Why Americans Suffer From Vitamin D Deficiency? – Part 2

Welcome back to the Sicilian Secret Diet Plan Podcast! If you’re new here, we’re thrilled to have you. If you’re a returning listener, we can’t thank you enough for your continued support. Dr. Sandra Cammarata, a psychiatrist born and raised in Sicily, and Dr. Giovanni Campanile, a seasoned cardiologist, are here to guide you on a journey towards better health and longevity through the Sicilian Mediterranean diet. Their motto? “Be well, deliciously.”

All About Vitamin D

In this special edition of our podcast, we’re kicking off a new series focusing on specific health topics, starting with the sunshine vitamin—vitamin D. As we emerge from winter, many of us find ourselves with a deficiency in this crucial nutrient. Vitamin D, a fat-soluble vitamin, is stored in our liver and fatty tissues. But during the winter months, with less sunlight exposure, our bodies struggle to produce enough of it. Let’s delve into why this vitamin is so essential and how you can ensure you’re getting enough.

The Science of Vitamin D Synthesis

Vitamin D is a bit of a superstar in the world of nutrients. It’s not just a vitamin; it’s a steroid hormone that undergoes a fascinating transformation process in our bodies. When our skin is exposed to ultraviolet light, it converts pre-vitamin D into cholecalciferol. This form then travels to the liver, where it’s transformed into 25-hydroxy vitamin D, the major circulating form. Next, it heads to the kidneys, where it becomes the active steroid hormone known as calcitriol.

When doctors measure your vitamin D levels, they typically measure 25-hydroxy vitamin D. There are five forms of vitamin D, but the primary ones to know are ergocalciferol and cholecalciferol. These are the heavy hitters in the vitamin D world.

Getting Vitamin D from Your Diet

Interestingly, vitamin D is produced mostly by animals, some plants, and fungi. Certain mushrooms, when exposed to sunlight, produce an incredible amount of vitamin D, making sun-dried mushrooms a powerful supplement. Other dietary sources include salmon, cod liver oil, and fortified foods. These vitamins are absorbed by the gut and incorporated into small fat globules called chylomicrons, which then pass into the lymphatic system and finally the blood.

To Supplement or Not to Supplement?

So, should you be taking vitamin D supplements? A 2008 double-blind randomized study involving 68 healthy adults found no difference in vitamin D levels when given either ergocalciferol or cholecalciferol, concluding both were equally effective. However, more recent studies suggest that cholecalciferol might have higher bioactivity.

The frequency of vitamin D administration, as well as factors like age, sex, and ethnicity, play significant roles. Current recommendations lean towards supplementing with cholecalciferol, as it increases the total concentration of 25-hydroxy vitamin D more efficiently.

Why Testing for Vitamin D is Crucial

Given that up to 70% of the US population has some form of vitamin D insufficiency, testing is essential. Adults with deficiency can present with osteomalacia, while children might develop rickets. Certain populations, like dark-skinned individuals, are at higher risk due to greater amounts of melanin in their skin, requiring more sun exposure for vitamin D metabolism.

Modern Lifestyles and Vitamin D Deficiency

Our modern lifestyles contribute significantly to vitamin D deficiency. We spend most of our days indoors, use sunblock, and cover our skin to avoid skin cancer—habits that, unlike those of our hunter-gatherer ancestors, hinder vitamin D synthesis. Other contributing factors include obesity, low education, smoking, diabetes, and chronic conditions like celiac disease or liver and kidney diseases.

Supplementation Recommendations

The Food and Nutrition Board and the National Academies of Science recommend varying levels of vitamin D intake based on age and life stage. Infants need about 400 IU, while adults up to age 70 require about 600 IU. For pregnant and lactating women, the recommendation is higher, at 4,000 IU per day. Regularly measuring vitamin D levels is crucial to ensure optimal intake and avoid toxicity.

Finding the Optimal Vitamin D Level

In my practice, I aim for an optimal vitamin D level of 50-80 ng/mL in my patients. Some people need 1,000 IU per day, while others might require up to 10,000 IU. The best way to determine your needs is through a 25-hydroxy vitamin D test, ensuring you avoid both deficiency and toxicity, which can cause serious symptoms like gastrointestinal and neurological issues.

Vitamin D and Calcium Homeostasis

Vitamin D plays a critical role in calcium absorption and homeostasis. The body maintains circulating calcium levels through a feedback loop involving intestinal absorption, bone release, and renal reclamation and excretion of calcium. The best way to get calcium is through diet. However, older adults often have low vitamin D due to changes in the gut and kidneys, leading to age-related bone loss and conditions like osteoporosis.

Vitamin D and Gut Health

A healthy gut is essential for vitamin D absorption. Conditions like dysbiosis can result in malabsorption of vitamins and minerals, including vitamin D, contributing to osteoporosis and other health issues. Taking vitamin D supplements with vitamin K is recommended, as vitamin K works synergistically with vitamin D to improve calcium homeostasis, keeping calcium in the bones and out of the arteries.

Vitamin D’s Role in Oral Health

Vitamin D also promotes tooth remineralization, reducing the risk of cavities. Taking 1,000 IU of vitamin D per day can protect against tooth decay caused by acidic foods and drinks.

Final Thoughts on Vitamin D

In summary, vitamin D is a powerhouse nutrient that helps fight disease, reduces the risk of multiple sclerosis, decreases high blood pressure, supports immune health, regulates mood, and aids in weight loss. Ensuring you get enough sunlight, regularly measure your vitamin D levels, and avoid toxicity is crucial for optimal health.

Thank you for tuning in and being part of our journey towards better health. Please send us your questions and feedback—we’re here to provide valuable, free information regularly.

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Join us next time for another episode of the Sicilian Secret Diet Plan Podcast. Stay healthy and be well, deliciously!