The Vitamin D Newsletter November 2007
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Of all the vitamin D things that happened in the last few months, the most dramatic occurred in Canada, and will spare Canadian mothers from seeing tragic diseases develop in their children. Unfortunately, the same foresight didn't occur in Washington, D.C., where a much publicized conference on 21st century vitamin D at the National Institutes of Health (NIH) turned out to be an "evidence-based" cover-up of 21st century vitamin D research and resulted in no mothers, or children, being spared. Vitamin D and Health in the 21st Century: An Update. Office of Dietary Supplements, NIH.
"Protecting babies from later illness"
The same week the NIH was conducting their cover-up at latitude 39 degrees North, the Canadian Pediatric Society, at 43 degrees North, used evidence-based medicine to recommend that pregnant women begin taking 2,000 IU of vitamin D per day, which is 10 (ten) times more than the 200 IU/day the NIH recommended for pregnant women 4 degrees further south. According to the Canadian press, the Canadian Pediatric Society acted "to protect babies from a litany of illnesses later in life." How can two different mainstream medical organizations look at the same scientific data and come up with recommendations that vary by an order of magnitude? Perhaps a latitudinal gradient exists for evidence-based medicine. Kirkey, S. Experts prescribe massive increase of vitamin D. CanWest News Service. 2007.09.25. Mittelstaedt, M. Take more vitamin D, mothers told. Globe and Mail. 2007.09.24.
Some will point out that 2,000 IU (.05 mg) per day is often not enough to adequately prevent or treat vitamin D deficiency during pregnancy. This is true. Hollis BW, Wagner CL. Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutr. 2006 Aug;84(2):273.
Others will point out that even 4,000 IU/day (.1 mg/day) is not enough for breast-feeding mothers to maintain adequate levels of vitamin D in their breast milk; that it takes about 6,000 IU/ day (.15 mg/day). This is also true. Basile LA, et al. The effect of high-dose vitamin D supplementation on serum vitamin D levels and milk calcium concentration in lactating women and their infants. Breastfeed Med. 2006 Spring;1(1):27–35. Wagner CL, et al. High-dose vitamin D3 supplementation in a cohort of breastfeeding mothers and their infants: a 6-month follow-up pilot study. Breastfeed Med. 2006 Summer;1(2):59–70.
However, both criticisms miss the point. For a large mainstream professional organization like the Canadian Pediatric Association to buck both the Canadian and U.S. established health authorities by a factor of ten is unprecedented. It means the vitamin D message is getting through to some in organized medicine.
Organized medicine ignores the evidence
Health Canada, the official Canadian governmental health agency, immediately took exception to its own pediatricians, using brilliant bureaucratic thinking. They said, "The United States Institute of Medicine (IOM) establishes nutrient reference values, which are used by Health Canada to set policies and standards. Until an update of the Dietary Reference Intakes for vitamin D is issued by the IOM, Health Canada continues to recommend 200 IU of vitamin D per day for adults 19–50 years of age, including pregnant and lactating women." They could have added, "regardless of the scientific and medical evidence." Vitamin D intake should stay the same for now: Health Canada. CBC News. 2007.09.25.
Apparently, Health Canada wants to continue the naturalistic Tuskegee experiment that has been conducted on developing babies over the last 20 years—especially on the brains of African-American babies. This vitamin D experiment began in the late 1980s when every relevant official organization began telling us all, including pregnant women and children, to assiduously avoid sunlight. Who wants to get squamous cell skin cancer or age their skin?
But did those same organizations recommend compensatory vitamin D to make up for what our skin stopped making with sun-avoidance? No, they did not. In fact, as you will see, several years after the American Pediatric Association recommended strict sun avoidance for all children, they reduced—not increased—recommended vitamin D intakes in childhood!
And so began the epidemics of asthma, diabetes, autism...
The story begins in the 1980s, when dermatologists, heavily funded by the cosmetics and sun screen industry, began warning about the dangers of sunlight. In 1989, the American Medical Association's Council on Scientific Affairs sided with the dermatologists and formally warned about the dangers of sun-exposure, advising mothers and children to "stay out of the sun as much as possible." The dermatologists, or should I say cosmetologists, rejoiced. American Medical Association. Harmful effects of ultraviolet radiation. Council on Scientific Affairs. JAMA 1989;262(3):380–4.
But something else happened in the 1980s; the current triple childhood epidemics of asthma, diabetes, and autism all quietly began. van den Hazel P, et al. Today's epidemics in children: possible relations to environmental pollution and suggested preventive measures. Acta Paediatr Suppl. 2006 Oct;95(453):18–25. Next, in 1999, the American Academy of Pediatrics went further, advising mothers to always keep infants out of direct sunlight, use sun-protective clothes, sun block, and make sure children's activities in general minimize sunlight exposure. Furthermore, quite inexplicably, they reported there was "no evidence" that rigorous sun protection would affect vitamin D levels. The triple childhood epidemics exploded. American Pediatric Association. Ultraviolet light: a hazard to children. American Academy of Pediatrics. Committee on Environmental Health. Pediatrics 1999;104(2 Pt 1):328–33.
By 2002, the Centers for Disease Control (CDC) gleefully reported sun avoidance advice was successful: "protection from sun exposure is now reported for a high proportion of children." Not a word of concern from the CDC about the vitamin D levels of these sun-deprived children, but plenty of wonder about what was causing the childhood epidemics of asthma, diabetes, and autism. Hall HI, Jorgensen CM, McDavid K, Kraft JM, Breslow R. Protection from sun exposure in US white children ages 6 months to 11 years. Public Health Rep 2001;116(4):353–61.
...and that of vitamin D deficiency
In an act of nonfeasance that some mothers may eventually find unforgivable, these same medical organizations made no effort to compensate for the vitamin D deficiency their sun-avoidance advice would predictably induce. For example, when the AMA's Council on Scientific Affairs (cited above) warned about the dangers of sunlight, they did not even mention that sunlight triggers the formation of vitamin D.
Furthermore, the Food and Nutrition Board's (FNB) recommendations for young women, pregnant women, infants, and children did not increase during the decades of sun-avoidance advice: 200 units (which is a minuscule .005 mg) per day for all infants, children, pregnant women, and young adults regardless of body weight. That is, the FNB did and does recommend the same daily .005 mg for 5 pound infants as they do for 150 pound pregnant women! Let's see, five pounds pided by .005 mg versus 150 pounds pided by .005 mg? Does a pregnant woman really need 30 times less vitamin D than her baby per pound of body weight or are the folks at the FNB mathematically challenged? Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Food and Nutrition Board, Institute of Medicine. 1997.
Tragically, in 2001, the American Academy of Pediatrics cut their longstanding 400 IU (.01 mg) per day recommendation for children in half, to 200 IU (.005 mg)—apparently simply due to a bureaucratic need to comply with FNB recommendations—despite their earlier advice that children should assiduously avoid sunlight. The triple epidemics exploded. Gartner LM, Greer FR; Section on Breastfeeding and Committee on Nutrition. American Academy of Pediatrics. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 2003;111(4 Pt 1):908–10.
Almost all newborns now deficient, especially black infants
Of course, the result of this "evidence-based," but common senseless, medical advice was that now almost no newborns have adequate levels and many black infants have virtually no vitamin D in their blood stream. Certainly evidence-based medicine started out as a great idea, but all too often it has deteriorated to mean, "Have the drug companies sponsored a relevant clinical trial?" Women mistakenly think evidence-based medicine was used to set the amount of vitamin D in prenatal vitamins and that by taking them they will prevent vitamin D deficiency during pregnancy. But the 200 IU (.005 mg) per day recommendation for pregnant women by the FNB was afterthought based, not evidence based, and the standard 400 IU (.01 mg) of vitamin D in most prenatal vitamins was set by the vitamin industry, not the FNB. However, the 400 IU (.01 mg) in most prenatal vitamins is still such a tiny amount, it has almost no effect on vitamin D levels. Bodnar LM, et al. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007 Feb;137(2):447–52.
What happened next? The triple childhood epidemics of asthma, diabetes, and autism blossomed. And there is abundant evidence (but no proof) all three epidemics are a direct and tragic result of sunlight deprivation. Whenever you see a child with asthma, diabetes, or autism, just think: American Medical Association, American Pediatric Association, Institute of Medicine, Centers for Disease Control, National Institutes of Health, or Food and Nutrition Board. Litonjua AA, Weiss ST. Is vitamin D deficiency to blame for the asthma epidemic? J Allergy Clin Immunol. 2007 Oct 3. Hypponen E, et al. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001 Nov 3;358(9292):1500–3. Cannell JJ. Autism and vitamin D. Med Hypotheses. 2007 Oct 4.
Vitamin D needed in womb, and after
Of course, children not only need vitamin D in the womb, they need it after they are born, 400 IU per day extra if they are on formula; breast fed infants need even more, around 600 IU per day. Around the age of 1 year, when the switch is made from vitamin D-rich formula to the empty calories of juice, a child needs even more—about 1,000 IU per day. (By the way, it's no wonder parents of autistic children think vaccinations cause autism. Their child deteriorated around the time they got their 12–18 month vaccinations, which is, coincidentally, the same time they started juice and stopped infant formula, thus depriving their child's brain of any meaningful sources of vitamin D.)
What can pregnant women who follow the new Canadian Pediatric Society recommendation for 2,000 IU of vitamin D per day expect to see in their children? It is more a matter of what they won't see rather than what they will see. They won't see their child gasping for breath, giving themselves insulin injections, or repetitively banging their head on the televison screen.
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John Jacob Cannell MD Executive Director