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Subject: [To-Your-Health] Vit D and Calcium Help To Prevent Cancer


http://www.life-enhancement.com/article_template.asp?ID=1867

Article Title: Vitamin D and Calcium Combat Cancer
Article Date: 8/1/2007Vitamin D and Calcium Go Well Together
Vitamin D and
Calcium Combat Cancer
Large amounts of these nutrients reduced the
All-cancer risk in postmenopausal women by 60%
By Hyla Cass, M.D.
Ome things go so well together, don’t they? Peaches and cream, fish and
chips, wine and cheese, bacon and eggs, chocolate and just about anything, .
. . Are you starting to salivate? Good, because I have another great pair
for you. It’s . . . Oh, the title gave it away, didn’t it? Although the
prospect of a vitamin/mineral combo may not set your taste buds tingling,
the rest of your body would be grateful for a good daily dose of this
dietary dynamic duo.
We have long known that vitamin D and calcium are essential for our health
and that proper calcium metabolism depends critically on adequate amounts of
vitamin D, a steroid hormone popularly known as the “sunshine vitamin.” Both
of these nutrients play important roles in the prevention and treatment of
various diseases. A new study published by researchers at Creighton
University in Omaha, Nebraska, however, has startled the medical world by
providing unusually strong evidence of an anticancer effect for the vitamin
D and calcium pair.1 Dr. Cedric Garland, a prominent vitamin D researcher at
UC San Diego (who was not involved in the study), said,2
The findings . . . Are a breakthrough of great medical and public health
importance. No other method to prevent cancer has been identified that has
such a powerful impact.
Like Striking Oil
Got your attention? Then let’s see what the researchers were looking for,
and what they found. Their initial objective was to examine the efficacy of
calcium alone and calcium plus vitamin D in maintaining bone health and
preventing bone disease, such as osteoporosis. Their interest in cancer was
secondary—until they analyzed their data and saw what they had. Imagine
drilling for water and finding oil instead—it must have been something like
that. They decided to defer publication of their findings regarding bone
health and publish their cancer findings first.

© iStockphoto.com/
Wojciech Krusinski
The study was a 4-year, randomized, double-blind, placebo-controlled trial
involving 1179 healthy postmenopausal women from a nine-county rural area of
eastern Nebraska. The women’s average age was 67; their average body mass
index was 29 (I.e., as a group they were considerably overweight but not
quite obese); their circulating vitamin D levels were within the normal
range; and they had all been cancer-free for at least 10 years before the
trial began. All of them were white, although that was not a criterion for
inclusion in the study.
The women were divided into three groups who were given the following
supplements to take daily (Ca is the chemical symbol for calcium):
Calcium, as either calcium citrate (1400 mg of Ca per day) or calcium
carbonate (1500 mg of Ca per day), plus a vitamin D placebo. This group was
called Ca-only.


Calcium (as above) plus vitamin D in the form of cholecalciferol (vitamin
D3), 1000 IU (25 mcg) per day. (The government’s recommended Daily Value for
vitamin D is 400 IU.) This group was called Ca+D.


Calcium and vitamin D placebos (the control group).
Vitamin D (with Calcium) Reduces Cancer by 60%
Over the 4-year period, 50 women developed nonskin cancers of various
kinds—13 during the first year and 37 thereafter. Analysis of the data
showed that the risk for such an event was reduced by 47% in the Ca-only
group (compared with placebo) and by 60% in the Ca+D group. Remarkable!
Suspecting that some of the cancers found during the first year may already
have been present but undetected at the outset of the study, the researchers
reanalyzed the data using only the 37 cases that developed during the final
3 years. The results showed that the risk reduction for the Ca-only group
was nearly unchanged at 41%, but for the Ca+D group, it improved
substantially to 77%!
Further data analysis showed that the results were unaffected by age or body
mass index, but they did correlate significantly with the women’s vitamin D
levels at baseline and after 1 year: the higher the vitamin D levels at
either of these time points, the lower the risk of developing cancer. There
were no serious supplement-related adverse events during the course of the
study.
The Sun and Vitamin D Reduce Cancer Risk
The vitamin D-induced risk reduction for all cancers seen in this study
jibes with, and provides strong support for, observations made over the past
half-century. It was first noticed over 60 years ago that there is a
geographic pattern of cancer mortality in North America that follows the sun
in an inverse sense: the greater the average yearly amount of sunlight in a
given region, the lower the nonskin cancer incidence and the lower the
mortality rate for many kinds of cancer.1 This protective effect of the sun
was attributed to the fact that solar ultraviolet radiation synthesizes
vitamin D from 7-dehydrocholesterol in our skin, via photochemical reactions
stimulated by the short-wavelength, high-energy UVB rays.*



*More sunlight means more skin exposure, on average, hence higher natural
vitamin D levels. Bear in mind, however, that overexposure to the sun can
cause skin cancer. Sunscreen provides protection against that, but it also
blocks the synthesis of vitamin D, so there’s a tradeoff here. [For more on
this, see the sidebar accompanying this article. See also the sidebar “When
Is a Vitamin Not a Vitamin?” in the article “Vitamin D May Improve Mood and
Cognition in the Elderly” (February 2007).]



How Much Vitamin D and Calcium Do We Need?
Except during winter months, especially at latitudes above about 40º, the
sun can easily provide all the vitamin D most people need. Indeed, many
people do get most, if not all, of their vitamin D from exposure to the
sun’s beneficent rays. The trouble is, though, that many others do not get
enough exposure, for various reasons. The people most likely to be deficient
in vitamin D are those who live in northern latitudes, especially in the
northeastern United States, where a common type of air pollution (acid haze,
which precedes acid rain) blocks much of the solar ultraviolet radiation.
Paradoxically, in our commendable zeal to avoid skin cancer by covering up
or using sunscreen when we’re outdoors, we may be setting ourselves up for a
greater risk of most other types of cancer. Sunscreen blocks vitamin D
synthesis more effectively than it prevents skin cancer (an SPF value of
only 8 reduces vitamin D synthesis by 95%).1 An easy way to solve this
problem is to get about 10–15 minutes of sun exposure on our arms or legs
before applying the sunscreen, three times a week.
People who don’t get outdoors much (or at all) are at the greatest risk of
vitamin D deficiency. Many of the elderly fit that description, and their
risk is further increased by the reduced capacity of their skin to
synthesize vitamin D even when it is exposed to the sun. Most foods,
unfortunately, are poor sources of this fat-soluble vitamin, the exceptions
being fatty fish (such as salmon), fish-liver oils (yuck!), and fortified
milk and cereals. Thus, for many people, supplementation is the best way to
ensure adequate supplies of this bone-building, cancer-preventing vitamin.
For many years, the government’s recommended daily intake of vitamin D has
been 400 IU. In a recent review article published by some of America’s
leading authorities on vitamin D, however, the authors pointed to studies
demonstrating the beneficial use—with no toxicity—of vitamin D doses of many
thousands of IU daily.2 They concluded,
These studies indicate that ideal daily doses of vitamin D exceed current
recommendations by an order of magnitude.
Since “order of magnitude” means “roughly a factor of 10,” the authors are
saying that amounts of about 4000 IU (with considerable latitude in either
direction) would be ideal.
We also need calcium, of course—plenty of it, as calcium is the body’s
number one mineral. About 99% of it is found in our bones and teeth. The
rest is in our blood and soft tissues, where it plays physiological roles so
crucial to our survival that an inadequate intake will cause the body to
demineralize its own bones (which weakens them, of course) to make up for
the deficiency. Maintaining serum calcium levels within a narrow range is
vital for normal functioning of our nervous system as well as for regulating
the secretion of various hormones, such as insulin.
The best food sources of calcium are dairy products and certain vegetables
and grains—but do we get enough calcium? No, according to scientists at the
Linus Pauling Institute (LPI), who report that “Average dietary intakes of
calcium in the U.S. are well below the adequate intake (AI) recommendation
for every age and gender group, especially in females.”3
While recommending that we get as much of our calcium as possible from food
(because foods contain other important nutrients that make the calcium more
bioavailable), the LPI scientists state that supplementation may be
necessary for those who have difficulty in achieving that goal. They
recommend that adults through age 50 consume a total (diet plus supplements)
of 1000 mg of calcium daily; for older adults, they recommend 1200 mg/day.
The calcium intakes recommended for the U.S. population are higher than
those in most other countries because of our higher intake of protein, which
causes the urinary excretion of calcium. It’s also worth noting that,
although supplemental calcium alone cannot usually restore lost bone mass in
individuals with osteoporosis, it can help prevent further loss.
References
Higdon J. Vitamin D. Linus Pauling Institute, Corvallis, OR, 2004.
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF,
Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect 2006
134(6):1129-40.
Higdon J, Drake VJ. Calcium. Linus Pauling Institute, Corvallis, OR, 2007.


Indeed, the Creighton University researchers cited a large body of evidence
linking low vitamin D levels with an increased risk of cancer. Referring to
“25(OH)D” (25-hydroxycholecalciferol), the principal chemical form in which
vitamin D circulates in the blood, they concluded their own report by saying
1
We found that improving vitamin D nutritional status substantially reduced
all-cancer risk in postmenopausal women. Furthermore, baseline and
treatment-induced serum 25(OH)D concentrations were themselves strong
predictors of cancer risk. These findings highlight the importance of
promoting optimum vitamin D status and underscore the value of achieving and
maintaining a high serum 25(OH)D concentration.
Hey, What About the Calcium?
By now you’re probably wondering why all the attention is focused on vitamin
D, when calcium alone produced such a strong effect. Good question, and in
the answer lies a cautionary tale. Raw data can be highly misleading,
especially to those who are not experts in the science in question and in
the mathematical methods required for data analysis. Which of these methods
are used in a given case depends on the nature of the study protocol in
question, and invalid conclusions can be drawn if the methods are
inappropriate to the case.
In this study, statistical calculations (presumably appropriate ones)
indicated that the protective effect observed in the Ca-only group was
marginal and might be due merely to chance. Thus the role of calcium was
unclear, but the authors opined that if its effect was real, it could
plausibly be connected to the patients’ vitamin D status. The protective
effect of that nutrient was not in doubt—the analysis showed a real and
substantial benefit from vitamin D when used together with calcium.
When Intervention Is Better than Observation
The significance of this study lies partly in the fact that it was the first
interventional trial to assess the efficacy of large amounts of supplemental
vitamin D in preventing cancer. Here the subjects were given the vitamin in
accord with a known regimen so that its effects could be measured over a
period of time.
For many years previously, there had been a growing body of evidence of such
anticancer effects based on observational studies, in which the incidence of
cancer was correlated with the study group’s demographic and nutritional
profiles, such as their geographic location and their circulating vitamin D
levels (the source of which is hard to account for because most of it comes
from sun exposure). Observational studies are extremely valuable, but
interventional studies are often better able to discern real effects, owing
to the controlled nature of the trial.
Stay Tuned, but Supplement
The Creighton University study raises two obvious questions: What about
premenopausal women? What about men? For the answers, we’ll have to stay
tuned for future studies, but our knowledge of the biological effects of
vitamin D, particularly with regard to its inhibition of cell proliferation,
makes it reasonable to suppose that the results will be similar. Science is
full of surprises, though, and only hard evidence will tell the tale.
Meanwhile, we should all make sure that our bodies are well supplied with
vitamin D and calcium—they go so well together.
References
Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D
and calcium supplementation reduces cancer risk: results of a randomized
trial. Am J Clin Nutr 2007;85:1586-91.
Ross T, Conn J. Associated Press report, June 7, 2007.


Dr. Hyla Cass is a nationally recognized expert in integrative medicine, an
assistant clinical professor of psychiatry at the UCLA School of Medicine,
and the author or coauthor of several popular books, including Natural
Highs: Supplements, Nutrition, and Mind-Body Techniques to Help You Feel
Good All the Time and 8 Weeks to Vibrant Health: A Woman’s Take-Charge
Program to Correct Imbalances, Reclaim Energy, and Restore Well-Being.
http://www.life-enhancement.com/article_template.asp?ID=1867

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