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Sannheten om D-vitamin, sol og helse. Lille Måne 2019 Johan Moan, Prof. Emeritus, UiO

Sannheten om D-vitamin, sol og helse. Lille Måne 2019 Johan Moan, Prof. Emeritus, UiO. Vitamin D is important, really hot stuff!!! NOW!!!!. Just watch, keep eyes and ears open!. Time magazine. In 2007 Time magazine cited the “benefits of vitamin D” in its list of

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Sannheten om D-vitamin, sol og helse. Lille Måne 2019 Johan Moan, Prof. Emeritus, UiO

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  1. Sannheten om D-vitamin, sol og helse. Lille Måne 2019 Johan Moan, Prof. Emeritus, UiO

  2. Vitamin Dis important, really hot stuff!!!NOW!!!! Just watch, keep eyes and ears open!

  3. Time magazine In 2007 Time magazine cited the “benefits of vitamin D” in its list of “Top 10 Medical Breakthroughs”

  4. Vitamin D mangel Rakitt Osteomalasi Beinskjørhet Vinterdepresjon Tuberkulose Depresjon Infertilitet Hjerte- og karsykdom Katarr Kreft Influensa Metabolsk Syndrom Perifer vaskulær sykdom MS Hypertensjon Diabetes type 1 & 2 Artritt Kronisk tretthet Kronisk hjertesvikt Systemisk lupus erythematosus

  5. List of vitamin D-sensitive diseases A-H 1. Acne 2. Acute lower respiratory infection 3. Alzheimer’s disease 4. Amyotrophic lateral sclerosis5. Anaphylaxis 6. Anemia 7. Ankylosing spondylitis 8. Anxiety 9. Asthma 10. Athersclerosis 11. Autism 12. Bacterial vaginosis 13. Biliary cirrhosis, primary 14. Birth defects 15. Bones – fractures 16. Bones – osteopenia 17. Bones – osteoporosis 18. Bones – rickets 19. Brain injury, traumatic 20. Bronchitis 21-40. Cancer – 20 types (Bladder, breast, cervical, colorectal, endometrial, esophageal, gallbladder, gastric, Hodgkin’s lymphoma, leukemia, lung, melanoma, multiple myeloma, non-Hodgkin’s lymphoma, ovarian, pancreatic, prostate, renal, vulvar) 41. Cardiovascular disease 42. Celiac disease 43. Cerebrovascular disease 44. Chronic kidney disease 45. Chronic liver disease 46. Chronic, non-specific 47. Muscle pain 48. Cognitive impairment 49. Common cold 50. Epstein-Barr virus 51. Congestive heart failure 52. Chronic obstructive pulmonary disease 53. Coronary heart disease 54. Craniotabies 55. Cystic fibrosis 56. Dental caries 57. Depression 58. Diabetes, type 1 59. Diabetes, type 2 60. Epilepsy 61. Fertility, regular menses 62. Fibromyalgia 63. Hashimoto's thyroiditis 64. Headache 65. Hearing loss 66. Hepatitis 67. HIV/AIDS 68. Hypercalcemia 69. Hyperparathyroidism 70. Hypertension

  6. List of vitamin D-sensitive diseases I-V 71. Inflammatory bowel disease 72. Influenza, type A 73. Insulin resistance 74. Ischemic cardiac arrhythmias 75. Kidney stones 76. Lupus 77. Macular degeneration 78. Meningitis 79. Metabolic disease 80. Mononucleosis 81. Multiple sclerosis 82. Muscle strength 83. Osteoarthritis 84. Pancreatitis 85. Parkinson’s disease 86. Pelvic floor status 87. Periodontal disease 88. Peripheral artery disease 89. Pelvic floor status 90. Periodontal disease 91. Peripheral artery disease 92. Pneumonia 93. Polycystic ovary syndrome 94. Post herpetic neuralgia 95. Preeclampsia 96. Premature birth and low birth weight 97. Psoriatic arthritis 98. Renal failure 99. Renal osteodystrophy 100. Rheumatoid arthritis 101. Respiratory syncytial virus 102. Schizophrenia 103. Sepsis/septicemia 104. Sickle cell disease 105. Systemic sclerosis 106. Tonsillitis 107. Tuberculosis 108. Thrombosis 109. Uterine leiomyomas (fibroids) 110. Vascular dementia 111. Vitiligo vulgaris …

  7. D-vitamin-forskningen har eksplodert! Siden 1995 har det vært en eventyrlig forskningsaktivitet om D-vitamin. Nye, viktige ting oppdages nesten hver dag.

  8. Sola er hovedkilden vår til D-vitamin om sommeren 30 min whole body sun exposure (midsummer, Norway) would give 10.000 – 20.000 IU. This equals 300 ml cod liver oil or 1 kg salmon! 30 min

  9. Sol og solarier er utrolig effektive D-vitaminprodusenter!Er det klokt å forby dem?

  10. *J.A. MacLaughlin et al. Science. Vol. 216

  11. Serum concentration of vitamin D from oral vitamin D3 or UV exposure Oral 25 000 IU (=) 250 ml cod liver oil 30 min midsummer sun Serum vitamin D (ng/ml) 1MED Oral 10 000 IU Time, (hours) UV versus intake of vitamin D

  12. HOW MUCH OF SKIN SURFACE IS EXPOSED? < 0.5 % Radiumhospitalet

  13. Normally we should get vitamin D from the sun all year long, but, alas, the latitude---!! thewordsforinspiration.com

  14. Vitamin D status in Scandinavia • 20-120 % higher levels during summer • In Norway vitamin D could be produced between April and October *Oslo: National Nutrition Council; 2006:1-87

  15. Hva gjør vi når sola ikke virker, i måneder med r? • Vi reiser til Afrika. • Vi tar tran, 3 spiseskjeer per dag. • Vi tar piller, minst 40 mikrogram per dag.

  16. D-vitaminet har vært en aktør i hele livets historie. Fra først av var det et solskjold for encellede organismer: Phytoplankton Zooplankton

  17. And our story started-- 20 N Rift Valley, our cradle, Our ancestors came here more than 7 million years ago. Little by little they started to walk upright 0 20 S

  18. De aller første menneskene var kvite, så ble de svarte, og så kvite igjen da de reiste nordover. Svart hud trenger nemlig seks ganger mer sol enn kvit hud for å lage nok D-vitamin!!

  19. Skin colour and latitude Relethford 1997

  20. Kvinner og menn • Kvinner er litt viktigere enn menn. • Det er viktigere evolusjonsmessig å sikre kvinner å ha nok D-vitamin enn å sikre menn. • Derfor har kvinner litt lysere hud! • Skallete menn har en fordel!

  21. Neanderthal food Found at a cave: • 80 reindeer • 16 mamoths • 6 bisons • 4 rhinos (nasehorn) • 4 horses • 2 hippos (flodhester) • Three small fishes!!!! • No D-pills!!!

  22. The sculls in the graveyard from a battle between Egyptans and Persians • Army 1 constantly wore clothes and helmets during training (Shade army) • Army 2 trained bareheaded and with limited clothing (Sun army) • Sculls from the Shade army had holes, cracks, breaks • Sculls from the Sun army had intact bones

  23. Innendørsarbeid og dårlig mat etter urbaniseringen resulterte i Den engelske syke: Rakitt

  24. ”DEN ENGELSKE SYKE” • Historien om rakitt ”den engelske syke” • Ukjent før urbaniseringen og den industrielle revolusjon • Rakitt, klassisk D-vitaminmangel

  25. What is a vitamin? A ”vital amine” Katalyst for important reactions MUST be obtained from diet (Vit D is not a vitamin since it is produced in skin) Water soluble: C, B,-- Lipid soluble: A, D, --

  26. What is vitamin D? Fettløselige prohormon Vitamin D2Vitamin D3 (ergocalciferol i gjær) (cholecalciferol i fisk) Nytt: D2 og D3 er nesten like effektive

  27. What is vitamin D? A precursor of the active hormone calcitriol!! A vitamin MUST be obtained from intake. A hormone is produced in one part of the body and acts in another part.

  28. What is a hormone? Hormone = ”Set in action”, ”get going” A hormone is produced in one part of the body and acts in another part. Sends signals between cells Controls, regulates cell/tissue activities Mood, metabolism, fight, flight, sex, puberty, menopause

  29. What is calcitriol and how is it made? Calcitriol is a hormone produced from Vitamin D in the body All vitamin D metabolites are bound to DBP,transported to where they are needed calcitriol, 1,25(OH)D3, THE ACTIVE HORMONE. New information: Many other tissues than liver and kidneys are homes for the hydroxylations and formation of calcitriol from vitamin D. (Hydroxylations lead to higher water solubility)

  30. Vitamin D is formed in severalsteps from 7-dehydrocholesterol, 7DH,in theskin Ca ½ hour mid day sun midsummer in Norway gives max D. Larger doses break down D, or its precursors! 7DH in the skin is renewed whithin 24 hours. Then the skin is ready for the next sun exposure!

  31. Fat-soluble vitamins - D 90 % Vitamin D: Calcium and phosphate metabolism, bone mineralization and neuromuscular activity 10%

  32. Et mysterium: Hvorfor virker sol og tran likt? Begge kurerer den engelske syke (rakitt).

  33. Vitamin D fra sol og fra mat må begge gå veien om leveren

  34. Hvordan får vi nok vitamin D? Sol. Mat: Feit fisk. Piller.

  35. Serum 25-hydroxyvitamin D3 levels on 0, 1000, 5000, and 10,000 IU of Vitamin D3 a Day (80 ng/ml) 10,000 IU (60 ng/ml) 5000 IU (30 ng/ml) 1000 IU 0 Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Heaney et al (2003) Am J Clin Nutr.

  36. Anbefalt inntak: Anslagsvis 2000 IE, 50 mikrogram. Tre skjeer tran. Noen matvarer inneholder litt kalsidiol. Kalsidiol lager kalsitriol ca fire ganger mer effektivt enn vitamin D selv!!

  37. How does vitaminD act in our cells? 2. Slow action: It enters cells, binds to DNA and changes, up or down, the expression of more than 2000 genes! Proteins for defence are made. D acts in an epigenetic manner. Two modes of action: 1. Rapid action: It binds to membranes and influences ion transport in and out of the cells.

  38. VitaminD is transported in the blood bound to DBP. DBP goes to tissues which have vitamin D receptors, VDRs All tissues needing vitamin D have VDRs

  39. VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR VDR ESSENTIALLY EVERY TISSUE AND CELL HAS A VDR

  40. VDR in the brain (Kalueff & Tuohimaa 2007)We have VDRs only where we need D!!! So we need vitamin D in the brain

  41. Sol, D-vitamin og sex • D-vitaminet er beslektet med kjønnshormonene. • D-vitaminfattig kost fører til at forsøksdyr produserer mindre testosteron og østrogen. • Tilførsel av D-vitamin fra kost eller sol øker testosteronmengden. • Et solarieforsøk med menn i 1939 viste at menn med lite testosteron fikk økt mengden med 120 % etter fem dagers solariebesøk. • Unnfangelsesraten er høyest om høsten når D-vitamin-nivået er størst.

  42. D-vitaminets rolle for noen sykdommer utenfor beinsystemet

  43. Coronary/heart diseases • Increasing in many countries • Many reasons: obesity, stress, D-vitamin deficiency • Obesity and defiency of vitamin D are connected

  44. Kaplan-Meier curves showing the crude cumulative probability of first cardiovascular events in participants with hypertension. 25(OH)D < 37,5 nmol/L 25(OH)D >= 37,5 nmol/L Wang TJ et al, Circulation, 2008, 117 (4)

  45. Vitamin D and cardiovascular disease • Blood Pressure higher in winter • BP higher with increasing latitude • BP higher with darker skin pigmentation • HTN patients given UV treatments 3 times per week for 6 weeks had Vitamin D level increases of 162% and saw mild decreases in BP Krause et al. Lancet. 1998;352(9129):709. • Small doses of Vit D (800IU) for 8 weeks decreased BP and pulse rate Pfeifer et al. J Clin Endocrinol Metab. 2001;86(4):258.

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