Lyle MacWilliam Vitamin D Interview One third of Australians are deficient in vitamin D and this is leading to an increase in the incidence of cancer and other illnesses such as diabetes and cardiovascular disease. This research, carried out by the Centre of Physical Activity and Nutrition Research at Deakin University in Melbourne, indicates that Aussies need to significantly increase their intake of vitamin D to protect their health. But the RDI (recommended daily intake) here in Australia does not reflect this research, leaving consumers in the dark about the levels they should be consuming of this vital nutrient.
Those at greatest risk of vitamin D deficiency are women, the elderly, the obese, people doing less than 2.5 hours of physical activity a week and people of non-European background. Also at high risk are women who wear veiled clothing on a daily basis.
Interview with Lyle MacWilliamLyle MacWilliam, author of NutriSearch Comparative Guide to Nutritional Supplements 2012 is urging the government to increase the RDI of vitamin D in Australia. He says that health campaigns urging people to stay out of sunlight, to protect themselves from developing skin cancers, have gone too far. He believes that this scare tactic has gone dangerously wrong with people now avoiding sunlight. Inadequate exposure to bright sunlight renders the body deficient in vitamin D.
Question: What are the symptoms and affects of vitamin D deficiency?
Lyle MacWilliam: Vitamin D deficiency is the most misdiagnosed and unrecognised health challenge in the world. Mild vitamin D deficiency is generally asymptomatic - a person can be insufficient (mildly deficient) in the nutrient without showing any overt clinical symptoms. However, an individual's lifetime risk for the development of serious diseases, such as cancers, heart disease, osteoporosis, diabetes, multiple sclerosis and autoimmune disorders (to name but a few), is increasingly elevated in direct correlation to the degree of vitamin D deficiency. Mild deficiency of vitamin D begins as blood levels of 25-hydroxyvitamin D (25-OH vitamin D) fall below the threshold of 75 nannomoles per litre (nmol/L) of blood.
Frank deficiency occurs at blood levels below 50 nmol/L and can lead to progressive demineralisation of the bone mineral matrix. At this point, the individual can begin to experience deep bone pain, chronic fatigue, increased incidence of fractures, osteomalacia (softening of the bone), osteoporosis and the development of spinal deformities, muscle cramps and weakness, increased blood pressure (hypertension) and elevated cholesterol.
Measuring whether a person is deficient in vitamin D involves nothing more than a simple blood test. Through blood sampling, a physician can determine the level 25-OH vitamin D, the major circulating form of vitamin D in the blood. In the past, the reference point used to determine vitamin D insufficiency varied amongst clinical studies; however, most clinical researchers today accept the benchmark of 75 nmol/L as the cut-off point for insufficiency. Studies show that this is the point where progressive pathologic deficiencies in bone structure begin to appear.
Problematically, the current Nutrient Reference Values for vitamin D in Australia and New Zealand (National Health and Medical Research Council, Department of Health and Ageing, Australia, 2005) cite a level of only 27.5 nmol/L as the blood levels required to avoid deficiency states. This is almost one half of the lower limit for frank vitamin D deficiency now recognised by most scientific studies. Clearly, the current recommended levels of adequate intake for vitamin D in Australia and New Zealand are seriously out of date and fail to reflect the standards used in most scientific studies to evaluate the level of vitamin D deficiency. Both the Australian and New Zealand governments have been remiss in not keeping abreast of the emergent science on vitamin D and in not updating this requirement to reflect the current scientific consensus.
Question: How can vitamin D deficiency affect us in the long term?
Lyle MacWilliam: What we have learned about vitamin D over the last decade may well turn out to be the medical breakthrough of the century. We used to think that vitamin D was simply about calcium and string bones - but now we know it is so much more.
For most practitioners in mainstream medicine, it is simply incomprehensible that an ordinary vitamin can: reduce the risks of heart attacks by as much as 50%; decrease the risks of cancers of the breast, colon, and prostate by a similar amount; reduce infectious diseases, including influenza, by as much as 90%; combat both type-1 and type-2 diabetes; diminish the risk of dementia and associated neurological dysfunctions; and dramatically impede the incidence of multiple sclerosis and other autoimmune disease - but this is no ordinary vitamin.
More than 2500 published studies support vitamin D's role in the prevention of cancer. Together, the findings suggest that vitamin D from strong sunlight, or provided in supplement form, is responsible for preventing a host of internal cancers. Three of the most prevalent and feared cancers-breast, colorectal, and prostate cancer-are highly influenced by the amount of sun exposure and vitamin D status.
A recent 4-year, population-based, double-blind, randomised placebo-controlled trial-the gold standard for clinical trials-has reported an astounding finding. Post-menopausal women who supplemented with 1,100 IU/day of vitamin D and 1,500 mg/day of calcium reduced their risk of dying from ALL cancers by more than 66%. This remarkable finding suggests that vitamin D could be the single most effective means of preventing cancer-even outpacing the benefits of a healthy lifestyle.
We now know that when you are exposed to strong sunlight or supplement with high levels of vitamin D, excess vitamin D is stored in cellular tissues to be activated at any time in order to regulate aberrant cell growth that can lead to cancer. Once activated, vitamin D-acting at the cellular level-stops the chaotic reproduction and growth of these aberrant cells by inducing apoptosis (cellular suicide) and inhibits the formation of new blood vessels needed to nourish cancerous growth-effectively snuffing out cancer before it takes hold. This understanding provides us with enormous capacity for prevention. It is the singular reason why scientists at the University of California, San Diego, now contend that low vitamin D status may be the root cause of all cancers.
People who are deficient in the sunshine vitamin are also much more likely to have hypertension (high blood pressure), type-2 diabetes, and elevated triglycerides (a major risk factor for heart disease). Vitamin D reduces blood pressure by relaxing the smooth muscles lining the artery walls and by regulating the release of renin, a hormone manufactured by the kidneys that increases vasoconstriction (constriction of the arteries).
As well, vitamin D is a potent anti-inflammatory agent; the hormone expresses a powerful effect in reducing levels of C-reactive protein (CRP), a principal biological marker of inflammation and heart disease. In fact, the ability of vitamin D to reduce CRP levels appears to be far more pronounced than that of the statin drugs commonly used to reduce the risk of heart attack. Moreover, the vitamin's benefits in stimulating general cardiovascular function are now recognised as being on par with that of aerobic exercise. A deficiency of vitamin D diminishes the contractile function of the heart, contributes to dysfunction in the endothelial lining of the blood vessels, exacerbates atherosclerotic plaque formation, and contributes to congestive heart failure.
Vitamin D has even demonstrated protective effects against autoimmune dysfunctions that occur when the immune system begins to attack its own host. Diseases such as lupus, fibromyalgia, type-1 diabetes (an autoimmune disease of the pancreas), psoriasis, rheumatoid arthritis, chronic fatigue syndrome, and multiple sclerosis are some of the common autoimmune diseases related to impaired vitamin D status. Very recent studies reveal that the presence of activated vitamin D may help attenuate the over-response of our immune system to reduce both allergic and autoimmune responses. One of the mechanisms appears to be vitamin D's ability to inhibit the activation of Nuclear Factor kappa-Beta (NF kappa-ß), an important cellular signalling protein that acts as a sentinel in the body's inflammatory cascade.
Question: Who is at risk of being vitamin D deficient?
Lyle MacWilliam: Vitamin D is known as the sunshine vitamin for good reason. It is manufactured from a precursor of cholesterol when the ultraviolet B rays of the sun penetrate the skin. In fact, the only way for the body to obtain sufficient vitamin D is to expose the skin to sunlight on a regular basis and without the use of sun block. There is insufficient vitamin D in the diet to meet our daily requirements. Ten to twenty minutes of exposure to strong sunlight is all the body needs to meet your daily requirements. Failing regular exposure, the only way to avoid deficiency in this critical nutrient is to supplement.
Studies show that in any given population the level of risk of deficiency on vitamin D is dependant on a number of factors, including: lifestyle choices, behavioral practices, cultural practices, skin pigmentation and levels of fitness. People who practice sun avoidance or who spend most of their day indoors will become vitamin D deficient unless they supplement. As well, women who wear veiled clothing have been found to be at serious risk of deficiency - covering the entire body with clothing virtually eliminates any sunlight from penetrating the skin. Anyone with darkly pigmented skin is also at higher risk of deficiency because the melanin of the skin acts as a natural sunscreen to filter out the UVB rays that are necessary for the manufacture of vitamin D. That is likely why African-Americans have been found to have significantly higher rates of cancer, hypertension, heart disease and type 2 diabetes than does the white population. The level of vitamin D deficiency amongst African-Americans - particularly those living in more northern latitudes where the seasonal fluxuation of sunlight is greater - has been found to be markedly greater than the general population. This same ethnic correlation is found amongst the Maori, Aborigine and Pacific Islands peoples, whose darker skins increase their risk of deficiency. Lastly, an individual's level of body fat will also determine their risk of deficiency. Obese individuals need at least 3 times the daily intake requirement for vitamin D because excess fat sequesters the vitamin D in the adipose tissues, locking it down so that the hormone is unavailable for the body's use.
Latitude also determines risk. For years, the evidence has mounted that sun exposure is an effective prevention and treatment for immune disorders, several cancers, and heart disease. The prevalence of these disorders correlates directly with latitude-the further you deviate from the equatorial zone, where the sunlight is always strong, the higher is the incidence of these diseases. The importance of sunlight to the body's immune response, for example, is demonstrated dutifully each year when the waning sunlight of autumn presages the onslaught of the flu season. Contrary to conventional wisdom, many researchers now believe that seasonal infections, such as colds and influenza, may actually be the result of decreased levels of vitamin D rather than of increased wintertime viral activity.
Question: How do we get our recommended dose of vitamin D?
Lyle MacWilliam: The best way to obtain your daily requirements for vitamin D is through regular exposure to sunlight. Ten to twenty minutes a day will provide the equivalent of 10,000 International Units of the hormone taken orally. You cannot get too much vitamin D from the sun as the excess vitamin D produced is either stored in fatty tissues, to be released during the winter months when the sunlight is too low, or it will be metabolised by the body.
For those who cannot get out in the sun on a regular basis, the only way to fulfill your requirement for vitamin D is to supplement. Unless you want to eat three can of sardines or 50-100 eggs every day, you imply will not get enough vitamin D from your food. Vitamin D supplementation is inexpensive, safe and effective.
In Canada, Australia and New Zealand, where vitamin D is measured in nannomoles per litre (nmol/L) of blood, the objective in supplementation is to raise your blood level of 25-hydroxyvitamin D to within the reference range of 100-150 nmol/L, as determined by a simple blood test. The equivalent reference range in the United States is 40-60 nannograms per millilitre (40-60 ng/mL). To do so, Dr. Michael Holick, the world's foremost authority on vitamin D, suggests a daily dose of vitamin D between 2,000 - 5,000 IU (50 - 125 µg) as determined by blood tests. He argues that you can safely take up to 10,000 IU/day (250 µg/day) for at least five months without any signs of toxicity.
Question: Why are so many Australians Vitamin D deficient?
Lyle MacWilliam: Australia is a country renowned for its sunshine, warm weather and great beaches, so it seems illogical that almost three quarters of the Australian population does not have sufficient blood levels of the sunshine vitamin considered necessary for good health-a finding recently published by Deakins University researchers. However, Australia is also a country where skin melanoma, caused by chronic overexposure to the sun is of great public concern. Ironically, it may well be the long-term over-reliance on sunscreens that has led to both a deficiency in vitamin D and a commensurate increase in skin melanoma. Here's why.
During the 1960s, after it was discovered that over-exposure to sunlight could contribute to skin cancer and premature wrinkling, a massive shift in public perception was engineered by the global drug and cosmetic industries, which realised immense profits from pedaling the notion that the sun was bad and must be avoided at all costs. Over the next 50 years, throughout North America, Australia, New Zealand and elsewhere, "cover up and slap on the sunscreen" became the marketing slogan for a global campaign that would prove largely responsible for a worldwide epidemic of vitamin D deficiency that most experts contend was entirely avoidable.
Ironically, the development of early sunscreens effectively blocked the sun's burning UVB rays while allowing unintentional over-exposure to the more damaging UVA rays, known to be a primary cause of skin melanoma. Consequently, for years application of these sunscreens actually contributed to the rapid rise in death rates from this type of cancer. While modern sunscreens now protect against both types of radiation, these sunscreens filter out virtually all of the capacity of the skin to manufacture vitamin D. Application of SPF 8 sunblock eliminates 90% of your skin's ability to manufacture vitamin D, while SPF 30 removes 99% of the skin's capacity to manufacture the sunshine vitamin. Even today, the misguided fear and excessive avoidance of the sun-and the public's blind allegiance to the mantra of "cover up and slap it on"-dangerously hinders our ability to obtain sufficient vitamin D by natural means.
Moreover, there is another campaign that is exacerbating the widespread deficiency in vitamin D - and once again, it is the global drug cartel that is behind the scenes. For years, the drug industry has pushed the campaign to lower cholesterol levels through the use of statin drugs, and millions of people take these cholesterol lowering medications without the knowledge that these powerful drugs impede the ability of the body to manufacture vitamin D - along with a lot of other important steroid hormones, including the sex hormones. Statins do so by inhibiting the pathway for the production of a metabolic precursor of cholesterol, known as dehydrocholesterol, which happens to be the very substrate used for the formation of vitamin D. So by taking a statin drug to lower cholesterol, you are also short-circuiting the ability of your body to make vitamin D through sun exposure.
The bottom line is this: sunlight is NOT unhealthy. Moderate whole-body exposure to strong sunlight is essential for good health. Ten to twenty minutes a day when the sun is high in the sky is enough to produce all the vitamin D you need, then you can cover up to protect against over-exposure. During the fall and winter months, when it may not be possible to get sufficient sun exposure, everyone should consider supplementing with 1,000 to 2,000 IU of vitamin D.
Question: What is the current RDI of vitamin D in Australia and what do you believe the RDI should be?
Lyle MacWilliam: In light of emergent research supporting the protective powers of vitamin D, both Canada and the United States have recently moved to increase the recommended daily intake for vitamin U D to 600 IU (15 micrograms) per day - a level most experts contend is still far too low. What is worse, the RDI for Australia and New Zealand has not budged an inch. It remains at a miniscule 200 IU (5 mcg) per day.
When you consider that just 10-20 minutes of full-body exposure to strong sunlight provides vitamin D blood levels equivalent to 10,000 IU/day taken orally, even the new new reference standard of 600 IU/day for North America appears scientifically indefensible. Mother Nature is frugal-she would not have allowed for the manufacture of such prodigious levels of vitamin D in the skin if there was not an established biological need. While a marginal improvement over the previous standard, this new reference standard for vitamin D may still be 5 to 10 times too low for optimal health.
Why has the Australian government not seen fit to increase its recommended dietary intake for vitamin D? Part of the problem is that the government's standards for measuring vitamin Deficiency is considerably too lax.
The current Nutrient Reference Values for vitamin D in Australia and New Zealand (National Health and Medical Research Council, Department of Health and Ageing, Australia, 2005) cite a level of only 27.5 nmol/L as the blood levels required to avoid deficiency states. This is almost one half the lower limit for frank vitamin D deficiency now recognised by most scientific studies.
Clearly, the current recommended levels of adequate intake for vitamin D in Australia and New Zealand are seriously out of date and fail to reflect the standards used in most scientific studies to evaluate the level of vitamin D deficiency. Both the Australian and New Zealand governments have been remiss in not keeping abreast of the emergent science on vitamin D and in not updating this requirement to reflect the current scientific consensus.
Question: Why did you originally becoming involved in researching vitamin D?
Lyle MacWilliam: As a Canadian company researching and comparing the nutrient content of natural health products in the global marketplace, NutriSearch constantly reviews emergent scientific research on nutritional supplements. When we saw the very recent exciting new findings on the wide-ranging protective powers of vitamin D, we decided to revise our analytical model, which we use to rate supplements and to re-evaluate products we had previously reviewed in both the North American and ANZ markets. We were specifically looking for evidence of companies that have responded to the new information on vitamin D by substantially improving their formulations to reflect the need for higher intakes of this nutrient.
In our review of the Australian and New Zealand markets, conducted for the research and publication of our newly released NutriSearch Consumer's Guide to Nutritional Supplements, we were surprised to find very few of the popular brands of nutritional supplements on the market had significantly increased the levels of vitamin D in their daily vitamin/minerals products, in response to the emergent research on vitamin D. However there were some leaders out there - companies such as USANA Heath Sciences, Thorne Research, Nature's Way and others - who have significantly upped the levels of vitamin D in their product formulations in response to the emergent scientific evidence. We would like to take this opportunity to congratulate and recognise these companies for their continued leadership in the field of natural health products.
Interview by Brooke Hunter