Medical Panel: Don't Go Overboard On Vitamin D

The Institute of Medicine is throwing cold water on the latest dietary supplement fad: big doses of vitamin D.
Humans make vitamin D when they are exposed to the sun. But many worry that clothing, indoor living and sunscreen are depriving most people from enough of the sunshine vitamin. It's also hard to get enough vitamin D from the diet, proponents say, despite fortification of milk and orange juice.
But the institute's Food and Nutrition Board, which makes official recommendations on dietary intake, says advocates of high-dose vitamin D are going overboard.
After two years of study and debate, the panel says children and most adults need 600 international units of vitamin D a day. People older than 70 need 800.
That's more than the previous targets, set 13 years ago, of 200 units a day for young adults, 400 for those older than 50.
But the new recommendations are much less than advocates of high-dose vitamin D claim is necessary. Many people believe daily doses of 1,000 to 4,000 units can prevent a long list of ailments — cancer, heart disease, diabetes, influenza and other infections, autism, immune disorders such as multiple sclerosis, and more.
The Institute of Medicine panel rejects those claims. The only benefit, it says, is to maintain healthy bones.
"The evidence was inconsistent and inconclusive as to a benefit of vitamin D in preventing cancer, cardiovascular disease, diabetes, autoimmune disorders and many other health outcomes beyond bone health," says Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston and one of the 14 IOM panel members.
"The Internet will say that vitamin D has all these benefits," adds Dr. Cliff Rosen of Maine Medical Center in Portland, another panelist. "But the evidence really isn't there."
The panel also found no national epidemic of vitamin D deficiency. Many proponents of high-dose supplements believe there is one, and many of the IOM experts thought it might be true.
"It was very surprising," Rosen says. "I think there were a lot of us who came in thinking that requirements should be much higher or that [average American] blood levels were not nearly as high. But it's very good news for the general population."
The new report says people's blood levels of vitamin D don't need to be higher than 20 nanograms per milliliter of blood. Leading proponents aim for a blood level of 30 or even 40.
If 30 were the right number, more than half of the U.S. population could be considered deficient in vitamin D.
"Let's face it, everybody wants a number," Rosen says. "Everybody wants to know their vitamin D level these days. And so when you look and you say, 'Gee, my level's 25 and it should be 30, and it doesn't seem harmful to take a supplement and more is better, then I should be doing that.' And that's exactly what happened."
The Institute of Medicine experts worry that taking vitamin D in large doses over a long period might harm some people. The evidence is inconclusive, but the panel points to studies hinting at higher levels of pancreatic and esophageal cancer. Panelists say there's reason to worry about excess deposits of calcium in arteries from too much vitamin D.
Dr. Michael Holick of Boston University, who discovered the active form of vitamin D 40 years ago and is a leading proponent of high doses, isn't backing away from his conviction that most people need at least 3,000 units a day. That's what he takes, and what he recommends to his patients. Sometimes he prescribes 50,000 units of vitamin D a week.
"My recommendation is very simple," Holick says. "I don't see any downside to increasing your vitamin D intake. When I've been recommending for the past decade that people take more than the [officially recommended] 200 units, there was a lot of skepticism. Now they're recommending three times what we recommended in 1997.
"I suspect a decade from now that they'll be recommending another three- or fourfold higher increase," Holick predicts.
Members of the Institute of Medicine panel say that's possible -– if rigorous studies back up the proponents' claims. Manson is launching a $22 million federally financed study that will involve 20,000 people across the country. They will be randomly assigned to take daily doses of vitamin D and omega-3 fatty acid (linked in many studies to lower levels of heart disease) –- together or alone. Others will get placebo pills.
But it will be five or six years before the results of that study are ripe, Manson says.
The Institute of Medicine panel also reconsidered calcium intake, because vitamin D and calcium together are necessary for healthy bone development and maintenance throughout life.
The panel says children ages 1 to 3 need 700 milligrams of calcium a day, while those ages 4 to 8 need 1,000 milligrams. Adolescents need no more than 1,300 milligrams, while adults up to age 50 need 1,000 milligrams. Starting at age 51, women need 1,200 milligrams of calcium a day, as do both men and women older than 70.

Funny pictures

before

after

What's that?

KagoNeko

This is an amazing cat

named KagoNeko-Shiro

it is a talking cat would use expressions

I love it so much

only because of its humor-face

Kairouan-Tunisia

NAME

Kairouan (the "fortified town" in Arabic).

LOCATION AND ACCESS

Chief town of the governorate, 160 km south of Tunis, 67 km south of Sousse.

Kairouan also produces a woven carpet the margoum, using mainly geometric Berber designs, lighter in weight and in a multitude of colors.

In Memorium: Hank Jones On Piano Jazz

Hear The Piano Jazz Session Please Click >>Here<<

In a career that spans seven decades, Hank Jones has worked with everyone who's anyone in jazz, including Benny Goodman, Coleman Hawkins, Ben Webster and Billie Holiday. On Sunday night, Jones died after a brief illness. He was 91. We remember his long legacy with a Piano Jazz session from 2009.

In celebration of Piano Jazz's 30th anniversary, Marian McPartland asked a few of her favorite musicians to sit in as guest hosts. An obvious first choice was Bill Charlap, a pianist who, in many respects, mirrors McPartland's elegant pianistic style, as well as her ability to play just about any kind of jazz. His knowledge of the American songbook is nothing short of encyclopedic, and his reverence for jazz history is evident in every note he plays.

McPartland and Charlap decided that Hank Jones would be a great guest for this program. The legendary pianist was one of McPartland's first guests on Piano Jazz in 1979, so to bring him back 30 years later completes the circle. Like McPartland, Jones was one of the few performing jazz nonagenarians. Charlap, who has long considered Jones a jazz piano hero, was eager to uncover the influences that created this legendary pianist.

Here, Jones talks about his early years in Detroit and references arranger/composer and clarinetist Bill Stegmeyer as the man who early on provided him with "great insight into the kind of harmonies" he still uses today. Those trademark harmonies emerge with an easy grace on "Lonely Woman."

Jones summed up his approach thusly: "Keep the melody intact," and "You're only at your best when you're relaxed." Those truths lie at the heart of all the music in this session, but especially so in their duets of "Oh, Look at Me Now" and Billy Strayhorn's "Lotus Blossom."

Strayhorn's songs and arrangements were, of course, a cornerstone of Duke Ellington's sound, and his name brings to Charlap's mind Ellington's "Sophisticated Lady." He plays the classic tune with a light, swinging touch, sometimes punctuating a phrase with abbreviated bass notes from the left hand. When Charlap finishes, the great Hank Jones said in unequivocal tones, "Superb! Superb! Superb!" That would be a great way to describe this special session.

Mick Jagger: Old 'Exile,' New Lyrics

Producer Don Was Revisits 'Exile On Main Street'

The "exile" began in 1971, when The Rolling Stones'members owed more taxes than they could pay in England, so they picked up and left the country. Of course, it was The Rolling Stones, so that meant quite a luxurious lifestyle. In the basement of a sprawling mansion in the south of France, the band recorded Exile on Main Street.

Upstairs, as legend has it, was a constant party.

"Decadent, degenerate behavior all around," Mick Jagger says. "The south of France is pretty much known for that. Still goes on."

But as Keith Richards said Monday, they didn't do too much partying themselves.

"People didn't come down to the basement much. I don't think people found the basement very interesting," Jagger says. "It was rather damp and unpleasant. It wasn't a peanut gallery kind of studio — there was nowhere to see from. There wasn't a control room with nice glass and lots of soft drinks. If people came down, they'd stay a couple minutes and go, 'Euh.' "

Old Song, New Lyrics

Jagger has been looking and listening back to the songs recorded during that chaotic summer. For the new re-release of Exile, The Rolling Stones went to the archive and searched through a trove of old tracks and outtakes. Some of the songs didn't even have lyrics, which allowed Jagger to fashion new songs out of 40-year-old tunes.

"When I started looking at this unreleased material, like 'Plundered My Soul,' I was quite impressed by how together the band was on something that was actually an outtake. An outtake is quite often about the stuff you haven't used," Jagger says. "It's very unfinished; it's a bit slovenly. Though it was a relatively undisciplined bunch of sessions, when we actually got into the sessions, I think the playing was quite disciplined."

In reworking this old material, Jagger had to write completely new lyrics for "Following the River." The words are quite reflexive and even a bit elegiac.

"It's what they call in the business a 'kiss-off song,' " Jagger says. "It's a regretful goodbye. It's not a nasty goodbye. It's saying goodbye and knowing you're going to miss her."

But Morning Edition host Renee Montagne wonders if these lyrics are four decades' worth of emotions, or if Jagger would have written them in 1971.

"I can only write from today," Jagger says. "Having said that, it's not that much different in tone from 'Angie' in a way, which is another kiss-off song. And until we started talking about this just now, I never thought of comparing them."

Exiled In France

As mentioned above, The Rolling Stones' members were avoiding tax problems in Britain, which is why they "exiled" to the south of France. But did they really feel like they were in exile?

"I think so, yeah. It was a bit of a wrench to give up our home lives in England," Jagger says. "At the time, it was a bit of a laugh for the first few months. After a while, you realize that from a comfortable English life, you've moved into a different kind of life. I mean, musicians of every stripe, they tend to be cosmopolitan kind of people. Perhaps musicians were the first cosmopolitan people. In the 18th century, they would move where the patronage was. In that way, it wasn't a satch of wrenches it might be for some other people."

But The Rolling Stones adjusted to life in France anyway. In the new liner notes to Exile on Main Street, guitarist Nick Taylor writes, "I'm not having any problem with the language here, because I don't speak French." Jagger then mentions what Bill Wyman says in the documentary — that the band was in the part of France where people went specifically for its food, yet he can't find his favorite tea bag.

In working on the reissue, Jagger spent half a year digging through that creative period of his life. Jagger writes in the liner notes that this album includes songs "you probably have second thoughts about," but was glad he did.

"Would I have changed Exile on Main Street if I could? I easily could have. This is a good opportunity," Jagger says, laughing. "No, I just wanted to add to it. I was asked by the record company if there was anything else of interest. I was trying to find things that stood up, and I think we managed to find things that did hold up, things that gave it extra depth. I was quite pleased with them."