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    Archive for the ‘vitamin D’ Category

    3 Little-Known, But Crucial, Vitamin D Facts

    Vitamin D is a nutrient (well, technically a hormone) that has had a substantial amount of research devoted to it over recent years. As someone who enjoys keeping up with the latest findings, I am often dismayed at the outdated — and often inaccurate– information shared with the public.

    Below, three crucial, but little-known, vitamin D facts everyone must know for the sake of their health.

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    Subway’s New Fortified Breads: A Good Source of “Healthwashing”

    Last week, while the new and “healthier” Happy Meals captured the attention of the nutrition and public health world, the folks at Subway quietly announced their latest “commitment to nutrition” — breads fortified with calcium and vitamin D. In brief, “now, each 6-inch serving of bread in the 24,000-plus U.S. restaurants provides 30 percent of the daily recommended value of calcium and 20 percent of the daily recommended value of vitamin D.”

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    Beyond Milk: There’s Much More To Bone Health than Calcium and Vitamin D

    Those of you who follow me on Twitter (or read my tidbits on Facebook regularly) know my stance on milk — yes, it is a good source of calcium and vitamin D (though, remember, milk in the US contains vitamin D because it is mandated by law; in many other countries, milk is devoid of the sunshine vitamin), but not the best source; it also lacks many nutrients that are crucial for healthy bones.

    Too often, conversations and debates on the nutritional “worth” of milk turn into a “cows” versus “soybeans” face-off or, if it’s slightly more advanced, “cows” versus all the available milk alternatives (soy, almond, coconut, hemp, oat, and hazelnut).

    As far as calcium is concerned, fortified foods and beverages contain calcium that is just as absorbable as — and in some cases, more absorbable than — the calcium in milk.  In other words — the added calcium in soy or almond milk is just as good for your bones as the one in cow’s milk (or any other animal’s milk, for that matter).

    Unlike the vast majority of nutrients, which only work effectively within their respective food matrices (i.e.: vitamin E, which needs to work with other antioxidants that are present in the foods it is in to do its job properly), calcium’s health benefits are equally derived from food or supplementation.

    Vitamin D is fortified in dairy and non-dairy milks.  Besides, in order to consume the high amounts we now know are needed for overall health (not just bone health), supplementation is a must.

    In order to truly tackle the topic of bone health, though, we need to go beyond the calcium and vitamin D content of milk and its vegan analogues and instead identify all the nutrients that play important roles in bone health.  In doing so, we find that milk is far from the king of the bone health hill.

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    You Ask, I Answer: Calcium Absorption, Kidney Stone Risk, and Gelatin-Free Vitamin D Supplements

    0904-calcium-supplements1. Is there research that indicates that calcium carbonate’s absorption is superior to that of calcium citrate?

    2. My doctor recently suggested that I supplement my diet with calcium and vitamin D. Is there a heightened risk of developing kidney stones associated with calcium supplementation?

    3. Most of the vitamin D supplements I’ve found contain gelatin as an ingredient. Do you know of any alternative products?

    – Josh Griffin
    (Location Unknown)

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    There’s More to Osteoporosis than Calcium

    osteoporosis-illustratedThe majority of news articles on osteoporosis never fail to mention that calcium is a key nutrient in slowing down bone density loss.

    While that is an established fact, there are other nutrients and behaviors that are just as important in risk-reduction and management of osteoporosis.

    Here’s a handy cheat sheet:

    • Phosphorus: High intakes inhibit calcium absorption and bone metabolism.  Ironically, dairy products are quite high in phosphorus.  Yet another reason why calcium intake should come from a variety of foods (i.e.: leafy green vegetables, chickpeas, almonds), including dairy (if so desired).
    • Smoking: negatively affects bone metabolism and decreases bone density levels.
    • Sodium: Excessive amounts (not at all uncommon in the “Standard American Diet”) increase calcium losses in urine.
    • Vitamin D: Facilitates calcium absorption.  Note: current guidelines (400 International Units of Vitamin D per day) are too low.  Supplement 1,000 – 2,000 International Units every day.
    • Vitamin K: Helps bind calcium to the bone matrix.
    • Weight-bearing exercise.

    There are also preliminary studies which show that zinc, manganese, and even vitamin A may play important roles as well.

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    Where Do You Stand on the Chocolate Milk Controversy?

    4415_Raise-Your-Hand

    Update (1/20/12): My stance on this issue has since solidified. I fully support chocolate milk bans at schools. In short, children consume excessive amounts of sugars, and chocolate milk only contributes to that amount. It is important to consider the “view from 30,000 feet” and realize that fixing school lunch goes well beyond the chocolate milk issue, but this is an easy step we can take to lower added sugar intake in school cafeterias.

    Over the past few days, the nutrition blogosphere has fervently discussed the latest controversy — the “Raise Your Hand for Chocolate Milk” campaign.

    Led by the Milk Processor Education Program and the National Dairy Council, the program aims to “keep chocolate milk on the menu in schools nationwide”, in light of “lunch advocates [who] are calling [to remove chocolate milk from the lunch line, a decision that could] cause more harm than good when it comes to children’s health.”

    The repertoire of widgets, colorful handouts and downloadable documents make it clear that a significant amount of money has been invested in this campaign.

    If that wasn’t enough, there is also a partnership with the National Football League and this slick promotional video that features Registered Dietitians and celeb-moms Angie Harmon and Rebecca Romijn vocalizing their support for keeping chocolate milk in schools.

    So, what to make of this?

    Nutrition professionals across the country have vastly different feelings on the matter.

    One side of the debate is succinctly explained in Dr. Marion Nestle’s top-notch blog, Food Politics.

    Dr. Nestle states:

    “The rationale for the campaign?  If you get rid of chocolate milk, kids won’t drink milk.  You will deprive kids of the nutrients in milk and contribute to the “milk deficit.”   After all, this rationale goes, chocolate milk is better than soda (Oops.  Didn’t we just hear something like this relative to the Smart Choices fiasco?).”

    She also adds that this “it’s all about the children!” campaign is about something else — profit.

    Specifically, Dr. Nestle states, “schools represent sales of 460 million gallons of milk – more than 7% of total milk sales — [and slightly more than] half of flavored milk is sold in schools.”

    Other nutritionists, however, see this campaign as one that takes the important step of “looking at the big picture.”

    While they realize chocolate milk is not an ideal beverage, it is a better alternative than sodas or sugar-laden fruit drinks.  If chocolate milk is the only way a child will drink milk, they argue, then it would be a true shame to have it removed from school cafeterias across the country.

    I am absolutely torn.

    As regular readers of Small Bites know, I have my issues with The Dairy Council.  I find it troubling that, due to their large budget and forceful lobby, they have managed to convince an entire nation that the only way to get calcium in one’s diet is through dairy products.

    Approximately three quarters of African Americans and Asian Americans are lactose intolerant; many of them are not aware that calcium is found in broccoli, bok choy, almonds, and chickpeas.  Due to the Dairy Council’s influence, many educational pamphlets fail to mention non-dairy sources of calcium!

    In fact, this campaign fails to mention that chocolate soymilk offers the exact same nutrients.

    That said, chocolate milk is far from calcium-fortified junk.

    Apart from the popular mineral, chocolate milk also offers potassium, magnesium, vitamin D (fortified), riboflavin, and vitamin B12.  It is very different from a calcium-fortified Kool Aid drink.

    A standard cafeteria-size carton of chocolate milk contains 12 grams (a tablespoon) of added sugar.  That amounts to 48 more calories than non-flavored milk.  I simply can’t muster much emotion over 48 extra calories (assuming, of course, that chocolate milk consumption is kept to one 8-ounce carton a day).

    Similarly, 12 grams of added sugar are not a big deal in a diet that is otherwise not sugar-laden.  Sadly, the average US teenager consumes six tablespoons of sugar on a daily basis!

    So, in that sense, since any decrease in added sugar intake is positive, why not slash an entire tablespoon by getting rid of chocolate milk?  Then again, why not focus on the nutrition-void, sugar-filled junk that is also available at school cafeterias?

    By the way, what has been missing from a lot of the articles and blog posts I have read is this: a chocolate milk ban is absolutely meaningless if, during their lunch period, students can purchase a bottle of Snapple iced tea (added sugar count: 3 tablespoons!) from a vending machine.

    While I very well may eventually take a firm stand either “for” or “against” keeping chocolate milk in schools, I am currently undecided.

    For the time being, I want to open the floor for discussion.

    What do you think?  Is chocolate milk worth worrying about?  Why or why not?

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    ‘Tis The Season… to Supplement!

    0805p44c-vitamin_d-mIf you live north of the Georgia stateline (or, for European readers, north of Naples), it’s time to purchase vitamin D supplements.

    Remember that from late October to mid April, the sun rays involved in vitamin D production (UVB rays) don’t reach you if you live above that particular longitude.

    Aim for 1,000 to 2,000 International Units of vitamin D a day.

    The popularly-quoted official triple-digit recommendations have not caught up with the multitude of recent top-notch research studies that clearly indicate we need at least 1,000 International Units a day.

    By the way, it does not matter if your supplement is made up of vitamin D2 or vitamin D3.

    Also, keep in mind that certain foods — milk, dairy-free milk alternatives, and cereals — already offer some supplemental vitamin D.

    Below are two Vitamin D-related questions I have received and are worth sharing:

    Are tanning beds a good way to get UVB rays during these next few months?  (Kate R., via Facebook)

    No.  Tanning beds aren’t an exact replica of the sun.

    Many of them contain higher amounts of UVA rays and significantly lower amounts of the vitamin-D-producing UVB rays.

    The risks far outweigh the benefits.

    Is cod liver oil a good way to supplement vitamin D? (Adam L., via Facebook)

    While cod liver oil has long been passed down as a “healthy food to give your child” tip from one generation to the next, the consensus among nutrition professionals is that it is not the optimal source of vitamin D.

    The concern revolves around cod liver oil’s extremely high vitamin A content.

    Since vitamin A is a fat-soluble vitamin, extraneous amounts are stored, rather than excreted (as is the case with vitamin C, a water-soluble vitamin).

    Taking in the 1,000 – 2,000 International Unit Vitamin D recommendation via cod liver oil delivers an exorbitant amount of vitamin A.

    This is especially problematic in light of research that shows vitamin D’s bioavailability is diminished in the presence of high amounts of vitamin A.

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    When NOT To Go Skim

    product_sc_whiteIf you are a regular skim milk drinker and optimal nutrition is your goal, there are certain times when low-fat (1%), reduced-fat (2%), or soy (rather than skim) is the way to go.

    Although all milk in the United States is fortified with vitamins A & D, non-fat milk is a rather useless vehicle for it.  Why?  Vitamins A and D are fat-soluble, meaning they need to be consumed along with a small amount of fat (3 or 4 grams usually suffice) to be absorbed.

    If at any point in the day you are drinking non-fat milk without any other source of fat, you are much better off opting for a low-fat variety.

    Remember, an 8-ounce cup of low-fat milk only contains 14 more calories, 1.8 more grams of fat, and 0.9 more grams of saturated fat than that same amount of skim milk.

    If you enjoy the taste of soy milk, make yourself a vegan latte.  A cup of soy milk contains enough fat to help you absorb fat-soluble nutrients.

    Here are some tips to help you get the most out of your dairy consumption:

    • Accompany your fat-free morning latte with a healthy fat (i.e.: 1 tablespoon of the nut butter of your choice on whole grain toast)
    • Not a fan of sipping coffee between bites of food?  Make your coffee with low-fat, reduced fat, or soy milk
    • If you only like your oatmeal with non-fat milk, throw in some raw almonds or walnuts in there to help you absorb vitamins A and D
    • If you only enjoy fruit smoothies made with non-fat milk, add a tablespoon of ground flaxseed to add that important small amount of fat
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    The (Non-Existent) Battle of the Sexes

    300054755506The makers of Centrum are heavily advertising their newest multivitamin — Centrum Ultra Women’s — on television.

    This product — “specially formulated with key nutrients to help meet a woman’s nutritional needs” — contains additional amounts of Vitamin D (which the commercial points out “has been shown to promote breast health”) and calcium.

    Sounds lovely, but this is marketing hype in its purest form.

    First of all, the link between vitamin D intake and breast cancer is only suggestive at this point.  More research is certainly needed.

    Additionally, there is a growing body of research which suggests that adequate levels of vitamin D may help lower men’s risk of developing prostate cancer.

    As for the extra calcium (the Ultra Women’s formula provides 500 milligrams, while the Ultra Men’s offers 210 milligrams) — why?  Men and women have the exact same calcium recommendations (these fluctuate according to age, not sex).

    Main takeaway: both sexes equally benefit from adequate nutrition.

    His and hers multivitamins are simply a result of Madison Avenue looking to maximize profit.  Don’t fall for it.

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    You Ask, I Answer: Vitamin D Production

    300px-Sol_de_Mayo-Bandera_de_Uruguay.svgHow much Vitamin D does our body make from the sun?

    Shouldn’t that be the amount we try to get from supplements?

    – Rick (last name withheld)
    Baton Rouge, LA

    Our bodies can synthesize up to 10,00 International Units of Vitamin D from sunlight.

    Remember, our bodies are intelligent enough to know when to stop Vitamin D production (if not for these self-regulatory mechanisms, we could potentially synthesize millions of International Units per day, which would be very harmful.)

    The fact that we can safely take in 10,000 International Units does not mean we should aim to get that much from supplements in pill form.

    That figure is considered the Upper Tolerable Intake — “the highest level of daily intake of a nutrient that is likely to pose no risk of adverse health effects for most people.”

    The research literature on Vitamin D clearly shows that daily intakes of 1,000 International Units provide the necessary health benefits for most people (some individuals, like expecting mothers and the elderly, have shown to benefit more effectively with supplement ranging from 1,500 to 2,000 International Units a day).

    I strongly agree with nutrition scientists who are flabbergasted by the ridiculously low curret recommended Vitamin D intakes.  They need a major overhaul… ASAP.

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    You Ask, I Answer: What Vitamin D Supplement Should I Buy?

    vitamindI can’t figure out what type of vitamin D supplement to buy. There appear to be many different kinds with confusing labels.

    Some had names that made references to sunlight, but I still wasn’t sure. You discussed a few posts back what to look for in a fish oil supplement, but what about vitamin D?

    Also, my boyfriend works outside (we live in Austin, Texas). He doesn’t tolerate milk, but he eats cheese.

    Should he take a vitamin D supplement also, or does he likely get enough sun exposure from being outside all day?

    – Kristin Macbride
    Via the blog

    Despite all the marketing hype you see, there isn’t much diversity in the Vitamin D supplement market.

    There are only two different types you can purchase — vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol).

    While vitamin D2 is a yeast or fungus-based vegan form, supplemental vitamin D3 is synthesized from lanolin, a substance obtained from sheep’s sebaceous glands.

    It was initially believed that vitamin D3 was more efficient because it raised serum levels of 25(OH)D (25-hydroxyvitamin D, which reflects vitamin D status in blood) more efficiently that vitamin D2.

    The latest research, however, shows no difference between both forms if they are supplemented on a daily basis at a rate of 1,000 International Units per day.

    Remember — vitamin D is a fat-soluble vitamin, so you need to take your supplement with a meal that contains some fat (as little as 3 grams).

    Taking a vitamin D supplement with a glass of water three hours after dinner before going to bed doesn’t accomplish anything.

    As for your boyfriend’s situation: since you live in a geographical area where UVB rays (the ones necessary for skin synthesis of vitamin D) reach you year-round, he doesn’t need to supplement if he is exposed to thirty minutes of sunlight (without sunscreen protection) on approximately forty to fifty percent of his body between the hours of 10 AM and 2 PM.

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    In The News: D-Pressing News

    sunshineDisturbing news courtesy of a recent national study led by researchers at Albert Einstein College of Medicine of Yeshiva University: “about 70 percent of U.S. children have low levels of vitamin D, which puts them at higher risk for bone and heart disease.”

    Specifically, 9 percent of U.S. children are Vitamin D deficient, while an astonishing 61 percent are vitamin D insufficient (meaning they do not meet required levels, but have not yet develop deficiencies).

    Even more disturbingly, “cases of rickets, a bone disease in infants caused by low vitamin D levels, have also been increasing.”

    Geographic location is a significant obstacle to obtaining optimal vitamin D levels.  Anyone living north of Georgia, for example, is unable to synthesize the vitamin from sunlight between October and April since UVB rays are not poweful enough.

    While dairy products — and their alternatives — are fortified with vitamin D, children do not consume enough of these foods to meet needs.

    Vitamin D is an exception to my “food first, then supplements” rule.

    I highly recommend EVERYONE supplement their diet with at least 800 – 1,000 International Units of Vitamin D every day (note: that figure includes vitamin D from fortified foods).

    Current vitamin D recommendations are outdated; they do not reflect overwhelming evidence from recent clinical research trails that demonstrate substantial health benefits from the higher intakes mentioned above.

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    You Ask, I Answer: Children & Soy Milk

    pearl-original-soymilkDo you think it’s okay for toddlers to forgo cow’s milk altogether and just drink soy milk instead?

    – Jane (last name withheld)
    Waltham, MA

    Absolutely.

    As long as the brand of soy milk they are drinking is fortified with calcium and Vitamin D (as most are) and it contains some fat (as most do), I don’t see a problem.

    Since soy milk provides roughly a half or two thirds of the fat in whole milk, be sure to make up for that by providing some extra fat in their meals.

    I certainly don’t recommend buying “light” versions.

    Remember, too, that all soy milks (except unsweetened ones) contain added sugar.  Yes, even plain flavors.

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    You Ask, I Answer: Fat-Soluble Vitamins

    olive-oil-bottlesHow much fat do you need to eat in a meal to ensure proper absorption of vitamin A?

    – Corey Clark
    (Location withheld)

    Great question!

    There’s nothing more frustrating than eating a nutritious meal only to completely miss out on the absorption of certain vitamins and minerals.

    Remember, vitamins A, D, E, and K are fat-soluble.  They need fat to be absorbed; eating them in a completely fat-free meal (ie: salad with fat-free dressing and vinegar) is an exercise in futility.

    To ensure you are absorbing these nutrients at maximum capacity, be sure to consume them with at least 4 or 5 grams of fat.

    That should not be a hard task.  The following foods provide that amount of fat:

    • 1 teaspoon oil
    • 8 almonds
    • 1.5 ounces salmon (equivalent to a mere HALF deck of cards!)
    • A quarter of an avocado
    • Half an ounce of cheese
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    Advertising the Artificial

    ellie_kriegerThe National Dairy Council’s latest “Got Milk?” advertising campaign (seen here at left) is the first in its 16-year history to feature a Registered Dietitian.  Golf clap.

    Forgive my lack of enthusiasm, but it’s the ad’s accompaying text that I have a serious problem with:

    When it comes to wellness, little things really make a difference.  Like drinking three glasses of lowfat or fat free milk a day.  It’s loaded with Vitamin D, the sunny super nutrient whose preventing health benefits have everyone buzzing.  Just think of it as liquid sunshine.”

    Bad grammar apart (starting a sentence with “like”?  Really?), I  take issue with the fact that the advertised nutrient is simply tacked on.

    Vitamin D is not inherently present in milk — or any dairy product, for that matter.  It just so happens that in the United States, as a result of fortification laws passed in the 1930s, a cup of milk currently provides 100 International Units of Vitamin D (that’s a quarter of a day’s worth of the considered-by-many-to-be-low requirement).

    This advertisement would make no sense in a country like England, where milk is not fortified with Vitamin D.

    Besides, almost every non-dairy milk product (almond, soy, oat, and rice) is also fortified with the vitamin.  So what makes dairy milk special in that regard?  Nothing.

    In fact, a serving of sugary cereal like Lucky Charms offers as much Vitamin D as a cup of milk.  Imagine how silly this advertisement would look if it featured a big box of Lucky Charms.

    Why can’t the National Dairy Council keep it honest and make it clear that milk is “loaded” with Vitamin D as a result of fortification?

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