Monday, May 11, 2015

Health Benefits of Vitamin D an Sunlight- Dental Problems, Allergies, Skin Conditions

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."


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