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Sources high in vitamin D include cod-liver oil, salmon, milk, yogurt and eggs.

‘D’-termining
what’s good for you
Vitamin D is kind of a mystery nutrient
By Debra Gelbart

V
itamin D is a misunderstood nutrient. It’s vital for
good health, but it’s not clear yet whether it can
actually deliver on all of its celebrated potential.
“Without adequate vitamin D, you
can’t have healthy bones,” said George
Gendy, M.D., an orthopedic surgeon who
performs surgery at the Abrazo Arrow-
head Campus in Glendale.
“All kinds of preliminary studies cor-
relate low vitamin D levels to a variety
of medical conditions, but larger, better-
designed studies lead to mixed results,”
explained Natasha Bhuyan, M.D., a
family medicine doctor in Phoenix. “The
best studies show there is no benefit to
taking vitamin D to treat conditions like
depression, fatigue, diabetes, osteoar-
thritis or chronic pain. But Vitamin D
does decrease fall risk in elderly adults
and it may reduce the risk of a moderate
to severe worsening of chronic obstruc-
tive pulmonary disease (but not upper
respiratory infection) in patients with
COPD and low vitamin D.”
)',,'1 5+,-58'/3 !'// ,$8' Some clinical trials also have sug-
gested a possible association between
vitamin D and cancer risk, the National
Cancer Institute has reported.
known as calcitriol. Calcitriol is the
bioactive form of vitamin D and is a
steroid hormone that helps regulate
calcium and phosphorus.”
Getting enough vitamin D
Exposure of at least 30 percent of your
skin’s surface to direct sunlight without
sunscreen for 15 minutes a day is
the only way to potentially absorb
adequate vitamin D through sunlight
during peak times of the day (between
3 and 5 p.m.), Gendy said. “But here
in Arizona, we simply don’t do that in
the summer because it’s so hot.” As a
result, he said, many people don’t get
enough vitamin D without taking diet
into consideration.
Yet it can be tricky to take in the 600
international units (IU) of vitamin D
recommended every day for adults and
children over the age of 1.
“Very few foods contain high
amounts of vitamin D, though many
are now fortified,” said Jaclyn Cham-
berlain, RDN, a registered dietitian

.21,$2! 76'' *'4!2-'8'6, What should your

vitamin D level be?
nutritionist and project manager with
Pinnacle Prevention, a Chandler-based
The challenge for doctors is that there i nonprofit. Natural sources high in vita-
10 YEARS AGO NOW s disagreement on optimal serum min D include cod-liver oil, salmon and
Patient was Patient goes
(blood) levels of vitamin D. other fatty fish, she said. Fortified food
sources include milk and yogurt, forti-
required to stay home the
“There isn’t consensus in the medical
fied orange juice, and fortified cereals.
in hospital SAME-DAY
community about the optimal level of
vitamin D in the blood,” Bhuyan said. Eggs, particularly egg yolks, are also a
1-2 NIGHTS “Even different labs will have different source of vitamin D.
ranges for low versus normal, which “If you’re not a big fish eater and
can be quite confusing to patients. In consume two or three servings of milk
general, below 20 ng per ml (nanograms or yogurt a day (the recommended
#+!! 76'' *'4!2-'8'6, per milliliter, a unit of measure for test
results) is considered low, but I've seen
amount), it may be worth asking your
doctor about vitamin D supplementa-
some labs mark 30 as low. The issue is, tion.” She added that adults over 70
10 YEARS AGO NOW we don't know if there is truly a benefit have a higher need for vitamin D, “as
Patient was Patient to treating people with vitamin D level their ability to synthesize vitamin D
required to stay may stay in the 20s.” through sunlight decreases with age.”
This age group needs 800 IU per day.
in hospital 1 NIGHT
Gendy said he recommends a vitamin
It’s important not to over-supple-
3-4 NIGHTS D level of between 35 and 50 ng per ml.
“Over 100 is too high,” he said. ment, Chamberlain said. “High intakes
have been associated with kidney
stones and other health issues. Up to
A vitamin…or something else?
4,000 IU per day is considered safe
*'&20$!$,2,$56 ($8' When you take vitamin D as a supple-
ment, it is a vitamin. Once in your body,
for most adults, and 1,000-3,000 IU
per day are considered safe for infants
it becomes a hormone.
and children, depending on age. Speak
10 YEARS AGO NOW Vitamin D is taken as a supplement
with your physician or talk to a dieti-
in its inactive form, Bhuyan explained,
SEVERAL 6-8 WEEKS, and that inactive form is considered
tian about your individual needs and
recommendations to avoid over-
MONTHS patients encouraged “a pre-hormone. It needs to be activated
supplementation.”
to walk the same day in the kidney and liver into what’s
of procedure
Exposure of at least 30 percent
of your skin’s surface to direct
sunlight without sunscreen
for 15 minutes a day is the
only way to potentially absorb
adequate vitamin D through
sunlight during peak times
of the day.

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Sources: Gerontol A Biol Sci Med Sci. 1995 Nov;50 Spec No:5-8, American College of Sports Medicine, Exer-
cise and the Older Adult, US Department of Health and Human Services, Osteoporosis Research, Education
and Health Promotion, Annals of internal medicine (Impact Factor: 16.1). 04/1996; 124(6):568-72, J Am Geriatr
Soc. 1995 Jul;43(7):756-60, J Am Geriatr Soc. 2004 May;52(5):657-65, Health Day March 11, 2014, Journal
of Strength & Conditioning Research: October 2012, Volume 26, Issue 10, p 2806-2811, Archives of Internal
Medicine August 6, 2012, Nutrition & Metabolism May 17, 2012