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Serum 25-hydroxyvitamin D status of the US population: 1988-1994 compared with 2000-2004. Looker AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano MF, Yetley EA. Am J Clin Nutr. 2008 Dec;88(6):1519-27. PMID: 19064511 doi:10.3945/ajcn.2008.26182 Conclusions: Overall, mean serum 25(OH)D was lower in 2000-2004 than 1988-1994. Assay changes unrelated to changes in vitamin D status accounted for much of the difference in most population groups. In an adult subgroup, combined changes in BMI, milk intake, and sun protection appeared to contribute to a real decline in vitamin D status. In summary, age-standardized mean serum 25(OH)D concentrations based on observed values were significantly lower in 2000-2004 than in 1988-1994 in all groups examined. Adjustment for assay changes noticeably reduced the difference between surveys. However, mean serum 25(OH)D concentrations remained significantly lower in males (except Mexican Americans) in NHANES 2000-2004 than in NHANES III, even after adjustment for assay differences. This remaining difference likely represents a real decline in vitamin D status. Changes in BMI, milk intake, and sun protection appeared to contribute to this decline in a subgroup of non-Hispanic white adults. The possibility that trends in overweight, sun protection, and milk intake may continue supports the need to continue monitoring the serum 25(OH)D status of the population

Continuous changes in the healthcare reimbursement criteria require executives across the industry to focus on enterprise-wide changes that have a positive effect on supply chain savings. It's a complex problem and it's easy to get distracted on one issue when having the ability to see a clear BIG picture of your entire supply chain is what can lead to the most dramatic results and return on investments. Register for MHS' webinar on November 01 (2:00pm EST) to learn about how their customers experience an average 4:1 ROI with continual savings into the millions and a positive financial impact to their bottom line through inventory reduction, avoidance of obsolete and expired inventory, improved charge capture for each patient, and physician preference card optimization. Click on http://bit.ly/UvD3nq Presenters *Michael Ferris: Co-Founder, MHS with over 30 years of supply chain management experience *Steve Basiliere: Former Director of Supply Chain Services at Saints Medical Center, Lowell, MA *Art Kozyrovicius: Finance and Procurement Systems Support at New York-Presbyterian Hospital, New York, NY WHY ATTEND? Join a unique discussion with healthcare supply chain thought leaders and understand how to drive significant and sustainable supply chain operational improvements. Get a jump on making an immediate and positive impact on your bottom line as you head into 2013. Register by clicking on http://bit.ly/UvD3nq Note: Event will be online, through WebEx Please Register at http://bit.ly/UvD3nq

Volume 66 Issue s2 , Pages S73 - S217 (October 2008) Special Issue: 22nd Marabou Symposium: The Changing Faces of Vitamin D

BACKGROUND: To determine the effect of vitamin D binding protein (DBP) genotypes on 25-hydroxyvitamin D [25(OH)D] changes with vitamin D supplements, we studied 98 adults receiving 600 or 4000 IU/d vitamin D(3) for one year. METHODS: The DBP functional variant, T436K, was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: Mean 25(OH)D increases were 97% for TT (n=48), 151% for TK (n=31) and 307% (n=6) for KK genotypes (p=.004). CONCLUSIONS: As with baseline 25(OH)D, T436K genotype predicts 25(OH)D changes after long-term vitamin D supplementation. Common genetic variants of the vitamin D binding protein (DBP) predict differences in response of serum 25-hydroxyvitamin D [25(OH)D] to vitamin D supplementation. Fu L, Yun F, Oczak M, Wong BY, Vieth R, Cole DE. Clin Biochem. 2009 Jul;42(10-11):1174-7. Epub 2009 Mar 18. PMID: 19302999

Vitamin D-Related Changes in Physical Performance: A Systematic Review. Annweiler C, Schott AM, Berrut G, Fantino B, Beauchet O. J Nutr Health Aging. 2009;13(10):893-898. PMID: 19924350 Conclusions: The findings show that the association between vitamin D and physical performance remains controversial. Observational studies and clinical trials yielded divergent results, which highlights the complex and to date still poorly understood association between serum vitamin D concentration or vitamin D supplementation and physical performance.

Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. Vieth R, Ladak Y, Walfish PG. J Clin Endocrinol Metab. 2003 Jan;88(1):185-91. PMID: 12519850 This study shows that all age groups exhibit a high prevalence of 25(OH)D insufficiency and secondary hyperparathyroidism. Older adults are just as efficient in maintaining 25(OH)D, but they need more vitamin D to produce the higher 25(OH)D concentrations required to overcome the hyperparathyroidism associated with their diminishing renal function

nfluence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. Webb AR, Kline L, Holick MF. J Clin Endocrinol Metab. 1988 Aug;67(2):373-8. PMID: 2839537 doi:10.1210/jcem-67-2-373 These results quantify the dramatic influence of changes in solar UVB radiation on cutaneous vitamin D3 synthesis and indicate the latitudinal increase in the length of the "vitamin D winter" during which dietary supplementation of the vitamin may be advisable.

Prospective study of serum vitamin D and cancer mortality in the United States. Freedman DM, Looker AC, Chang SC, Graubard BI. J Natl Cancer Inst. 2007 Nov 7;99(21):1594-602. Epub 2007 Oct 30. PMID: 17971526 doi:10.1093/jnci/djm204 CONCLUSIONS: Our results do not support an association between 25(OH)D and total cancer mortality, although there was an inverse relationship between 25(OH)D levels and colorectal cancer mortality.

Vitamin D and its role in skeletal muscle. Ceglia L. Curr Opin Clin Nutr Metab Care. 2009 Sep 18. [Epub ahead of print] PMID: 19770647 SUMMARY: Further studies are needed to fully characterize the underlying mechanisms of vitamin D action in human muscle tissue, to understand how these actions translate into changes in muscle cell morphology and improvements in physical performance, and to define the 25-hydroxyvitamin D level at which to achieve these beneficial effects in muscle.

Serum levels of vitamin D metabolites and breast cancer risk in the prostate, lung, colorectal, and ovarian cancer screening trial. Freedman DM, Chang SC, Falk RT, Purdue MP, Huang WY, McCarty CA, Hollis BW, Graubard BI, Berg CD, Ziegler RG. Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):889-94. Epub 2008 Apr 1. PMID: 18381472 doi: 10.1158/1055-9965.EPI-07-2594 In this prospective study of postmenopausal women, we did not observe an inverse association between circulating 25(OH)D or 1,25(OH)2D and breast cancer risk, although we cannot exclude an association in younger women or with long-term or earlier exposure

In the last post, we talked about the new report on vitamin D and cancer from the International Agency for Research into Cancer (IARC). In this one, we'll summarise what the report has to say on the balance between getting enough vitamin D through sun exposure and reducing the risk of skin cancer by being SunSmart. IARC calls for more trials to really pin down the effects of vitamin D supplements - either positive or negative - depending on how much vitamin D people already have in their system. Until then, they feel that there is no solid basis for changing any existing recommendations about vitamin D.

Dietary acid-base balance, bone resorption, and calcium excretion. Jajoo R, Song L, Rasmussen H, Harris SS, Dawson-Hughes B. J Am Coll Nutr. 2006 Jun;25(3):224-30. PMID: 16766781 Conclusions: Diet changes that increase renal NAE are associated with increases in serum PTH, bone resorption, and calcium excretion over a 60-day period.

Acid-base balance has an effect on bone turnover, especially on the rates of bone resorption and calcium mobilization. Bone mineral participates in the defense against acid-base disturbances, especially against metabolic acidosis (Lemann et al. 1966, Green & Kleeman 1991). The role of the bone mineral is important in the acid-base disorders, as no appreciable change in the intestinal calcium absorption occurs (Bichara et al. 1990). In the mammalian body, mainly three hormones regulate the calcium metabolism and the bone turnover. 1,25-dihydroxycholecalciferol (vitamin D derivative) increases calcium absorption from the intestine and, indirectly, from bone. Parathyroid hormone mobilizes calcium from the bone and increases the urinary phosphate excretion. Calcitonin inhibits bone resorption (Ganong 1981). Used as drugs, these hormones are also capable of inducing acid-base disorders. Calcitonin administration (Escanero et al. 1991) and vitamin D excess (Bichara et al. 1990) have been reported to cause metabolic alkalosis.

Low serum 25-hydroxyvitamin D concentrations and secondary hyperparathyroidism in middle-aged white strict vegetarians. Lamberg-Allardt C, Kärkkäinen M, Seppänen R, Biström H. Am J Clin Nutr. 1993 Nov;58(5):684-9. PMID: 8237875 In conclusion, white strict vegetarians are at risk of vitamin D deficiency, at least in the winter, primarily because of a low dietary vitamin D intake, despite a normal sunlight exposure in summer. Low serum 25(OH)D concentrations are accompanied by high S-iPTH concentrations, which also are affected by a low calcium intake. The effect of these changes on bone health remains to be evaluated.

Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. Gloth FM 3rd, Alam W, Hollis B. J Nutr Health Aging. 1999;3(1):5-7. PMID: 10888476 All subjects receiving vitamin D improved in all outcome measures. The phototherapy group showed no significant change in depression scale measures. Vitamin D status improved in both groups (74% vitamin D group, p < 0.005 and 36% phototherapy group, p < 0.01). Improvement in 25-OH D was significantly associated with improvement in depression scale scores (r2=0.26; p=0.05). Vitamin D may be an important treatment for SAD. Further studies will be necessary to confirm these findings..

Many U.S. teenagers -- including half of African Americans -- would be considered vitamin D-deficient if the definition of deficiency were changed to what many experts recommend, a new study finds. Right now, people are considered to have an overt deficiency in vitamin D when blood levels drop below 11 nanograms per milliliter (ng/mL), but there is debate over how the optimal vitamin D level should be define

The American diet circa 2007 is a disaster - but positive change has begun. Those were the twin themes of the "Fourth Annual Nutrition and Health Conference" held in San Diego, Calif., May 14-16, 2007. The conference was sponsored by the University of Arizona's College of Medicine in conjunction with the Program in Integrative Medicine (PIM); PIM was founded and is co-directed by Dr. Weil. \n\nThe three-day event brought together leading nutrition researchers from around the world, bearing plenty of both bad and good news. Some highlights:

A Lecture by Reinhold Vieth, Professor, Departments of Nutritional Sciences and Laboratory Medicine and Pathobiology, Mount Sinai Hospital. Presentation Date: Friday, October 21, 2005 (works in Internet Explorer, but not properly in Firefox (slides don't change in Firefox)).

Vitamin D deficiency is the cause of common obesity. Foss YJ. Med Hypotheses. 2009 Mar;72(3):314-21. Epub 2008 Dec 2. PMID: 19054627 doi:10.1016/j.mehy.2008.10.005 Common obesity and the metabolic syndrome may therefore result from an anomalous adaptive winter response. The stimulus for the winter response is proposed to be a fall in vitamin D. The synthesis of vitamin D is dependent upon the absorption of radiation in the ultraviolet-B range of sunlight. At ground level at mid-latitudes, UV-B radiation falls in the autumn and becomes negligible in winter. It has previously been proposed that vitamin D evolved in primitive organisms as a UV-B sensitive photoreceptor with the function of signaling changes in sunlight intensity. It is here proposed that a fall in vitamin D in the form of circulating calcidiol is the stimulus for the winter response, which consists of an accumulation of fat mass (obesity) and the induction of a winter metabolism (the metabolic syndrome). Vitamin D deficiency can account for the secular trends in the prevalence of obesity and for individual differences in its onset and severity. It may be possible to reverse the increasing prevalence of obesity by improving vitamin D status.

"The major factor which stimulates weight gain in winter months is vitamin D. Human bodies get vitamin D from sunlight; as the hours of sunlight become less with the onset of fall, so our levels of vitamin D decrease. Low levels of vitamin D affect the brain's production of the hormone leptin. Leptin plays a vital role in controlling appetite and metabolism; so as the amount of vitamin D in our bodies decreases so does the leptin, and this causes an increase in our appetite and a change in our metabolism. Researchers at Aberdeen University found that obese people had 10% less vitamin D than people of average weight. The study also found that excess body fat absorbed vitamin D so the body couldn't use it. Scientists now believe that there is a direct correlation between obesity and low levels of vitamin D.