Women on HRT Helped by Extra Calcium, Vitamin D?

Study found hip fracture rate was 57 percent lower in those also taking supplements

By Serena Gordon

HealthDay Reporter

WEDNESDAY, June 26 (HealthDay News) -- Although there has been significant debate about whether calcium and vitamin D supplements are beneficial for older women, new research suggests that the answer may be yes for those who are taking hormone replacement therapy.

Women using HRT who also took daily supplements of calcium and vitamin D saw a 40 percent reduction in their rate of hip fractures compared to women who took placebo supplements, according to the study.

"We found that women who were on hormones had less hip fractures, and women who were on hormones and calcium and vitamin D supplements had even fewer hip fractures," said study author Dr. John Robbins, a professor of medicine at the University of California at Davis.

Results of the study were published online June 26 in the journal Menopause.

As many as half of all women over 50 will have an osteoporosis-related fracture in their lifetime, according to the U.S. Preventive Services Task Force (USPSTF). Osteoporosis is a condition caused by a loss of bone mass and density, which leaves bones fragile and more susceptible to fractures. Calcium is an important component in bone growth, and vitamin D helps the body absorb calcium.

What's not clear is if supplements of these nutrients are as helpful in keeping bones strong as they are from natural sources, such as diet. The USPSTF recently looked at the effect of 1,000 milligrams of daily calcium and 400 international units of vitamin D. In February, they concluded that women shouldn't take calcium and vitamin D supplements because the available evidence wasn't strong enough to show a significant benefit. They added that the benefits of higher doses are unknown.

The new study included data from the Women's Health Study on about 30,000 postmenopausal women between the ages of 50 and 79. Many of the women were taking hormone replacement therapy -- either estrogen alone or a combination of estrogen and progesterone.

Just over 16,000 women participated in the calcium and vitamin D portion of the study. They were randomly selected to receive either a placebo or 1,000 milligrams of calcium and 400 international units of vitamin D each day. The average follow-up time was about seven years.

The hormone therapy and the supplements together were the most effective treatment for reducing hip fracture risk. The researchers found that the combination reduced the risk of hip fracture by 57 percent.

Overall, the rate of hip fracture was 11 per 10,000 women per year for those who took both hormones and supplements. Women who took only hormones had a hip fracture rate of 18 per 10,000, while those who took only supplements had a hip fracture rate of 25 per 10,000. Women who received neither therapy had 22 hip fractures per 10,000 women.

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Multiple Sclerosis and Diet: Vitamin D, Swank and Wahls Diets, and More

SOURCES:

Ellen Mowry, MD, assistant professor, department of neurology, Johns Hopkins University, Baltimore.

National MS Society: "Nutrition and Diet."

Allen C. Bowling, MD, PhD, medical director, Multiple Sclerosis Service, Colorado Neurological Institute; clinical associate professor of neurology, University of Colorado-Denver and Health Sciences Center; author, Complementary and Alternative Medicine and Multiple Sclerosis; co-author, The Everything Health Guide to Multiple Sclerosis.

Yale News: "Yale Researchers Identify Salt as a Trigger of Autoimmune Diseases."

Jagannath, V. Cochrane Database of Systematic Reviews, 2010.

Terry Wahls, MD: "Eating the Wahls Way."

National Multiple Sclerosis Society: "Vitamins, Minerals, & Herbs in MS: An Introduction."

Multiple Sclerosis Foundation: "Multiple Sclerosis FAQs."

Wergeland, S. Acta Neurologica Scandinavica, 2012.

Swank MS Foundation: "About the Swank Low-Fat Diet for the Treatment of MS."

National Multiple Sclerosis Society: "The Omega-3 Factor."

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Vitamin D Supplements Tied to Lower Blood Pressure in Blacks

Study found modest, but significant, drops depending on dosage

By Steven Reinberg

HealthDay Reporter

FRIDAY, March 15 (HealthDay News) -- Black Americans who take vitamin D supplements may significantly lower their blood pressure, a new study suggests.

"Compared with other races, blacks in the United States are more likely to have vitamin D deficiency and more likely to have high blood pressure," said lead researcher Dr. John Forman, an assistant professor of medicine at the renal division of Brigham and Women's Hospital in Boston.

But among the black study participants, three months of supplemental vitamin D was associated with a drop in systolic blood pressure (the top number in a blood pressure reading) of up to 4 mm Hg, the researchers found.

"If our findings are confirmed by other studies, then vitamin D supplementation may be a useful means of helping black individuals lower their blood pressure," Forman said.

Dr. Michael Holick, a professor of medicine, physiology and biophysics at Boston University School of Medicine, said that vitamin D may lower blood pressure by causing blood vessels to relax, allowing for more and easier blood flow.

In addition, because many black Americans are deficient in vitamin D, taking a supplement may benefit their health even more, said Holick, who was not involved with the study.

"We are now beginning to believe that a lot of the health disparities between blacks and whites are due to vitamin D deficiency, including the risk for type 2 diabetes, heart disease, cancers and even infectious disease," he said.

Diet and sunlight are two natural sources of vitamin D in humans. However, having dark-colored skin cuts down on the amount of vitamin D the skin makes, according to the U.S. National Institutes of Health.

For the study, published online March 13 and in the April print issue of the journal Hypertension, Forman's team randomly assigned 250 black participants to one of three doses of vitamin D supplements or an inactive placebo.

After three months, the researchers found that those taking 1,000 international units (IU) of vitamin D a day saw their systolic blood pressure drop by 0.7 mm Hg. For those taking 2,000 IU, the drop was 3.4 mm Hg, and for those taking 4,000 IU, systolic pressure dropped by 4 mm Hg.

In contrast, those receiving the placebo saw their systolic blood pressure rise by 1.7 mm Hg, the researchers noted.

Forman said the gains from supplemental vitamin D were significant, but modest. In addition, there were no changes in diastolic blood pressure among those in any group.

Systolic blood pressure is pressure in the arteries when the heart beats. Diastolic blood pressure, the bottom number, is pressure in the arteries between heart beats, the study authors pointed out.

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Extra Vitamin D May Ease Crohn's Symptoms, Study Finds

Improvements reported in muscle strength, fatigue and quality of life

By Kathleen Doheny

HealthDay Reporter

SATURDAY, May 18 (HealthDay News) -- Vitamin D supplements may help those with Crohn's disease overcome the fatigue and decreased muscle strength associated with the inflammatory bowel disease, according to new research.

Extra vitamin D "was associated with significantly less physical, emotional and general fatigue, greater quality of life and the ability to perform activities of daily living," said Tara Raftery, a research dietitian and doctoral candidate at Trinity College Dublin. She is scheduled to present the findings Saturday at the Digestive Disease Week meeting in Orlando, Fla.

Raftery and her colleagues evaluated 27 patients who had Crohn's in remission. (Even in remission, fatigue and quality of life can be problematic.) The patients were assigned to take either 2,000 IUs (international units) of vitamin D a day or a dummy vitamin for three months.

Before and after the study, the researchers measured hand-grip strength, fatigue, quality of life and blood levels of vitamin D.

"Hand-grip strength is a proxy measure of muscle function," Raftery said. "Muscle function has been known to be reduced in Crohn's disease."

Besides boosting bone growth and remodeling, vitamin D is thought to improve neuromuscular and immune function, reduce inflammation and help with other bodily tasks. Children and adults aged 1 year to 70 are advised to get 600 IUs a day; older adults, 800, according to the U.S. National Institutes of Health (NIH).

Vitamin D is found in fatty fish such as salmon, in smaller amounts in cheese, egg yolks and beef liver, and in fortified foods such as milk.

Sometimes called the sunshine vitamin, vitamin D is also produced when the sun's rays strike the skin.

Crohn's can affect any part of the gastrointestinal tract, but most commonly affects the end of the small bowel and the beginning of the colon. Symptoms vary, but may include persistent diarrhea, rectal bleeding, abdominal cramps, and pain and constipation. About 700,000 Americans are affected, according to the Crohn's & Colitis Foundation of America.

Its cause is not well understood, but Crohn's is thought to involve heredity and environmental factors. Experts believe that in those with Crohn's, the immune system attacks harmless intestinal bacteria, triggering chronic inflammation and, eventually, the disease symptoms.

The daily vitamin D supplement benefitted participants in many ways, Raftery found. "When levels of vitamin D peaked at 30 ng/mL (75 nmol/L) or more [a level considered healthy], muscle function in both the dominant and non-dominant hands were significantly higher than in those who had levels less than 30 ng/mL," she said.

Quality of life improved more for the D-supplement group, too. Using a standard measure to evaluate quality of life, the researchers found those who achieved a healthy blood level of the vitamin scored 24 points higher than those not on supplements. A 20-point difference is considered meaningful from a "real-world" perspective, Raftery said.

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Do Vitamin Supplements Make Sense?

Feb. 27, 2013 -- For years, women have been told to take extra calcium to guard against osteoporosis.

But doctors just reversed that advice. After looking at scores of studies, the U.S. Preventive Services Task Force (USPSTF) says that common doses of calcium and vitamin D don’t prevent fractures in women past menopause who have healthy bones, and they may raise the risk of kidney stones.

That recommendation comes on the heels of two new studies showing that men and women with high calcium levels from supplements were more likely to die of heart disease than those who got less calcium or who got their calcium from diet alone.

Calcium is just the latest supplement to falter under scientific scrutiny. Other studies have questioned the value of fish oil, and antioxidants like vitamins C, E, and beta-carotene.

Does that mean you should ditch your daily calcium pill? What about other kinds of supplements?

Experts on both sides of the debate say that despite discouraging headlines, it’s still smart for some people to take supplements, depending on their individual nutritional needs.

“I think scientists are still trying to make sense of it all, particularly the latest calcium studies. In many cases the risks don’t appear to apply to all people,” says Carol Haggans, a registered dietitian who keeps up with the latest research for the Office of Dietary Supplements at the National Institutes of Health.

Duffy MacKay, ND, cautions that nutrition research is complex and still “in its infancy.” He is vice president of scientific and regulatory affairs at the Council for Responsible Nutrition, a group that promotes supplements. 

Haggans says people should get two messages loud and clear:

Whole foods nearly always top pills. “We need certain amounts of these vitamins and minerals, and it’s preferable to get them from eating a variety of healthy foods. That really should be the basis of what people are trying to do,” she says.More is not better. “When you’re starting to take individual supplements or higher doses, that’s when you can potentially get into trouble,” she says.

Here’s what science says about several other popular supplements:

Women planning a pregnancy need at least 400 micrograms of folic acid from fortified foods or supplements each day, according to the National Institute of Medicine. Folic acid has been shown to prevent serious birth defects of the spine and brain. It may also cut a child’s chances of developing autism.

A recent study in the Journal of the American Medical Association found that women who started taking folic acid at least a month before their pregnancy and for eight weeks after conception had a 40% lower risk of having a child with autism than women who didn’t take folic acid.

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Vitamin D Supplements: Is What You See What You Get?

Title: Vitamin D Supplements: Is What You See What You Get?
Category: Health News
Created: 2/11/2013 4:36:00 PM
Last Editorial Review: 2/12/2013 12:00:00 AM

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Vitamin D Supplements: Is What You See What You Get?

By Denise Mann

HealthDay Reporter

MONDAY, Feb. 11 (HealthDay News) -- Many vitamin D supplements may not contain what their label says they do, a new study warns.

Some pills may pack a lot more vitamin D than the label states, and others may provide markedly less, according to the findings, published in a research letter Feb. 11 in JAMA Internal Medicine.

The researchers are more concerned by pills delivering too little of the vitamin than pills providing too much.

"It can be hard to overdose on vitamin D," said study author Dr. Erin LeBlanc, an endocrinologist and researcher with the Kaiser Permanente Center for Health Research in Portland, Ore. However, the findings "may be a concern for those who have been told by their doctor to take vitamin D if their chosen supplement does not have the amount listed."

Vitamin D is known as the sunshine vitamin because it is produced in response to exposure to natural sunlight. This nutrient is also added to milk and other foods, and is available in small amounts in fatty fish, beef liver, cheese, and egg yolks. Still, it can be challenging to get as much D as needed through diet, so supplements are often recommended. Some researchers have linked vitamin D deficiency to the bone disease osteoporosis, heart disease and some types of cancer.

Exactly how much vitamin D people need has been somewhat controversial in recent years. The independent, not-for-profit Institute of Medicine recommends 600 international units (IU) a day for teens and adults, or 800 IU for those older than 70. Some groups feel that this bar was set too low.

In the new study, researchers analyzed 55 over-the-counter bottles of vitamin D supplements from 12 manufacturers. They also tested vitamin D pills made at a compounding pharmacy, which creates individualized drugs. The manufacturers were unidentified.

Overall, the amount of vitamin D found in the supplements ranged from 9 percent to 146 percent of what was listed on the label.

When LeBlanc and colleagues tested five pills from the same bottle, the supplements had anywhere from 52 percent to 135 percent of the stated amounts. When five pills were averaged, however, two-thirds were within the stated range.

Although the vitamin supplement industry remains largely unregulated, some manufacturers volunteer to have the quality of their supplements tested by the independent, not-for-profit U.S. Pharmacopeial Convention (USP), which sets standards for supplements.

One of the study samples had USP verification. "Generally, the pills that were from this manufacturer were more accurate," LeBlanc said.

Supplements from compounding pharmacies were the least accurate, LeBlanc said.

Duffy MacKay, vice president of scientific and regulatory affairs at the Council for Responsible Nutrition in Washington D.C., a trade group representing supplement manufacturers and ingredient suppliers, said that there is no excuse for supplements to deviate from their labels. Still, he said, "I am comforted that there are no safety concerns."

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Low Vitamin D More Common in Overweight Kids

By Rita Rubin
WebMD Health News

Dec. 24, 2012 -- Overweight and obese children and teens are more likely to have low vitamin D levels than kids with healthy weights, a new study suggests.

The study is published in Pediatrics.

Vitamin D is essential for bone health. Bone growth is high during childhood and adolescence. So it may be especially important to identify and treat vitamin D deficiency during that time, the researchers write.

Vitamin D deficiency is also linked to a variety of chronic conditions, such as:

High blood pressureType 1 diabetesMultiple sclerosis

 Previous research suggests that obesity may put you at risk for vitamin D deficiency.

Researchers in the study analyzed data from more than 12,000 U.S. children and teens aged 6 to 18. The children were enrolled in the 2003-2006 National Health and Nutrition Examination Survey.

About 21% of the healthy-weight youngsters were deficient in vitamin D. That was also true for 29% of those who were overweight, 34% of those who were obese, and 49% of those who were severely obese.

Even after accounting for such factors as vitamin D supplementation and intake of milk, which is typically fortified with vitamin D, the rates of vitamin D deficiency were higher in Latinos and African-Americans. Among the severely obese youngsters, 27% of whites, 52% of Latinos, and 87% of African-Americans were deficient in vitamin D.

"The particularly high prevalence in severely obese and minority children suggests that targeted screening and treatment guidance is needed," the researchers conclude.

Researcher Christy Turer, MD, a pediatrician at the University of Texas Southwestern Medical Center and Children's Medical Center in Dallas, says she and her colleagues already were routinely checking vitamin D levels in children at specialty clinics, such as weight management clinics. Those found to be deficient are prescribed high-dose vitamin D supplements, a pill taken weekly. After eight weeks of treatment, their levels are rechecked, and if they're near normal, she'll cut them back to monthly doses of vitamin D supplements.

Turer also recommends that vitamin-D-deficient patients drink low-fat milk. If they don't like to drink plain milk, she says they can add artificially sweetened flavors that add only 15 calories a serving.

"The reason that milk is important is it has not just vitamin D, but it has calcium," she says. Unsweetened soy milk and almond milk are also good sources of vitamin D and calcium, Turer says.

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Vitamin Drinks for Beautiful Skin – Do They Work?

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Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Healthy Beauty Healthy Beauty Feature Stories Email a FriendPrint Article Healthy Beauty Tools & ResourcesNatural Help for Dry Hair Love Your Lashes and Brows What Can Cosmetic Dentistry Do?9 Tips for Fresher BreathTake a Tour of Gorgeous Hair Know How to Get Great Nails? The Truth About Beauty Beverages Do certain drinks deliver beauty benefits -- or is that wishful thinking? Experts weigh in. Font Size A A A ByLiesa Goins
WebMD Feature Reviewed byEmmy M. Graber, MD

"Beauty beverages" have flooded the market in recent years, promising to transform humble water into a powerful anti-aging, skin perfecting potion.

According to market research firm Mintel, nearly 300 new food and drink products with "functional beauty benefits" launched in 2008, about double the number in 2007. Products like Borba, Glowelle, Crystal Light Skin Essentials, BeautyScoop, and Noah's Naturals Anti-Aging Beauty Elixir all claim to improve appearance and fight the signs of time on your skin.

But can what you drink really make a difference in how you look?

What Are Beauty Beverages?

"Just as beauty is in the eye of the beholder, a beauty drink is in the perspective of the consumer," says New York nutritionist Keri Glassman, MS, RD, CDN.

"Drinks with beauty benefits usually contain vitamins, amino acids, or botanicals that possess antioxidant activities," says New York dermatologist Francesca Fusco, MD. "A person should usually get enough of these nutrients through diet. But drinking them is a reasonable way to supplement."

How Well Do They Work?

There are nutrients that can improve skin health, but the jury is out on how effective a beauty beverage can be at shuttling this nutrition straight to your skin.

Ideally, everyone would eat a healthy diet packed with fruits and vegetables, lean protein, good fats, and whole grains, says Los Angeles dermatologist Howard Murad, MD, who sells supplements as part of his skincare line. He sees supplements as a good back-up plan.

"I have tried to put adequate amounts of supplements in drinks, but they aren't palatable at the levels required to see benefits," Murad says. "Plus, to make a supplement drinkable, you need to add preservatives, emulsifiers, and sweeteners -- things that aren't ideal to ingest."

The makers of beauty drinks say that sometimes eating well isn't enough. "Even people who eat a healthy diet have problems with their skin, hair, and nails," says plastic surgeon Michelle Yagoda, MD, creator of BeautyScoop. "So absorption can be a problem and liquids tend to be more bio-available to your body."

"A drinkable supplement can be an effective way to treat skin because it can contain vitamins that are more bio-available and easier for the body to absorb," says Scott-Vincent Borba, founder and CEO of the skin product company Borba.

However, experts such as New York dermatologist Neal Schultz, MD, disagree. "Certain nutrients do help the skin, but that doesn't mean putting them in a drink will have the same effect as eating a well-balanced diet," Schultz says. "The body is too smart for that.

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