Vitamin D: 1 of the 4 Nutrient of Concern

Stan Starsky: Hi, I’m from Stan Starsky from Peace, Love & Snacks, author of the healthy snacks cookbook, Peace, Love & Snacks. I am with Rachel Begun. Rachel is a registered dietitian. She’s also the spokesperson for the Academy of Nutrition & Dietitics. You’re going to want to check out Rachel’s website just actually Welcome, Rachel.


Rachel Begun: Hi, how are you?


Stan: Hey! Thanks for taking some of the time to speak with me.


Rachel: Yeah, absolutely! We talked a litlte bit earlier. We’re going to talk about Vitamin D. So, let’s just jump right in. I hear a lot about vitamin D especially recently within the past few  years, but what is it? What is vitamin D?


Rachel: Well, vitamin D, which is often called the sunshine vitamin, as well is a fat soluble vitamin that can be obtained through food and it also can be synthesized by the body when the skin is exposed to the sun. Because it can be synthesized through sunlight, it’s not considered an essential dietary vitamin, meaning we don’t have to obtain it from food, however, it’s really important to focus on dietary sources because many of us aren’t getting enough exposure to sunlight to obtain the adequate amounts that we need.


Stan: May I ask you, it’s fat-soluble? So, that’s different than other vitamin? Aren’t all vitamins fat-soluble vitamins then?


Rachel: Yes, there are water-soluble vitamins and then, there are fat-soluble vitamins. With fat-soluble vitamins, you actually need fat in the diet in order to absorb the nutrients into the body. It’s really important to actually take in healthy fats into your diets so that you can absorb the fat-soluble vitamins. Some of the other fat-soluble vitamins are A, E and K along with vitamin D.


Stan: Okay. Well, we’ll get into some more information on how to get it, but what does it actually do? Why should I care about vitamin D?


Rachel: Well, the more we learn about vitamin D, the more we realize it’s really a nutrition superstar. Most people know vitamin D for its bone health benefit, but really, that’s just one many roles it plays in the body. Some of the other significant roles that it plays are it helps to regulate cell growth, neuromuscular function, as well as immunity. There’s even some preliminary evidence showing that it may play a role in preventing some chronic disease, things like Cancer, cardiovascular disease and autoimmune conditions. But regarding these, we do need more research in the area to understand the role that it plays and to make any specific kinds of recommendation.


Stan: We started to talk a little bit about how you’d get it. You mentioned sunshine. Can you talk some more about that? Can you give us some more tips on how to get vitamin D.


Rachel: Sure! Well, in addition to our bodies making it from sunlight being exposed to skin, there’s actually dietary sources. But actually, there are only a few natural dietary sources of vitamin D, so we can obtain it both through natural dietary sources, as well as fortified sources.


Some of the natural dietary sources include things like oily fish – things like salmon, tuna, mackerel, eggyolks are also a great dietary source that’s a natural source – beef liver and muschrooms. In fact, some mushrooms are actually being exposed to ultraviolet light in order to boost their vitamin D contents.


And then, there’s the fortified dietary sources. That’s important to now because the majority of vitamin D in the Americans’ diet actually does come from fortified dietary sources. Fortified sources include cow’s milk and yoghurt, some of the alternative milk, such as soy, almond, hemp and rice and then, things like orange juice and breakfast cereals.


Stan: Yeah, I’ve seen a lot of orange juice now that has vitamin D, as well. I’m kind of curious, can you get too much of it? Should we be concerned about that, as well?


Rachel: Well, it’s not likely to get too much vitamin D. In fact, most of us aren’t getting enough. Vitamin D is actually one of four nutrients that has been identified as a nutrient of concern by the dietary guidelines for Americans. What that means is that these are nutrients that are most likely to be missing from the average American diet. So again, it’s not likely to get too much, but you can overdo it. That’s more likely due to supplementation and not food.


And then, another aspect is that you can’t get vitamin D toxicity from too much sun exposure because the body actually limits the amount of production.


Stan: I guess I’m kind of wondering, too, why are people deficient? I guess they’re not eating enough of these categories and not getting enough sunlight? Maybe you can shed some light on that, as well?


Rachel: There are people who are more likely to be deficient in vitamin D and for various reasons. Some of those people would include older adults because their skin is less efficient at making vitamin D and the kidneys are also less able to convert it to its active form.  You’re more likely to see vitamin D deficiency in older adults.


Also, people with limited sun exposure. Because they live in  northern latitudes and aren’t out and about in the sun as much as people in warmer climates.


Then also, people with dark skin because they’re actually less able to make vitamin D from the sun.


Then you have people who have malabsorption disorders. Those might be with Crohn’s diases or Celiac disease.


And then, an interesting category is that obese people can tend to be deficient in vitamin D because the fat sequesters vitamin D and prevents it from entering the circulation.


We also sometimes see vitamin D deficiency in people who have undergone bypass surgery or gastric bypass surgery. That’s because the site of the small intestine where vitamin D is absorbed is bypassed from that surgery.


Stan: Interesting!


Rachel: Yeah.


Stan: We talked a little bit before too some medicines, as well, getting on that topic too of why some people are likely deficient? Are there any certain medication you should be concerned about either over-the-counter or prescription medication that might cause deficiency?


Rachel: Yes, there are definitely some medicines out there that can interfere with vitamin D absorption. It’s important to talk to your doctor if you’re taking any of these drugs when you’re concerned about bone health.


They’re primarily more prescription drugs, things like corticosteroids such as prednizone, which are often prescribed to reduce inflammation for many disease and health issues. Corticosteroids can aclty interfere with vitamin D so that the Calcium is not absorbed into the body.


The reason vitamin D is so important for bone health is because vitamin D needs to be present in order for Calcium to be absorbed, so that’s the role that it plays in bone health.


Some other drugs that can be an issue are some weight loss drugs and cholesterol lowering drugs because they actually reduce the absorption of fat-soluble vitamins and as we’ve mentioend before, vitamin D is a fat-soluble vitamin.


And also, drugs for epilepsy. They can actually increase the breakdown of vitamin D, so again, they can reduce Calcium absorption. So, those are the main categories of medicine that are of concerned.


And again, if there is a history of bone health issues in the family, then certainly, that should be mentoned to doctors when they’re prescribing drugs.


Stan: We kind of got a little bit of a feel for some of the things that vitamin D can do and I’ve got a couple of places or some ideas how to get vitamin D. Is there any way I can know or some of our listeners can know if they’re getting enough? Should they just spend about half hour in the sun and eat some mushrooms? Is there any sort of guidelines?


Rachel: Well, there are guidelines. The current average daily recommended amounts, which actually assumes little to no exposure to sunlight are 400 international units since up until year one. And then, for people 1-70 years old and/or pregnant and breastfeeding women, the recommended go up to 600 international units. And then, for people who are 71 years and older, it goes up to 800 international units. But there seem to be in the scientific community whether we should be increasing these recommended daily amounts as many feel the current guidelines may not be adequate for meeting needs.


So yes, it’s using a combination. Depending on your diet, as well as any contraindication for medicines or just any issues that there might be, it would range, but people should definitely  be getting vitamin D through dietary sources, as well as exposure to sunlight. If they’re not getting enough from those sources, the supplementation may be a course of action.


But really, you wouldn’t know if you’re not getting enough unless a doctor gives you a blood test and actually sees the amount of vitamin D in the blood. You wouldn’t really have any symptoms that you would be aware of other than some general symptoms that might cause you to go to your doctor.


Stan: Any thoughts, too, you mentioned oily fish, egg yolks, mushrooms. Those are just a few things that I was able to drag down. Can you put that maybe into quantities a bit? If you had two eggs, would that be about enough vitamin D for the day roughly speaking?


Rachel: Well, yes. As far as eggs are concerned, it’s really important that you eat the egg yolks for vitamin D because that’s where the vitamin D resides; it’s in the egg yolk. Assuming that there aren’t cardiovascular issues where a doctor may be telling you to reduce consumption because of high cholesterol levels, you can actually eat up to an egg a day. That might mean a couple of eggs a few times a week.


But really, for vitamin D, because there are so few dietary sources, eating the yolks is important from a vitamin D perspective.


And then, with the fishes, again, it’s the oily fishes – things like salmon, tuna and mackerel. For there, also for guidelines for other issues such as heart-healthy fats it provides, you probably want to be getting at least a couple of servings of these oily fishes a week. That’s at a minimum.


And then, mushrooms, they’re such a great way to get vitamin D and knowing that they’re also a good source of vitamins and minerals and phytonutrients. They’re also very low in calories. Mushrooms can be added to so many different foods in the diet – everything from salads to eggs to being used as a substitute for meat in things like burgers or taco meat. Really, mushrooms are a great way to get vitamin D and they have so many other health benefits, as well.


And then, beef liver, which is probably not a food that many people put on their lists of foods to eat in regular amounts, know that if it is eaten on occasion, it does have health benefits and one of those is vitamin D.


Those really are the primary natural dietary sources. If you know you’re not getting enough of those foods in the diet from natural dietary sources, that’s where you really want to rely on fortified foods because they can contribute more vitamin D in the diet than even some of the natural dietary sources.


In fact, way back when, it was a public health campaign to add vitamin D to milk because rickets was such an issue for children. Rickets is actually a disease. That’s the softening and weakening of the bones in children, which can lead to fractures or the bowing of the legs that we often see. That is the reason that vitamin D was added to milk in the first place; it was to avoid that disease. It was a very successful campaign because rickets was pretty much wiped out as a concerned when vitamin D was added to milk.


The issue now is that children are often drinking juices and sodas in place of milk. We’re actually starting to see more of a swing back to some more cases of rickets because they’re not getting that vitamin D from the milk that used to be so much more common in the diet.


Stan: Interesting! I really hardly ever eat mushrooms. I gotten to eating a lot of green stuff, but that’s good to know too about mushroom.


Does it matter too if you cook them or eat them raw? Does that even matter with vitamin D all that much.


Rachel: I think both are fun. But again, because vitamin D is a fat soluble vitamin, when you are eating these foods, it’s good to have a source of dietary fat when you’re eating them. So, with mushrooms, if you’re eating them in a salad, having a proper size portion of dressing that might have some healthy boil in it, that’s a good option. Also, you may sauté the mushroom (i.e. sautéing them in olive oil). Also, things with eggs, you might want to cook them with a little bit of healthy fat. Even butter is okay because that’s a fat that certainly will increase the solubility of the vitamin D.


So, raw or cooked is fine, but again, you want to be getting some healthy fats in your diet. That doesn’t necessarily mean you have to be eating it at exactly the same time as the mushroom. There’s so many ways of eating mushrooms that recipes incorporate with healthy fats. You’ll certainly see a lot of recipes where that’s the case. It certainly helps the solubility of the vitamin D.


Stan: Rachel, that’s good. That’s really interesting stuff. I learned quite a bit. Hey! It’s about time to wrap it up. Is there any final thoughts or one or two tips or things that you’d like to leave people with?


Rachel: Yes, I would actually. I just want to reiterate something I said before. Many of us really aren’t getting enough vitamin D. Again, it is one of four nutrients that are identified by the dietary guidelines for Americans as being a nutrient of concern. That means that many Americans are not getting enough in their diet. Again, if you’re not getting enough exposure to sunlight, you want to be making sure that you’re getting vitamin D from natural and fortified dietary sources – definitely with a focus on natural sources. If supplementation is necessary to get you to the levels that you need to be at, then that’s certainly welcome, as well.


Stan: Excellent! Excellent! Rachel, that was really good. I appreciate it. Thanks again for speaking with me. I learned quite a bit, so thank you.


Rachel: Thank you. I appreciate it.


Stan: Well, that about wraps it up. I’m Stan Starsky from Peace, Love & Snacks, author of the healthy snacks cookbook, Peace, Love & Snacks. Once again, I am with Rachel Begun wrapping up that conversation. As I’ve mentioned, I’ve learned quite a bit.


Rachel is a registered dietitian. She’s the spokesperson for the Academy of Nutrition and Dietetics. You’re going to want to check out her website. Please go to Until next time! I’ll speak to you then.


Snack time!

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