The Vitamin D Newsletter June 2009
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Pregnancy and Gestational Vitamin D Deficiency In the last 3 years, an increasing amount of research suggests that some of the damage done by Vitamin D deficiency is done in-utero, while the fetus is developing. Much of that damage may be permanent, that is, it can not be fully reversed by taking Vitamin D after birth. This research indicates Vitamin D deficiency during pregnancy endangers the mother's life and health, and is the origin for a host of future perils for the child, especially for the child's brain and immune system. Some of the damage done by maternal Vitamin D deficiency may not show up for 30 years. Let's start with the mother.
Incidence of Gestational Vitamin D Deficiency Dr. Joyce Lee and her colleagues at the University of Michigan studied 40 pregnant women, the majority taking prenatal vitamins. Only two had blood levels >50 ng/mL and only three had levels >40 ng/mL. That is, 37 of 40 pregnant women had levels below 40 ng/mL, and the majority had levels below 20 ng/mL. More than 25% had levels below 10 ng/mL.
Dr. Lisa Bodnar, a prolific Vitamin D researcher, and her colleagues at the University of Pittsburg studied 400 pregnant Pennsylvania women; 63% had levels below 30 ng/mL and 44% of the black women in the study had levels below 15 ng/mL. Prenatal vitamins had little effect on the incidence of deficiency.
Dr. Dijkstra and colleagues studied 70 pregnant women in the Netherlands, none had levels above 40 ng/mL and 50% had levels below 10 ng/mL. Again, prenatal vitamins appeared to have little effect on 25(OH)D levels, as you might expect since prenatal vitamins only contain 400 IU of Vitamin D.
Thus, more than 95% of pregnant women have 25(OH)D levels below 50 ng/mL, the level that may indicate chronic substrate starvation. That is, they are using up any Vitamin D they have very quickly and do not have enough to store for future use. Pretty scary.
Effects on the Mother Caesarean section The rate of Caesarean section in American women has increased from 5% in 1970 to 30% today. Dr. Anne Merewood and her colleagues at Boston University School of Medicine found women with levels below 15 ng/mL were four times more likely to have a Cesarean section than were women with higher levels. Among the few women with levels above 50 ng/mL, the Caesarean section rate was the same as it was in 1970, about 5%.
Preeclampsia Preeclampsia is a common obstetrical condition in which hypertension is combined with excess protein in the urine. It greatly increases the risk of the mother developing eclampsia and then dying from a stroke. Dr. Lisa Bodnar and her colleagues found women with 25(OH)D levels less than 15 ng/mL had a five-fold (5 fold) increase in the risk of preeclampsia.
Gestational Diabetes Diabetes during pregnancy affects about 5% of all pregnant women, is increasing in incidence, and may have deleterious effects on the fetus. Dr. Cuilin Zhang and colleagues at the NIH found women with low 25(OH)D levels were almost 3 times more likely to develop diabetes during pregnancy.
Bacterial Vaginitis Dr. Lisa Bodnar and her colleagues found pregnant women with the lowest 25(OH)D level are almost twice as likely to get a bacterial vaginal infection during their pregnancy.
Effects on the child Seventeen experts—many of them world-class experts—recently recommended:
"Until we have better information on doses of vitamin D that will reliably provide adequate blood levels of 25(OH)D without toxicity, treatment of vitamin D deficiency in otherwise healthy children should be individualized according to the numerous factors that affect 25(OH)D levels, such as body weight, percent body fat, skin melanin, latitude, season of the year, and sun exposure. The doses of sunshine or oral vitamin D3 used in healthy children should be designed to maintain 25(OH)D levels above 50 ng/mL. As a rule, in the absence of significant sun exposure, we believe that most healthy children need about 1,000 IU of vitamin D3 daily per 11 kg (25 lb) of body weight to obtain levels greater than 50 ng/mL. Some will need more, and others less. In our opinion, children with chronic illnesses such as autism, diabetes, and/or frequent infections should be supplemented with higher doses of sunshine or vitamin D3, doses adequate to maintain their 25(OH)D levels in the mid-normal of the reference range (65 ng/mL) — and should be so supplemented year-round (p. 868)."
That's right. Healthy children need about 1,000 IU per 25 pounds of body weight and their 25(OH)D levels should be >50 ng/mL, year-round.
Eight years before the above recommendations, Professor John McGrath of the Queensland Centre for Mental Health Research theorized that maternal Vitamin D deficiency adversely "imprinted" the fetus, making infants more liable for a host of adult disorders. Research since that time has supported McGrath's theory. Consider, for a minute, what it must be like for John McGrath, to know that maternal Vitamin D deficiency is causing such widespread devastation, to know it could be so easily treated, but to also know he must wait the decades that will be required to deal with the problem.
Schizophrenia Dr. Dennis Kinney and his colleagues at Harvard published a fascinating paper last month on the role of maternal Vitamin D deficiency in the development of schizophrenia, in support of Dr. McGrath's theory. As they point out, the role of inadequate Vitamin D during brain development appears to "overwhelm" other effects, explaining why schizophrenia has so many of the footprints of a maternal Vitamin D deficiency disorder, such as strong latitudinal variation, excess winter births, and skin color.
Autism I will say not more, other than to point out that Scientific American ran a lengthy article last month on my autism theory but the editors insisted that the author not cite me, nor my paper, because I am "not a scientist."
Mental Retardation The only evidence that Vitamin D deficiency is a common cause of mental retardation is from researchers at the CDC who found mild mental retardation is twice as common among African Americans as whites, and that the politically correct explanation—socioeconomic factors—cannot explain it. If latitudinal studies of mild mental retardation exist, I am unable to locate them.
Of course, it is claimed you are a racist if you believe these studies. In fact, a number of writers have told me their editors will not allow writers to discuss these studies in their stories. I am glad these studies were conducted by researchers at the CDC. Although, I worry about their political longevity at the CDC after reporting such findings.
I will mention one other fact (at my peril) and that is the fact that a very smart man, President Barack Obama, was born in the late summer (August) and has a brain that developed in a womb covered in white skin, during the spring and summer, in the subtropics (Latitude 21 degrees North), during an age before sun-avoidance was the mantra (1961). Make what you want to of that fact. My point is that whites living at temperate latitudes may have a huge developmental advantage over blacks, an advantage that begins immediately after conception, an advantage that has nothing to do with innate genetic ability and everything to do with environment.
Newborn Lower Respiratory Tract Infection Newborn babies are vulnerable to infections in their lungs and women with the lowest 25(OH)D level during pregnancy were much more likely to have their newborn in the ICU being treated for lower respiratory tract infections. Drs. Walker and Modlin at UCLA recently presented reasons why viral pneumonia is probably only one of many pediatric Vitamin D deficient infections.
Birth weight While conflicting results exist on the effects of maternal Vitamin D deficiency and birth weight, the majority of the studies find an effect. Furthermore, the studies are comparing women who have virtually no intake to women who have minuscule intakes. For example, women who ingested around 600 IU per day were more likely to have normal weight babies compared to women whose intake was less than 300 IU per day. One can only wonder what would happen if pregnant women had adequate intakes? Drs. Scholl and Chen, at the Department of Obstetrics at the University of Medicine and Dentistry of New Jersey, concluded pregnant women need 6,000 IU per day, not the 400 IU/day contained in prenatal vitamins.