- With Mayo Clinic nutritionists
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
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Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
Katherine Zeratsky and Jennifer Nelson
Jennifer K. Nelson, M.S., R.D., L.D., C.N.S.D.
Jennifer Nelson is your link to a better diet. As specialty editor of the Food & Nutrition Center, she plays a vital role in bringing you healthy recipes and meal planning."Nutrition is one way people have direct control over the quality of their lives," she says. "I hope to translate the science of nutrition into ways that people can select and prepare great-tasting foods that help maintain health and treat disease."
A St. Paul, Minn., native, she is certified by the National Board of Nutrition Support Certification, has been with Mayo Clinic since 1978, and is director of clinical dietetics and an associate professor of nutrition at Mayo Clinic College of Medicine.
She leads clinical nutrition efforts for a staff of more than 50 clinical dietitians and nine dietetic technicians and oversees staffing, strategic and financial planning, and quality improvement. Nelson was co-editor of the James Beard Foundation Award-winning "The New Mayo Clinic Cookbook." She has been a contributing author to and reviewer of many Mayo Clinic books, including "Mayo Clinic Healthy Weight for EveryBody," "The Mayo Clinic Family Health Book" and "The Mayo Clinic/Williams Sonoma Cookbook." She contributes to the strategic direction of the Food & Nutrition Center, which includes creating recipes and menus, reviewing nutrition content of various articles, and answering nutrition questions posed to Ask a Specialist.
Katherine Zeratsky, R.D., L.D.
As a specialty editor for the Food & Nutrition Center, Katherine Zeratsky helps you sort through the facts and figures, the fads and the hype to learn more about nutrition and diet.A Marinette, Wis., native, she is certified in dietetics by the state of Minnesota and the American Dietetic Association. She has been with Mayo Clinic since 1999.
She is active in nutrition-related curriculum and course development in pediatrics at Mayo Clinic Rochester and nutrition education related to the physiology and recommended intakes for premature infants.
Other areas of interest include breast milk and formula safety, neonatal feeding, and nutrition for breast-feeding mothers.
She graduated from the University of Wisconsin-Madison, served a dietetic internship at the University of Iowa Hospitals and Clinics, and worked as a registered dietitian and health risk counselor at ThedaCare of Appleton, Wis., before joining the Mayo Clinic staff.
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Nutrition-wise blog
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Jan. 8, 2009
Shedding light on vitamin D
By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
It's winter in the Northern hemisphere and for many that means sunshine is in short supply. As a result, your vitamin D levels may be on the decline. Should you be worried? How much vitamin D do you really need? What's the best way to get it? Several studies published in the December 2008 issue of the American Journal of Clinical Nutrition attempt to shed light on these questions.
One of the studies found that vitamin D levels appear lower among Americans today than 15 to 20 years ago. Researchers attributed the decline to the following factors: increasing weight, declining milk consumption, and increasing use of sun protection.
On a brighter note, another study demonstrated that fortifying foods, such as milk, with vitamin D does improve vitamin D status in adults.
A third study looked at vitamin D levels in the winter months. The study showed that people who get less sun in the summer need slightly higher vitamin D supplementation in the winter to maintain recommended levels. Interestingly, the top dose in the study was 600 international units, which is higher than the 400 international units of vitamin D generally found in multivitamins.
So what does this all mean? The data we have seems to tell us that:
- Although 10-15 minutes of daily sun in non-peak hours can provide adequate vitamin D, people who use sun protection (which should be most of us) need to look for other sources of vitamin D.
- Fatty fish, egg yolks, and fortified foods are good dietary sources of vitamin D. And toxicity from fortified foods is rare.
- Vitamin D supplements at currently recommended doses can increase vitamin D levels in the body.
Some questions still remain. What happens if you take more vitamin D than the current recommendation? Is there an upper limit beyond which you are harmed rather than helped?
What are your thoughts? For those of you who don't take a multivitamin or vitamin D supplement, will these studies change your mind? For those of you who take a supplement, how much are you taking? What changes have you noticed as a result?
To your health,
Katherine
46 comments posted
January 1, 2010 1:16 p.m.
The Mayo Clinic needs to improve their content on vitamin D. Since D is important to your immune system, low D blood levels significantly increase your risk of dying from infections, heart disease and cancer. If you take only one vitamin or supplement, D's the one that can save your life. If you're catching colds and flu all winter, you're probably low. Dosage questions? Is 1000 IU enough? 5000 IU too much? The only way to be sure is blood test. Ask your doctor for: 25-hydroxy vitamin D total. Result should be about 50 ng/ml. D can be slow to rise. Most people will need at least 5000 IU per day to see a significant increase over six months. At age 52, my maintenance dose seems to be about 5000 IU 5 days a week. 2000 IU daily might be enough if you get lots of sun. However, with aging, we may lose the ability to make vitamin D from sun. If you want to be sure, get the blood test.
- Elaine
November 26, 2009 2:39 p.m.
what is adults vitamin D lever should be. mine is 30.
- Mary
November 5, 2009 9:59 a.m.
I'm age 71. I've had moderately high blood pressure, depression, and significant arthritis pain for about 10 years, and I take blood pressure meds, an antidepressant, and an NSAID. My doctor ordered a vitamin D blood test. He says that on a scale of 33-100, mine is at 8! I don't get out in the sun very much because walking is/was diffiuclt with the arthritis. I don't eat dairy products anymore because it make arthritis flare up. I don't drink fortified orange juice because it seems to acidic now. Doctor gave me samples of therapeutic vitamin D from a high-quality manufacturer (10,000 IU per capsule). I'm to take one capsule per day for 7 days, then one capsule per week thereafter. I will be retested in about 6 months. Amazing! After a week, my mood has lifted! The blood pressure went down to 100/63, so I am to stop taking the BP meds for a couple of days and check the BP to see if indeed it is back to normal, and the arthritis pain is now manageable. Earlier this year my bone scan showed that I have osteopenia, so I am on Fosamax, which I will continue unless directed otherwise. My doctor, an M.D., is well educated on this; shared info from some respected journals (I didn't ask for citations). It is amazing that such a small thing can have such bad symptoms -- and that it easily "fixable." Even people without medical resources can get more sunshine and/or eat more Vitamin D foods. What a nice way to alleviate some of our personal "health care crises.&q
- Paula
October 28, 2009 1:24 p.m.
Check out these sources of information: www.grassrootshealth.org Look in the Documenttation section for the: 1. Definitive statement and "Call to action" from 16 eminent scientists 2. Disease Incidence Prevention Chart www.ucsd.tv Search for "Vitamins" Start with presentations by Carole Baggerly & Frank Garland www.direct-ms.org Go to Information / Presentations Watch the presentation "Prospects for Vitamin D Nutrition". The speaker is Professor Reinhold Vieth who states that 50,000 IU of Vitamin D3 in a single dose is not a problem and 10,000 per day is OK. After that ask your doctor to test your blood for "25 hydroxy-vitamin D" Then make your own decisions about how much Vitamin D to take, as your doctor may nut be as well educated about it as you are.
- Rufus
October 27, 2009 12:15 p.m.
I find it most disturbing that current medical and lay literature sources are bursting at the seams with convincing evidence of the far-reaching benefits of the hormone we call vitamin D, and yet the FNB and the NIH have not updated their recommendations for daily vitamin D supplements since the one they published in 1997. That recommendation was for 200, 400, or 600 i.u. daily, depending on one's age. In fact, the NIH held a conference of experts in August this past summer, but won't share the decisions made at that meeting until next spring. In the meanwhile, an uninformed public will likely pay the consequences of their "thumb-twiddling". After a good bit of study on this topic during the past 2 years, it's my opinion that an adult should receive a MINIMUM of 2000 i.u. vitamin D daily, and 4000 to 5000 i.u. is probably closer to their real need for optimal health outcomes.
- Russ
October 20, 2009 4:45 p.m.
After 8 weeks of the prescription dose of 50000 ius/week & 6 weeks of 1000 ius daily, my D levels are still only 16. & I have always eaten alot of dairy & a fair amount of fish & am in the sun daily for my work. Makes no sense. If it's an absorption problem why isn't there a patch or sublingual tablets? I don't absorb B12 either so I take a sublingual tab for that. We need help!
- cb, socal
October 9, 2009 12:05 p.m.
My D level was tested at 17. After 12 weeks of 50,000 units, once a week, it only went up to 24. My sister was on the same dose/time and her level tripled. Any thoughts on why my body's response was so minimal?
- Wendy
October 6, 2009 3:31 p.m.
It doesn't matter how much vitamin D-3 you take. The key is never let your level fall below 40, should be 50-80. I found out how important this was AFTER I had breast cancer, I tested at 19. So do what you have to to maintain this level it is so very important to know your number, keep track and don't listen to anyone who tells you that 40 or less is okay. The older you get the less your skin will allow the sun to absorb. Also gelcaps only.
- Betty
September 17, 2009 12:16 a.m.
I ran into a woman friend the other day who said she is on 3,000 IU daily of Vit. D. Here's the thing: she looked tan! She has beautiful skin, but was always very pale. Now she looks "sun-kissed" - seriously, she looked just radiant! Said she hadn't been this tan since she was a child. Can Vit. D make you look tan?
- Marianne
September 13, 2009 9:35 a.m.
I just was listening to talk radio, to a doctor promoting his vitamin D + omega 3 supplement together and he said we adults need the two together. he added that we should take 5,000 I.U. daily of Vit. D, which I thought was a toxic level, even for living in a midwestern state. He also said our blood tests should be taken and we should be at around 50-60 (20-100 is the normal range), not in the 30 range. I am a Medical Assistant and work for a very busy and well esteemed practice in the community and the doctors in general do not want their patients to go beyond 2-3,000 I.U. daily. What do you believe to be accurate?
- Wendy
46 comments posted