Vitamin D and Calcium

Vitamin D3 Deficiency Associated with Increased Risk of Cancer
Review of article recently published in the American Journal of Clinical Nutrition, June 2007:

Vitamin D and Calcium supplementation reduces cancer risk: results of a randomized trial.

Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP Am J Clin Nutr. 2007 Jun;85(6):1586-91

This was a 4 year, population-based, double blind, randomized, placebo controlled trial (an extremely well designed study) .This trial looked at healthy women greater than 55 years old in the Midwest. The primary goal of the study was to demonstrate the benefit of vitamin D, at a higher dose than recommended (1000 IU versus 400 IU) and calcium in improving bone density. The improvement in bone density was clearly demonstrated.

The secondary part of this study, and I believe represents the most crucial findings, examines the beneficial effect of vitamin D and Calcium in reducing all cancers. Again a much higher dose of vitamin D was used in comparison to other studies which used a much lower, disturbingly recommended dietary amount of 400 IU.

A multitude of studies have been published on the topic of increasing Vitamin D doses, going all the way back to the early 1900s. With the advent of the Industrial Revolution, a sharp increase in the number of cases of rickets was identified in industrialized cities. Edward Mellanby published a study linking rickets to Vitamin D deficiency in Britain and Elmer McCollum published similar findings a year later.

This led to “Vitamin D Fortified” milk, when the United States mandated that milk be fortified with Vitamin D, so that every quart of milk would also contain 400 IUs of Vitamin D. A follow-up study has shown that this is insufficient due to the decrease in the consumption of milk in the adult diet, as well as in the increase in the use of sunscreen, which significantly reduces the body’s natural production of Vitamin D.

(Holick, 2004). Studies show SPF 8 alone reduces this production by >95% (MF, 2003) (MF, Vitamin D: New Horizons for the 21st Century, 1994) (Matsuoka LY, 1988). These studies have led to an increased amount of research being conducted on the effects of Vitamin D deficiency, with many surprising findings.

This study is a well designed, clear, and concise which makes the findings even more powerful. This study had three different groups. One group was given daily dosing of Calcium and Vitamin D supplements at 1100 IU. The second group received calcium supplementation alone. The third group received placebos (sugar pill).

The women in the community were randomly chosen to go into each group. The study was a prospective trial which means it went from day-1 through day-1460 (four years). This study was also a double-blind, randomized placebo trial, which means that neither the doctor nor the patient knew what they were taking. All pills were identical in color and shape, so no one who could influence the study (prescribers and researchers) could identify which group a patient was in.

This trial went on for four years, at which point they ceased dosing and opened all the envelopes to see who was in which group and look for trends. That’s when it really gets good. The women in the Vitamin D and Calcium group had approximately a 60 % reduction in ALL cancers: colon cancers, breast cancers, lung cancers, lymphomas and leukemias. These finding are supported by a separate study which showed that a higher intake of Vitamin D3 and Calcium prevented the type of colon cancers which make up >90% of human colon cancer in western countries in animal testing (Kan Yang, 2008).

The 60% reduction figure is impressive; so they reviewed the results even more carefully to identify other factors. The results were even more impressive, as this dietary supplement regimen was taken by people who were already developing cancer prior to treatment (as cancer was identified within the first year of treatment). When they looked at only those who developed cancer in years two, three, and four, they found a 75 % reduction in all cancers.

These are extremely important results. NSAID medications (specifically Aspirin) were shown to decrease the risk of breast cancer by up to 20% (A. Agrawal, 2007) and received substantial media attention. Why have the benefits of Vitamin D not become common knowledge? Has your doctor put you on a Vitamin D supplement? Why are the pharmaceuticals not jumping on this and advertising a new medication during the Superbowl? One month of Vitamin D3 therapy is approximately $1.35. This is another example of how vitamins are not cheap, as their value to your body is very high, they are simply inexpensive.

Even though it looks at the age group specifically, I believe that all ladies and men would benefit from the cancer-protecting effects of Vitamin D3 or cholecalciferol. What’s the difference between Vitamin D3 and “normal” Vitamin D?

Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study.

Garland CF, Comstock GW, Garland FC, Helsing KJ, Shaw EK, Gorham ED.

Department of Community and Family Medicine, School of Medicine, University of California, San Diego, La Jolla.

Risk of colon cancer was reduced by 75% in the third quintile (27-32 ng/ml) and by 80% in the fourth quintile (33-41 ng/ml) of serum 25-OHD. Risk of getting colon cancer decreased three-fold in people with a serum 25-OHD concentration of 20 ng/ml or more. The results are consistent with a protective effect of serum 25-OHD on colon cancer.

Lancet. 1989 Nov 18;2(8673):1176-8.

Intakes of calcium and vitamin D and breast cancer risk in women.

Lin J, Manson JE, Lee IM, Cook NR, Buring JE, Zhang SM.

Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA. jhlin@rics.bwh.harvard.edu

BACKGROUND: Animal data suggest the potential anticarcinogenic effects of calcium and vitamin D on breast cancer development. However, epidemiologic data relating calcium and vitamin D levels to breast cancer have been inconclusive. METHODS: We prospectively evaluated total calcium and vitamin D intake in relation to breast cancer incidence among 10,578 premenopausal and 20,909 postmenopausal women 45 years or older who were free of cancer and cardiovascular disease at baseline in the Women’s Health Study. Baseline dietary intake was assessed by a food frequency questionnaire. We used Cox proportional hazards regression to estimate hazard ratios and 95% confidence intervals. RESULTS: During an average of 10 years of follow-up, 276 premenopausal and 743 postmenopausal women had a confirmed diagnosis of incident invasive breast cancer. Higher intakes of total calcium and vitamin D were moderately associated with a lower risk of premenopausal breast cancer; the hazard ratios in the group with the highest relative to the lowest quintile of intake were 0.61 (95% confidence interval, 0.40-0.92) for calcium (P = .04 for trend) and 0.65 (95% confidence interval, 0.42-1.00) for vitamin D intake (P = .07 for trend). The inverse association with both nutrients was also present for large or poorly differentiated breast tumors among premenopausal women (P< or =.04 for trend). By contrast, intakes of both nutrients were not inversely associated with the risk of breast cancer among postmenopausal women. CONCLUSIONS: Findings from this study suggest that higher intakes of calcium and vitamin D may be associated with a lower risk of developing premenopausal breast cancer. The likely apparent protection in premenopausal women may be more pronounced for more aggressive breast tumors.
PMID: 17533208 Nutr Cancer. 2007;59(1):54-61.

Dietary vitamin D and calcium intake and premenopausal breast cancer risk in a German case-control study.

Abbas S, Linseisen J, Chang-Claude J.

Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.

Epidemiological studies and laboratory data suggest that vitamin D may protect against the development of cancer, including breast cancer. Vitamin D supply affects the bioavailability of dietary calcium, which might also have anticarcinogenic effects. However, few studies considered them jointly. We used a population-based case-control study in Germany to examine the independent and joint effects of dietary vitamin D and calcium on premenopausal breast cancer risk. Dietary information was assessed using a validated food frequency questionnaire from 278 premenopausal cases and 666 age-matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate models adjusting vitamin D models for calcium intake and vice versa. Breast cancer risk was significantly inversely associated with vitamin D intake. The OR and 95% CI for the highest intake category (> or = 5 microg/day) was 0.50 (95% CI = 0.26-0.96) compared with the lowest (< 2 microg/day; P(trend) = 0.02). Dietary calcium intake was not associated with breast cancer (OR = 0.73, 95% CI = 0.41-1.29) for the highest (> or = 1,300 mg/day) versus the lowest category (< 700 mg/day), P(trend) = 0.29). No statistically significant interaction between the 2 nutrients was observed. Our data support a protective effect of dietary vitamin D on premenopausal breast cancer risk independent of dietary calcium intake.
PMID: 17927502 Improving calcium and vitamin D nutritional status substantially reduces all-cancer risk in postmenopausal women.

Works Cited

BIBLIOGRAPHY A. Agrawal, I. S. (2007, November). NSAIDs and breast cancer: a possible prevention and treatment strategy. Retrieved from International Journal of Clinical Practice: http://www3.interscience.wiley.com/journal/119418229/abstract?CRETRY=1&SRETRY=0
Holick, M. F. (2004, December). VITAMIN D AND HEALTH IN THE 21ST CENTURY: BONE AND BEYOND. Retrieved from American Journal of Clinical Nutrition: http://www.ajcn.org/cgi/content/full/80/6/1678S
Kan Yang, N. K. (2008, October 1). Dietary Induction of Colonic Tumors in a Mouse Model of Sporadic Colon Cancer. Retrieved from American Association for Cancer Research: http://cancerres.aacrjournals.org/cgi/content/short/68/19/7803?rss=1
Matsuoka LY, I. L. (1988). Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D. Arch Dermatol , 1802-1804.
MF, H. (2003). Vitamin D: a millennium perspective. J Cell Biochem , 296–307.
MF, H. (1994). Vitamin D: New Horizons for the 21st Century. American Journal of Clinical Nutrition , 619–630.