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Vitamin D Council wraps up late summer program

Posted on: October 12, 2011   by  Brant Cebulla

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The Vitamin D Council wrapped up a pilot program last week here in San Luis Obispo, California, where we tabled at the weekly Farmers’ Market, handing out brochures and vitamin D supplements in attempt to both educate about vitamin D and treat deficiency. The Farmers’ Market takes place Thursday nights and depending on the week, attracts anywhere from 5,000 to 15,000 attendees a night. We felt it was a good venue to educate the masses in an efficient manner and target a broad spectrum of people.

A big thank you goes out to Bio-Tech Pharmacal for donating 1400 bottles of 5000 IU D3 to the Vitamin D Council. We tabled over 8 weeks. On those nights, we would hand out about 200 bottles of vitamin D and 200 brochures with information on vitamin D, deficiency and supplementation.

This pilot program gave us several insights and brought up a lot of questions about what role the Vitamin D Council should play in educating the public. Educating over the Internet is a convenient venue. You are able to provide and disseminate large amounts of information (for instance, there are hundreds of pages on our website with information), while the user has infinite outside sources just a few clicks away (PubMed, Google, etc…) if they want to check claims or question logic. In person, you don’t have the same benefit. The best you can do is provide an information sheet (i.e. brochure) and do your best answering questions and covering key concepts.

Was handing out 5000 IU bottles of vitamin D a good thing to do? Initially, we viewed it as a direct approach to carrying out our mission, by providing the goods to treat people’s (likely) deficiency. We applied for a small grant to fund this program, and the foundation we applied to rejected our grant on the basis that the field was competitive (understandable) and that they were not too keen on the idea of handing out supplements, particularly at that dose.

Some Farmers’ Market attendees were up on vitamin D, had doctors who monitored their levels on a regular basis, had doctors who were having them take 5,000 IU/day, who made sure they were getting plenty of sensible sun exposure. These were encouraging moments, as it reaffirmed that some doctors and individuals were up on the current research and could think and reason independent of the IOM recommendations.

Some Farmers’ Market attendees had been tested for vitamin D and knew they were deficient. Some had done nothing about it; others were taking a dose that would not sufficiently raise their blood levels. This is an area of concern. There is still great disconnect between what kind of blood level you can expect based on what kind of supplement regimen you take. With 25(OH)D levels below 20 ng/ml, many people were taking 1000 IU to try to break 30, 40, 50 ng/ml thresholds, based on their physician’s poor advice.

We displayed a big poster of Cedric Garland and Grassroots Health’s chart (displayed below) on what kind of supplement regimen they need to take to get into sufficient ranges. In my opinion, every physician should have a copy of this chart and the paper it stems from. Dr. Cannell blogged about this paper last week. Considering we do not know what the sun exposure and dietary habits will be for every individual, should this paper not act as thee go to source for what kind of supplement regimen an individual should start on?

Garland CF, French CB, Baggerly LL, Heaney RP. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.

Lastly and mostly, Farmers’ Market attendees with no background on vitamin D were often worried about the seemingly high dose, often citing the 5000 IU figure, and not the 1250% daily value. This has me believe that the vitamin D “revolution” would have a great more deal of success if we switched from IU to µg, as the general public would be more willing to take 125 µg than 5000 IU. A study of this sort would be amusing.

In short, if an attendee had no background on vitamin D, they were usually unwilling to take a brochure or bottle of vitamin D and were skeptical of our organization in general. I do not blame them with the gluttony of misinformation and supplements out there that may do more harm than good. I believe this would be my response as well.

Out of this, questions loom. Should the Vitamin D Council take a more conservative approach? Should our organization stick to being educational, allowing others to make decisions for themselves? What kind of role should a nonprofit play in the health and wellness industry, and how can we be most effective in tackling the deficiency pandemic? Like the foundation felt, is handing out supplements too imposing? What are everyone’s thoughts?

11 Responses to Vitamin D Council wraps up late summer program

  1. JBG

    First, some info–

    What does the brochure say?

    How many 5000 IU pills were in each giveaway bottle?

    In the meantime, I recommend against using mcg instead of IU with the intent of deceiving people about the size of the dose. Deceit will not get us where we want to go.

  2. Brant Cebulla

    John,

    Brochure is here: http://www.vitamindcouncil.org/index.aspx?o=4955
    Sections include “What is vitamin D?” “Why is vitamin D important? “Do we get enough vitamin D?” “Am I deficient?” “How can I treat me deficiency?” and “About the Vitamin D Council.”

    We handed out both 250 and 100 count bottles of vitamin D 5000 IU per capsule.

    Agreed on the mcg/IU. My point is, it is amusing that people are fearful of arbitrary figures (the layman has no concept of what an “International Unit” is) rather than the % daily value.

  3. bobsssruxton@yahoo.com

    I think it is wise to educate, test levels and make things possible with further study.
    Imagine what a powerful tool you have in maintaining health through a multifaceted approach!

    My Dr has ordered Vit D 2 for me in the past..what can I do to enlighten her..a Sloan Kettering Oncologist???

  4. John

    I liked the brochure, although the formatting could be clearer and I thought it was silly to talk about fingernails and gums when the real subjects are cancer, autism, and MS. I’d suggest you change the inscrutable “myocardial infarction” to “heart attack,” and list the auto-immune diseases that are mentioned as a group. People don’t know what diseases are auto-immune diseases. They just know that Uncle Bob has Multiple Sclerosis and they’ll listen when you tell them being low on Vitamin D is associated with getting it.

    And on the units of measurement question, I would recommend you continue to talk about the dose that is on most bottles of D3, which is IU. Otherwise there is a translation problem. I think learning that they are getting only a tiny fraction of the D3 they need will help people understand how it is possible we are getting so many serious diseases from being low on Vitamin D. It’s because we are so very low. I would address that very point in the brochure when talking about dose.

  5. glen2240

    As nice as was your summer program, it seems to me it has too much of a promotional aspect which is a lot like so many “health food” booths. You weren’t selling anything but I’ll bet many people would expect something like that.

    I think educational material is likely the best route, despite the medical world’s seeming stand against the Vitamin D Council, it ought to be directly to the doctors with the research citations, etc. (kept as brief as possible so they will read it instead of the trash). You can’t very well compete with the Drug companies detail people’s millions ($$$) but they certainly need to know more of the research of which they are deficient.

    With respect to your many postings, I wonder if the charge discourages them (the detail people are free and sometimes with perps). Could you have some sort of coverage under a universal password (plus the Dr’s name) that would give them access to your information? I have Kaiser health insurance and on one of my trips for a blood draw, the nurse mentioned her enthusiasm for vitamin D. I wonder if Kaiser, in general, is up on it. How about other non-profit health services being contacted? I should help reduce a lot of their care expenses if they start the vitamin D. Thanks, Glen Shue

  6. gerskan

    Any effort to educate and improve people’s health, longevity and quality of life is laudable. After all Dr Cannell has done to educate us all, I share the frustration he and many others feel. It’s hard to understand slow adoption of good science and the dirth of logical, rational thought regarding obvious conclusions about Vit D deficiency and the needless sickness, suffering and death. I have tried giving away Vit D to people that could benefit hugely. Unless they are willing to take the time and make the effort to educate themselves, I have probably wasted my time and money. Unless someone reads and comprehends the need, value and benefits of adequate Vit D, they will not likely continue to supplement and monitor to gain the benefits they could.

    I don’t feel that presenting a dosage in different units is deceptive. It could be extremely helpful for some people. Most medications/supplements are measured in milligrams and dosages range from a “small” 2 mg. to a “REALLY BIG” 1000 mg. We experienced the same sort of “BIG NUMBER” fear when we discovered that doses of 10,000 mg. of Vitamin C rapidly stopped coughs and colds. People were much more willing to try 10- 1 gram capsules than 10- 1000 mg capsules. (the exact same dosage) Perception is important, if we need to present in different units to overcome bias or ignorance, why not? My personal and family Vitamin D dosages are now counted mentally in 1000 iu units. My grandchildren take 1-5 depending on health, sun exposure and weight. My wife, grown children and I take 5-15 using similar criteria and semi regular test results. For most adults 5000 iu would be a simple dosage unit:
    1 capsule for average size person with some sun exposure,
    2 capsules for less sun or larger person,
    3 capsules for health challenges

    May you all experience the Vitamin D health benefits my family and I have enjoyed!

  7. glen2240

    P.S. As a matter of interest, I learned about the new push with vitamin D about 20 years ago when one of my Tai Chi students told me about it re: prostate cancer. I have some sort of growth and was told by the doctor he could do surgery but there was risk that I might be worse off and “You will likely die of something else before it gets you.” I’ve been taking 2,000 IU capsules daily since and there has been no change since that time.
    Also, I was the FDA’s vitamin D analyst (rat bio assay) from 1950 – 1960 and supervised the assays into the 70’s. I went administrative for a while and returned to the lab as vitamin B12 analyst then back to the front office from which I retired in 1992.

  8. Brant Cebulla

    glen2240, I think you hit the nail on the head when you said, “it seems to me it has too much of a promotional aspect which is a lot like so many ‘health food’ booths. You weren’t selling anything but I’ll bet many people would expect something like that.” We did get that sense.

    On the other hand, and what I didn’t mention in the blog post, is that we actually tried just educating one of the nights, and didn’t hand out any vitamin D. We had about a 95% decrease in traffic.

    This gets to the root of the issue — what’s effective and what’s right and where do you find a balance between the two? “Promotional” angles come off gimmicky and leave you open to discreditable perceptions, yet draw in the masses. “Educational” angles come off creditable, but do not have the benefit of appealing to the masses.

    That being said, after this program, I think the Vitamin D Council has sided on being more educational than promotional.

  9. JBG

    Brant, thanks. I now see the link to the brochure in the original post; somehow I missed it the first time around.

    I think efforts like at the Farmers Market are useful for testing ways of presenting things. Lessons learned can feed back into design of the website. For many first-time website visitors, you may have only 90 seconds and one screen’s worth of material to persuade them to read further. That’s about the amount of material in the brochure (or a bit less than that).

    The brochure is good, but I think it could be improved. An earlier commentor’s mention of “heart attack” vs “myocardial infarction” is a simple example. I would be willing to make detailed proposals if you decide to do this again. (Instructional design was one of my career areas.)

    At the Farmers Market, I would suggest handing out the brochures only, including at the end of the brochure an offer of 100 free pills if the person comes back and asks for them. Getting the person to put forth that much of an affirmative action considerably increases the likelihood that the pills will actually get used.

    Along with the free pills, it would be useful to provide another information sheet with detailed directions on testing, supplement choices and sources, and sunbathing.

    In my part region (and most of the northern half of the country), it would make sense to feature protection against the flu/flu-like illness in the main brochure. That was the BIG change that my wife and I noticed when we started taking enough vitamin D five or six years ago — no more sick Februaries! In San Luis Obispo, some other symptomatic anchor with reasonably quick effect will have to do, and perhaps your choice of skin, nails, and gums is the best available.

    In my own attempts to evangelize among friends and acquaintances, I’ve noticed that a sizable proportion of people have a deep-seated close-mindedness about messages with an identifiable nutritional aspect. Catholic theologians have a concept of the “invincibly ignorant” that seems applicable. Most people resist anything new and different (to them). The latter can often be reached; the former, in my experience, are not worth the effort.

  10. JBG

    Brant, while I was composing, you commented about the decline in response when not handing out pills. Not sure how my notion of making the free pills available, but on request, would compare with whatever you actually did. Only experience would tell.

  11. Tom

    I agree with Glen – I think you will get far more leverage by concentrating on the folks in primary care clinics, who have become much more open to the message in the last 18 months or so. Let them take to message to general public. – Tom Weishaar

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