Re: Yet More Vitamin D Benefits

December 18, 2005

It is ironic that this list includes some of the most maligned foods

in the last fifty years, a time during which North Americans, cutting

back on them because they are told these are unhealthy for them, have

become the very lazy, overweight, pitiful epigones of the hardy people

they once were.

>

> http://news.bbc.co.uk/2/hi/health/4521060.stm

>

> Rodney.

>

December 18, 2005

It is ironic that this list includes some of the most maligned foods

in the last fifty years, a time during which North Americans, cutting

back on them because they are told these are unhealthy for them, have

become the very lazy, overweight, pitiful epigones of the hardy people

they once were.

>

> http://news.bbc.co.uk/2/hi/health/4521060.stm

>

> Rodney.

>

December 18, 2005

Hi All,

It seems that intake of vitamin D is important for lung function.

It may inform to indicate that two abbreviations that are not defined in the

abstract of the paper are for: forced expiratory volume in one second and forced

vital capacity.

The subject may bear on CRers and me more due our greater levels of

osteoporosis.

My lung function under-perform (if lung infections are relevant), I have

osteoporosis and I have very few colds or flu.

The pdf of papers below are available.

http://news.bbc.co.uk/2/hi/health/4521060.stm

Make No Bones About It: Increasing Epidemiologic Evidence Links Vitamin D to

Pulmonary Function and COPD

lind J.

Chest 2005 128: 3781-3783

Highlighting the article by Black and colleagues1 in the current issue of CHEST

(see

page 3792) on the association between vitamin D and lung function is important

for

many reasons. Reduced maximally attained lung function and the accelerated

decline

of pulmonary function are markers of an individual’s increased susceptibility to

COPD, which is a potentially preventable disease with significant health and

economic impact in the United States and worldwide.23 Moreover, reduced lung

function is a major risk factor for cardiovascular morbidity and mortality,

independent of smoking.4 Thus, while historically dubbed the " Cinderella

pulmonary

condition, " we are seeing a well-deserved increase in research support, studies,

and

publications related to COPD and determinants of lung function given the

projected

growing public health impact.25 The factors examined thus far in epidemiologic

studies, including smoking, which has received the most attention, account for

only

a portion of the risk,6 suggesting that adult lung function is influenced by

as-yet-undefined chemical, psychological, behavioral, or biological factors that

influence host susceptibility.

Black and colleagues1 examined the relationship between serum vitamin D levels

and

lung function in a cross-sectional analysis of the Third National Health,

Nutrition

and Examination Survey, a large representative sample (approximately 14,000

subjects) of the US population. They examined the relationship between percent

predicted FEV1 and FVC values and the circulating concentration of

25-hydroxyvitamin

D, and demonstrated a significant relationship between higher vitamin D levels

and

increased lung function with a suggested dose-response effect

Epidemiologic observational studies suggest associations but do not prove

causality.

Rather, the inference that the observed association represents a cause-effect

relationship should be considered in light of a number of epidemiologic criteria

for

causality, as follows: biological plausibility; strength of the association;

reduced

likelihood of alternative explanations due to confounding; temporal sequence of

events; dose-response relationship; and consistency across studies in different

populations.

Evidence Supporting Biological Plausibility

Evidence is increasing that suggests an expanded role for vitamin D in health

outcomes apart from its classic actions on the gut and bone. The vitamin D3

metabolite, 1,25-dihydroxyvitamin D3 and its synthetic analogs also have potent

antiproliferative, differentiative, and immunomodulatory activities, exerting

these

effects through the vitamin D receptor (VDR). The authors cite evidence linking

vitamin D to modulation of the formation of metalloproteinases and fibroblast

proliferation, which is involved in lung remodeling, as potential pathways

through

which vitamin D may influence lung function. Other evidence has demonstrated the

expression of the VDR in various immune cells with documented effects of vitamin

D

on many immune cell types involved in both innate and adaptive immunity.7 At the

same time, evolving research has demonstrated interrelationships between

immune-mediated inflammatory processes and chronic lung disease. Airway

inflammation

is recognized as a central process in the pathogenesis of COPD.8 Vitamin D has

been

shown to prevent the induction of experimental inflammatory diseases in mice

including allergic asthma.9 In turn, atopy and various asthma-like phenotypes

have

been linked to reduced lung function10 and increased morbidity and mortality

oxidative stress,12 which is another purported mechanism underlying COPD risk.13

Genetic susceptibility studies14 have linked variants in the VDR to an increased

risk of COPD. Studies1516 examining the association between VDR variants and the

rate of decline in pulmonary function among smokers have had mixed results.

These

overlapping data suggest a role for vitamin D in chronic inflammatory responses

in

the lung, which in turn contribute to lung function over time.

Need for Further Epidemiologic Evidence

Consistency across studies provides a compelling basis for causal inferences in

epidemiologic research. Examining the same hypothesized relationship between

levels

of vitamin D and pulmonary function in diverse populations will be important.

Seeing

a similar relationship across different studies involving different sample

populations controlling for potential confounders in various ways, strengthens

the

case for causality. Observing a dose-response relationship, as suggested in the

current study by Black and colleagues,1 provides further suggestive evidence of

causality. This cross-sectional analysis cannot discern temporal associations.

Longitudinal data supporting the role for vitamin D in the rate of decline of

lung

function will be important. Before researchers embark on randomized controlled

trials, as the authors suggest, they would be helped by taking advantage of

other

large existing data sets in which the association between vitamin D and lung

function can be further examined. It will likely be necessary to design future

observational studies that specifically address the influence of vitamin D and

lung

function in which careful attention is paid to measuring the potential

confounders.

Often, when secondary data analysis is performed to examine a hypothesis other

than

the aims intended in the original study, key confounders are measured either

inadequately or not at all with consequential effects on any inferences being

made.17

It will also be important to consider interactions among a number of these

environmental and host factors contributing to lung function rather than simply

controlling for them as potential confounders.18 For example, in addition to

vitamin

D other environmental exposures are known to operate through oxidative stress

pathways (eg, tobacco smoke and air pollutants). It has also been suggested19

that

hypovitaminosis D increases the susceptibility to psychological stress. There is

evidence that psychological stress augments oxidative stress and modifies the

host

response to other inflammatory oxidative toxins such as tobacco smoke and air

pollutants. Thus, cumulative factors that may modify oxidative toxicity may have

additive or multiplicative effects on lung function. Vitamin D may interact with

stress, tobacco smoke, and air pollutants through an oxidative/antioxidative

imbalance, influencing lung inflammation and consequently lung function.20

Future

studies should also consider gene-environment interactions that may further

elucidate the underlying mechanisms.

Shedding Light on Sociodemographic Factors and Lung Function

Nutritional habits, levels of nutrients, and dietary factors such as vitamin D

intake can vary based on sociodemographic factors including gender, age, and

socioeconomic status.21 Similarly, physical activity levels may differ across

certain subgroups.22 It will be important for future studies to examine how the

relationship between vitamin D and these other factors might explain

differential

effects on lung function and COPD risk in susceptible subgroups (eg, based on

socioeconomic status, gender, and race/ethnicity).2324

Further Evidence of the Public Health Importance

Finally, in addition to the disturbing projected trends for COPD, epidemiologic

studies have suggested that hypovitaminosis D is reemerging as an important

public

health problem in the United States and worldwide.25 It will be important to

conduct

other studies examining the relationship between vitamin D and lung function, as

this would be a relatively simple low-cost intervention that would likely have

high

compliance to potentially prevent or slow the loss of lung function in

susceptible

subgroups. More data are needed to suggest which groups might be helped most by

such

interventions.

Black PN, Scragg R.

Relationship between serum 25-hydroxyvitamin d and pulmonary function in the

third

national health and nutrition examination survey.

Chest. 2005 Dec;128(6):3792-8.

PMID: 16354847

CONTEXT: Age, gender, height, ethnicity, and smoking are important determinants

of

lung function but do not explain all of the variation between individuals. Low

concentrations of vitamin D have been associated with a number of diseases,

including osteoporosis, hypertension, and type I diabetes. It is possible that

serum

concentrations of vitamin D might also influence pulmonary function. OBJECTIVES:

To

determine the relationship between serum concentrations of 25-hydroxy vitamin D

and

pulmonary function.Design, setting and participants: The analysis was conducted

using data from the Third National Health and Nutrition Examination Survey,

which

was a cross-sectional survey of the US civilian population that was conducted

from

1988 to 1994. The analyses were restricted to 14,091 people who >/= 20 years of

age,

were interviewed at mobile examination centers, and had undergone spirometry,

and in

whom serum 25-hydroxy vitamin D levels had been measured. RESULTS: After

adjustment

for age, gender, height, body mass index, ethnicity, and smoking history, the

mean

FEV(1) was 126 mL (SE, 22 mL), and the mean FVC was 172 mL (SE, 26 mL) greater

for

the highest quintile of serum 25-hydroxy vitamin D level (>/= 85.7 nmol/L)

compared

with the lowest quintile (</= 40.4 nmol/L; p < 0.0001). With further adjustment

for

physical activity, the intake of vitamin D supplements, milk intake, and the

level

of serum antioxidants, the mean difference between the highest and lowest

quintiles

of 25-hydroxy vitamin D was 106 mL (SE, 24 mL) for FEV(1), and 142 mL (SE, 29

mL)

for FVC (p < 0.0001). CONCLUSIONS: There is a strong relationship between serum

concentrations of 25-hydroxy vitamin D(,) FEV(1), and FVC. Further studies are

necessary to determine whether supplementation with vitamin D is of any benefit

in

patients with respiratory disease.

Al Pater, PhD; email: old542000@...

__________________________________________________

December 18, 2005

Hi All,

It seems that intake of vitamin D is important for lung function.

It may inform to indicate that two abbreviations that are not defined in the

abstract of the paper are for: forced expiratory volume in one second and forced

vital capacity.

The subject may bear on CRers and me more due our greater levels of

osteoporosis.

My lung function under-perform (if lung infections are relevant), I have

osteoporosis and I have very few colds or flu.

The pdf of papers below are available.

http://news.bbc.co.uk/2/hi/health/4521060.stm

Make No Bones About It: Increasing Epidemiologic Evidence Links Vitamin D to

Pulmonary Function and COPD

lind J.

Chest 2005 128: 3781-3783

Highlighting the article by Black and colleagues1 in the current issue of CHEST

(see

page 3792) on the association between vitamin D and lung function is important

for

many reasons. Reduced maximally attained lung function and the accelerated

decline

of pulmonary function are markers of an individual’s increased susceptibility to

COPD, which is a potentially preventable disease with significant health and

economic impact in the United States and worldwide.23 Moreover, reduced lung

function is a major risk factor for cardiovascular morbidity and mortality,

independent of smoking.4 Thus, while historically dubbed the " Cinderella

pulmonary

condition, " we are seeing a well-deserved increase in research support, studies,

and

publications related to COPD and determinants of lung function given the

projected

growing public health impact.25 The factors examined thus far in epidemiologic

studies, including smoking, which has received the most attention, account for

only

a portion of the risk,6 suggesting that adult lung function is influenced by

as-yet-undefined chemical, psychological, behavioral, or biological factors that

influence host susceptibility.

Black and colleagues1 examined the relationship between serum vitamin D levels

and

lung function in a cross-sectional analysis of the Third National Health,

Nutrition

and Examination Survey, a large representative sample (approximately 14,000

subjects) of the US population. They examined the relationship between percent

predicted FEV1 and FVC values and the circulating concentration of

25-hydroxyvitamin

D, and demonstrated a significant relationship between higher vitamin D levels

and

increased lung function with a suggested dose-response effect

Epidemiologic observational studies suggest associations but do not prove

causality.

Rather, the inference that the observed association represents a cause-effect

relationship should be considered in light of a number of epidemiologic criteria

for

causality, as follows: biological plausibility; strength of the association;

reduced

likelihood of alternative explanations due to confounding; temporal sequence of

events; dose-response relationship; and consistency across studies in different

populations.

Evidence Supporting Biological Plausibility

Evidence is increasing that suggests an expanded role for vitamin D in health

outcomes apart from its classic actions on the gut and bone. The vitamin D3

metabolite, 1,25-dihydroxyvitamin D3 and its synthetic analogs also have potent

antiproliferative, differentiative, and immunomodulatory activities, exerting

these

effects through the vitamin D receptor (VDR). The authors cite evidence linking

vitamin D to modulation of the formation of metalloproteinases and fibroblast

proliferation, which is involved in lung remodeling, as potential pathways

through

which vitamin D may influence lung function. Other evidence has demonstrated the

expression of the VDR in various immune cells with documented effects of vitamin

D

on many immune cell types involved in both innate and adaptive immunity.7 At the

same time, evolving research has demonstrated interrelationships between

immune-mediated inflammatory processes and chronic lung disease. Airway

inflammation

is recognized as a central process in the pathogenesis of COPD.8 Vitamin D has

been

shown to prevent the induction of experimental inflammatory diseases in mice

including allergic asthma.9 In turn, atopy and various asthma-like phenotypes

have

been linked to reduced lung function10 and increased morbidity and mortality

oxidative stress,12 which is another purported mechanism underlying COPD risk.13

Genetic susceptibility studies14 have linked variants in the VDR to an increased

risk of COPD. Studies1516 examining the association between VDR variants and the

rate of decline in pulmonary function among smokers have had mixed results.

These

overlapping data suggest a role for vitamin D in chronic inflammatory responses

in

the lung, which in turn contribute to lung function over time.

Need for Further Epidemiologic Evidence

Consistency across studies provides a compelling basis for causal inferences in

epidemiologic research. Examining the same hypothesized relationship between

levels

of vitamin D and pulmonary function in diverse populations will be important.

Seeing

a similar relationship across different studies involving different sample

populations controlling for potential confounders in various ways, strengthens

the

case for causality. Observing a dose-response relationship, as suggested in the

current study by Black and colleagues,1 provides further suggestive evidence of

causality. This cross-sectional analysis cannot discern temporal associations.

Longitudinal data supporting the role for vitamin D in the rate of decline of

lung

function will be important. Before researchers embark on randomized controlled

trials, as the authors suggest, they would be helped by taking advantage of

other

large existing data sets in which the association between vitamin D and lung

function can be further examined. It will likely be necessary to design future

observational studies that specifically address the influence of vitamin D and

lung

function in which careful attention is paid to measuring the potential

confounders.

Often, when secondary data analysis is performed to examine a hypothesis other

than

the aims intended in the original study, key confounders are measured either

inadequately or not at all with consequential effects on any inferences being

made.17

It will also be important to consider interactions among a number of these

environmental and host factors contributing to lung function rather than simply

controlling for them as potential confounders.18 For example, in addition to

vitamin

D other environmental exposures are known to operate through oxidative stress

pathways (eg, tobacco smoke and air pollutants). It has also been suggested19

that

hypovitaminosis D increases the susceptibility to psychological stress. There is

evidence that psychological stress augments oxidative stress and modifies the

host

response to other inflammatory oxidative toxins such as tobacco smoke and air

pollutants. Thus, cumulative factors that may modify oxidative toxicity may have

additive or multiplicative effects on lung function. Vitamin D may interact with

stress, tobacco smoke, and air pollutants through an oxidative/antioxidative

imbalance, influencing lung inflammation and consequently lung function.20

Future

studies should also consider gene-environment interactions that may further

elucidate the underlying mechanisms.

Shedding Light on Sociodemographic Factors and Lung Function

Nutritional habits, levels of nutrients, and dietary factors such as vitamin D

intake can vary based on sociodemographic factors including gender, age, and

socioeconomic status.21 Similarly, physical activity levels may differ across

certain subgroups.22 It will be important for future studies to examine how the

relationship between vitamin D and these other factors might explain

differential

effects on lung function and COPD risk in susceptible subgroups (eg, based on

socioeconomic status, gender, and race/ethnicity).2324

Further Evidence of the Public Health Importance

Finally, in addition to the disturbing projected trends for COPD, epidemiologic

studies have suggested that hypovitaminosis D is reemerging as an important

public

health problem in the United States and worldwide.25 It will be important to

conduct

other studies examining the relationship between vitamin D and lung function, as

this would be a relatively simple low-cost intervention that would likely have

high

compliance to potentially prevent or slow the loss of lung function in

susceptible

subgroups. More data are needed to suggest which groups might be helped most by

such

interventions.

Black PN, Scragg R.

Relationship between serum 25-hydroxyvitamin d and pulmonary function in the

third

national health and nutrition examination survey.

Chest. 2005 Dec;128(6):3792-8.

PMID: 16354847

CONTEXT: Age, gender, height, ethnicity, and smoking are important determinants

of

lung function but do not explain all of the variation between individuals. Low

concentrations of vitamin D have been associated with a number of diseases,

including osteoporosis, hypertension, and type I diabetes. It is possible that

serum

concentrations of vitamin D might also influence pulmonary function. OBJECTIVES:

To

determine the relationship between serum concentrations of 25-hydroxy vitamin D

and

pulmonary function.Design, setting and participants: The analysis was conducted

using data from the Third National Health and Nutrition Examination Survey,

which

was a cross-sectional survey of the US civilian population that was conducted

from

1988 to 1994. The analyses were restricted to 14,091 people who >/= 20 years of

age,

were interviewed at mobile examination centers, and had undergone spirometry,

and in

whom serum 25-hydroxy vitamin D levels had been measured. RESULTS: After

adjustment

for age, gender, height, body mass index, ethnicity, and smoking history, the

mean

FEV(1) was 126 mL (SE, 22 mL), and the mean FVC was 172 mL (SE, 26 mL) greater

for

the highest quintile of serum 25-hydroxy vitamin D level (>/= 85.7 nmol/L)

compared

with the lowest quintile (</= 40.4 nmol/L; p < 0.0001). With further adjustment

for

physical activity, the intake of vitamin D supplements, milk intake, and the

level

of serum antioxidants, the mean difference between the highest and lowest

quintiles

of 25-hydroxy vitamin D was 106 mL (SE, 24 mL) for FEV(1), and 142 mL (SE, 29

mL)

for FVC (p < 0.0001). CONCLUSIONS: There is a strong relationship between serum

concentrations of 25-hydroxy vitamin D(,) FEV(1), and FVC. Further studies are

necessary to determine whether supplementation with vitamin D is of any benefit

in

patients with respiratory disease.

Al Pater, PhD; email: old542000@...

__________________________________________________

December 18, 2005

"The team found that those people with the highest concentration of vitamin D in their blood significantly outperformed others in tests to measure their lung function. {5% is significant}

However, he said: "Although there is a definite relationship between lung function and vitamin D, it is unclear if increases in vitamin D through supplements or dietary intake will actually improve lung function in patients with chronic respiratory diseases."

{test on those with chronic respiratory disease - I cannot infer a benefit to me.}

The tests included:

The FEV1 test which measures the volume of air that can be forced in one second after taking a deep breath.

The FVC test which measures the total volume of air that is expelled after taking a deep breath

The researchers found vitamin D was higher in men than women, was inversely related to obesity levels, and declined with age. "

{men don't live as long as women; obesity may cause the lower level of vit D; everything declines with age, it seems.}

So do we supplement vit D, and possibly raise BP? How much?

Regards.

[ ] Yet More Vitamin D Benefits

http://news.bbc.co.uk/2/hi/health/4521060.stmRodney.

December 18, 2005

"The team found that those people with the highest concentration of vitamin D in their blood significantly outperformed others in tests to measure their lung function. {5% is significant}

However, he said: "Although there is a definite relationship between lung function and vitamin D, it is unclear if increases in vitamin D through supplements or dietary intake will actually improve lung function in patients with chronic respiratory diseases."

{test on those with chronic respiratory disease - I cannot infer a benefit to me.}

The tests included:

The FEV1 test which measures the volume of air that can be forced in one second after taking a deep breath.

The FVC test which measures the total volume of air that is expelled after taking a deep breath

The researchers found vitamin D was higher in men than women, was inversely related to obesity levels, and declined with age. "

{men don't live as long as women; obesity may cause the lower level of vit D; everything declines with age, it seems.}

So do we supplement vit D, and possibly raise BP? How much?

Regards.

[ ] Yet More Vitamin D Benefits

http://news.bbc.co.uk/2/hi/health/4521060.stmRodney.

December 18, 2005

Hi JW:

Just to be clear ............. are you saying that vitamin D can

increase blood pressure?

Rodney.

--- In , " jwwright " <jwwright@e...>

wrote:

> So do we supplement vit D, and possibly raise BP? How much?

>

> Regards.

December 18, 2005

Hi JW:

Just to be clear ............. are you saying that vitamin D can

increase blood pressure?

Rodney.

--- In , " jwwright " <jwwright@e...>

wrote:

> So do we supplement vit D, and possibly raise BP? How much?

>

> Regards.

December 19, 2005

Hi folks:

It looks like JW's answer will likely be: " Yes " . For vitamin

D ..............

" Doses greater than 1,000 IU a day are not recommended; signs and

symptoms of a toxic reaction include loss of appetite, headache,

nausea, vomiting, diarrhea and excessive thirst and urination. Taking

10,000 to 15,000 IU a day regularly can cause weight loss, paleness,

constipation, fever, and a number of serious complications. Long-term

overconsumption of vitamin D at any dose greater than 1,000 IU day

may cause high blood pressure and premature hardening of the

arteries. Bones may weaken and a calcium buildup in muscles and other

soft tissues may occur. Kidney damage may also develop. "

From:

http://www.wholehealthmd.com/refshelf/substances_view/1,1525,905,00.ht

ml

But the above does seem a little strange. Especially when people in

the sun all day get many thousands of IUs of vitamin D daily. So is

skin-generated vitamin D different from the pill type?

Rodney.

>

> > So do we supplement vit D, and possibly raise BP? How much?

> >

> > Regards.

>

December 19, 2005