Vitamin Vitamin D D
and and YOUYOU
Vitamin D Toxicity
• It’s pretty hard to get too much vitamin D.
• Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E.
• What is Vitamin D?– Vitamin D’s Role in the Body– The Impact of Deficiency and Toxicity
• How Much Vitamin D Do You Need?
• What are the Sources of Vitamin D?– Food– Sunlight– Supplements
Vitamin D Vitamin D AgendaAgenda
What is What is Vitamin Vitamin
D D
• Vitamin D is a nutrient that is key to good health.
• It helps your body absorb calcium
Meet Vitamin Meet Vitamin DD
• Your body needs vitamin D to fight off illnesses.
• Vitamin D also helps your muscles move.
• It even plays a role in nervous system communication.
Meet Vitamin Meet Vitamin DD
• Harmful to bone health.-Rickets-Osteomalacia-Osteoporosis
The Impact of The Impact of DeficiencyDeficiency
Deficiency Deficiency Linked to Linked to
Increased Risk:Increased Risk:– High Blood Pressure– Heart Disease– Diabetes and Insulin
Resistance– Cancer– Depression– Macular degeneration– Autoimmune disorders
• Multiple Sclerosis
The Impact of The Impact of DeficiencyDeficiency
• Linked to decreased:– Mental ability– Athletic performance– Muscle fibers and fast
twitch muscles– Immune function
Notable Vitamin D ResearchA larger study followed 18,225 men 40-65y and
initially free of diagnosed heart disease for 10 years. In this study men with moderately low levels of vitamin D in their blood (15.1 to 22.5ng/ml) had about a 60% increased risk of having a heart attack. Those who were deficient in vitamin D (<15ng/ml of 25-OH D) were more than twice as likely to suffer a heart attack compared to those with an adequate level of vitamin D in their blood (>30ng/ml).
Notable Vitamin D Research
• “Vitamin D deficiency not only causes rickets among children but also precipitates and exacerbates osteoporosis among adults and causes […] osteomalacia.
Notable Vitamin D Research
“Researchers noticed that people who don’t have enough vitamin D tend to fall more often than other people. They found that taking a vitamin D supplement reduces the risk of falling by up to 22%. […]
“Also, vitamin D, in combination with calcium, but not calcium alone, may prevent falls by decreasing body sway and blood pressure.”
Notable Vitamin D Research
A placebo-controlled trial of Nebraska women found that 1100 IU of vitamin D for 4 years cut their risk of developing breast, colon, and other internal cancers. 1 Even 1,100 IU may not be adequate to optimize immune function.
Am J Clin Nutr 2007;85:1586-91
Notable Vitamin D Research
An analysis of 18 randomized controlled clinical trials showed that vitamin D supplements significantly reduced the risk of dying from all causes combined.
Arch Intern Med 2007;167:1730-7
What About Too Much
• It is possible to get too much vitamin D.
• When there’s too much of it in the blood, it’s called toxicity.
The Impact of The Impact of ToxicityToxicity
• Vitamin D toxicity is extremely rare.
• Vitamin D is sometimes considered the most toxic of the fat-soluble vitamins, but…
The Impact of The Impact of ToxicityToxicity
• Signs and symptoms:–Nausea and vomiting–Constipation–Reduced appetite/weight
loss–Weakness
Excess Dcan also lead to excess Calcium!
Signs of elevated blood calcium levels:– Heart rhythm issues
– Confusion/disorientation
Vitamin D Toxicity
• It’s pretty hard to get too much vitamin D.
• Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E.
How Much How Much Vitamin D Vitamin D
Do You Do You Need Need
American American TrendsTrends
• Vitamin D and its metabolites target more than 200 human genes that impact not only bone health but also immune function and many other bodily functions.
American American TrendsTrends
• However, the current government guideline for vitamin D requirement is based only on the need for vitamin D to prevent bone disease.
• That level may not be adequate to meet all other metabolic functions that utilize vitamin D
American American TrendsTrends
• Most Americans do not get enough vitamin D.
The Dietary Guidelines have labeled it a “nutrient of concern.”
American American TrendsTrends
It’s harder for some people to get enough vitamin D than others.
• African Americans
• Hispanics
• People who are obese
• People with high blood pressure or high LDL cholesterol levels
Sources Sources of of
Vitamin Vitamin D D
Food Sunlight
Supplements
Food Food SourcesSources
Most foods have very little vitamin D
Food Food SourcesSources
Natural sources include:• Fatty fish (salmon, tuna, mackerel), Cod liver oil
• Mushrooms • Beef liver
• Cheese • Eggs
Vitamin D Fortified Foods:
• Milk
• Breakfast cereal
• Orange juice
Food sources:
Cod liver oil 1 tablespoon 1360 IU
Swordfish, 3 ounces 566 IU
Salmon, 3 ounces 447 IU
Tuna, 3 ounces 154 IU
Orange juice, fortified 137 IU
Milk, fortified 115-124 IU
Yogurt, fortified 80 IU
Vitamin D Vitamin D & &
SunlightSunlightVitamin D is often called “The Sunshine Vitamin”
Vitamin D and Sunshine
• Did you know that, when your body is exposed to sunlight, it starts making vitamin D?
• This kind of vitamin D must then be activated by your body.
Vitamin D Toxicity
• It’s pretty hard to get too much vitamin D.
• Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E.
How Much How Much SunshineSunshine
Vitamin D Toxicity
• It’s pretty hard to get too much vitamin D.
• Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E.
Approximately 5–30 minutes of sun
exposure between 10am - 3pm at least
twice a week. Expose face, arms,
legs, or back without sunscreen.
Factors…Factors…• Age • Skin color• How much skin is exposed• Length of exposure• Geographic location
• Time of year • Time of day • Cloud cover• Smog, dust, haze
Skin Type & Skin Type & SunlightSunlight
• Skin type 1 – very fair, always burns
• Skin type 2 – white, tans with difficulty
• Skin type 3 – creamy white, sometimes burns
• Skin type 4 – brown, rarely burns, tans with ease
• Skin type 5 – dark brown, tans easily
• Skin type 6 – black, tans very easily
Are YouAre YouGetting Getting Enough D?Enough D?
It is time for a poll!
Too Little Sunshine Too Little Sunshine ??
• Balance sun exposure for vitamin D with sun protection to reduce skin cancer risk.
• According to the National Institute of Health, despite importance of sun for Vitamin D, they still encourage limiting sun exposure.
• So that brings us to … supplementation!
SupplemenSupplementsts
Vitamin D Supplements
• Vitamin D supplements usually contain either vitamin D2 or vitamin D3.
• Both increase vitamin D levels in the bloodstream.
D2 versus D3D2 versus D3• Fatty fish offer vitamin D3 while
mushrooms offer vitamin D2.
• Vitamin D2 can be harder for your body to process, but only in extremely high doses
You may NEED a You may NEED a supplement if…supplement if…
• Age 50+• Limited sun exposure• Adults with darker skin • Consume little D from food• Do not absorb fat well (digestion/disease)
• People who avoid milk products• People who are overweight or obese
Vitamin D Review
• What is Vitamin D?– Vitamin D’s Role in the Body– The Impact of Deficiency and Toxicity
• How Much Vitamin D Do You Need?• What Are The Sources of Vitamin D
– Food– Sunlight– Supplements
Vitamin D Toxicity
• It’s pretty hard to get too much vitamin D.
• Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E.
Time for a Time for a Quiz !!Quiz !!
Vitamin D Quiz
• Which of the options below is NOT an effect of a vitamin D deficiency?
• Rickets • Osteomalacia
• Osteoporosis • None of the above
• True or false: Vitamin D toxicity is rarer than vitamin D deficiency.
Vitamin D Quiz
• Which of the options below is NOT an effect of a vitamin D deficiency?
• Rickets • Osteomalacia
• Osteoporosis • None of the above
• True or false: Vitamin D toxicity is rarer than vitamin D deficiency.
Vitamin D Quiz
• It’s harder for some people to get enough vitamin D, including ____.
• Women • People with dark skin
• Children • People with red hair
• True or false: Most foods don’t contain much naturally-occurring vitamin D.
Vitamin D Quiz
• It’s harder for some people to get enough vitamin D, including ____.
• Women • People with dark skin
• Children • People with red hair
• True or false: Most foods don’t contain much naturally-occurring vitamin D.
Vitamin D Quiz
• Which food is often fortified with vitamin D?• Milk • Fish• Carrots • Cookies
• True or false: Vitamin D2 supplements have very different effects than vitamin D3 supplements.
Vitamin D Quiz
• Which food is often fortified with vitamin D?• Milk • Fish• Carrots • Cookies
• True or false: Vitamin D2 supplements have very different effects than vitamin D3 supplements.
ResourcesResources• https://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-
the-vitamin-d-my-body-needs/• http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/• http://www.hhs.gov/news/healthbeat/2008/01/20080108a.html• http://www.health.gov/dietaryguidelines/dga2010/
DietaryGuidelines2010.pdf • http://www.ncbi.nlm.nih.gov/pubmed/21310306• http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/#h8
http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/vitamin-d?sitearea=ETO
Now for More About Vitamin D
Just kidding, we’re done
Vitamin D Review
• What is Vitamin D?– Vitamin D’s Role in the Body– The Impact of Deficiency and Toxicity
• How Much Vitamin D Do You Need?• Sources of Vitamin D
– Food– Sun– Supplements
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