Newsletter #8 |July 2010Jim LaValle, R.Ph., CCN, MS - America's Natural Pharmacist.


Metabolic Minute: Learn to feel healthy every day  -  LaValle Metabolic Institute
James LaValle, R.Ph., MS

Note from Jim LaValle


The cutting edge of natural medicine is a fascinating place. Even after 25 years it still exhilarates me when I learn about new therapies that I can use to help my patients. Oftentimes, though, my enthusiasm can get squelched due to the snail's pace at which proven research gets incorporated into medical education and practice.  However, recently I have been very impressed with the way conventional medicine latched onto a nutritional factor for heath, and that was with Vitamin D.  It seemed like almost over night vitamin D testing was being done in almost every medical office in the U.S.   

In reality, intense vitamin D research has been going on over the last 25 years.  However in recent years research overwhelmingly concluded vitamin D levels are a huge public health concern, and rapid action was needed and thankfully was taken.  Lack of vitamin D is linked with devastating illnesses that wrack up astronomical medical costs.  Yet vitamin D is inexpensive when compared to the monetary costs and suffering these diseases cause, and the testing is also very simple - a blood test.  So to not take action would be unconscionable.

But before we "dive off the deep end," let's take a closer look at how the famous "sunshine vitamin," along with other nutrients, can help you get an edge on your health this summer.  Read our article this month to learn more about why vitamin D levels are so important, as well as some measures you can take to protect your skin this summer.


Jim

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"D"iving into Summer

Wow - the last 25 years of research has finally and definitively shown that getting adequate vitamin D is one of the best preventive health measures a person can take. 

Just look at all that medical research has identified regarding vitamin D:

Bone Health
Everyone knows we need vitamin D to absorb calcium and therefore to build and maintain healthy teeth and bones. During growth/development and pregnancy we should absorb about 80% of our dietary calcium taken in. As adults we should absorb about 30% of our dietary calcium. However, when vitamin D is low, we only absorb about 15% of the calcium we take in, affecting not just teeth and bones, but osteoporosis risk and even weight management and blood pressure.(1)

Cancer
Vitamin D works to prevent cancer in several ways; it build a strong immune system, promotes cancer cell death, and block blood supply to cancer cells. In both estrogen receptor-positive and estrogen receptor-negative breast cancer cells, the active form of vitamin D was found to inhibit cancer cell growth.(2) An eight-year study found that those whose vitamin D levels were the highest (33-41 ng/ml) had an 80% less chance of colon cancer.(3) And in prostate cancer research, men with a higher-normal range of vitamin D level had the lowest risk of prostate cancer.(4)  Overall, risk of cancer death increases in both men and women when they have minimal exposure to sunlight, most likely because sunshine is the best source for vitamin D.(5)

Immunity
According to a research summary, healthy levels of vitamin D decrease risk of autoimmune diseases like insulin-dependent diabetes, rheumatoid arthritis and multiple sclerosis. This is thought to be because the immune system develops self-reactive T-cells (immune cells that cause the body to attack itself,) when it doesn't get enough.(6) Vitamin D strengthens the immune system and may even prevent colds and flu.(7)  In fact, some experts think that building vitamin D levels could prevent flu epidemics.

Insulin Resistance and Weight Gain - Vitamin D helps the body's insulin work better.  Therefore vitamin D plays a role in helping prevent weight gain and Type 2 diabetes, as well.(8)

Getting Enough Vitamin D
Do you know your vitamin D level? (See sidebar.) If your levels are low, there are a number of ways to increase them.   Although we usually think of getting our vitamins from food sources, it can be difficult to get all the vitamin D you need from food alone.  Fish oils in fatty fish (like cod, sardine, and wild caught salmon) are the only good dietary source of vitamin D.  Other foods like egg yolks contain very small amounts.  Milk is fortified with vitamin D, but not everyone tolerates it.  

We talk about vitamin D in the summer, because our bodies can produce vitamin D in our skin after a short exposure of anywhere from 5 to 30 minutes in the sun.  Exposure should occur from 10 AM to 3 PM at least twice a week, and should include at least the face arms, legs, and back(14).  The nice thing about getting vitamin D from the sun is that you avoid getting too much, because the body has built-in controls that prevent overproduction.(15) 

Oddly, studies have found that even in those with plenty of sun exposure, like people living in Hawaii and Arizona, vitamin D levels are low in as many as 50% of people.(9,10) Sunscreen may have been to blame in the study of Hawaiians, but the study in Arizona found that dark skin and higher BMI's were the factors most associated with low vitamin D.(11)

Dark-skinned individuals are not the only ones who have difficulty getting enough vitamin D.  Other populations at risk include breast-fed babies, since breast milk does not contain adequate vitamin D; children who spend considerable time indoors; and the elderly, due to their skin's lessened ability to produce vitamin D and less time spent outdoors.(12)  In those who are overweight, fat holds onto vitamin D, preventing it from circulating throughout the body.(13)

In getting vitamin D from the sun, there are other limiting factors.  Latitude, time of day and time of year all affect the amount of UVB rays available for pre-vitamin D synthesis in the skin.  For example, in Boston between the months of November and February there aren't enough UVB rays to produce any vitamin D at all.(16)  Time is also a factor--most of the working world just can't get out to sunbathe on a regular basis.  Also, the overuse of sunscreen can limit vitamin D production, because sunscreen blocks UVB rays--the very thing that produces vitamin D in our skin.(17)

There is one caution in getting your vitamin D from the sun.  Besides the D-producing UVB rays, sunlight also contains UVA rays which produce cancer-causing free radicals and can damage the skin over time. The good news is it only takes minimal exposure to the sun and not an entire day on the beach to produce vitamin D.  So if you can, spend some time in the sun; allow that 5 to 30 minutes depending on skin type-before applying sunscreen.  And after sunbathing, don't be in such a rush to get showered, because it takes 8 hours for 80% of pre-vitamin D to be converted to vitamin D so that it can be used by the body.(18)  (This may explain why people in sunny regions are often low in vitamin D - they bathe and remove the oils from the skin that contain vitamin D.)

How Diet Helps
Experts are divided as to whether unprotected sun exposure for vitamin D outweighs any increased risk for skin cancer from the sun. Some advise to always use sunscreen and to use supplements for vitamin D.  We believe that getting some sun for vitamin D is probably advisable as long as you don't allow yourself to burn and you limit the amount of time you expose yourself without sunscreen.  You can also take other measures to protect yourself if you want to take in some sun for vitamin D.  

For example you can prevent skin damage by making sure you are taking in plenty of antioxidant foods. One study compared those who supplemented their diet with tomato paste and olive oil to those who did not and found the group that ate these foods were slower to burn.(19) Other studies had groups supplementing with carotenoids and vitamin E, both powerful antioxidants, and found that those who supplemented over a consistent length of time were less likely to burn.(20,21)  The key here is that antioxidants block free radical formation--the very thing that causes sun damage to our skin.  

Foods high in antioxidants that may be beneficial include bell peppers, broccoli, papaya, strawberries and Brussels sprouts (good sources of vitamin C); sunflower seeds, almonds, olives, and dark green leafy vegetables (good sources of vitamin E); raspberries and blueberries (sources of ellagic acid); oranges, lemons and limes (sources of limonene); green tea (a source of powerful antioxidants called epigallocatechins); and kale, spinach, collards, turnip greens, broccoli, peas, corn, Brussels sprouts and romaine lettuce (good sources of the carotenoids, lutein and zeaxanthin).

With low vitamin D levels, most doctors will recommend a supplement to rebuild levels.  After that we recommend 5000 IU vitamin D3 per day for adults as a good maintenance dosage. Because it is difficult to get enough vitamin D from diet alone, getting a healthy and safe dose of sunshine and/or supplementing are the best ways to establish a good vitamin D level.

This is just a small sampling of research and I hope it will motivate you to call your doctor to find out your vitamin D level, and use foods and sun in combination with vitamin D supplements to keep levels where they should be.

1.  Holick M, et al. Vitamin D importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004;79:362-71.
2.  Srilatha S, et al. Vitamin D growth inhibition of breast cancer cells: gene expression patterns assessed by cDNA microarray.  Breast Cancer Research and Treatment. 2003;80:49-62.
3.  Garland C, et al. Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study. The Lancet.18 Nov 1989;334(8673):1176-1178.
4.  Tuohimma P, et al. Both High and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic countries.  Int. J. Cancer. 2004;108:104-108.
5.  Holick M, et al. Vitamin D importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79:362-71.
6.  Cantorna M et al. Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Exp Biol and Med; 229(11):1136-1142.
7.  Cannell J, et al. Epidemic influenza and vitamin D. Epidemiology and Infection. 2006;134(6):1129-1140.
8. http://www.vitamindcouncil.org/researchDiabetes.shtml
9.  Binkley N, et al. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab. Jun 2007;92(6):2130-5.
10.  Holick M. Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 1995;61(suppl):638S-45S.
11.  Jacobs E, et al. Vitamin D insufficiency in southern Arizona.  Am J Clinical Nutr. Mar 2008;87(3):608-13.
12.  http://ods.od.nih.gov/factsheets/VitaminD_pf.asp
13.  Wortsman J, et al. Decreased bioavailablitiy of vitamin D in obesity.  Am J Clin Nutr. Sept 2000;72(3):690-693.
14.  Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-81.
15.  Holick MF. Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 1995;61(suppl):638S-45S.
16.  Webb A, et al. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrin Metab. 1988;67:373-81.
17.  Matsuoka L, et al. Sunscreens suppress cutaneous vitamin D synthesis. J Clin Endocrinol Metab. 1987;64:1165-8.
18.  Holick MF. Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 1995;61(suppl):638S-45S.
19.  Stahl W, et al. Dietary tomato paste protects against ultraviolet light-induced erythema in humans.  Journal of Nutrition. 2001;131:1449-1451.
20.  Eberlein-Konig B MD, et al. Protective effect against sunburn of combined systemic ascorbic acid (vitamin C) and d-a-tocopherol (vitamin E). J Amer Acad of Derm. Jan 1998;38(1):45-48.
21. Stahl W, et al. Carotenoids and carotenoids plus vitamin E protect against ultraviolet light-induced erythema in humans. Am J Clin Nutr. 2000;71:795-8.
22. http://www.vitamindcouncil.org/health/deficiency/am-i-vitamin-d-deficient.shtml

Greetings!

Welcome.  We hope you find our new newsletter a valuable source of information that will help you in your journey to improved health and well-being. For further information we invite you to visit the LaValle Metabolic Institute.


LaValle Metabolic Institute | www.lmihealth.com

The LaValle Metabolic Institute is an interdisciplinary healthcare facility utilizing expertise from an experienced staff of medical doctors, registered nurses, registered dieticians, and a clinical pharmacist that uncover metabolic disruptions and reccommend proven therapies which improve our patients' health and well-being.

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Testing for Vitamin D
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Make sure that your doctor orders a test for 25-hydroxyvitamin D, also known as 25(OH)D. Home test kits are also available through several labs, such as ZRT Labs. While optimal levels are still being determined the experts at the Vitamin D Council now believe that the minimum level is 50 ng/ml,  and recommend that Vitamin D levels should range from 50 to 80 ng/ml in both kids and adults year-round. (22)


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Is Sunscreen Safe?

Recent studies have suggested that melanoma rates have actually increased since the use of sunscreen has risen. Some experts feel this is because sunscreen may block some of the valuable vitamin D our bodies need.  Some feel it is because they allow us to spend too much time in the sun, and therefore too much UVA exposure. The Environmental Working Group tested several sunscreens and recommends the following brands as both safe (lacking risky ingredients) and effective:

1. Badger SPF 30
2. Peter Thomas Roth Titanium Dioxide Sunblock (SPF 30)
3. Lavera Sun Screen Neutral SPF 40
4. UV Natural Baby SPF30+ Broad Spectrum Sunscreen
5. Vanicream Sunscreen Sport (formerly Sunscreen SPF 35) (SPF 35)
6. UV Natural SPORT SPF 30& Very Water Resistant (old formulation)
7. California Baby SPF 30+ Sunblock Stick No Fragrance
8. California Baby SPF 30+ Sunblock Stick Everyday/Year-Round
9. Keys Soap Solar RX Sunblock (SPF 30) (old formulation)
10. KINeSYS KIDS Sunscreen Spray with Parsol 1789 (SPF 30+)
11. California Baby SPF 30+ Sunscreen Lotion Everyday/Year-Round
12. California Baby SPF 30+ Sunscreen Lotion Natural Bug Blend
13. California Baby SPF 30+ Sunscreen Lotion No Fragrance
14. Dr. Brandt Body Barrier Gel (SPF 30)
15. Dermalogica Ultra Sensitive FaceBlock (SPF 25)
16. Aubrey Organics Green Tea Sunblock For Children
17. Mustela Moderate Sun Protection Stick (SPF 20)




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