s Orthomolecular Medicine News Service, January 16, 2014 - Top 20 vitamin D papers for 2013 | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Orthomolecular Medicine News Service, January 16, 2014 - Top 20 vitamin D papers for 2013

Staff Writer

articles by this author...

Editing and Researching news and stories about global and local Pharmacy Issues

Orthomolecular Medicine News Service, January 16, 2014

Top 20 vitamin D papers for 2013

by William B. Grant, PhD

(OMNS Jan 16, 2014) There were 3774 papers published in 2013 with vitamin D in the title or abstract according to pubmed.gov, up from 3099 in 2012.
Among the top 20 vitamin D papers chosen to highlight for 2013 were 11 reviews, five observational studies, one geographical ecological study, one trial, one laboratory study, and one analysis of data from published results.
The papers were chosen in part by the number of times they have been cited in other works as reported by Scholar.Google.com and in part based on expert opinion by vitamin D researchers.
The fact that two-thirds of the papers were reviews is an indication of the relative maturity of the field. However, as noted in the discussion, the weak link in the vitamin D story is the limited number of randomized controlled trials (RCTs) reporting beneficial effects of vitamin D.
As discussed in the paper by Heaney [2013], the primary reason for this result is that vitamin D RCTs have been poorly designed and conducted in general; researchers have generally designed vitamin D RCTs based on the pharmaceutical drug model, which assumes no other source of the agent and a linear dose-response relation. These conditions are not satisfied for vitamin D. As a result, many of the trials enrolled people who had relatively high serum 25-hydroxyvitamin D [25(OH)D] levels and gave them too little vitamin D to produce a beneficial effect.

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Especially Important Original Studies

A randomized controlled trial with 400 or 2000 IU/d vitamin D3 found that gene expression in white blood cells was affected by vitamin D [Hossein-nezhad et al., 2013]. There was some improvement in 291 genes and significant improvement in 66 genes. In addition, 17 vitamin D-regulated genes were found with new candidate vitamin D response elements "which have been shown to be important for transcriptional regulation, immune function, response to stress and DNA repair". This study provides strong support for the role of vitamin D in affecting risk of cancer, autoimmune disorders and cardiovascular disease.

An observational study found that serum 25(OH)D levels below 30 nmol/l (12 ng/ml) were associated with 1.0-1.6 additional cases of spontaneous preterm birth before 35 weeks' gestation per 100 births for nonwhite mothers compared to levels above 75 nmol/l (30 ng/ml) [Bodnar, 2014]. Placental inflammatory lesions played a role in this relation. It was not understood why there was no relation between serum 25(OH)D level and risk of premature birth for white mothers. This paper adds to the literature on the beneficial role of higher serum 25(OH)D levels during pregnancy.

Vrieling et al. [2013] conducted a prospective cohort study in Germany including 2,177 incident stage I-IV postmenopausal breast cancer patients aged 50-74 years. Lower concentrations of 25(OH)D were significantly associated with an 86% higher risk of overall mortality and a 76% higher risk of distant disease in stage I-IIIa but not in stage IIIb-IV breast cancer patients. This study adds to the evidence that vitamin D plays an important role in cancer and all-cause survival.

A laboratory study identified several genes associated with triple negative/basal-like breast cancer that are regulated by vitamin D receptors [Laporta and Welsh, epub], thereby providing additional evidence that vitamin D can be useful in reducing risk of and treating breast cancer.

A pair of papers published in the open-access journal Dermato-Endocrinology discussed the evidence that solar ultraviolet-B irradiance and vitamin D reduce the risk of autism. In one, the prevalence of autism by state for those aged 6 to 17 years was found inversely correlated with summertime solar UVB doses [Grant and Cannell, 2013]. Rates for African Americans were higher than for European Americans. The variation with respect to solar UVB doses is similar to that reported previously for many types of internal cancer and dental caries in the United States. Summertime solar UVB doses in the United States are highest in the Southwest, lowest in the Northeast due to a combination of factors involving surface elevation, aerosol and cloud levels, and stratospheric ozone amounts. In the second paper, the evidence supporting the role of vitamin D in reducing the risk of autism and treating those with autism was presented and discussed. The mechanisms seem to include effects on reducing DNA mutations, anti-inflammation and antiautoimmune effects, and upregulating glutathione [Cannell and Grant, 2013]. It is not clear from either study what the relative contributions of maternal and infant serum 25(OH)D levels might be. These two papers add to the understanding of the roles of solar UVB and vitamin D in reducing risk of autism and could lead to a reduction in the epidemic of autism.

One of the roles of vitamin D is the reduction of inflammation. In a study of morbidly obese women, serum 25(OH)D levels were found inversely correlated with several indicators of inflammation including high-sensitive C-reactive protein, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) after accounting for confounding factors including body mass index (BMI) [Bellia et al., 2013]. This study adds to the literature connecting low serum 25(OH)D level to increased risk of inflammation. This is important since inflammation is an important risk factor for many chronic diseases.

Another paper analyzed data from 21 adult cohort studies involving 42,000 participants with information on BMI, serum 25(OH)D levels, and genes related to BMI and 25(OH)D. The analysis found that each 1 kg/m(2) increase in BMI was associated with a 4.2% lower serum 25(OH)D level [Vimaleswaran, 2013]. The authors were also able to conclude that changes in serum 25(OH)D level would not affect BMI.

One of the concerns regarding taking vitamin D supplements is the possible risk of developing kidney stones. An analysis of data on 2000 participants of the GrassrootsHealth.net vitamin D testing program followed for an average of 19 months found no statistically significant association between serum 25-hydroxyvitamin D and kidney stones (P?=?0.42) in the range of 20-100 ng/ml. However, higher BMI was associated with an increased risk [Nguyen et al., 2013].

Comprehensive Reviews of the Health Benefits of Vitamin D

Pludowski et al. [2013] reviewed the evidence of health benefits of vitamin D as one of the outcomes of a vitamin D conference attended by over 500 people in Warsaw, Poland in October 2012. The evidence reviewed was primarily from observational studies. They found "Adequate vitamin D status seems to be protective against musculoskeletal disorders (muscle weakness, falls, fractures), infectious diseases, autoimmune diseases, cardiovascular disease, type 1 and type 2 diabetes mellitus, several types of cancer, neurocognitive dysfunction and mental illness, and other diseases, as well as infertility and adverse pregnancy and birth outcomes. Vitamin D deficiency/insufficiency is associated with all-cause mortality." This paper provided the basis for recommending serum 25(OH)D levels of at least 30 ng/ml (75 nmol/l) for Central and Eastern Europe.

Hossein-nezhad and Holick [2013] reviewed the effects of vitamin D on the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and mortality. The authors recommend a serum 25(OH)D level of at least 30 ng/ml. This paper has open access.

The paper by Haussler et al. [2013] summarizes the molecular mechanisms of vitamin D, with primary emphasis on the classical functions of vitamin D on intestinal calcium and phosphate absorption and effects on skeletal and calcium homeostasis, but also discussion of how the active form of vitamin D, 1,25-dihydroxyvitamin D, affects gene expression and, thus risk of chronic diseases such as cancer, cardiovascular disease, and type 2 diabetes mellitus.

The paper by Palacios and Gonzalez [2013] presents an overview of what is known about serum 25(OH)D levels globally. Six maps are presented with data on vitamin D status (percent of population50% for European countries, but are 36% for China and 91% for India.

The Actions of Vitamin D

The effects of vitamin D on gene expression are controlled by the action of the hormonal metabolite of vitamin D, 1,25-dihydroxyvitamin D on vitamin D receptors (VDRs). A paper by Carlberg and Campbell [2013] reviews the actions of the VDR in comparison with those of other transcription factors in order to better understand the role of vitamin D on gene expression.

The Role of Vitamin D for Specific Health Outcomes

The paper by Song et al. [2013] presents a meta-analysis of 21 prospective studies of type 2 diabetes mellitus incidence with respect to serum 25(OH)D level at time of enrollment in the studies. The studies involved a total of 76,220 participants and 4,996 incident type 2 diabetes cases. The second order fit to the data went from a relative risk of 1.00 at 35 nmol/l (14 ng/ml) to 0.45 at 150 nmol/l (60 ng/ml). This analysis provides strong support for the role of vitamin D in reducing the risk of type 2 diabetes mellitus.

Girgis and colleagues [2013] published a comprehensive review of the role of vitamin D on skeletal muscle. It has 51 pages and 390 references. It should be the standard reference on the topic for years.

A paper by DeLuca et al. [2013] reviewed the evidence from 225 papers for the role of vitamin D in reducing risk of nervous system diseases: Alzheimer's disease, amyotrophic lateral sclerosis, autism, multiple sclerosis, Parkinson's disease, and schizophrenia. The strongest evidence is for multiple sclerosis. They note that evidence from many types of studies finds that vitamin D plays a crucial role in cellular proliferation and differentiation, neurotrophism, neuroprotection, neurotransmission, and neuroplasticity. Given the importance and devastation of neurological diseases, more research on the role of vitamin D in reducing risk of these diseases is warranted.

A Skeptical Viewpoint

One paper that has gotten considerable publicity is one calling into question the health benefits of vitamin D. Autier and colleagues published a paper comparing vitamin D randomized controlled trials to prospective studies based on health outcomes with respect to serum[25(OH)D levels [Autier et al., 2013]. While they found reasonable evidence from the observational studies that higher serum 25(OH)D levels were correlated with lower disease and mortality rates, they noted that few randomized controlled trials (RCTs) agreed with the observational studies. They also noted that inflammation is an important aspect of many diseases, but that RCTs have not shown that vitamin D can reduce inflammation. They proposed "the hypothesis that variations in 25(OH)D concentrations would essentially be a result, and not a cause, of ill health." As noted with respect to the paper by Bellia et al. [2013], there is evidence that serum 25(OH)D levels are inversely correlated with markers of inflammation. The vitamin D RCTs conducted to date have for the most part been poorly designed and conducted as pointed out by Heaney [2014]. Vitamin D RCTs have mostly been done using the pharmaceutical drug model, paying limited attention to other sources of vitamin D, not seeking to enroll people with low serum 25(OH)D levels, supplement them with sufficient vitamin D to raise their levels to those that have significant impact on health outcome, and also measure serum 25(OH)D levels later in the study. The proper way to examine causality with respect to vitamin D is to apply Hill's criteria for causality in a biological system [Hill, 1965]. These criteria appropriate for vitamin D include strength of association, consistent findings in different populations, temporality, biological gradient, plausibility (e.g., mechanisms), coherence, experiment (e.g., RCT), and analogy. Not all criteria need be satisfied, but the more that are, the stronger the case. A number of health outcomes have been found to satisfy Hill's criteria for causality for vitamin D including many types of cancer. Unfortunately, the paper by Autier and colleagues will likely dissuade many from recommending vitamin D in their practice or using it personally.

To learn more:

For further information on vitamin D, the interested reader is directed to these websites: http://www.Grassrootshealth.net, http://www.VitaminDCouncil.org, and http://www.VitaminDWiki.com.

Dr. William Grant directs the Sunlight, Nutrition and Health Research Center http://www.sunarc.org/ . This paper was reviewed by:

Carole A. Baggerly, Director, http://www.Grassrootshealth.net

Barbara J Boucher. MD, FRCP, Centre for Diabetes, Blizard Institute, Bart's & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

Michael F. Holick, MD, PhD, Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, and the Vitamin D, Skin, and Bone Research Laboratory, Boston University Medical Center, Boston.

Henry Lahore, Director, http://www.vitaminDwiki.com

Pawel Pludowski, MD, Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland


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