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"Good research is good for medicine. The only thing more important than good research is ethical research. The February 16th issue of the New England Journal of Medicine (NEJM) had a research paper on vitamin D and colon cancer. Was it good research? Was it ethical research? At stake are the lives of 36,000 older American women who agreed to participate in the Women's Health Initiative. "

Use of vitamin D in clinical practice. Cannell JJ, Hollis BW. Altern Med Rev. 2008 Mar;13(1):6-20. PMID: 18377099 The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) is the only way to make the diagnosis and to assure treatment is adequate and safe. Three treatment modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D3 supplementation. Treatment of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin D per day should be sufficient to maintain year-round 25(OH)D levels between 40-70 ng per mL. In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25(OH)D levels between 55 -70 ng per mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH)D and serum calcium. Vitamin D should always be

Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Vieth R, Kimball S, Hu A, Walfish PG. Nutr J. 2004 Jul 19;3:8. PMID: 15260882 doi:10.1186/1475-2891-3-8 CONCLUSION: The highest AI for vitamin D brought summertime 25(OH)D to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional vitamin D.

Tufts OpenCourseWare is part of a new educational movement initiated by MIT that provides free access to course content for everyone online. Tufts' course offerings demonstrate the University's strength in the life sciences in addition to its multidisciplinary approach, international perspective and underlying ethic of service to its local, national and international communities.

Vegetarianism is the practice of following a diet based on plant-based foods including fruits, vegetables, cereal grains, nuts, and seeds, with or without dairy products and eggs.[1] A vegetarian does not eat meat, game, poultry, fish, crustacea, shellfish, or products of animal slaughter such as animal-derived gelatin and rennet.[1][2][3] A vegan diet is a form of vegetarian diet which excludes all animal products, including dairy products, eggs, and honey. A lacto-vegetarian diet includes dairy products but excludes eggs, an ovo-vegetarian diet includes eggs but not dairy products, and a lacto-ovo vegetarian diet includes both eggs and dairy products. Vegetarianism may be adopted for ethical, health, environmental, religious, political, cultural, aesthetic, economic, or other reason A 1999 metastudy[22] combined data from five studies from western countries. The metastudy reported mortality ratios, where lower numbers indicated fewer deaths, for fish eaters to be .82, vegetarians to be .84, occasional meat eaters to be .84. Regular meat eaters and vegans shared the highest mortality ratio of 1.00. The study reported the numbers of deaths in each category, and expected error ranges for each ratio, and adjustments made to the data. However, the "lower mortality was due largely to the relatively low prevalence of smoking in these [vegetarian] cohorts". Out of the major causes of death studied, only one difference in mortality rate was attributed to the difference in diet, as the conclusion states: "vegetarians had a 24% lower mortality from ischemic heart disease than nonvegetarians, but no associations of a vegetarian diet with other major causes of death were established."[2

Increasing numbers of people are choosing to exclude meat from their diet, be it for ethical or health reasons. For some, avoiding meat and its products is a part of their religious beliefs. There should be no reason why a meat-free diet that is planned carefully should lack essential nutrients.