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Vitamin D supplementation policy

Patients on the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. are expected to avoid sources of vitamin D. Federal policies requiring and allowing vitamin D supplementation in various food products vary by country.

In the U.S., with many patients taking [vitamin D] and many physicians prescribing it, some of whom are megadosing it, what we really have going on is a massive, uncontrolled experiment.

James Stein, M.D., University of Wisconsin School of Medicine and Public Health

History of vitamin D supplementation in the U.S. and Europe

In the United States, vitamin D supplementation began in earnest in the 1930s.

Quaker Oats received the first license in February 1927 to manufacture vitamin D–enriched breakfast cereal. Licenses were issued to pharmaceutical companies (Abbott Laboratories, Mead Johnson, Parke Davis, Winthrop Chemical Co, and Squibb) to manufacture a medicinal vitamin D product. By 1934, the irradiation process was extended to produce vitamin D–fortified milk. Soon, vitamin D fortification was achieved inexpensively by adding vitamin D directly to milk.

The fortification of milk with vitamin D was also adopted in Europe; however, the process was not closely monitored, and in Great Britain it caused an outbreak of vitamin D intoxication, or hypercalcemia, the clinical manifestations of which are loss of appetite, lethargy, excessive thirst and polyuria, nausea and vomiting, constipation, and muscle weakness, and renal failure if the hypercalcemic state is unrecognized and prolonged. This outbreak led to the banning of the vitamin D fortification of milk in most of Europe.

Kumaravel Rajakumar, et al 1)

Hywel Davies, M.D. has explained that the reason given for milk fortification was the prevention of rickets, the bone disease in children common in post-industrial England, and among Black children in relatively sunless northern US states.

Rickets has not existed in the US except in readily defined groups (cults or ethnic groups that avoid the sun) for nearly a century, yet supplementation with synthetic vitamin D products is advocated for all, including young people living outdoors in sun-bathed states like California. This is palpably absurd!

The mis-labeling of this compound as a vitamin is regrettable, as it gave a potential toxin an aura of undeserved innocence. Vitamin D is not a vitamin, but a steroid, which is, in its most active form, a powerful hormone with receptors widely distributed in the tissues of the body. As with other steroids, excessive consumption has risks.

Hywel Davies

According to the Marshall PathogenesisA description for how chronic inflammatory diseases originate and develop., it is not coincidental that the prevalence of diabetes, cardiovascular disease, and obesity all began to sharply increase in the U.S. following World War II. The systematic supplementation of the food chain allowed slow-growing chronic bacterial forms to proliferate, which has led to increased rates of these diseases.

Early recommendations that vitamin D be discontinued

In the 1950s and 1960s, various physicians' groups recommended discontinuing supplementing the food chain with vitamin D. A 1974 study by Lindén points to evidence of increased myocardial infarction (heart attack) and kidney stones for those consuming vitamin D.

Various national committees (British Medical Association, 1950; Canadian Bulletin on Nutrition, 1953; American Academy of Pediatrics, 1963, 1965) have recommended the discontinuation of fortifying food with vitamin D. In the present study fortified food provided only a minor part of the individual vitamin D consumption. An attempt should be made to restrict the intake from all sources save from the production of the skin. Efforts should particularly be made to dispel the concept of vitamin D preparations as tonics, and consideration should be given to the ease with which vitamin D preparations can be acquired through commercial sale.

Victor Lindén, M.D. 2)

Recent rates of supplementation

A September 2010 report published by Nutrition Business Journal points out that in the previous two years, vitamin D supplement sales to consumers have increased by more than 100% per year – a four-fold increase.3)

A number of researchers and public health advocates have proposed adding high doses of vitamin D to other substances such as breads.4)

No biological basis for supplementation in healthy people

According to a 2010 editorial by Drs. Reddy and Gilchrest, there is no basis for vitamin D supplementation in the general population.

Neither the biologic validity of “vitamin D insufficiency” nor the health benefit of maintaining high serum 25(OH)D levels has been established for the general population.

Kavitha K. Reddy and Barbara A. Gilchrest 5)

The adoption of the deterministic (“one size fits all”) approach to vitamin D supplementation makes no room for random variation and runs contrary to the strong possibility that supplementation will be harming some people.

If the optimal serum 25(OH)D level for skeletal health is 30 ng/mL or greater, then vitamin D insufficiency is widespread, affecting about 75% of adults based on a recent survey of more than 20,000 Americans. However, after a comprehensive analysis of existing research studies, the Institute of Medicine recently concluded that nearly all individuals are vitamin D replete when their 25(OH)D levels are 20 ng/mL or greater. Furthermore, two recent publications challenge the belief that 25(OH)D levels greater than 30 ng/mL are optimal for bone health. In a randomized, placebo-controlled trial, high-dose, once- yearly vitamin D therapy increased the incidence of fractures and falls. The second study reported that high- dose vitamin D did not reduce levels of parathyroid hormone or bone resorption among adults with 25(OH)D levels less than 32 ng/mL at baseline. It is time to question whether serum 25(OH)D levels of 30 ng/mL or greater are necessary for all individuals.

K.E. Hansen, High-Dose Vitamin D: Helpful or Harmful? 6)

Food supplementation policy, by country

United States

Fluid milk and breakfast cereals are the predominant vehicles for vitamin D in the United States.7)

The U.S. Food and Drug Administration does not require the addition of vitamin D to milk, but it does regulate the inexpensive additive. The FDA has jurisdiction because in sufficient amounts vitamin D can be poisonous8) (to say nothing of the secosteroid's long-term effect on chronic disease).

A number of dairy manufacturers have opted not to fortify their product lines with vitamin D, or to supplement only with vitamin A. One can verify this information with the National Dairy Council.

Labeling in the U.S.

Sometimes, in cases where fortified milk is used as an ingredient for a product, a label will not accurately reflect how much vitamin D is in the product.

Also, some manufacturers are not careful about following directions to list all ingredients. They have a grace period during a manufacturing change when the old labels might still be used.

Canada

Canada fortifies fluid milk and margarine.9)

Europe

In Europe, fortification with vitamin D varies. In some countries, the level of fortification can be quite low, at least in comparison to other developed countries. However, it's common practice, especially in Scandinavian countries to give children cod liver oil. One Finnish study of children born in 1966 found that between 74 and 88% of their mothers reported giving them cod liver oil.10)

United Kingdom

The only UK product required by law to have vitamin D added is margarine and margarine-like spreads. Butter is not fortified, though it will have a small amount of vitamin D naturally.

Fresh milk does not have extra D added except for that used in US Army bases. Dried milk, tinned evaporated milk, and baby formula all have added D. Fresh cheese doesn't have added D. For processed cheese, cheese spreads, and yogurt, read the label. Sheep's milk has naturally more D than cow's milk, so those who are needing to reduce their 25-DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver. might want to avoid Feta cheese.

Many breakfast cereals have added D, and most have added folic acid.

Australia and New Zealand

In Australia, margarine and some milk and milk products are currently fortified with vitamin D. In New Zealand fortification of margarine is not mandatory, but since 1996 voluntary fortification of margarine, fats and dairy food items has been permitted.11)

Increase in supplementation by consumers

Among people who use dietary supplements, the most popular products at the end of 2010 were fish oil, multivitamins, vitamin D, calcium and CoQ10 according to a survey by ConsumerLab.com. Use of vitamin D surged in 2010 to 56.2% of those surveyed, up from 47.9% in 2009 and 36.9% in 2008 - a 52% increase over the two-year period.

Inform food manufacturers that you object to supplementation

The following letter to a manufacturer may be adapted for your use to inform food producers that adding vitamin D isn't healthy for everyone.

I have just become aware of the fact that you will be adding Vitamin D to your Buttery Spread products in the future. Can you tell me if this will mean that you will no longer offer a spread without vitamin D? Or will there be a choice?

The information I read makes it seem that this replaces the product without Vitamin D. I have not used any other butter spread product since yours came on the market. I had chosen it in the past because I believe it to be the healthiest choice. But with the added Vitamin D, I will no longer be buying the product.

I am currently undergoing a medical treatment to cure a very serious disease. It is in a group of diseases that are not uncommon to a growing percentage of the population. The dysregulation of vitamin D is a major culprit in these diseases and our society's increasing propensity for adding supplements to our foods I fear will cause an epidemic of these diseases someday - and they are already on the rise now.

There is such a thing as getting too much ingested Vitamin D for many people. I believe that consumers should have a choice of how or if they want to get supplements into their diet and I, for one, do and will gladly continue to purchase the products of companies that offer the consumer this choice.

Unfortunately, I will abandon any product or company that chooses to take this choice away from me. I really do like your butter product and the concern that your company shows towards trying to offer healthy choices to your consumers. I hope that Smart Balance continues to offer the choice of products without Vitamin D.

Notes and comments

broke survey by ConsumerLab.com

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References

1)
SOLAR ultraviolet radiation and vitamin D: a historical perspective.
Rajakumar K, Greenspan SL, Thomas SB, Holick MF
Am J Public Health97p1746-54(2007 Oct)
2)
Vitamin D and myocardial infarction.
Lindén V
Br Med J3p647-50(1974 Sep 14)
3)
Why the IOM recommendations for vitamin D are deficient.
Heaney RP, Holick MF
J Bone Miner Res26p455-7(2011 Mar)
4)
Bioavailability and efficacy of vitamin D2 from UV-irradiated yeast in growing, vitamin D-deficient rats.
Hohman EE, Martin BR, Lachcik PJ, Gordon DT, Fleet JC, Weaver CM
J Agric Food Chem59p2341-6(2011 Mar 23)
5)
Gilchrest, B.A. and Reddy, K.K. (2010). “What Is All This Commotion about Vitamin D?” Journal of Investigative Dermatology. 130: 321–326.
6)
High-Dose Vitamin D: Helpful or Harmful?
Hansen KE
Curr Rheumatol Repp(2011 Mar 3)
7) , 9)
Vitamin D fortification in the United States and Canada: current status and data needs.
Calvo MS, Whiting SJ, Barton CN
Am J Clin Nutr80p1710S-6S(2004 Dec)
8)
An outbreak of hypervitaminosis D associated with the overfortification of milk from a home-delivery dairy.
Blank S, Scanlon KS, Sinks TH, Lett S, Falk H
Am J Public Health85p656-9(1995 May)
10)
Infant vitamin d supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966.
Hyppönen E, Sovio U, Wjst M, Patel S, Pekkanen J, Hartikainen AL, Järvelinb MR
Ann N Y Acad Sci1037p84-95(2004 Dec)
11)
Vitamin D intake and vitamin D status of Australians.
Nowson CA, Margerison C
Med J Aust177p149-52(2002 Aug 5)
home/food/vitamind/vitamin_d_supplementation_policy.txt · Last modified: 10.26.2018 by sallieq
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