Sunshine of Your Love Part 3: What is e-D-ible?

This is the third installment in our series about the sun.  For context, please read 
Sunshine of Your Love Part 1: Safely Getting What You Need and 
Sunshine of Your Love Part 2: The D Factor.  

After our last discussion of the inherent problems with getting your vitamin D from the sun alone, we were left with the question: So where can we get the vitamin D we need?  Today, let's talk food.  

Getting Your Vitamin D From Food

The vitamin D humans (and all animals) produce from a chemical reaction in our skin under UVB rays is D3, in the form of cholecalciferol, the most readily usable form by our bodies.  If we eat animals, we get the same form of vitamin D that we make ourselves.  Another form, vitamin D2, is produced by plants and fungi, but you're unlikely to ingest much of it when you eat the plant or fungus.  Special treatment of plants and fungus can extract the vitamin D for use in fortified foods and supplementation.  However,  since plants and animals are vastly different creatures down to the cellular level, their form of vitamin D isn't an equivalent to ours.  That is why if you are outsourcing your vitamin D needs, you must choose vitamin D from animal sources.  We'll discuss this more below under Fortified Foods: The Right Stuff.  Thus, our sources for vitamin D from food are: animals or fortified foods.

Fortified Foods: Frankenfoods

You've seen them before.  Cartons of milk and orange juice, containers of yogurt and margarine, and boxes of breakfast cereal all telling us they are a source of vitamin D.  On the surface, the game plan seems solid.  These are foods built from the ground up, combining numerous distilled ingredients to craft a whole new food novel to any creature in existence.  In theory, you would think the builders have your best interests in mind: they have the power to create super-nutritious super-foods.

For example, Total Cereal tells us they offer "100% Nutrition" by giving us 100% of the Daily Value of 12 vitamins and minerals.  How responsible of them!  One hitch: sugar is their number two ingredient and corn syrup, number three.  In each 3/4 cup serving, I repeat: 3/4 cup serving, there are 5 grams of sugar, or just over one teaspoon or sugar packet.  Exactly how does that contribute to total nutrition?

Unfortunately, the arms race in the processed food industry isn't to create a more nutritious product giving lasting health benefits; it's for profit and convenience (which leads to more profit).  The old saying rings true once more: 'You can have it cheap, you can have it good, or you can have it fast.  Choose two.'  Unfortunately, high quality, nutritional "goodness" has been sacrificed for cheap, fast food.

Just browsing through your average supermarket would make our ancestors weep.  Where the hell is the real food?  Oh yeah, tucked away on the periphery are the meats, fruit, and veggies, outliers of the industrial complex.  Even these aren't immune to commodification as we reconfigure and patent genetic codes creating genetically modified organisms, industrialize even "organic" farming, and feed waste products and surplus into animal "products" through CAFOs (Concentrated Animal Feeding Operations, also known as factory farms) producing meat instead of raising animals.  Food is being redefined away from its biological roots and into products that can be produced, refined, and commodified.    

Processed foods, a multitude of refined parts compressed into one whole, are less than ideal for many reasons.  One, they're made to sell.  Profit comes before any altruistic desires for the betterment of human health.  Perhaps this isn't true for every product out there, but certainly most.  Tell me how these products were created to nourish us: pancake batter in an aerosol can, fruit-flavored products without any real fruit, or meat substitutes with ingredient lists longer and more unpronounceable than those of beauty products, just to name a few.  To show just how abhorrent the whole creation of a food marketed as "healthy" really is, take the following passage from The Omnivore's Dilemma by Michael Pollan.  Let's play, What Am I?

...four cents' worth of commodity corn (or some other equally cheap grain) transformed into four dollars' worth of processed food.  What an alchemy!  Yet it is performed straightforwardly enough: by taking several of the output streams issuing from a wet mill (corn meal, corn starch, corn sweetener, as well as a handful of tinier chemical fractions) and then assembling them into an attractively novel form.  Further value is added in the form of color and taste, then branding and packaging.  Oh yes, and vitamins and minerals, which are added to give the product a sheen of healthfulness and to replace the nutrients that are lost whenever whole foods are processed.

So, what am I?  See the answer at the end of this post.  And even if you are okay with the whole frankenfood thing, there are other pitfalls to fortified foods.  Does it even give you what you need?  Is it even worth it?  Let's explore dairy, next.    

Fortified Foods: Does Milk Really Do a Body Good?

What about dairy products?  Although processed, they are closer to the source--their ingredient lists are short.  Can't I get my vitamin D from milk like the ads tell me?  No, because:
1.  Milk and dairy products aren't for everyone.  You can be healthy without them in your diet.
2.  Milk alone doesn't have the amount of vitamin D you need even when it's fortified.
3.  Skim milk doesn't have the fat you need to absorb vitamin D.  
4.  The trans fat in margarine totally gunks up the process of utilizing vitamin D.    

One, dairy may not "do a body good," at least not for every body.  There is definitely some debate about the healthiness of milk.  See Mark's Daily Apple for a good summary.  We'll hit that one another day, but for now, read up on why The Paleo Diet doesn't like dairy.  For more depth, check out founder Dr. Loren Cordain's argument at his website.  For as many opponents, there are just as many proponents of full-fat dairy like PaNu, The Weston A. Price Foundation,  The Heart Scan Blog, and Whole Health Source, to only name a few.  For me, I'll probably continue to partake in high fat dairy like butter and cream and try to mininmize my dairy that isn't full fat, raw, and grassfed.  Although I know dairy has many benefits, it also has some detriments I've seen firsthand in my N=1 experiments: I get plegmy, wake up congested, get a runny nose, and sometimes get a sore throat.  And that is dairy alone--no grains to confound these results.  The severity depends on the quantity, source, and form of dairy.  Definitely something is at work here.  And remember, on a paleo-style diet you are absorbing your calcium from your veggies (because a clean digestive system is an efficient one) and your vitamin D from other sources we'll discuss below.  So no one NEEDS milk to survive, except breastfeeding babies.  Just saying.

Okay, dairy is a personal choice, but as our second problem can it even provide the vitamin D you need?  This discussion of Vitamin D and Milk from a UC Riverside professor that we cited in our first installment is a good resource to answer this question.

Milk from all lactating animals, including humans, contains vitamin D3 that has been produced photochemically from 7-dehydrocholesterol present in the skin. In cow's milk it has been determined that the concentration of vitamin D3 in milk provided by the cow is roughly 35-70 International Units per quart as determined via biological assay and approximately 50-80 International Units as determined by modern chemical mass spectrometric procedures. However these are rather low levels of vitamin D3 from the perspective of providing the 200-400 IU per day as recommended by the Food and Nutrition Board of the Institute of Medicine. 

And remember, that 200-400 IU recommendation is way below that suggested by The Vitamin D Council to achieve 50-80 ng/mL blood levels.  They say to take 5k daily and recheck in 2-3 months.  Since milk isn't a great source for vitamin D naturally, it's fortified.  According to the article cited above, every quart is fortified with 400 IU of vitamin D.  So to drink your 5K a day, that would be 12 and a half quarts a day.  Even a more conservative dosage of 1k a day would be two and a half quarts.  Thirsty?  

Another problem, we've been told fat is bad for us, so we switched to heart-healthy skim.  But on this blog we've time and again taken skim milk to task for not containing the healthiest part: the fat!  Fat is where the vitamin D and other vitamins, essential fatty acids, and important constituents reside.  Fat is necessary for absorption of fat soluble vitamins like...say it with me now...Vitamin D!  And other forms of commercial milk aren't off the hook even if they DO contain fat because they are pasteurized and homogenized.  There is a LOT to say about these processes and how they destroy everything sacred about milk, so read the Weston Price Foundation's treatise: Milk: It Does a Body Good?  

Does that mean our precious, fortified, non-butter, saving-us-from-the-evils-of-saturated-fat spread (also known as margarine) is out too?  Um, YES.  Besides being a processed product made from an array of chemicals, margarine is mostly trans fat (trans fatty acids are made from the hydrogenation of vegetable oils and there is little argument about them NOT being the least bit healthy).  And why is trans fat a problem specifically with vitamin D fortification?  It interferes with the conversion of vitamin D into calcidiol in the liver.  Maybe the producers know it screws up the process, so they are just hedging their bets and dumping more vitamin D in there to hopefully balance it all out.  And you would think that with all the effort we put into refining and producing products based on their constituent parts that we could actually craft healthy products.  Silly me, it's a sci-fi pipe dream to think that food production is out to meet our nutritional needs.  Guess I'll have to wait for Asimov's yeast products and Star Trek's replicators.... Sigh.  

Fortified Foods: The Right Stuff

But other foods are fortified besides dairy, you say?  How about heart-healthy OJ fortified with calcium and vitamin D?  Even if everything seems "right" with vitamin D-fortified foods, other problems emerge.  Take that fortified OJ.  According to Minute Maid, it's just juice, calcium sources, and vitamin D3 (good for them!).  What's the problem?  The juice.  What's wrong with juice?  The fact that in 250ml or ONE cup there are 120 calories, 28g of carbohydrate (25 of which is sugar), and NO satiating fiber.  That's three Zone blocks right there and it's certainly NOT a low glycemic food.  One cup of orange juice is over 50 times the calories of an orange.  While it is difficult to overeat fruit because of their fibrous bulk, it's effortless to down a big glass of OJ and feel like you are doing your body good.  And good luck feeling full; without significant protein, any fat, or any fiber, you're just fanning the flames.  The worst part?  That sugar load, calories and all, isn't so different from soda.  In fact, 240ml of Coca-Cola Classic is only 96 calories and 27g of carbohydrate/sugar.  Are those vitamins and minerals in fortified OJ really enough to make it healthier?  For more on why juice is a no-go, please read my article: Just Say No...to Juice?

Another pitfall?  Fortification with vitamin D often involves the form vitamin D2, which comes from plants or fungi.  One catch, plants/fungi are entirely different beings than animals.  Our bodies are wired very differently, down to the cellular level (cell walls in plants and cell membranes in animals are quite different).  Plant vitamin D, D2, is not the same as our vitamin D, D3, so it is much less efficient to use the plant form to get what we need.  This study calls for an end to vitamin D2 fortification and supplementation because it is NOT an equivalent to D3.  The authors state that vitamin D2 is NOT as effective at raising vitamin D levels, has a shorter shelf life, may lead to incorrect circulating vitamin D measurements, and is metabolized differently, thereby it doesn't assume the same functions as vitamin D3.  Dr. Davis from The Heart Scan Blog concurs.  He discusses how D2 is a cheaper supplement than D3, but it pales in comparison to the effectiveness of D3 in the body.  

Insult to injury?  Even if producers fortify foods with the most bioavailable form of vitamin D, D3, the source is up for grabs.  Just because they are fortifying cow's milk, doesn't mean that added D3 is from a cow.  It could be from any animal used to make that source.  There are NO requirements to identify the source of ingredients like vitamin D.  Isn't that a little disturbing?

Animal Sources of Vitamin D

So where can you get natural animal sources of vitamin D?  Fish, for one.  Salmon, sardines, and shrimp are very good to excellent sources according to The World's Healthiest Foods (a nutritional database) and eggs follow close behind (and yes, you have to eat the yolk, which contains all the nutritional goodness like the vitamin D!).  That website also lists vitamin D-fortified cow's milk as a very good source, but we are going for whole foods, not processed, and I already discussed it's detriments above.  

Meat quality matters.  Wild-caught fish has significantly more vitamin D than non-organic farm-raised, which lends more evidence to support our preference for sustainable wild-caught, grass-fed, and pasture-raised sources of meat.  For more information on sustainable fish, check out the Monterey Bay Aquarium's Seafood Watch list.  The Weston Price Foundation article further elaborates that the plankton and other fish in the diets of the fish we eat provide their vitamin D (that they cannot synthesize it from the sun themselves).  Thus, farm-raised fish on a processed (usually grain-based) diet are not getting the dietary vitamin D to become as rich a source as their wild brethren.  Unless, of course, we fortify their grain-based diet, which leads us back around to the argument above: we CANNOT make better foods than those found in nature.  The Weston Price Foundation article also mentions that we aren't even exploiting the real WHOLE foods that contain the most vitamin D, like the organ meats, skin, fat, and insects that are uncommon modern foods. 

Unfortunately, getting the vitamin D you need is NOT as simple as just eating your fill of fish.  The quantity of vitamin D in different foods varies.  It even varies for the SAME foods!  Argh!  For instance, mackerel cooked 3 to 3.5oz is 388 IU here (for 3oz) and 345 IU here (for 3.5oz).  Either way, even the best food sources (one 3-4 oz serving of salmon with up to 794 IU, although most charts have it closer to 400 IU) are a drop in the bucket for what you need.  And if what I have read is right, we do NOT want to listen to the daily recommended values given on those sites (400 IU a day, are you serious?).  Remember, we are shooting for 5000 IU a day according to The Vitamin D Council.  But the real number you need depends entirely upon your own vitamin D level, so get checked!  The Vitamin D Council recommends 50–80 ng/mL (or 125–200 nM/L) year-round.  Taking the average 400IU in 4oz of the best food source (salmon), that would take 12 and half servings a day.  Hungry?

Additionally, there is also a whole can of worms to explore with vitamin D's cofactors (read more about them at the Vitamin D Council): those vitamins and minerals necessary for it to do it's many jobs.  Any deficiencies and you're screwed.  This is more detail than we can handle today, so it suffices to say that you should eat REAL FOOD and make sure your diet is full of variety and rich sources of vitamins and minerals, including sustainable wild-caught fish, pasture-raised poultry and eggs, grass-fed meat, and local and seasonal vegetables, fruit, and nuts.  

And what about getting the vitamin D you need?  Well, that question has not been answered yet.  I guess it's to be continued:

Sunshine of Your Love Part 4: Supplementation

References

General references used extensively (in addition to those cited above):
The Omnivore's Dilemma by Michael Pollan

The World's Healthiest Foods: Vitamin D

Weston Price Foundation's article: The Miracle of Vitamin D and Milk: It Does a Body Good?

The Vitamin D Council

Answer to What Am I: breakfast cereal.  Still think it's a healthy start to your day?