The number of publications on vitamin D just keeps mounting.
Consumer acceptance increases apace. In recent peer-reviewed published research, bone health, cancer, cardiovascular health, depression, diabetes, leg-artery disease, pain and even all-cause mortality are only some of the health conditions associated with vitamin D insufficiency.
In an era where the benefits of supplementation across the board are being challenged, the expansion of supportive science for this fat-soluble vitamin theoretically should make it the next poster child for significant industry emphasis as we fight the ongoing battle for industry validation.
In July, an article appeared in USA Today discussing consumer trends, relating to testing for vitamin D. According to one of the testing labs cited, "tests ordered for vitamin D grew by about 80 per cent from May 2007 to May 2008." Apparently, a perfect storm is brewing — substantiating science, health and economic impact, plus consumer awareness.
The only element lacking is the supportive government/health policy environment that might create even more research dollars, as well as instructions in the form of health guidelines.
Earlier this year, I spoke with a Canadian health-policy expert (Canadian Institutes of Health Research — CIHR) at an industry event in Quebec City. Part of my presentation focused on the fact that despite recent evidence, Health Canada guidelines for vitamin D consumption remained based on decade-old-plus thinking: "Health Canada uses the United States Institute of Medicine's (IOM) nutrient standards to set policies and standards. Until the IOM updates the Dietary Reference Intakes for vitamin D…." (Health Canada release, June 2007). Incidentally, the latest IOM vitamin D evaluation was in 1997. In my dialogue with this health-policy individual, he indicated that North American experts and authorities were talking about an update to the guidelines, based on recent evidence, that at least would potentially acknowledge higher upper limits and daily values.
Recently, the American Journal of Clinical Nutrition and the National Institutes of Health (NIH) weighed in on the matter at the conference "Vitamin D and health in the 21st century, an update." The session, "Key gaps in understanding health effects of vitamin D," suggested that while research has continued for vitamin D, many studies failed to account for confounders, and few studies examined vitamin D independently of calcium or other nutrients. The list of negatives continues: the common marker, a biomarker of vitamin D exposure, is plagued by variable assays; there is a lack of a standard reference material; research has not validated 25(OH) concentrations with functional outcomes, and the connection with various outcomes, including chronic diseases and soft-tissue calcification, is not well understood.
All in all, not a ringing endorsement. Though with enough research interest to trigger a conference in the first place, one presumes the research community is committed to redoubling ongoing efforts. The entire issue demands at least three questions:
- How does one organize the research community to gain a level of satisfaction in the shortest period?
- What is a reasonable time frame for these activities?
- Is there a partial response in the shorter term that would allow experts to at least acknowledge some benefit of supplementation in cases of deficiency, and translate the results into a health-policy change?
The NIH admits that the US Department of Health and Human Services, in collaboration with the US Departments of Agriculture and Defense and Health Canada, is currently in discussions with the Institute of Medicine to revisit the 1997 recommendations. However, the NIH stands by the premise that it is possible to get the currently recommended amounts of vitamin D from diet.
Fundamentally, I'm not sure why industry pressure on vitamin D has been tepid. One would think that supplements companies would champ at the bit for the opportunity to translate emerging science into a positive outcome on human health. The identified health conditions are so incredibly diverse, and from a cost standpoint, the supplement is relatively cheap.
One thing is for certain. The headlines will continue to ring out in support of vitamin D … is anyone out there listening?
Len Monheit is president and editor of NPIcenter. [email protected]
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