The New York Times published an article titled “Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It,” on Saturday, Aug. 18. The main thrust of the article is that one of the vitamin’s primary boosters, Michael Holick, MD, has been compromised by funding he has received from entities that stand to benefit from higher sales and greater demand for testing.
Funding from industry
Dr. Holick is an endocrinologist associated with the Boston University School of Medicine. He has studied the forms of vitamin D and their roles in the body for many years and was instrumental in helping to boost the official guidelines for daily intake.
Dr. Holick acknowledged in interviews for The Times article that since 1979 he has worked as a consultant for Quest Diagnostics, a large lab company that does vitamin D testing. But he was quoted in the article as saying that funding support from industry, “Doesn't influence me in terms of talking about the health benefits of vitamin D.”
The article went on to question the evidence backing the call for higher vitamin D intakes. The article makes the case that there is no credible evidence that more vitamin D makes people healthier.
Joan Lappe, PhD, RN, of the Creighton University School of Nursing, said in her view the article betrays a bias for the results of large, randomly controlled trials at the expense of an avalanche of other types of research supporting the health benefits of vitamin D.
“These bodies that make health policy base their decisions solely on RCTs,” Lappe told NutraIngredients-USA.
Non skeletal effects subject of only a few RCTs
Vitamin D has a widely recognized benefit in preventing rickets, a bone disease caused by deficiency. This effect is no longer questioned, even by The Times. But the evidence for the vitamin’s many other effects is more nuanced and includes data from other types of studies, not just RCTs, Lappe said.
“When you look at the non skeletal effects, there have really been very few large scale RCTs on vitamin D,” she said.
“Probably the most compelling research is that which has shown how the cells need vitamin D. Almost every cell in our body has a specific vitamin D receptor. So it seems basic to proper cell functioning,” Lappe said.
Lappe has conducted research of her own on vitamin D. In 2017 she was the lead author on a trial that looked at vitamin D3 and calcium supplementation and its link to cancer incidence in older women. The four-year trial recruited more than 2,000 subjects in 31 rural counties.
“We found an effect, but unfortunately not one that reached statistical significance. So my trial is one of those that would be discounted,” Lappe said.
“But our cancer study also showed clearly that if you put all those women together, and group them by their 25-hydroxy vitamin D levels, the more vitamin D, the lower the incidence of cancer,” she said.
“I think there is just so much confusion about nutrition research. It’s not like a drug trial. This is a nutrient, and subjects not receiving the supplement will still get some vitamin D in their diet or from sunshine,” Lappe said.
Official recognition
Duffy MacKay, ND, senior vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, hinged his response to article on the fact that vitamin D’s importance has been officially recognized.
“Vitamin D is identified as a shortfall nutrient of public health concern in the government’s Dietary Guidelines for Americans. Well-conducted research demonstrates the positive health benefits of vitamin D supplementation and documents the critical role it plays in bone health and immune function. While the New York Times casts a negative light on Dr. Holick’s work with testing providers and other stakeholder groups, the article ignores the fact that a majority of Americans, 94 percent, fail to achieve their government-recommended intakes of vitamin D and that supplementing with vitamin D helps to fill nutrient gaps that are often difficult to achieve from diet or sun exposure alone,” he said.
“Focusing on the consulting activity of one individual does not erase the well-established benefits of vitamin D and could lead many people to dismiss those health benefits, particularly among populations who are missing this crucial nutrient from their diets,” MacKay continued.
“Vitamin D is controversial for some reason,” Lappe said. “There are really two camps, those who truly believe, and those who don’t. But if we are talking evidence-based, there is really no evidence that vitamin D is in any way harmful. And its inexpensive and has no side effects, so if there is even some evidence of benefit, why not?”