Arkansas Democrat-Gazette

Studies: Overload of vitamin D risky

- LENNY BERNSTEIN

Vitamin D, in combinatio­n with calcium, is said to be good for your bones. You should consume modest amounts in your diet, if possible (and for most people that is quite possible), or in the form of supplement­s if you can’t get enough via food and drink.

We know this. But somehow we have arrived at a point when some physicians are prescribin­g large doses of vitamin D supplement­s for their patients in the hope of preventing cancer, cardiovasc­ular disease, diabetes, autoimmune disorders and other maladies, despite a lack of evidence that this works, according to a new commentary in JAMA: The Journal of the American Medical Associatio­n.

Other people are loading up on vitamin D on their own.

“Clinical enthusiasm for supplement­al vitamin D has outpaced available evidence on its effectiven­ess,” JoAnn E. Manson and Shari S. Bassuk of the Division of Preventive Medicine at Brigham and Women’s Hospital in Boston wrote recently in the journal’s online version.

This practice isn’t totally harmless. You should be consuming 600 internatio­nal units daily if you’re between the ages of 1 and 70, and 800 IU each day if you’re 71 or older, according to the Institute of Medicine, the health arm of the National Academy of Sciences. These amounts are enough for 97.5 percent of U.S. and Canadian residents, according to the institute. (Sunlight stimulates production of vitamin D for people in sunnier climes.)

Go above 4,000 IUs, unless there’s a specific reason that you need that amount, and you risk kidney stones, calcificat­ion of blood vessels and possibly the very cardiovasc­ular disease you were seeking to prevent, Manson said. So how did we get here? “I think there’s been a [disconnect­ion] between the observatio­nal studies and the randomized clinical trials to date,” Manson said. Over the past 15 years, those studies “have looked promising, and very often they’ve been reported by the media as suggesting that vitamin D has these benefits. I think there’s a general perception that if some is good, more is better.

“I think it’s important to un

derstand that more is not necessaril­y better.”

Manson is leading the most extensive clinical trial of vitamin D use ever, an examinatio­n of 25,875 people across the United States to determine whether vitamin D is helpful against cancer, cardiovasc­ular disease, diabetes, depression, infection, autoimmune disorders and other conditions. The results are expected in late 2017 or early 2018.

In the meantime, how much vitamin D should people consume? The recommende­d dietary allowance works out to three or four servings each day of fortified foods such as milk, yogurt, soy beverages, orange juice or cereal and fatty fish twice a week, according to Manson’s commentary.

She also called on physicians not to overscreen patients for vitamin D deficienci­es, a practice that can lead to overprescr­ibing it.

“Large trials of other widely used supplement­s have sometimes found benefits,” Manson wrote, “but in other cases — such as with high doses of beta carotene, vitamin E and selenium — have disproved some health claims for these supplement­s and identified health risks that may not have otherwise been detected.”

 ?? Arkansas Democrat-Gazette/KIRK MONTGOMERY ??
Arkansas Democrat-Gazette/KIRK MONTGOMERY

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