Millions of children around the world suffer from malnourishment. While the worst problems are in Asia and Africa, “severe acute malnutrition” is the most extreme and very obvious when you see the physical toll it takes.
Scientists from Queen Mary University of London (QMUL) and University of the Punjab in Southern Pakistan recently focused on the latter region, where nearly 1.5 million children are dangerously malnourished, to analyze the effectiveness of vitamin D3 supplementation in restoring the health of such children. The Conversation notes:
“Severe acute malnutrition is the most extreme and visible form of undernutrition. Affected children have very low weight for their height and severe muscle wasting; they may also have swollen feet, face and limbs. About 20m [million] children are affected worldwide, mainly in Asia and Africa where it is a major cause of death.
Children with severe acute malnutrition also commonly have low levels of vitamin D. This micronutrient is important for muscle and bone health and for maintaining a healthy immune system.”1
A total of 185 severely malnourished children, aged 6 months to 4 years, completed the follow-up as well as the trial, which was published by The American Journal of Clinical Nutrition.2 The first group of 93 children was randomly selected to receive two oral 5-milligram (mg) doses of vitamin D dissolved in olive oil while the remaining 92 were given a placebo with the same taste: olive oil without the vitamin D.
None of the children or their parents knew which children were in which group; and both groups were started on the “standard” treatment for malnourishment: a “high-energy” ready-to-use therapeutic food (RUTF) paste (called Plumpy Nut), containing a small amount of vitamin D and other essential micronutrients, but which “reliably correct deficiency.”
Vitamin D3 Slows the Trajectory of Delayed Childhood Development
After just two months of being given the supplement, the children began to gain “significant” weight, exhibit measurably better muscle tone, motor and language development and bone health, as well as improved immune systems, according to the researchers involved in the clinically-governed trial. The scientists explained:
“The primary outcome was the proportion of participants gaining (more than)15 percent of baseline weight at 8 weeks after starting ready-to-use therapeutic food … Secondary outcomes were mean weight-for-height or -length z score and the proportion of participants with delayed development at the end of the study.”3
While the high-dose vitamin D3 supplementation did not change the baseline weight for the children at the end of the trial, it did increase the weight-for-height or -length score, and reduced the trajectory of delayed development in other specific areas, including:
- Global development
- Gross motor development
- Fine motor development
- Language development
In a 2014 review4 of the efficacy of vitamin D3 supplementation in adult mortality, researchers reported evidence that it may decrease mortality in elderly women, but also observed several interesting results:
- When different forms of vitamin D were assessed, only vitamin D3 decreased mortality (not D2, alfacalcidol or calcitriol)
- Vitamin D3 statistically significantly decreased cancer mortality
- Vitamin D3 combined with calcium supplementation increased the risk of patients developing kidney stones
- Vitamin D3 seemed to decrease mortality in elderly people living independently or in institutional care
Previous Research: ‘D’ Does More Than You Realized
Lead study author Adrian Martineau and a team from QMUL reported more than a year ago that vitamin D is not only effective for preventing and treating colds, flu and acute respiratory infections, but it’s also crucial for bone and muscle health.
The extensive review (somewhat at odds regarding vitamin D’s respiratory capability) was published in the BMJ5 in 2017 and included 25 clinical trials with close to 11,000 participants and was conducted in 14 countries, including the U.S., the U.K., Afghanistan, Belgium, Canada, Japan, India, Italy and Australia.
Addressing why some results in the trials showed effectiveness in some trials and not in others, Martineau explained that supplementation with vitamin D is strongest in people with the lowest levels of vitamin D, but also makes more of a difference when the doses are administered daily or weekly rather than more intermittently, and added:
“Vitamin D fortification of foods provides a steady, low-level intake of vitamin D that has virtually eliminated profound vitamin D deficiency in several countries. By demonstrating this new benefit of vitamin D, our study strengthens the case for introducing food fortification to improve vitamin D levels in countries such as the UK where profound vitamin D deficiency is common.”6
While sun exposure is your best source of vitamin D, it can be difficult to get enough if you live in less-than-sunny locales like the U.K. The researchers also indicated that colds and flu, rather than necessarily being caused by winter conditions, are more brought on by the season’s lack of strong sunlight and resulting lowered vitamin D levels, which also might explain why vitamin D also has protective effects against asthma, which is typically exacerbated by respiratory viruses.
The QMUL studies also found that when people with the lowest baseline D levels (below 25 nanomoles per liter, a minuscule liquid measurement, or 10 nanograms per milliliter (ng/mL)) supplemented with D on a daily or weekly basis, their risk for developing acute respiratory infections was cut in half. That’s not to say that others with higher vitamin D levels didn’t benefit as well, because there was only a 10 percent reduction, which was still considered a positive.
Taking vitamin D was found to be as equally protective against acute respiratory infections as flu shots for flu-like illnesses, which in 2013 caused the death of 2.65 million people worldwide. Flu symptoms are the most common reason people visit their doctors and miss work days, so the bottom line, QMUL reasoned, is that encouraging more widespread vitamin D supplementation instead of pushing for more flu vaccinations would be safer and more effective in every way.
Vitamin D Deficiency Linked to a Greater Diabetes Risk
Researchers tried to determine whether higher vitamin D levels might be associated with a lower Type 2 diabetes risk in another study, assessing results from 903 participants with an average age of 74 and known to be diabetes-free as well as prediabetes-free. Assessment started in 1997 and continued through 2009.
The authors noted they started the study to answer associations between low plasma concentrations of vitamin D metabolites and higher risk of several cancers,7 cardiovascular disease,8 bone fractures9 and metabolic syndrome.10 Then scientists started looking at possible links to increases in Type 2 diabetes mellitus,11 but without clarity on whether D deficiency was involved.
The analysis, published in PLoS One,12 showed that having a vitamin D level of greater than 30 ng/mL was “associated with a significant and substantial reduction in later diabetes risk.” Additionally, it was noted that “Sufficient 25-D levels obtained naturally from sunlight and food, not supplementation, might be more relevant to reduce diabetes risk.”13
Separate research looked at clinical evidence that such a deficiency was on the rise in the U.S. focusing on the years between 1988 to 1994 and 2001 to 2004. The analysis revealed that 77 percent of U.S. adults are deficient, and deficiency levels had doubled between the two study periods. Researchers concluded that “Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency.”14
How to Optimize Your Vitamin D and Help Others Optimize Theirs
Regarding the above problems and many others caused, or at least aggravated by, a deficiency in vitamin D, most people already know that to prevent it, getting daily sunlight exposure on the greater part of your body is the best way to do it. It’s natural and it’s free, provided you don’t overdo it.
However, there are many places around the world where sunlight is at a premium. For people who for whatever reason are unable to get the optimal amount of sunlight, use of a high-quality tanning bed or vitamin D3 supplementation have been determined to be among the very best remedies.
The Institute of Medicine (IOM) recommends 20 ng/mL of serum concentration of 25-hydroxy vitamin D as an adequate level, or 600 IUs a day up to age 70 and 800 IUs if you’re over 70, but many vitamin D researchers believe that’s not even enough to prevent osteomalacia, let alone take advantage of vitamin D’s additional health benefits.
For optimal health and disease prevention, a level between 60 and 80 ng/mL appears to be ideal, and this may require 8,000 IUs per day to achieve for some people. The only way to be sure you’re safely within the therapeutic range is to get your levels tested.
Recent studies have also shown that the high number of premature births not only can be attributed to low vitamin D in mothers, but also that vitamin D supplementation improved the rates of premature births in the U.S. In fact, the Organic & Natural Health Association (O&N) has submitted a petition to the U.S. Food and Drug Administration (FDA) to allow vitamin D dietary supplements to make that claim. O&N asserts:
“Proper levels of Vitamin D reduce the risk of both mother’s pregnancy outcomes and their baby’s health outcomes. Significantly higher Vitamin D levels during pregnancy has been shown to reduce preterm birth by 60 percent, virtually eliminating certain pregnancy complications, and reducing many others.”15
As it stands now, federal regulations generally prohibit supplement and food companies from making disease prevention or treatment claims on package labels or in marketing materials, Holistic Primary Care16 notes.
The hope is that if the FDA approves the vitamin D health claim, it would pave the way for women to become aware of the importance of vitamin D during pregnancy and make routine monitoring commonplace. You can participate by supporting the petition by filling out O&N’s action alert, which will ultimately contact your representatives in Washington to request their support.
The Role of Vitamin D in Disease Prevention
A growing body of evidence shows that vitamin D plays a crucial role in disease prevention and maintaining optimal health. There are about 30,000 genes in your body, and vitamin D affects nearly 3,000 of them, as well as vitamin D receptors located throughout your body.