Article 52: First Course; Vitamin D, As in Our Daily Deficiency

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The founder and owner of Natural Ovens of Manitowoc, Paul Stitt, has turned his sights from bread to chocolate. It started a few years ago when his son, Todd, was diagnosed at age 37 with osteoporosis. This after eating a healthy diet his whole life, Stitt said, "including plenty of organic milk and cheeses. He exercised, he was the perfect picture of health (otherwise)." "It took me four years to figure out the cause," said Stitt, naming it as a deficiency of vitamin D.
Based on research of the last decade, particularly the last five years, medical experts widely agree that the current RDA for vitamin D 400 International Units (IU) is woefully low. And the result is myriad unnecessary health problems including but not limited to bone disease. The recommendations for vitamin D were set at 400 IU about half a century ago "with no scientific basis," said Bruce Hollis, professor of pediatrics, biochemistry and molecular biology at the Medical University of South Carolina and a vitamin D researcher. "At that level vitamin D does absolutely nothing." The recommendation resulted from a meeting of well-meaning pediatricians worried about rickets in children, Hollis said. All they really knew at the time was that 1 teaspoon of cod liver oil would cure rickets in a baby. And that 1 teaspoon contains 400 IU.
"In an infant that was a pretty remarkable recommendation," Hollis said; "400 units in a small baby really does something. But they made a tragic mistake by applying that recommendation to adults as well." Vitamin D is not really a vitamin at all, according to Hollis it's a hormone. It's made in our skin, and from there it gets activated through the body. The primary avenue for intake of vitamin D is exposure to sunlight. "As a species, way back, we were bathed in sunshine, we never had any shortage of it," Hollis said. Of course, this all changed as people became more civilized, spent more time indoors, began wearing clothes and, now, sunblock which inhibits production of vitamin D.
Studies have not definitively determined how many Americans are deficient in vitamin D, but according to Hollis, probably close to 100% of African-Americans are. (The darker the skin, the harder it is to get vitamin D from the sun.) Residents of northern climates are more likely to be deficient as well. "We really need to consider that, in general, most people may be vitamin D deficient," said Ed Giovannucci, professor of epidemiology and nutrition at the Harvard School of Public Health, who has researched the link between vitamin D and cancer prevention. While the link to bone disease is clearest, increasing evidence suggests that vitamin D plays a significant role in preventing many other maladies, including multiple sclerosis and multiple forms of cancer. If Americans suddenly across the board upped their levels of vitamin D, would we see a reduction in cancer rates?
While there isn't a "gold standard study," said Giovannucci, "a lot of data would support that, at least for some of the major cancers like colon, breast and possibly prostate. We already know people are getting too little vitamin D for osteoporosis prevention. And given the other potential benefits, I think we really need to rethink the current recommendations." The question is how much. "Based on current evidence, I'd say a minimum of 1,000 International Units a day, but that may turn out to be too low," Giovannucci said. "The evidence suggests that we may require at least 2,000, especially if we're not getting enough sun exposure."
Hollis and others think 4,000 International Units a day is more like it. Currently, 2,000 IU is on the books as the upper "safe" limit to avoid vitamin toxicity, Giovannucci said. But that's probably "much too conservative," he said, adding that studies have shown people can get as much as 10,000 units per day without any toxicity. Personally, he said, he's comfortable with 3,000 or 4,000 units a day, "but we have to be careful before making recommendations for the general population." Some experts recommend getting measured annually for vitamin D just as we do now for cholesterol and setting supplemental levels accordingly.
Hollis expects the RDA will be increased in the next few years; the Food and Drug Administration and other major national and international health groups are concerned about vitamin D, he said. But getting upward of 10 times the current RDA isn't easy to do.
Sunshine is the best avenue, but dermatologists are quick to bring up melanoma. For most of us, supplements are probably the best idea, Hollis said. Milk is fortified with vitamin D but only 100 IU per 8-ounce cup. Saltwater fish such as herring, salmon, sardines and fish liver oils are about the only good natural food sources of D. The problem is, over-the-counter vitamins contain very low doses of vitamin D, based on the current RDA, and "you can't take a fistful of vitamins every day." Hollis usually refers people to a Web site, www.carlsonlabs.com, which sells gel caps that contain 2,000 IU of vitamin D.
Stitt the baker (who had retired in January) has another idea: superfoods. To that end, he has produced a couple of products aimed at reversing this problem. One is bread although he can't legally label it "bread," or even a "food" by FDA rules, because it has such high levels of a nutrient. So his Natural Ovens loaf, with 1,000 International Units of vitamin D per slice, is called Bone Builder Whole Grain Supplement. But it's sold in stores in the bread department. Likewise, he can't label his vitamin-D powerhouse chocolates "chocolates" or even "clusters," as he was calling the coconut candies. Instead, the packages are labeled "Dietary Supplement" and called "Chocolate Sunshine." He is able to use the additional words "Good for you" and "Vitamin D Rich Dark Chocolate." Each chocolate has 2,000 IU of vitamin D and 90 calories and just 1 teaspoon of sugar. Stitt is also working on a vitamin D-laced peanut butter cookie snack and chocolate peanut butter spread. The chocolates, priced at $9 to $10 for a bag of 17 to 18, are sold at Woodman's, Sendik's stores, Grasch Foods and select Sentry stores and soon will be in Roundy's stores.
Meanwhile, Stitt's son is doing much better, he said. Stitt's company, Natural Ovens, sponsored a research study in Eastern Europe last year. The study found that intake of 5,000 IU of vitamin D a day for a year resulted in an increase in bone density of 23%. The results were to be reported this week at a meeting of the American Society for Bone Mineral Research and they have been submitted for publication, Stitt said.