How to Design, Conduct, and Analyze Vitamin D Clinical Trials

Size: px
Start display at page:

Download "How to Design, Conduct, and Analyze Vitamin D Clinical Trials"

Transcription

1 How to Design, Conduct, and Analyze Vitamin D Clinical Trials William B. Grant, PhD Sunlight, Nutrition and Health Research Center wbgrant@infionline.net

2 Disclosure I receive funding from Bio-Tech Pharmacal, Inc. (Fayetteville, Arkansas, USA), a supplier of research-grade vitamin D3.

3 Outline Part 1 Benefits of UVB exposure and vitamin D for Cancer Cardiovascular disease Respiratory tract infections

4 Outline Part 2 Background few successful vitamin D trials Reason: based on guidelines for drugs resulting in vitamin D dose being used. Should be based on 25(OH)D concentrations Examples: cancer; premature birth Steps involved for trials based on 25(OH)D Colorectal cancer survival Coronary heart disease

5 UVB, Vitamin D and Cancer Ecological Studies of UVB and Cancer Incidence and Mortality The Garland brothers made the first ecological study of cancer and solar UVB. They realized that cancer rates were lowest in the sunniest part of the country and highest in the least sunny part. They hypothesized that since vitamin D production is the most important physiological effect of solar radiation, vitamin D was likely the agent.

6 Colon Cancer Mortality Rates, White Males, United States, Dotted lines indicate annual solar radiation doses

7 UVB Dose Map from NASA

8 breast prostate kidney, urinary stomach

9

10 Types of Cancer Reduced by UVB Exposure in the U.S. Digestive tract: colon, esophageal, laryngeal, oral, pharyngeal, rectal, small intestine Female: breast, endometrial, ovarian, vulvar Urogenital: bladder, kidney, prostate, testicular Miscellaneous organs: gallbladder, lung, pancreatic, thyroid Blood: Hodgkin s lymphoma, leukemia, non- Hodgkin s lymphoma

11 Occupational UVB Exposure 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 in the five Nordic countries. UVB index used was standardized incidence rate for lip cancer less that for lung cancer. Outdoor occupations had the highest UVB index. Grant, Dermato-Endocrinology, December 2012

12 Bladder and Kidney Cancer for Males

13 Observational Studies Observational studies of vitamin D and cancer incidence, survival or mortality rates are generally based on 25(OH)D concentrations. In prospective studies, 25(OH)D near the time of cancer diagnosis is a better value than one measured many years prior to cancer diagnosis. There is very little evidence that having cancer changes 25(OH)D concentration. Thus, case-control studies should be preferred.

14 Risk of Breast Cancer with Respect to 25(OH)D as Function of Follow-up Period Grant, Dermato-Endocrinology, 2011

15 OR adjusted Breast Cancer Incidence Odds Ratio vs. 25(OH)D Concentration OR adjusted OR adjusted low 95% CI OR adjusted high 95% CI OHD (nmol/l) Grant WB, Boucher BJ. PLoS One May 1;12(5):e

16 Clinical Trials on Cancer Incidence Three vitamin D clinical trials have found that vitamin D plus cancer reduces risk of cancer Lappe et al., IU/d vitamin D, 1450 mg/d calcium Women s Health Initiative [Bolland, 2011] 400 IU/d vitamin D3, 1000 mg/d calcium Lappe et al., IU/d vitamin D, 1500 mg/d calcium

17 Cancer Survival in Norway [Tretli, 2012]

18 Colorectal Cancer Survival in Germany Maalmi H, Walter V, Jansen L, Chang-Claude J, Owen RW, Ulrich A, Schöttker B, Hoffmeister M, Brenner H. Relationship of very low serum 25-hydroxyvitamin D 3 levels with long-term survival in a large cohort of colorectal cancer patients from Germany. Eur J Epidemiol Sep 7. doi: /s z. [Epub ahead of print]

19 Cardiovascular Disease Meta-analysis [Wang, 2012]

20 Vitamin D Supplementation for Cardiovascular Health Outcomes. Forty-five RCTs were identified. Eight RCTs with BP and 6 RCTs with large artery stiffness as the end points were found to comply with guidelines for the optimal design of clinical trials evaluating nutrient effects. Only 2 of the RCTs with an optimal design were effective in decreasing BP with vitamin D supplementation, although these were of moderate sample size (<150) and very short duration (8 weeks for both), whilst no RCT was effective in reducing large artery stiffness. Similar results were observed for atherosclerotic and endothelial function markers as end points. Only 1 RCT reported cardiovascular events as an end point and found neither increased nor decreased incident cardiovascular events over 7 years of follow-up. Veloudi P, Jones G, Sharman JE. Pulse (Basel) Jan;4(4):

21 25(OH)D, PTH and Risk of Coronary Heart Disease Mean 25(OH)D for quartiles: 43, 58, 69, 84 nmol/l Qi L et al. Independent and Synergistic Associations of Biomarkers of Vitamin D Status With Risk of Coronary Heart Disease. Arterioscler Thromb Vasc Biol Sep 7

22 Respiratory Tract Infections Sunlight exposure was the common treatment for tuberculosis before the widespread use of antibiotics. Vitamin D fights bacteria and some viruses through induction of cathelicidin, a polypeptide with antimicrobial and antiendotoxin properties.

23 Influenza John Cannell proposed that influenza was largely seasonal due to seasonal variations in solar UVB doses. Two clinical trials, one involving postmenopausal African-American women, the other involving Japanese school children, supported that hypothesis. (Cold temperature also contributes to the seasonality.)

24 Acute Respiratory Tract Infections (ARIs) - Clinical Trials A trial with 100,000 IU/mo vitamin D3 in New Zealand failed to reduce risk of ARIs [Murdoch, 2012]. Reason: mean baseline 25(OH)D was 72 nmol/l. A trial in Mongolia with 300 IU/d reduced risk of ARIs by 50% [Camargo, 2012]. Reason: mean baseline 25(OH)D was 17 nmol/l.

25 Meta-analysis of Vitamin D Clinical Trials for Prevention of ARIs eligible randomised controlled trials (total participants, aged 0 to 95 years) were identified. Vitamin D supplementation reduced the risk of ARI among all participants (adjusted OR 0.88, 95% confidence interval 0.81 to 0.96; P for heterogeneity <0.001). In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses (aor 0.81, 0.72 to 0.91) but not in those receiving one or more bolus doses.

26 Meta-analysis of Vitamin D Clinical Trials for Prevention of ARIs - 2 Among those receiving daily or weekly vitamin D, protective effects were stronger in those with baseline 25(OH)D levels <25 nmol/l (aor 0.30, 0.17 to 0.53) than in those with baseline 25(OH)D levels 25 nmol/l (aor 0.75, 0.60 to 0.95; P for interaction=0.006). Martineau A, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ, 2017.

27 How to Design Vitamin D Clinical Trials Based on 25(OH)D Concentration With the foregoing as background, we now turn to how to design vitamin D clinical trials based on 25(OH)D concentrations.

28 Observational Sutdies Observational studies based on 25(OH)D concentrations are considered weak evidence for establishing causality. 25(OH)D concentrations could be due to: Dietary components such as meat and eggs with health effects Non-vitamin D effects of UV exposure Exercise Obesity (generally corrected)

29 Background Our findings suggest that vitamin D supplementation with or without calcium does not reduce skeletal or non-skeletal outcomes in unselected community-dwelling individuals by more than 15%. Future trials with similar designs are unlikely to alter these conclusions. Bolland MJ, Grey A, Gamble GD, Reid IR. Lancet Diabetes Endocrinol. 2014

30 Problems with Traditional Vitamin D Clinical Trials 1 Based on the inappropriate guidelines for pharmaceutical drugs The trial is the only source of the agent There is a linear dose-response relationship 2 Doses often too low 3 Baseline 25(OH)D concentration often too high 4 Poor compliance

31 Heaney s [2014] Rules for individual clinical studies of nutrient effects Basal nutrient status must be measured, used as an inclusion criterion for entry into study. 2. The intervention must be large enough to change nutrient status and must be quantified by suitable analyses. 3. The change in nutrient status produced in those enrolled in the trials must be measured and recorded.

32 Heaney s [2014] Rules for individual clinical studies of nutrient effects The hypothesis to be tested must be that a change in nutrient status produces the sought-for effect. 5. Conutrient status must be optimized in order to ensure that the test nutrient is the only nutrition related, limiting factor in the response. Heaney RP. Guidelines for optimizing design and analysis of clinical studies of nutrient effects. Nutr Rev. 2014;72(1):48-54.

33 Variation of 25(OH)D Concentration with Oral Vitamin D Intake Garland CF, French CB, Baggerly LL, Heaney RP. Anticancer Res Feb;31(2):

34 Expected Changes in 25(OH)D Concentration for 1000 IU/d vitamin D3 Garland et al. 2011

35 Proposal: Base Vitamin D Clinical Trials on 25(OH)D Concentration The proposal is that vitamin D clinical trials be based on 25(OH)D concentrations, not vitamin D dose. 25(OH)D should be measured perhaps 2X/yr. Basing them on concentrations would have to be stated in the protocol; otherwise journals may not accept the results. Grant WB, Boucher BJ, Bhattoa HJ, Lahore. Why vitamin D clinical trials should be based on 25-hydroxyvitamin D concentrations. JSBMB. J Steroid Biochem Mol Biol Aug 22. pii: S (17)

36 Clinical Trial: 4 yrs with 2000 IU/d Vitamin D mg/ca vs. Placebo Among 2303 randomized women (mean age, 65.2 yrs; mean baseline serum 25(OH)D level, 33 ng/ml), mean BMI, 30 kg/m 2. At year 1, serum 25(OH)D levels were 44 ng/ml in the vitamin D3 + calcium group and 32 ng/ml in the placebo group. A new diagnosis of cancer was confirmed in 109 participants, 45 (3.9%) in the vitamin D3 + calcium group and 64 (5.6%) in the placebo group.

37 Clinical Trial: 4 yrs with 2000 IU/d Vitamin D mg/ca vs. Placebo Kaplan-Meier incidence over 4 years was (95% CI, to 0.056) in the vitamin D3 + calcium group and (95% CI, to 0.076) in the placebo group; P = Unfortunately, insignificant at P = 0.05 level. Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. JAMA. 2017;317(12):

38 Results from the Lappe Study Based on 25(OH)D Concentrations (online only) nmol/l Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. JAMA Mar 28;317(12):

39 Gestation Week vs. 25(OH)D Concentration nmol/l McDonnell SL, Baggerly KA, Baggerly CA, Aliano JL, French CB, Baggerly LL, Ebeling MD, Rittenberg CS, Goodier CG, Mateus Niño JF, Wineland RJ, Newman RB, Hollis BW, Wagner CL. PLoS One Jul 24;12(7):e

40 Steps Involved 1 Obtain 25(OH)D concentration-health outcome of interest relationship. 2 Determine the range of baseline and achieved 25(OH)D concentrations desired. 3 Determine the 25(OH)D concentration distribution of the population of interest (and those likely to be included in the trial).

41 Obtain Population Data on 25(OH)D concentration Obtain data on known population distributions of serum 25OHD concentrations, e.g. for Canadians aged yrs [Grant, 2016]. Decile 25OHD Decile 25OHD (nmol/l) (nmol/l)

42 Cancer cases baseline Calculate the Expected Incidence vs. 25(OH)D with Supplementation Cancer cases baseline Cancer cases, 400 IU/d Cancer cases, 1000 IU/d Cancer cases, 2000 IU/d Cancer cases 4000 IU/d Baseline 25OHD (nmol/l)

43 Relative Risk Calculations - Calculate relative risk (RR) using, e.g., The number of participant-years can be varied to find the number required to achieve significant results at the p=0.05 level. Allow additional numbers to cover poor compliance, drop outs, undue lag times, etc. The lower the baseline 25(OH)D concentration, the fewer people needed.

44 OR for 35 nmol/l Results for Baseline 25(OH)D = 35 nmol/l, 2000 IU/d OR for 35 nmol/l 95% CI, low 95% CI, high Approximately 1000 participant years required N

45 OR for 65 nmol/l Results for Baseline 25(OH)D = 65 nmol/l, 2000 IU/d OR for 65 nmol/l 95% CI, low 95% CI, high Approximately 5000 participant years required N

46 Use 25(OH)D Results During Trial to Titrate the Vitamin D Dose Since there are large individual variations in 25(OH)D with respect to vitamin D dose, it is important to adjust the vitamin D dose after 3-6 months of the trial using 25(OH)D measurements. In addition, doing so overcomes objections that results based on 25(OH)D concentrations are merely from an observational study.

47 Additional Points to Consider 1. Seek participants with low baseline serum 25(OH)D values. 2. Use vitamin D3, not vitamin D2 and at sufficiently high doses, IU/d. 3. Consider giving a loading dose of vitamin D3 to reach target 25(OH)D concentrations rapidly.

48 Additional Points to Consider 4. Measure baseline serum 25(OH)D concentrations and repeat at suitable intervals to assess compliance and the achievement of target 25(OH)D values. 5. If calcium and/or magnesium are given, give them in both arms. (Magnesium helps convert vitamin D to 25(OH)D.)

49 Additional Points to Consider 6. Monitor participants UVB exposure, as well as dietary and supplemental intakes of vitamin D3 and potential confounders, including obesity and genetic variants. 7. Allow for the natural history of disease development in planning RCT duration and dosing, and for subject age. 8. Analyze results in terms of 25(OH)D values at baseline, at completion, and at intervals before disease diagnosis.

50 Additional Points to Consider 9. Carefully consider vitamin D dosing interval with respect to compliance and physiological effect. Daily or weekly are likely best. 10. If, for ethical reasons, participants in the control are given 400 IU/d vitamin D, the resulting increase in 25(OH)D concentration should be factored into the selection of participants and into outcome analyses.

51 Ongoing Major Vitamin D Trials VITamin D and OmegA-3 TriaL (VITAL) (U.S.) D-Health Trial (Australia) Vitamin D Assessment (ViDA) Study (N.Z.) Vitamin D and Type 2 Diabetes (D2d) study (U.S.) Finnish Vitamin D Trial (FIND) These trials will complete data acquisition, analyze data and publish results in

52 Ongoing Large-scale Vitamin D3 Clinical Trials These trials are still based on vitamin D dose. 25(OH)D concentrations were measured for some of the participants, but were not used as criteria for participation. They are expected to provide some information on vitamin D in disease prevention.

53 Further Recommendations Important health outcomes that need additional support from vitamin D clinical trials: Cancer survival Cardiovascular disease recurrence Pregnancy and birth outcomes Non-respiratory tract infection outcomes Surgery outcomes with raised 25(OH)D prior to surgery and maintained elevated

54 Summary and Conclusion Observational studies in the past decade indicate that vitamin D has many important health effects. Vitamin D clinical trials have confirmed some of these effects, but were often poorly designed. Basing vitamin D clinical trials on 25(OH)D concentrations should lead to confirmation of vitamin D s benefits in disease prevention and treatment.

How to Design, Conduct, and Analyze Vitamin D Clinical Trials

How to Design, Conduct, and Analyze Vitamin D Clinical Trials How to Design, Conduct, and Analyze Vitamin D Clinical Trials William B. Grant, PhD Sunlight, Nutrition and Health Research Center wbgrant@infionline.net Disclosure I receive funding from Bio-Tech Pharmacal,

More information

Benefits of Vitamin D for Cancer and Pregnancy/Birth Outcomes. William B. Grant, PhD Sunlight, Nutrition and Health Research Center, San Francisco

Benefits of Vitamin D for Cancer and Pregnancy/Birth Outcomes. William B. Grant, PhD Sunlight, Nutrition and Health Research Center, San Francisco Benefits of Vitamin D for Cancer and Pregnancy/Birth Outcomes William B. Grant, PhD Sunlight, Nutrition and Health Research Center, San Francisco Disclosure I receive funding from Bio Tech Pharmacal, Inc.

More information

Sunbed Use in Europe: Important Health Benefits and Minimal Health Risks

Sunbed Use in Europe: Important Health Benefits and Minimal Health Risks Sunbed Use in Europe: Important Health Benefits and Minimal Health Risks William B. Grant, Ph.D. Director Sunlight, Nutrition and Health Research Center, San Francisco Outline Health Benefits of UV exposure

More information

Emerging Areas Relating Vitamin D to Health

Emerging Areas Relating Vitamin D to Health ILSI SEA Region Vit D Conference, Australia, June 2012 (www.ilsi.org/sea Region) Emerging Areas Relating Vitamin D to Health Peter R Ebeling MD FRACP NorthWest Academic Centre and Dept Endocrinology The

More information

Vitamin D supplementation of professionally active adults

Vitamin D supplementation of professionally active adults Vitamin D supplementation of professionally active adults VITAMIN D MINIMUM, MAXIMUM, OPTIMUM FRIDAY, SEPTEMBER 22 ND 2017 Samantha Kimball, PhD, MLT Research Director Pure North S Energy Foundation The

More information

FOR CONSUMERS AND PATIENTS

FOR CONSUMERS AND PATIENTS AVAILABILITY OF VITAMIN D FOR CONSUMERS AND PATIENTS Prof. Heike A. Bischoff-Ferrari, MD, DrPH Centre on Aging and Mobility, University of Zurich Dept. of Rheumatology, University Hospital Zurich Overview

More information

Vitamin D and Calcium Therapy: how much is enough

Vitamin D and Calcium Therapy: how much is enough Vitamin D and Calcium Therapy: how much is enough Daniel D Bikle, MD, PhD Professor of Medicine VA Medical Center and University of California San Francisco DISCLOSURE Nothing to disclose 1 RECOMMENDATIONS

More information

The Endocrine Society Guidelines

The Endocrine Society Guidelines Vitamin D and Calcium Therapy: how much is enough DISCLOSURE Daniel D Bikle, MD, PhD Professor of Medicine VA Medical Center and University of California San Francisco Nothing to disclose RECOMMENDATIONS

More information

Update on vitamin D. J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska USA

Update on vitamin D. J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska USA Update on vitamin D J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska 68131 USA Cali, Colombia 2016 definitions DRIs are the recommended dietary reference intakes

More information

Observational Studies vs. Randomized Controlled Trials

Observational Studies vs. Randomized Controlled Trials Observational Studies vs. Randomized Controlled Trials Edward Giovannucci, MD, ScD Harvard School of Public Health Harvard Medical School Boston MA 02115 (1)The relevance of observational data as compared

More information

Vitamin D: Conflict of Interest Statement Corporate. Outline 7/5/2016

Vitamin D: Conflict of Interest Statement Corporate. Outline 7/5/2016 Vitamin D: What s New and Not? Clifford J Rosen MD Maine Medical Center Research Institute rosenc@mmc.org Conflict of Interest Statement Corporate NO STOCKS or EQUITY Editor UpToDate, New England Journal

More information

Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Objectives

Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Objectives Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Bess Dawson-Hughes, MD Disclosures: Amgen, DSM, Nestle, Opko, Pfizer, Roche, Tricida Interrelationships of muscle

More information

Understanding Vitamin D: To D or not to D? Anastassios G Pittas, MD MS Tufts Medical Center

Understanding Vitamin D: To D or not to D? Anastassios G Pittas, MD MS Tufts Medical Center Understanding Vitamin D: To D or not to D? Anastassios G Pittas, MD MS Tufts Medical Center D2dstudy.org pittas@d2dstudy.org Disclosure: NIH funding Popularity of vitamin D RESEARCH CONSUMERS 40000 Publications

More information

Supplementary appendix

Supplementary appendix Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Bolland MJ, Grey A, Gamble GD, Reid IR. The

More information

Vitamina D: un ormone multifunzione

Vitamina D: un ormone multifunzione Vitamina D: un ormone multifunzione Introduction And Infections Diego Peroni Clinica Pediatrica Universita di Ferrara Food Allergy Asthma Conclusions diego.peroni@unife.it Holick, M. F. J. Clin. Invest.

More information

Cancer in Huron County

Cancer in Huron County Cancer in Huron County 2-29 Prepared by: Erica Clark, Epidemiologist April 214 77722B London Road RR 5, Clinton, ON NM 1L 519.482.3416 F: 519.482.782 www.huronhealthunit.com Cancer Health Status Report

More information

SUN HEALTH TECHNOLOGIES

SUN HEALTH TECHNOLOGIES SUN HEALTH TECHNOLOGIES CORRELATION BETWEEN VITAMIN D, UVB, AND MS Researchers are finding a strong association between vitamin D levels, UVB exposure and multiple sclerosis (MS). According to the Mayo

More information

MEDICAL POLICY EFFECTIVE DATE: 08/21/14 REVISED DATE: 04/16/15, 06/16/16, 07/20/17 SUBJECT: SCREENING FOR VITAMIN D DEFICIENCY

MEDICAL POLICY EFFECTIVE DATE: 08/21/14 REVISED DATE: 04/16/15, 06/16/16, 07/20/17 SUBJECT: SCREENING FOR VITAMIN D DEFICIENCY MEDICAL POLICY SUBJECT: SCREENING FOR VITAMIN D DEFICIENCY A nonprofit independent licensee of the BlueCross BlueShield Association PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not

More information

Moving Research into Practice. Vitamin D. GrassrootsHealth. Serum Level vs Intake. Moving Research into Practice.

Moving Research into Practice. Vitamin D. GrassrootsHealth. Serum Level vs Intake. Moving Research into Practice. Serum Level vs Intake Garland, C.F., French, C.B., Baggerly, Leo L., Heaney, Rorbert P., (2011) Vitamin D Supplement Doses and Serum 25-Hydroxyvitamin D in the Range Associated with Cancer Prevention.

More information

Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People

Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People For the Motion: Professor Roger Francis, Institute for Ageing and Health, Newcastle University,

More information

Researching Genetic Influences in Different Racial/Ethnic Populations and Cancer

Researching Genetic Influences in Different Racial/Ethnic Populations and Cancer Researching Genetic Influences in Different Racial/Ethnic Populations and Cancer Lenora WM Loo, PhD Assistant Professor (Specialist) University of Hawaii Cancer Center Off-Label Use Disclosure I do not

More information

The epidemiology of vitamin D and colorectal cancer: recent findings Edward Giovannucci a,b,c

The epidemiology of vitamin D and colorectal cancer: recent findings Edward Giovannucci a,b,c The epidemiology of vitamin D and colorectal cancer: recent findings Edward Giovannucci a,b,c Purpose of review To highlight the human studies published over the past year examining the influence of vitamin

More information

Economic Analyses of Nutrient Interventions for Chronic Disease Prevention Paul M. Coates, Ph.D. Director

Economic Analyses of Nutrient Interventions for Chronic Disease Prevention Paul M. Coates, Ph.D. Director Economic Analyses of Nutrient Interventions for Chronic Disease Prevention Paul M. Coates, Ph.D. Director Office of Dietary Supplements National Institutes of Health Overview What is the science telling

More information

Cancers attributable to excess body weight in Canada in D Zakaria, A Shaw Public Health Agency of Canada

Cancers attributable to excess body weight in Canada in D Zakaria, A Shaw Public Health Agency of Canada Cancers attributable to excess body weight in Canada in 2010 D Zakaria, A Shaw Public Health Agency of Canada Introduction Cancer is a huge burden in Canada: Nearly 50% of Canadians are expected to be

More information

Olio di oliva nella prevenzione. Carlo La Vecchia Università degli Studi di Milano Enrico Pira Università degli Studi di Torino

Olio di oliva nella prevenzione. Carlo La Vecchia Università degli Studi di Milano Enrico Pira Università degli Studi di Torino Olio di oliva nella prevenzione della patologia cronicodegenerativa, con focus sul cancro Carlo La Vecchia Università degli Studi di Milano Enrico Pira Università degli Studi di Torino Olive oil and cancer:

More information

The Association between Vitamin D and Lung Cancer Risk in Finnish Male Smokers. Julia Burkley Briarcliff High School

The Association between Vitamin D and Lung Cancer Risk in Finnish Male Smokers. Julia Burkley Briarcliff High School The Association between Vitamin D and Lung Cancer Risk in Finnish Male Smokers. Julia Burkley Briarcliff High School 2 Burkley Table of Contents Introduction~ Pg. 2 Methods~ Pg. 4 Ethics Statement~ Pg.

More information

ESPEN Congress Prague 2007

ESPEN Congress Prague 2007 ESPEN Congress Prague 2007 Key papers in the field of nutrition Dietitian Geila S Rozen Key Papers in the field of Nutrition ESPEN 2007 Prague Geila S Rozen Clinical Nutrition Dep. Rambam health campus

More information

Vitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP

Vitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP Vitamin D Vitamin functioning as hormone Todd A Fearer, MD FACP Vitamin overview Vitamins are organic compounds that are essential in small amounts for normal metabolism They are different from minerals

More information

Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine

Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine meek.shon@mayo.edu 2016 MFMER 3561772-1 Update on Vitamin D Shon Meek MD, PhD 20 th Annual Endocrine Update January 30-Feb 3, 2017 Disclosure Relevant

More information

NSAC Statement of Advice : Should women be screened for vitamin D during pregnancy in New Zealand?

NSAC Statement of Advice : Should women be screened for vitamin D during pregnancy in New Zealand? Date 16 NOVEMBER 2009 Date sent to Director General 12 FEBRUARY 2010 NSAC Statement of Advice : Should women be screened for vitamin D during pregnancy in New Zealand? To From Stephen McKernan, Director-General

More information

Diagnosis and Treatment of Vitamin D Deficiency Workshop. UV: The original Source! How to use it

Diagnosis and Treatment of Vitamin D Deficiency Workshop. UV: The original Source! How to use it Diagnosis and Treatment of Vitamin D Deficiency Workshop UV: The original Source! How to use it April 9, 2010 Edward D. Gorham, Ph.D., Cedric F. Garland, Dr.P.H., and Sharif B. Mohr, M.P.H., Frank C. Garland,

More information

Biomarkers: examples from cancer epidemiology

Biomarkers: examples from cancer epidemiology Biomarkers: examples from cancer epidemiology In memory of Sheila Bingham Tim Key Cancer Epidemiology Unit Nuffield Department of Clinical Medicine University of Oxford Sheila Bingham (Rodwell) 1947-2009

More information

THE TRUTH ABOUT THE VITAL STUDY ON OMEGA-3 and VITAMIN D

THE TRUTH ABOUT THE VITAL STUDY ON OMEGA-3 and VITAMIN D THE TRUTH ABOUT THE VITAL STUDY ON OMEGA-3 and VITAMIN D There have been two recent publications regarding the findings from the VITAL study that have gotten a lot of media attention because of their conclusions

More information

The effect of supplementation with vitamin D on recurrent ischemic events and sudden cardiac death in patients with acute coronary syndrome

The effect of supplementation with vitamin D on recurrent ischemic events and sudden cardiac death in patients with acute coronary syndrome CRC IRB Proposal Matthew Champion PGY-1 8/29/12 The effect of supplementation with vitamin D on recurrent ischemic events and sudden cardiac death in patients with acute coronary syndrome Study Purpose

More information

Biostatistics and Epidemiology Step 1 Sample Questions Set 2. Diagnostic and Screening Tests

Biostatistics and Epidemiology Step 1 Sample Questions Set 2. Diagnostic and Screening Tests Biostatistics and Epidemiology Step 1 Sample Questions Set 2 Diagnostic and Screening Tests 1. A rare disorder of amino acid metabolism causes severe mental retardation if left untreated. If the disease

More information

Vitamin D and Cancer Prevention

Vitamin D and Cancer Prevention Curr Nutr Rep (2012) 1:24 29 DOI 10.1007/s13668-011-0005-8 CANCER (MF LEITZMANN, SECTION EDITOR) Vitamin D and Cancer Prevention Hajo Zeeb Published online: 17 January 2012 # Springer Science+Business

More information

The Role of Observational Studies. Edward Giovannucci, MD, ScD Departments of Nutrition and Epidemiology

The Role of Observational Studies. Edward Giovannucci, MD, ScD Departments of Nutrition and Epidemiology The Role of Observational Studies Edward Giovannucci, MD, ScD Departments of Nutrition and Epidemiology Disclosure Information As required, I would like to report that I have no financial relationships

More information

Vitamin D supplementation in clinical practice: a practical approach

Vitamin D supplementation in clinical practice: a practical approach Vitamin D supplementation in clinical practice: a practical approach Theocharis Koufakis MD, PhD Internist Research Associate Division of Endocrinology and Metabolism - Diabetes Center, 1 st Department

More information

Overview. Musculoskeletal consequences of Vitamin D deficiency. Non-musculoskeletal associations of Vitamin D deficiency

Overview. Musculoskeletal consequences of Vitamin D deficiency. Non-musculoskeletal associations of Vitamin D deficiency Vitamin D Zulf Mughal Consultant in Paediatric Bone Disorders Department of Paediatric Endocriology Royal Manchester Children's Hospital Manchester M13 0JH Bone Study Day, 28 th September 2012 Overview

More information

The Vitamin D Gap. Vitamin D intake guidelines were established to prevent. Estimating an adequate intake of vitamin D. FEATURE VITAMIN D GAP

The Vitamin D Gap. Vitamin D intake guidelines were established to prevent. Estimating an adequate intake of vitamin D. FEATURE VITAMIN D GAP The Vitamin D Gap Estimating an adequate intake of vitamin D. By Laurence Montgomery, ND and George Tardik, ND Vitamin D intake guidelines were established to prevent rickets in children and osteomalacia

More information

Physical activity, Obesity, Diet and Colorectal Cancer Prognosis. Jeffrey Meyerhardt, MD, MPH Dana-Farber Cancer Institute Boston, MA

Physical activity, Obesity, Diet and Colorectal Cancer Prognosis. Jeffrey Meyerhardt, MD, MPH Dana-Farber Cancer Institute Boston, MA Physical activity, Obesity, Diet and Colorectal Cancer Prognosis Jeffrey Meyerhardt, MD, MPH Dana-Farber Cancer Institute Boston, MA Colorectal Cancer Incidence ~148,000 cases in US annually and ~50,000

More information

POSITION STATEMENT Vit D

POSITION STATEMENT Vit D POSITION STATEMENT Vit D APPROVED BY THE AUSTRALIAN AND NEW ZEALAND BONE AND MINERAL SOCIETY, RISKS AND BENEFITS OF SUN EXPOSURE POSITION STATEMENT Summary statement A balance is required between avoiding

More information

Cancer in Halton. Halton Region Cancer Incidence and Mortality Report

Cancer in Halton. Halton Region Cancer Incidence and Mortality Report Cancer in Halton Halton Region Cancer Incidence and Mortality Report 2008 2012 The Regional Municipality of Halton March 2017 Reference: Halton Region Health Department, Cancer in Halton: Halton Region

More information

Vitamin D and Inflammation

Vitamin D and Inflammation Vitamin D and Inflammation Susan Harris, D.Sc. Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University Boston, MA Vitamin D Liver 25(OH)D storage form nmol/l=ng/ml x 2.5 Renal 1,25(OH)

More information

Correlations of Obesity, Comorbidity and Treatment: Implications for Survival Analysis and Interpretation

Correlations of Obesity, Comorbidity and Treatment: Implications for Survival Analysis and Interpretation Correlations of Obesity, Comorbidity and Treatment: Implications for Survival Analysis and Interpretation Rachel Ballard-Barbash, MD, MPH Applied Research Program (ARP) Division of Cancer Control and Population

More information

Vitamin D Supplementation During Pregnancy and Infancy Reduces Sensitisation to House Dust Mite: a Randomised Controlled Trial

Vitamin D Supplementation During Pregnancy and Infancy Reduces Sensitisation to House Dust Mite: a Randomised Controlled Trial Vitamin D Supplementation During Pregnancy and Infancy Reduces Sensitisation to House Dust Mite: a Randomised Controlled Trial Cameron Grant, 1 4 Julian Crane, 3 Ed Mitchell, 1 Jan Sinclair, 4 Alistair

More information

Susan Steck, Ph.D., M.P.H., R.D.

Susan Steck, Ph.D., M.P.H., R.D. Susan Steck, Ph.D., M.P.H., R.D. Associate Professor Department of Epidemiology and Biostatistics Cancer Prevention and Control Program Center for Research in Nutrition and Health Disparities Arnold School

More information

Cancer Prevention & Control in Adolescent & Young Adult Survivors

Cancer Prevention & Control in Adolescent & Young Adult Survivors + Cancer Prevention & Control in Adolescent & Young Adult Survivors NCPF Workshop July 15-16, 2013 Patricia A. Ganz, MD UCLA Schools of Medicine & Public Health Jonsson Comprehensive Cancer Center + Overview

More information

The Role of Vitamin D in Heart Disease. Janet Long, MSN, ACNP, CLS, FAHA, FNLA Cardiovascular Institute Rhode Island Hospital and The Miriam Hospital

The Role of Vitamin D in Heart Disease. Janet Long, MSN, ACNP, CLS, FAHA, FNLA Cardiovascular Institute Rhode Island Hospital and The Miriam Hospital The Role of Vitamin D in Heart Disease Janet Long, MSN, ACNP, CLS, FAHA, FNLA Cardiovascular Institute Rhode Island Hospital and The Miriam Hospital None Conflict of Interest What is Vitamin D Produced

More information

IOM DRI Research Synthesis Workshop June 7-8, 2006

IOM DRI Research Synthesis Workshop June 7-8, 2006 The Dietary Requirement for Vitamin D: Looking Beyond Bone Bruce W. Hollis, Ph.D. Medical University of South Carolina Charleston, SC Presentation: Dr. Bruce Hollis 1 Metabolism of Vitamin D Under Conditions

More information

VITAMIN D THE ICEBERG UNDER THE SURFACE. Robert P. Heaney, M.D., F.A.C.P. Creighton University Osteoporosis Research Center

VITAMIN D THE ICEBERG UNDER THE SURFACE. Robert P. Heaney, M.D., F.A.C.P. Creighton University Osteoporosis Research Center VITAMIN D THE ICEBERG UNDER THE SURFACE Robert P. Heaney, M.D., F.A.C.P. Creighton University Osteoporosis Research Center DISCLOSURES Robert P. Heaney, M.D. no personal financial relationships to disclose

More information

2018 Texas Cancer Registry Annual Report

2018 Texas Cancer Registry Annual Report 2018 Texas Cancer Registry Annual Report As Required by Texas Health and Safety Code Section 82.007 November 2018 Table of Contents Executive Summary... 1 1. Introduction... 2 2. Background... 3 Cancer

More information

BAD TO THE BONE. Peter Jones, Rheumatologist QE Health, Rotorua. GP CME Conference Rotorua, June 2008

BAD TO THE BONE. Peter Jones, Rheumatologist QE Health, Rotorua. GP CME Conference Rotorua, June 2008 BAD TO THE BONE Peter Jones, Rheumatologist QE Health, Rotorua GP CME Conference Rotorua, June 2008 Agenda Osteoporosis in Men Vitamin D and Calcium Long-term treatment with Bisphosphonates Pathophysiology

More information

N Follow -up years. (cases/controls or participants, gender) Cases: 105 men and 125 women; Controls: 206 men and 246 women

N Follow -up years. (cases/controls or participants, gender) Cases: 105 men and 125 women; Controls: 206 men and 246 women Supplementary Table 1. characteristics of 21 independent studies (extracted from 1 eligible articles) of blood 2(OH)D Levels and incident type 2 Author, Publicatio n year Source populatio n Design N Follow

More information

The Multiethnic Cohort Study: Studying Ethnic Diversity and Cancer. Laurence N. Kolonel, MD, PhD

The Multiethnic Cohort Study: Studying Ethnic Diversity and Cancer. Laurence N. Kolonel, MD, PhD The Multiethnic Cohort Study: Studying Ethnic Diversity and Cancer Laurence N. Kolonel, MD, PhD Background of the Multiethnic Cohort Study (MEC) Features of the Design Multiethnic: Five groups in Hawaii

More information

In addition to bone health, emerging science reveals a non-skeletal benefit of vitamin D for several other health outcomes.

In addition to bone health, emerging science reveals a non-skeletal benefit of vitamin D for several other health outcomes. Vitamin D AT A GLANCE Introduction Vitamin D comprises a group of fat-soluble compounds that are essential for maintaining the mineral balance in the body. The vitamin D form synthesized in humans is called

More information

IS VITAMIN D IMPORTANT IN THE MANAGEMENT OF TUBERCULOSIS?

IS VITAMIN D IMPORTANT IN THE MANAGEMENT OF TUBERCULOSIS? IS VITAMIN D IMPORTANT IN THE MANAGEMENT OF TUBERCULOSIS? Dr Heather Milburn Consultant Respiratory Physician Guy s & St Thomas NHS Foundation Trust READER IN Respiratory Medicine KING S College London

More information

Folate and prevention of neural tube defects: Tracking red blood cell concentrations will help guide policy decisions about fortification

Folate and prevention of neural tube defects: Tracking red blood cell concentrations will help guide policy decisions about fortification Folate and prevention of neural tube defects: Tracking red blood cell concentrations will help guide policy decisions about fortification Derrick Bennett, University of Oxford, UK 8 October, 2014 IXth

More information

Dr. Eisenstein s Minimum Daily Probiotics Recommendations Colony Forming Units (CFU) Please click on the image

Dr. Eisenstein s Minimum Daily Probiotics Recommendations Colony Forming Units (CFU) Please click on the image Dr. Eisenstein s Minimum Daily Probiotics Recommendations Colony Forming Units (CFU) Please click on the image 1. Health maintenance adults 20 Billion CFU daily 2. Children 5 Billion CFU daily 3. Colds

More information

RELATIONS AMONG OBESITY, ADULT WEIGHT STATUS AND CANCER IN US ADULTS. A Thesis. with Distinction from the School of Allied Medical

RELATIONS AMONG OBESITY, ADULT WEIGHT STATUS AND CANCER IN US ADULTS. A Thesis. with Distinction from the School of Allied Medical RELATIONS AMONG OBESITY, ADULT WEIGHT STATUS AND CANCER IN US ADULTS A Thesis Presented in Partial Fulfillment of the Requirements to Graduate with Distinction from the School of Allied Medical Professions

More information

SECTION 4. Nutrition and Disease in the Japan Collaborative Cohort Study for Evaluation of Cancer (JACC) Hiroyasu Iso, Yoshimi Kubota.

SECTION 4. Nutrition and Disease in the Japan Collaborative Cohort Study for Evaluation of Cancer (JACC) Hiroyasu Iso, Yoshimi Kubota. Nutrition and Disease SECTION 4 Nutrition and Disease in the Japan Collaborative Cohort Study for Evaluation of Cancer (JACC) Hiroyasu Iso, Yoshimi Kubota Abstract Nutrition effects on mortality in the

More information

Overview and Comparisons of Risk of Bias and Strength of Evidence Assessment Tools: Opportunities and Challenges of Application in Developing DRIs

Overview and Comparisons of Risk of Bias and Strength of Evidence Assessment Tools: Opportunities and Challenges of Application in Developing DRIs Workshop on Guiding Principles for the Inclusion of Chronic Diseases Endpoints in Future Dietary Reference Intakes (DRIs) Overview and Comparisons of Risk of Bias and Strength of Evidence Assessment Tools:

More information

V t i amin i n D a nd n d Calc l iu i m u : Rol o e l in i n Pr P eve v nt n io i n and n d Tr T eatment n of o Fr F actur u es and n d Fa F ll l s

V t i amin i n D a nd n d Calc l iu i m u : Rol o e l in i n Pr P eve v nt n io i n and n d Tr T eatment n of o Fr F actur u es and n d Fa F ll l s Vitamin D and Calcium: Role in Prevention and Treatment of Fractures and Falls Osteoporosis 21: New Insights In Research, Diagnosis, and Clinical Care Deborah Sellmeyer, MD Director, Johns Hopkins Metabolic

More information

Vitamin D and public health: an overview of recent research on common diseases and mortality in adulthood

Vitamin D and public health: an overview of recent research on common diseases and mortality in adulthood Public Health Nutrition: 14(9), 1515 1532 doi:10.1017/s1368980011001455 Vitamin D and public health: an overview of recent research on common diseases and mortality in adulthood Robert Scragg* School of

More information

A Cure for the Mid-Winter Blahs

A Cure for the Mid-Winter Blahs Vitamin D A Cure for the Mid-Winter Blahs by: Heidi Fritz, MA, ND Bolton Naturopathic Clinic 64 King St W, Bolton, Ontario L7E 1C7 www.boltonnaturopathic.ca Part I: Why Vitamin D? Vitamin D 3, also known

More information

Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women A Randomized Clinical Trial

Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women A Randomized Clinical Trial Research JAMA Original Investigation Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women A Randomized Clinical Trial Joan Lappe, PhD, RN; Patrice Watson, PhD; Dianne Travers-Gustafson,

More information

Pancreat ic Cancer UK. policy briefing. A cancer of unmet need: the pancreatic cancer research challenge

Pancreat ic Cancer UK. policy briefing. A cancer of unmet need: the pancreatic cancer research challenge Pancreat ic Cancer UK policy briefing A cancer of unmet need: the pancreatic cancer research challenge Introduction Pancreatic Cancer UK s Study for Survival, launched in 2011, marked the first ever comprehensive

More information

The Impact of Life Style & Dietary Habits on Vitamin D status Among Young Emiratis. Fatme Al Anouti, Ph.D. Zayed University, Abu Dhabi

The Impact of Life Style & Dietary Habits on Vitamin D status Among Young Emiratis. Fatme Al Anouti, Ph.D. Zayed University, Abu Dhabi The Impact of Life Style & Dietary Habits on Vitamin D status Among Young Emiratis Fatme Al Anouti, Ph.D. Zayed University, Abu Dhabi The Sun-Shine Vitamin Vitamin D is unique because it can be synthesized

More information

Overweight and Obesity in Older Persons: Impact Upon Health and Mortality Outcomes

Overweight and Obesity in Older Persons: Impact Upon Health and Mortality Outcomes Overweight and Obesity in Older Persons: Impact Upon Health and Mortality Outcomes Gordon L Jensen, MD, PhD Senior Associate Dean for Research Professor of Medicine and Nutrition Objectives Health outcomes

More information

Theories: Reduced Milk Consumption. Case of the A Family. Physiology of Vitamin D. Why Is Everyone Vitamin D Deficient?

Theories: Reduced Milk Consumption. Case of the A Family. Physiology of Vitamin D. Why Is Everyone Vitamin D Deficient? Case of the A Family Theories: Reduced Milk Consumption Osama A. 51 y/o male from Sudan; 4 children Oldest son Ahmed, tears ACL Soccer Youngest Son, Osman, fx Ulna cross St Second Son, Ayman, Fx Tib/Fib

More information

YOUR VITAMIN D CHEAT-SHEET

YOUR VITAMIN D CHEAT-SHEET YOUR VITAMIN D CHEAT-SHEET When using the cutoff of 20 ng/ml (50 nmol/l) for vitamin D deficiency, according to data collected by the Centers for Disease Control (CDC), 90 million Americans are vitamin

More information

Importance of Vitamin D in Healthy Ageing. Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014

Importance of Vitamin D in Healthy Ageing. Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014 Importance of Vitamin D in Healthy Ageing Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014 Healthy life expectancy the challenge! Life expectancy

More information

Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial 1,2

Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial 1,2 Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial 1,2 Joan M Lappe, Dianne Travers-Gustafson, K Michael Davies, Robert R Recker, and Robert P Heaney ABSTRACT Background:

More information

VITAMIN D IN HEALTH AND DISEASE

VITAMIN D IN HEALTH AND DISEASE VITAMIN D IN HEALTH AND DISEASE Margus Lember University of Tartu, Estonia ESIM, Saas Fee, January 16, 2014 l It`s most healthy to live on the southern side of a mountain l Hippokrates of Kos 460-370 BC

More information

CFDR Semi Annual Research Showcase May 1st, 2014

CFDR Semi Annual Research Showcase May 1st, 2014 CFDR Semi Annual Research Showcase May 1st, 2014 Source: Canada s Aging Population, Health Canada, 2002, p. 3 s The 2006 Census revealed that 4.3 million Canadians were > 65 y Almost 7% lived in health

More information

Enclosed you will find our revised manuscript, entitled Sunlight for better or for worse?. One version with, one without track changes.

Enclosed you will find our revised manuscript, entitled Sunlight for better or for worse?. One version with, one without track changes. Noordwijk, 03-02-2016 Dear Editor, Enclosed you will find our revised manuscript, entitled Sunlight for better or for worse?. One version with, one without track changes. In response to the reviewers constructive

More information

The WCRF/AICR Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective Methods, Approaches and Lessons Learned

The WCRF/AICR Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective Methods, Approaches and Lessons Learned The WCRF/AICR Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective Methods, Approaches and Lessons Learned Teresa Norat, PhD Principal Research Fellow Imperial College

More information

The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis

The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis Mark J Bolland, Andrew Grey, Greg D Gamble, Ian R Reid Summary Background Vitamin D insufficiency

More information

Welcome to mmlearn.org

Welcome to mmlearn.org Welcome to mmlearn.org VITAMIN D SUNSHINE VITAMIN INTRODUCTION Familiar with skeletal needs Rickets Osteoporosis Fractures INTRODUCTION Not as familiar other associations Immune system Cancer Cardiovascular

More information

Diet, obesity, lifestyle and cancer prevention:

Diet, obesity, lifestyle and cancer prevention: Diet, obesity, lifestyle and cancer prevention: Epidemiologic perspectives Graham A Colditz, MD DrPH Niess-Gain Professor Chief, November, 2017 Outline Review evidence on contribution of diet, obesity,

More information

Publications by Core, Collaborative, BAA, and Ancillary Study* as of 11/5/2013

Publications by Core, Collaborative, BAA, and Ancillary Study* as of 11/5/2013 Publications by Core, Collaborative, BAA, and Ancillary Study* as of 11/5/2013 Study # MS ID Title Reference W1 - CT core analytes on 6% Subsample; quarterly core analytes on QC pools A and B W1, W6 204

More information

Nutrition and gastrointestinal cancer: An update of the epidemiological evidence

Nutrition and gastrointestinal cancer: An update of the epidemiological evidence Nutrition and gastrointestinal cancer: An update of the epidemiological evidence Krasimira Aleksandrova, PhD MPH Nutrition, Immunity and Metabolsim Start-up Lab Department of Epidemiology German Institute

More information

VITAMIN D AND THE ATHLETE

VITAMIN D AND THE ATHLETE VITAMIN D AND THE ATHLETE CONSIDERATIONS FOR THE PRACTITIONER Written by Bruce Hamilton, Qatar Vitamin D is a steroid hormone that has previously been given little attention, partially as a result of its

More information

Vitamin D during pregnancy and breastfeeding

Vitamin D during pregnancy and breastfeeding Vitamin D during pregnancy and breastfeeding Getting the right nutrients and eating well when you re pregnant or breastfeeding is important for your baby s growth and development. Vitamin D helps you to

More information

Cancer in Ontario. 1 in 2. Ontarians will develop cancer in their lifetime. 1 in 4. Ontarians will die from cancer

Cancer in Ontario. 1 in 2. Ontarians will develop cancer in their lifetime. 1 in 4. Ontarians will die from cancer Cancer in Ontario 1 in 2 Ontarians will develop cancer in their lifetime 1 in 4 Ontarians will die from cancer 14 ONTARIO CANCER STATISTICS 2016 1 Cancer in Ontario An overview Cancer is a group of more

More information

The Continuous Update Project: concept, purpose, methods and results

The Continuous Update Project: concept, purpose, methods and results The Continuous Update Project: concept, purpose, methods and results Teresa Norat August 27-0 2012 Montreal, Canada Continuous Update Project Keep Report updated into the future WCRF/AICR working with

More information

Cancer in Utah: An Overview of Cancer Incidence and Mortality from

Cancer in Utah: An Overview of Cancer Incidence and Mortality from Cancer in Utah: An Overview of Cancer Incidence and Mortality from 1973-2010 A publication of the Utah Cancer Registry January 2014 Prepared by: C. Janna Harrell, MS Senior Research Analyst Kimberly A.

More information

APPENDIX ONE: ICD CODES

APPENDIX ONE: ICD CODES APPENDIX ONE: ICD CODES ICD-10-AM ICD-9-CM Malignant neoplasms C00 C97 140 208, 238.6, 273.3 Lip, oral cavity and pharynx C00 C14 140 149 Digestive organs C15 C26 150 157, 159 Oesophagus 4 C15 150 excluding

More information

Cancer Facts & Figures for African Americans

Cancer Facts & Figures for African Americans Cancer Facts & Figures for African Americans What is the Impact of Cancer on African Americans in Indiana? Table 12. Burden of Cancer among African Americans Indiana, 2004 2008 Average number of cases

More information

The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements.

The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements. The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements. SIR EDWARD MELLANBY 1 8 8 4-1 9 5 5 A D I E T C H A R A C T E R I S T I C O F S

More information

Prevention of cancer the influence of diet

Prevention of cancer the influence of diet Prevention of cancer the influence of diet Food Network, 2010 Anne Tjønneland Institut for Epidemiologisk Kræftforskning, Kræftens Bekæmpelse Risk of cancer Indien / USA Aldersspecifik brystkræftincidens

More information

Featured Topic: Black Mustard Seed (4 slides)

Featured Topic: Black Mustard Seed (4 slides) Featured Topic: Black Mustard Seed (4 slides) Medicinal Mustard Black mustard seed (B. nigra) is in the same family as cruciferous vegetables, including: Cabbage Broccoli Turnips Cauliflower Kale Brussels

More information

Vitamin D supplementation in reducing the risk of vitamin D insufficiency during infancy

Vitamin D supplementation in reducing the risk of vitamin D insufficiency during infancy Vitamin D supplementation in reducing the risk of vitamin D insufficiency during infancy An evidence based review of the literature Carmen Hayward Patient presentation 20 day-old Caucasian infant From

More information

BECAUSE OF THE BENEFIT OF

BECAUSE OF THE BENEFIT OF ORIGINAL INVESTIGATION Dairy Food, Calcium, and Risk of Cancer in the NIH-AARP Diet and Health Study Yikyung Park, ScD; Michael F. Leitzmann, MD; Amy F. Subar, PhD; Albert Hollenbeck, PhD; Arthur Schatzkin,

More information

Canada: Equitable Cancer Care Access and Outcomes? Historic Observational Evidence: Incidence Versus Survival, Canada Versus the United States

Canada: Equitable Cancer Care Access and Outcomes? Historic Observational Evidence: Incidence Versus Survival, Canada Versus the United States Canada: Equitable Cancer Care Access and Outcomes? Historic Observational Evidence: Incidence Versus Survival, Canada Versus the United States This work is funded by the: Canadian Institutes of Health

More information

Master of Public Health, International Health, August 2003 University of Alabama, Birmingham, Alabama

Master of Public Health, International Health, August 2003 University of Alabama, Birmingham, Alabama Sharif Mohr, MPH, PhD 465 7 th Ave N St. Petersburg, FL 33701 (407) 625-4681 sbmohr75@gmail.com EDUCATION: Doctor of Philosophy in Public Health (Epidemiology), May 2012 University of California, San Diego,

More information

Esophageal Cancer: Iran Story

Esophageal Cancer: Iran Story Esophageal Cancer: Iran Story Reza Malekzadeh, MD Digestive Disease Research Institute, Tehran University of Medical Sciences Arash Etemadi, MD PhD National Cancer Institute, NIH, Bethesda, MD Esophageal

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Henson KE, Brock R, Charnock J, Wickramasinghe B, Will O, Pitman A. Risk of suicide after cancer diagnosis in England. JAMA Psychiatry. Published online November 21, 2018.

More information

Vitamin D in pregnancy and lactation

Vitamin D in pregnancy and lactation Vitamin D in pregnancy and lactation October 2014 Dr Pamela von Hurst Co-Director, Vitamin D Research Centre Massey University Vitamin D 101 Metabolism Sources Measuring status Overview of presentation

More information