Vitamin D and Calcium

1. Nutrients that prevent Cancer Vitamin D and Calcium

2. Vitamin D • Fat-soluble vitamin • Sources • Foods • Naturally found in very few foods • Added to many foods on the market • Supplements • Sunlight

3. Vitamin D • Daily Recommended Intake • Current minimum intake recommendations • Birth-50 years = 200 IU • 51-70 years = 400 IU • 71+ years = 600 IU • Currently being debated

4. Food Sources of Vitamin D 3 oz smoked salmon = 583 IU 3 oz light tuna, canned in oil = 229 IU 1 large, whole egg = 29 IU

5. Foods Fortified with Vitamin D 8 oz skim milk = 115 IU 8 oz orange juice = 100 IU 1 cup Cheerios = 40 IU ½ cup yogurt = 40 IU

6. Calcium • Essential mineral • Daily Recommended Intakes • 9-18 years = 1300 mg • 19-50 years = 1000 mg • 51 years and older =1200 mg

7. Calcium • Sources in the diet • Milk • Yogurt • Cheese • Dark green vegetables • Fortified sources • Cereals • Bread • Orange Juice

8. Calcium content of foods 8 oz milk = 300 mg 8 oz low-fat yogurt= 230 mg ½ cup cooked Spinach = 120 mg 1 cup Cheerios = 100 mg

9. Dietary Supplements • Calcium • Carbonate or citrate • Dose dependent absorption • Two doses per day • Vitamin D • D2 or D3 • D3 is best

10. A single serving = 1 cup 1 serving has 100 calories 10% Daily Value of calcium 1000mg * 0.10 = 100mg 10% Daily Value of vitamin D 400IU * 0.10 = 40 IU http://www.fda.gov

11. Vitamin D Functions • Many uses in the body • Promotes absorption of calcium from the small intestine • Maintain blood levels of calcium and phosphate for bone formation, mineralization, growth, and repair • Improves muscle strength and immune function • Reduces inflammation

12. Vitamin D Deficiency • At risk populations • Breastfed infants • Older adults • People with limited sun exposure • Darker skin pigments • Certain religious groups

13. Vitamin D Related Diseases • Rickets • Osteomalacia • Osteoporosis

14. Calcium Functions • Major component of bones and teeth • A small amount of calcium circulates in the blood • Essential for clotting of the blood • Aids in the normal functioning of the nerves, muscles, and heart

15. Calcium Deficiency • At risk populations • Children and youth • Post-menopausal women • Elderly • People with poor diets, lacking in dairy foods

16. Vitamin D and Cancer • Roles in prevention of • Colon cancer • Breast cancer

19. Vitamin D and Cancer • How it prevents • Promotes cellular differentiation • Decreases cancer cell growth • Stimulates cell deaths

20. Vitamin D Cancer Research • Mostly observational studies, only show correlation • Food frequency questionnaires • Interviews • Diet records

21. Vitamin D & Colon Cancer Research • Third National Health and Nutrition Examination Survey • Epidemiologic study • 16,818 participants • Examined blood levels of vitamin D • Results • Blood levels 80nmol/L or higher reduced risk by 72%

22. Vitamin D Cancer Research • American Cancer Society’s Cancer Prevention Study II Nutrition Cohort • Studied 120,000 men and women • Analyzed diet, medical history, and lifestyle • Results • Men with intakes of 520 IU or higher from both diet and supplementation slightly lowered risk • No effect in women

23. Vitamin D & Breast Cancer Research • Cancer Prevention Study II Nutrition Cohort • Participants • 68,567 postmenopausal women • Completed questionnaire on dietary intake, family history, and supplement use • Results • Women who consumed higher amounts of vitamin D and calcium from dairy products reduced their risk of breast cancer

24. True or False. Vitamin D is not necessary for Calcium to be absorbed in the body.

25. True or False. Vitamin D is not necessary for Calcium to be absorbed by the body.

26. Calcium and Cancer • Roles in prevention of: • Colon cancer • Breast cancer • Premenopausal women

27. Calcium and Cancer • How it prevents cancer • Exact mechanism is unclear • Biochemical level • Calcium binds to bile acids and fatty acids in the gastrointestinal tract to form insoluble complexes • Reduces the ability of the acids to damage cells in the lining of the colon and act directly in reducing cell proliferation in the lining of the colon

28. Calcium and Colon Cancer Research • Nurses’ Health Study and Health Professionals Follow-up study • Analyzed 135,000 men and women • Results • People who consumed 700mg or more per day reduced risk by 35-45% • Effect was only recognized in distal area of colon

29. Calcium & Colon Cancer Research • National Institutes of Health-American Association of Retired Persons Diet and Health Study • Results • High intakes of total calcium, dietary calcium, and calcium supplements lowered the risk of colon cancer • 20% among men • 30% among women

30. Calcium & Colon Cancer Research • Study in Iowa • 34,000 women participated • Two groups • Intakes of 1280mg or more per day • Intakes of 800mg or less per day • Calcium intake from both diet and supplements • Results • 41% reduction in colon cancer risk associated with higher intake

31. Calcium and Breast Cancer Prevention • Nurses’ Health Study • 3,000 women • Calcium intakes 800 mg or more per day • Particularly from dairy products • Low-fat or non-fat milk • Yogurt • Cheese • Compared to intakes of 200 mg or less from dairy • Results • Reduced risk in premenopausal women but NOT postmenopausal.

32. Calcium and Breast Cancer Prevention • Women’s Health Study • 30,000 women • Two groups: • Intakes1366mg or more per day • Intakes less than 617mg per day • Results • Reduced risk in increased intake of calcium • Only in premenopausal women

33. What have we learned? • Vitamin D and calcium both plays roles in preventing cancer • The recommended intakes • Calcium = 1000mg • Vitamin D = 400 IU • Many ways to increase intake • Change diet • Include supplements