Calcium and Vitamin D in Childhood Obesity

In a previous blog, we discussed the beneficial impact of higher calcium intakes and higher vitamin D blood levels on successful weight loss in adults.  New research studies also suggest that vitamin D and calcium might reduce the risk of obesity for some children.

In one childhood obesity research study, investigators examined the relationship between calcium intake and body composition in African-American children (free to download).  In this study, 186 African-American children at risk for being overweight were asked with the help of their elders to record food intake for 3 days.  Body composition and body weight measures were taken and analyzed in respect to nutrient intake.  The investigators reported:

• Less than half of the children met the dietary recommended intake of any of the vitamins and minerals measured with only about 1% meeting calcium recommendations and about 4% meeting vitamin D recommendations.
• When the study volunteers were examined as a whole group, no links were evident between calcium intake and body composition or body mass index.
• However, when looking at differences between boys and girls, it was clear that girls who consumed less than 314 milligrams of calcium per day had a higher percent of fat mass than girls who consumed more than 634 milligrams of calcium per day.

In the second childhood obesity research study, investigators assessed the link between vitamin D blood levels and changes in body mass index and waist size in more than 450 5-12 year old children.  For this study, blood levels of vitamin D were measured at baseline and classified as deficient (less than 50 nmol/L), insufficient (more than 50 nmol/L, but less than 75 nmol/L) or sufficient (more than 75 nmol/L).  Body changes were assessed yearly for approximately 3 years.  In this study, children deficient in vitamin D were shown to have greater increases in body mass index, skin-fold thickness, and waist size over the 3-year follow-up period than children with sufficient blood levels of vitamin D.  Additionally, a lack of vitamin D was linked to slower growth rates in girls.

These two studies both show that deficiencies in calcium and vitamin D might be linked to some children having an increased risk for becoming overweight or obese.  The reason for the difference between African-American boys and girls in regards to calcium's impact on body fat is uncertain; however, the study researchers point out that their analysis was negatively effected by the very low percent of children consuming adequate levels of calcium (1%).  In truth, the insufficient intake of most vitamins and minerals in this group of children is one of the most disturbing results of this first study.  In this study, less than 10% of the children consumed adequate amounts of calcium, magnesium, phosphorus, potassium, folate, vitamin D, vitamin A, and vitamin K based on food intake records!  Ensuring that children get adequate nutrition is an important step to both maintaining overall health as well as possibly reducing their risk for both childhood and adult obesity.

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Vitamin D - How Much Do We Need?

Vitamin D has been a hotly debated micronutrient over the last few years.  Current dietary recommendations as set by the Institute of Medicine are that adults up to 50 years of age require 200 International Units (IU) per day, that adults 51 - 70 years of age should obtain 400 IU per day, and adults over 70 years of age should get 600 IU per day.  For purposes of safety the Institute of Medicine has set a tolerable upper level intake at 2,000 IU per day.  Since these recommendations were set, science has continued to explore the health benefits of vitamin D with many of these studies suggesting that much higher doses of vitamin D are needed to achieve health benefits beyond meeting basic nutritional requirements.  The weight of the evidence for a higher daily recommendation has led the Institute of Medicine to re-evaluate their recommendations for dietary vitamin D with a final report due to be released in the very near future.

In an attempt to provide relevant data for the re-evaluation of dietary vitamin D recommendations, a new vitamin D research study aimed at determining the appropriate amounts of vitamin D for health benefits and safety was conducted.  For their assessment of vitamin D the nutrition researchers analyzed previously published research trials on the potential benefits of vitamin D for fractures, falls, heart health, and cancer and on the safety of vitamin D at high doses.  The results of this data analysis showed:

• Fractures - Doses of vitamin D between 482-770 IU per day reduced the risk for non-vertebral fractures by about 20% and reduced the risk for hip fractures by about 18%.  Lower doses of vitamin D did not reduce fracture risk.  Optimum fracture prevention occurred with blood levels of vitamin D between 75-110 nmol/L (30-44 ng/ml).
• Fall Prevention - the risk of falling was reduced by 19% when vitamin D was consumed at doses of 700-1,000 IU per day, while lower doses did not reduce the risk of falls.  Optimum fall prevention was observed when blood levels of vitamin D were between 75-100 nmol/L.
• Non-Skeletal Endpoints - data collected and analyzed from studies on the impact of vitamin D on cancer, heart health, hypertension, and overall mortality suggest that optimum benefits were achieved with a blood level of vitamin D around 100 nmol/L.
• Safety - Elevated calcium levels are typically used to measure vitamin D toxicity.  According to this new report, vitamin D intake up to 100,000 IU per day or blood levels up to about 640 nmol/L had no effect on average blood calcium levels.  While a handful of individual case reports of elevated calcium were identified, all the relevant cases occurred at vitamin D blood levels higher than 500 nmol/L.

This is an important study that might well influence new dietary recommendations for vitamin D.   According to these study results, an optimum blood level of vitamin D for a range of health benefits is between 70-110 nmol/L.  The study investigators indicated that this level can be obtained by consuming between 1,800-4,000 IU vitamin D per day.  This daily consumption amount is substantially higher than the current upper limit of 2,000 IU per day as set by the Institute of Medicine.  However, based on the data from this study, doses much higher than this had no toxicity.  In those cases where elevated calcium was observed, blood levels of vitamin D were 4 to 5 times higher than the optimum levels.  Based on these study results, consuming 1,800-4,000 IU per day appears to have numerous health benefits with little or no risk of toxicity.

In addition to the health endpoints examined in this study, a previous study has suggested that vitamin D might support weight loss. In this study, a vitamin D blood level of 30 ng/ml was associated with a weight loss of about 12 pounds.  A blood level of 30 ng/ml is equivalent to 75 nmol/L and is thus within the optimum range defined by the latest study.

According to this latest study, consumption of 400-800 IU per day leaves about 50% of the adult population with below-optimum blood levels of vitamin D.  It will be interesting to see if the Institute of Medicine changes their recommendation for vitamin D intake and if so to what level. 

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Higher Calcium & Vitamin D Levels Support Weight Loss

The effect of vitamins and minerals on weight loss has been and remains an active area of research investigation.  Two of the most studied are calcium and vitamin D; however, the results to date have been mixed and inconsistent making the role of the calcium and vitamin D in weight loss somewhat controversial.

A new weight loss study published online ahead of print in the American Journal of Clinical Nutrition further examined this possible relationship.  Weight loss researchers collected and analyzed data from 322 volunteers who took part in the 2-year Dietary Intervention Randomized Controlled Trial.  The results of the weight loss researchers analysis showed that:

• Vitamin D blood levels at the beginning of the study were lower in volunteers with higher body mass index (BMI) scores.
• At 6 months, higher levels of dairy calcium consumption were linked with greater weight loss.  An average of 580 milligrams of calcium per day was linked to a weight loss of about 12 lbs on average, while intake of about 360 milligrams per day on average was associated with a weight loss of about 8 lbs.
• Similar results were observed for vitamin D.  Blood levels of about 30 ng/ml vitamin D on average were also associated with a weight loss of about 12 lbs.
• Each incremental increase in dietary calcium intake was associated with about a 45% increased chance of losing 10 lbs, while each incremental increase in vitamin D blood levels increased the chances of successfully losing 10 lbs by about 70%.

These are excellent results indicating that higher consumption of calcium and higher blood levels of vitamin D, two important micronutrients, might be related to greater weight loss while dieting.  In general, it is very important to make sure you get adequate amounts of vitamins and minerals when dieting since dieting has been reported to lead to insufficient micronutrient intake.  This study not only supports that, but also indicates that getting enough of these two micronutrients might be one key to successful weight loss.  If you are not getting adequate amounts of these and other micronutrients through your regular diet and lifestyle, a good multivitamin/multimineral can be a good way to get your fully daily complement of vitamins and minerals.

My easy diet plan includes milk protein bars and shakes fortified with calcium (30-60% DV), vitamin D (25-35% DV), and other important vitamins and minerals.  Visit us at www.drtabor.com to learn more or tune in to watch me on QVC September 12th from 1 AM - 2 AM EST!

Vitamin D Might Support Normal Physical Function in Seniors

Over the last several years, research has shown that vitamin D appears to play an important role in many aspects of human health, including the maintenance of normal muscle health.  However, little research has looked at the role of vitamin D on physical function in older individuals.

A new vitamin D research study examined the potential association between vitamin D blood levels and leg function in nearly 3,000 individuals with an average age of 75 years.  For this study, researchers measured blood levels of vitamin D in the study volunteers and then asked them to perform a short battery of physical tasks, including walking 400 meters and knee strength tests.  The study investigators reported that:

• Volunteers with vitamin D blood levels greater than 75 nmol/L had higher overall physical performance scores compared to volunteers with low vitamin D levels (less than 50 nmol/L).
• Individuals with high vitamin D blood levels were able to walk at a faster speed than subjects with low vitamin D levels.
• Knee strength was not different between individuals with low or high vitamin D levels.

This is interesting research that adds to the growing body of evidence around the importance of vitamin D for normal human health.  This new research suggests that maintaining adequate vitamin D levels might help support normal muscle health as we get older.  However, it is important to remember that this study only looked at associations and was not able to determine cause and effect.  Therefore, it is possible that the better physical performance in individuals with higher vitamin D levels could be due to other things.  Nonetheless, insufficient levels of vitamin D can lead to a variety of chronic conditions, so it is important to make sure you get enough vitamin D each day.

While you can generally get all the vitamin D you need by spending time in the sun, you can also get vitamin D in the diet.  My milk protein bars and milk protein shakes provide 25 - 35% of most people's daily needs, making them a delicious and easy way to boost your vitamin D levels.

The Importance of Vitamin D

While we are all aware of the importance of vitamin D for its important role in bone metabolism, recent research has shown us that vitamin D might play an important role in many chronic health conditions.  A new review article on the non-classical roles of vitamin D in human health was published just a few days ago and while it is free to download and read by everyone, I wanted to take this opportunity to briefly summarize some of the information in the paper.

• Vitamin D Production - Under normal conditions, we can get all or close to all the vitamin D we need from sunlight.  However, the amount of sun we get is effected by a number of factors including season, geographical location, weather conditions, clothing choices, sunscreen use, and more.

• Vitamin D Status - Despite the fact that our skin has the ability to produce enough vitamin D for our needs, many of us are deficient in vitamin D.  Many researchers suggest that blood levels of 50 nmol/L is an adequate amount of vitamin D and that anything less is insufficient.  Based on this blood level recommendation,  between 50 - 90% of people across the globe are vitamin D deficient.

• Health Impact - According to this review paper, vitamin D might be important for improving muscle function, supporting a healthy blood pressure, promoting normal blood sugar health, and supporting normal hearth health in obese individuals.

• Adequate Vitamin D Levels - The author of this review paper suggests that optimal blood levels of vitamin D are between 75 - 372 nmol/L.  Depending on an individuals current vitamin D blood levels, daily intake of about 50 micrograms/day might be needed to increase blood levels to the proposed optimal levels.

In regards to the optimal amount of vitamin D blood levels, it is important to remember that the doses potentially required to reach these levels are substantially higher than the daily recommended intake set forth by the Institute of Medicine, which ranges from 5 - 15 micrograms/day depending upon an individual's stage of life.  The 50 microgram/day dose discussed above is actually the current recommended upper intake level.  However, this review is correct that research supports the use of higher amounts of vitamin D for a variety of health benefits.  The research as a whole has been strong enough to convince the Institute of Medicine to re-evaluate its vitamin D recommendations with potentially new recommendations to be revealed this summer.  The NIH's Office of Dietary Supplments has an excellent Fact Sheet on vitamin D based on current recommendations and makes a good companion read to this new review article.

Getting enough vitamin D, whether it be through exposure to sunlight or daily consumption, is an important lifestyle choice we all need to make.  Another important lifestyle choice for which we should all strive is maintaining a healthy body weight.  My diet plan is a simple way to manage one's body weight, whether looking to lose weight or simply maintain a healthy body weight.