The Institute of Medicine recommendations on vitamin D are a new low in ignorance and data suppression.

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By Marc Sorenson, EdD

The Institute of Medicine (IOM), a health arm of the National Academy of Sciences, has just released its long-awaited vitamin D supplementation recommendations. To the disappointment of the world’s leading vitamin D scientists, those recommendations make a mockery of an exhaustive body of scientific research.

The IOM suggests that 600 international units (IU) of supplemented vitamin D3 per day is ideal, and that a blood level of 20 ng/ml is sufficient for optimal human health. The IOM also suggests that supplementation with higher quantities of vitamin D could be harmful and that there are no randomized controlled trials to prove the safety or efficacy of higher levels of supplementation.

The Sunlight Institute declares that the IOM’s recommendations are ill-conceived and dangerous for the following seven reasons:

1. Extensive research indicates that if there were no other dietary source of vitamin D, 600 IU per day in adults would produce a blood level, on average, of about 6 ng/ml, a level so low that it correlates to the occurrence of the disease osteomalacia or “adult rickets.” Incredibly, in the press conference, it was stated that 600 IU would be adequate at the North and South Poles.

2. The IOM considers the 600-IU-per-day recommendation, added to dietary sources and sunlight exposure, to be sufficient for optimal health. In reality, little vitamin D is present in foods. For example, three glasses of vitamin D-fortified milk provides only 300 IU; 3.5 oz. of farmed salmon, 200 IU; a glass of fortified orange juice, 100 IU totaling a mere 1,200 IU per day including the IOM-recommended 600 IU supplement. Sunlight exposure, the most natural and productive source of vitamin D, could easily fill in the gap to a 2,000 IU level during the summer, but in the winter, north of latitude 340,(On a line from Los Angeles to Atlanta, for example) little or no vitamin D is produced. In the northern US and in Canada, “vitamin D winter” (the time during which the body cannot produce any vitamin D from the reduced amount of available sunshine) lasts for several months. Ninety-five percent of Canadians are considered (by non-IOM measures) to be D deficient in winter, and Americans in the Northern states are not much better. A 600-IU supplement plus the IOM’s recommended food sources is a recipe for a winter health disaster, which may include highly increased susceptibility to colds, influenza, cancer, heart disease MS, septicemia and numerous other maladies. It was also stated at the IOM press conference that the average American gets 200-300 IU from food.

3. Vitamin D blood level of 20 ng/ml are not really even sufficient for bone health, and that number sets research back several years. The “normal vitamin D range” printed on laboratory blood-test results prior to 2005 was from 8.9 ng/ml to 46.7 ng/ml. Based on newer research findings, that range changed after 2005, and lab test results began carrying the statement, “Recent studies consider the lower limit of 32 ng/ml to be a threshold for optimal health” with a reference to research conducted by Dr. Bruce Hollis who is widely regarded as one of the world’s top vitamin D scientists. (Hollis BW. J Nutr 2005;135:317-22) Dr. Hollis stated: “The current adult recommendations for vitamin D, 200-600 IU per day, are very inadequate when one considers that a 10-15 min whole-body exposure to peak summer sun will generate and release up to 20,000 IU vitamin D-3 into the circulation.” Hollis has also established that pregnant and lactating women need as much as 6,000 IU daily to provide for their own and their infants’ needs (Hollis, BW. J Bone Miner Res 2007;22, suppl 2:V39-44). The IOM’s low recommendations attempt to take us back to the Dark Ages of vitamin D knowledge.

4. The fact that up to 20,000 IU of vitamin D can be produced by sunlight exposure (the natural source of vitamin D) defines the IOM recommendation of 600 IU as being ludicrous. 600 IU is produced in summer sunlight in less than one minute in a light skinned individual. If God or nature created a system that produces such a vast quantity of D, there is a reason for it, and it is obvious that 5,000 IU per day is not harmful. Dr. Reinhold Vieth has presented compelling information that there is no evidence of any toxicity or adverse effects at prolonged intakes of 10,000 IU per day (Vieth, R Ann Epidemiol;2009;19:441-5).

5. The IOM also inexplicably recommended the same vitamin D intake for infants as for adults (600 IU), which to any reasonable person, is illogical.

6. The IOM used only bone health to make its recommendations, but bone health is a terrible indicator of adequate vitamin D levels because only very small quantities of vitamin D are adequate to ensure bone health. The IOM, by ignoring both observational and randomized controlled trials showing that low levels of vitamin D correlate to a multitude of health problems including cancer, heart disease, depression, influenza, Multiple Sclerosis, and autism, has done a dreadful disservice to those struggling with these and other health issues that are impacted by low vitamin D levels.

7. Ironically, the IOM consulted with several leading vitamin D researchers but then completely ignored their recommendations. This indicates a bias that may extend beyond simple ignorance and descend into the realm of concealing information.

Another of the most prolific researchers in the vitamin D field, Dr. William Grant, gave the Sunlight Institute this statement regarding his feelings about the IOM report:

“The Dietary Reference Intakes for Vitamin D and Calcium committee of the Institute of Medicine of the National Academies was essentially a tool of the agencies that funded the study, including the Food and Drug Administration and the National Institutes of Health. Federal sponsors defined the key questions, and a technical expert panel was assembled to refine the questions and establish inclusion and exclusion criteria for the studies to be reviewed. By excluding ecological studies and case-control studies in which serum 25(OH)D levels were measured at time of diagnosis, they in essence dictated the conclusion that vitamin D has no health benefits other than for healthy bones. Since 90% of our vitamin D comes from the sun, they throw out 90% of the evidence. The work of this committee contrasts with well-conducted scientific reviews such as that by the Intergovernmental Panel on Climate Change, which included over 600 scientists contributing to the report and 500 scientists as reviewers. The process was open rather than behind closed doors and resulted in a Nobel Prize for the contributors. If only health policy were treated as a science instead of a business tool.”
William B. Grant, Sunlight, Nutrition and Health Research Center (SUNARC), San Francisco

In putting forth its report, the IOM has destroyed any credibility it might have had with those who conduct the science of vitamin D. The IOM has misled the public and placed itself on a level with those who, in the past, ignorantly told us to avoid sunlight exposure at all costs. If the public follows their recommendations we will return to the Dark Ages of health awareness; the report is an absurd suppression of critically important research.

Vitamin D deficiency is costing Europe a fortune in lives and money!

Dr. William B Grant and his colleagues have just released a paper that analyzes the terrible financial burden that Europe is bearing due to lack of sunlight and vitamin D.[1] The diseases they mention that are related to vitamin D deficiency and have severe economic effects are “several types of cancer, cardiovascular disease, diabetes mellitus, several bacterial and viral infections, and autoimmune diseases such as multiple sclerosis.”

The reasons offered for the deficiency are high latitudes, indoor living (lack of sunlight exposure), lack of sufficient dietary vitamin D and lack of vitamin D fortification in most European countries. The cost is estimated at a staggering 187,000 million Euros per year.

These researchers estimate that the cost to educate and test the population and furnish the supplementation that would eliminate the deficiency—and thereby eliminate the diseases caused by it—would be about 10,000 million Euros yearly. What a great return on investment that would be! For every Euro spent on the program 18.7 would be saved.

Let’s hope that the heads of state listen to Dr Grant and his colleagues, and let’s pray that the U.S. and Canada do the same. We cannot allow vitamin D deficiency to take the lives of millions of people while we wait for more research to be sure. The research on the marvelous benefits of optimal vitamin D levels piles up weekly; the time to act is now.

Dr. Grant, by the way wrote the foreword for my book, and there is a tribute to his work therein. His dedication to informing the public and saving lives is second to none.

[1] Grant, W.B., et al., Estimated benefit of increased vitamin D status in reducing the economic burden of disease
in western Europe, Progress in Biophysics and Molecular Biology (2009), doi:10.1016/j.pbiomolbio.2009.02.003

Sarah Palin, vitamin D and tanning beds, part 4: The truth about tanning beds and melanoma

We have discussed in this “Sarah Palin” series, the fact that she was probably correct in installing (with her own money) a tanning bed in the Alaska Governor’s mansion. We showed that melanoma risk has increased exponentially as sunlight exposure had decreased. We also showed that melanomas occur most frequently on areas of the body that receive the least sunlight. As Dr Frank Garland stated in a conference of vitamin D Scientists in San Diego, California, “Melanoma is a disease of indoor office workers.”[1] He and his brother, Cedric had done research showing that indoor workers had about a 50% greater risk of melanoma than outdoor workers.[2]

In this blog I make the point that not all of the research on tanning beds is bad, although you’d never know it by the broadsides coming out of the American Academy of Dermatology, the American Cancer Society and others who have a very strong financial interest in hiding or refuting any positive news about either sunlight or tanning beds. This and the next article in the series will discuss some of the positive research that has appeared in medical and scientific journals and been ignored.

Several studies have investigated the relationship of tanning-bed use to melanoma and a review of 22 investigations done from 1979 through 2002 showed that only four indicated tanning beds increased melanoma risk; eighteen showed no association.[3] One that showed an increased melanoma risk was conducted by Dr. Philippe Autier and colleagues in Belgium in 1991.[4] However, in 2002 Dr. Autier conducted another study in which no association between tanning bed use and melanoma was found.[5] This report stated, “No result suggested a dose-response curve, and no association was even present for subjects who reported more than 35 hours of cumulated tanning bed use at least 19 yrs before the interview. Our study doesn’t support the possibility that tanning bed use could increase melanoma risk.” Isn’t it interesting that such reports usually die in obscurity?

I looked for other studies that might have come to contrary conclusions and found one from 2007.[6] It was a meta-analysis of 19 studies that concluded tanning beds do increase the melanoma risk. However, when Dr. William Grant assessed the meta-analysis, he noted that the studies failed to take skin type into consideration.[7] He re-analyzed the data and determined: “These results indicate that when studies largely influenced by inclusion of people with skin phenotype 1 [light-skinned non-tanners] without adjustment for skin phenotype are removed from the meta-analysis, no significant relation is found between tanning bed use and risk of CMM [cutaneous malignant melanoma].” There is no doubt that non-tanners, especially if they have large numbers of moles, need to be extremely cautious when they are exposed to ultraviolet (UV) light, whether from sunlight or tanning beds, the reason being that they burn so easily. More than a few seconds of exposure can burn this skin type. However, it appears that all other types can benefit from moderate UV exposure.

Stay tune for more on tanning beds and melanoma in the next chapter regarding Sarah’s tanning bed.

[1] Garland F. Address to the Grassroots health Vitamin D conference, December 2, 2008.
[2] Garland F. et al. Occupational sunlight exposure and melanoma in the USA Navy. Arch Environ Health 1990; 45:261-67.
[3] International Smart Tan Network 2006. Research shows no connection between tanning and melanoma: Why this is misunderstood.
[4] Autier, P. et al. Cutaneous malignant melanoma and exposure to sunlamps and tanning beds: a descriptive study in Belgium.
[5] Autier, P. et al. tanning bed use and risk of melanoma: results from a large multicentric European study. Poster at the XVIII International Pigment Cell conference held 9-13 September 2002 at Egmond, The Netherlands.
[6] International Agency for Research on Cancer Working Group on artificial ultraviolet light (UV) and skin cancer. The association of use of tanning beds with cutaneous malignant melanoma and other skin cancer: a systematic review. Int J Cancer 2007;120:1116-22.
[7] Grant, W. Insufficient evidence exists to link tanning bed use to risk of melanoma for other than those with skin phenotype 1. Sunlight, Nutrition and Health Research Center (SUNARC). March 9, 2007. www. SUNARC.org.

The latest on vitamin D and cancer: Dr William Grant’s brilliant review.

Dr William Grant, who writes and compiles research as fast as I can read it, gave me a tremendous assist in keeping me abreast of the current research as I wrote my book. His latest paper is entitled “How strong is the evidence that solar ultraviolet B and vitamin D reduce the risk of cancer? An examination using Hill’s criteria for causality[1]” Although the link between vitamin D deficiency and cancer should well-established, there are those who stubbornly demand more proof while millions more die of cancer caused by vitamin D deficiency. In this paper, there is sufficient proof to convince all but the most biased reader. He uses a well-accepted scientific assessment, known as Hill’s criteria for causality, which determines whether the presence or absence of one factor causes the presence of another. In this case the “causal” factor is vitamin D deficiency, and the caused factor (result) is cancer.

Here are the qualifications for causality as established by Dr. A Bradford Hill:
1. Strength of association
2. Consistency (repeated observation)
3. Specificity (one agent, one result)
4. Temporality (exposure precedes effect)
5. Biological gradient (dose-response relation)
6. Plausibility (e.g., mechanisms)
7. Coherency (no serious conflict with the generally known facts
of the natural history and biology of the disease)
8. Experimental verification (randomized, controlled trial)
9. Analogy with other causal relationships

Using these criteria, Dr. Grant discusses the voluminous research pointing out that the vitamin D-deficiency theory of cancer causality in most deadly cancers satisfies most, if not all, of Hill’s criteria. In other words, there is little doubt that vitamin D deficiency is a primary cause of cancer. For those who are scientifically inclined, I suggest you read the paper, which you can find online by searching the citation below. If you are not so inclined, take my word for it; this paper makes an irrefutable case. Neglect your sunlight and your optimal vitamin D levels at your peril. But remember, never burn!

[1] Grant, W. How strong is the evidence that solar ultraviolet B and vitamin D reduce the risk of cancer? An examination using Hill’s criteria for causality Dermato-Endocrinology 2009:1:14-21.