I'll make this short because frankly, it's too stupid to bother with much. The only reason I'm bothering at all is because...
- The dozens of questions I've received about it
- Grant Whores with a twist ('further research would be pointless')
- The Media Whores are all over it like stink on shit (typical)
To sum it up, it's a meta-analysis of a bunch of past studies. Basically, there's no new study being done, but a study of a bunch of studies where they toss all the past results into a single database and analyze it as though it was one massive study. In this case, it comes out to about 105 randomized controlled trials with about 380,000 participants. The idea is that with a lot more data, statistical analysis will be more sound than, say, an RTC with 50 participants. Probably has some value and use in some applications, but: garbage in, garbage out.
What's the garbage in? That these are all old, obsolete studies where the dose of Vitamin D given was typically 400 IU; i.e., pretty much the various RDAs around the chronically vitamin D deficient world. Originally, the recommended daily allowance (200 IU, if I recall) was that level required to prevent rickets! Think about that.
What this means is that the difference between no vitamin D supplementation and supplementation at 200-400 IU is just like no supplementation at all; so conducting studies on the effect of supplementation unsurprisingly gets the result one would expect...or, perhaps, that one hoped for, since vitamin D is dirt cheap and has profound general health effects—as reported by thousands of N=1s in the comments of dozens of posts over 6 years here, and chez non-whoring bloggers many places elsewhere.
Here's an interview by Carole Baggerly of GrassrootsHealth of Dr. Cedric Garland of the UCSD Moores Cancer Center, who's been studying vitamin D in clinical settings since 1980 (do the math). He's pretty beside himself. What's funny is that I wrote that "garbage in, garbage out" comment above before hearing Garland use the exact same phrase several times in the interview.
If you don't listen to the 18 minutes (most of the main points are made in the first half and the second half is a lot about recommended vitamin D levels, dosages, etc.) then here's something Dr. Garland wrote up [emphasis added].
"This meta-analysis is nothing new and is already obsolete, since it is mainly based on old papers that used too little vitamin D to expect any effect. A New Zealand study saying we should only supplement people with vitamin D deficiency and evidence of bone loss is equally wrong. Virtually everyone in New Zealand, and most adults in the US, are vitamin D deficient by modern criteria, being below 32 ng/ml. The reality is that we now know that they are deficient with regard to extraskeletal effects of 25(OH)D if their serum level is below 40 ng/ml.
"These papers should be disregarded as obsolete work. We are moving into a new era of using vitamin D3 in doses no less that 4,000 IU/day for people aged 9 years and older (The NAS-IOM total upper level intakes [TULI's] that are safe for daily use per NAS-IOM monograph, 2011). Studies using less than 4000 IU/day are on the verge of obsolescence.
"It does not matter much that giving 400 IU/d in the meta-analysis being cited did not achieve very much -- the amount given to the subjects was less than a tenth the effective dose. The authors of this review did not use any epidemiological research and they appear to have paid no attention in their conclusions to the only RCT that was relevant, that of Lappe et al. in 2007.
"Lappe et al. used 1100 IU/day of vitamin D3 and 1500 mg/day of calcium. They achieved a serum level of approximately 40 ng/ml. It reported a 77% reduction in incidence of all invasive cancer combined, after a 1-year run-in period. The benefit was 60% less cancer without a run-in period. These cancers included breast, colon, lung and others. The women in the Lappe et al. RCT were very compliant. The result was statistically significant.
"The Lappe et al, study and the many supportive epidemiological studies that preceded and followed it should prove to even the most ill-informed skeptic that vitamin D prevents most cancer. It is incredible that the authors of this review virtually disregarded all of the relevant epidemiology and this randomized controlled clinical trial.
"Several scientists have informed the editors of the journal, that published the review, presenting their objections to the conclusions this study reached, they were based on obsolete low-dose vitamin D studies, and that they virtually totally neglected the work of the entire science of epidemiology.
"Doctors and their patients should not be discouraged by this obsolete review. Patients aged 9 years and older can take 4,000 IU/day of vitamin D3 safely according to the National Academy of Sciences-Institute of Medicine (2011 monograph). The benefits of such a dose will be substantial. The scientific data already accumulated is easily strong enough to support this. Serum 25(OH)D should be monitored regularly in any event, and serum calcium in older adults or anyone where there is a concern about hypercalcemia. It is true that the current NAS-IOM RDA is 600-800 IU/day of vitamin D3, but higher doses seem far more logical and safer now for most people based on studies and the Lappe et al RCT of 1100 IU/day of vitamin D3. Sale and intake of vitamin D2 should end, as there is no solid support for its efficacy against non-skeletal diseases, unlike vitamin D3.
"Another supporting clinical trial would be good, but we have a great one in Lappe et al. If we ever decide to do another RCT we should use no less than 4000 IU/d of vitamin D3 and 1000-1250 mg/day of calcium. Such a trial may be impossible, though, because members of the placebo group may eventually take supplements on their own, or human subjects protection committees may not allow depriving anyone of vitamin D at these doses in this emerging era of knowledge about their powerful benefits at appropriate, monitored doses in preventing very serious diseases that we have never before been able to effectively prevent, including breast cancer, colorectal cancer, pancreatic cancer, type 1 diabetes, and much of multiple sclerosis and type 2 diabetes. It is an exciting time for using vitamin D at no less than 4000 IU/day with regular serum 25(OH)D monitoring to prevent these fatal diseases."
More about this travesty at http://www.grassrootshealth.net/webinars, where another doc, Dr. Ed Gorham, UCSD Department of Family and Preventive Medicine, rings in [emphasis added].
"Frustration with the fact that lives are now being sacrificed on a golden cross of clinical trials compels me to respond.
"The two recent reviews of flawed RCTs by Autier and Bolland have produced not surprisingly flawed conclusions. Low dose, lack of compliance, cross-over, and poor follow-up over the long-term course a prevention trial requires often limit the utility of such findings.
"Why is evidence from cohort studies, nested case-control studies (including serum studies) and ecological studies ignored? These have found strong associations between high vitamin D status or high UVB exposure and reduced risk of many chronic diseases. To account for the inverse relationship between world-wide UVB irradiance in as many as 175 countries and reduced risk of breast cancer, colon cancer, multiple sclerosis, hypertension and diabetes, it would be necessary to postulate that just prior to diagnosis, patients in whom these conditions are soon to develop suddenly migrate to a higher latitude.
"Strength of the association, consistency, reproducibility, evidence of a temporal sequence from cohort studies, and dose-response criteria using 25(OH)D as a biomarker have each been satisfied with respect to vitamin D and these outcomes. The syndromic aspect of these deficiency outcomes is typical of a deficiency condition in which a vital nutrient such as vitamin D plays a key role in so many basic physiological functions; from immune modulation in suppressing diabetes and MS, to supporting tight junctions between epithelial cells. Tight junctions supported by vitamin D and calcium of course favor apoptosis and the normal cell cycle over the cell disjunction and dysplasia that leads to cancer.
"Many epidemiologic advances have been based on observational studies. It is fortunate we didn't rely on RCTs to recognize the hazards of cigarette smoking or second-hand smoke, which were determined through case-control studies and cohort studies respectively. To his undying credit, Dr. John Snow did not resort to forcing some residents of Broadstreet to drink from that pump supplying water contaminated by cholera. Do our ethics allow us to withhold vitamin D to only 800 IU in a placebo group such as that of VITAL? 800 IU would on average raise baseline serum vitamin D levels barely 8 ng/ml. VITAL will place half the participants at risk of what is finally becoming regarded by vitamin D experts as the vitamin D deficiency syndrome. Likewise, the meager 2,000 IU per day given to the treatment group in Vital will still fall short of many of the benefits of vitamin D sufficiency which become apparent when patients achieve a 40-60ng/ml 25(OH)D range. Many thanks for this opportunity to share these frustrations with which I believe you may sympathize."
This all just reeks of typical whore bullshit.
In a rational world, Mark Bolland, Andrew Grey, Greg Gamble, and Ian Reid would be tied up in the town square, stripped down and beaten to bloody pulps, to the off-with-their-heads cheers of the onlooking crowd...which of course would be the taxpaying citizens of New Zealand, who've experienced the anal rape of having paid for this full employment scheme of a pile of rotten, smelly, whore garbage via The Health Research Council.
...And let's not leave out these bunch of grant whores: Stephen Fortmann, Brittany Burda, Caitlyn Senger, Jennifer Lin, and Evelyn Whitlock, for this similar piece of whore trash funded by the butt-raped American taxpayers via the Agency for Healthcare Research and Quality.
And what the hell, lets just include virtually the entirety of the Moron Stream Media, both print and broadcast, for good measure. Calling them whore's is an insult to honest prostitutes worldwide.
For all my many past posts and mentions of vitamin D over the last six years, see here. Also, if you supplement vitamin D, consider the equally important vitamin K2 (MK-4, Menatetrenone...Weston A. Price's Activator X in Nutrition and Physical Degeneration) that I've also blogged about or mentioned dozens of times over the same amount of time. It works synergistically with D to ensure that your minerals go everyplace they should (bones and teeth) and no place they shouldn't (arteries).
Oh, as an afterthought, check this out: Amid the Murk of ‘Gut Flora,’ Vitamin D Receptor Emerges as a Key Player.
Now scientists have found that the vitamin D receptor is a key player amid the gut bacteria – what scientists refer to matter-of-factly as the “gut flora” – helping to govern their activity, responding to their cues, and sometimes countering their presence. The work was published online recently in the American Journal of Pathology.
The findings deliver a new lead to scientists investigating how bacteria might play a role in the development of inflammatory bowel diseases such as Crohn’s disease or ulceractive colitis. The work complements studies suggesting that Salmonella infection can increase the risk of inflammatory bowel disease.
“Vitamin D deficiency is a known factor in the pathology of inflammatory bowel disease and colon cancer,” said microbiologist Jun Sun, Ph.D., of the University of Rochester Medical Center, “but there have been very few reports about how bacteria might play a role by targeting the vitamin D receptor. Our work suggests one possible mechanism, by working through the vitamin D receptor, a sensor and regulator for the majority of functions of vitamin D.”
Don't try to get anything valuable or worthwhile from a grant or media whores.