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Professor Departments of Nutritional Sciences, Laboratory Medicine, and Pathobiology, Bone and Mineral Laboratory, Pathology and Laboratory Medicine, University of Toronto, Toronto, Canada M5S 3E2 Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada

Not enough vitamin D: health consequences for Canadians. Schwalfenberg G. Can Fam Physician. 2007 May;53(5):841-54. Review PMID: 17872747 Conclusion Low levels of VTD are considered a major public health problem in Canada, especially during the winter. Those with risk factors should be screened for low 25(OH)D levels and repletion therapy instituted if needed. Researchers have estimated that the oral dose of vitamin D3 to attain and maintain 25(OH)D levels >80 nmol/L is 2200 IU/d if baseline levels are 20 to 40 nmol/L, 1800 IU/d if levels are 40 to 60 nmol/L, and 1160 IU/d if levels are between 60 and 80 nmol/L.64 We need to ensure that patients have healthy blood levels of 25(OH)D to prevent levels of parathyroid hormone from rising and to maximize absorption of calcium, magnesium, and phosphate. Positive effects on bone are marginal at best unless patients consume at least 800 IU/d of VTD. The emerging and exciting role of the VTD receptor and the actions of VTD in maintaining health in other cell types have become more apparent during the last decade.

Differences in vitamin D status between countries in young adults and the elderly. McKenna MJ. Am J Med. 1992 Jul;93(1):69-77. PMID: 1385673 PURPOSE: To compare vitamin D status between countries in young adults and in the elderly. MATERIALS AND METHODS: Reports on vitamin D status (as assessed by serum 25-hydroxyvitamin D) from 1971 to 1990 were reviewed. Studies were grouped according to geographic regions: North America (including Canada and the United States); Scandinavia (including Denmark, Finland, Norway, and Sweden); and Central and Western Europe (including Belgium, France, Germany, Ireland, The Netherlands, Switzerland, and the United Kingdom). RESULTS: Vitamin D status varies with the season in young adults and in the elderly, and is lower during the winter in Europe than in both North America and Scandinavia. Oral vitamin D intake is lower in Europe than in both North America and Scandinavia. Hypovitaminosis D and related abnormalities in bone chemistry are most common in elderly residents in Europe but are reported in all elderly populations. CONCLUSIONS: The vitamin D status in young adults and the elderly varies widely with the country of residence. Adequate exposure to summer sunlight is the essential means to ample supply, but oral intake augmented by both fortification and supplementation is necessary to maintain baseline stores. All countries should adopt a fortification policy. It seems likely that the elderly would benefit additionally from a daily supplement of 10 micrograms of vitamin D.

Vitamin D deficiency: a worldwide problem with health consequences. Holick MF, Chen TC. Am J Clin Nutr. 2008 Apr;87(4):1080S-6S. Review. PMID: 18400738 A reevaluation needs to take place of what the adequate intakes of vitamin D should be for children and adults. The literature over the past decade suggests that the Institute of Medicine recommendations in 1997 (83) are inadequate, and some experts including us suggest that both children and adults should take ≥800-1000 IU vitamin D/d from dietary and supplemental sources (4, 9, 77) when sunlight is unable to provide it. This recommendation, however, has not yet been embraced either by official government or pediatric organizations in the United States, Canada, or Europe for either children or adults.

Seasonal affective disorder (SAD) is a type of winter-time depression experienced by people those who live in northern latitudes such as those of New York, Seattle, all of Canada, and Northern Europe. I believe it is primarily a disorder of sunlight/vitamin D deficiency. Vitamin D, when administered in late winter, produces a positive effect on mood in only five days.[1] One theory for this is that vitamin D stimulates the brain to produce more serotonin. In a wintertime experiment, serum vitamin D levels doubled in six months through supplementation and dramatically increased scores on a wellbeing assessment.[2] Two groups were given either 1,000 IU or 4,000 IU of vitamin D daily. And although both groups improved, the higher dose produced better results.

Despite inadequacies in information concerning the minimum prophylactic requirement of vitamin D for all age groups beyond infancy, there is no doubt that a total intake of 400 I.U. per day is adequate to prevent vitamin D deficiency in substantially all normal children from birth through adolescence. Evidence derived from the study of idiopathic hypercalcemia suggests that certain infants excessively sensitive to the toxic action of vitamin D may, on rare occasions, be adversely affected by daily intakes of 3,000 to 4,000 I.U. and sometimes considerably less. Because of the prevalent practice of food fortification in the United States and Canada, there is now a definite possibility that the individual, even the young infant, may ingest considerably more than the recommended vitamin D allowance, and intakes of 2,000 to 3,500 I.U. per day are possible, particularly beyond infancy. Although there has been no specific evidence that intakes of this order produce deleterious effects beyond infancy, it is pointed out that the long-term consequences of this new nutritional situation on older children or adults are entirely unknown.

San Diego, CA (PRWEB) May 25, 2009 -- Coming on the heels of the publishing in the Annals of Epidemiology of a new study led by Dr. Cedric Garland, on the preventive measures of vitamin D, GrassrootsHealth D*action Project is calling on physicians, health clinics and groups throughout the country to recognize the need for determining vitamin D levels and to ensure the public have their blood levels of vitamin D tested. According to research from the newly published study by 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."

One hour public information video lecture about vitamin D by professor Reinhold Vieth, Toronto University, Canada.Also a video lecture about nutritional interventions in multiple sclerosis,

Supplements of vitamin D at 'critical time periods' may be key to reducing the risk of multiple sclerosis, according to a new study from the UK and Canada. Researchers report that vitamin D may interact with a specific genetic component called HLA-DRB1*1501 that is known to increase the risk of multiple sclerosis by three-fold

"So why is Dr Vieth so frustrated? You might think he'd have cause for celebration. But for him and other vitamin D researchers around the world, the good news comes with a bitter aftertaste. They believe they can prove vitamin D could help millions live longer and be healthier and yet they have not been able to convince their own governments. In the US and Canada, official vitamin D policy is set by the Institute of Medicine. And in the opinion of Vieth, the current recommendations - 200 International Units per day for people under 50, 400 for people aged 51-70, and 600 for those 71 and older - are outrageously low. Bruce Hollis, professor of paediatrics at the Medical University of South Carolina, calls 400 IU a day "a joke". That's because the best research suggests that to achieve the higher vitamin D blood levels associated with disease prevention, most adults in the US would need to take 1,000-2,000 IU a day: five to 10 times more than the current official recommendation for adult In 1999, Reinhold Vieth (pictured right) published a review of vitamin D research in response to the IOM conclusions. In it, he argued that there was no evidence that amounts lower than 20,000 IU a day could be toxic. "Throughout my preparation of this review, I was amazed at the lack of evidence supporting statements about the toxicity of moderate doses of vitamin D," Vieth wrote. Studies have since shown 10,000 IU a day of vitamin D to be safe. While any substance will become toxic in excess, vitamin D researchers today accept that the current vitamin D recommendations could be more than quadrupled with no fear of toxicity.!

Vitamin D for cancer prevention: global perspective. Garland CF, Gorham ED, Mohr SB, Garland FC. Ann Epidemiol. 2009 Jul;19(7):468-83. Review. PMID: 19523595 RESULTS/CONCLUSIONS: It is projected that raising the minimum year-around serum 25(OH)D level to 40 to 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 fourths of deaths from these diseases in the United States and Canada, based on observational studies combined with a randomized trial. Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half. There are no unreasonable risks from intake of 2000 IU per day of vitamin D(3), or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increase intake of vitamin D and calcium.

"Powerful new evidence about the ability of vitamin D to stem a wide range of diseases has brought the prospect of a nationwide programme to prescribe it in Scotland as a dietary supplement significantly closer. Reports at the weekend suggested that experts were increasingly convinced that the so-called sunshine drug - whose significance was first revealed in detail by The Times last year - could make a difference to the country's appalling health record. New research suggests that high doses of vitamin D could dramatically cut the relapse rate in people with multiple sclerosis. According to scientists in Canada, more than a third of sufferers taking high levels of supplement

Wintertime vitamin D insufficiency is common in young Canadian women, and their vitamin D intake does not prevent it. Vieth R, Cole DE, Hawker GA, Trang HM, Rubin LA. Eur J Clin Nutr. 2001 Dec;55(12):1091-7. PMID: 11781676 INTERPRETATION: The self-reported vitamin D intake from milk and/or multivitamins does not relate to prevention of low vitamin D nutritional status of young women in winter. Recommended vitamin D intakes are too small to prevent insufficiency. Vitamin D nutrition can only be assessed by measuring serum 25(OH)D concentration.

Dietary Reference Intakes for Vitamin D and Calcium An IOM committee has been named to undertake a study to assess current relevant data and update as appropriate the DRIs for vitamin D and calcium. The review will include consideration of chronic and non-chronic disease indicators. The study will also incorporate, as appropriate, systematic evidence-based reviews of the literature and an assessment of potential indicators of adequacy and of excess intake. Indicators for adequacy and excess will be selected based on the strength and quality of the evidence and the demonstrated public health significance, taking into consideration sources of uncertainty in the evidence.

Vitamin D supplementation. Eveleigh B. Can Fam Physician. 2007 Sep;53(9):1435; author reply 1435. PMID: 17872869 My concern regarding vitamin D2 is that it is a synthetic analogue and might interact with the vitamin D receptor differently in various cell systems. It has been reported that vitamin D3 might improve glycemic control.7 Vitamin D2 has been reported to cause worsening of glycemic control in people of East Indian descent.8 Is this because of vitamin D receptor polymorphism, or because of enhanced 24-hydroxylase enzyme activation, or is it due to how vitamin D2 interacts with the receptor? Until this has been sorted out, I feel safest using vitamin D3. There are about 2000 synthetic analogues of vitamin D. The search is on for one that can cross the blood-brain barrier to treat certain types of brain cancers without causing hypercalcemia.9 But then again, what other effects would this compound have? There are still so many unknowns

Not enough vitamin D: health consequences for Canadians.\nSchwalfenberg G.\nCan Fam Physician. 2007 May;53(5):841-54. Review.\nPMID: 17872747 \n

Our vision: To significantly improve the health of Canadians through the preventative health strategy of maintaining optimum vitamin D blood levels.