Is the Vitamin D Craze Over Now?

In the past few years, sales of vitamin D supplements have soared. More and more people have been tested for vitamin D deficiencies, and many doctors advised their patients to up their intake. But this trend may be coming to an abrupt halt.

Today, the non-profit, non-affiliated, Institute of Medicine is publishing a report relating to vitamin D intake (and calcium too) with some interesting conclusions:

In this report, the IOM proposes new reference values that are based on much more information and higher-quality studies than were available when the values for these nutrients were first set in 1997. The IOM finds that the evidence supports a role for vitamin D and calcium in bone health but not in other health conditions. Further, emerging evidence indicates that too much of these nutrients may be harmful, challenging the concept that “more is better.”

Simply put: for most people, levels of vitamin D in the blood are sufficiently high and do not warrant supplementation. In fact, too much MAY BE HARMFUL!

Of course the “experts” from supplement industry will argue:

Andrew Shao, an executive vice president at the Council for Responsible Nutrition, a trade group, said the panel was being overly cautious, especially in its recommendations about vitamin D. He said there was no convincing evidence that people were being harmed by taking supplements, and he said higher levels of vitamin D, in particular, could be beneficial. Read more from the New York Times…

(Incidentally, “Council for Responsible Nutrition” sounds so official and non jaded,  when in fact it is just a front group representing the interests of multi-billion supplement companies. A more fitting name would be “Buy More Supplements Interest Group”).

What you need to know:

Humans need vitamin D. It works together with calcium to keep our bones strong and healthy. That’s why milk is often fortified with vitamin D.

Our body sources Vitamin D in 2 ways:

  • exposure to the sun
  • from food / supplements

The top food sources are cod liver oil (as many baby boomers may recall from their childhood), sardines, tuna, eel, beef liver, mushrooms and eggs. Many foods are now being fortified with vitamin D,

The current recommendation for Vitamin D consumption is 400 IU (international units) per day. But many doctors are advising parents to increase their kids intake, especially in colder states where sunlight exposure is not an option for many months during the year.

The IOM will now recommend that the daily dosage increase to 600 IU, and not the mega-doses that some would have parents scrambling to provide their kids (up to 5000IU per pill).

The significance of the IOM report is that we can stop worrying about buying their kids supplements this or that vitamin, and get back to thinking about more important issues, such as eating meals made from real food, not processed junk foods.

What to do at the supermarket:

As we like to remind folks, try to get your vitamins and minerals from real food, not supplements.  The best sources are foods

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  • Mateo

    I know so many peoples whose diet is overwhelmingly full of sardines, tuna, eel, beef liver, mushrooms and eggs – how on earth could anyone in the northern hemisphere have a vitamin d deficiency? The facts are, vitamin d is in hardly any food naturally – the only fortified food group I know of is/are dairy. What if you are sensitive to dairy, please list some realistic foods for those people or suggest spending time outside in the sun.

  • Brooke

    I think that in addition to your “what to do at the supermarket,” we should all keep in mind that the best source of vitamin D is sunlight. I know the post mentioned this, but I felt it would have been worth reiterating in the summary. We must not be afraid of the outdoors for ourselves or our children.

  • http://www.visualsuperglue.com matt gordon

    i agree that a better balance of being outside is best. more importantly, people of color need more time since the absorption of vitamin d is based on skin melanin. also, excercise usually comes with being outside so it is a double win.
    as for food, i think that marketing is involved with the vitamin d craze. plus, will we ever be able to have the conversation that it is not a vitamin but a hormone? the food industry holds on to outdated models both ways

  • Bill McNye

    @Mateo – What, you don’t eat eel three times a week? Poeple who can, or wont, drink milk are problaly in the group of people that should take a suppliment. Or eat more eel or beef liver. Yum yum!!!

    I wonder what the next vitamin fad will be?

  • Jennifer

    Vitamin D is actually a prohormone. It serves vital functions in bone metabolism, and is necessary to carry thyroid hormone (T3) into the cell.

    Low vitamin D levels are associated with bone loss, depression, arthritis (including rheumatoid arthritis, psoriasis, skin rashes, MS, asthma, increased respiratory infections, thyroid dysfunction, metabolic syndrome, and cancers including breast cancer, colon cancer, ovarian and pancreatic cancer.

    I recently had my vitamin D levels tested and I was deficient at 22ng/ml. I do not get out in the sun very much because of my fair skin and family history of skin cancer. I do not like milk, but do consume fatty fish and yogurt.

    I feel that more research needs to be done. I do not agree that most Americans are getting adequate Vit D through food sources.

    Sunlight is an excellent source of Vit D; however, not all places have adequate sunlight year round. I have always heard that Vit D & Vit A were the most toxic fat soluble vitamins.

    This topic is very interesting and I look forward to a national guideline one day.

  • http://www.feedyourheaddiet.com Ken Leebow

    I think the doc in this cartoon states the case very well: http://bit.ly/dGZUjH

  • Jen B

    We test all our patients for Vitamin D levels here in the Pacific NW, where sun is scarce. I’m shocked when one comes back normal- it happens that rarely. I’m used to seeing levels under 10 for our chronically ill patients. We prescribe 50,000 IUs per week for two months, and even then a lot of them are still too low. This is especially bad for minority patients who do not absorb sun the way fair-skinned people do. Our orthopedics department sees rickets- RICKETS- on at least a weekly basis.

    Milk is fortified to prevent rickets, not to provide the full amount of Vitamin D we need. Just because your bones aren’t soft doesn’t mean you’re getting enough Vitamin D. The low end for “normal” is 30, and some are recommending it be 40 or 50.

    The problem is sometimes even worse in very sunny places, because people have been taught to slather on sunscreen and stay out of the sun- which to someone like me, who has a family history of skin cancer, is important. These problems with Vitamin D are a direct effect of advising people to stay out of the sun to avoid skin cancer- which is still good advice!

    I take 4000 IUs a day. It is really hard to OD on Vitamin D at 2-4000 IUs a day, even if it is fat-soluble, although if one took 50,000 IUs daily you could.

    Recent reports showed many breastfed babies are deficient in Vitamin D- because most people shield their babies from the sun. This is far from over, and if you don’t like vitamin supplements get some cod-liver oil, they even make it so it doesn’t taste nasty.

    But the best sources are NOT foods!!! Yes, if you live up in the Arctic and eat only oily sea creatures, you’re fine, but the best source is sunlight. Does that mean we go tan ourselves silly? No, that means we take supplements, because sun is a risk as well, especially to pale people like me. I consider this article quite irresponsible, honestly. I know a few dermatologists, orthopedists, pediatricians, and nutritionists who would like a word with you.

  • http://foodtrainers.blogspot.com Lauren Slayton

    Do I think Vitamin D does seem like a craze or a trend? Yes. Do I think people should supplement D, I do. I think that making the anti D case may add to people’s confusion. Most women’s vitamin D levels I see are low, in the northeast from Nov-Marc it is hard to get enough D and as Mateo mentioned, it’s hard to eat it. Eggs, while listed as a source, have very little D. Is D the be all and end all of supplements? No. Do I take it/suggest many clients take it? I do.

  • Monica

    I used to put on sunscreen every time i went outside even if it was 5 minutes. But my skin started getting gray and dry. So know i go outside without sunscreen and my skin glows and has its natural color back. It feels smooth to the touch. That’s why i think its crazy to be so afraid of the sun like people are now. A little sun wont kill you. I don’t recommend overexposure, too much of everything is bad. I thought that was common sense…

  • Laura

    I live in the Pacific NW where the sun is seldom seen. We started taking Vit D 3 years ago. My kids do not get sick, haven’t been sick with more than a few sniffles since I started them on a 1000u in a chewable. When my mom, with Parkinsons Disease lived with us, she did not get a cold or the flu while I was adding Vit D to her meds and vitamins. Before that, she used to get colds that dragged on for months and the flu at least every year. I used to get Strep Throat every year, maybe even twice a year. I haven’t had it in 3 years. When my neighbor came down with a terrible cold, I gave him some Vit D tablets to try and he was amazed how fast his cold went away–he kept the bottle : ) Jen B above confirms my conviction that everyone (nearly) in the Pac NW is low in D.

  • Nicole

    I live in Canada and we don’t have irradicated mushrooms- so they are not a source of vitamin D here. Also i cannot make vitamin D from sunshine between ~october to march. lets see how i do with my diet!!!

    Canadas Food Guide recommends i have 2 milk products daily and fatty fish twice weekly (3-3.5oz each) as well as limit juice to 1/2c daily. There is no recommendation for egg yolks per week but i don’t usually eat more than 2 weekly on average

    Lets add up my estiamted daily vitamin D intake from food while staying within established guidelines:

    7 glasses milk/ week: 700 IU
    7 servings of yogurt (175g)/week: ~310 IU
    7oz Salmon/week: 171 IU
    2 egg yolk/ week: 50mg
    4 tsp fortified margerine daily: 700 IU
    1/2 cup fortified OJ daily: 350 IU

    AVERAGE DAILY TOTAL: 325 IU daily

    A far cry from 600. I can’t see how i can double my intake of food sources without risking weight gain and other associated health concequences associated with being over weight and/or obese!!!!

    I don’t see how people can continue to say its easy to get your vitamin D from Food!!!

  • http://lovinlosing.com Carolyn @ Lovin’ Losing

    My doc had me tested last winter and it came back I was deficient, so now I take one supplement/day, not sure of the IU, but I think it’s 400.

  • Gerome

    Three observations:

    1. There are still highly-respected authorities on Vitamin D who believe the recommended 600 mg/day is low. Check out Michael Holick and Bruce Hollis’s research. Neither was on the IOM board.

    2. The new upper limit on for D in the DRIs is very high, meaning that you can safely take 4000 mg per day (that’s a lot more than even Holick or Hollis would suggest). So the whole notion of getting too much is a weak arguement. The IOM says “take 600, but it’s safe to take up to 4000″.

    3. Andrew Shao from CRN is Dr. Andrew Shao. He holds a PhD in nutritional biochemistry. While he is often quoted since he is a spokesperson for the industry, it is appropriate to acknowledge his credentials. We can all see what might be perceived as a bias to sell more product, so it is only fair to also show that he actually knows what he’s talking about.

  • Gerome

    One more.

    4. This article assumes that the IOM is correct… that they finally got it right. But in 1997 they suggested 200 IU for adult males under 51. Where they right then? Not according to them today. When they bump it up to 1000 in a few years, we can look back to today and wonder.

  • http://www.thefrugaldietitian.com Nancy-The Frugal Dietitian

    This only just begins the debate. I consult in nursing homes/assisted living and group homes and about half tested came back very low. Taking megadoses of Vit D without being tested is ridiculous too. I was tested and thought as a Dietitian I was doing everything right. I was even taking a Vit D of 400 IU/day but I tested very low. I wish Dr. would stop ordering the prescription Vit D and recommend the Vit D 3 instead.
    Milk is NOT a reliable source as some studies have shown – it is lower than 100 IU on average that is listed on the food label. PLUS kids would have to drink/eat 4 servings of milk/day to get even close to 400 IU/day then we would have a problem of iron (Fe deficiency). Most cheese does NOT have Vit D added while only some yogurts do.

  • WilliamB

    @Jennifer
    The study specifically looked at Vit D levels in the US population. The authors were surprised but pleased to learn that in general, the US population does not suffer from Vit D deficiency.

    I used to use sunscreen every time I went out. Now I do it half the year so I get some Vit D. The standard recommendation used to be 15-20 min sunlight/day – has this been updated recently?

    OJ is fortified with Vit D also.

  • Laura

    The study seemed to be concerned with Vit D levels and bone health. There are other benefits to Vit D, strengthening the immune system for one. The report seemed to ignore everything but bone health. More studies are certainly needed.

  • Cactus Wren

    @Ken Leebow
    Ken, you don’t have to advertise your for-profit website in *every* comment you post here.

  • Sara Jensen

    I am a personal trainer and couldn’t agree more with the closing statement that the best source for vitamins comes from the “real” source, in this case unprocessed, unfortified foods and sunlight. This article fails to mention that the term “fortified” is another way to “supplement” foods. It is my opinion that fortified vitamins are not a sufficient resource for vitamin intake. Many things that have fortified vitamins in them fail to indicate the source of the vitamin, and most of the time they are synthetic (lab made) vitamins and don’t come from natural sources. Our bodies don’t recognize those sources in the same way they do when it comes from natural substances. In most cases our body doesn’t even know how to process that fortified vitamin source and it ends up flushing it out in our urine. In that instance, our body has to work harder then normal to process the chemical make up of the synthesized vitamin, and it can cause damage over time. I wish they would do more studies of that nature, rather then just limiting it as they have here.

  • http://www.thefrugaldietitian.com Nancy-The Frugal Dietitian

    Keep in mind that Vit D is poorly absorbed in non-fat foods. If you are drinking orange juice or eating non-fat yogurt and nothing else, the absorption will be less than if you have fat in the meal.

  • Lynda

    There was an article on Wall Street Journal about three days ago too. I had a coworker that developed an allergic reaction to prescribed megadose of vitamin D (10000 IU). It is scary that the doctor doesn’t even know about vitamin/mineral toxicity!

  • JST Books

     liquid calcium is also believed to reduce the risk of high blood pressure.