likelihood of developing diabetes was 62 percent lower in men and women with the highest circulating vitamin C levels, relative to men and women with the lowest vitamin C levels.

Factoring out other characteristics associated with diabetes risk, such as older age, gender, family history, alcohol intake, physical activity, smoking status and body weight did not significantly alter these associations.

These data offer “persuasive evidence of a beneficial effect of vitamin C and fruit and vegetable intake on diabetes risk,” Forouhi and colleagues conclude.