Dr. Lili Nasseri - Freelance Travel and Health Writer

Are You Getting Enough Vitamin D? Shahrvand, North Vancouver BC Published: Friday Jan 30, 2009 Page: 42 Living on the West Coast we are blessed with mild weather, but not a lot of sunshine. I myself need the sun. At home, our condo faces the North East. The realtor told us that we'd get lots of 'early morning light'. This translated into sunshine coming in from two windows from 7 am to 10am. Like most people, I go to work at 7 am and return home when the sun is on the other side, if it has not already set. As a result, I have the strange habit of gravitating towards windows at work, restaurants and even Ikea, when I notice a sliver of sunshine escaping through the clouds. I go and stand in its brightness, basking in its warmth. My husband jokingly blames this strange habit on my name, Lili. He figures if I weren't named after a flower, I wouldn't have such a deep need to see the sun every day. But I know that I am not alone, as I hear my patients complain daily about the gloominess of winter and the rain. The lack of sunshine in Vancouver leads to bigger issues, specifically a lack of vitamin D. Several studies have shown a high prevalence of vitamin D deficiency among people who live in the Northern Hemisphere. A study published in the American Journal of Medicine in 2002 found that nearly two-thirds of healthy, young adults in Boston had low vitamin D levels by the end of winter. And they get more sunshine than we do! We have long known that vitamin D is essential for bone health and the prevention of osteoporosis. This is through its action on the gut where it promotes the absorption of calcium. But mounting evidence shows that vitamin D plays an important role beyond the bones. New studies have shown that low vitamin D levels increase the risk of both type 1 and type 2 diabetes, hypertension, multiple sclerosis and cancers of the breast, colon, prostate, ovaries and the esophagus. Foods that Contain Vitamin D Currently, Health Canada recommends 800-1000 IU of Vitamin D intake in all adults with inadequate sun exposure. Foods that contain high amounts of vitamin D include oily fish such as salmon and mackerel, as well as fortified milk and other dairy products. A single serving of wild salmon has approximately 1000 IU of vitamin D. When fried in vegetable oil, the vitamin D content decreases by half, to 500 IU. Thus, it is best to eat salmon baked, and not fried. One glass of fortified milk should contain approximately 200 IU of vitamin D. But studies have shown that products can contain less than what is written on the box, sometimes up to 80% less. Vegetables, other than raw shiitake mushrooms (100 g = 75 IU), are not a good source of vitamin D. So where does this leave us? I routinely advise all my patients to supplement their diet with a multivitamin as most contain at least 400 IU. If you hate fish and are lactose intolerant, then you should probably take 800 IU to 1000 IU by supplementation. Remember though, that more is not better. Vitamin D is a fat-soluble vitamin which remains stored in the body and excess intake will lead to toxicity. This can lead to bleeding, kidney damage and muscle weakness, just to name a few. A Good Excuse to Go Down South Only 5-10 minutes of sun exposure on the face and hands three times a week are required to meet our weekly vitamin D requirements. Thus there is no excuse for coming back from a trip to Mexico ten shades darker. In fact, if you sunbathe in a bathing suit just long enough to produce a mild burn, your body produces the equivalent of 10,000 to 25,000 IU of oral vitamin D. The good news is that you can't overdose on the vitamin D made by your skin. At last year's American Academy of Dermatology conference in San Antonio Texas, I attended a talk on sunscreen. The presenter was a dermatologist from Florida who showed, interspersed throughout her presentation, pictures of herself and her family clad from head to toe in white cotton outfits and wearing large hats. Her message was clear, unprotected sun exposure will lead to skin cancer. So even though we don't get nearly as much sun here as those lucky Floridians, it is important to wear sunscreen with both UVA and UVB protection. The only time I break this rule, is while I sit at 7 am in the little square of sunshine in our condo, drinking my cup of coffee.

Are You Getting Enough Vitamin D?

Shahrvand, North Vancouver BC
Published: Friday Jan 30, 2009
Page: 42

Living on the West Coast we are blessed with mild weather, but not a lot of sunshine. I myself need the sun. At home, our condo faces the North East. The realtor told us that we'd get lots of 'early morning light'. This translated into sunshine coming in from two windows from 7 am to 10am. Like most people, I go to work at 7 am and return home when the sun is on the other side, if it has not already set. As a result, I have the strange habit of gravitating towards windows at work, restaurants and even Ikea, when I notice a sliver of sunshine escaping through the clouds. I go and stand in its brightness, basking in its warmth. My husband jokingly blames this strange habit on my name, Lili. He figures if I weren't named after a flower, I wouldn't have such a deep need to see the sun every day. But I know that I am not alone, as I hear my patients complain daily about the gloominess of winter and the rain.

The lack of sunshine in Vancouver leads to bigger issues, specifically a lack of vitamin D. Several studies have shown a high prevalence of vitamin D deficiency among people who live in the Northern Hemisphere. A study published in the American Journal of Medicine in 2002 found that nearly two-thirds of healthy, young adults in Boston had low vitamin D levels by the end of winter. And they get more sunshine than we do!

We have long known that vitamin D is essential for bone health and the prevention of osteoporosis. This is through its action on the gut where it promotes the absorption of calcium. But mounting evidence shows that vitamin D plays an important role beyond the bones. New studies have shown that low vitamin D levels increase the risk of both type 1 and type 2 diabetes, hypertension, multiple sclerosis and cancers of the breast, colon, prostate, ovaries and the esophagus.

Foods that Contain Vitamin D

Currently, Health Canada recommends 800-1000 IU of Vitamin D intake in all adults with inadequate sun exposure. Foods that contain high amounts of vitamin D include oily fish such as salmon and mackerel, as well as fortified milk and other dairy products. A single serving of wild salmon has approximately 1000 IU of vitamin D. When fried in vegetable oil, the vitamin D content decreases by half, to 500 IU. Thus, it is best to eat salmon baked, and not fried.

One glass of fortified milk should contain approximately 200 IU of vitamin D. But studies have shown that products can contain less than what is written on the box, sometimes up to 80% less.

Vegetables, other than raw shiitake mushrooms (100 g = 75 IU), are not a good source of vitamin D.

So where does this leave us? I routinely advise all my patients to supplement their diet with a multivitamin as most contain at least 400 IU. If you hate fish and are lactose intolerant, then you should probably take 800 IU to 1000 IU by supplementation. Remember though, that more is not better. Vitamin D is a fat-soluble vitamin which remains stored in the body and excess intake will lead to toxicity. This can lead to bleeding, kidney damage and muscle weakness, just to name a few.

A Good Excuse to Go Down South

Only 5-10 minutes of sun exposure on the face and hands three times a week are required to meet our weekly vitamin D requirements. Thus there is no excuse for coming back from a trip to Mexico ten shades darker. In fact, if you sunbathe in a bathing suit just long enough to produce a mild burn, your body produces the equivalent of 10,000 to 25,000 IU of oral vitamin D. The good news is that you can't overdose on the vitamin D made by your skin.

At last year's American Academy of Dermatology conference in San Antonio Texas, I attended a talk on sunscreen. The presenter was a dermatologist from Florida who showed, interspersed throughout her presentation, pictures of herself and her family clad from head to toe in white cotton outfits and wearing large hats. Her message was clear, unprotected sun exposure will lead to skin cancer.

So even though we don't get nearly as much sun here as those lucky Floridians, it is important to wear sunscreen with both UVA and UVB protection. The only time I break this rule, is while I sit at 7 am in the little square of sunshine in our condo, drinking my cup of coffee.