Here is a dilemma. The latest studies on vitamin D are pointing to a D-ficiency in most Americans. It seems the government recommendation, called the AI (adequate intake), needs to be increased if it is to keep up with the latest research findings. Vitamin D is not in a lot of foods, so for most people sun exposure is a primary source. Yet too much sun exposure increases the risk for skin cancer. Ask columnist Dr. Leslie Baumann (e-mail: drb@drbaumann.com) for more on that topic. And even the sun is no guarantee. In a recent study of 93 young sun-worshipping Hawaiians, half had low vitamin D levels, yet 40 percent of them wore no sunscreen.

Vitamin D's role in bone density is well established. Research shows that optimal blood levels of vitamin D reduce the risk of fractures, improve lower extremity function and reduce tooth loss. Epidemiological studies link low vitamin D levels to a higher risk of certain types of cancer, particularly colon cancer. More clinical research on the cancer link is needed.

The government's recommended AI is 200 IU until age 50, 400 IU ages 51-70 and 600 IU over age 70. Vitamin D researchers recommend an intake of at least 800-1,000 IU a day. Vitamin D is in butter, egg yolks, fish oils and fortified foods such as milk, soy milk and cereals. Then there is the sun, which, considering the Hawaiians, might not be enough. Good calcium supplements contain vitamin D, as do most multivitamins. Everyone is unique so the best way to determine whether you are at peak D is to have a test of vitamin D blood levels. This is not part of a routine annual blood test. I don't think I have ever had one, but I suggest you discuss it with your doctor.

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