Healthy Life Newsletter, September 2020
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Dr. Manson of Harvard Medical School and Lead Researcher: “Vitamin D May Be More Important Now than Ever”
(go to link above to follow live links in this article)
“Vitamin D may be even more important now than ever,” says Dr. JoAnn Manson, MD, DrPH, of Harvard Medical School and Brigham and Women’s Hospital. Dr. Manson was the lead researcher and author of the VITAL trial and its resulting publications, which focused on the effects of supplemental vitamin D and omega-3s on specific health outcomes, mainly cancer and cardiovascular health. Now, with the current coronavirus epidemic, she is urging everyone to do what they can to avoid vitamin D deficiency, through sun exposure and supplements, due to emerging and growing evidence that vitamin D status may be related to the risk of developing COVID-19 disease and to its severity.
It is known that vitamin D is important to the immune system , for several different reasons, and that it plays a major role in reducing inflammation and regulating cytokine storm events such as those resulting from COVID-19. Additional studies involving cell cultures have documented vitamin D’s effect on respiratory cell function, and there is much existing evidence that patients with respiratory infections tend to have lower vitamin D levels.
Due to the evidence of the association between vitamin D deficiency and COVID-19 disease and severity, all are encouraged to help reduce their risk of vitamin D deficiency by getting regular outdoor sunshine exposure in order to make vitamin D in the skin - as always, be sure not to burn. Also, being physically active while outdoors may boost overall health, and can be done while maintaining social distancing.
Dr. Manson is planning a randomized clinical trial of vitamin D supplementation on reducing the risk and severity of COVID-19. In the meantime, she encourages the use of measures to reduce your risk of vitamin D deficiency, including considering a vitamin D supplement.
(Go to link above for more detail and links to research)
The Immune System Relies on Vitamin D for Optimal Function
Vitamin D has many roles within immune system function. Without a certain amount of vitamin D available, different parts of the immune reaction will be hindered. Several studies have emerged during the COVID-19 pandemic showing a significant association between low vitamin D levels and an increased risk of COVID-19 infection and severity. We recently reviewed a study by Maghbooli et al that found much better outcomes among individuals with vitamin D levels over 30 ng/ml (75 nmol/L). The data was further analyzed based on vitamin D levels of at least 40 ng/ml, and while there were not enough patients for a full analysis based on this classification, they found that of those over 40 years old with vitamin D blood levels less than 30 ng/ml, 20% died from COVID-19, whereas those with levels of at least 30 ng/ml, 9.7% died, and those with levels of at least 40 ng/ml, only 6.3% died.
Findings from a Population Study in Israel
Merzon et al. examined data from individuals in Israel who were tested for COVID-19 infection between February 1st and April 30th of 2020 to see if there was an association between low vitamin D levels and the risk of COVID-19 infection and hospitalization. Out of 7,807 individuals with data on vitamin D levels and COVID status, a total of 782 tested positive for COVID-19 and 7,025 tested negative.
The data showed an almost 60% increased risk in COVID-19 infection for individuals whose vitamin D level was below 30 ng/ml (75 nmol/L) compared to individuals whose vitamin D level was 30 ng/ml or higher. The analysis also found that among the COVID-19 positive individuals, there was an almost doubled risk of hospitalization for those whose vitamin D levels were below 30 ng/ml .
(Note from Dr. Mha Atma: You need a blood test to know your vitamin D status. This is important. It’s a standard test that you can ask your doctor to run, or you can get do-it-yourself testing kits by enrolling in an ongoing vitamin D study at daction.grassrootshealth.net.)
Lose the Weight, Lose the Migraines
Migraine headaches and obesity - not a pleasant combination, from both a health and daily living perspective. Both conditions can be debilitating, limiting sufferers’ ability to function and enjoy the activities that, to put it bluntly, make life worth living.
But what if addressing one condition could address the other at the same time? Such appears to be the case, according to research. In an analysis of 10 studies involving nearly 500 total patients, weight loss was associated with significant reductions in headache frequency (number of days per month), duration, pain intensity and disability. Original weight (severity of obesity) and weight loss achieved during the study period did not appear to impact the results. In other words, lose weight, lose migraines!
The American Migraine Foundation emphasizes the connection between weight and migraines on its website: “The risk of migraine increases with increasing obesity status – from normal weight to overweight to obese. In addition, obesity increases the risk of someone with an episodic pattern of headaches transforming to a chronic pattern.” With that said and in light of the above research, ensuring your weight is in the healthy range should be your #1 health priority if you’re experiencing migraines. Plus, you’ll enjoy the myriad other benefits sustained weight loss can facilitate in terms of reduced disease risk. And in the era of COVID-19, don’t forget that obesity is recognized as a key risk factor for complications. If you need help with weight loss, migraines or both, talk to your doctor for more information.
Don’t Sabotage Your Aerobic Fitness
All that aerobic exercise you used to be doing at the gym – and hopefully have been doing outdoors or at home since COVID-19 restrictions took effect – may not be yielding the benefit it should if your diet is still in the dumps.
In fact, a diet that features too many refined carbohydrates, sugars and other high glycemic index foods (all of which keep your blood glucose levels high) can actually sabotage your aerobic program.
Here’s how: Increased blood sugar levels (“hyperglycemia”) may decrease the benefits of aerobic exercise, suggests new research. Published in Nature Metabolism, the study found that when young adult volunteers ingested glucose (sugar), participants who displayed impaired glucose tolerance (a condition reflected by higher blood sugar levels) also had the lowest aerobic exercise capacity. In other words, even when performing aerobic exercise, they were unable to increase their exercise capacity compared to young adults with lower blood sugar levels. The researchers suggest this may have occurred because participants’ muscles did not adapt to aerobic activity as they normally would.
It’s often said that a sound diet and consistent exercise go hand in hand, and this study proves it. If you want to get the most out of your aerobic exercise, don’t sabotage it by eating poorly. Learn how to keep your blood sugar in the safe range (which won’t just benefit your aerobic exercise efforts, but will also reduce your risk of type 2 diabetes and other health issues).
Too Much TV Is Bad News for Your Lungs?
You’ve probably heard that too much time spent watching television can contribute to obesity, and that too much time spent anywhere without moving (for example, on a plane) can elevate the risk of a blot clot – but what about too much television time leading to a potentially fatal blot clot in the lungs? That’s the suggestion emerging from a recent study that tracked 85,000 adults (ages 40-79) for 19 years to determine how overall daily television time influenced the development of a pulmonary embolism.
According to study findings, adults who reported watching five or more hours of TV a day were 2.5 times more likely to die of a clot compared to adults who reporting watching two-and-a-half hours or less of television daily.
The study authors suggest several ways to reduce the risk of a blood clot, one of which sounds distinctly healthier than the other: Get up from the couch periodically to stretch your legs / body; or reduce the amount of time you spend watching TV, which presumably will give you more time to spend in more active, blood-clot-inhibiting pursuits. We’ll go with the latter and encourage you to watch less TV and use the time for health-promoting physical activity.
Children and Sleep
Sleep plays a critical role in our physical and psychological health, but not enough people understand its importance – and even fewer take steps to maximize its benefits. Lost sleep, poor sleep, disrupted sleep, inadequate sleep; we’re in the throes of a sleep pandemic that’s only been made worse by COVID-19.
Adults aren’t the only ones suffering the consequences of poor sleep; the younger population can experience academic and psychosocial issues, according to a study conducted by researchers at Children’s Hospital of Philadelphia and published in the Journal of Child Psychology and Psychiatry.
The researchers identified five general patterns of sleep among more than 5,000 children tracked at various points from birth through 10-11 years of age: persistent sleep problems through middle childhood (7.7 percent), limited infant / preschool sleep problems (9.0 percent), increased middle childhood sleep problems (17.0 percent), mild sleep problems over time (14.4 percent) and no sleep problems (51.9 percent).
Compared with children who experienced no sleep issues, children with persistent sleep issues through middle childhood experienced the most challenges with academic performance and psychosocial development (self-control and emotional / behavioral health). Even children categorized into one of the lower levels of sleep problems still experienced some degree of psychosocial impairment and reduced quality of life (as reported by caregivers), although not to the extent as children with persistent sleep issues.
Sleep matters, no matter your age, but developing healthy habits when we’re young plants the seeds for a lifetime of health and wellness. To ensure your child gets a good night’s sleep – particularly in the age of COVID-19, cellphones and social media, see these tips from Stanford Children’s Health and talk to your doctor.
The Power of Curcumin (Turmeric): Good for Body and Mind
By Dr. Ajay Goel
For overall well-being, curcumin from turmeric (Curcuma longa) may be one of the best natural medicines available. This one compound eases pain, reduces systemic inflammation, stops free-radical damage, alleviates depression, and protects cellular processes throughout the body.
No doubt that treatment in the past with curcumin has been challenging. Curcuminoids can be difficult for the body to absorb. Outside of a daily regimen of dietary curcumin from an early age, it can be especially tough for anyone who may have consumed a standard American diet over their lifetime to get therapeutic benefits from plain turmeric extracts or even standardized 95 percent curcumin extracts.
That is why some important research has focused on a clinically studied curcumin that is blended with turmeric essential oil (also a source of ar-turmerone). This crucial difference helps it absorb more efficiently and remain in the bloodstream at meaningful levels for a longer period than standard extracts, making it a viable option for many conditions, including rheumatoid arthritis and osteoarthritis.
Let’s Look at the Research
One study using this curcumin blended with turmeric essential oil followed 45 individuals with rheumatoid arthritis, randomized to three groups. Group one received diclofenac sodium, 50 mg, twice daily; group two received 500 mg of the curcumin, twice daily; and group three received both diclofenac sodium and the curcumin.
Curcumin was more effective than diclofenac sodium at reducing joint pain and swelling. Combining it with the drug was no more effective than using the botanical alone, and taking the drug alone was less effective.
Read the rest of this article and see references.
(Note from Dr. Mha Atma: When turmeric is combined with a small amount of black pepper and with olive or coconut oil, absorption and utilization go way up. For a recipe go to drmhaatma.com)
Rest Easy: 5 Ways to Get Better Sleep Tonight
It’s one thing to fall asleep; it’s another to stay asleep all night and even another to enjoy a full night of peaceful, restorative sleep that gives your body and mind an appropriate setting to repair, recharge and renew.
Too many Americans don’t get enough sleep and when they do, it’s often interrupted or punctuated by constant tossing and turning. That’s bad news from a health perspective, both in the short and long term. According to the Division of Sleep Medicine at Harvard Medical School, “a lack of adequate sleep can affect judgment, mood, ability to learn and retain information, and may increase the risk of serious accidents and injury. In the long term, chronic sleep deprivation may lead to a host of health problems including obesity, diabetes, cardiovascular disease, and even early mortality [death].”
Suffice it to say that sleep is a big deal, which makes ensuring you get enough sleep of prime importance. Here are five ways you can get better sleep tonight and every night thereafter:
\1. Wind down: Transition from your busy, hectic day at least an hour before bed so you’re not up half the night. Stress and sleep are bad partners, to say the least, so your pre-sleep routine should emphasize calmness and relaxation. Take a bath or shower, listen to soft music or meditate – whatever it takes for you to leave your stress-filled day behind you (at least until morning).
\2. Exercise early: Physical activity has plentiful health benefits, but if you work out before bed, it can make sleep difficult. On the other hand, exercising first thing in the morning will make sleeping at night easier because your body will be fatigued after a long day. Exercising right before bed can leave you amped up, sore and/or unable to settle in for a long, relaxing night’s rest.
\3. Shut the fridge: Put police tape around the fridge after dinner and you’ll likely get better sleep because your inability to pursue late-night eating (cheating) will let your body relax and doze off. The premise is simple, if you think about it: The body is a factory, processing and burning food all day. If the factory doesn’t close for the evening, it keeps on processing – and you stay awake while it does. Try eating a cheeseburger and fries an hour before bed; your eyes may feel sleepy, but your stomach will stay wide awake – and so will you.
\4. Timing is everything: Ever heard of a circadian rhythm? As sleep goes, it’s our body’s internal “clock” and it runs on a 24-hour schedule. To maximize restorative sleep, regulate your internal clock by going to sleep and waking up at around the same time every night and morning, respectively. It might be difficult to go to sleep on a regular schedule because of various factors, but you can usually control when you wake up – it’s just a matter of willing yourself out of bed.
\5. Don’t push it: One of the worst habits of chronically poor sleepers is the tendency to push it; to stay up longer than the body is willing. Sometimes that’s unavoidable, but too often Americans spend hour after late-night hour glued to the television (or these days, the computer), fighting off sleep and suffering the consequences. When the body says rest, listen and go to bed. You’ll be thankful you did.
How Much Vitamin D? Don’t Stop at the RDA
By David Seaman, DC, MS, DABCN
Vitamin D deficiency officially emerged as an important risk factor for chronic disease in the early 2000s. This finding was a product of scientific research, rather than a consensus statement from a health policy group or government organization. It was not until around 2010 that the Institute of Medicine (IOM) of the National Academies of Sciences, Engineering and Medicine came out with an updated official statement about vitamin D needs.1 The IOM [now known as the National Academy of Medicine] is actually a private entity that advises the U.S. government. The IOM set the estimated requirement at 400 IU/day for all age groups and set the upper-level intake at 4,000 IU/day for anyone age 9 or older.
What’s the Basis for the RDA?
This IOM report was met with harsh criticism from vitamin D researchers, none of whom was invited to participate in process that led to the recommendations. For example, Drs. R.P. Heaney and M.F. Holick stated:2
The IOM recommendations for vitamin D fail in a major way on logic, on science, and on effective public guidance. … We have deliberately avoided a mind-numbing laundry list of the vast number of factual inaccuracies and misinterpretations of the report. … For now, our recommendation to the American public is that the IOM report should be taken with a grain of salt (another nutrient the IOM finds risky).
In short, by following the IOM guidelines, many people will still not achieve adequate vitamin D levels [measured as 25(OH)D], which most labs set at 30-100 ng/mL. Some vitamin D researchers argue that 40 ng/mL should be considered the low end of normal, likely because many people do not achieve the bone protection effect of vitamin D until this level is achieved.2 My personal impression is that we should try to maintain a 25(OH)D level of at least 70 ng/mL.3
Adequate Levels, Toxicity and Other Considerations
To achieve adequate vitamin D levels, we must either get adequate sun exposure or take a vitamin D3 supplement. Unnecessary fear often enters a person’s mind when they consider how much supplemental vitamin D3 is safe. Dr. Heaney, whom I mentioned above, has explained that 10,000 IU/day should be the safe upper limit.4 I realize 10,000 may see like a lot, but that is because we typically think of supplementation in milligram (mg) or gram (g) amounts.
With this in mind, it should be understood that 40,000 IU of vitamin D3 is just 1 mg. In other words, 10,000 IU is just .25 mg or 250 mcg.
The IOM’s report states that “very high levels of vitamin D (above 10,000 IUs per day) are known to cause kidney and tissue damage.” In contrast, the DRI [Dietary Reference Intakes] book published by the IOM5 says 10,000-40,000 IU per day is the threshold for toxicity.
It is important to understand that vitamin D toxicity cannot be determined based on how much vitamin D3 is taken on a daily basis; it is correlated to serum 25(OH)D levels. The IOM’s DRI book for vitamin D and calcium states that vitamin D toxicity is not identified until serum 25(OH)D reaches 200-240 ng/mL or higher. Based on this, you can see why it is foolish to worry about the supplemental dose of vitamin D3. Even worse, it is especially problematic that the IOM would suggest taking 10,000 IU/day causes kidney and tissue damage.
The, dare I say, sole focus related to vitamin D supplementation should be one’s 25(OH)D level. The minimum goal should be to reach at least 40 ng/mL, all the while knowing 100 ng/mL is within the normal range and signs of toxicity will not typically appear until at least 200 ng/mL is exceeded.
This means there should be zero emotion about taking vitamin D3 supplements. If you have normal serum 25(OH)D because you are in the sun a lot, then there is no need to supplement. Otherwise, your supplemental level should be tailored to keep your 25(OH)D at 40 ng/mL higher. This is why the RDA or RDI fails: for vitamin D, it is not about your intake, it is about achieving a proper 25(OH)D level.
Why Vitamin D Matters: A Profound Micronutrient
Here is why you should care about your 25(OH)D level. Vitamin D is involved in the modulation of more than 1,000 different genes. In particular, vitamin D modulates immune cell expression. A deficiency in vitamin D leads to an overproduction of pro-inflammatory Th1 cells and an underproduction of anti-inflammatory Th2 and T-regulatory cells. The outcome is an overproduction of pro-inflammatory cytokines, such as IL-1, IL-6 and tumor necrosis factor; and an underproduction of IL-10, which is a key anti-inflammatory cytokine.3
The same shift to overproduce pro-inflammatory cytokines occurs when one lacks magnesium and omega-3 fatty acids. Obesity also leads to the same state of chronic inflammation. This should alert you to the reason why just supplementing with vitamin D to achieve normal levels may not relieve patients from pain, depression and other pro-inflammatory conditions.3
Studies that report about the ineffectiveness of vitamin D do not comment on the other nutritional factors that promote the same state of chronic inflammation as vitamin D deficiency.
My suggestion is to normalize the many pro-inflammatory markers that are easy to measure, of which vitamin D is just one. Lipids, glucose, body mass index and waist:hip ratio are other examples to take into account.3,6
References
Dietary Reference Intakes for Calcium and Vitamin D. Institute of Medicine of the National Academies, Brief Report, November 2010.
Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res, 2011;26:452-54.
Seaman DR. The DeFlame Diet: DeFlame Your Diet, Body, and Mind. Wilmington, NC: Shadow Panther Press, 2016: p.p. 213-218.
Hathcock JN, Shao A, Vieth R, Heaney RP. Risk assessment for vitamin D. Am J Clin Nutr, 2007;85(1):6-18.
DRI Dietary Reference Intakes: Calcium and Vitamin D. Institute of Medicine of the National Academies. Washington, D.C.: National Academies Press, 2011.
Seaman DR. Body mass index and musculoskeletal pain: is there a connection? Chiro Man Ther. 2013;21:15