Tag Archives: vitamin D

Take Vitamin D With Largest Meal to Increase Blood Levels

The Healthy Librarian at the Happy Healthy Long Life blog wrote about a small scientific study documenting an incredibly easy way to increase blood levels of vitamin D in people taking supplemental vitamin D: 

Take the supplement with the largest meal of the day

Subjects of this research were taking vitamin D supplements—often a very high dose—for medical reasons, yet blood levels remained unacceptably low.  Blood levels of vitamin D (25-hydroxyvitamin D) rose by 50% simply by taking the same dose with the largest daily meal. 

Other people, including young healthy adults, may or may not respond the same way.  Do you know?

As for me, I’ll be sure to take my vitamin D supplement with my largest meal.

Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary, nutritional supplement, or exercise changes.

 

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My Ketogenic Mediterranean Diet: Day 59 + Updated Supplement Recommendations

888894Weight: 154 lb

Transgressions: none

Exercise: 90 minutes horse grooming and trail riding

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I’ve finalized the latest supplements for dieters on the Ketogenic Mediterranean Diet, and tinkered with the original plan: Version 2.0 is published.

Daily supplements:

  • 1 or 2 plain Centrum multivitamin/multimineral supplements (two if over 250 lb or 114 kg)
  • Magnesium oxide 250 mg
  • Calcium carbonate 500 mg elemental calcium  (500 mg twice daily if over 250 lb or 114 kg)
  • Extra vitamin D to reach total of 1,000–1,2000 IU (each Centrum has 400 IU)
  • Potassium gluconate 2,750 mg (450 mg elemental potassium) or Morton Salt Substitute (potassium chloride) ¼ tsp (1.2 g)
  • If prone to constipation: sugar-free Metamucil powder 1–2 rounded tsp (5.8–11.6 g) in water
  • At least three quarts or liters of water 

Steve

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My Ketogenic Mediterranean Diet: Day 15 and Week 2 Recap

Just a few supplements

Just a few supplements

Weight: 162 lb (73.6 kg)

Waist circumference: 35 inches (89 cm)

Transgressions: none

Exercise: none

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Down 3 lb (1.36 kg) for the second week of the diet, for a total of 8 (3.64 kg) since the start two weeks ago.  Waist size down 1.5 inches in two weeks.  I still doubt the majority of  that loss weight is fat.  More likely to be water, glycogen, and intestinal contents.  But some of it’s fat.  Rate of weight loss likely to slow soon, which is fine with me.

My daily caloric intake for the last week has averaged 1,850 calories.  Total daily digestible carbohydrate is about 25 g.

Nutrient analysis at NutritionData suggests that my food consumption is deficient in vitamins D, E, thiamine, B6, folate, pantothenic acid.  Less commonly are suggested deficiencies in vitamins A, C, K, niacin, and B12.  It also suggests inadequate intake of minerals: calcium, iron, magnesium, potassium, sodium (!), copper, manganese, and occasionally zinc.

In any case, I’ve been taking a Centrum multivitamin and multimineral supplement and extra vitamin D (400 IU) daily.  A single  Centrum tablet has the following “percent daily values” for vitamins and minerals: 100% for C, D, E, thiamine,B6, folate, niacin, pantothenic acid, B12, and iron.  It also has the following percent daily values: vitamin A 70%, vitamin K 31%, calcium 20%, magnesium 13%, potassium 2%, copper 25%, zinc 73%, and manganese 115%.  [Note that the manufacturer could change the composition at any time.]

Summary of Vitamin and Mineral Content

This very low-carbohydrate ketogenic diet may be deficient in multiple vitamins and minerals, unless supplemented.  A single Centrum ensures good levels, for most adults, except for possibly calcium, magnesium, potassium, sodium, copper, zinc, and vitamin K. 

Supplementing with elemental calcium (e.g., calcium carbonate) 500-1,000 mg daily might be a good idea.  Magnesium and potassium supplements might be a good idea.  Adding some salt (NaCl) to food should supply enough sodium.  [The standard American diet has far more salt than necessary.]     

 I’m just not convinced yet that this diet could actually be deficient in potassium.

Clinically significant deficiencies of copper and magnesium based on diet are probably rare.  I’ll have to do more research.  Nearly all the low blood levels of magnesium I see are in heavy alcohol drinkers or people using diuretics.

If you try a very low-carb ketogenic diet, you might ask your physician to draw blood levels of magesium and potassium two weeks after you start.

After two weeks on the Ketogenic Mediterranean Diet I feel as fine as usual.  I don’t see or feel any signs of vitamin or mineral deficiency.  But an experiment of one isn’t worth much.

Easy bruising is a relatively common occurrence in people on very low-carb ketogenic diets.  I wonder if it’s related to vitamin K deficiency.  Such bruising is seen also in children on the seizure-control ketogenic diet (not for weight loss); the diet seems to unmask a preexisting genetic predisposition to bleeding.

Vitamin K intake is a serious concern for people taking certain blood thinners (anticoagulants): coumadin, warfarin, coumarin.  Too much vitamin K counteracts the blood thinner; too little enhances the blood thinning.  Both situations are dangerous.  [I’m not talking about aspirin and Plavix.]  

I’m doing my nutritional analysis at NutritionData.  You can analyze your own diet via My Tracking.  They have a footnote accompanying the nutrient analysis for all of my vitamins and minerals: “missing or incomplete value.”  I assume that means the reported micronutrient amounts could be higher than reported. 

Potential Supplement Recommendation for the Ketogenic Mediterranean Diet

[This is a work in progress.  Stay tuned.]

Taking two Centrums daily could neatly solve the potential deficits of vitamins A and K, and minerals magnesium, copper, and zinc.  On the other hand, it could be overkill.  Add calcium as above, and maybe extra vitamin D 400 IU.  [There’s good evidence that the current U.S. Daily Value for vitamin D is too low.]  To summarize this daily supplementation regimen:

  • Two Centrums 
  • Additional calcium (elemental) 500-1,000 mg
  • Additional vitamin D 400 IU   

-Steve

Disclaimer:  Information herein is meant to complement, not replace, any advice or information from your personal health professional.  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary changes, such as vitamin and mineral supplementation.

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Do Vitamin D and Calcium Supplements Cut Risk of Diabetes?

Cliffs of Dover: Pure White Calcium Carbonate

Cliffs of Dover: Pure White Calcium Carbonate

Several studies have associated vitamin D and calcium intake with lower risk of developing type 2 diabetes.  After reading that the Institute of Medicine in 2010 will probably increase the recommended amounts of vitamin D for every one, I decided to review the literature pertinent to diabetes.

Over the last 10 years, studies have associated low blood levels of vitamin D with a higher risk of cardiovascular disease, death, type 2 diabetes, some cancers, infections, autoimmune diseases, frequent falls in the elderly, and dementia.

The Institute of Medicine (in the U.S.) currently recommends 200 IU (international units) per day for people under 50, 400 IU for people 50-70, with an upper intake level of 2,000 IU per day.  I assume those amounts refer to a combination of food (or supplements) and the vitamin D your skin makes (but how do we know that?). 

The new recommendation is expected to be around 1,000-2,000 IU per day.  It’s quite difficult to get close to that just with food.  With adequate sun exposure, we can make some vitamin D.  But the dermatologists have scared us out of the sun with horror stories of skin cancer.  I’ve seen some tragic cases in my own patients.  Skin covered with sunscreen doesn’t make vitamin D.  It can be difficult to get enough sun exposure, especially at higher latitudes in winter

I reviewed scientific articles pertinent to tyepe 2 diabetes via PubMed and list the best ones for you below.   The evidence in favor of using vitamin D and calcium supplements to prevent diabetes is weak, but may be correct. 

I found nothing to suggest that high vitamin D and calcium intake (whether food or supplements) helps control established cases of diabetes. 

Take-Home Points 

If you want to prevent type 2 diabetes with supplements, 1000 IU of vitamin D and 800-1000 mg of elemental calcium daily might help.  The evidence is not strong.  It might help; it might not.  But it’s unlikely to hurt.  Check with your personal physician first.  More studies are needed.  Calcium supplements are routinely recommended by expert nutrition panels for people over 60 to prevent osteoporosis.  The vitamin D supplement may be healthy in other ways.

Who, in particular, might want to prevent type 2 diabetes?  People with . . .

I’m sufficiently convinced about the nondiabetic vitamin D benefits that I’m going to start taking 1,000 IU per day.

Steve Parker, M.D.,

References:

Pittas, Anastassios, et al.  The effects of calcium and vitamin D supplementatinon on blood glucose and markers of inflammatin in nondiabetic adults.  Diabetes Care, 30 (2007): 980-9896.

Chowdhurry, T.A., et al.  Vitamin D and type 2 diabetes: Is there a link?  Primary Care Diabetes, April 21, 2009 (Epub ahead of print).

Pittas, Anastassios, et al.  Vitamin D and calcium intake in relation to type 2 diabetes in women.  Diabetes Care, 29 (2006): 650-656.

Knept, P., et al.  Serum vitamin D and subsequent occurrence of type 2 diabetes.  Epidemiology, 19 (2008): 666-671.

de Boer, I.H., et al.  Calcium plus vitamin D supplementation and hte risk of incident diabetes in the Womens’ health Initiative.  Diabetes Care, 31 (2008): 701-707. (Epub January 30, 2008).

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