Back in July, I pointed out a nice review of vitamin D published in the Journal of the American Medical Association (JAMA). In case you're not aware, JAMA is a general medicine publication. In other words, it doesn't confine its articles to any one specific specialty or subspecialty. In fact, you can find articles on surgeries as well as medicine, children as well as old adults, women & men. I mention this to make a comparison to a journals such as JACC, the Journal of the American College of Cardiology, which is devoted entirely to heart disease, and JCEM, the Journal of Clinical Endocrinology and Metabolism, which is devoted entirely to hormones.
I wanted to point out this distinction since I found a nice article on vitamin D and its potential cardiac benefits in an issue of JACC published last month. Whenever you find one specialty's journal publishing on the topic of another specialty, you know it's got to be important. Or perhaps you're reading a family medicine journal since we're trained to care for the whole person!
In any case, this article is well written, reviewing the observational studies supporting the need for more vitamin D. It also digs deeper into the controversy by dividing studies into those w/adequate statistical power and those without. And while the authors cautiously support the notion that we need more vitamin D than we current receive/consume on average, they balance this with the acknowledgement that we also need a good, strong, randomized, double-blind, placebo-controlled trial of adequate numbers & duration to truly back up their belief.
In any case, this article is well written, reviewing the observational studies supporting the need for more vitamin D. It also digs deeper into the controversy by dividing studies into those w/adequate statistical power and those without. And while the authors cautiously support the notion that we need more vitamin D than we current receive/consume on average, they balance this with the acknowledgement that we also need a good, strong, randomized, double-blind, placebo-controlled trial of adequate numbers & duration to truly back up their belief.
Of keen interest then is the VITAL (VITamin D and OmegA-3 TriaL) study sponsored by the National Institutes of Health using Lovaza (nee Omacor) 1g daily plus vitamin D3 2,000IU daily. The authors rightly pointed several errors (they politely referred to these as limitations) in the study, especially the lack of baseline 25OH vitamin D levels in all participants, such that those who are severely deficient may not receive enough vitamin D to become completely normalized. More importantly, we have not yet defined what is truly optimal as opposed to what is merely normal. Think about it this way. Would you rather pass with a D or with an A? Both grades are considered passing but wouldn't you rather have an A?
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