Nutrition and Health Research Center

San Francisco, CA, United States

Nutrition and Health Research Center

San Francisco, CA, United States
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Grant W.B.,Nutrition and Health Research Center
European Journal of Clinical Nutrition | Year: 2011

Background/Objectives: The goal of this work is to estimate the reduction in mortality rates for six geopolitical regions of the world under the assumption that serum 25-hydroxyvitamin D (25(OH)D) levels increase from 54 to 110 nmol/l. Subjects/Methods: This study is based on interpretation of the journal literature relating to the effects of solar ultraviolet-B (UVB) and vitamin D in reducing the risk of disease and estimates of the serum 25(OH)D level-disease risk relations for cancer, cardiovascular disease (CVD) and respiratory infections. The vitamin D-sensitive diseases that account for more than half of global mortality rates are CVD, cancer, respiratory infections, respiratory diseases, tuberculosis and diabetes mellitus. Additional vitamin D-sensitive diseases and conditions that account for 2 to 3% of global mortality rates are Alzheimer's disease, falls, meningitis, Parkinson's disease, maternal sepsis, maternal hypertension (pre-eclampsia) and multiple sclerosis. Increasing serum 25(OH)D levels from 54 to 110 nmol/l would reduce the vitamin D-sensitive disease mortality rate by an estimated 20%. Results: The reduction in all-cause mortality rates range from 7.6% for African females to 17.3% for European females. Reductions for males average 0.6% lower than for females. The estimated increase in life expectancy is 2 years for all six regions. Conclusions: Increasing serum 25(OH)D levels is the most cost-effective way to reduce global mortality rates, as the cost of vitamin D is very low and there are few adverse effects from oral intake and/or frequent moderate UVB irradiance with sufficient body surface area exposed. © 2011 Macmillan Publishers Limited All rights reserved.


Grant W.B.,Nutrition and Health Research Center
Journal of Alzheimer's Disease | Year: 2014

Background: Alzheimer's disease (AD) rates in Japan and developing countries have risen rapidly in recent years. Researchers have associated factors such as the Western diet, obesity, alcohol consumption, and smoking with risk of AD. Objective: This paper evaluates whether the dietary transition might explain the rising trend of AD prevalence in Japan and in developing countries, evaluating other factors when possible. Methods: This study used two approaches to see whether dietary or other changes could explain AD trends in Japan and developing countries. One approach involved comparing trends of AD in Japan with changes in national dietary supply factors, alcohol consumption, and lung cancer mortality rates from zero to 25 years before the prevalence data. The second compared AD prevalence values for eight developing countries with dietary supply factors from zero to 25 years before the prevalence data. Results: For Japan, alcohol consumption, animal product, meat and rice supply, and lung cancer rates correlated highly with AD prevalence data, with the strongest correlation for a lag of 15-25 years. In the eight-country study, total energy and animal fat correlated highly with AD prevalence data, with a lag of 15-20 years. Mechanisms to explain the findings include increased obesity for the eight countries, and increases in cholesterol, saturated fat, and iron from increases in animal products and meat supply for Japan. Conclusion: Evidently AD rates will continue rising in non-Western countries for some time unless we address major risk factors involving diet, obesity, and smoking. © 2014 - IOS Press and the authors. All rights reserved.


Grant W.B.,Nutrition and Health Research Center
Journal of Photochemistry and Photobiology B: Biology | Year: 2010

The evidence is increasing that higher serum 25-hydroxyvitamin D [25(OH)D] levels reduce the risk of many types of cancer. Ecological and observational studies yield the strongest evidence, with support from studies of mechanisms. A key question is identifying the relation between serum 25(OH)D level and cancer incidence. Meta-analyses of such studies is a reasonable approach to determine the serum 25(OH)D level-cancer incidence relation. This paper reports new meta-analyses for breast and colorectal cancers. Currently, the journal literature offers seven prospective breast cancer and ten prospective colorectal cancer studies that can be used. The data for these studies graphed and compared. Data from some of the studies were multiplied by factors to bring all the studies into reasonable agreement with a tentative dose-response relation. The data were fit with a variety of functions; the best fits were nonlinear functions that tended to asymptotically reach a lower odds ratio at higher serum 25(OH)D levels. These analyses estimated that the 50% reduction in incidence occurs for a value of 78. nmol/L compared with the value at 24. nmol/L for breast cancer, and a value of 60. nmol/L compared with the value at 15. nmol/L for colorectal cancer. Although these results are reasonable, some concern exists that a single serum 25(OH)D level, measured years prior to diagnosis of cancer, does not adequately represent the serum levels for the entire period before diagnosis. Future prospective studies should include more serum 25(OH)D level measurements during the study course. © 2010 Elsevier B.V.


Grant W.B.,Nutrition and Health Research Center
Dermato-Endocrinology | Year: 2012

A large body of evidence indicates that solar ultraviolet-B (UVB) irradiance and vitamin D reduce the risk of incidence and death for many types of cancer. However, most of that evidence comes from midlatitude regions, where solar UVB doses are generally high in summer. Data on cancer standardized incidence ratios (SIRs) by sex and 54 occupation categories based on 1.4 million male and 1.36 million female cancer cases for 1961-2005 in the five Nordic countries provide the basis for an ecological study of the role of solar UVB in the risk of many types of cancer at high latitudes. Lip cancer SIRs less lung cancer SIRs for men was the best index of solar UVB dose, which was weakly inversely correlated with both melanoma and nonmelanoma skin cancer (NMSC) SIRs. Lung cancer SIRs were used as the index of the effects of smoking. For men, the UVB index was significantly inversely correlated with 14 types of internal cancer - bladder, breast, colon, gallbladder, kidney, laryngeal, liver, lung, oral, pancreatic, pharyngeal, prostate, rectal and small intestine cancer. For women, the same UVB index was inversely correlated with bladder, breast and colon cancer. These results generally agree with findings from other studies. These results provide more support for the UVB-vitamin D-cancer hypothesis and suggest that widespread fear of chronic solar ultraviolet (UV) irradiance may be misplaced. © 2012 Landes Bioscience.


Grant W.B.,Nutrition and Health Research Center
Scandinavian journal of public health | Year: 2011

A low serum 25-hydroxyvitamin D [25(OH)D] level is a risk factor for many diseases, including musculoskeletal diseases, many types of cancer, cardiovascular diseases, diabetes mellitus, infectious diseases, autoimmune diseases, and brain diseases. This report estimates the reduction in mortality rates for the five Nordic countries for an increase in population mean serum 25-hydroxyvitamin D level to 105 nmol/L. Serum vitamin D dose-incidence/prognosis relationships can be developed with significant levels of reliability for most vitamin D-sensitive diseases on the basis of ecological, cross-sectional, and observational studies, randomized controlled trials, and meta-analysis of such studies. These dose-response relations are used to estimate the population-wide benefit of raising mean serum 25(OH)D concentration to 105 nmol/L for the five Nordic countries. From this study, the reductions in mortality rates possible by raising population mean serum 25(OH)D levels to 105 nmol/L are: Denmark, 17% (estimated range,11%-24%); Finland, 24% (17%-32%); Iceland, 24% (17%-32%); Norway, 18% (11%-26%); and Sweden, 18% (8%-25%). Reaching these levels would require changes in health policies with respect to solar ultraviolet-B (UVB) irradiance, vitamin D fortification of food, availability of vitamin D and calcium supplements, and attitude toward use of UVB lamps. Adverse effects of oral vitamin D intake are limited, and those from UVB irradiance are minor compared with the benefits.


The Cohort Consortium Vitamin D Polling Project of Rarer Cancers (VDPP ) study failed to find a beneficial role of prediagnostic serum 25-hydroxyvitamin D [25(OH)D] levels on risk of seven types of rarer cancer: endometrial, esophageal, gastric, kidney, ovarian and pancreatic cancer and non-Hodgkin's lymphoma (NHL). However, ecological studies and studies of oral vitamin D intake have generally found solar ultraviolet B (UVB) and oral vitamin D inversely correlated with incidence and/or mortality rates of these cancers. To explore the discrepancy, I conducted an ecological study of cancer mortality rates for white Americans in the United States for 1950-1994 with data for 503 state economic areas in multiple linear regression analyses with respect to UVB for July, lung cancer, alcohol consumption and urban/rural residence. UVB was significantly inversely correlated with six types of cancer (not pancreatic cancer) in both periods. However, the adjusted R2 values were much lower for cancers with lower mortality rates than those in an earlier ecological study that used state-averaged data. This finding suggests that the VDPP study may have had too few cases. Thus, the VDPP study should not be considered as providing strong evidence against the solar UVB-vitamin D-cancer hypothesis. © 2010 Landes Bioscience.


France has unexplained large latitudinal variations in cancer incidence and mortality rates. Studies of cancer rate variations in several other countries, as well as in multicountry studies, have explained such variations primarily in terms of gradients in solar ultraviolet-B (UVB) doses and vitamin D production. To investigate this possibility in France, I obtained data on cancer incidence and mortality rates for 21 continental regions and used this information in regression analyses with respect to latitude. This study also used dietary data. Significant positive correlations with latitude emerged for breast, colorectal, esophageal (males), lung (males), prostate, both uterine cervix and uterine corpus, all and all less lung cancer. Although correlations with latitude were similar for males and females, the regression variance for all and all less lung cancer was about twice as high for males than for females. Lung cancer incidence and mortality rates for females had little latitudinal gradient, indicating that smoking may have also contributed to the latitudinal gradients for males. On the basis of the available dietary factor, micro- and macronutrient data, dietary differences do not significantly affect geographical variation in cancer rates. These results are consistent with solar UVB's reducing the risk of cancer through production of vitamin D. In the context of serum 25-hydroxyvitamin D level-cancer incidence relations, cancer rates could be reduced significantly in France if everyone obtained an additional 1,000 IU/day of vitamin D. Many other benefits of vitamin D exist as well. © 2010 Landes Bioscience.


Grant W.B.,Nutrition and Health Research Center
Anti-Cancer Agents in Medicinal Chemistry | Year: 2013

The ultraviolet-B (UVB)-vitamin D-cancer hypothesis was proposed in 1980 yet has not been fully accepted. Ecological studies based on geographical variations of cancer rates with respect to solar UVB doses have supported the hypothesis for about 20 cancers. This paper reviews the evidence from studies of personal or group UVB irradiance. Studies have associated personal UVB irradiance with reduced risk for breast, colon, endometrial, prostate, and renal cancer, as well as non-Hodgkin's lymphoma (NHL). However, some studies have also found increased risk of NHL from UV irradiance, probably due to immunosuppression by UVA near 370 nm. Several related approaches have also been used to study the hypothesis. Studies in Norway and the UK found that diagnosis in summer or fall is associated with increased survival rates for breast, colon, lung, and prostate cancer, as well as Hodgkin's lymphoma. Diagnosis of nonmelanoma skin cancer is associated with reduced risk of several cancers in sunny countries, but not often in highlatitude countries. Living at higher surface elevation is associated with reduced risk of some cancers. In a recent analyzed study of cancer rates for 54 occupations in Nordic countries, a UVB index based on standardized incidence ratios of lip cancer less those for lung cancer was inversely correlated with 15 types of cancer for males, but only four types for females. This ecological study provides additional evidence that UVB doses at high latitudes are adequate to reduce the risk of cancer, but requires considerable time outside to produce sufficient vitamin D. Because only vitamin D production has been proposed to explain the UVB-cancer link, studies reviewed in this paper should be considered strong evidence for the hypothesis. © 2013 Bentham Science Publishers.


Grant W.B.,Nutrition and Health Research Center
Dermato-Endocrinology | Year: 2012

Evidence continues to mount that vitamin D reduces the risk and mortality rates of many types of disease. However, evidence from prospective cohort studies is sometimes weaker than that from case-control and ecological studies. A suggested reason for this discrepancy is that, because serum levels of 25-hydroxyvitamin D [25(OH)D] change over time, a single 25(OH)D concentration measurement taken at study enrollment does not reliably indicate 25(OH)D concentration related to the health outcome. To evaluate this suggestion further, this paper plots results from 12 prospective cohort studies of all-cause mortality rate vs. follow-up time. The regression fit to the hazard ratio per 20-nmol/l increase in serum 25(OH)D concentration vs. time increased from 0.82 (95% CI, 0.67-1.02) for 6 y to 0.96 (95% CI, 0.90-1.01) for 14 y. Thevalue extrapolated for zero follow-up time was 0.72 (95% CI, 0.50-1.03), giving a hazard ratio reduction 3.5 times higher than the standard result from the meta-analysis [0.92 (95% CI, 0.89-0.95)]. Using the example of the Vitamin D Pooling Project of Rarer Cancers, this paper also discusses follow-up time's effect in interpreting prospective cohort studies of cancer outcome. This paper recommends that meta-analyses of prospective cohort studies account for follow-up time and, if possible, that studies measure serum 25(OH)D concentration every 2-4 y. © 2012 Landes Bioscience.


Grant W.B.,Nutrition and Health Research Center
Clinical Cancer Research | Year: 2014

Vitamin D deficiency is associated with increased risk of prostate cancer for those with elevated prostatespecific antigen (PSA) level or abnormal digital rectal examination. Vitamin D deficiency is also associated with aggressive prostate cancer. Vitamin D level could be added as an additional factor to consider before ordering a biopsy. © 2014 AACR.

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