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Vitamin D Newsletter
John Jacob Cannell, M.D.
View Dr. Cannell's bibliography here.
John Jacob Cannell was born in Washington DC on June 21, 1948. During his college years he had a penchant for social activism and was deeply involved in working against the Vietnam War. While at University of Maryland he helped organize the "March on Washington" and also demonstrated against the war at the 1968 Chicago Democratic Convention. In 1969, he dropped out of college to join the government's Volunteers in Service to America (VISTA) program. Quickly dismayed with VISTA's ineffectiveness, Cannell returned to University of Maryland where he graduated Phi Beta Kappa in Zoology. Cannell then went on to medical school at the University of North Carolina. After a year of a surgery internship at the University of Utah and four years of practicing itinerant emergency medicine, he began as a general practitioner in the coalfields of Appalachia.
The Black Lung Debate
In 1983 Dr. Cannell started the Cannell Clinic, Inc. in Flat Top, West Virginia. It wasn't long before Cannell noticed that all of his coal-mining patients smoked cigarettes, prompting him to start an anti-smoking activist campaign. He hired several teenage workers to speak against smoking, ask stores not to sell cigarettes, and make presentations to businesses. He even asked a patient dying from emphysema if she wanted to record a television ad against smoking. She jumped at the chance and the Cannell Clinic, Inc. ran the ad frequently on local television. Cannell paid for newspaper ads that compared cigarettes to drugs and he even announced that his clinic would no longer accept patients who smoked. The New York Times took notice and ran a story on his anti-smoking activities in Feburary of 1988.
However, Cannell eventually gave up his anti-smoking campaign after learning what Appalachian coal miners learned long ago. "Doc," the coal miners would tell him, "I need to smoke to get my Black Lung." You see, coal miners who smoke are more likely to qualify for the federal Black Lung disability program than those who don't. Since mine owners don't provide reasonable retirement benefits, the miners consider Black Lung their "retirement."
During Black Lung exams doctors measure lung function. Coal miners who have never smoked often do not have the severe pulmonary function deterioration found in smoking miners, and thus no Black Lung. This is because silicosis was common before newer OSHA regulations. Now the miners get anthracosis, which may cause impressive x-ray changes, even though it often does not severely impair pulmonary function (the miners have to smoke to assure that). Cannell found that a miner who had smoked heavily all his life often got Black Lung after a few years in the mines. However, a miner who didn't smoke might have a hard time getting his "retirement" after serving twenty years underground.
Cannell lobbied the members of the West Virginia Medical Society asking for a resolution to stop using pulmonary function testing to award Black Lung benefits and instead endorse years of service as the basis for receiving the benefit. However, Cannell soon learned that West Virginia doctors made a large amount of money by administering Black Lung medical exams (as lawyers did by appealing those exams). Realizing Black Lung was the only retirement miners had and that powerful interests wanted to keep it that way, Cannell had to give up. He could no longer ethically ask the miners to stop smoking if that meant they would end up living out their old age in poverty. He tried to interest the press in this tragic story, though to no avail.
"Lake Woebegone" and fradulent testing
It wasn't much longer until Cannell found a new cause to champion for. In the late '80s, the Beckley Register/Herald ran a story stating that all 55 West Virginia counties were above the national average on commercial elementary standardized achievement tests after which the local newspaper ran an editorial congratulating both state and local officials. Cannell read the stories and decided to do some investigating.
Upon researching "normed referenced" commercial elementary achievement tests, Cannell discovered that the commercial publishers are free to choose their own "norm group" (a group of students said to represent the average which are given the test without any test preparation). The publishers sell the test booklets, the norms, and the answer keys to school officials who reuse the same booklets (with the same questions) each year. Teachers told Cannell that any administrator seeking a promotion will have his teachers handle the booklets so that they can teach the answers to their students.
As an experiment, Cannell called publisher CTB/McGraw Hill, pretending to be a school official interested in buying their test. He expressed concern that his students might not be above average and he would look bad when the local press found out. The salesperson assured him that was unlikely to happen with their test because they are "careful with their norm group." But if he was still concerned, they could provide "low socioeconomic norms" with the test, basically guaranteeing his students would score above the national average. Cannell was soon discovered and CTB/McGraw Hill responded with the threat of a lawsuit.
Outraged, Cannell set out to find out the rankings of other poverty-stricken states, such as Mississippi, Louisiana, Arkansas, South Carolina, Tennessee, Georgia and Kentucky—interestingly, they were all "above the national average." This reminded Cannell of "Lake Woebegone," Garrison Keillor's mythical Minnesota town where "all the women are strong, all the men are good-looking, and all the children are above average." Yet once again, the press wasn't interested.
Realizing that if all those poor states were "above the national average," then all 50 states were probably claiming the same thing and more than likely, nobody knew it! Sure enough, the U.S. Department of Education confirmed that they do not regulate or oversee commercial achievement testing in the United States. William Bennett, then Secretary of Education, had no idea what the states were reporting to their citizens, and it was the same with all his predecessors. They did not consider it their business as it was the for-profit business of commercial test publishers like CTB/McGraw Hill and Houghton Mifflin.
This led Cannell to form the nonprofit, Friends for Education, in 1986 which began a grassroots organization to reform the public education system. Noticing how filthy the local schools were, Friends for Education began a "Dirtiest Public School in West Virginia Contest," the winner of which would get $100.00 worth of mops, brooms, and soap from Friends for Education. School officials were outraged, but the mops came out of the closet and the schools seemed to get cleaner.
In addition, Friends for Education filed sexual discrimination complaints against the West Virginia State Department of Education, claiming women held 80% of the low paying teaching jobs, but men held 80% of the higher paying administrative positions. They had filed similar complaints in Raleigh County just 18 months earlier.
In 1987 Cannell then went to Arch Moore and publicly asked for his $1,000.00 donation back. Arch Moore, while running for governor in 1984, had promised Cannell he would reform public education in West Virginia upon being elected. Moore, who had yet to make any reforms, refused to refund Cannell's money. Moore was later convicted of bribery and income tax evasion charges for robbing, of all things, the state's Black Lung fund.
Up to this point, only the local press was interested in Cannell's compelling story as no one in the national press could believe that the government would allow such corrupt testing. So Cannell then collected the results from all 50 states—which, of course, were all "above the national average." and this finally got the attention of the national press.
The story got high-profile coverage in The New York Times, The Wall Street Journal plus hundreds of other newspapers. It even received segments on the McNeill/Lehrer Show and Sunday Today.
Friends for Education received two small grants from the Kettering Family Foundation, which allowed Cannell time to write and publish two booklets on the subject of fraudulent testing as well as pen an article for the leading test journal in the country—in fact, that entire issue was devoted to his discovery of "Lake Woebegone" testing.
Friends for Education then filed consumer fraud complaints with the Attorney Generals of all fifty states. Secretary of Education William Bennett held a special meeting about the issue, Congress held hearings on "Lake Woebegone" testing, and CBS' Sixty Minutes featured a segment on Cannell's work exposing the fraudulent testing.
Yet despite all this, nothing changed. The schools continued to give the tests, administrators proudly reported the scores, and newspapers dutifully printed the "above average and improving" story. Of course the politicians loved it. Bill Clinton ran heavily on his education record, proudly pointing to Arkansas test scores, in spite of the fact that Arkansas had particularly fraudulent testing during Clinton's tenure. To his credit though, Clinton proposed a national testing program in his 1997 State of the Union message, a program that would have ended "Lake Woebegone" testing in America. Clinton wasn't alone in using deceptive test results; the Rand Corporation reported the same thing about Bush during the 2000 election.
The politicians weren't the only beneficiaries—the school administrators looked great, the teachers also looked like they were doing a good job, the test publishing business flourished and parents were delighted to learn that their Johnny was above the national average. A perfect con, everyone benefits except the kids (who are often poor and black), being told they are doing okay when they are probably destined to graduate functionally illiterate.
Cannell believes norm-referenced testing of American elementary school kids is just as fraudulent today as it was 15 years ago. A more recent New York Times article, reports that fraudulent testing is more popular than ever. Bush's new testing program will still allow states to use "Lake Woebegone" commercial achievement tests to claim they are above the national average. However, it mandates that states can only tell half the kids they are above the state average.
A renewed interest in clinical nutrition
Discouraged over having wasted so much time, effort, and money trying to improve public education and needing a change in his life, Cannell left general practice and went back to school to study psychiatry. He moved to Atascadero, California in the late '90s and began working as a psychiatrist at Atascadero State Hospital, the largest hospital in America for the criminally insane. There, his long-held interest in clinical nutrition was re-awakened. And the further he delved into the subject of nutrition, the more and more vitamin D3 cholecalciferol caught his attention.
The formation of the Vitamin D Council
As Cannell began to study the effects of vitamin D, he immediately realized that the Food and Nutrition Board (FNB) of the U.S. Government's Institute of Medicine (IOM) was placing many Americans at risk. He read that vitamin D insufficiency was common in older adults, even using conservative cutoff levels for vitamin D blood levels, with a reported prevalence of 57% of medical inpatients.
He also found that in Canada, more than 20% of healthy young women had low vitamin D levels, with the prevalence higher among nonwhites as expected due to skin pigmentation. Vitamin D Expert Dr. Reinhold Vieth clearly pointed out that vitamin D supplements (such as multivitamins or dairy products) did not prevent the deficiency; in fact, the two were not even related! Dr Fuller and Dr. Casparian, in 2001, reviewed the literature and concluded, "Previous studies that have found serum levels of vitamin D in their sun-protected subjects to be in the normal range may need to be reevaluated." Forty-two percent of black women had hypovitaminosis D but only 4.2% of whites. As early as 1992, other authors found a significant incidence of vitamin D deficiency.
Cannell read that for otherwise healthy persons, the FNB listed adequate intake (AI) for vitamin D at 200, 400, or 600 IU a day, depending on the person's age. Then in 2003, Professor Heaney and colleagues made this statement in the American Journal of Clinical Nutrition: "The recommendations of the Food and Nutrition Board with respect to oral vitamin D input fall into a curious zone between irrelevance and inadequacy. For those persons with extensive solar exposure, the recommended inputs add little to their usual daily production, and for those with no exposure, the recommended doses are insufficient to ensure desired 25(OH)D concentration."
Cannell concluded that if one totally avoids the sun and then strictly follows the FNB's recommendation, one will eventually develop vitamin D deficiency. After additional studying, Cannell came to believe that the physiological human requirements (from all sources) for vitamin D are approximately 10 times higher than the current AI listed by the FNB.
The problem with the FNB's recommendation is that most people greatly exceed the UL of vitamin D by simply spending a few minutes outside in the summer sun while wearing their bathing suits. In 1995, Professor Holick, of Boston University, demonstrated that a brief full-body dose of noonday summer sun is comparable to taking between 10,000–25,000 IU of vitamin D. Four earlier papers all found similar rates of natural vitamin D production. Dr. Adam and his colleagues found that up to 50,000 IU/day of vitamin D was released into the circulation of Caucasians after 30 minutes of noontime summer sun. Three additional studies support the fact that even older humans make at least 8,000–10,000 IU/day, after brief exposure to sunlight.
Cannell realized the high rate of natural production of vitamin D in the skin had profound implications for the natural human condition. These amounts are, by definition, physiological and are made after a relatively brief period in the sun (at least in Caucasians) in the summer at temperate latitudes—as long as clothes, glass, or sun block do not cover the skin. Vieth reviewed this issue in detail in 1999, in a well-written and scholarly document that should have dispelled any unwarranted fear of toxicity concerning physiological doses of vitamin D. It is important to note that blacks need 5 to 10 times longer in the sun than do whites to achieve similar vitamin D production.
Cannell was left wondering whom he should believe, nature or the FNB? In 2003, he recruited professional colleagues, friends, and family for a board of directors and took the steps necessary to incorporate The Vitamin D Council as a tax exempt, nonprofit, 501(c)(e) corporation.
In Sept 2006 Dr. Cannell had his manuscript, Epidemic Influenza and Vitamin D, published in Cambridge University Press' prestigious Journal of Epidemiology and Infection. The paper presented a revolutionary new theory on vitamin D's link to influenza and was co-written by some of the world's top vitamin D experts.
Page last edited: 21 September 2012