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 Vitamin D deficiency has been implicated in a variety of cancers (herehere, and here). Now a study found that vitamin D levels are linked to the long-term outcome in women with breast cancer. Researchers found that after 7 years, women with the highest levels of vitamin D had about a 30 percent better likelihood of survival from breast cancer than women with the lowest levels of vitamin D, The study put women into one of three groups based on their levels of vitamin D (as measured in the blood 2 months after the initial breast cancer diagnosis): deficient - levels below 20.0 ng/mL; insufficient - 20.0 to 29.9 ng/mL; and sufficient - greater than or equal to 30.0 ng/mL. They found that almost half of the women were vitamin D deficient, and another third were insufficient.

The researchers said the findings "provide compelling observational evidence for inverse associations between vitamin D levels and risk of breast cancer progression and death". In other words, the higher the vitamin D levels, the better the outcome. NOTE: Good vitamin D levels can usually be obtained with one 1000 IU supplement of vitamin D3 per day. Or expose bare skin to sunlight - after all, it is called the "sunshine vitamin". From Medical Xpress:

Higher vitamin D levels associated with better outcomes in breast cancer survivors

Women with higher vitamin D levels in their blood following a breast cancer diagnosis had significantly better long-term outcomes, according to new research from Kaiser Permanente and Roswell Park Cancer Institute....Vitamin D is a nutrient best known for its role in maintaining healthy bones; conversely, vitamin D deficiency has been associated with the risk for several cancers.

Common sources of vitamin D include sun exposure, fatty fish oils, vitamin supplements, and fortified milks and cereals. While the mechanisms for how vitamin D influences breast cancer outcomes are not well understood, researchers believe it may be related to its role in promoting normal mammary-cell development, and inhibiting the reproduction of and promoting the death of cancer cells.

"We found that women with the highest levels of vitamin D levels had about a 30 percent better likelihood of survival than women with the lowest levels of vitamin D," said Lawrence H. Kushi, ScD....principal investigator of Kaiser Permanente's Pathways study of breast cancer survivorship. The current study included 1,666 Pathways study members who provided samples between 2006 and 2013....had a diagnosis of invasive breast cancer in 2006. Participants provided blood samples within two months of diagnosis and answered questions about diet, lifestyle and other risk factors, with follow-ups at six months and at two, four, six and eight years.

"With the extremely rich data sources from a large sample size, we were able to prospectively analyze three major breast cancer outcomes—recurrence, second primary cancer and death," said Song Yao, PhD, associate professor of oncology at Roswell Park Cancer Institute and the study's lead author....In addition to lower overall mortality among all breast cancer survivors studied, the researchers found even stronger associations among premenopausal women in the highest third of vitamin D levels for breast-cancer-specific (63 percent better), recurrence-free (48 percent better) and invasive-disease-free survival (42 percent better), during a median follow up of seven years. [Original study]

New research has found that low vitamin D levels among older adults is associated with accelerated cognitive decline and impaired performance (particularly in areas of memory and executive function). The next research in this area will have to look at whether vitamin D supplementation will change (slow down) the decline. Please note that it is widely accepted that an average daily intake of 1000 IU  of D3 daily is safe. The best source of  vitamin D is sunlight. From Science Daily:

Low vitamin D among elderly associated with decline in cognition, dementia

Vitamin D insufficiency among the elderly is highly correlated with accelerated cognitive decline and impaired performance, particularly in domains such as memory loss that are associated with Alzheimer's disease and dementia, researchers with the UC Davis Alzheimer's Disease Center and Rutgers University have found. The effect is "substantial," with individuals with low vitamin D declining at a rate three times faster than those with adequate vitamin D levels

The researchers said their findings amplify the importance of identifying vitamin D insufficiency among the elderly, particularly high-risk groups such as African-Americans and Hispanics, who are less able to absorb the nutrient from its most plentiful source: sunshine. Among those groups and other darker-skinned individuals, low vitamin D should be considered a risk factor for dementia, they said. "Independent of race or ethnicity, baseline cognitive abilities and a host of other risk factors, vitamin D insufficiency was associated with significantly faster declines in both episodic memory and executive function performance," said Joshua Miller...

The large, longitudinal study was conducted in nearly 400 racially and ethnically diverse men and women in Northern California participating in longitudinal research at the Alzheimer's Disease Center in Sacramento, Calif. Fifty percent of participants were Caucasian and 50 percent were African-American or Hispanic. The participants had a mean age of 76 and were either cognitively normal, had mild cognitive impairment, or dementia.The participants' serum vitamin D status was measured at the beginning of the study.... Overall, 26 percent were deficient and 35 percent were insufficient. Among Caucasians, 54 percent had low vitamin D, compared with 70 percent of African-Americans and Hispanics.

Over five years of follow-up, vitamin D deficient individuals experienced cognitive declines that were two-to-three times faster than those with adequate serum vitamin D levels. In other words it took only two years for the deficient individuals to decline as much as their counterparts with adequate Vitamin D declined during the five-year follow-up period.

Exposing the skin to sunlight is the major source of vitamin D. Racial and some ethnic minorities are at greater risk of low vitamin D because the higher concentration of melanin that makes their skin darker -- and protects against skin cancer in sunny climates -- also inhibits synthesis of vitamin D. Diet is the other major source of vitamin D. Dietary vitamin D is obtained particularly through dairy consumption. The intake of dairy products is especially low among minority groups, with only 6.5 percent of African-Americans and 11 percent of Mexican-Americans nationwide consuming the recommended three daily servings of dairy products, the study says.

Can you have too high levels of vitamin D? The researchers themselves say that the results show there is a J shaped curve linking vitamin D levels in the blood and mortality - both too high and too low levels are linked to higher levels of mortality. From Science Daily:

High levels of vitamin D is suspected of increasing mortality rates

The level of vitamin D in our blood should neither be too high nor to low. Scientists have now shown that there is a connection between high levels of vitamin D and cardiovascular deaths.

In terms of public health, a lack of vitamin D has long been a focal point. Several studies have shown that too low levels can prove detrimental to our health. However, new research from the University of Copenhagen reveals, for the first time, that also too high levels of vitamin D in our blood is connected to an increased risk of dying from a stroke or a coronary.

"We have studied the level of vitamin D in 247,574 Danes, and so far, it constitutes the world's largest basis for this type of study. We have also analysed their mortality rate over a seven-year period after taking the initial blood sample, and in that time 16,645 patients had died. Furthermore, we have looked at the connection between their deaths and their levels of vitamin D," Professor at the Department of Clinical Medicine, Peter Schwarz explains.

The conclusion is clear: the study confirms that there is indeed a correlation between mortality rates and too low levels of vitamin D, but the new thing is that the level of vitamin D can also be too high.

"If your vitamin D level is below 50 or over 100 nanomol per litre, there is an greater connection to deaths. We have looked at what caused the death of patients, and when numbers are above 100, it appears that there is an increased risk of dying from a stroke or a coronary. In other words, levels of vitamin D should not be too low, but neither should they be too high. Levels should be somewhere in between 50 and 100 nanomol per litre, and our study indicates that 70 is the most preferable level," Peter Schwartz states.

The possibility of lowering the risk of ischemic stroke (and poor recovery from it) is a good reason to try to increase vitamin D levels - by supplements and/or sunlight. Note that an ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. From Medical Xpress:

Low vitamin D predicts more severe strokes, poor health post-stroke

Stroke patients with low vitamin D levels were found to be more likely than those with normal vitamin D levels to suffer severe strokes and have poor health months after stroke, according to research presented at the American Stroke Association's International Stroke Conference 2015. Low vitamin D has been associated in past studies with neurovascular injury (damage to the major blood vessels supplying the brain, brainstem, and upper spinal cord).

"Many of the people we consider at high risk for developing stroke have low vitamin D levels. Understanding the link between stroke severity and vitamin D status will help us determine if we should treat vitamin D deficiency in these high-risk patients," said Nils Henninger, M.D., senior study author and assistant professor of neurology and psychiatry at University of Massachusetts Medical School in Worchester.

Henninger and colleagues studied whether low blood levels of 25-hydroxyvitamin D, a marker of vitamin D status, is predictive of ischemic stroke severity and poor health after stroke in 96 stroke patients treated between January 2013 and January 2014 at a U.S. hospital. They found:

  • Overall, patients who had low vitamin D levels –defined as less than 30 nanograms per milliliter (ng/mL) – had about two-times larger areas of dead tissue resulting from obstruction of the blood supply compared to patients with normal vitamin D levels.
  • This association was similar among patients who suffered lacunar strokes (in which the small, intricate arteries of the brain are affected) and patients with non-lacunar strokes (such as those caused by carotid disease or by a clot that originated elsewhere in the body).
  • For each 10 ng/mL reduction in vitamin D level, the chance for healthy recovery in the three months following stroke decreased by almost half, regardless of the patient's age or initial stroke severity.

More discussion of the benefits of vitamin D. From Science Daily:

Vitamin D deficiency, depression linked in international study

Vitamin D deficiency is not just harmful to physical health -- it also might impact mental health, according to a team of researchers that has found a link between seasonal affective disorder, or SAD, and a lack of sunlight. "Rather than being one of many factors, vitamin D could have a regulative role in the development of SAD," said Alan Stewart of the University of Georgia College of Education.

Stewart and Michael Kimlin from QUT's School of Public Health and Social Work conducted a review of more than 100 leading articles and found a relationship between vitamin D and seasonal depression."Seasonal affective disorder is believed to affect up to 10 percent of the population, depending upon geographical location, and is a type of depression related to changes in season," said Stewart, an associate professor in the department of counseling and human development services.

"We believe there are several reasons for this, including that vitamin D levels fluctuate in the body seasonally, in direct relation to seasonally available sunlight," he said. "For example, studies show there is a lag of about eight weeks between the peak in intensity of ultraviolet radiation and the onset of SAD, and this correlates with the time it takes for UV radiation to be processed by the body into vitamin D.

Vitamin D is also involved in the synthesis of serotonin and dopamine within the brain, both chemicals linked to depression, according to the researchers. "Evidence exists that low levels of dopamine and serotonin are linked to depression, therefore it is logical that there may be a relationship between low levels of vitamin D and depressive symptoms," said Kimlin, a Cancer Council Queensland Professor of Cancer Prevention Reseach. "Studies have also found depressed patients commonly had lower levels of vitamin D."

Vitamin D levels varied according to the pigmentation of the skin. People with dark skin often record lower levels of vitamin D, according to the researchers.

Kimlin, who heads QUT's National Health and Medical Research Council Centre for Research Excellence in Sun and Health, said adequate levels of vitamin D were essential in maintaining bone health, with deficiency causing osteomalacia in adults and rickets in children. Vitamin D levels of more than 50 nanomoles per liter are recommended by the U.S. Institute of Medicine...."A few minutes of sunlight exposure each day should be enough for most people to maintain an adequate vitamin D status."

It would be exciting if vitamin D supplementation improves cognitive function in the elderly. From Science Daily:

Vitamin D deficiency, cognition appear to be linked in older adults

Vitamin D deficiency and cognitive impairment are common in older adults, but there isn't a lot of conclusive research into whether there's a relationship between the two.

"This study provides increasing evidence that suggests there is an association between low vitamin D levels and cognitive decline over time," said lead author Valerie Wilson, M.D., assistant professor of geriatrics at Wake Forest Baptist. "Although this study cannot establish a direct cause and effect relationship, it would have a huge public health implication if vitamin D supplementation could be shown to improve cognitive performance over time because deficiency is so common in the population."

Wilson and colleagues were interested in the association between vitamin D levels and cognitive function over time in older adults. They used data from the Health, Aging and Body composition (Health ABC) study to look at the relationship. The researchers looked at 2,777 well-functioning adults aged 70 to 79 whose cognitive function was measured at the study's onset and again four years later. Vitamin D levels were measured at the 12-month follow-up visit.

The Health ABC study cohort consists of 3,075 Medicare-eligible, white and black, well-functioning, community-dwelling older adults who were recruited between April 1997 and June 1998 from Pittsburgh, Pa., and Memphis, Tenn.

"With just the baseline observational data, you can't conclude that low vitamin D causes cognitive decline. When we looked four years down the road, low vitamin D was associated with worse cognitive performance on one of the two cognitive tests used," Wilson said. "It is interesting that there is this association and ultimately the next question is whether or not supplementing vitamin D would improve cognitive function over time."