Booster Shots

Oddities, musings and news from the health world

Category: vitamins

FDA warns against overdosing infants with vitamin D

June 15, 2010 | 10:13 am

The Food and Drug Administration on Tuesday warned parents about the dangers of giving infants more than 400 international units (IU) of vitamin D, a risk that is exacerbated by the spread of supplement containers with droppers that hold larger amounts of the vitamin. At the same time, the agency sent a letter to manufacturers urging them to mark droppers more clearly and to use droppers that hold only the recommended amount of the vitamin.

Vitamin D promotes calcium absorption in the gut and plays a key role in the development of strong bones. Supplementation is recommended for some infants, especially those being breast-fed, because a deficiency can lead to bone problems such as thinning, soft and misshapen bones, such as those found in rickets.  Overdoses of the vitamin, however, can cause nausea and vomiting, loss of appetite, excessive thirst, frequent urination, constipation, abdominal pain, muscle weakness, muscle and joint aches, confusion and fatigue, as well as more serious consequences such as kidney disease. The American Academy of Pediatrics thus recommends that infants receive no more than 400 IU of vitamin D per day.

The problem, the agency said, is that many droppers in supplement bottles are not clearly marked with the correct amount, or are excessively large, increasing the likelihood that a parent can inadvertantly give an overdose. If a parent is unable to determine the dose of vitamin delivered by the dropper, he or she should contact their pediatrician or pharmacist for guidance.

-- Thomas H. Maugh II

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Annual mega-dose of vitamin D doesn't reduce fractures, study finds

May 11, 2010 |  1:30 pm

Sufficient vitamin D is vital to bone health and preventing the bone-thinning disease osteoporosis. But a new study shows an experimental therapy involving a once-a-year mega-dose of vitamin D did not prevent bone fractures and actually increased the risk of falls and fractures.

Researchers in Australia gave a single, annual dose of 500,000 international units of vitamin D or a placebo to 2,256 women, ages 70 and older, at high risk for fracture. But after three to five years, the study showed that 74% of the women in the vitamin D group had at least one fall compared with 68% of the women in the placebo group. Women in the vitamin D group had 171 fractures compared with 135 in the placebo group.

Vitamin D supplementation of 800 IU a day is known to be important for good bone health. It's not clear why an annual mega-dose may backfire. It's possible that vitamin D improved the women's overall health and well-being to the extent that they were more active and mobile and had more opportunities to fall. But no matter, said the authors of a commentary accompanying the study, it's safe and effective to take the vitamin at lower doses daily, weekly or monthly.

The study was published Tuesday in the Journal of the American Medical Assn.

— Shari Roan

Older adults need twice the recommended amount of vitamin D per day, group says

May 10, 2010 | 10:12 am

Older adults need up to twice the amount of vitamin D than is typically recommended, according to guidelines released Monday by the International Osteoporosis Foundation.

Bone Concluding a meeting in Switzerland, the group urged adults, defined by this group as 65 and older, to aim for a 25-OHD blood level -- the primary marker for vitamin D in the blood -- of 75 nanomoles per liter. To reach that level, one would need an intake of 20 to 25 micrograms per day (or 800 to 1,000 international units) of vitamin D.

That is significantly greater than the U.S. Recommended Daily Allowance of 10 micrograms (400 IU) for people ages 51 to 70 and 15 micrograms (600 IU) for people 71 and older. Moreover, the international group cautioned that intakes of up to 50 micrograms or 2,000 IU may be necessary for people who are obese, have osteoporosis, have limited sun exposure or who have problems absorbing vitamin D.

The guidelines also recommended vitamin D blood tests for people who may be deficient. The lead author of the statement, Dr. Bess Dawson-Hughes of Tufts University, noted that many people worldwide do not get enough vitamin D.

"This high prevalence of suboptimal levels raises the possibility that many falls and fractures can be prevented with vitamin D supplementation," she said in the statement. "This is a relatively easy public health measure that could have significant positive effects on the incidence of osteoporotic fractures."

-- Shari Roan

Photo: A magnification of healthy bone, left, and bone thinned and weakened by osteoporosis. Credit: PR NewsFoto

Vitamin E helps nonalcoholic fatty liver disease

April 28, 2010 |  4:05 pm

Vitamin E pills can help people with a nonalcoholic fatty liver disease called steatohepatitis, researchers reported Wednesday. There is currently no treatment for the disease, which is similar to the liver disease that is caused by excessive drinking and that can lead to cirrhosis and scarring the impair the function of the organ, eventually proving fatal. It can affect people of all ages and most of them drink little, if any, alcohol. It is believed to be caused by abnormal metabolism of fats, which raises the level of damaging oxidants in the liver. An estimated 3% to 4% of Americans are afflicted with the problem, although many do not realize they have it.Vitamin e

"This is an important landmark in the search for effective treatments for [the disease]," said Patricia Robuck of the National Institute of Diabetes and Digestive and Kidney Diseases, project scientist for the new study.

Several small studies had previously suggested that insulin sensitizers and antioxidants might alter the progression of the disease. To test that possibility, a National Institutes of Health Clinical Research Network on the disease, led by Dr. Arun J. Sanyal of Virginia Commonwealth University, enrolled 247 adults with the disease but without diabetes, dividing them into three groups. One group received 800 international units of vitamin E daily, the second received the diabetes drug pioglitazone and the third received a placebo. It was the largest clinical trial ever conducted for treating the disease.

The researchers reported online in the New England Journal of Medicine that 43% of the patients receiving vitamin E showed a major improvement in liver function, compared with 19% of those who received either placebo or pioglitazone. Pioglitazone reduced liver inflammation and improved retention of lipids in 34% of the individual receiving it, but the improvements were not statistically significant. But those taking the diabetes drug also had a 10-pound weight gain.

Although the government funded the study, the pioglitazone was donated by its manufacturer, a U.S. subsidiary of Japan's Takeda Pharmaceutical and the vitamin E was donated by supplement maker Pharmavite of Mission Hills.

-- Thomas H. Maugh II

Photo: Robert Gauthier / Los Angeles Times

Vitamin D supplementation can be tricky

March 15, 2010 |  1:34 pm

Vitamind Vitamin D may help prevent and treat heart disease, according to research released Monday from the American College of Cardiology meeting in Atlanta. But bringing vitamin D levels up to a "normal" range is a confusing issue, and there are many questions about what constitutes proper levels of the nutrient.

Experts suggest that vitamin D levels should be at least 30 nanograms per milliliter for optimal health, and some experts have suggested even higher levels are better. As many as three-quarters of American adults are thought to have deficient levels. Vitamin D is synthesized in the skin from sunshine and is found in a limited number of foods. But many people prefer to take vitamin D supplements to boost blood levels.

In another study presented at the meeting Monday, researchers found that the effects of supplementation can vary depending on race. In particular, what is consider to be a low level in whites may actually be adequate in black people. The study, from researchers at Wake Forest University, found that higher levels of vitamin D in blacks was associated with more calcium in the arteries of the heart, which can increase the risk of heart attack.

"This is the opposite effect of what is felt to occur in white patients and shows that the accepted 'normal' range of vitamin D may be different between blacks and whites," the lead author of the study, Dr. Barry I. Freedman, said in a news release.

-- Shari Roan

Photo credit: Anne Cusack  /  Los Angeles Times

Does your vitamin C live in the kitchen? You may want to relocate it

March 3, 2010 | 11:43 am

If you're like most people you probably keep your vitamins in the kitchen, or maybe the bathroom. Bad idea, say researchers from Purdue University, who found that humidity and high temperatures may seriously degrade products such as vitamin C.

HobmzgkfThe findings were published last month in a study in the online version of the Journal of Agricultural and Food Chemistry. In it, the authors observed the stability of two types of vitamin C--sodium ascorbate and ascorbic acid, both also used as food additives--under a variety of humidity and temperature states. They were looking for deliquescence, when a water-soluble substance dissolves and becomes liquid after it absorbs moisture in the air. For a visual, think of what happens to sugar or salt when it's left out in muggy weather.

With vitamin C, however, more than clumping happens--those conditions can also cause chemical instabilities.

The researchers found that though humidity and temperature caused degradation in both forms of vitamin C, humidity had a greater effect. They also noted that the two conditions worked in tandem--higher temperatures caused more vitamin C instability when it was stored above a certain humidity.

Senior author Lisa Mauer, an associate professor of food science at Purdue, noted that even when humidity and temperatures drop and the vitamin C product goes back to a solid state, it may already be too late. "Any chemical changes or degradation that have occurred before resolidification don't reverse," she said in a news release. "You don't regain a vitamin C content after the product resolidifies or is moved to a lower humidity. The chemical changes we've observed are not reversible."

That aside, keep in mind that you might not even need those vitamin supplements. Studies have found certain vitamins and supplements may not reduce the risk of stroke, cardiovascular disease, or certain types of cancer. Much to consider the next time you're in the vitamin aisle.

-- Jeannine Stein

Photo credit: Anne Cusack / Los Angeles Times

Let's put vitamin D in the water

January 28, 2010 |  6:11 am

Vitamin D is synthesized in the skin via sunlight. But according to piles of research in recent years, most people aren't getting enough of the nutrient, and deficiencies may contribute to cancer, diabetes and cognitive decline. The latest study links vitamin D deficiency and asthma.

Asthma In a study at National Jewish Health in Denver, researchers found that adult asthma patients with the highest levels of vitamin D in their blood had better lung function compared with people with the lowest levels.  Higher vitamin D levels were associated with an increased response to dexamethasone, an inhaled steroid that many patients use to control their symptoms. The study, published today in the American Journal of Respiratory and Critical Care Medicine, also found that obese asthma patients tended to have lower vitamin D levels.

"Our findings suggest that vitamin D levels influence a number of important features of asthma, including lung function, bronchospasm and therapeutic response to steroids," Dr. Rand Sutherland, chief of the pulmonary division at National Jewish Health, said in a news release. "The next question to answer is whether giving supplemental vitamin D will lead to clinical improvements in patients with asthma. We are developing prospective studies to answer that."

Here's an August 2009 Los Angeles Times story discussing the emerging research on vitamin D deficiency. Maybe adding it to water isn't a great idea, but neither is overexposure to sunlight. Supplements anyone?

-- Shari Roan

Photo credit: Getty Images

Take vitamin D and calcium for bone health

January 13, 2010 |  6:00 am

Vitamin D does not lower the risk of bone fractures unless it's taken with calcium, a new study reports.

VitD Previous research on vitamin D's effects have been conflicting. Some studies have found supplements reduce the risk of fractures while others haven't. Researchers in Denmark analyzed seven studies on the question. The studies included a total of 68,517 people whose average age was 70. The study concluded that vitamin D given alone in doses of 10 to 20 micrograms per day is not effective in fracture prevention. But when calcium and vitamin D were given together the fracture rates were reduced. The analysis, however, compared vitamin D with no treatment or vitamin D plus calcium versus no treatment. There was no direct comparison of vitamin D alone and vitamin D plus calcium.

Other research also suggests that the combination of vitamin D and calcium is the best approach. But the issue of supplements for bone health isn't settled. A different meta-analysis, published last year, found that doses of Vitamin D of 400 international units (about 10 micrograms) per day prevented non-vertebral fractures. And the authors of the new study, published in the British Medical Journal, acknowledge that additional vitamin D studies are needed, especially examining higher doses.

-- Shari Roan

Photo credit: Robert Gauthier  /  Los Angeles Times

Low vitamin D levels in blacks may explain higher rates of heart disease

January 6, 2010 |  3:06 pm

The disparity in rates of heart disease deaths between blacks and whites can be attributed in large part to low levels of vitamin D in a substantial portion of the black population, researchers have found. Their dark skin cuts down on the production of vitamin D--which is produced primarily by sunlight--particularly among those who live at higher latitudes where sunlight is less intense than it is closer to the equator, said Dr. Kevin Fiscella of the University of Rochester, a co-author of the paper appearing Thursday in the Annals of Family Medicine. In general, blacks require three to five times as much exposure to sunlight as whites to produce the same amount of vitamin D.

The study also found a higher risk of death from heart disease in whites with abnormally low levels of vitamin D.

Low levels of vitamin D have previously been linked to increases in high blood pressure, obesity, diabetes, peripheral artery disease, kidney disease and breast cancer. To further explore the links, Fiscella and Dr. Peter Franks of UC Davis studied vitamin D levels in 15,000 people who participated in the third National Health and Nutrition Survey from 1988 to 1994 and correlated them to deaths reported in the National Death Index through 2001. Overall, they found that the 25% of subjects in the study with the lowest blood levels of vitamin D had a 40% higher risk of dying from heart disease than those in the upper 75%. Blacks in the study had a 38% higher risk of dying from heart disease than whites, they found, but low blood levels of vitamin D accounted for about two-thirds of the increased risk. The rest could be attributed to poverty.

Current federal guidelines for vitamin D call for consumption of 400 International Units (IUs) of vitamin D for most adults and 600 IUs for those over age 70. Fiscella did not make a recommendation for daily intake, but most researchers studying vitamin D now take between 1,500 and 2,000 IUs per day. The general consensus is that no harm is associated with a daily intake of up to 10,000 IUs. And many physicians agree that, when you have your annual visit with your doctor, he or she should measure your vitamin D levels.

-- Thomas H. Maugh II

Twenty minutes of sunlight per day provides most whites with enough vitamin D, but blacks require three to five times as much exposure. Credit: Al Schaben / L.A. Times

Choosing your diet: A new year’s resolution primer

December 30, 2009 |  4:59 pm
Cake As the deadline for new year’s resolutions approaches, dieting sits on the lips of talk show hosts and at the fingertips of bloggers everywhere. With all the new fads debuting and old favorites that just won’t exit stage left, prospective dieters might have some trouble sorting through the hype. Unique as each weight-loss system surely is, here are a few categories they fall into:

Low-carb: The carbohydrate, once seen as the basis for healthy eating in the vintage USDA food pyramid, is now nutrient non-grata in many a modern diet.

These regimens come in many forms, from the high-fat, high-protein Atkins diet to the more balanced South Beach diet. Atkins’ devotion to dairy, meat and other types of protein at the expense of fruits, vegetables, grains and fiber-rich foods can lead to constipation, heart disease and nutritional deficiencies.

The South Beach diet has been noted for being more healthful and nutrient-friendly, but some sites warn that some of the initial weight lost is just water – and like any diet, it’s difficult to keep up in the long run. 

The workhorses:  Jenny Craig and Weight Watchers are two good examples. These systems have been around for decades, and it’s possibly their no-gimmick style – not prohibiting certain foods, limiting calorie intake and controlling weight long-term – that has helped keep them around.

Some complain that they focus on the bottom line and don’t encourage eating healthier foods – more fiber-rich items, better fats, balanced meals – as much as they should.

Buy my food: Slim-Fast, Nutrisystem and the many “cookie diets” that have sprung up in the wake of Sanford Siegal’s original plan all fall into this category. The food offerings – whether they’re a meal-replacement shake or a civilian MRE – often get mixed reviews, and these perceived limitations on taste and choice might inspire devotees to “cheat” and go foraging for other flavorful fare. 

Drive-by: As I posted earlier, fast-food chains from McDonald's to Taco Bell are trying to market lower calorie, low-fat entrees. Sure, there are plenty of relatively healthful options available on each of these menus. But remember, fast-food joints are the purveyors of hidden-calorie vehicles such as soda. And you can’t eat two boxes of nachos or tack on an order of fries, just because the total number of calories still falls under your daily limit, and still expect to get your daily value of vitamins and minerals.

The trick is to be informed, and not let the drive-through window dictate your eating habits. Wake Forest University Baptist Medical Center provides a comprehensive list of major chains and links to their nutrition labels here.

Crash diet: If it promises you will shed pounds and feel great by the end of the week, don’t do it. The weight you’re losing is likely water and muscle. It throws your system out of whack in the short term, and the results don’t stick in the long term. Plan ahead for that beach body or that 10 -year reunion: eat healthy and exercise.

The key to a healthy weight lies in finding the eating habits (and exercise regimen) that work for you – eat fruits and vegetables, moderate (but don’t cut out) fats and oils, and reduce your portion sizes.
But if you must find a ready-made diet, Frontline has a chart comparing some of the more (in)famous diets out there, and WebMD provides an alphabetical list of more than 60 diet reviews.

P.S. If you’re looking to lose weight, it’s not just about food. Sleep habits, daily activities and other lifestyle habits factor in too. That’s what "Freakonomics" authors Stephen J. Dubner and Steven D. Levitt found back in 2005 when they wrote about a professor who perfected his individualized weight-loss system.

-- Amina Khan

Photo credit: Larry Crowe / Associated Press


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