More Vitamin D = lower rates of tooth decay
A new review of existing studies points
toward a potential role for vitamin D in helping to prevent dental caries, or
tooth decay.
The review, published in the December,
2012 issue of Nutrition Reviews,
encompassed 24 controlled clinical trials, spanning the 1920s to the 1980s, on
approximately 3,000 children in several countries. These trials showed that
vitamin D was associated with an approximately 50 percent reduction in the
incidence of tooth decay.
"My main goal was to summarize the
clinical trial database so that we could take a fresh look at this vitamin D
question," said Dr. Philippe Hujoel of the University of Washington, who
conducted the review.
While vitamin D's role in supporting bone
health has not been disputed, significant disagreement has historically existed
over its role in preventing caries, Hujoel noted. The American Medical
Association and the U.S. National Research Council concluded around 1950 that
vitamin D was beneficial in managing dental caries. The American Dental
Association said otherwise – based on the same evidence. In 1989, the National
Research Council, despite new evidence supporting vitamin D's caries-fighting
benefits, called the issue "unresolved."
Current reviews by the Institute of
Medicine, the U.S. Department of Human Health and Service and the American
Dental Association draw no conclusions on the vitamin D evidence as it relates
to dental caries.
"Such inconsistent conclusions by
different organizations do not make much sense from an evidence-based
perspective," Hujoel said. The trials he reviewed increased vitamin D
levels in children through the use of supplemental UV radiation or by
supplementing the children's diet with cod-liver oil or other products
containing the vitamin.
The clinical trials he reviewed were
conducted in the United States, Great Britain, Canada, Austria, New Zealand and
Sweden. Trials were conducted in institutional settings, schools, medical and
dental practices, or hospitals. The subjects were children or young adults
between the ages of 2 and 16 years, with a weighted mean age of 10 years.
Hujoel's findings come as no surprise to
researchers familiar with past vitamin D studies. According to Dr. Michael
Hollick, professor of medicine at the Boston University Medical Center,
"the findings from the University of Washington reaffirm the importance of
vitamin D for dental health." He said that "children who are vitamin
D deficient have poor and delayed teeth eruption and are prone to dental
caries."
The vitamin D question takes on greater
importance in the light of current public health trends. Vitamin D levels in
many populations are decreasing while dental caries levels in young children
are increasing.
"Whether this is more than just a
coincidence is open to debate," Hujoel said. "In the meantime,
pregnant women or young mothers can do little harm by realizing that vitamin D
is essential to their offspring's health. Vitamin D does lead to teeth and
bones that are better mineralized."
Hujoel added a note of caution to his
findings: "One has to be careful with the interpretation of this
systematic review. The trials had weaknesses which could have biased the
result, and most of the trial participants lived in an era that differs
profoundly from today's environment. "
Hujoel has joint appointments as a
professor in the University of Washington School of Dentistry's Department of
Oral Health Sciences and as an adjunct professor of epidemiology in the UW
School of Public Health. His research has concentrated on nutrition with a
focus on low-carbohydrate diets, harmful effects of diagnostic radiation, and
evidence-based methodology and applications.
His research has also covered sugar substitutes,
the use of antibiotics in the treatment of periodontal disease, and cleft lip
and cleft palate. He has also studied the link between dental disease and
systemic disease, as well as trends in disease prevalence.
Vitamin D can help protect the gums from
bacterial infections
Laboratory-grown gingival cells treated
with vitamin D boosted their production of an endogenous antibiotic, and killed
more bacteria than untreated cells, according to a paper in the June 2011 issue
of the journal Infection and Immunity.
The research suggests that vitamin D can help protect the gums from bacterial
infections that lead to gingivitis and periodontitis. Periodontitis affects up
to 50 percent of the US population, is a major cause of tooth loss, and can
also contribute to heart disease. Most Americans are deficient in vitamin D.
His interest piqued by another
laboratory's discovery that vitamin D could stimulate white blood cells to
produce natural proteins that have antibiotic activity, Gill Diamond of the
UMDNJ -- New Jersey Dental School, Newark, showed that vitamin D could
stimulate lung cells to produce LL-37, a natural antibiotic protein, and kill
more bacteria. That suggested that , vitamin D might help cystic fibrosis
patients. Next, in the new research, he showed that vitamin D has the same
effct on gingival cells.
Then, Diamond found that vitamin D also
stimulates gingival cells to produce another protein, called TREM-1, which had
not been well-studied, but which was thought to be made by white blood cells.
He found that it boosts production of pro-inflammatory cytokines.
The new research also showed that vitamin
D coordinates expression of a number of genes not previously considered to be
part of the vitamin D pathway. Those genes may be involved in additional
infection-fighting pathways. A more comprehensive understanding of how vitamin
D carries out this regulation at the molecular level -- something Diamond hopes
to investigate -- will enable targeted therapies using vitamin D, he says.
Interestingly, Diamond also found that
lung and gum cells appear to have the ability to activate inactive forms of
vitamin D, says Diamond. "This means that we may even be able to use
vitamin D therapy topically, if that proves true."
Vitamin D has become a hot area of
research in recent years. In addition to infectious diseases, studies suggest
that it has protective effects against autoimmune diseases, and certain
cancers.
Diamond says that after he began
conducting research on vitamin D, he began taking it as a supplement. Since
then, "I have had only one cold in four years, and that one lasted only
three days," he says. "Other people I've met who have done the same
have seen similar results. We are trying to figure out how it's working, and
what other infectious diseases can be mitigated by it."
Vitamin D significantly improves symptoms of winter-related
atopic dermatitis in children
A study conducted in more than 100 Mongolian schoolchildren
found that daily treatment with a vitamin D supplement significantly reduced
the symptoms of winter-related atopic dermatitis, a type of eczema. Led by a
Massachusetts General Hospital (MGH) physician, the report in the October 2014
issue of the Journal of Allergy and Clinical Immunology supports the
results of a preliminary study that showed similar results in a small group of
children in Boston.
"While we don't know the exact proportion of patients
with atopic dermatitis whose symptoms worsen in the winter, the problem is
common," says Carlos Camargo, MD, DrPH, MGH Department of Emergency
Medicine. "In this large group of patients, who probably had low levels of
vitamin D, taking daily vitamin D supplements – which are inexpensive, safe and
widely available – proved to be quite helpful." Camargo led both the
earlier Boston pilot study and the current investigation, which was performed
in collaboration with investigators from the Health Sciences University of
Mongolia.
A chronic inflammatory disorder of the skin, atopic
dermatitis is uncomfortable and makes patients more vulnerable to bacterial
infection. Symptoms of the disorder – most commonly seen in children – often
worsen during wintertime. While controlled administration of ultraviolet light,
which can stimulate the production of vitamin D in the skin, is a common
treatment for severe atopic dermatitis, the possibility that vitamin D
deficiency contributes to the seasonal worsening of symptoms had received
little consideration prior to the Boston study. That investigation involved
only 11 children but provided preliminary support for the hypothesis.
The current study, conducted in collaboration with the
National Dermatology Center in Mongolia, enrolled 107 children, ages 2 to 17,
from nine outpatient clinics in the capital city of Ulaanbaatar. The
participants – all of whom had a history of atopic dermatitis symptoms
worsening either during cold weather or around the transition from autumn to winter
– were randomly divided into two groups. One group received a daily vitamin D
dose of 1000 IU while the other received a placebo – both delivered in
odorless, colorless and tasteless drops. Neither the children's parents nor the
study investigators knew to which group participants had been assigned.
Standard evaluations of atopic dermatitis symptoms were
conducted at the outset of the trial and at the end of the month-long study
period, and parents were also asked whether they saw any improvement in their
child's condition. At the end of the month, children receiving the vitamin D
supplement had an average 29 percent improvement on the primary assessment tool
used, compared with 16 percent improvement in the placebo group. Additional
assessments – including the report from parents – also showed significantly
greater improvement among children receiving vitamin D.
While
data gathered at the outset of the study could not determine whether or not
participating children were deficient in vitamin D, the authors note that an
even larger study of Ulaanbaatar children conducted at the same time found
significant vitamin D deficiency in 98 percent of participants, supporting the
probability that the children in this study were also deficient. While future
studies are needed to assess the value of vitamin D treatment in adults and in
children with year-round symptoms, Camargo – a professor of Medicine at Harvard
Medical School – says that parents of children with symptoms that worsen in the
winter should try a vitamin D supplement for a few weeks when symptoms flare to
see if it helps. He encourages parents to discuss this study and their plan
with their primary care provider.
Vitamin
D provides relief for those with chronic hives
A study by researchers at the University
of Nebraska Medical Center shows vitamin D as an add-on therapy could provide
some relief for chronic hives, a condition with no cure and few treatment
options. An allergic skin condition, chronic hives create red, itchy welts on
the skin and sometimes swelling. They can occur daily and last longer than six
weeks, even years.
Jill Poole, M.D., associate professor in
the UNMC Department of Internal Medicine, was principal investigator of a study
in the Feb. 7 edition of the Annals of Allergy, Asthma and Immunology. The
two-year study looked at the role of over-the-counter vitamin D3 as a
supplemental treatment for chronic hives.
Over 12 weeks, 38 study participants
daily took a triple-drug combination of allergy medications (one prescription
and two over-the-counter drugs) and one vitamin D3, an over-the-counter
supplement. Half of the patient's took 600 IUs of vitamin D3 and the other half
took 4000 IUs.
Researchers found after just one week,
the severity of patients' symptoms decreased by 33 percent for both groups. But
at the end of three months, the group taking 4000 IUs of vitamin D3 had a
further 40 percent decrease in severity of their hives. The low vitamin D3
treatment group had no further improvement after the first week.
"We consider the results in patients
a significant improvement," Dr. Poole said. "This higher dosing of
readily available vitamin D3 shows promise without adverse effects. Vitamin D3
could be considered a safe and potentially beneficial therapy.
"It was not a cure, but it showed
benefit when added to anti-allergy medications. Patients taking the higher dose
had less severe hives -- they didn't have as many hives and had a decrease in
the number of days a week they had hives.
In the study, patients had suffered from
five to 20 years with severe hives. Some had been on therapy and others none.
The cause of hives is not generally
known, but allergy and autoimmune reactions sometimes play a role. Treatment
options for chronic hives are limited.
"Standard therapy is to control
symptoms with antihistamines and other allergy medications," Dr. Poole
said. "Some are costly and can pose substantial side effects."
She said the study didn't include
patients with kidney disease or those with calcium disorders.
Sunshine may help to prevent allergies and eczema
Increased exposure to sunlight may reduce
the risk of both food allergies and eczema in children, according to a new
scientific study .
Researchers from the European Centre for
Environment & Human Health, along with several Australian institutions,
have found that children living in areas with lower levels of sunlight are at
greater risk of developing food allergies and the skin condition eczema,
compared to those in areas with higher UV.
The research team used data from a study
of Australian children and analysed how rates of food allergy, eczema and
asthma varied throughout the country. As well as finding a link between
latitude and allergies to peanut and egg, the results showed that on average
children in the south of the country are twice as likely to develop eczema as
those in the north.
The report builds upon existing evidence
that suggests exposure to the sun may play a role in rising levels of food
allergy and eczema. Sunlight is important because it provides our body with the
fuel to create vitamin D in the skin, and locations closer to the equator
typically receive higher levels of sunshine. Australia is a particularly good
place for this type of study as it spans nearly 3000 miles from north to south,
with a large variation in climate, day length and sun strength - from
Queensland in the north to Tasmania in the south.
Dr Nick Osborne, who led the research,
believes these findings provide us with an important insight into the
prevalence of food allergies and eczema, which appear to be on the increase. Dr
Osborne also cautioned that exposure to sunlight can vary for a host of reasons
beyond latitude, such as local climate variations and behaviours, and these
factors will also need to be considered.
He said "This investigation has
further underlined the association between food allergies, eczema and where you
live. We're now hoping to study these effects at a much finer scale and examine
which factors such as temperature, infectious disease or vitamin D are the main
drivers of this relationship. As always, care has to be taken we are not
exposed to too much sunlight, increasing the risk of skin cancer."
No comments:
Post a Comment