Canada Orders Vitamin D Study

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Canada orders vitamin D study


MARTIN MITTELSTAEDT
From Saturday's Globe and Mail
May 10, 2008 at 12:52 AM EDT

Health Canada says it will launch a study by this fall investigating dramatic claims that a lack of vitamin D could be linked to ailments such as cancer, heart disease and multiple sclerosis.
There has been rising pressure on Health Canada for such an investigation because the Canadian Cancer Society and the Canadian Pediatric Society say the evidence on the benefits of taking more of the sunshine vitamin is so strong that they are recommending large doses of it – amounts that, for some ages, are five to 10 times higher than what the government advises.
Major disagreements among respected public-health agencies about the required amount of an everyday vitamin are almost unheard of in the medical community, and Health Canada, in response to questions from The Globe and Mail, said it intends to sign a contract by this fall for a study on vitamin D health claims and dosage.
The vitamin review will be conducted by the Institute of Medicine's Food and Nutrition Board, a respected Washington-based science advisory group.


Many researchers view Canada's current standard as seriously outdated because it was developed in 1997, and was based mainly on the low levels of vitamin D needed to prevent childhood rickets.
The pledge ends a year-long period in which Health Canada has said reviewing the vitamin was a “high priority.” But it did little to resolve the dose controversy, in part because of the Byzantine procedure it follows to determine how much of any nutrient people should pop daily.
Canadian levels aren't set in this country, but through a harmonization process with the United States based on studies from the Food and Nutrition Board.
Until now, the board has not weighed in on the vitamin D controversy because it hasn't been formally approached by either Canada or the United States and it won't study the topic unless one or both governments ask. Neither country has requested a vitamin D review, said Linda Meyers, the board's director, although she said both governments have recently made informal approaches.
Resolving the issue will be relatively inexpensive, compared against the billions of dollars some experts contend are being added to North America's medical bills due to vitamin D deficiencies. According to Ms. Meyers, a study would cost $1-million and take one year to complete.
Linking nutrient standards to a cumbersome binational process has angered some groups in Canada, in part because of mounting evidence that Canadians, living at a more northerly latitude, are at higher risk of vitamin D insufficiency than citizens of the United States.
Most of a person's vitamin D is made when skin is exposed to strong, ultraviolet sunlight, hence the sunshine vitamin moniker. Light is too weak to make it the natural way for about six months during fall and winter in Canada, an effect that isn't as pronounced in large parts of the United States, making up-to-date supplementation advice more important for Canadians.
“When science and credible organizations are making those recommendations [for more vitamin D] and the government is seemingly focused on harmonization, there is not a rationale there,” contends Brent Patterson, spokesman for the Council of Canadians. The nationalist advocacy organization wrote Health Minister Tony Clement in March complaining that the vitamin harmonization process could be harming Canadians.
Getting the right dose of vitamin D has emerged as a pressing topic because dozens of recent studies have linked insufficiency to chronic health problems.
A dose review is “very urgent because I've seen remarkable things happen in my practice” using vitamin D treatments, said Gerry Schwalfenberg, a clinical lecturer in the department of family medicine at the University of Alberta in Edmonton. He has found that the nutrient helps with diabetes and chronic back pain at doses higher than what Health Canada recommends.
Frank Garland, professor in the department of family and preventive medicine at the University of California San Diego, said “the argument is pretty clear that you guys [in Canada] are in a geographical situation which puts you at higher risk than most of the United States” of having low levels of vitamin D.
Canada's current recommended doses range from 200 to 600 international units a day, depending on age.
A review of the standard is “absolutely critical,” Dr. Garland said. “The current recommended daily allowance seems only to be able to be useful in prevention of rickets in childhood, and the latest information that we have is that levels, instead of 200 [IU], really need to be 2,000 [IU].”

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