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Vitamin D Deficiency Behind Many Western Cancers?
twilight30 wrote us with a link to an article in the Globe and Mail. If further study bears out the findings, new research into the causative agents behind disease and cancer may have a drastic impact on the health of citizens in Canada and the US. According to a four-year clinical trial, there's a direct link between cancer and Vitamin D deficiency. "[The] trial involving 1,200 women, and found those taking the vitamin had about a 60-per-cent reduction in cancer incidence, compared with those who didn't take it, a drop so large — twice the impact on cancer attributed to smoking — it almost looks like a typographical error. And in an era of pricey medical advances, the reduction seems even more remarkable because it was achieved with an over-the-counter supplement costing pennies a day. One of the researchers who made the discovery, professor of medicine Robert Heaney of Creighton University in Nebraska, says vitamin D deficiency is showing up in so many illnesses besides cancer that nearly all disease figures in Canada and the U.S. will need to be re-evaluated. 'We don't really know what the status of chronic disease is in the North American population,' he said, 'until we normalize vitamin D status.'"
I believe that Vitamin D might protect against some cancers.
However, I do not agree that Vitamin D deficiency can be responsible for about 60% cancers.
Here are my reasons why:
1) The process of carcinogenesis (initiation of the first DNA mutation/ adduct required to form cancer to the stage of clinically overt disease) in most cases takes more than 4 years. This clinical trial is only 4 years and too premature to reach to conclusions.
2) I have yet to read the paper, but it is necessary to know whether this trial was truly randomized meaning that the those who got the Vitamin D pill and those who got the placebo were similar to each other in all other ways. It is possible that if it is not randomized, a healthier cohort of people chose to take Vitamin D for a long time.
3) It is also important to know how they treated those people who dropped out of taking the Vitamin D pills. It is possible that unhealthier people dropped out and then we were comparing all subjects in the placebo group to the "healthier" people in the Vitamin D group.
4) A risk reduction of 60% (= relative risk of 0.4) is epidemiologically very strong and if that was the case, we would have already found such a role of Vitamin D much earlier (like 30 years before or so). There is something called Bradford Hill's criteria for causation in epidemiology which has strength of association as one of the criteria. The rationale for that is if we had a confounder which is actually responsible for the effect, we would have known it before because it is more likely to have a stronger effect. The same principle goes here. We do not know anything that could prevents so many types of cancer with such great attributable fraction. The magnitude of effects of like 2.5 or reduction of risk to 0.4 were the strengths we used to see in the papers of 1970s. Hence I think there could be some issues with the study design and data analysis of this study if they found such a great magnitude of effect.
Having said that I think that Vitamin D might prevent many cancers, but I expect a lower magnitude of the effect.
Not so fast ;)
Vitamin D is a fat soluble vitamin and is present in meat products. Deficiency in Vitamin D causes rickets. Vitamin D is so-called, and many would think it was not available without a dietary source, but it is produced in the skin under the influence of UV light. It then gets processed by the liver, then 'activated' in the kidneys and off it goes and does good things.
Because it is fat soluble, it is unlike Vitamin C in that stores are steady and no Vitamin D production only starts to cause problems after several months.
Whilst Vitamin D requirements increase with age, sun exposure commonly decreases with age, especially in the elderly. Much of this is simply a lifestyle issue.
Importantly, Vitamin D is already known to have immunomodulatory activities (a well functioning immune system is critical in preventing cancer over time). It is also known to induce some cancers to self-destruct.
Do it yourself, because no one else will do it yourself. [beta blockade 10-17 Feb]
The doctor that I work for has asked me to research this very line of thinking for her, pulling every article out I could find on multiple sclerosis (MS) and Vitamin D, and I even ended up using some of that research in a paper I wrote for an English class.
There's a very significant link between Vitamin D deficiency and MS. Most MS cases occur in the far north and far south climes. Think of southern Australia and Tasmania and northern Europe and United States, areas where sunshine is at low levels for as much as nine to ten months out of the year. We are able to make Vitamin D via sun exposure on the skin, which for humans, is a primary source of Vitamin D. Some of these studies find that people who had high levels of sun exposure as children greatly reduces their risk of contracting MS.
Don't believe me? Read these studies. There are tons more just like them, confirming the suspicion.
Our white skin color comes from the Caucasus mountains, north of Iran. That's why white people are called Caucasians. I had a woman friend whose ancestry was from northern Iran, and it was amazing to see how white she was, in a way I thought was beautiful. Comparing her skin and mine, it was easy to see that I am a mixture of Caucasian and something else.
Probably the reason northern people are white is that black people inter-marrying with a high concentration of white people tends to produce lighter-skinned new generations.
All humans apparently spread from an original migration from Africa, but the people who initially migrated tended to continue to migrate, and migrated much more than those who initially stayed in Africa.
Inuit... Inuit have relatively dark colored skins...
n uit-onto-thin-ice/2006/05/26/1148524886121.html
http://www.smh.com.au/news/world/climate-forces-i
And Inuit have been living in the North for many thousands upon thousands of years (50,000 I think). Actually I am always amazed at how dark their skin is comparing to where they live. It's not like you are going to see a bunch of Inuit suntanning on the tundra...
A skin near the equator that is light colored? Hmm... How about Amazon natives? http://bbs.keyhole.com/ubb/z0302a1700/amazon.jpg
The Amazon is about as close to the equator that you can get and their skin is relatively light colored when compared to say the skin color of an individual from Africa. And last I heard Amazon natives have been there for many many many thousands of years.
So the nutshell is equator = darkness of your skin color is HOGWASH! Want me to prove it even further? How about the aboriginals of Australia when compared to an individual from Malaysia? Aboriginals are much much darker and further away from the equator than individuals from Malaysia....
"You can't make a race horse of a pig"
"No," said Samuel, "but you can make very fast pig"
That's funny, cause I taped some lectures at a major research institution back in '04 where an evolutionary biologist cited the link between skin color and latitude. So apparently not all evolutionary biologists subscribe to this belief.
Too little sun exposure causes a Vitamin D deficiency. When women have Vitamin D deficiencies, they become less fertile. And interestingly, if I recall correctly, too much sun exposure interferes with women's antral follicle development - the ones in the ovaries, not on the skin. Therefore, there is the potential for selective pressure to be both not too dark and not too light.
Is natural selection - note that I said Natural Selection, not evolution - fast enough to cause the suppression of darker-skinned people at the poles and lighter-skinned people at the equator? Well, if I started off with a population where everyone's blood type was either AB, A, or B, and I sterilized all of the people with B alleles, the population would soon be all type A. No other factor has as direct an impact on a population's genes than fertility, by definition. Forget skin cancer. Skin cancer won't prevent most people from having children. Having no viable eggs will.
So nobody's saying those strange cosmic rays created the variation we see in people's skin tones. But it's daft to push aside the direct impact that skin color and latitude have on fertility, and the large body of circumstantial evidence we have in the form of human geography.
Here are a few of them:
Humble, M. (2007). [Vitamin D deficiency probably more common than earlier apprehended. Prevention and treatment could result in unexpected public health effects]. Läkartidningen, 104(11), 853-7.
Nielsen, LR, & Mosekilde, L. (2007). [Vitamin D and breast cancer]. Ugeskrift for læger, 169(14), 1299-302.
Ondková, S, Macejová, D, & Brtko, J. (2006). Role of dihydroxyvitamin D(3) and its nuclear receptor in novel directed therapies for cancer. General physiology and biophysics, 25(4), 339-53.
Garland, CF, Gorham, ED, Mohr, SB, et al. (2007). Vitamin D and prevention of breast cancer: pooled analysis. The Journal of steroid biochemistry and molecular biology, 103(3-5), 708-11.
The results also makes sense in evolutionary terms.
A Good Troll is better than a Bad Human.
Several counter-points:
- Southern and particularly South Africa are HOT, very hot, and it's sunny almost every day of the year. Summer is baking hot for months. Rudimentary research would've turned that up.
- The black people of South Africa are here as a result of a relatively recent massive migration of the Bantu peoples from around the Cameroon area that spread first East and then South. In South Africa they have been here probably not more than 1500 years.
- The indigenous people of South Africa that have been here for a long time (10,000+ years), e.g. the Khoesan, DO in fact have lighter complexions than the Bantu peoples that came from the equatorial regions.
- Even the 'black' people of South Africa ARE in fact lighter than their self-same relatives from up North - in fact generally speaking the closer you get to the equator, the darker the black people get. (That itself appears to be another strong argument for the Vitamin D correlation, although it's not that cut and dry because some, or perhaps much, of the lightening of the blacks in South Africa is due to generations of interbreeding with e.g. Khoesan peoples.)
I have Vitamin D deficiency, and it came close to ruining my life. I am a scientist, but I also have dark skin that never burns. Even though I don't own a car, I just can't get the 2-3 hours of sunshine daily needed to fulfill my Vitamin D requirement; white folks only need 20 minutes. Moreover, it's kind of chilly where I live, so I wear long pants and sleeves much of the time.
Over time, I developed a pain that just sucked the life out of me -- like I was playing four quarters of football daily, with the flu. Even with powerful pain killers I couldn't sleep, and woke up every day feeling I was hit by a bus.
The link to cancer is still an open question, but the pain is a hard fact.
PS: The only way to overdose on Vitamin D is to abuse prescription-strength supplements or cod liver oil.