The Hottest Vitamin Under the Sun

Vitamin D may just be considered the it vitamin of 2009. This year, it seemed stories on the sunshine vitamin were published daily. Studies on its role in bone health, heart health, immune health, weight management, cancer prevention and other health conditions poured from scientific journals. With the outbreak of H1N1 influenza, the Public Health Agency of Canada plans to test vitamin D levels of people who contract the virus in order to find new ways to fight it; and the U.S. Institutes of Medicine (IOM) announced it will review the recommended daily values of vitamin D intake.

Yes, vitamin D was hot this year, and not just because it comes to us from sun exposure. With all the news reports and studies, its no wonder awareness of vitamin D is up among consumers. The International Food Information Councils (IFIC) Functional Foods/Foods for Health consumer survey, released in August 2009, found 90 percent of Americans recognized vitamin D offers bone-health benefits compared to 81 percent in 2007. For responders who had children, 19 percent said they look for their childrens foods and beverages to be fortified with vitamin D. Michael McBurney, Ph.D., FACN, head of scientific affairs, DSM Nutritional Products Inc. added, Fifty-six percent of those surveyed were already choosing foods with vitamin D to promote bone health, and another 38 percent were very or somewhat likely to do so.

But consumers beyond those looking for bone benefits for the old and the young are also seeking vitamin D fortification and dietary supplements. Traditionally, consumers were interested in calcium supplements with vitamin D; however, because of the scientific studies in the last a few years, they are now more interested in trying vitamin D for boosting the immune system, helping to fight the flu, etc., said Steve Huang, manager, PAT Vitamins.

Vitamin D comes in two biologically inactive precursors. D3, also known as cholecalciferol, is produced by the skin when its exposed to ultraviolet B (UVB) radiation; D2, also known as ergocalciferol, comes from plants exposed to UV light. The liver and kidneys synthesize both forms of vitamin D into 1,25-dihydroxyvitamin D (1,25(OH)2D), to make it active in the body. However, David Garner, partner, Marco Hi-Tech JV LLC, argued the body prefers consumption of D3, adding, D3 is said to be the best form of vitamin D (cholecalciferol) as it is the natural type that also is created whenever skin is exposed to sunlight.

Humans may not be able to get all of their vitamin D from the sun due to amount of skin that is exposed, the length of exposure, UV wavelength, latitude, season, skin melanin content and age. Therefore, people are more interested in increasing their vitamin D by consuming the nutrient, but most unfortified foods do not provide adequate amounts. The few foods that do contain a significant amount of vitamin Dbutter, cream, egg yolks and fatty fish, such as herring, catfish and salmonare not, and in some cases shouldnt be, prevalent in todays diets.

The reality is that the average U.S. diet does not provide the required amount of vitamin D, said Dinesh Venkateswaran, technical marketing manager, DSM Nutritional Products Inc. Therefore, dietary supplements may be useful sources for these nutrients that otherwise might be consumed in less than recommended amounts.

U.S. dietary reference intake (DRI) guidelines established in 1997 by IOM recommend 200 IU/d of vitamin D through age 50, 400 IU/d for people ages 51 to 70 and 600 IU/d for those 71 and older. But many experts now say everyone likely needs more. For instance, in 2008, The American Academy of Pediatrics the American Academy of Pediatrics (AAP) recommended breastfed infants receive supplements of 400 IU/d of vitamin D until they are weaned and consume more than 1,000 mL/d of vitamin D-fortified formula or whole milk.¹ All non-breastfed infants ingesting less than 1,000 mL/d of vitamin D-fortified formula or milk should receive a vitamin D supplement of 400 IU/d, they said. AAP also recommends older children and adolescents should take a 400 IU vitamin D supplement daily. In response, a new IOM panel is reviewing the recommendations on vitamin D and calcium and a report is expected in spring 2010.

Huang believes FDA will follow suit. In 2010, we believe FDA will probably increase dramatically the recommended daily allowance (RDA) for vitamin D, he said. This will push further growth of vitamin D sales in functional foods and nutritional products.

Those sought-after products will include dairy items as well as new innovations, said Diane Hnat, senior technical marketing manager DSM Nutritional Products.Historically milk, margarine and ready-to-eat (RTE) cereal have been the most popular food delivery vehicles for vitamin D, she said. It is also allowed under the enrichment guidelines for grain products, and has picked up momentum with its additional approval in juice drinks with calcium.

Those who formulate with vitamin D may want to invest in tests to ensure quality. Product stability is very important in vitamin D products, Huang said. We have excellent stability test results to offer our customers. Also the impurities in the vitamin D are a concern, so we have utilized HPLC testing methods to assure the purity of our vitamin D products.

The fat-soluble nature of the vitamin can also pose a challenge. Vitamin D is fat-soluble so water-dispersible forms are required for many applications, Hnat said. The encapsulants capability to hold up during processing of foods like RTD meal replacements or processed cheese is important.

Garner added it is less difficult to formulate vitamin D in supplements than in liquid forms. While vitamin D is easy to process for supplements such as tablets, it is very demanding to make it part of any liquid formulation and/or clear and stable supplements, he said. He noted NovaSOL D from Marco Hi-Tech is a water-soluble nutrient and therefore can be used in transparent liquids.

New products fortified with vitamin D may help the many who are deficient. Recent studies have shown pregnant women who lived at a latitude of 54 to 55 degrees north (about as north as Central Canada) had insufficient levels, even among those who use supplements.² Mothers-to-be who have lower levels of vitamin D are more likely to give birth via cesarean section.³ And Turkish researchers encouraged pregnant women to supplement their diets with vitamin D in order to reduce the risk of their children contracting acute lower respiratory infections.⁴

Once the children are out of the womb, they may still not be getting all of their vitamin D needs. In the United States, 61 percent of children aged 1 to 21 years who completed the National Health and Nutrition Examination Survey 2001-2004 had insufficient levels of vitamin D.⁵ Only 4 percent had taken a 400 IU/d supplement of vitamin D for the past 30 days. That same study found deficiency was associated with elevated parathyroid hormone levels, higher systolic blood pressure, lower serum calcium and high-density lipoprotein (HDL) cholesterol levels.

The heart-health benefits of vitamin D dont stop with the youth. A University of Colorado study found an inverse relationship between vitamin D levels and cardiovascular disease (CVD), as well as all-cause mortality.⁶ A review in The American Journal of the Medical Sciences states cross-sectional studies found vitamin D deficiency was associated with increased risk of CVD, including hypertension, heart failure and ischemic heart disease.⁷ And Reuters reported at a September 2009 meeting of the American Heart Association in Chicago, researchers presented study that found younger white women with vitamin D deficiencies are about three times more likely to have high blood pressure in middle age than those with normal vitamin levels.

Because vitamin D is necessary for calcium absorption into the body, vitamin D is closely associated with bone health. In fact, one Swiss study found among men and women, vitamin D status seems to be the dominant predictor of bone mineral density (BMD) relative to calcium intake.⁸ In the study, only women with vitamin D concentrations less than 50 nm seem to benefit from a higher calcium intake alone. In a later review of eight randomized controlled trials, those same researchers found supplemental vitamin D in a dose of 700 to 1,000 IU/d reduced the risk of falling among older adults by 19 percent.⁹ However, doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l did not reduce the risk of falling.

McBurney added supplementing with vitamin D is good for bone health throughout life. Bones are remodeled every day, all our life, he said. So it is important to build bones when one is young, and to maintain adequate vitamin D status to maintain strong bones for life.

The benefits of vitamin D go well beyond the heart and bones. Keeping vitamin D levels high may also protect against colon cancer,¹⁰ cold and flu,¹¹ Alzheimers disease,¹² multiple sclerosis,¹³ ovarian cancer¹⁴ and weight gain.¹⁵

With all the new studies finding vitamin Ds health benefits (every study referenced in this article is from 2009), the sunshine vitamins future is, well, sunny. Scientists are discovering new insights into the role of vitamin D, McBurney said. With the unraveling of the human genome, we are living in a period of discovery unprecedented in history. The future is very exciting.

References on the next page

References for "Hottest Vitamin Under the Sun"

1.            Wagner CL, et al. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008 Nov;122(5):1142-52.

2.            Holmes VA, et al. Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study. Br J Nutr. 2009 Sep;102(6):876-81.

3.            Merewood A, et al. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009 Mar;94(3):940-5.

4.            Karatekin G, et al. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr. 2009 Apr;63(4):473-7.

5.            Kumar J, et al. Prevalence and Associations of 25-Hydroxyvitamin D Deficiency in US Children: NHANES 2001-2004. Pediatrics. 2009 Aug 3.

6.            Ginde AA, Prospective Study of Serum 25-Hydroxyvitamin D Level, Cardiovascular Disease Mortality, and All-Cause Mortality in Older U.S. Adults. J Am Geriatr Soc. 2009 Jun 22.

7.            Judd SE, Tangpricha V. Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci. 2009 Jul;338(1):40-4.

8.            Bischoff-Ferrari HA , et al. Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. J Bone Miner Res. 2009 May;24(5):935-42.

9.            H A Bischoff-Ferrari, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. J Bone Miner Res. 2009 Oct 1; 339:b3692

10.          Freedman DM, et al. Sunlight, hormone replacement status and colorectal cancer risk in post-menopausal women. Int J Cancer. 2009 Sep 30.

11.          Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009 Feb 23;169(4):384-90.

12.          Masoumi, A, et al. 1,25-dihydroxyvitamin D3 Interacts with Curcuminoids to Stimulate Amyloid- Clearance by Macrophages of Alzheimers Disease Patients. J Alzheimers Dis. 2009 July; 17(3): 703-717

13.          D.Sioka C, et al.  Multiple sclerosis, osteoporosis, and vitamin D. J Neurol Sci. 2009 Sep 30.

14.          Toriola AT, et al. Serum 25-hydroxyvitamin D and the risk of ovarian cancer. Eur J Cancer. 2009 Aug 25.

15.          The Endocrine Society (2009, June 12). Successful Weight Loss With Dieting Is Linked To Vitamin D Levels. ScienceDaily. Retrieved October 6, 2009, from