Participants: George Guthrie, Tim Arnott
Series Code: WM
Program Code: WM000334
00:01 The following program presents principles designed
00:03 to promote good health and is not intended to 00:05 take the place of personalized professional 00:07 care. The opinions and ideas expressed are those of 00:10 the speaker. Viewers are encouraged to 00:13 draw their own conclusions about 00:14 the information presented. 00:36 Welcome to "Wonderfully Made." My name is 00:39 Dr. George Guthrie, Medical director of The 00:41 Lifestyle Center of America. Have you ever been 00:44 told by your doctor that you should avoid sun 00:48 exposure. You know too much sun can actually 00:52 cause, cause sunburn which is uncomfortable but 00:55 often lead to skin cancer as well, on the other 01:00 hand you need some sun exposure to be healthy 01:05 we're here to talk about it today on Wonderfully Made 01:08 joining me is Dr. Tim Arnott. Hi George, 01:12 good to be here, yeah good to be here Tim. 01:15 Well, so there is this is argument too much sun, 01:19 too little sun, I am sure everybody's heard 01:23 how important it is to stay out of the sun, 01:25 but what benefits might the sun have to us. 01:30 Well, George it's very interesting that sunlight 01:35 actually can help you lower your risk of a number 01:38 of disease, in fact are you aware that sun exposure 01:42 could actually lower your risk of developing high 01:44 blood pressure and that can help you lower 01:47 your risk of coronary artery disease and perhaps 01:50 even lower your risk of stroke. Now, when it comes 01:52 to your bones you could actually lower your risk 01:55 of osteoporosis and an adult form of rickets, 02:01 something similar to rickets that's called 02:03 Osteomalacia and did you also know that you could 02:07 perhaps lower your risk, your child's risk of 02:11 type-1 diabetes by helping them to get adequate 02:15 sun exposure. Oh! These are some rather 02:19 amazing claims you're making here doc, 02:21 it seems to me folks should understand what the 02:24 active element is that we are talking about here, 02:27 Vitamin D. Absolutely Vitamin D is the, 02:32 the important element you may not, well you may 02:35 have thought that when you eat that bean and 02:38 that whole grain. That the calcium and the 02:41 magnesium and the phosphorous in those foods, 02:45 just automatically goes into your blood stream 02:48 after the digestive process, but the reality is that 02:52 the creator has designed us so that in order to 02:55 get the maximum amount of calcium, magnesium 02:59 and phosphorous from the food in the intestine 03:02 into the blood stream you need the help of an 03:06 important vitamin that vitamin is vitamin D. 03:09 Now, George tell us how is it that Vitamin D, 03:12 is actually made. Well, it's actually misnamed it's 03:16 not really a vitamin overall it's a hormone. 03:20 We didn't understand that as we discovered it 03:23 we came it through this disease process we know 03:26 as rickets and nobody knows, knew what cause 03:30 the disease process as they began to experiment 03:34 and try to find out, one doctor discovered they 03:37 can take kids with rickets and put them in front of 03:39 an arc and that would take care of their rickets 03:43 and then. You're talking about an arc lamp, 03:45 yes, is that correct, an arc lamp a strong electrical 03:48 arc and then they discovered that we could 03:52 actually put them, the kids on the roof of the 03:56 hospital and their rickets would go away I mean 03:58 that's that was kind of interesting, from that 04:01 came the discovery of this substance actually 04:06 which we call a vitamin but which is actually a 04:08 hormone. In fact what happens is this, cholesterol in 04:12 our bodies in the skin it goes through a little 04:15 preparation process and then sunlight comes and 04:19 hits that cholesterol in the skin and in hitting it 04:24 breaks one of its rings and turns it into what we 04:27 understand to be Vitamin D, its actually a Previtamin 04:31 D first which can be stored in the skin and then 04:34 released into the blood stream as our body needs it 04:37 to manage calcium, magnesium and some other 04:40 things, absolutely and so vitamin D is so very 04:44 important and the other thing to keep in mind 04:47 as if your kidney disease, if you have diabetes 04:50 and your kidneys have been injured perhaps you 04:52 had long-standing high blood pressure and your 04:55 kidneys have been injured from that, 04:57 you may not be turning vitamin D, Previtamin D 05:01 into the active form of vitamin D and so it's even 05:05 more important for those individuals to make sure 05:08 that they have all of the vitamin D that they 05:10 need, and the other thing that's important is if 05:12 you have extra dark skin and extra protection 05:16 in the skin from the sun those individuals especially 05:20 need to listen to this program because not 05:24 uncommonly George those individuals who have 05:26 darker skin pigment are especially at risk 05:30 of having low vitamin D levels and they could 05:35 have higher blood pressure, actually higher risk 05:36 of cancer, higher risk of osteoporosis and higher 05:40 risk of these autoimmune diseases a type 05:43 1 diabetes, Lupus and even Rheumatoid arthritis. 05:47 In the recent enhanced data there is, that's the 05:52 national collection of data that occurs on a 05:55 regular basis in this country when they looked at 05:57 vitamin D, they were estimates of 40 to 60 06:00 percent of African Americans actually deficient 06:04 in vitamin D, and once I say that we really 06:07 should point out that if you're going to measure 06:09 this in your blood to see if you have adequate 06:12 amounts that one should be measured is called 06:16 25-hydroxy-vitamin D, chances are your 06:21 doctor hasn't thought of it, it would be good 06:24 for you to write it down. So, we will mention it 06:27 again towards the end of the program but just 06:29 to let you know 25- hydroxy-vitamin D is the 06:33 important one. It's actually made from the 06:37 vitamin D that comes from the skin it goes to the 06:40 liver its turned into the 25-hydroxy and then as 06:44 you pointed out to Tim, the kidney changes it to its 06:47 most active form, the 1,25-dihydroxyvitamin 06:51 D folks don't need to remember that. 06:53 Now, George what they do need to remember 06:56 and what Dr. Michael Holick at Boston University 06:59 an expert in Vitamin D physiology recommends is 07:02 that we have our Vitamin D level checked every 07:06 year just like you might check a cholesterol level 07:09 and as George mentioned earlier that's the 07:11 25-hydroxy-form of vitamin D. So, really all 07:16 you need to remember the number 25 and Vitamin D 07:20 and your doctor should be able to take it from 07:22 there once a year. Now, just a word on where we 07:26 might want that vitamin D level to be when it is 07:29 checked because frankly George the last time I 07:33 had it checked on one of my patients I saw that 07:36 if they were seven with their level they would be 07:39 in the normal range, is that really true? 07:42 Well, the normal range is generally defined in a 07:44 population, they will measure a population, 07:48 measure two standard deviations in either way and 07:51 then say that's a normal from the bottom end to 07:54 the top end but we know for vitamin D, 07:58 that in order to get optimal positive benefits 08:02 from the vitamin D it really should be greater than 08:05 30 to turn down or turn off the parathyroid hormone 08:10 and Pros probably closer to 40 in order to give 08:13 optimal protection against cancer maybe we should 08:16 talk a little bit about that, yes actually very 08:20 interesting studies coming out showing that 08:23 vitamin D has an affect on the cells of your body, 08:28 it actually slows down the rate of cell division and 08:33 vitamin D actually encourages the cells of your body 08:36 to go to full maturation, in other words to become 08:40 a completely fully matured cell and of course 08:43 cancer is, is a cell that is dividing too rapidly cell 08:48 division out of control and it leads to cells that are 08:52 not fully mature. So, vitamin D is a powerful tool 08:56 to help lower the risk of cancer now what cancers 08:59 are we actually talking about. Well, I think of 09:02 Dr. Garland study that look at several thousand 09:05 people got their vitamin D levels and then watch 09:09 them over several years time to see who would 09:13 actually that colon cancer or cancers they found 09:18 an 80 percent reduction in colon cancer in those 09:22 that started with a highes levels of vitamin D, 09:26 that's significant, 80 percent lower risk of the 09:30 number one cancer of men and women who are not 09:34 smoking. Now, that's something that you can walk 09:37 outside for and frankly you don't have to walk 09:41 outside for very long in order to get all of the 09:44 vitamin D that you need. What is the 09:47 recommendation for skin exposure in order to get 09:51 at least a minimum amount of vitamin D. 09:53 Well, you know there is a little science behind 09:55 deciding this and my understanding is as it is 09:58 done with healthy medical students what ever 10:00 that means they put them on the, out in the sun to 10:05 turn them just pink not to burn but just pink all 10:08 over and if they turn just pink they make some where 10:11 between 10 to 20,000 international units just 10:16 with that slight reddening of the skin, 10:18 doing calculations from that down to the 10:22 recommended daily intake of either four hundred 10:25 international units a day for younger adults and 10:28 for those who are over 7600 international units 10:32 we find that about seven minutes a day well 10:37 technically three days a week but better seven 10:40 minutes a day with just the head neck and the 10:43 wrist and hands exposed will actually make 10:46 adequate amount of vitamin D for people. 10:49 Alright and so you wanna spend a few minutes I 10:53 believe Dr. Michael Holick recommends little bit 10:56 more probably 15 minutes but it depends frankly 11:00 on where you live if you live in Miami, seven 11:02 minutes probably is perfect in fact it may be a 11:05 little too much depending on what kind of skin 11:08 that you have, so anyway from seven to fifteen 11:12 minutes three days a week on your face, hands and 11:15 arms, not much exposure and you will get to the 11:18 vitamin D that you need but just remember that 11:21 if you live in north of Oklahoma city, 11:23 Oklahoma during the winter your probably won't 11:26 make any vitamin D and so that's why its 11:30 important that you store up a little extra during 11:33 the summer months to compensate for what 11:36 you won't be making during the winter months 11:39 and what is our recommendation on taking a 11:41 supplement or we recommending the 200 the 11:44 400 and the 600. Well, how we get vitamin D 11:49 orally is really another interesting topic, 11:54 in order to take care of rickets in this country 11:57 the Federal Government decided to put vitamin D 12:02 with in milk a lot of us think of milk as a source of 12:07 vitamin D but the truth is its not observed that 12:11 well and some studies that actually looked at milk 12:14 off the shelf found that the vitamin D they said 12:17 was in their wasn't in there to begin with. 12:19 Now, I am sure industry has done some things to 12:21 correct that since that became known. 12:24 But vitamin D, taken orally is not all that well 12:28 observed and so it would make sense for those 12:32 people who are at risk for example those people 12:35 who are living in the north in the winter time, 12:38 those people who are unable to get out in the 12:40 sun at all to take a supplement, supplement. 12:44 And while the international unit recommendation 12:47 is about 400 to 600 if you are gonna take it 12:50 orally probably need a thousand international 12:54 units to maintain a level and we know that it's 12:57 safe to take up to 2,000 international units a day 13:00 of the vitamin D, with out any toxicity or problems. 13:04 So, certainly if you are not spending much time 13:07 outside may be you have a night job and you 13:10 sleep during the day, or may be you are African 13:13 American and have a extra protection in your 13:16 skin against the sun and certainly those 13:20 individuals who are at higher risk and we're gonna 13:23 talk about that in a few minutes. Those who are 13:25 at higher risk of vitamin D deficiency, these 13:28 individuals would probably want to take a thousand 13:31 international units of vitamin D, and as George 13:35 mentioned the American institute of medicine says 13:37 that is a safe level once you at one year of age 13:42 all the way through adulthood and you can take 13:44 up to 2,000 international units a day. 13:47 Now, as we've mentioned earlier George there is 13:50 actually some evidence of that vitamin D could 13:55 actually help lowering your risk of autoimmune 13:58 diseases, tell us a little bit about this. I don't 14:01 think we understand for assure the mechanism it 14:05 probably at least in my mind has something to do 14:08 with that anticancer effect where it helps to the 14:11 cells to differentiate and do what they are suppose 14:14 to, one of the isomers of the vitamin D actually 14:17 goes into the nucleus and helps to balance 14:20 things out. Autoimmune disease is a whole host of 14:26 diseases which the immune system gets confused 14:29 and starts to fight ourselves for example people 14:34 with rheumatoid arthritis have the immune system 14:36 turning and actually fighting the joints. 14:40 Sometimes it attacks the skin sometimes a variety 14:43 of different areas and it seems that adding vitamin 14:47 D, may actually help to control that reaction 14:51 especially if it's caught early in the disease. 14:55 And so we see that Vitamin D will actually help your 14:58 immune system your white blood cells if you will 15:02 to better determine whether what they are 15:05 dealing inside you is self or non-self, friend or 15:10 enemy and you certainly don't want your immune 15:12 system fighting yourself because this can be 15:15 devastating and that's what happens in type 1 15:18 diabetes. Now, Dr. Koponen at the Institute for 15:22 Child Health in London conducted some very 15:25 interesting studies on Finnish children. You may not 15:28 know that Finland in this country where they have 15:31 very little sunlight during the winter months. 15:35 In fact, they don't have any during parts of that 15:37 time at season, and they're not getting as much of 15:41 the direct rays of the sun being that far north. 15:45 So, these individuals have a significant increase 15:48 risk of vitamin D deficiency and they have the 15:50 number 1, their children that is have the number 1 15:53 risk of type 1 diabetes in the world and what 15:57 they did was to put this children half of them on 16:01 vitamin D and another group was just put on a 16:05 placebo and what they were able to show is that 16:08 individuals, children in Finland who took vitamin D 16:12 were at 88 percent lower risk of type-1 Diabetes 16:17 during the course of that study, then what they 16:20 did was to take individuals children in Finland and 16:24 put them on the recommended daily allowance 16:27 so for vitamin D, by the Finnish Government, 16:30 2,000 international units a day which we mentioned 16:33 earlier as the upper limit of safe intake in this 16:38 country by our government and what they 16:40 showed with these children taking 2,000 16:43 international units of Vitamin D a day were at 16:46 78 percent lower risk of type 1 diabetes 16:50 compared to children who were taking less than 16:53 2,000 international units of vitamin D. And so for 16:58 those individuals whose children are not 17:01 getting the sun exposure that you might want 17:05 them to get for some one reason or another you 17:08 would probably want to make sure that they are 17:10 getting at least a thousand international units a 17:13 day and if they're severally limited in sun exposure 17:17 you may want to boost that even as much as 2,000 17:20 international units a day and so remember 17:24 vitamin D, sunlight actually helps your body to 17:29 not the so interesting in harming you, your own 17:33 tissue but you know this is kind of interesting Tim, 17:35 I understand how the folks in Finland, the kids in 17:38 Finland don't get enough sunlight especially in the 17:41 winter is my understanding that there is an 17:43 increase in vitamin D deficiency related diseases 17:47 in this country as well. Do, you think that might 17:51 have something to do how much time kids spend 17:54 in front of a TV or a video monitor, absolutely, 17:58 that's what I was alluding to, children are 18:01 spending more and more time in side now, 18:04 recently we've been hearing about this as a epidemic 18:08 of childhood obesity and type two diabetes in 18:12 children largely related to their non use of the 18:17 large muscle groups because they are spending 18:19 more indoors in front of the scene and not realizing 18:24 they are not only gaining weight and developing 18:27 insulin resistance and diabetes but they are being 18:31 deprived of an important if you will vitamin D 18:35 which is so important for strong bones for a 18:39 healthy immune system that knows the difference 18:41 between and non self and so many other 18:44 benefits of keeping blood pressure low. 18:47 So, its so important to step out just for 18:50 seven minutes three times a week we would 18:54 recommend that you would spend probably seven 18:57 to fifteen minutes most days of the week because 19:01 vitamin D is so important but of course we want 19:03 to emphasize you don't wanna burn your skin in 19:06 fact you don't even wanna turn your skin pink and 19:10 Dr. Michael Holick would actually tell you that your 19:12 only need to spend one forth of the time outside 19:16 that it would take to burn the skin to get all 19:19 vitamin D you need. So, if you burn the skin in 19:22 fifteen minutes then four minutes is all that you 19:25 need to spend out there to get all the vitamin D 19:28 that you need. Tim, we've mentioned of type 1 19:32 diabetes probably not been caused by vitamin D 19:37 deficiency but vitamin D deficiency allowing it to 19:40 come because immune system is not that balance. 19:43 There are also some connections with that type 19:46 two diabetes and apparently in some resistance and 19:49 what not. Tell us about that oh this is exciting 19:52 in fact you know if you have some free time rather 19:56 than spending it in front of screen you may want 19:58 to spend some time reading about your own body's 20:02 physiology you know we're told that our children 20:04 should understand how their body works and 20:08 I was fascinated to read that the body actually 20:13 needs calcium in order to release the little 20:18 packets of insulin from the beta cell of the islets of 20:22 the pancreas. So, that you can put that insulin 20:25 out into the blood stream so it can go out and help 20:27 your blood sugar and the fats in the blood should be 20:30 taken up and so in order to release insulin from 20:34 the pancreas you need a good calcium level and 20:37 of course you won't have a good calcium level 20:40 unless you step outside and get some sun or and, 20:44 and or take a supplement and frankly we're 20:48 recommending both at least that I usually 20:50 recommend to my patients spend your seven 20:52 to fifteen minutes daily out in the sunlight and 20:56 take at least a thousand international units of 20:58 vitamin D don't take anymore than 2,000 international 21:02 units and remember you've got vitamin D in some of 21:05 the foods that you are taking in perhaps and also in 21:08 that multivitamin so take that in the consideration when 21:12 you're calculating of the 2,000 total for today. 21:16 Its also true that not only as that beta cell function 21:21 improve but also insulin sensitivity, there is some 21:23 recent study pointing to that is improving how diabetes 21:28 actually need less insulin to get the same response. 21:31 In fact, there is good news for both type 1, 21:33 and type 2 diabetes in the vitamin D realm. 21:37 Now, Dr. Chapuy and his colleagues at Lyon, 21:42 France reported to the New England Journal of 21:44 medicine a very interesting benefit of vitamin D 21:47 and calcium for women who are at high risk of a 21:51 hip fracture. These women were actually average age 21:54 78 to 90 now they were healthy but you know 21:59 when you get that to that age your bones are 22:02 typically have lost a fair amount of calcium and 22:05 you're at higher risk of a fracture and so what 22:08 they did was they took half of these individuals these 22:11 women and they put them on a double placebo the 22:14 other half of the women were actually put on 22:17 1200 mg of elemental calcium and 800 international 22:23 units of vitamin D and then they followed these women 22:27 and found that those who are taking the calcium 22:31 and the vitamin D were actually at 43 percent 22:36 lower risk of a hip fracture 18 months later and the 22:41 bone mineral density that means the calcium part 22:45 of the bone actually increased by 3 percent in 22:49 those women on the two supplements versus a 22:52 five percent decrease in bone mineral density in 22:56 those who are in the double placebo after 18 months. 23:00 And so just paying attention to some simply things 23:04 like calcium and vitamin D can prevent to 23:07 something very potentially serious as a hip 23:09 fracture because after a hip fracture what often 23:14 happens is an elderly individual may be put to 23:17 surgery to do a pinning of that hip they may 23:20 develop an ammonia after the surgery and that 23:24 can often times be life threatening or it may 23:28 lead to the rest of life spent in a long term care 23:32 facility and so. Keeping the bones strong very, 23:36 very important benefit of vitamin D. There are 23:41 couple other groups of people that are at risk 23:45 for having low vitamin D levels, one of those are 23:49 new born infants you know those that are breast 23:53 feed do not get any vitamin D in the breast milk, 23:58 remember the cow's milk doesn't have it in it, 24:00 it really had to be added and of course is added 24:03 to formulas. There are some doctors who are 24:06 recommending that when babies come home from 24:07 the hospital they actually get a vitamin D shot or 24:11 some way to get the vitamin D in until they 24:14 finally old enough and their parents are, are able 24:18 to get them out in the sun so they can get a 24:19 little bit of vitamin D. At the other extreme of life 24:23 is this the elderly group people who are older 24:28 have a decrease in the body's ability to make the 24:30 previtamin D and so are often deficient in it 24:34 and these need to be, both these groups need 24:37 to be watched very carefully. There's another 24:40 group of individuals who would benefit from 24:42 vitamin D there was an article published in the 24:47 annals in New York state the medical society there, 24:51 they've published a case report of five individuals 24:54 who had severe weakness, these individuals 24:57 were either wheelchair bond or they were not 25:00 able to get off of a bed they were basically not 25:03 ambulatory and they found these individuals 25:06 were severally vitamin D deficient and all that 25:10 they did was to give them a loading dose of vitamin 25:13 D, 50,000 international units once a week for 25:16 six weeks and all five of these chronically ill 25:21 patients who are unable to walk were, were able to 25:24 get up and be ambulatory just after replacing 25:29 the vitamin D, because the muscles actually need 25:32 a good calcium level in order to have strength 25:35 and so if your vitamin D is rock bottom because 25:38 you're not getting out in the sunlight your 25:40 calcium and the tissue will be low. The muscles 25:43 will not have the strength that they need, 25:45 and so if you've been facing some fatigue or some 25:48 weakness of the muscles vitamin D maybe part 25:52 of the solution for you. At lifestyle center of 25:56 America where we both work, for the last almost 26:01 two years we have been measuring vitamin D 26:03 levels on people who come for help. 26:06 Now these, this group of people often has a group 26:10 of illness as we focus on lifestyle diseases diabetes, 26:14 heart disease, hypertension, obesity. 26:19 We have found depending on how we measure it, 26:22 upto about sixty percent of this people have 26:26 less than optimal levels of vitamin D, that's a 26:29 significant number of people, getting that monitored 26:33 and fixed is an important part of their treatment. 26:36 Now Vitamin D is a fascinating sort of a subject 26:43 if you would, it's neat how the creator has put 26:47 together, something as bad if we can put it that 26:51 way as cholesterol when hit by the sun and 26:57 we might for spiritual lesson spell that SON 27:01 become something that is very beneficial and 27:04 protective, it brings life to us protection against 27:09 death and cancer and as well energy and good 27:14 physiologic function isn't that amazing. 27:18 Tim, in our last little bit let's review what the 27:21 levels should be if people have chance to 27:24 write that 25-hydroxy- vitamin D level down 27:28 again. Yes, so the vitamin D level that you 27:32 would like to have is about at least 30, 30 to 60 27:37 and frankly 40 to 60 would probably be even 27:40 better and that's again the number 27:41 25-hydroxy-vitamin D and just a final word those 27:47 with Fibromyalgia may also find significant 27:50 benefit from getting their vitamin D level up 27:54 because muscles that don't have 27:57 enough calcium can tightened and actually be 28:00 very, very constricting and painful. So, we would 28:03 recommend that you get all of the benefits of 28:07 sunlight that the creator has chosen and find 28:10 out once again how you are wonderfully made. |
Revised 2014-12-17