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Vitamin D and cancer: maintaining levels key to protection?

By Stephen Daniells , 12-May-2008

Ensuring levels of vitamin D never get low could be a way of protecting against cancer, suggests a new study from Germany.

Death from fatal cancer was reduced by 55 per cent amongst people with higher vitamin D levels, according to data collected from 3,299 patients taking part in the Ludwigshafen Risk and Cardiovascular Health study and reported in the journal Cancer Epidemiology, Biomarkers & Prevention. The study adds to a growing body of science supporting potential anti-cancer benefits of the vitamin, and increases the volume of calls for raising the recommended daily allowance from 400 IU to 1,000 IU. "These data support other studies suggesting that vitamin D supplementation might be promising for the treatment and/or prevention of cancer and are in line with the national recommendation of the Canadian Cancer Society for the supplementation of 1,000 IU/d vitamin D for all adults during winter and for persons at high risk for vitamin D deficiency all year-round," wrote lead author Stefan Pilz from University of Heidelberg. The link between vitamin D intake and protection from cancer dates from the 1940s when Frank Apperly demonstrated a link between latitude and deaths from cancer, and suggested that sunlight gave "a relative cancer immunity." Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. Both D3 and D2 precursors are hydroxylated in the liver and kidneys to form 25- hydroxyvitamin D (25(OH)D), the non-active 'storage' form, and 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active form that is tightly controlled by the body. Blood levels of 25(OH)D and 1,25-(OH)2D were measured in the study participants, and over the course of 7.75 years, 95 patients deaths due to cancer were documented. The most common cancers were lung, colon, and pancreas. After adjusting for various potential confounding factors, the researchers report that people with the highest level of 25(OH)D (76.3 nanomoles per litre) were 55 per cent less likely to die form fatal cancer than those with the lowest levels (18.1 nmol/L). Moreover, every increase of 25 nmol/L in 25(OH)D levels was associated with a 34 per cent risk reduction, added the researchers. However, no association was observed between levels of 1,25(OH)2D and cancer risk. "Our finding that 1,25(OH)2D was not associated with increased risk of fatal cancer does not argue against a crucial role of 1,25(OH)D in the prevention of cancer because intracellular 1,25(OH)2D levels can best be estimated by serum 25(OH)D concentrations, which are rate limiting for the conversion of 25(OH)D to 1,25(OH)2D," stated the researchers. The results, while in need of support from additional studies, indicate a anti-cancer role for maintained vitamin D levels, and highlight the potential of supplements or fortified foods. This is particularly important in northern climes were sunshine levels are not strong enough for long periods for the body to synthesise the vitamin itself. Experts call for higher levels Calls to increase the current recommendations of 200 IU per day for children and adults up to 50 years of age for vitamin D up to 800 - 1000 IU vitamin D3, have become more frequent in both scientific and public circles. Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. The vitamin can be manufactured in the body on exposure to sunlight and also consumed in relatively low quantities from the diet. However because of the low dietary amounts, and lack of sunshine in northern climates, with some estimates claiming that as much as 60 per cent of northern populations may be vitamin D deficient. In adults, vitamin D deficiency may precipitate or exacerbate osteopenia, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, infectious diseases and cardiovascular diseases. Source: Cancer Epidemiology, Biomarkers & Prevention 2008, Volume 17, Number 5, Pages 1228-1233, doi:1055-9965.EPI-08-0002 "Low Serum Levels of 25-Hydroxyvitamin D Predict Fatal Cancer in Patients Referred to Coronary Angiography" Authors: S. Pilz, H. Dobnig, B. Winklhofer-Roob, G. Riedmuller, J.E. Fischer, U. Seelhorst, B. Wellnitz, B.O. Boehm, W. Marz

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