The Healthy Librarian's Friday Five: Vitamin D for Babies, Pregnancy, Pelvic Floor Health, and Possible Breast Cancer Prevention. Skip the Caffeinated Coffee and Try Some New Smoothie and Sushi Recipes

"I'm telling every pregnant mother I see to to take 4000 IUs and every nursing mother to take 6,400 IUs of Vitamin D. 

I think it is medical malpractice for obstetricians not to know what the Vitamin D level of their patients is.  This study will put them on notice."

-Dr. Bruce W. Hollis, Professor of Pediatrics and Biochemistry and Molecular Biology, Director of Pediatric Nutritional Sciences at the Medical University of South Carolina in Charleston, SC-

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In December 2009 I wrote about the results of Drs. Bruce Hollis' & Carole Wagner's "practice guideline-changing" research on the importance of Vitamin D in pregnancy.  Click here for the whole story.

Well, the "latest news" is that Dr. Carole Wagner just presented these results to the Pediatric Academic Society's meeting on May 1-4, 2010 in Vancouver, Canada.  The PAS meeting is sponsored by four top pediatric medical societies, so this is an important step in getting the vitamin D/pregnancy news out there.

The Results of Drs. Hollis & Wagner's Vitamin D & Pregnancy Research

• The take-home message is that pregnant women should take 4,000 International Units a day, according to Carol Wagner, MD, of the Medical University of South Carolina in Charleston.
• Women taking the 4000 IUs increased their vitamin D level by about 50%--to a normal level of 40 ng/mL.
  
• Premature births and premature labor were reduced by 50% at both 32 and 37 weeks in those taking the highest levels.
• Fewer babies were born "small for dates"--which means smaller than expected for the time spent in the womb.  This is a little-known pregnancy complication of taking inadequate amounts of vitamin D.
• Women in the 2000 & 4000 IU groups reduced their number of infections throughout pregnancy by 50%: including respiratory infections, like colds and flu, as well as fewer vaginal and periodontal (gum) infections.
• The common complications of pregnancy like gestational diabetes, increased blood pressure, and pre-eclampsia were reduced by 30%.
  
• The babies born to moms getting the highest vitamin D levels had fewer colds and less eczema.
• Vitamin is not really a vitamin--it's a pre-hormone.  Wagner says women who are deficient in vitamin D have a HORMONE deficiency--not a vitamin deficiency.
  
• Hollis & Wagner's study found that this dose--which is significantly higher than the typical prenatal vitamin dose of 400 IUs of vitamin D is completely safe.

Click here to read the report of Wagner's recent PAS meeting presentation.

If you do not see the video of Dr. Wagner's interview, click here.

Adequate Vitamin D Prevents Pelvic Floor Disorders in Women

I sure wish my generation had known about this vitamin D news way back when we were having babies!

So..listen up young moms--not only should you increase your intake of vitamin D for your baby's benefit, but keep on taking it to prevent any of the future pelvic floor issues that childbirth is known bring our way.

According to a study published in the April 2010 issue of Obstetrics and Gynecology 115(4):795-803, "Vitamin D and Pelvic Floor Disorders in Women", higher vitamin D levels are linked to a lower risk of pelvic floor disorders.  About 1 in 4 women are "blessed" with:

• Urinary incontinence
• Pelvic organ prolapse
• Fecal incontinence

According to Dr. Samuel S. Badalian, the lead author, "Because vitamin D receptors are present in human muscle tissue, a direct effect of vitamin D on muscle  physiology is biologically plausible.   Thus, it is not surprising  that vitamin D deficiency has long been clinically associated with impaired muscle strength and loss of mass.

Given that vitamin D insufficiency or deficiency is epidemic among adults, it is plausible that low vitamin D status contributes to the development of poor muscle strength and can lead to different pelvic floor disorders such as urinary/fecal incontinence and POP (pelvic organ prolapse)."

Bottom Line:  Higher vitamin D levels were associated with a decreased risk of any pelvic floor disorder in women 20 years and older.  The strongest association was with urinary incontinence--and it was significantly reduced in women 50 and older with vitamin D levels of 30 ng/mL or higher.  The authors suggest that treating vitamin D insufficiency could improve pelvic muscle strength, and possibly reduce common disorders, such as urinary incontinence.  Poise bladder control products should take note of their new competition!

This article was based on data from the 2005-2006 National Health and Nutrition Examination survey of 3,440 women.  1,881 women fit the study parameters.

Adequate Vitamin D May Cut Breast Cancer Risk

This latest article was published ahead of print on April 14, 2010 in the American Journal of Clinical Nutrition.  "Vitamin D and calcium intakes and breast cancer risk in pre- and postmenopausal women."  Anderson, Laura N. et al.  Thanks to super librarian colleague Mary Pat for emailing this article to me.

Unfortunately, this Canadian study based on 3,101 breast cancer patients and 3,471 healthy controls doesn't provide us with much new information when it comes to vitamin D and breast cancer.  

Here's how the study was set up: the researchers used a one-time questionnaire to collect data on how often participants ate foods that contained vitamin D (like fatty fish or milk), and how often and how long they took vitamin D supplements, multivitamins or calcium supplements.

The results:  "The study results do not support an association between vitamin D or calcium from food or total intake (of vitamin D) and breast cancer risk.  However, vitamin D intakes were relatively low in this study and supplemental vitamin D intakes greater than 400 IU/day were associated with a reduced breast cancer risk.  Based on this study, the authors recommend future studies with higher intakes (Yes!!! Like how about measuring vitamin D blood levels (not supplement intake) and looking at women with levels of 50 ng/mL?-my comment), possibly carried out as a chemoprevention trial."

According to Laura Anderson, one of the authors, "It looks promising for vitamin D."

But don't let this study discourage you.  Consider this.

• One study found considerable cancer risk reduction in post-menopausal women assigned to take 1000 IU/day of vitamin D, although there weren't many breast cancer cases in this particular study. Note: 1000 IUs is still low by today's standards, & will not significantly raise blood levels of vitamin D-my comment.  Am J Clin Nutr 2007:85:1586-91 Lappe, JM et al.
  
•  What about the cancer connection? It seems so far-fetched.  Dr. Hollis has collaborated with Dr. Walter Willett and the Harvard School of Public Health for over 15 years, studying epidemiologic data on the effects of vitamin D on cancer.  These studies have routinely shown that an adequate vitamin D status protects against 13 or 14 different cancers, including breast, prostate, and colon cancer. 

  Hollis is skeptical that vitamin D could treat cancer once you get it--its benefit is in preventing it in the first place--and having adequate levels will lower your risk.  Researchers in Nutrition Reviews project that a vitamin D blood level over 52 ng/mL would reduce breast cancer by 50%, and levels over 34 ng/mL would prevent 50% of the colon cancers.

  Here's how it works: Vitamin D helps control cell growth and that's why we think that it will reduce the risk of many deadly cancers like prostate, breast, and colon by as much as 50 percent.  In its role as a hormone, vitamin D travels all over our body delivering messages to activate genes and control cell growth. 

  If a cell turns cancerous, vitamin D delivers the instructions for that cell to self-destruct. Not enough vitamin D and that cancer cell might keep reproducing.  According to Hollis,  "vitamin D acts as a brake" when it comes to cancer.  It prevents cells from growing wildly out-of-control--and this mechanism has been studied for years.

The Effects of Coffee On Blood Vessel Health and Blood Pressure

Short story: Drinking caffeinated coffee in the morning, on an empty stomach had negative effects on endothelial (the linings of blood vessels) function up to 1 hour after consumption.  Blood pressure (systolic & diastolic) significantly increased, heart rate increased, and blood vessel dilation (known as flow- mediated dilation) significantly decreased by 22%. 

This is not a study I wanted to hear about.  I love my morning coffee, and I'm not very interested in giving it up.  The good news:  The negative effects did not occur with decaf!  Keep the coffee taste--ditch the caffeine. I can live with that.

Dr. Caldwell Esselstyn tipped me off to this just published study in the European Journal of Clinical Nutrition, 64:483-89, 2010 "Acute effects of coffee on endothelial function in healthy subjects,"  Buscemi, S. et al.   Esselstyn doesn't drink coffee, so he was pretty delighted with the study results.

All 17 of the study subjects were perfectly healthy--in case you're wondering.

The subjects who drank decaf coffee actually showed a significant improvement in their blood vessel dilation (good news to me), and the authors speculate that this might be because of coffee's considerable antioxidant content.  Polyphenols present in coffee are know to increase flow-mediated dilation.

But don't despair coffee lovers, even the authors aren't sure if the results of their study will support short or long-term detrimental cardiovascular effects.  And the question still remains: 

Can the antioxidants in coffee overcome caffeine's harmful effects?  Stay tuned.

Smoothie Recipes from Martha Rose Shulman & Vegan Sushi from Mark Bittman

 

For Martha Rose Shulmans' "Smoothies with Substance" Recipes click here

For Mark Bittman's Fantastic How-To-Vegetarian-Sushi-Instructions "For Sushi At Home, Skip the Fish" click here

Wishing you all a wonderful weekend, filled with decaffeinated coffee, lots of vitamin D sunshine, sushi, and smoothies!

Comments

[Chris G.]

Given the results were with regard to coffee on an empty stomach, its leaves open questions regarding the impact of coffee on a full stomach. I'd guess most health conscious folks are not skipping breakfast given the well-known health effects associated with that practice. I'd guess this would somewhat mitigate the effects on blood vessel dilation. In addition to weighing the anti-oxidant effects of coffee, the mental and even physical performance benefits of caffeine are obvious and substantial. In the final analysis, if coffee is my single vice, I'll willing to live with it.

[The Healthy Librarian]

I've got to agree with you, Chris, and I've got my cup of 1/2 French Roast & 1/2 decaf right next to me as I'm typing this. I just love my coffee!

[Chris]

Yes, and I'll third those comments! When I first read the part about coffee I thought "No! Please no! Not my coffee!".

I've given up or reduced a lot of things, but coffee would be really difficult.

I believe coffee has also been shown to be of benefit with regard to dementia and diabetes?

[Michelle]

I have given up meat, poultry, fish and dairy and fats, including vegetable fats, which includes olive oil and canola oil. I am just not ready to give up my morning coffee. I note that the article was about coffee on an empty subject, which I admit to adoring, so I try to eat something not too long after getting up.
I am married. My husband makes the coffee every morning -- nothing very exciting but with caffeine. He says he will not make decaf. I am not ready to buy a small coffee maker and start brewing my own. I will do it when I can talk myself into it, but frankly, I have done a lot to improve my heart. I will not be able to give up coffee right away, though I do respect the research.