There is nothing like a little scientific controversy to make a person feel like that guy with two watches. I got a bit mired in the discussion about how much vitamin D people need after we started to take fermented cod liver oil on a semi-regular basis. I wasn’t specifically looking to learn more about Vitamin D, I was pretty convinced about the benefits of cod liver oil, especially in the winter, but starting with a NY Times Well Blog post on the “Hype or Miracle” of vitamin D I found myself trying to figure what our understanding of the vitamin really amounts to.
Americans apparently are showing deficiencies in vitamin D and there are myriad findings for the implications of these deficiencies and apparently just as many ideas about what to do about them. The most common suggestion seems to be upping the RDI and encouraging medical practitioners to give patients who seem to have deficiencies and/or issues that are now being connected to deficiencies high doses of vit. D supplements. The second solution is to increase the vitamin d in the food supply, already vitamin D is put into whole milk and also some orange juice. So this would increase the vitamin D intake of those who consume those foods, whether or not they have deficiencies.
I take issue with both solutions and here’s why. Vitamin D is only found in a few foods, and my inclination is that there is a reason for that. Most of our vitamin D is synthesized through exposure to the sun, and to avoid getting too much of the nutrient steroid hormone the body starts to block the synthesis process when we get too much (hence the darkening of the skin). These two facts seem to say, vitamin d is important but it’s not something to have in excess. That said, clearly our consumption of this nutrient steroid hormone would be in decline since so few of us now have livelihoods that bring us outside and even when we aren’t working, much of our time is spent under roofs. Then, even for those who do go outside there is that pesky dark and cold part of the year that makes it even more difficult. We also consume far fewer vitamin D rich foods, like organ meats, fish, and eggs.
I’m sorry if this seems too obvious, but instead of raising the consumption level of vitamin d to levels that the human body has maybe never experienced we should probably just increase our consumption of naturally vitamin D rich foods as was traditionally done, in the winter and spend some time outdoors when it’s nice out. This follows a very sound and traditional pattern of labor and consumption, meat and indoor activities in the winter, lots of veggies and sun in the spring and summer and fall. Why would supplementation be necessary since we have historically gotten what we need from food and being outside?
I guess it is this kind of controversy that draws me to premise of the research of Dr. Weston Price and the information put out by the Weston A Price foundation. The first question of his research was “is disease inherent?” He saw so much disease in his dental practice- in the mouth and beyond- he was moved to find out if this was just the plight of humanity or an expression of something wrong but preventable. So he looked for people in the world without disease and then looked to find out how they got to be in that lucky state. Dr. Daphne Miller did the same thing in her book. She found people who lacked certain chronic diseases and then looked to their traditions (mostly food traditions, but their lifestyle as a whole as well) to find out how they maintained that level of health. Miller and Price did not isolate a substance and call it a cure, though they did identify powerful foods (raw milk and raw milk products, cod liver oil, nopales, fermented foods, whole fats) that when eaten in their natural/whole state along with the regular traditional diet contributed to remarkable overall health. The research I have come across of sources of vitamin D may discuss co-factors (things the body needs to use something else) but never looks at the whole food. Complexity of a diet, maybe there is more to vitamin D rich foods than just vitamin D?
The lack of attention to traditional foods is a problem in general for health research and specifically the supplement solution this research often leads to, particularly through the food supply- putting substances in other substances where they don’t necessarily belong. (I talked about this before here, and it doesn’t seem beneficial) Maybe, just maybe, the world works the way it does for a reason and there is a good explanation for why milk doesn’t have vitamin d (human or cow). Not to mention orange juice. I think many would agree that our limited understanding of such complex processes might not lead us to the right conclusions and that we need a better point of reference for guiding what we put in our bodies than isolated scientific studies. If you feel like you need a reminder of how little we know about the body, check out the Human Microbiome Project.
I found this article interesting for pointing out the flaws in much of the research supporting increased D supplementation. They also have some useful observations of the role of money and industry in these recommendations, particularly the excitement over increased D fortification by those who produce the supplemented products and the concern that supplementation continues only in their foods so they can maintain that market edge. (A note about this article: the authors of that site have a particular understanding of the role of Vitamin D in the immune system and the relationship with pathogenic bacteria that the they suspect are responsible for chronic disease. Now, their whole theory is currently on the fringe and flies in the face of much research to date about immunity and particularly about vitamin d. But most research dealing with the role of microbes in our body is currently fringe because it is something we know so little about, and most of it flies in the face of what is currently known about such things as human development, physiology, immunity, and nutrition. But it makes sense that if we don’t understand something that makes up 90% of our cells we probably know very little about all that stuff over which that 90% has influence. Again, check out that Human Microbiome Project)
My general conclusion from looking into Vitamin D is that the problems and benefits of the hormone isn’t the hormone per se, but everything the hormone is involved in. And we know very little about all that, so what is our point of reference for understanding what the body needs beyond this limited reductionist view? The Weston A Price foundation can turn people off because the information is often self-referential and can seem too scrupulous or the recommendations too impractical. These are fair assessments for the most part, but what I appreciate about their information is that they use traditional wisdom and foods in their whole form as a guide for what works and why. This practice doesn’t fit in with scientific method, but what if it did? What if, in addition to clinical trials, health researchers had to find out what the role of the substance they are researching was in traditional and healthy populations and then work from their on how to best utilize that substance for modern health issues. Vitamin D researchers might then see the role of the other fat soluble vitamins in balancing out the toxicity potential since they are often found together in foods. There might be better connections made with the role of fat in the diet and cholesterol in the body when looking at how the body makes and uses the hormone D. We might have avoided the low-fat craze if there had been a requirement to take into account fat in the diet of healthy people around the world.
The issue, as always, is that food as medicine in the traditional sense isn’t a very profitable enterprise. If it were, vitamin deficiencies of any kind would force us to look at what worked before the deficiency and to return to that practice. Instead of encouraging the sale of more pills, the National Institute of Health could support funding for outdoor education and workforce requirements for taking lunch breaks and walking/biking to work. Such suggestions may not seem practical, but at least we know they’ve worked for humanity thus far.
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