D for Detroit
D for Detroit

FURTHER READING:

D for Detroit addresses profound needs, the absense of which can result in severe consequences. Some of the studies/articles/sources which promote a Sense of Urgency are noted below. For convenience, they are divided into several categories:

A) The Need

B) Vitamin D Studies & Impact

C) Dosage

D) Economic &/or Social Implications

E) Other / Supportive Information

Each category is not intended to be an exhaustive listing of all pertinent articles but, rather, is representative of the body of research or information available. With the implementation of 'D for Detroit', we encourage (and will promote) further research in all categories to provide additional data and information on the human, social, and financial value of good health. A good community assures the healthiest possible beginning to life for each child and each mother. It provides a solid foundation upon which each person can grow with a better opportunity for physical & intellectual health.

Links to more resources on Vitamin D:

Grassroots Health, a consortium of researchers and Universities educatucating the public on serious need for increasing blood levels of vitamin d www.grassrootshealth.net

The Vitamin D Council - Dr Cannell - Excellant source for current research and facts on vitamin d

www.vitamindcouncil.org

The UV Advantage - Dr Michael Holick - Leading researcher fron the Univesity of Boston www.uvadvantage.org

The Need - Pregnancy and Gestational Vitamin D Deficiency

Tiniest Babies Carry Biggest CostsTUESDAY, March 17 (HealthDay News) — One year of medical costs paid by a company’s health insurance for a premature baby could cover the medical costs of almost a dozen healthy, full-term babies, a new report from the March of Dimes claims.

Medical costs for healthy, full-term babies during their first year average $4,551, of which about $3,800 is covered by employer heath insurance. But for preterm babies, the cost is almost $50,000, with about $46,000 paid by employer insurance.

“The report is really aimed at the business community,” Jennifer L. Howse, the March of Dimes president, said. “The purpose of the report is to underscore the very serious financial consequences of the rising problem of premature birth in our country.”

By highlighting the costs of premature birth, the March of Dimes is hoping to get businesses to take steps to make sure employees and their families get good prenatal care, Howse said. “Being an employer who provides employee health insurance, you are a stakeholder in prevention,” she said. “Good prevention equals a healthier workforce.”

http://news.health.com/2009/03/17/tiniest-babies-carry-biggest-costs/

Pregnancy and Gestational Vitamin D Deficiency - Vitamin d Council-John Jacob Cannell MD

In the last 3 years, an increasing amount of research suggests that some of the damage done by Vitamin D deficiency is done in-utero, while the fetus is developing. Much of that damage may be permanent, that is, it can not be fully reversed by taking Vitamin D after birth. This research indicates Vitamin D deficiency during pregnancy endangers the mother's life and health, and is the origin for a host of future perils for the child, especially for the child's brain and immune system. Some of the damage done by maternal Vitamin D deficiency may not show up for 30 years. Let's start with the mother. Incidence of Gestational Vitamin D DeficiencyDr. Joyce Lee and her colleagues at the University of Michigan studied 40 pregnant women, the majority taking prenatal vitamins. Only two had blood levels >50 ng/mL and only three had levels >40 ng/mL. That is, 37 of 40 pregnant women had levels below 40 ng/mL, and the majority had levels below 20 ng/mL. More than 25% had levels below 10 ng/mL. Lee JM, Smith JR, Philipp BL, Chen TC, Mathieu J, Holick MF. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila). 2007 Jan;46(1):42–4. Dr. Lisa Bodnar, a prolific Vitamin D researcher, and her colleagues at the University of Pittsburg studied 400 pregnant Pennsylvania women; 63% had levels below 30 ng/mL and 44% of the black women in the study had levels below 15 ng/mL. Prenatal vitamins had little effect on the incidence of deficiency. Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007 Feb;137(2):447–52. Dr. Dijkstra and colleagues studied 70 pregnant women in the Netherlands, none had levels above 40 ng/mL and 50% had levels below 10 ng/mL. Again, prenatal vitamins appeared to have little effect on 25(OH)D levels, as you might expect since prenatal vitamins only contain 400 IU of Vitamin D. Dijkstra SH, van Beek A, Janssen JW, de Vleeschouwer LH, Huysman WA, van den Akker EL. High prevalence of vitamin D deficiency in newborns of high-risk mothers. Arch Dis Child Fetal Neonatal Ed. 2007 Apr 25. Thus, more than 95% of pregnant women have 25(OH)D levels below 50 ng/mL, the level that may indicate chronic substrate starvation. That is, they are using up any Vitamin D they have very quickly and do not have enough to store for future use.

http://www.vitamindcouncil.org/newsletter/pregnancy-and-gestational-vitamin-d-deficiency.shtml

Mayo Clinic- During pregnancy, the active form of vitamin D increases significantly, particularly in the second and third trimesters. During this time, the baby's bones are developing, as are the brain, the nervous system, and the other organs.

Recently, a review published in the journal "Nutrition Reviews" looked at the research about vitamin D and maternal, fetal, and infant health. Although much more research is required, it appears that vitamin D contributes to improving pregnancy outcomes, such as decreasing the risk of pre-eclampsia, and improving length of gestation, birth weight, and infant bone mineralization. It also appears that sufficient vitamin D in early life may decrease the risk of health problems later in life such as schizophrenia, brain tumors, asthma, multiple sclerosis, and autoimmune diseases such as type 1 diabetes.

http://www.mayoclinic.com/health/vitamin-d-pregnancy/MY00511

Prenatal Vitamin D Deficiency- The researchers, from Queen's University, Belfast, the University of Ulster, and Belfast City Hospital report their findings in the British Journal of Nutrition. Many mothers to be are not getting enough vitamin D, even those taking supplements at the recommended doses, says a new study from Northern Ireland.

http://www.nutraingredients-usa.com/Health-condition-categories/Maternal-infant-health/Current-vitamin-D-doses-insufficient-for-mothers-to-be/?utm_source=Newsletter_Product&utm_medium=email&utm_campaign=Newsletter%2BProduct

Prenatal Vitamin D DeficiencyVitamin D Council- In the last 3 years, an increasing amount of research suggests that some of the damage done by Vitamin D deficiencyis done in-utero, while the fetus is developing. Much of that damage may be permanent, that is, it can not be fully reversed by taking Vitamin D after birth. This research indicates Vitamin D deficiency during pregnancy endangers the mother's life and health, and is the origin for a host of future perils for the child, especially for the child's brain and immune system. Some of the damage done by maternal Vitamin D deficiency may not show up for 30 years. Let's start with the mother.

http://www.vitamindcouncil.org/newsletter/pregnancy-and-gestational-vitamin-d-deficiency.shtml

Prenatal Vitamin D Deficiency -.. American Journal of Clinical Nutrition Jörg Reichrath and Kerstin Querings, Department of Dermatology
The Saarland University Hospital

....a growing body of evidence now clearly indicatesthat adequate vitamin D concentrations during pregnancy arenot only necessary to ensure appropriate maternal responsesto the calcium demands of the fetus and neonatal handling ofcalcium, but also of great importance to guarantee the healthydevelopment of a broad variety of tissues, including the immunesystem. Consequently, vitamin D deficiency during pregnancymay represent for the fetus a predisposing factor for the futuredevelopment of a multitude of diseases not related to fetalgrowth and bone metabolism, including diseases of the immunesystem, such as atopic dermatitis, type 1 diabetes, and otherautoimmune diseases.

http://www.ajcn.org/cgi/content/full/81/5/1177

Prenatal Vitamin D Deficiency Study - Dr Carol Wagner, Dr Bruce Hollis University South Carolina - Reported in Medpage Today - Women who took high doses of vitamin D during pregnancy had a significantly reduced risk of co-morbidities, including premature birth, results of a randomized trial showed. The take-home message is that pregnant women should take 4,000 International Units a day, according to Carol Wagner, MD, of the Medical University of South Carolina in Charleston,

That dose is not only safe, but prevents a range of complications associated with pregnancy, Wagner told attendees at the the Pediatric Academic Societies meeting here.

http://www.medpagetoday.com/MeetingCoverage/PAS/19847?utm_content=GroupCL&utm_medium=email&impressionId=1272696596554&utm_campaign=DailyHeadlines&utm_source=mSpoke&userid=155246

Prenatal Vitamin D Deficiency Study - Dr Carol Wagner, Dr Bruce Hollis University South Carolina as reported by Vitamin D Council

  1. 4,000 IU/day during pregnancy was safe (not a single adverse event) but only resulted in a mean Vitamin D blood levelof 27 ng/mL in the newborn infants, indicating to me that 4,000 IU per day during pregnancy is not enough.
  2. During pregnancy, 25(OH)D(Vitamin D) levels had a direct influence on activated Vitamin D levels in the mother's blood, with a minimum Vitamin D level of 40 ng/mL needed for mothers to obtain maximum activated vitamin D levels. (As most pregnant women have Vitamin D levels less than 40 ng/mL, this implies most pregnant women suffer from chronic substrate starvation and cannot make as much activated Vitamin D as their placenta want to make.)
  3. Complications of pregnancy, such as preterm labor, preterm birth, and infection were lowest in women taking 4,000 IU/day, Women taking 2,000 IU per day had more infections than women taking 4,000 IU/day. Women taking 400 IU/day, as exists in prenatal vitamins, had double the pregnancy complications of the women taking 4,000 IU/day. 
www.vitamindcouncil.org/newsletter/more-vitamin-d-studies-of-interest.shtml

A previously unexplored candidate influence on the black-white disparity in adverse birth outcomes is maternal vitamin D status - Department of Epidemiology, University of Pittsburgh Graduate School of Public Health

This review summarizes the evidence relating maternal vitamin D to preeclampsia, spontaneous preterm birth, gestational diabetes, and fetal growth restriction, and addresses gaps in our understanding of the contribution of vitamin D to the intractable black-white disparity in these conditions. The literature reviewed highlights strong biologic plausibility of role for vitamin D in the pathophysiology of these poor pregnancy outcomes. Data also suggest that maternal vitamin D deficiency may increase the risk of preeclampsia and fetal growth restriction. Less research has been done in support of relations with spontaneous preterm birth and gestational diabetes, and fetal and infant survival have rarely been studied. Few trials of vitamin D supplementation have been conducted in pregnant women with adequate power to test effects on birth outcomes. Importantly, black pregnant women have rarely been studied in vitamin D-birth outcomes research.

http://www.ncbi.nlm.nih.gov/pubmed/20403218?dopt=AbstractPlus

McGill University and University of Southern California research has discovered that low levels of vitamin D is linked to muscle fat and decreased strength in young women - Journal of Clinical Endocrinology & Metabolism Vol. 95, No. 4 1595-1601

Vitamin D insufficiency has now reached epidemic proportions and has been linked to increased body fat and decreased muscle strength. Study subjects young women 16 - 22 in California.

Approximately 59% of subjects were 25OHD insufficient (29 ng/ml), of which 24% were deficient (20 ng/ml), whereas 41% were sufficient (30 ng/ml). A strong negative relationship was present between serum 25OHD and CT measures of percent muscle fat (r = –0.37; P < 0.001). In contrast, no relationship was observed between circulating 25OHD concentrations and CT measures of thigh muscle area (r = 0.16; P = 0.14). Multiple regression analysis indicated that the relation between 25OHD and muscle adiposity was independent of body mass or CT measures of sc and visceral fat. Percent muscle fat was significantly lower in women with normal serum 25OHD concentrations than in women with insufficient levels and deficient levels (3.15 ± 1.4 vs. 3.90 ± 1.9; P = 0.038).

They found that vitamin D insufficiency is associated with increased fat infiltration in muscle in healthy young women.

Vitamin D Studies and Impact

Preeclampsia- Vitamin Ddeficiency early in pregnancy is associated with a five-fold increased risk of preeclampsia, according to a study from the University of Pittsburgh Schools of the Health Sciences reported in the Journal of Clinical Endocrinology and Metabolism.

http://www.medicalnewstoday.com/articles/81965.php

Preeclampsia-The risk of pre-eclampsiawas 27 per cent lower in women who consumed vitamin Dsupplements with daily doses of 10 to 15 micrograms, compared to women who did not take supplements, according to researchers from the Norwegian Institute of Public Health.

However, a correlation between vitamin D intake and omega-3fatty acid intake was observed, and the researchers noted that “further research is needed to disentangle the separate effects of these nutrients”.

Pre-eclampsia, affecting two to three per cent of all pregnancies, occurs when a mother&#039;s blood pressure rises to the hypertensive range, and excretion of protein in the urine becomes too high. It is estimated to be responsible for about 60,000 deaths worldwide.

Increased intakes of vitamin D during pregnancy may reduce the development by about 25 per cent, suggests a study with over 20,000 Norwegian women.

http://www.nutraingredients-usa.com/Research/Vitamin-D-may-reduce-pre-eclampsia-risk-Study

Infections- A vaginal infection called bacterial vaginosis (BV) has been linked to low vitamin D levels in pregnant women, reports a study in the Journal of Nutrition.Black women seem to be disproportionately affected by BV, and they are also more likely to be vitamin D deficient.

http://bastyrcenter.org/content/view/1613/

Infections- Children born preterm after a pregnancy complicated by the bacterial infection of placenta and amniotic fluid (chorioamnionitis) were significantly more likely to develop asthma by age eight than preemies without such exposure, according to Darios Getahun, MD, MPH, of Kaiser Permanente Department of Research and Evaluation in Pasadena.

http://www.medpagetoday.com/Pediatrics/Asthma/18252?utm_content=GroupCL&utm_medium=email&impressionId=1265183464075&utm_campaign=DailyHeadlines&utm_source=mSpoke&userid=155246

Low Birth Weight Linked to Adult Respiratory Illness - Eric C. Walter, MD, of the University of Washington Division of Pulmonary and Critical Care - Underweight newborns are at increased risk of serious respiratory illness as young adults and may account for tens of thousands of hospitalizations at a cost of more than $200 million annually, researchers found.

http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/15030?userid=155246&impressionId=1247462037241&utm_source=mSpoke&utm_medium=email&utm_campaign=DailyHeadlines&utm_content=Group1

Low vitamin D intake during pregnancy is associated with lower birth weights in babies, according to a study.

The researchers from McGill University, Canada, suggest the study shows vitamin D may be an important regulator for foetal growth.

The study is published in the Canadian Medical Association Journal.

http://news.bbc.co.uk/2/hi/health/4938932.stm

Type 1 diabetes - Dietary vitamin D supplementation is associated with reduced risk of type 1 diabetes. Ensuring adequate vitamin D supplementation for infants could help to reverse the increasing trend in the incidence of type 1 diabetes.

http://www.direct-ms.org/pdf/VitDOtherAuto/VitDType1Diabetes.pdf

Vitamin D and pregnancy diabetes

10.12.08 Diabetes is a real complication when it occurs as a result of pregnancy, and there are all kinds of scientific theories about why previously healthy,non-diabetic women can develop this condition during ‘gestation’. Scientists working at the National Centre for Health in Bethsaida, Maryland, have been looking at the role of vitamin D in maintaining normal blood sugar levels. However, they say, studies looking at blood concentrations of 25-hydroxyvitamin D (25-[OH] D) in relation to diabetes risk are limited. Their objective was to determine the association between pregnant womens plasma vitamin D concentrations in early pregnancy and the risk for gestational diabetes mellitus (GDM).

Results showed that, among women who developed GDM, maternal plasma 25-[OH] D concentrations at an average of 16 weeks of gestation were significantly lower than controls those who didn’t get the condition, leading them to conclude that; “Findings from the present study suggest that maternal vitamin D deficiency in early pregnancy is significantly associated with an elevated risk for Gestational Diabetes Mellitis”.

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D for Detroit
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Clarkston, Mi. 48346


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Reducing Risky births in Michigan