Letter from the Director: Controversy or Self-Interest? 

At GrassrootsHealth, we are always attending to the latest research and making decisions on what to bring to your attention. Is it a well done study?  Are the results meaningful to our population?  We tend not to report on the 'bad' studies since there are so many good studies. We want to provide positive direction. 

This last week, however, there was one article in JAMA (Journal of the American Medical Association) that caught my eye for all the wrong reasons and I want to give you my thoughts and let you decide.

In the article, the author states: "However, clinical enthusiasm for supplemental vitamin D has outpaced available evidence on its effectiveness and threatens to jeopardize the ability of researchers to conduct randomized trials in "usual-risk" populations." Later in the paper she goes on to describe other trials as, "... these trials will be informative only if the results are not diluted by widespread out-of-study prescription and use of high-dose vitamin D supplementation in the enrolled populations. Primary care physicians who routinely screen for 25(OH)D and prescribe high-dose supplements in the absence of a clear clinical indication may reduce differences in intakes between study groups, jeopardizing the opportunity for the trials to yield informative results."

The particular trial that Dr. Manson is running is giving a dose of 2000 IU/day.  At the beginning of that study, counsel was provided by a number of researchers on our panel that 2000 IU/day was not enough to show any meaningful information, the population at large was already becoming aware of many of the benefits of vitamin D and, foods were being fortified, etc..  And, many studies had already been done at that or even higher levels.  So, by the time the study would be done (2017) there truly wouldn't be enough people still on that dosage to make a difference. In the table showing the other studies currently in process, they are almost all using 'bolus' doses (very large, once/month/longer time periods) which have also been demonstrated to have problems, "...they increase the rate of catabolism (break down) of the relevant metabolites" per Dr. Garland.

Click here to see a letter that Dr. William Grant has written in response to this article.

And, Dr. Michael Holick has written a letter to the journal partially reiterating the Endocrine Society's Guidelines. Here is a snippet from his letter.

"However, based on the large number of association and ecological studies relating vitamin D deficiency with many chronic illnesses including cardiovascular disease, autoimmune diseases, several cancers, neurocognitive dysfunction, type 2 diabetes and infectious diseases, the Endocrine Society recommended that there was no downside to increasing a person's vitamin D intake to the recommended levels (preferred range 40-60 ng/ml) and that there may be some additional health benefits by following their guidelines for the treatment and prevention of vitamin D deficiency."

It seems to me that recommending we 'wait' for the clinical trials is much more indicative at this point of an interest in the trial, not in health. So much valid research has already been done. It is urgent to act now with simple, cost effective, safe and of high probability of benefit.

I have a very simple question to ask you, our readers. Do you know enough to take action now?  If not, how can we help you?  We at GrassrootsHealth, as well as our panel of researchers, are still confident that there is much to gain by getting your serum level to 40-60 ng/ml (100-150 nmol/L) and, you, by participating in the D*action project, are making the best of all contributions to furthering the knowledge about health with vitamin D.  Please spread the word, keep it up!  

Thanks for your ongoing participation.

Carole Baggerly 

Director, GrassrootsHealth

A Public Health Promotion & Research Organization

Moving Research into Practice NOW!