1. Vitamin D andYOU

2. Vitamin D Toxicity It’s pretty hard to get too much vitamin D. Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E. What is Vitamin D? –Vitamin D’s Role in the Body –The Impact of Deficiency and Toxicity How Much Vitamin D Do You Need? What are the Sources of Vitamin D? –Food –Sunlight –Supplements Vitamin D Agenda

3. What is Vitamin D

4. Vitamin D is a nutrient that is key to good health. It helps your body absorb calcium Meet Vitamin D

5. Your body needs vitamin D to fight off illnesses. Vitamin D also helps your muscles move. It even plays a role in nervous system communication. Meet Vitamin D

6. Harmful to bone health. -Rickets -Osteomalacia -Osteoporosis The Impact of Deficiency

7. Deficiency Linked to Increased Risk: –High Blood Pressure –Heart Disease –Diabetes and Insulin Resistance –Cancer –Depression –Macular degeneration –Autoimmune disorders Multiple Sclerosis

8. The Impact of Deficiency Linked to decreased: –Mental ability –Athletic performance –Muscle fibers and fast twitch muscles –Immune function

9. Notable Vitamin D Research A larger study followed 18,225 men 40-65y and initially free of diagnosed heart disease for 10 years. In this study men with moderately low levels of vitamin D in their blood (15.1 to 22.5ng/ml) had about a 60% increased risk of having a heart attack. Those who were deficient in vitamin D ( 30ng/ml).

10. Notable Vitamin D Research “Vitamin D deficiency not only causes rickets among children but also precipitates and exacerbates osteoporosis among adults and causes […] osteomalacia.

11. Notable Vitamin D Research “Researchers noticed that people who don’t have enough vitamin D tend to fall more often than other people. They found that taking a vitamin D supplement reduces the risk of falling by up to 22%. […] “Also, vitamin D, in combination with calcium, but not calcium alone, may prevent falls by decreasing body sway and blood pressure.”

12. Notable Vitamin D Research A placebo-controlled trial of Nebraska women found that 1100 IU of vitamin D for 4 years cut their risk of developing breast, colon, and other internal cancers. 1 Even 1,100 IU may not be adequate to optimize immune function. Am J Clin Nutr 2007;85:1586-91

13. Notable Vitamin D Research An analysis of 18 randomized controlled clinical trials showed that vitamin D supplements significantly reduced the risk of dying from all causes combined. Arch Intern Med 2007;167:1730-7

14. What About Too Much It is possible to get too much vitamin D. When there’s too much of it in the blood, it’s called toxicity.

15. The Impact of Toxicity Vitamin D toxicity is extremely rare. Vitamin D is sometimes considered the most toxic of the fat-soluble vitamins, but…

16. The Impact of Toxicity Signs and symptoms: –Nausea and vomiting –Constipation –Reduced appetite/weight loss –Weakness

17. Excess D can also lead to excess Calcium! Signs of elevated blood calcium levels: –Heart rhythm issues –Confusion/disorientation

18. Vitamin D Toxicity It’s pretty hard to get too much vitamin D. Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E. How Much Vitamin D Do You Need

19. American Trends Vitamin D and its metabolites target more than 200 human genes that impact not only bone health but also immune function and many other bodily functions.

20. American Trends However, the current government guideline for vitamin D requirement is based only on the need for vitamin D to prevent bone disease. That level may not be adequate to meet all other metabolic functions that utilize vitamin D

21. American Trends Most Americans do not get enough vitamin D. The Dietary Guidelines have labeled it a “nutrient of concern.”

22. American Trends It’s harder for some people to get enough vitamin D than others. African Americans Hispanics People who are obese People with high blood pressure or high LDL cholesterol levels

25. Sources of Vitamin D Food Sunlight Supplements

26. Food Sources Most foods have very little vitamin D

27. Food Sources Natural sources include: Fatty fish (salmon, tuna, mackerel), Cod liver oil Mushrooms Beef liver Cheese Eggs Vitamin D Fortified Foods: Milk Breakfast cereal Orange juice

28. Food sources: Cod liver oil 1 tablespoon1360 IU Swordfish, 3 ounces566 IU Salmon, 3 ounces447 IU Tuna, 3 ounces154 IU Orange juice, fortified137 IU Milk, fortified115-124 IU Yogurt, fortified80 IU

29. Vitamin D & Sunlight Vitamin D is often called “The Sunshine Vitamin”

30. Vitamin D and Sunshine Did you know that, when your body is exposed to sunlight, it starts making vitamin D? This kind of vitamin D must then be activated by your body.

31. Vitamin D Toxicity It’s pretty hard to get too much vitamin D. Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E. How Much Sunshine

32. Vitamin D Toxicity It’s pretty hard to get too much vitamin D. Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E. Approximately 5–30 minutes of sun exposure between 10am - 3pm at least twice a week. Expose face, arms, legs, or back without sunscreen.

33. Factors… Age Skin color How much skin is exposed Length of exposure Geographic location Time of year Time of day Cloud cover Smog, dust, haze

34. Skin Type & Sunlight Skin type 1 – very fair, always burns Skin type 2 – white, tans with difficulty Skin type 3 – creamy white, sometimes burns Skin type 4 – brown, rarely burns, tans with ease Skin type 5 – dark brown, tans easily Skin type 6 – black, tans very easily

35. Are You Getting Enough D? It is time for a poll!

36. Too Little Sunshine ? Balance sun exposure for vitamin D with sun protection to reduce skin cancer risk. According to the National Institute of Health, despite importance of sun for Vitamin D, they still encourage limiting sun exposure. So that brings us to … supplementation!

37. Supplements

38. Vitamin D Supplements Vitamin D supplements usually contain either vitamin D2 or vitamin D3. Both increase vitamin D levels in the bloodstream.

39. D2 versus D3 Fatty fish offer vitamin D3 while mushrooms offer vitamin D2. Vitamin D2 can be harder for your body to process, but only in extremely high doses

40. You may NEED a supplement if… Age 50+ Limited sun exposure Adults with darker skin Consume little D from food Do not absorb fat well (digestion/disease) People who avoid milk products People who are overweight or obese

41. Vitamin D Review What is Vitamin D? –Vitamin D’s Role in the Body –The Impact of Deficiency and Toxicity How Much Vitamin D Do You Need? What Are The Sources of Vitamin D –Food –Sunlight –Supplements

42. Vitamin D Toxicity It’s pretty hard to get too much vitamin D. Vitamin D is not nearly as toxic as overdoses of vitamin A and it is much less likely to increase your risk of dying than too much vitamin E. Time for a Quiz !!

43. Vitamin D Quiz Which of the options below is NOT an effect of a vitamin D deficiency? Rickets Osteomalacia Osteoporosis None of the above True or false: Vitamin D toxicity is rarer than vitamin D deficiency.

44. Vitamin D Quiz Which of the options below is NOT an effect of a vitamin D deficiency? Rickets Osteomalacia Osteoporosis None of the above True or false: Vitamin D toxicity is rarer than vitamin D deficiency.

45. Vitamin D Quiz It’s harder for some people to get enough vitamin D, including ____. Women People with dark skin Children People with red hair True or false: Most foods don’t contain much naturally-occurring vitamin D.

46. Vitamin D Quiz It’s harder for some people to get enough vitamin D, including ____. Women People with dark skin Children People with red hair True or false: Most foods don’t contain much naturally-occurring vitamin D.

47. Vitamin D Quiz Which food is often fortified with vitamin D? Milk Fish Carrots Cookies True or false: Vitamin D2 supplements have very different effects than vitamin D3 supplements.

48. Vitamin D Quiz Which food is often fortified with vitamin D? Milk Fish Carrots Cookies True or false: Vitamin D2 supplements have very different effects than vitamin D3 supplements.

49. Resources https://www.vitamindcouncil.org/about-vitamin-d/how-do-i- get-the-vitamin-d-my-body-needs/ http://ods.od.nih.gov/factsheets/VitaminD- HealthProfessional/ http://www.hhs.gov/news/healthbeat/2008/01/20080108a.h tml http://www.health.gov/dietaryguidelines/dga2010/DietaryG uidelines2010.pdf http://www.ncbi.nlm.nih.gov/pubmed/21310306 http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/#h8 http://www.cancer.org/treatment/treatmentsandsideeffects/ complementaryandalternativemedicine/herbsvitaminsandm inerals/vitamin-d?sitearea=ETO

50. Now for More About Vitamin D Just kidding, we’re done

51. Vitamin D Review What is Vitamin D? –Vitamin D’s Role in the Body –The Impact of Deficiency and Toxicity How Much Vitamin D Do You Need? Sources of Vitamin D –Food –Sun –Supplements