We don’t get much sunshine up here in the Great Northwest.  And few sunny days mean many of us are deficient in Vitamin D.  In fact, Vitamin D deficiency is remarkably common even for those living in sunnier climes.

Most Seattleites are unaware that we have a Vitamin D expert right in our own backyard.  Craig A. Keebler, MD holds board certifications in obstetrics, gynecology and bariatric medicine.  His book, Know Your D, sets out to teach us about this essential nutrient.

Zing:  To those who are new to the Vitamin D topic, how would you describe Vitamin D in a nutshell?

Dr. Keebler:  Actually, Vitamin D is not a typical vitamin.  It’s a gene regulator.  Vitamin D activates nearly 1000 genes necessary for good health.  For example, it activates at least 60 genes to prevent or defeat cancer cells.  It regulates over 12 genes that support the immune system.  Vitamin D influences genes that regulate insulin production and effectiveness.  It has an effect on genes that decrease inflammation and prevent autoimmunity.  Even reproductive health depends on Vitamin D.

Zing:  What got you interested in Vitamin D?

Dr. Keebler:  I was working at the time in my medically supervised weight loss clinic.  I knew about Vitamin D but it was not a focus of my practice.  I was asked by a Rheumatology nurse practitioner if I knew my own Vitamin D level.  I was shocked to find out my level was low despite it being summertime.  I then learned that people who are obese have a harder time achieving healthy blood levels.  Of course, people with obesity also face increased risk of inflammatory conditions and blood sugar problems.  So Vitamin D grew to become an important consideration as I took care of these patients.

Zing:  Why are so many of us deficient?

Dr. Keebler:  It’s a consequence of modern life.  For most of human history: 90% of our Vitamin D was produced from UV light hitting exposed skin.  Now, we are outside less as a society (less work, play and exercise happen outside).  Even when we are outside, we lather on sunscreen more than ever before.  Now, it’s appropriate to use sunscreen, but since it prevents Vitamin D production it’s important to use a Vitamin D supplement.

Zing:  What did you find most surprising as you began to research Vitamin D?

Dr. Keebler:  Every month, one can find a whole new area of Vitamin D investigation.  We are finding so many areas of health and disease that are affected.  Take Vitamin D and brain health.  Animal studies are showing us that offspring born to mothers with decreased Vitamin D have more mood disorders, more learning impairments, focus and social problems.  Bottom line: the brain is very dependent on Vitamin D.

Zing:  Any clinical success stories involving Vitamin D?

Dr. Keebler:  Here’s an observation that struck me: After improving their Vitamin D to healthy levels, my patients would tell me “This is the first winter that I’ve lived in Seattle that I didn’t have the blues.”  This goes back to Vitamin D’s influence on brain health.

Zing:  What precautions should people be aware of?

Dr. Keebler:  Ideally, people should work with a healthcare practitioner who can check your blood level and custom tailor a dose to fit your specific needs.  Regular checks (minimum once a year; more often if you have a specific health concern) will prevent the possibility of getting too much.  By the way, there are no recent reports of toxicity (meaning overdose).  Past reports of Vitamin D blood toxicity involved people taking 100,000+ units per day.  (The common adult maintenance dose is less than 10,000 units per day.)  The big problem of our time is not the threat of overdose, its inadequate supply.

Zing:  What do you think is the next frontier in Vitamin D research?

Zing:   Back to those who are Vitamin D newcomers.  What key takeaway should they remember about Vitamin D?

Dr. Keebler:  How about three things:

1. Assume you are Vitamin D deficient until proven otherwise!  40ng/ml is a blood level where many health benefits are noticed.  Speaking of testing, the best blood test is called “25-Hydroxy-Vitamin D” (sometimes abbreviated 25-OH Vitamin D).
2. It’s easier and safer to achieve healthy levels via supplementation than it is to rely on sun exposure.
3. There are very few food sources that can give an adequate daily supply.  But for those who are really interested, 10 cans of sardines will do it!

Learn more about Vitamin D and Dr. Keebler’s book at KnowYourD.com

My first grader is a sporty kid and so we move through the seasons with a variety of sports leagues. Coaches change, teams vary but one thing stays the same – the quality of the post-game snacks provided for the kids. They are consistently high in added sugars. Does a 45 minute fast paced basketball game really necessitate the provision of fruit juice, fruit roll ups, and dried fruit chips? All seemingly nutritious choices but all together mean a lot of added sugar.

Drs Robert H. Lustig, Laura A. Schmidt and Claire D. Brindis have plenty to say about added sugar in the American diet. They are actually calling for added sugars (sucrose and high fructose corn syrup) to be regulated by governments in similar ways to tobacco and alcohol so that public health is protected.

That’s a highly controversial statement so let’s take a look at the evidence they provide.

In 2003, four widely accepted criteria were adopted that justify the regulation of alcohol:

• Unavoidability (or pervasive throughout society)
• Toxicity
• Potential for abuse
• Negative impact on society

In America today, sugar is added to nearly all processed foods – it is pervasive in our food supply.

Is it toxic? There is good evidence to suggest that consuming too much sugar is linked to high blood pressure, high triglycerides, insulin resistance and Type 2 diabetes. This is not only because sugar is adding excess, non-nutritious calories to the diet. Sucrose and high fructose corn syrup increase uric acid which raises blood pressure. They also need to be metabolized by the liver and if too much is eaten, can actually cause fatty liver – a disease that is also caused by excessive alcohol consumption. A recent study also showed that added sugar consumption may increase cardiovascular risk factors because it increases visceral fat, the kind that accumulates around internal organs.

Can sugar be abused? There are now several studies that show that humans can become dependent on sugar. Sugar can mess with the functioning of our hormones grehlin and leptin so we feel hungrier and are not satisfied as easily when we do eat. Sugar also plays havoc with dopamine signals in the brain. It reduces dopamine signaling in the brain’s reward center so it makes us want to eat more so we can experience more pleasure from the food.

Does excessive sugar intake have a negative impact on society? Well, if we look at the US costs to deal with metabolic syndrome (that cluster of high blood pressure, high triglycerides and high blood sugar), the numbers are staggering. $150 billion annually on health care resources alone!

So, if we agree that sugar intake meets the criteria for government regulation, then how do we reduce sugar consumption on a national level?

Drs Lustig, Schmidt and Brindis have good ideas modeled on successful tobacco and alcohol interventions. They would ideally like to ban television commercials for products with added sugar that are geared towards children. They propose tightening licensing requirements on vending machines and snack bars that sell sugary products in schools and workplaces. There is a strong sugar lobby that will make these kinds of changes difficult – but not impossible -as proven by tobacco and alcohol interventions.

Whether or not you agree with these ideas, it does make logical sense to look at your own level of added sugar consumption. The American Heart Association recommends limiting added sugars to no more than 100 calories per day for women and no more than 150 calories per day for men. Zing Bars are a great example of a delicious treat that is low in sugar and is a good source of fiber, protein, vitamins and minerals. Be aware of added sugars in foods you choose – you’ll be doing your health a favor!