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Lack of Vitamin D Linked to Heart Attacks and Premature Death

The largest study yet on vitamin D deficiency shows that it is associated with an 80 percent increased risk of heart attacks and premature death (Arterioscler Thromb Vasc Biol, 2012 Nov;32(11):2794-802). The authors followed 10,170 men and women from the Copenhagen City Heart Study for 29 years. They then analyzed all 17 previously-published prospective studies on the association between vitamin D levels and risk of heart attacks. In both their study and the previous 17 studies, the risk of ischemic heart disease was 39 percent higher and the risk of death was 46 percent higher in the quartile with the lowest vitamin D levels relative to people with the highest levels of the vitamin D.

HEART ATTACKS ARE DEADLY MORE OFTEN THAN SKIN CANCERS. You cannot meet your needs for vitamin D from the food that you eat. You have to get more sunlight or take pills. Of course, excessive exposure to sunlight may increase risk for skin cancers. However, far more people die from heart attacks caused by lack of sunlight than from skin cancers caused by too much sunlight. Contrary to what most dermatologists say, the most effective way to meet your needs for vitamin D is to expose your skin to sunlight. This issue will be settled by two large, ongoing trials -- the 20,000-patient US Vitamin D and Omega-3 Trial (VITAL) study, which will be available in 2016 or 2017; and the UK Vitamin D and Longevity (VIDAL) trial.

TOO MUCH VITAMIN D IN PILLS MAY INCREASE RISK OF HEART ATTACKS. Giving 50,000 IU per week of vitamin D3 (more than 15 times the Recommended Dietary Allowance) to people with vitamin D deficiency, for eight weeks, increased risk for heart attacks by raising blood levels of total cholesterol, the bad low-density lipoprotein (LDL), and triglycerides more than in the placebo group (Arteriosclerosis, Thrombosis, and Vascular Biology, September 2012).

Large doses of vitamin D pills also increase blood calcium levels and reduce blood parathyroid hormone levels. Both are associated with increases in the bad LDL cholesterol and increased risk for heart attacks.

HOW LACK OF VITAMIN D MAY CAUSE HEART ATTACKS: Lack of vitamin D appears to increase risk of heart attacks by raising blood sugar levels. Low levels of vitamin D are associated with increased risk for diabetes (Nutrition Journal, September 9, 2012). Insulin prevents blood sugar levels from rising too high by attaching to insulin receptors on cells and then driving sugar from the bloodstream into cells. Lack of vitamin D prevents insulin from lowering high blood sugar levels.

When insulin fails to control blood sugar levels, and blood sugar levels rise too high, sugar sticks to the inner linings of arteries and damages the cells there to cause an erosion of the lining. Then the damaged area bleeds and clots, and cholesterol plaques form in the area. Eventually a plaque breaks off from one or more of the inner linings of an artery leading to the heart, travels down the ever-narrowing artery, and blocks the flow of blood to the heart muscle to cause a heart attack.

MY RECOMMENDATIONS: If your blood level of hydroxy-vitamin D is below 75 nmol/L (30 ng/ml), you are not getting enough vitamin D. Low levels of vitamin D increase your chances of developing high blood sugar levels that can damage every cell in your body. To get your vitamin D from the sun, expose your lower legs to sunlight for short periods. It is cumulative ultraviolet exposure over a lifetime that increases risk for skin cancers, so avoid exposing skin that has previous sun damage (usually the face, tops of ears, scalp, forearms and hands).

Follow all of the rules for preventing diabetes:
• Drink sugared drinks (including fruit juices) only when you exercise
• Avoid sugar-added foods
• Restrict red meat and fried foods
• Eat large amounts of fruits and vegetables
• Exercise at least one hour a day
• Avoid being overweight

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Sunlight May Offer More than Vitamin D Pills

A just-published study shows that pills containing the Recommended Dietary Allowance of vitamin D (400 or 1,000 units of vitamin D) did not change blood levels of total cholesterol, LDL, HDL, triglycerides or C-reactive protein, all known risks for heart disease (The Journal of Clinical Endocrinology & Metabolism, October 2012). Low levels of vitamin D are most commonly caused by lack of sunlight.

MY OPINION: I think that it is possible, but certainly not proven, that sunlight may give us something more than just vitamin D that helps to prevent heart attacks, cancers and premature death.

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Eating Fish, but Not Fish Oil Pills, Cuts Stroke Risk

A review of 36 prospective cohort studies, involving 794,000 people and 34,817 strokes, shows that eating two or more servings of fish each week was associated with a six to 12 percent reduction in strokes compared with eating one or fewer servings. Taking fish oil pills did not prevent strokes (British Medical Journal, October 30, 2012). Eating fish twice a week also helps to prevent heart attacks.

The authors state that "single nutrients may have limited effects on chronic disease outside of their original food sources." It is likely that eating fish prevents strokes, and fish oil pills may not prevent them, because:

• Fish contain, in addition to omega-3 fats, a wide range of nutrients such as vitamins D and B complex, essential amino acids, and trace elements that, in combination, prevent strokes;

• People who eat more fish may be eating less of unhealthful foods such as red meat; or

• People who eat fish also follow other health recommendations and therefore have a more healthful diet and/or higher socioeconomic status.

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This week's medical history:
Eleanor Roosevelt’s Doctors Vindicated 40 Years after Her Death

For a complete list of my medical history biographies go to Histories and Mysteries

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Recipe of the Week:

Roumanian Crock Pot Stew

You'll find lots of recipes and helpful tips in The Good Food Book
- it's FREE

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November 4th, 2012
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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