Vitamin D: an essential component for skeletal health – Dec 2011

Ann N Y Acad Sci. 2011 Dec;1240:E1-12. doi: 10.1111/j.1749-6632.2011.06374.x.
Wimalawansa SJ.
Division of Endocrinology, Metabolism & Nutrition, Department of Medicine, and UMDNJ, Robert Wood Johnson Medical School, Physiology and Integrative Biology, Graduate School of Biomedical Sciences, New Brunswick, New Jersey 08903-0019, USA. wimalasu@umdnj.edu

Vitamin D deficiency is increasing worldwide. Ultraviolet rays are supposed to provide humans over 80% of our vitamin D requirement; the rest is received through diet and supplements. In addition to enhancing calcium absorption from the intestine and mineralization of the osteoid tissue, vitamin D has many other physiological effects, including neuromodulation, improving muscle strength and coordination, insulin release, immunity and prevention of infections, and curtailing cancer. Whether the increased incidence of vitamin D deficiency is related to increased incidences of nonskeletal disorders remains to be determined. Serum levels of 25-hydroxyvitamin [25(OH)D] above 30 ng/mL indicate vitamin D sufficiency. An additional 1,000 IU of vitamin D/day is sufficient for most lighter-skinned individuals, whereas an extra 2,000 IU/day is needed by the elderly and dark-skinned individuals to maintain normal 25(OH)D levels. Additional research is needed to clarify the relationship between vitamin D and the nonskeletal systems, nonclassic functions, and targets of vitamin D.
© 2012 New York Academy of Sciences.
PMID: 22360357
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Notes on paper by VitaminDWiki

Sunlight needed:15% of body exposed 10-15 minutes a day, 4-6 times per week (page 3)

No More correctly stated: Only 10-15 minutes per day, 4-6 times per week is needed for a healthy, young, non-obese, white male, with 25% of skin exposed, while lying down, in the southern part of the US, in middle of the day, in the summer, with direct sun, in a rural area. Longer time or more exposed skin is needed if even one of those is not true.

Senior women need more than senior men due to estrogen deficiency (page 3)

Do not recall hearing this before. Seems possible

Vitamin D tests are becoming more accurate

Immo methods ==> physical methods ( LC/MS/MS) CLICK HERE

Reasons for vitamin D deficiency (page 4)

Author has a nice subset of 27+ reasons for vitamin D deficiency

2,600 IU daily is enough for 97% of elderly page 5

The unstated goal is probably for 20 ng. Suspect more is needed for 30 ng

Manifestations of vitamin D deficiency include inability to lose weight page 5

Do not recall seeing that before

Vitamin D2 produces similar increases in blood level as D3 page 7

No At worse case D2 actually decreases blood levels

Does not mention reaction to vitamin D when low on Magnesium page 7

Does not mention the important of co-factors in building bone

Does not mention possibility of supplementing the mother rather than the infant (page8)

Breast feeding mother would need 4,000 to 6,400 IU daily

More than 2000 IU needed for seniors with dark skin, women, obese, living far from equator, avoiding the sun, living in a senior facility, and wearing excessive clothes

See also VitaminDWiki

More about the author

Lifestyle Medicine and Promoting Your Health April 18 2012

Dr. Wimalawansa is a University Professor and Professor of Medicine at UMDNJ-Robert Wood Johnson Medical School. He earned a diploma in Medical Administration at the Johns Hopkins School of Business and an Executive MBA from Rutgers University. He works with more than ten different volunteer and charitable organizations, nationally and internationally. He has written several books, more than 200 scientific publications; 45 reviews and proceedings, 15 book chapters, 260 scientific abstracts; he has presented move than 160 invited lectures and holds six medical patents. He is a regular scientific reviewer for more than 20 national and international scientific journals and serves on several editorial boards and granting agencies. He has received multiple scientific awards, including several young investigator awards, the Dr. Boy Frame Award for Clinical Excellence in Metabolic Bone Diseases from ASBMR, the American Endocrine Society Glen Foundation Award, and an innovation award from the Asian Chamber of Commerce. He is the founder-president of several charitable organizations, including the International Foundation for Revitalization, Empowerment, Education, and Development; International Foundation for Chronic Disabilities; and Hela Foundation, North America. He is the chairman of the Wimalawansa Education Trust Fund for Needy Children and Chairman of the Wimalawansa Foundation, and a member of the National Advisory Council on South Asian Affairs. In 2005, Dr. Wimalawansa received a Lifetime Achievement Award from Sri Lankan Foundation, CA, for his contributions to science, humanity, and society. In 2007, he received the Dr. Oscar Gluck International Humanitarian award for his humanitarian contributions. His latest philanthropic work includes development of a novel highly cost-effective method for purifying contaminated water for drinking that is applicable for millions of people throughout the world.

In his Colloquium, Professor Wilmalawansa will be talking about the importance of diet, lifestyle and medical choices in promoting our health. Physical inactivity and unhealthy eating are major drivers of disease, death, and escalating healthcare costs. Lifestyle medicine applies lifestyle interventions such as environmental, behavioral, medical, and motivational principles in the treatment and management of chronic disease. Behavior modification is an important part of the management of most chronic diseases, such as diabetes, obesity, hypertension, osteoporosis, heart disease, and some cancers. Such diseases can be treated with lifestyle medicine as effectively as – or even more so – than with medications without the risks and unwanted side effects these can involve.

Hormones influence every cell, organ, and function of the body. They regulate mood, growth, metabolism, tissue function, and sexual and reproductive processes. Sustained elevation of stress-related hormones like glucocorticoids and adrenaline has marked negative effects on human health. Sustained and unmanaged stress adversely affects not only the endocrine functions, but also the nervous system, which can result in depression, hypertension, diabetes, obesity, etc. These can be treated effectively with lifestyle medicine.

A key part of lifestyle medicine is to learn and teach the ability to cope with day-to-day stresses and how to adapt to rapidly changing circumstances. Most human disorders are initiated after maladaptation to stress. Thus, learning and practicing various stress-reducing methods, such as meditation, Tai-chi, yoga, exercises, or relaxation including listening to music or playing a musical instrument, can be helpful in alleviating excess stress. A balanced diet and regular exercise together with relaxation of the mind and the body can turn the negative spiral of mental and physical imbalance and stresses into a positive cycle of optimum health.

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