vitamin D

I can think of worse places to soak up that vitamin D.

One of the trendiest things in medicine today, if the medical world can have a ‘trendy’ thing, is vitamin D. Its totally the new(ish) buzz. Vitamin D has a whole list of functions throughout our bodies, but mostly is responsible for calcium absorption in our intestines and kidneys. The reason why this vitamin has become so exciting recently is that research is showing that it might have the ability to lower your cancer risk and reduce the chance of complications or death from cancer.

Lets look at what happens when we are vitamin D deficient: First, your intestines have a hard time absorbing calcium and phosphorous –> this forces your body to suck the calcium out of your skeleton –> this causes small areas of bone weakness and generally decreases the bone mineral density (weaker bones) –> this leads to osteoporosis in adults and muscle weakness in children. 

How does this relate to cancer? Cancer will often spread from its point of origin to the bone. If your bones are stronger then the cancer has a harder time spreading there.  

The major source of vitamin D has always been exposure of skin to sunlight. When it is produced in the skin, vitamin D can last at least twice as long in the blood compared to when you eat your D. Therefor, the main cause of vitamin D deficiency is not getting enough sun. Here are a few factors that can reduce your skins production of D: 

1. darker skin (you’ll need 3-5 times more sun exposure than lighter skin),
2. aging,
3. topical sunscreen (SPF 30 reduces vitamin D synthesis by more than 95%),
4. obesity (the fat holds the vitamin hostage).

In the absence of sun exposure it is difficult, if not impossible, to obtain an adequate amount of vitamin D from dietary sources without supplementation. But we also have to be careful about the risk of skin cancer from too much sun. The current recommendation is to spend 10-15 minutes in the sun, without sunscreen, three times a week. But its not a bad idea to eat some vitamin D or take a vitamin D supplement. 

Here are some dietary sources of vitamin D:

• cod liver oil (400-1,000 IU/tsp)
• salmon, fresh (600-1,000 IU/ 3.5oz)
• salmon, other (100-600 IU/ 3.5oz)
• shitake mushrooms, dried (1,600 IU/ 3.5 oz)
• fortified milk, OJ, infant formula, yogurt (100 IU/ 8oz)

Here is the recommended daily intake of vitamin D, from all sources (food, sun, supplements):

• age 0-1 year:        400-1,000 IU
• age 1-18 years:    600-1,000 IU
• age 19  on:            1,500-2,000 IU

Numerous studies have suggested that adequate blood vitamin D levels (above 30) may have additional health benefits in reducing autoimmune diseases, type 2 diabetes, cardiovascular disease, and infectious diseases. This doesn’t mean that the more vitamin D you eat, the healthier you will be. You can, for example, overdose on vitamin D and end up with calcium deposits in your blood. And some people might actually have an increased chance of some types of cancer when they have too much vitamin D. 

In summary: vitamin D is made when your skin is exposed to sunlight and, less efficiently, can also be eaten or taken as a supplement. Vitamin D is used by the body to help keep your bones healthy; so a deficiency can lead to osteoporosis. Vitamin D is also proving to be an important factor in preventing or limiting cancer. Personally, I am now taking vitamin D supplements and sitting in the sun for a few extra minutes each week, arms and legs exposed. But I’m not going to stop putting sunscreen on my face and neck because I’m vain and want to look young for as long as possible.

organic contraversy

Why do you eat organic foods? Or, do you eat organic foods at all? A few months ago an article was published that tried to compare the nutritional value of organic foods versus conventionally grown foods (a similar article was published in 2011). Let me spare you the suspense, they didn’t find much of a difference in the vitamin and nutrient content of produce; nor did they find a difference in the protein or fat content of organic and conventional milk. But is this why we eat organic foods? I thought we were supposed to eat organic foods in order to avoid eating pesticides and because it might be nicer to the earth, not because they had more vitamins.

Organic food is big business, and is growing. Between 1997 and 2010, U.S. sales of organic foods increased from $3.6 to $26.7 billion. A food is organic when it is grown without synthetic pesticides or fertilizers or routine antibiotics or growth hormones. Organic livestock are fed organic feed and have access to the outdoors, direct sunlight, fresh air and freedom of movement. Organic foods are also usually processed without irradiation or chemical food additives and not grown from genetically modified organisms (GMOs).

So we don’t find a nutritional difference between organic and conventional foods. What about pesticides? The study reported that pesticides were found in 7% of organic produce and 38% of conventional produce. Great! So here is at least one reason to eat organic foods: fewer pesticides.

One would assume that, with fewer pesticides, we would have more bacteria and pests. Aside from E coli, which carries a higher risk in organic foods, the research found no difference in bacterial contamination of organic versus conventional foods. (Here is another source that confirms that  the pesticides aren’t even killing what they are supposed to be killing.)

Actually, pesticide use appears to increase the risk of antibiotic-resistant bacteria by 33-35%. Although this might not matter much because the over-use of antibiotics in humans is the major cause of antibiotic resistant infections in humans.

It’s important to know that this research, which was a review of many other articles, had some flaws. The samples of certain foods could not be standardized. For example, sampling milk that was pasteurized versus raw or collected in winter versus summer can have a significant impact on the results – and this was not standardized. Or, for example, some studies tested whole apples while others removed the peel. What we need is a long-term study of health outcomes of populations consuming mostly organic versus conventionally produced food, which would be very expensive.

Looks to me like eating organic foods might still be more beneficial than conventionally produced foods. But if you can’t afford, or don’t have access to organic foods then don’t worry too much. It’s still much healthier to eat conventionally produced food that you prepare yourself than it is to eat processed foods. Here is a downloadable list of the top foods that you should try to buy organic and top foods with the lowest pesticide count (not as important to buy the organic versions).

the antioxidant myth

Do you remember James Watson, of Watson and Crick DNA fame? Well, aside from turning into a racist homophobe, he has also dedicated the later part of his life to cancer research. Just last week he published a ‘cancer manifesto‘  railing against the future of cancer research and calling in to question the therapeutic benefits of anti-oxidants, suggesting that some forms of anti-oxidants (beta-carotene, vitamin A, vitamin C, vitamin E and selenium) might even cause some types of cancer.

And Watson is not alone. Dr. David Agus, an oncologist who wrote a great book called The End of Illness, has been arguing against the over-use of anti-oxidants for more than a year. And here is another great resource that espouses the same message. 

We are urged to eat anti-oxidant rich foods because they neutralize free radicals that can damage DNA. But is this really true? Can we prevent cancer by eating more blueberries and broccoli? Watson and Agus argue that, in fact, instead of preventing or curing cancer, anti-oxidants might raise the risk of disease or early death. That, if we overload our bodies with antioxidants, it can prevent free radicals from doing what they are supposed to do, which is to kill damaged cells and invaders like bacteria.

But, when you think about it, its not surprising that anti-oxidants don’t cure or prevent disease. Look at who is sending us this message. Its usually coming from someone trying to sell you something. “Take this pill. Eat this product. Drink this elixir.” and you, too, can live forever. Did you really think that a martini could be made healthy by adding pomegranate juice?

Living longer and healthier is only achieved with equal parts effort and luck. You have to exercise, eat healthy, don’t smoke or do drugs or drink too much alcohol. These are all difficult habits, until you relent and just start doing them until they become your normal. You should still enjoy anti-oxidant rich foods, just eat them because they taste good, not because you think they will prevent cancer.

fertility, an interview with Dr. Shahin Ghadir

You know how sometimes you hear about women who, in their mid thirties, finally start trying to get pregnant and then are shocked that they don’t conceive naturally and are devastated that they might need medical intervention to make a baby? I was never one of those women. I don’t, at all, understand these women. Maybe its because I have studied the body for so long, or maybe its just my personality, but I never assumed that my body would just be waiting for me until I was ready to get pregnant.

Still, it didn’t occur to me that I could be, or should be, proactive about my fertility, until recently. So many women I know are using fertility treatments to assist in becoming pregnant- women that are much younger than I expected. So I decided to ask Dr. Shahin Ghadir about fertility. Dr. Ghadir, a friend of mine for more than 15 years, is a reproductive endocrinologist, double board-certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility, and assistant clinical professor at both UCLA and USC Keck Schools of Medicine. He is the perfect combination of kind, patient, and straight forward. I sat down with Dr. Ghadir to learn more.

Dr. Lustig’s Crusade

Dr. Lustig’s Crusade – is he fighting a losing battle?

Apropos Nina’s recent review of sugar and sugar substitutes – a leader in the fight against table sugar and high-fructose corn syrup additives recently publised his first book. “Fat Chance” may seem like pop-science but trust me folks, the data is also published and widely available. Fructose is not metabolized like glucose. It takes a toll on the liver and increases the lipids in our bloodstream further predisposing to heart disease. Dr. Lustig, is a Professor of Pediatrics in the Division of Endocrinology at UCSF and the Director of the Weight Assessment for Teen and Child Health (WATCH) Program. If you’d like to learn more about his work, I highly recommend you watch his lecture which is available on YouTube. There are two versions: scientific (which I suggest for all) and less-scientific. This is not some boring video about nutrition. This thing has 3 million views! But if you really want the “skinny” (drum-beat) – just watch this short 60 minutes video from last year – although you will have to tolerate the Emmy®-award winning douche, Sanjay Gupta.

Polio in Afghanistan

Edison and Vaccination

Hundreds of years of scientific thought and the lives of some of the worlds most intelligent laureates have been dedicated to prolonging human life. Vaccines were a milestone in this effort. Like Thomas Edison’s creation of the light bulb – just as we are not lighting candles and moping around in the dark, we are also not dying of measles, mumps, rubella, smallpox, chickenpox anymore.

Vaccines have everything to do with this achievement. In fact, the smallpox vaccine worked so well that it doesn’t exist anymore. Unfortunately, we still contend with many other diseases. Honestly… we really do. Have you ever seen someone afflicted by Polio? In the last five years I’ve met two adults who survived Polio with lifelong consequences. A few countries in Africa and the Middle East remain Polio endemic. 

If enough people refuse vaccines we will begin to see outbreaks of some of these preventable disease right here in the USA. Oh… wait. We already have. Think measles aren’t a big deal? Well, it still kills about 1,000,000 children each year in developing countries. A million. It’s also the leading cause of blindness in children in Africa. And recent outbreaks due to vaccine refusal include other illness too: Pertussis (particularly in California), Mumps, Hepatitis A, B… it goes on.

Think you’re safe via herd immunity? Some people assume that since everyone else is vaccinated, they are safe from the disease. Well, that’s just irresponsible – both socially and for the individual. Until a communicable disease has been completely eradicated, it remains a threat. Keep in mind that outbreaks primarily affect those who cannot be vaccinated (newborns and the immune compromised) and those with declining immune systems (elderly).

Despite all of the lives saved, vaccines are constantly facing controversy and criticism;