The Vitamin D Cure Blog

This blog focuses on the heart and soul of health. The Vitamin D Cure emphasizes nutrition, targeted supplements, and exercise. Omega 3 fats and exercise were all over the science news in the last week. Remember in the book we recommend about 15 mg/lb of body weight daily of omega 3 fats from diet and supplement. We also recommend at least 30 minutes of exercise a day and aerobic exercise at least 3 times a week.

And this month for the palate, we have a vitamin D rich recipe of Salmon with asparagus and mushrooms. For Valentines Day you might chase this with some dark chocolate and a glass of port. Yuuuumy!

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com.

Seared Salmon with Asparagus & Mushrooms

Ingredients:
• 4 Fresh skinless wild salmon fillets (about 1 pound)
• Salt & Pepper
• 2 Tbsp. olive oil
• 2 cups sliced assorted mushrooms (such as button, cremini, shittake)
• 1 cup onion, chopped
• 6 cloves garlic, minced
• 1 Tbsp. fresh thyme, chopped
• 1 cup dry white wine
• 1 cup clam juice, fish stock, chicken stock or broth (whatever you have)
• 2 cups asparagus, cut into 1 1/2 in. long pieces
• 1 cup cherry tomatoes, halved
• 1 Tbsp. fresh parsley, chopped
• 1 tsp. lemon juice

Directions:
• Pat fish dry and season with salt and pepper.
• Heat 1 Tbsp. of olive oil in a large skillet over medium heat. Add the mushrooms and cook until golden brown, about 5 minutes. Add onion, garlic and thyme; cook until mushrooms are tender. Add the wine and bring to a boil; reduce heat and simmer uncovered for 15 minutes or until liquid is reduced to 1/4 cup.
• Add clam juice (or stock) and return to a boil. Reduce heat and simmer for another 15 minutes or until the liquid is reduced to 3/4 cup.
• Add the asparagus and cover; cook for about 3 minutes or until al dente (crisp-tender.) Stir in the tomatoes, parsley and lemon juice. Season with salt and pepper and transfer to a serving platter; keep warm.
• In the same skillet, heat the remaining olive oil over medium-high heat. Add the salmon and cook for 4-6 minutes per 1/2 inch thickness, or until fish flakes easily with a fork, turning once.
• Serve salmon over vegetable mixture and garnish with lemon wedges and fresh thyme.
Makes: 4 Servings

Vitamin D, Diet, and Exercise in the News

Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease.
JAMA. 2010 Jan 20;303(3):250-7.
Division of Cardiology, Room 5G1, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110, USA.

CONTEXT: Increased dietary intake of marine omega-3 fatty acids is associated
with prolonged survival in patients with coronary heart disease. However, the
mechanisms underlying this protective effect are poorly understood. OBJECTIVE: To
investigate the association of omega-3 fatty acid blood levels with temporal changes in telomere length, an emerging marker of biological age. DESIGN, SETTING, AND PARTICIPANTS: 608 ambulatory outpatients in California with stable coronary artery disease recruited from the Heart and Soul Study RESULTS: Individuals in the lowest quartile of DHA+EPA experienced the fastest rate of telomere shortening, whereas those in the highest quartile experienced the slowest rate of telomere shortening (P < .001 for linear trend across quartiles). Levels of DHA+EPA were associated with less telomere shortening before and after sequential adjustment for established risk factors and potential confounders. Each 1-SD increase in DHA+EPA levels was associated with a 32% reduction in the odds of telomere shortening. CONCLUSION: Among this cohort of patients with coronary artery disease, there was an inverse relationship between baseline blood levels of marine omega-3 fatty acids and the rate of telomere shortening over 5 years.

Long-Chain Omega-3 Fatty Acids for Indicated Prevention of Psychotic Disorders:A Randomized, Placebo-Controlled Trial.
Arch Gen Psychiatry. 2010 Feb;67(2):146-54.
Orygen Youth Health Research Centre, 35 Poplar Rd. Vienna, Austria

CONTEXT: The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain omega-3 polyunsaturated fatty acids (PUFAs) may be beneficial in a range of psychiatric conditions, including schizophrenia. Given that omega-3 PUFAs are generally beneficial to health and without clinically relevant adverse effects, their preventive use in psychosis merits investigation. OBJECTIVE: To determine whether omega-3 PUFAs reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis. DESIGN: Randomized, double-blind, placebo-controlled trial conducted between 2004 and 2007. PARTICIPANTS: Eighty-one individuals at ultra-high risk of psychotic disorder. INTERVENTIONS: A 12-week intervention period of 1.2-g/d omega-3 PUFA or placebo was followed by a 40-week monitoring period; the total study period was 12 months. RESULTS: 93.8% completed the intervention. By 12 months, 2 of 41 individuals (4.9%) in the omega-3 group and 11 of 40 (27.5%) in the placebo group had transitioned to psychotic disorder (P = .007). The difference between the groups in the cumulative risk of progression to full-threshold psychosis was 22.6% (95% confidence interval, 4.8-40.4). Omega-3 Polyunsaturated fatty acids also significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01) and improved functioning (P = .002) compared with placebo. The incidence of adverse effects did not differ between the treatment groups. CONCLUSIONS: Long-chain omega-3 PUFAs reduce the risk of progression to psychotic disorder and may offer a safe and efficacious strategy for indicated prevention in young people with sub-threshold psychotic states.

COMMENT: Higher omega 3 blood levels in heart patients appear to be associated with slower shortening of telomeres in white blood cells. Remember, the lengths of telomeres are associated with longevity or survival. In data edited from the book, the use of cod-liver oil to prevent rickets in Finland appeared to reduce the risk for schizophrenia in men 30 years later by as much as 78 percent. But, was this benefit from the vitamin D, the vitamin A or the omega 3 fats found in cod liver oil? This second study shows us that the omega-3 fats are playing an important role in this protection, and perhaps at any age preceding the onset of psychosis. It would break my heart if you didn’t take your omega 3 supplements.

Resistance training and executive functions: a 12-month randomized controlled trial.
Arch Intern Med. 2010 Jan 25;170(2):170-8.
Brain Research Centre, Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Department of Physical Therapy, University of British Columbia. 357-2647 Willow St, Vancouver, BC V5Z 3P1, Canada.

According the authors, among community-dwelling women aged 65 to 75 years, 12 months of progressive resistance training once or twice weekly improved selective attention and conflict resolution relative to twice-weekly balance and toning exercises. They also found that resistance training twice weekly improved peak quadriceps muscle power. This is the first study to demonstrate that engaging in progressive resistance training as infrequently as once a week can significantly benefit executive cognitive function in community-dwelling senior women.

In the same issue were two additional corroborating studies…

Physical activity and incident cognitive impairment in elderly persons: the INVADE study.
Arch Intern Med. 2010 Jan 25;170(2):186-93. Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany. Conclusion: Moderate or high physical activity is associated with a reduced incidence of cognitive impairment after 2 years in a large population-based cohort of elderly subjects.

Physical activity at midlife in relation to successful survival in women at age 70 years or older. Arch Intern Med. 2010 Jan 25;170(2):194-201. Department of Nutrition, Harvard School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA. Conclusion: These data provide evidence that higher levels of midlife physical activity are associated with exceptional health status among women who survive to older ages and corroborate the potential role of physical activity in improving overall health.

These data validate the Jack Lalanne phenomenon and the message in the Vitamin D Cure. Eat healthy, exercise hard, take some targeted supplements like vitamin D, omega 3 and magnesium, and you will live a long, healthy and vigorous life.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Hi Dr Dowd,

… I have been suffering with joint pain, muscle weakness, bone pain for 3 years. I am a 52 year old female. It was hard moving, getting up from a chair, holding heavy objects in my hands and so on. I have gone to physical therapist, with not much change. I have seen rheumatologists and also an endocrinologist…with no relief. I was given Lortab and steroids. They help for a little while. Last May my vitamin D was measured and was 20 or insufficient. My then rheumatologist told me to just supplement with D 3. Recently I bought a chewable D 3 1000 from GNC for my son and took one myself. The next day when I woke up, it was like I had gotten a huge steroid shot. It was unbelievable. I felt relieved. My pain was very minimal. My low back pain was gone. My back has been a problem for more than 3 years. … I bought your book last night and read it from beginning to end. …

Thank you,
Judy, from MI

Happy Holidays and Welcome to the Vitamin D Blog/Newsletter! I will attempt to keep you up on what I feel to be the most interesting vitamin D research. I have a very busy clinic in adult and pediatric rheumatology at The Arthritis Institute of Michigan in Brighton, Michigan, so my time available to post new blogs is limited to once a week. My interests in medicine extend far beyond vitamin D and I hope to share some of that with you in future books. I also supply blog information to eVitamins.com. I receive no compensation from them, only exposure.

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com . This week I asked her for a dessert recipe. It still complies with our Paleolithic principles. So, enjoy a little something sweet for the holidays.

Pear Berry Cinnamon Nut Crisp
Fruit filling
5 to 6 cups sliced pears–peeled, (2.5 to 3 pounds)
1 to 2 cups berries of your choice, fresh or frozen
1 to 2 tablespoons fresh lemon juice
1 T. ground flaxseed
1 to 2 tablespoons sugar
Crisp Topping
¾ cup chopped nuts of your choice
¼ cup ground flaxseed
¼ teaspoon salt
2 tablespoons brown sugar
¼ teaspoon cinnamon
2 to 3 tablespoons canola or vegetable oil
Directions
Preheat the oven to 400*F

Place the fruit in a medium-sized bowl, and toss with the lemon juice. Sprinkle in the flaxseed and sugar and toss until evenly coated, then transfer the mixture to an ungreased 9- or 10-inch pie pan. Don’t clean the bowl.

Use the same bowl to make the crisp topping. Combine the dry ingredients; use your fingers, if necessary, to mix in the brown sugar. Add the oil and mix with a fork and/or your hands until uniformly moistened. Carefully crumble the topping mixture over the fruit, and pat it into place. Place the pan on a baking tray, and bake in the center of the oven for 20 minutes, or until brown on top. Cool for at least 15 minutes before serving. Serve hot, warm, or at room temperature.
Serves: 4 to 6
Prep Time: 20 minutes
Cook Time: 20 minutes to bake

Vitamin D in the News
This week past there was a series of articles published in the International Journal of Endocrinology. This article was most interesting to me. This journal is open access, so you can read the full text of these papers. There are some good reviews of information we discuss in The Vitamin D Cure.

Vitamin d levels and lipid response to atorvastatin.
Int J Endocrinol. 2010;2010:320721. Epub 2009 Aug 19.
Department Internal Medicine, Rio Hortega Universitary Hospital, C/ Dulzaina 2,
University of Valladolid, 47012 Valladolid, Spain.

Objectives: Adequate vitamin D levels are necessary for good vascular health. 1,25-dihydroxycholecalciferol activates CYP3A4, an enzyme of the cytochrome P450 system, which metabolizes atorvastatin to its main metabolites. The objective of this study was to evaluate the response of cholesterol and triglycerides to atorvastatin according to vitamin D levels. Design and Methods: Sixty-three patients with acute myocardial infarction treated with low and high doses of atorvastatin were included. Levels of total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol were measured at baseline and at 12 months of follow-up. Baseline levels of 25-hydroxyvitamin D (25-OHD) were classified as deficient (<30 nmol/L),insufficient (30-50 nmol/L), and normal (>50 nmol/L). Results: In patients with 25-OHD <30nmol/L, there were no significant changes in levels of total cholesterol (173 +/-47 mg/dL versus 164 +/- 51 mg/dL), triglycerides (151 +/- 49 mg/dL versus 177 +/-94 mg/dL), and LDL cholesterol (111 +/- 48 mg/dL versus 92 45 +/- mg/dL); hereas patients with insufficient (30-50 nmol/L) and normal vitamin D (>50 nmol/L) had a good response to atorvastatin. Conclusions: We suggest that vitamin D concentrations >30nmol/L may be required for atorvastatin to reduce lipid levels in patients with acute myocardial infarction.

Comment: In short “Statins” (Lipitor, Zocor, etc…) appear to require a minimum amount of vitamin D (25(OH)D3) substrate (>12 ng/mL or 30 nmol/L) to produce their lipid lowering effects. And, this effect was dose dependent with more dramatic lipid lowering effects at vitamin D levels above 20 ng/mL or 50 nmol/L. More interesting than their lipid lowering effects is their effect on inflammation. We now know that coronary heart disease is an inflammatory disease. Vitamin D is essential for a normal and controlled inflammatory response. We also know that low levels of vitamin D are associated with increased cardiovascular mortality and all cause mortality. Does vitamin D deficiency impair the anti-inflammatory response to statins as well?

Quality of diet and potential renal acid load as risk factors for reduced bone
density in elderly women.
Bone. 2009 Dec 11.
Area di Geriatria, Università Campus Biomedico. Roma, Italy; Fondazione Alberto
Sordi Onlus. Roma, Italy.

BACKGROUND: Bone mineral density (BMD) may be influenced by the general dietary pattern and the potential renal acid load (PRAL). METHODS: We compared the
dietary intake (estimated using the European Prospective Investigation into Cancer and nutrition questionnaire) of 497 community-living women (60 years of age and older) grouped according to tertiles of baseline total, trabecular and cortical BMD estimated using tibial peripheral quantitative computed tomography (pQCT), and of BMD variation over 6 years. RESULTS: None of the other nutrients taken into account nor PRAL was associated with total BMD, with the exception that the intake of polyunsaturated fatty acids (PUFA) was slightly higher among women with the highest total BMD. Similar results were found for trabecular BMD. Cortical BMD was associated with serum 25-OH vitamin D (38.8, 43.2, and 49.5nmol/L in the first, second, and third tertiles, respectively; P=0.042). In the longitudinal analysis, a lower BMI was associated with greater loss of total BMD, while lower serum 25-OH vitamin D at baseline was associated with smaller loss of cortical BMD. CONCLUSIONS: We found no relationship between dietary acid load and BMD. We also confirmed the role of well-recognized risk factor for osteoporosis.

Comment: This study confirms the association between vitamin D levels and both cortical and trabecular bone over time. The higher the vitamin D level was between 15 and 25 ng/mL, the higher the bone mass. This study also confirms the bone protective effect of polyunsaturated fats in the diet that is well described in animal studies. In other words, omega-3 fats make for stronger bones. There was no relationship between dietary acidosis and bone mass. This contradicts previous epidemiological data.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Dear Doctor Dowd:

Thank you for your response! … My rheumatologist gave me no hope and told me the only thing I could do to keep down the inflammation is to take Tylenol or ibuprofen around the clock for the rest of my life (and have my kidneys checked yearly). If I had a flare-up, they would give me colchicine or if it got really bad, a cortisone shot. I showed her your book and one of the case studies that sounded exactly like me and she pooh-poohed it. I had worried about ending up like my grandmother who had rheumatoid arthritis and was almost totally crippled from it.

I’ve since visited a naturopath, and–against my endocrinologist’s and regular doctor’s advice–have begun taking 5,000 IU of vitamin D. My D3 level was 28 at that time. A re-test after 1.5 months showed I had improved to 46, and for the first time in years my C-reactive protein was normal–NOT high…

My knees feel better since I got a cortisone shot and had them drained (20 ccs each) in August. The shot has worn off and some pain returned, but not to the previous levels, and no noticeable swelling. I notice less swelling in my fingers, too, and am totally off ibuprofen.

By the way, our UV level is 1 today, even though it’s clear and bright (not raining!) in Seattle.

Thanks, again.

Susan

HAPPY NEW YEAR!

When the leaves change colors the availability of ultraviolet light to make vitamin D (UVB) disappears till next spring. Your vitamin D level then begins to fall along with all the leaves on the deciduous trees. Ten weeks after peak fall colors your vitamin D level is about half what it was at the end of summer. For me hear in Michigan (42° N) that is about Christmas time or New Year’s. For those of you who live in the southern part of the United States or below 35° N your vitamin D may never fall by half because your winter is not 10 weeks long. The only sources of vitamin D during winter are fat stores and supplements.

Mother Nature intended for us to burn most of our fat stores over the winter due to less food availability. Our Western lifestyles have us typically eating more food through the end of year holidays. So rather than liberating stored vitamin D by burning fat, we are increasing fat volume and retaining vitamin D in fat. If there were ever an appropriate use of fasting it would be from Thanksgiving through Easter. We should eat less in these winter months not more.

Moderate to intense physical activity also stimulates fat burning and will liberate vitamin D from fat stores. Maintaining a routine of this type of activity has been shown in CDC data to translate into significantly higher vitamin D levels. So follow the diet in the Vitamin D Cure year round and establish a daily routine of moderate physical activity.

Remember low vitamin D levels in the winter depress your mood and your immune system. So beat those winter blues and stop all those flu viruses with the Vitamin D Cure.

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com .

Broiled Spiced Salmon with Roasted Winter Squash & Fennel
Serves 4

For the vegetables:
• 1-1 ½ pound butternut squash, peeled, halved lengthwise, seeded, halved crosswise, then cut lengthwise into 3/4-inch-wide wedges
• 1 fennel bulb, trimmed, cut lengthwise into 1-inch-wide wedges
• 1 large onion, root end left intact, then cut lengthwise into 1/2-inch-wide wedges
• 3 tablespoons olive oil
• 1 teaspoon ground cumin
• 1 teaspoon ground cinnamon
• 1 teaspoon chili powder
• 1/2 teaspoon turmeric

For the Salmon:
• 4 Salmon fillets (4-6 oz. each)
• 1 Tbsp. reserved spice mixture from vegetables
• Salt & Pepper
• Olive oil

1. Position rack in bottom third of oven and preheat to 450°F.
2. Combine squash, fennel, and onion on heavy large rimmed baking sheet. Add oil and toss to coat. Mix all spices in small bowl to blend, reserve 1 Tbsp. for Salmon. Sprinkle spice mixture over vegetables and toss to coat. Sprinkle with salt and generous amount of pepper.
3. Roast until vegetables are tender and browned, turning once, about 45 minutes. Turn oven to broil.
4. For the salmon, foil line and spray a broil pan with nonstick spray.
5. Place salmon fillets on pan and drizzle with oil, season with salt and pepper and evenly sprinkle 4 fillets with reserved spice mixture.
6. Broil for 5 to 7 minutes or until fish flakes easily.
7. Serve over top roasted vegetables.

Vitamin D in the News

Vitamin D has profound and multiple effects on the immune system. This is particularly true when it comes to your response to infections. We know how it affects our response to tuberculosis. The effects of vitamin D on our response to viruses like the flu are a bit less clear. Here is an excellent review of the data that is our there.

Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials. Endocr Pract. 2009 Jul-Aug;15(5):438-49.
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30030, USA.
OBJECTIVE: To review the existing human controlled intervention studies of vitamin D as adjunctive therapy in settings of infection and provide recommendations for design and implementation of future studies in this field on the basis of the evidence reviewed. METHODS: We conducted a systematic review of randomized controlled clinical trials that studied vitamin D for treatment or prevention of infectious diseases in humans. Studies from 1948 through 2009 were identified through search terms in PubMed and Ovid MEDLINE. RESULTS: Thirteen published controlled trials were identified by our search criteria. Ten trials were placebo controlled, and 9 of the 10 were conducted in a rigorous double-blind design. The selected clinical trials demonstrated substantial heterogeneity in baseline patient demographics, sample size, and vitamin D intervention strategies. Serious adverse events attributable to vitamin D supplementation were rare across all studies. On the basis of studies reviewed to date, the strongest evidence supports further research into adjunctive vitamin D therapy for tuberculosis, influenza, and viral upper respiratory tract illnesses. In the selected studies, certain aspects of study design are highlighted to help guide future clinical research in the field. CONCLUSION: More rigorously designed clinical trials are needed for further evaluation of the relationship between vitamin D status and the immune response to infection as well as for delineation of necessary changes in clinical practice and medical care of patients with
Vitamin D deficiency in infectious disease settings.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Hi,
I am a Registered Nurse working in the City of London. As I live in rural Essex, I commute daily in to London. Reading my newspaper on the train a few weeks ago I came across an article on Vit. D. This seemed interesting so I ordered Dr. Dowd’s book.

On reading this book I realized that I ticked all the boxes of symptoms being Vitamin D deficient. I have weak muscles/aches/not much strength, and always struggle when I went to a Gym. I was diagnosed with Fibromyalgia around 10 years ago, which settled but I always feel fatigued etc… I lead a very busy life working full time in London as a Registered Nurse. You wouldn’t know that I have discomfort as I just get on with it.

A colleague took some blood and my level of Vit. D was 31 nmol/L range from out lab is 75 - 200 nmol/L. Magnesium level is 0.84 range from our lab is 0.65 - 1.05. I put myself on ‘Life Extention’ 1000iu x 2 daily from Victoria Health and Magnesium. I am trying to change my diet which was mostly vegetarian.

By the way I am Scottish….so not much sun in my life when I was growing up. I am going to keep to this regime and will let you know the outcome. So glad I came across the article and the book which will be useful for my colleagues and patients. I have ordered a couple of copies of the book to give to a couple of my doctor colleagues.

Regards,
Lorna.

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com .

Roasted Tomato and Vegetable Soup

Yield: 8 servings (1 1/3 cup)

Ingredients:
• 1 medium onion, chopped
• 1 stalk celery, sliced
• 1 medium carrot, chopped
• 2 cloves garlic, minced
• 1 Tbsp. olive oil
• 3 14-oz. cans chicken stock (low sodium)
• 2 cups butternut squash; peeled, seeded and cut into 1-in. pieces
• 1 14.5-oz. can fire-roasted diced tomatoes
• 1 15-to 19-oz. can cannellini beans, rinsed and drained
• 1 medium zucchini, halved lengthwise and sliced
• 1 cup small broccoli and/or cauliflower florets
• 1 Tbsp. fresh oregano, chopped
• 1/4 tsp. salt
• 1/4 tsp. black pepper

Directions:
• In a 4-quart pot, cook onion, celery, carrot, and garlic in hot oil over medium heat until tender, about 5 minutes.
• Stir in chicken stock, squash, and undrained tomatoes. Bring to a boil, reduce heat and simmer for 20 minutes covered.
• Add beans, zucchini, broccoli and/or cauliflower, oregano, salt and pepper; cook for another 5 minutes.
• Slow Cooker Option: Omit the olive oil and combine all ingredients except the zucchini, broccoli and/or cauliflower and fresh oregano in slow cooker. Cover and cook on low for 7 to 8 hours or on high for 3 to 4 hours. Add zucchini, broccoli and/or cauliflower and fresh oregano and cook 30 minutes more on high.
• You can have a grilled chicken breast or nice piece of white fish with a bowl of this soup.

Vitamin D in the News

In the book we speculated that HIV transmission might be greater with lower vitamin D levels. This data from Africa and Harvard suggests that the spread of HIV in Africa particularly between mother and child is at least in part due to lower vitamin D levels. These data also suggest that our lifestyles that lead to low vitamin D levels and malnutrition are facilitating another epidemic, HIV/AIDS.

High frequency of vitamin D deficiency in ambulatory HIV-Positive patients.AIDS Res Hum Retroviruses. 2009 Jan;25(1):9-14.
Infectious Disease Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.

Several reports have suggested an increased prevalence of osteopenia and osteoporosis in HIV-infected individuals. Vitamin D deficiency may be a risk factor for osteoporosis and bone fractures. These researchers determined the prevalence of vitamin D insufficiency in an outpatient HIV clinic in Boston. They collected serum levels of 25-OH vitamin D and evaluated calcium and vitamin D intake in adult HIV-positive outpatients during the winter and spring of 2005. Fifty-seven subjects were enrolled. The prevalence of moderate (< or = 20 and>10 ng/ml) and severe (< or =10 ng/ml) 25-OH vitamin D deficiency was 36.8% and 10.5%, respectively. Lower vitamin D intake was significantly associated with severe 25-OH vitamin D deficiency (p=0.01). Lactose intolerance tended to be associated with severe vitamin D deficiency (p=0.08). Antiretroviral use and low daily calcium intake were significantly associated with elevated parathyroid hormone levels (p=0.01 and 0.03, respectively). Vitamin D deficiency was frequent in ambulatory HIV-positive patients. HIV-infected individuals living in areas with low exposure to ultraviolet light during winter may benefit from vitamin D supplementation.

Perinatal Outcomes, Including Mother-to-Child Transmission of HIV, and Child
Mortality and Their Association with Maternal Vitamin D Status in Tanzania.
J Infect Dis. 2009 Aug 12.
Departments of Epidemiology, Nutrition, Biostatistics, and Global Health and Population, Harvard School of Public Health, and Channing Laboratory, Department Of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts; Departments of Internal Medicine, Pediatrics, and Community Health, Muhimbili University of Health and Allied Sciences, Dares Salaam, Tanzania.

Background. Vitamin D is a strong immunomodulator and may protect against adverse pregnancy outcomes, mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), and child mortality. Methods. A total of 884 HIV-infected pregnant women who were participating in a vitamin supplementation trial in Tanzania were monitored to assess pregnancy outcomes and child mortality. Results. No association was observed between maternal vitamin D status and adverse pregnancy outcomes, including low birth weight and preterm birth. In multivariate models, a low maternal vitamin D level (<32 ng/mL) was associated with a 50% higher risk (95% confidence interval [CI], 2%-120%) of MTCT of HIV at 6 weeks, a 2-fold higher risk of MTCT of HIV through breast-feeding among children who were HIV uninfected at 6 weeks (95% CI, 1.08-3.82), and a 46% higher overall risk of HIV infection (95% CI, 11%-91%). Children born to women with a low vitamin D level had a 61% higher risk of dying during follow-up (95% CI, 25%-107%). Conclusions. If found to be efficacious in randomized trials, vitamin D supplementation could prove to be an inexpensive method of reducing the burden of HIV infection and death among children, particularly in resource-limited settings.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Dr. Dowd,

First I’d like to say that your book has made quite an impact on my life. Because I have a sun-sensitive porphyria I have always avoided sunlight, but over the years that led to constant battles with viruses, anemia, and eventually heart failure and cancer. I became convinced that many of my problems were related to a vitamin D deficiency so I had my blood checked and sure enough I was deficient in spite of excellent DEXA scans.

I tried various levels of exposure to see what I could tolerate without triggering a porphyria attack and have come up with 15 minutes between 9 and 10am MST (Colorado) or after 4pm. I’ve done this three times a week most of the summer and my recent kidney scan showed that my cancer had decreased in size. My overall health is getting much better including my heart and lung function and viral load (I had viral pneumonia, CMV and Parvo all at one time!). Thanks so much for your work.

Janet, Colorado Springs

Many patients with diseases that prevent them from getting adequate sun exposure are vitamin D deficient. Supplementation using the tables in The Vitamin D Cure is safe, convenient, and inexpensive

Should I eat my vegetables raw or cooked? If I am taking an acid suppressing drug for my stomach, how does this affect digestion? These are some recurring questions I have been asked over the last year.

Let’s ask Mother Nature. Ruminant or grazing animals have lots of large flat teeth for chewing and grinding vegetable matter. Humans on the other hand have relatively few large teeth for grinding. Ruminant animals also have very large guts to process all the cellulose from vegetable matter like grasses. They have 3-4 compartments that make up their stomach as opposed to the human stomach which is a single compartment. Unlike the human stomach, ruminants ferment the food bolus with micro-organisms in their stomach. Their stomach is a bioreactor that produces the volatile organic acids (similar to vinegar) from which they obtain nutrition. The human stomach secretes acid to begin digestion primarily of protein.

Since our gut does not process our vegetables as in cattle, it helps to provide some of this processing before consumption. Cooking is only one of these methods of pre-processing vegetable matter for consumption. Chopping vegetables into small pieces enhances nutrient acquisition. Pureeing vegetable matter takes this one step further. Mixing vegetable matter with volatile organic acids such as vinegar will not only help kill unwanted bacterial but will enhance nutrient acquisition. Similarly the addition of oil to dressings increases the amounts of fat soluble nutrients available for absorption such as vitamins A, E, K and D.

Cooking vegetables increases some nutrients and decreases other nutrients. Fat soluble vitamins and minerals like magnesium are more available from cooked vegetables than from raw vegetables. Anti-oxidants and some water soluble nutrients like vitamin C decay the longer they are exposed to heat and the higher the heat applied. So ideally you should eat both cooked and raw vegetables. Steaming, programmed microwaving, and lightly sautéing in oil are the preferred methods of cooking. You can make raw purees with oil and vinegar and use as dressing on lightly cooked vegetables and cooked meats, thus combining these methods.

The addition of vinegar or citrus acids like lemon juice will enhance the absorption of minerals such as calcium, iron, and magnesium from food. This is a particularly useful technique for individuals who have had gastric bypass, or gastric surgery that reduces the capacity of their stomach to produce acid. Patients taking acid suppressing drugs due to heart burn should eliminate grain and dairy from their diet. This may allow them to discontinue their acid suppressing agent. Starches from grain and potatoes are prime culprits in producing reflux and heart burn.

Recipe of the Month
Remember our recipes are courtesy of Chef Kelly (kellychez@gmail.com). If you have recipes you would like to share or convert to follow the rules of The Vitamin D Cure send them to contact@thevitamindcure.com .

Cilantro and Chile stuffed Jumbo Shrimp
Serves 4

Ingredients:• 8 jumbo shrimp, in the shell (about 1 1/4 pounds)
• 3 sprigs fresh thyme, leaves stripped
• Juice of 2 limes (about 1/4 cup)
• 2 tablespoons extra-virgin olive oil
• 1 teaspoon salt, plus additional for seasoning
• Freshly ground black pepper
• 1 clove garlic, chopped
• 1/2 large jalapeno, with seeds
• 2 scallions, chopped
• 1 cup coarsely chopped fresh cilantro leaves

Directions:
Prepare the grill to medium-high. Without removing the shells, slit about 3/4 of the way through the shrimp down the ridged back and remove the vein that runs down the center. Rinse and pat the shrimp dry.

Next, whisk the thyme leaves, lime juice, 1 tablespoon of the olive oil, 1/2 teaspoon of the salt and black pepper, to taste, in a shallow bowl. Lay the shrimp cut side down in the lime mixture and refrigerate for 30 minutes.

In a food processor, pulse the garlic, jalapeno, scallions, remaining 1 tablespoon olive oil and remaining 1/2 teaspoon salt to make a coarse paste. Add the cilantro and pulse just enough to incorporate into the mixture. Spoon the mixture into the opening in the shrimp and close the shrimp.

Grill the shrimp shell side down (to keep filling from falling out) for 3 minutes. Turn to the other shell side, cover, and grill another 2 minutes or until the shrimp turn pink and are slightly firm to the touch. Sprinkle with salt and serve.

*Great served over a spinach salad with red onions, heirloom tomatoes, toasted pinenuts and a cilantro-lime vinaigrette.

Vitamin D Success Story
Please share your successes at success@thevitamindcure.com or online at Amazon. Your success story has a powerful impact on motivating others to change their lifestyle.

Dear Dr Dowd,

Congratulations on your book, one of only a few written by physicians using vitamin D in their practice. I have been taking vitamin D for about three years and my 25OHD3 level was 71ng/ml the last time it was tested, using the local Labcorp facility, thru services provided by Life Extension. I have gradually increased by daily dosage over the last few years, starting at a level of about 50 and gradually increasing it to where it is today by taking 8000 IU per day. I am 89 years old and play tennis twice a week. I am sure that the vitamin D is responsible for my ability to keep going. I also would like to mention that I have been using only potassium chloride as a table salt for the last three years and my K levels have always stayed within limits over the three years. Keep up the good work!

M Ferguson
Indio, Ca