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Are you vitamin D-ficient?

Vitamin D comes from the sun, but we're not getting enough of it

GETTING YOUR D

Most scientists agree the suggestions for vitamin D set by the Institute of Medicine are too low. Many recommend 800 to 1,000 units of vitamin D daily, unless you spend a lot of time outdoors. Here's what it takes to get that much D in one day:

10 cups fortified milk

or

One tablespoon cod liver oil

or

11 ounces salmon or mackerel

or

Four cans sardines

or

35 ounces fresh shiitake mushrooms

or

25 cups fortified corn flakes

or

10 cups D-fortified orange juice

or

50 eggs

or

15 ounces canned tuna fish

or

One (800 to 1,000 units) over-the-counter vitamin D supplement

SOURCE: National Institutes of Health

VITAMIN D RESEARCH

CANCER

Vitamin D emerged as a protective factor in a study of more than 3,000 adults who underwent a colonoscopy; there was a significantly lower risk of advanced cancerous lesions among those with the highest vitamin D intake, according to the National Institutes of Health. A four-year trial at Creighton University, published in the American Journal of Clinical Nutrition, found that the higher the level of vitamin D, the lower the risk of all cancers in post-menopausal women.

MULTIPLE SCLEROSIS

An analysis of two large Nurses' Health Study groups found a reduced risk of MS was associated with vitamin D supplementat
ion, according to a 2004 report in Neurology.

DIABETES

A study published in the Lancet in 2001 concluded that children who were given vitamin D supplementation were less likely to develop Type 1 diabetes.

RHEUMATOID ARTHRITIS

In the Iowa Women's Health Study, women consuming higher levels of vitamin D showed a reduced risk for rheumatoid arthritis.

CARDIOVASCULAR DISEASE

A study in the journal Circulation found that those with low vitamin D levels had a 62 percent increased risk of heart failure.

FALLS & FRACTURES

Seniors taking a high daily dose of vitamin D experience 72 percent fewer fractures, according to a study in the Journal of the American Geriatrics Society. A daily supplement of 800 units of vitamin D could prevent a quarter of hip fractures in older people, suggests a study in the Journal of the American Medical Association.

ASTHMA

In a study in the American Journal of Clinical Nutrition, children of mothers with lower intakes of vitamin D during pregnancy were more likely to develop asthma.

FIBROMYALGIA

Some researchers believe this disorder could actually be vitamin D deficiency, which can cause muscle weakness and pain. One Canada study, published in 2001 in the journal Rheumatology, found that half the fibromyalgia patients tested had low levels of vitamin D.

HOW MUCH SUN?

CALCULATOR: Dr. James Dowd, author of The Vitamin D Cure, provides a sunlight exposure calculator that tells you how many minutes of unprotected sun you need to produce vitamin D based on your skin type, weight, height, age and the UV Index for your location.

Click www.thevitamindcure.com/calculator.

jmailander@MiamiHerald.com

Fort Lauderdale Ocean Rescue Lt. Jim McCrady spends 10-hour days patrolling the beach. Most people would worry that's too much sun. But to some, McCrady, 41, is soaking up critical ultra-violet rays. McCrady may be slightly pink at the end of his four-day work week, but there's one thing he's not suffering from: lack of vitamin D.

Many of us cannot say the same.

Vitamin D comes primarily from the sun, not food. It's best known for helping calcium build strong bones. But an exploding area of research is raising theories about vitamin D's vital role in staving off colon cancer, multiple sclerosis, diabetes and heart disease.

For years it was assumed people got enough D from fortified milk and everyday sun exposure. Not so. Today, even by conservative estimates, at least half of all Americans have insufficient levels of vitamin D. Among those most at risk: breast-fed infants, adults over 50 and people with darker complexions.

Researchers call it ''an unrecognized epidemic,'' but its consequences could become apparent soon enough for this generation and its children.

''`We're seeing [weaker bones] not only in women, but men, too. As they get older, more and more men are having fractures, and it's the men who have two or three greater chances of dying after a hip fracture than women,'' says Dr. Silvina Levis, director of the University of Miami Osteoporosis Center.

South Floridians -- despite living in a sun-drenched climate -- are not immune. A University of Miami study found men and women here are just as likely to be D-deficient as those who live in the North. Although 97 percent of the study's participants reported taking multi-vitamins, which contain some D, 39 percent were vitamin D deficient.

''Unless you're walking to your car in your bikini, you may not get enough sun,'' says UM's Levis, who co-authored the study, published in 2005 in The Journal of Clinical Endocrinology & Metabolism.

MEDICAL DEBATE

How did it get to this point? Too many people have replaced fortified milk with soft drinks and juice. Too many are tethered to indoor lives, and when they spend time outside, they cover themselves -- and their children -- with sunscreen and clothing, for fear of skin cancer.

''Many dermatologists have thrown the baby out with the bath water,'' says Dr. James Dowd, a Michigan-based rheumatologist and author of The Vitamin D Cure (Wiley, $24.95), published this year. 'Their idea is `No sun at all. Always cover up. Sun is evil.' That's an extreme message. We need enough sun to make vitamin D.''

It can be daring for a doctor to prescribe even a short burst of sun without sunscreen, which can block D absorption if it has SPF 8 or higher. Just ask Dr. Michael Holick, who was asked to resign from the dermatology department at Boston University's medical school shortly after he published his 2004 book The UV Advantage (IBooks, $19.95). Holick's book, which touts the health benefits of limited UV exposure, drew loud protests from dermatologists and the sunscreen industry.

Too much sun is indeed harmful. Evidence that ultraviolet radiation causes skin cancer is so strong the U.S. Department of Health and Human Services lists UV radiation as a known carcinogen. At current rates, one in five Americans will develop skin cancer.

''Under no circumstances should anyone be misled into thinking that natural sunlight or tanning beds are better sources of vitamin D than foods or nutritional supplements. The only thing they are proven to be better at is increasing your risk of developing skin cancer,'' says a statement by the American Academy of Dermatology.

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