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Published on 1 Comment on Vegan Diet May Be Best For Weight Loss

I think many will say: Oh no! Totally vegan is best for weight loss?? From Science Daily:

Vegan diet best for weight loss even with carbohydrate consumption, study finds

People shed more weight on an entirely plant based diet, even if carbohydrates are also included, a study has concluded. Other benefits of eating a vegan diet include decreased levels of saturated and unsaturated fat, lower BMIs, and improved macro nutrients.

The study, conducted by the university's Arnold School of Public Health and published in The International Journal of Applied and Basic Nutritional Sciences, compared the amount of weight lost by those on vegan diets to those on a mostly plant-based diet, and those eating an omnivorous diet with a mix of animal products and plant based foods. At the end of six months, individuals on the vegan diet lost more weight than the other two groups by an average of 4.3%, or 16.5 pounds.

The study followed participants who were randomly assigned to one of five diets on the dietary spectrum: vegan which excludes all animal products, semi-vegetarian with occasional meat intake; pesco-vegetarian which excludes all meat except seafood; vegetarian which excludes all meat and seafood but includes animal products, and omnivorous, which excludes no foods.

Participants followed their assigned dietary restrictions for six months, with all groups except the omnivorous participating in weekly group meetings. Those who stuck to the vegan diet showed the greatest weight loss at the two and six month marks.The lead author on this study, Gabrielle Turner-McGrievy notes that the diet consumed by vegan participants was high in carbohydrates that rate low on the glycemic index. 

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Think lifestyle changes, not medications. From Medical Daily:

Mild Hypertension Should Be Treated With Advice On Lifestyle Changes, Not Medication

In 2013, Dr. Iona Heath, a retired general practitioner published an article in the Journal of  the American Medical Association, in which she spoke about the side effects of overtreatment and overdiagnosis of mild hypertension. Now, in a new study, researchers revisit this idea, saying that unnecessary treatment of mild hypertension in low-risk patients is harming them and putting a burden on health care resources. They also argue that there's a need to reexamine criteria for diagnosing hypertension and treating blood pressure. 

About 40 percent of the world’s population, including 67 million American adults, have hypertension. Over half are classified as having mild hypertension. 

More than half of people with mild hypertension are treated with drugs, but there has been no evidence to suggest that blood pressure-lowering drugs prevent heart attacks. Instead of prescribing drugs to control mild hypertension, the authors urge clinicians to recommend healthier lifestyles to patients, which include exercising, quitting smoking, and decreased alcohol consumption. They also urge clinics to improve the accuracy of blood pressure-measuring instruments and to inform patients about measuring blood pressure at home. 

From Medical Xpress:

Experts raise concern over unnecessary treatment of mild hypertension in low risk people

Lowering the drug threshold for high blood pressure has exposed millions of low-risk people around the world to drug treatment of uncertain benefit at huge cost to health systems, warn US experts in BMJ today. Dr Stephen Martin and colleagues argue that this strategy is failing patients and wasting healthcare resources.

Over half of people with mild hypertension are treated with medication. Yet treating low risk mildly hypertensive patients with drugs has not been proven to reduce cardiovascular disease or death. The authors argue that overemphasis on drug treatment "risks adverse effects, such as increased risk of falls, and misses opportunities to modify individual lifestyle choices and tackle lifestyle factors at a public health level."

And for those over 65 the levels can be even higher. From Science News:

'Mild' control of systolic blood pressure in older adults is adequate: 150 is good enough

A broad review of the use of medications to reduce blood pressure has confirmed that "mild" control of systolic pressure is adequate for adults age 65 or older -- in the elderly, there's no clear benefit to more aggressive use of medications to achieve a lower pressure. Historically, most medical practitioners tried to achieve control of systolic pressure -- the higher of the two blood pressure readings -- to 140 or less. Recently changed guidelines now suggest that for adults over 60, keeping the systolic pressure at 150 or less is adequate, and this extensive analysis confirms that.

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Take note: research has linked a lack of microbial diversity in human guts to various diseases. A solution: Eat more plants! From Science Daily:

Compared with apes, people's gut bacteria lack diversity, study finds

The microbes living in people's guts are much less diverse than those in humans' closest relatives, the African apes, an apparently long evolutionary trend that appears to be speeding up in more modern societies, with possible implications for human health, according to a new study.

Based on an analysis of how humans and three lineages of ape diverged from common ancestors, researchers determined that within the lineage that gave rise to modern humans, microbial diversity changed slowly and steadily for millions of years, but that rate of change has accelerated lately in humans from some parts of the world.

People in nonindustrialized societies have gut microbiomes that are 60 percent different from those of chimpanzees. Meanwhile, those living in the U.S. have gut microbiomes that are 70 percent different from those of chimps.

 "On the other hand, in apparently only hundreds of years -- and possibly a lot fewer -- people in the United States lost a great deal of diversity in the bacteria living in their gut."

That rapid change might translate into negative health effects for Americans. Previous research has shown that compared with several populations, people living in the U.S. have the lowest diversity of gut microbes. Still other research has linked a lack of microbial diversity in human guts to various diseases such as asthma, colon cancer and autoimmune diseases.

One possible explanation for humans evolving to have less diversity in their gut microbiomes is that they shifted to a diet with more meat and fewer plants. Plants require complex communities of microbes to break them down, which is not as true for meat.

As for why Americans have experienced much more rapid changes in microbial diversity compared with people in less industrialized societies, some experts have suggested more time spent indoors, increased use of antibacterial soaps and cleaners, widespread use of antibiotics and high numbers of births by Cesarean section all may play a role. Antibiotics and antimicrobial cleaners can kill good bacteria along with the bad, and C-section deliveries prevent babies from receiving certain bacteria from the mother typically conferred during vaginal births.

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An amazing and unforgettable story of a man researching the gut microbes that are increasingly lost in developed Westernized populations. And do go read the original story (see link).From Popular Science:

Scientist Gives Himself Fecal Transplant To Try A Hunter-Gatherer's Microbiome

Why a field researcher from America has exposed his colon to the gut microbiome of a tribesman from Tanzania.

It's not often we encounter a story that begins with a line like this: “AS THE SUN set over Lake Eyasi in Tanzania, nearly thirty minutes had passed since I had inserted a turkey baster into my bum and injected the feces of a Hadza man – a member of one of the last remaining hunter-gatherer tribes in the world – into the nether regions of my distal colon.”

The guy behind this essay, Jeff Leach, is part of a multi-national scientific research team that by his account has been living with the Hadza, hunter-gatherers in Tanzania, for over a year. They have collected hundreds of samples from humans, animals, and the environment in order to observe how the microbial communities in and around the Hadza change with the dramatic seasonal weather shifts in East Africa: six months of near-steady rain followed by six dry months.

The question driving the research is “what a normal or healthy microbiome might have looked like before the niceties and medications of late whacked the crap out of our gut bugs in the so-called modern world,” Leach writes.

The Hadza are contemporary people, Leach writes, not an undiscovered stone-age civilization. But they're excellent subjects for this research because they still live on plant and animal foods that humans have hunted and gathered for millennia, and their use of western medications is extremely limited.

The health impacts of what lives (or doesn't) in our guts are getting increased attention in Western dietary and medical circles -- and eating foods containing "probiotics" just scratches the surface. Recent research suggests that use of antibiotics may be fundamentally altering our gut biomes for the worse, increasing rates of allergies, asthma and weight gain.

As for fecal transplants, they're no longer career killers in polite medical conversation. Swapping poop from healthy to sick persons is now an up-and-up treatment for curing chronic gastrointestinal disease. The launch of the OpenBiome fecal transplant bank in the U.S. earlier this year seems to signal that the technique is going mainstream.

As for Jeff Leach, he describes his primary scientific motivation for self-administering a fecal transplant as testing the hypothesis "of microbial extinction, something I believe we all suffer from in the western world and may be at the root of what’s making us sick." The biggest change Leach and his girlfriend have noticed since the transplant is that he's passing a lot less gas. 

Read the rest of his very readable, informative and down-to-earth essay: (Re)Becoming Human: what happened the day I replaced 99% of the genes in my body with that [sic] of a hunter-gatherer.

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It is estimated that between 14,000 to 30,000 Americans die each year from Clostridium difficile infections. So finding a bacteria that could protect people from C. difficile is a big deal. However, it is only one bacteria, and sick people typically are depleted of a microbial community, not just one bacteria. From Science News:

Harmless bacterium edges out intestinal germ

Gut infections from the bacterium Clostridium difficile can be fought with a closely related but harmless microbe known as C. scindens. The friendly bacterium combats infection in mice by converting molecules produced in the liver into forms that inhibit C. difficile growth,researchers report October 22 in Nature.

C. scindens also appears to protect people from infection, the researchers found in a preliminary study in humans. The new findings could begin a path to the next generation of therapies using gut bacteria, says Alexander Khoruts, a gastroenterologist at the University of Minnesota in Minneapolis.

People who become infected with C. difficile typically have taken antibiotics, which wipe out the beneficial microbes in the gut, giving C. difficile a chance to take root. The infection can lead to cramps, diarrhea and even death. An estimated 500,000 to 1 million people get C. difficile infections each year in the United States. People with C. difficile receive more antibiotics to treat the infection or a fecal transplant to restore healthy microbes to the gut.

Several research groups have been trying to identify gut bacteria that are resilient in the face of C. difficile so that physicians can give patients those bacteria as a treatment, says Eric Pamer, an immunologist at Memorial Sloan Kettering Cancer Center. Single strains of bacteria such as C. scindens would offer significant advantages over fecal transplants: With a transplant, doctors screen the donated feces for pathogens that might sicken the recipient. But, Pamer says, “there are many things, viruses that have yet to be identified, that could be in a crude fecal product that might cause trouble.”  

Pamer and his team gave mice antibiotics to deplete beneficial microbes but not wipe them out completely. The researchers then fed the mice C. difficile spores and identified microbes that appeared in mice with lower amounts of C. difficile in their guts. C. scindens was the clear victor. It is harmless and present in most people, but in very low numbers.

The researchers also examined the microbial populations of 24 patients undergoing stem cell transplants. Those patients had lowered microbial diversity after receiving combinations of antibiotics, radiation and chemotherapy. The patients who didn’t develop C. difficile after the transplant were more likely to have C. scindens in their guts.

The researchers also investigated how C. scindens combats C. difficile. C. difficile begins growing after it is exposed to certain molecules secreted in bile after a meal. However, another form of the molecule inhibits C. difficile growth. C. scindens transforms the molecule from one form to the other, boosting resistance to C. difficile.  

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Again,the same message: get moving for health, including cognitive function. From Science Daily:

To reap the brain benefits of physical activity, just get moving

Everyone knows that exercise makes you feel more mentally alert at any age. But do you need to follow a specific training program to improve your cognitive function? Science has shown that the important thing is to just get moving. It's that simple.

The study compared the effects of different training methods on the cognitive functions of people aged 62 to 84 years. Two groups were assigned a high-intensity aerobic and strength-training program, whereas the third group performed tasks that targeted gross motor activities (coordination, balance, ball games, locomotive tasks, and flexibility). While the aerobics and strength-training were the only exercises that led to physical fitness improvements after 10 weeks (in terms of body composition, VO2 max, and maximum strength), all three groups showed equivalent improvement in cognitive performance.

The subjects in the third group performed activities that can easily be done at home, which is excellent news for sedentary people who can't see themselves suddenly going to a gym to work out. To improve your cognitive health, you can simply start by doing any activity you like. 

"Our study targeted executive functions, or the functions that allow us to continue reacting effectively to a changing environment. We use these functions to plan, organize, develop strategies, pay attention to and remember details, and manage time and space," explained Dr. Louis Bherer, PhD.

"For a long time, it was believed that only aerobic exercise could improve executive functions. More recently, science has shown that strength-training also leads to positive results. Our new findings suggest that structured activities that aim to improve gross motor skills can also improve executive functions, which decline as we age. I would like seniors to remember that they have the power to improve their physical and cognitive health at any age and that they have many avenues to reach this goal," concluded Dr. Nicolas Berryman, PhD.

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The studies are adding up that phthalates are harmful to humans of all ages, but uniquely so to the developing fetus. Boys exposed to high levels of phthalates before birth may have slightly altered genitals, specifically a shortened anogenital distance (the length between the anus and the genitals). This is concerning because in adulthood, this is associated with reduced semen quality and lower fertility in males - and considered a sign of incomplete masculinization. So try to avoid or lower exposure to phthalates during pregnancy (see posts on ENDOCRINE DISRUPTORS). From Environmental Health Perspectives:

Plastics chemical linked to changes in baby boys' genitals

Boys exposed in the womb to high levels of a chemical found in vinyl products are born with slightly altered genital development, according to research published today.The study of nearly 200 Swedish babies is the first to link the chemical di-isononyl phthalate (DiNP) to changes in the development of the human male reproductive tract.

Previous studies of baby boys in three countries found that a similar plastics chemical, DEHP, was associated with the same type of changes in their genitalia. Less is known about the reproductive risks of DiNP, a chemical which scientists say may be replacing DEHP in many products such as vinyl toys, flooring and packaging. In mice, high levels block testosterone and alter testicular development.

“Our data suggest that this substitute phthalate may not be safer than the chemical it is replacing,” wrote the researchers, led by Carl-Gustaf Bornehag at Sweden’s Karlstad University, in the journal Environmental Health Perspectives. Levels of DiNP in U.S. adults and children have more than doubled in the past decade.

The researchers measured metabolites of five phthalates in the urine of pregnant women during the first trimester. Development of male reproductive organs begins during that period, said senior study author Shanna Swan, a professor of reproductive science at Mount Sinai Hospital in New York. The researchers then measured the anogenital distance – the length between the anus and the genitals – when the boys were on average 21 months old. Boys who had been exposed to the highest levels of DiNP in the womb averaged a distance that was slightly shorter – about seven-hundredths of an inch – than the boys with the lowest exposures. “These were really subtle changes,” Swan said.

Considered a sign of incomplete masculinization, shortened anogenital distance in men has been associated with abnormal testicular development and reduced semen quality and fertility. In men, this measurement is typically 50 to 100 percent longer than in women. But it’s unknown whether a slightly shorter distance in infants corresponds with any fertility problems later in life.

For other phthalates, the study found shorter anogenital distance with higher concentrations, but the findings were not statistically significant, meaning they may have been due to chance. The Swedish women in the new study had phthalate levels similar to U.S. women in Swan's previous studies. Those studies, published in 2005 and 2008, linked several phthalates to shorter anogenital distance.

The scientists said exposures to the chemical can come from food or through skin contact with home furnishings or child-care articles. In 2008, the United States temporarily banned use of DiNP and two other phthalate plasticizers in toys and other children's products.... While it’s nearly impossible to eliminate exposure to phthalates, Swan suggested that pregnant women may be able to reduce their exposures by incorporating unprocessed, unpackaged foods into the diet and by avoiding heating or storing foods in plastic containers.

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Link between Vitamin D levels and asthma.From Science Daily:

Breathe easier: Get your vitamin D

Asthma, which inflames and narrows the airways, has become more common in recent years. While there is no known cure, asthma can be managed with medication and by avoiding allergens and other triggers. A new study points to a convenient, free way to manage acute asthmatic episodes -- catching some rays outside.

"Vitamin D has significant immunomodulatory effects and, as such, was believed to have an effect on asthma -- an immunologically mediated disease," said Dr. Confino-Cohen.

Dr. Confino-Cohen and her team of researchers analyzed the medical records of nearly four million members of Clalit Health Services, Israel's largest health care provider. The Vitamin D levels of 307,900 people were measured between 2008 and 2012. Researchers also took into account key predictors of asthma, such as obesity, smoking, and other chronic diseases. Of some 21,000 asthma patients in Israel studied, those with a Vitamin D deficiency were 25 percent more likely than other asthmatics to have had at least one flare-up in the recent past.

The researchers found that Vitamin D-deficient asthmatics were at a higher risk of an asthma attack. "Uncontrolled asthma" was defined as being prescribed at least five rescue inhalers, one prescription of oral corticosteroids, or visiting the doctor for asthma at least four times in a single year.

While most of the Vitamin D in people's bodies comes from exposure to the sun, dermatologists recommend obtaining the ingredient from other sources -- fish, eggs, cod liver oil, fortified milk, or a dietary supplement -- due to the dangers of overexposure to the sun.

Based on the findings, the researchers recommend that people whose asthma cannot be controlled with existing treatments have their Vitamin D levels tested. For those with a vitamin D deficiency, supplements may make sense.

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Another reason to improve your lifestyle - to treat erectile dysfunction (ED).

From Medical Daily: Erectile dysfunction can be reversed without medication

Men suffering from sexual dysfunction can be successful at reversing their problem by focusing on lifestyle factors and not just relying on medication, according to research. Researchers have highlighted the incidence of erectile dysfunction and lack of sexual desire among Australian men aged 35-80 years. 

Over a five-year period, 31% of the 810 men involved in the study developed some form of erectile dysfunction. The major risk factors for this are typically physical conditions rather than psychological ones, such as being overweight or obese, a higher level of alcohol intake, having sleeping difficulties or obstructive sleep apnoea, and age.

"The good news is, our study also found that a large proportion of men were naturally overcoming erectile dysfunction issues. The remission rate of those with erectile dysfunction was 29%, which is very high. This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition," Professor Wittert says.

"Erectile dysfunction can be a very serious issue because it's a marker of underlying cardiovascular disease, and it often occurs before heart conditions become apparent. Therefore, men should consider improving their weight and overall nutrition, exercise more, drink less alcohol and have a better night's sleep, as well as address risk factors such as diabetes, high blood pressure and cholesterol.

A question that some may have about the persistence of the HPV virus on surfaces . From Medical Daily: Sex Toys Can Show Traces Of HPV 24 Hours After Use, Have Increased Chance Of Spreading Virus, Despite Cleaning

Shared sex toys between two women and between women and men could have traces of the human papillomavirus even after they’ve been cleaned. According to a study published in the journal Sexually Transmitted Infections,researchers from the Division of Infectious Diseases at the Indiana University School of Medicine found that women could be potentially putting their partners at risk...HPV is one of the most commonly sexually transmitted diseases, approximately 79 million Americans are currently infected with the disease, and that number increases by 14 million each year.

The study focused on women between the ages of 18 and 29 who had been in sexual relationships with both a man and a women in the prior year. They gave each woman a cleaning product, one vibrator made of thermoplastic elastomer, and another made out of soft silicone. The participants were asked to swab the vibrations after vaginal use, immediately after cleaning, and 24 hours later.

The authors found that in 75 percent of vagina samples (9 out of 12), HPV was detected. In the nine vibrators from the HPV-positive women, 85 percent (8) of showed signs of the virus; after cleaning, 56 percent (5 of the 9) had traces of HPV. Twenty-four hours after cleaning the contaminated vibrators, 40 percent (2 out of the 5) of the swabs were still positive. They also found that silicone vibrators had a lower detection rate 24 hours after cleaning.

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The following medical article (actually an interview with Prof. Cedric F Garland, Department of Family & Preventive Medicine, University of California San Diego School of Medicine) is strongly in favor of Americans getting their Vitamin D levels tested, and taking vitamin D3 (if needed) to raise serum levels of vitamin D's metabolite 25(OH)D to at least 30 ng/mL and preferably more.

It is suggested that taking 1000 IU of vitamin D3 daily would achieve these levels in most people. From Medscape:

Vitamin D and Mortality Risk: Should Clinical Practice Change?

Traditionally associated with skeletal disease including osteoporosis and fractures, low levels of serum 25-hydroxyvitamin D (25[OH]D), the metabolite usually measured as a mark of vitamin D status, more recently have been linked to a wide range of nonskeletal diseases, including some cancers and autoimmune, cardiometabolic, and neurologic diseases. A number of studies also have reported an inverse association between 25(OH)D concentration and all-cause mortality.

To explore this association more, Medscape reached out to Dr. Cedric Garland, a well-known expert on vitamin D. Dr. Garland is a professor in the Division of Epidemiology, Department of Family and Preventive Medicine, and a Fellow of the American College of Epidemiology. He has a Doctor of Public Health degree from University of California San Diego and studied epidemiology at Johns Hopkins. His research has focused on vitamin D status in health and the association between vitamin D deficiency and increased risk for disease, including some common cancers (breast cancer, colon cancer, leukemia, and melanoma) and diabetes. He is active in seeking to reduce the risk for cancer and diabetes by improving vitamin D status among the US population.

To examine the relation between serum 25(OH)D and mortality, Dr. Garland and colleagues at the University of California San Diego and others in the United States pooled data from 32 studies published between 1966 and 2013.[6] They found an overall relative risk of 1.8 (95% confidence interval [CI]: 1.7-1.8; P <.001) comparing the lowest (0-9 ng/mL) with the highest (>30 ng/mL) category of 25(OH)D for all-cause mortality. Serum 25(OH)D concentrations ≤30 ng/mL were associated with higher all-cause mortality than concentrations >30 ng/mL (P <.01).

The investigators noted that these findings confirmed observations from the Institute of Medicine (IOM) that 25(OH)D levels of <20 ng/mL are too low for safety,[8] but they suggested a cut-off point of >30 ng/mL rather than >20 ng/mL for all-cause mortality reduction. This level "could be achieved in most individuals by intake of 1000 IU per day of vitamin D3," the investigators said, noting that this is described as a safe dose in almost all adults by both the IOM[8] and Endocrine Society[9] clinical guidelines on dietary intake of vitamin D.

In particular, a randomized clinical trial by Lappe et al[12] had demonstrated a reduced risk for all cancers with vitamin D supplementation in postmenopausal women.... Only one third of the US population is below 20 ng/mL,[15] but two thirds of the population is below 30 ng/mL.[16]

We decided to look at what would happen if we put together all the existing studies that have looked at the survival of "ordinary" people; that is, mostly people in general practices who did not, for the most part, have illnesses. Studies that only included people who were already ill were not eligible for inclusion in our analysis. We found 88 relevant studies, of which 32 presented their data by quartiles of intake, allowing us to see a dose response

The incidence of colon cancer is very high in countries like Iceland and Sweden, and other countries nearer the North Pole, and in countries like New Zealand, which is closer to the South Pole, and intermediate in countries at intermediate latitudes such as the United States, which is, on average, 38º north of the Equator. By the time you get down within the tropics, which is 23º from the Equator, it begins to decrease, and within 5º of the Equator there are vanishingly low incidence rates of colon cancer. In the past, some scientists theorized that the low incidence rates near the equator were due to intake of a high-fiber diet, but now my group believes -- and many others are leaning more in this direction -- that it is the high UVB irradiance and high circulating 25(OH)D year-around nearer the equator rather than a high-fiber diet that best explains the inverse association with solar UVB irradiance

Raising the serum 25(OH)D from 30 to 40 ng/mL reduces the incidence of breast, bowel, and lung cancer by 80%, as reported by Lappe and colleagues in their clinical trial.[12]On the other hand, if you lump all cancers together, in both sexes, and include countries where there is a whole lot of cigarette smoking, then you may obscure the effect of the vitamin D. Vitamin D is not able to overcome the effect of heavy smoking, and the CHANCES analysis[7] included data from people in countries like the Czech Republic, Poland, and Lithuania, where there is a huge amount of smoking. Although the effects are still there, they are weakened.

Studies such as our meta-analysis have provided us an opportunity to not just be locked into the present but to predict mortality on the basis of vitamin D levels in the present. I had expected our results to be convincing, but we were shocked at the persistence of the belief that very low levels of vitamin D, such as approximately 20 ng/mL, are safe. They are not safe with regard to breast and colon cancer, several other cancers, diabetes in youth and adulthood, fractures, and other complications of 25(OH)D <30 ng/mL. Even higher levels, such as 40-60 ng/mL, would be even safer, according to a letter of consensus of expert vitamin D scientists and physicians.

In addition, 2 ongoing trials, the CAPS study[23] (aiming to replicate the findings of Lappe et al[12]) and the VITAL study,[22] are both using a vitamin D3 dose of 2000 international units (IU)/day. I think that if I were to design a trial, knowing what we know today, I would use 4000-5000 IU/day. It seems as though each time we do a clinical trial, by the time the trial is completed, we know that the doses were too small to elicit an effect.

I am also concerned that there may be not enough calcium to see an effect. In CAPS, the women are being given 1500 mg of calcium, which was done in the original randomized controlled trial in which 80% of the cancers in postmenopausal women were prevented. I would have stayed with this design and dose for the VITAL trial. We know that it helps because in their original trial, Lappe and colleagues[12]examined the effects of vitamin D alone vs vitamin D plus calcium, and the effects were stronger when the calcium was included.

Testing should be universal. And ideally it should be done in March when the vitamin D is at its lowest levels. This will prevent hundreds of thousands of cases of serious diseases worldwide annually, beginning with postmenopausal breast cancer and including colon cancer and types 1 and 2 diabetes. Skipping this test would be equivalent to not measuring blood pressure, serum lipids, or weight at an annual exam.

No one should run a serum 25(OH)D less than 30 ng/mL. This means that two thirds of the US population needs supplementation. You may have noticed that President Obama was recently tested for his vitamin D, and it was 22.9 ng/mL.[35] His physicians wisely decided to treat him, and he is now taking vitamin D.