Vitamin D: D-fense for Better Health

Long out of the nutrition spotlight, vitamin D recently has moved to center stage as a nutrient that may help prevent major diseases and improve our well-being. Few vitamins can provide the specific health benefits of vitamin D.

For decades, parents knew that to help prevent the childhood soft bone deformity, rickets, kids were given milk (once fortified, a very good source of vitamin D and calcium) to drink. Vitamin D promotes bone strength by increasing calcium absorption. That was then.

Today, some things aren't so simple. For example, how much vitamin D do we need every day to ensure strong bones and nutritional adequacy?

That's a good question.

What has been established since 1997 (by the Food and Nutrition Board at the Institute of Medicine of The National Academies) is that Americans between 19-50 years old need 200IU; 51-70-year old adults need 400IUs; and those 71 and older need 600IU.

So what has changed to challenge those recommendations, what more do we need to know, and how can we incorporate the information into foodservice?

New, current research suggests that regular sun exposure (which activates a vitamin D precursor in the skin) is associated with substantial decreases in death rates from certain cancers and a decrease in overall cancer death rates.

Further, observational studies in humans have linked low vitamin D levels to an increase in many cancers, including prostate, kidney, lung, breast, ovary, stomach, bladder, pancreas and uterus, among others.

Supplemental vitamin D, along with calcium, has been shown to reduce hip fracture risk in elderly women when combined with supplemental calcium. Other research suggests that vitamin D may play a role in the prevention and treatment of diabetes, multiple sclerosis, hypertension and glucose intolerance.

And, this year's June 9 issue of Archives of Internal Medicine reports that low levels of vitamin D appear to be associated with a higher risk of heart attack in men.

A leader in vitamin D research and an advocate for increasing vitamin D intake, Robert P. Heaney, MD of Creighton University, has published numerous studies citing risks from low intakes and benefits from increased intake of this so-called sunshine vitamin.

His recent four-year study of post-menopausal women reported that those consuming calcium and 1,100IU of vitamin D developed about 80% fewer cancers than those who took a placebo or calcium alone. Some experts suggest adults get 600IU daily and up to 800IU a day for confined elderly patients.

Getting Your Daily D

There are three sources of essential nutrient vitamin D: sunshine, food and supplements.

(A multi-vitamin including D is a beneficial supplement for most people, especially those lacking adequate nutrition.)

For centuries, the sun's ultraviolet radiation absorbed by our skin provided adequate Vitamin D to humans. Things have changed. People who are confined to long-term care facilities, reside in the northern climes (New England, Pacific Northwest, Northern Great Plains, Alaska), those who exclusively work indoors, or wear full-length clothing and/or head coverings (such as scarves or caps), or are dark-skinned (melanin pigment reduces a body's ability to produce Vitamin D from sunshine) aren't getting adequate vitamin D from the sun.

And having been programmed to slather on high SPF sunscreen, enough ultra radiation may not penetrate the skin to activate the vitamin D.

(One possible exception: College students lolling on campus lawns may be one population that still gets enough vitamin D exclusively from sunshine.)

Yet, it doesn't take a lot of daily summer sun exposure, about 5-15 minutes on unprotected face and hands, to boost our vitamin D values. Take a short fresh-air walk mid-day, answer those cell phone calls outside, eat your afternoon snack or drink that latte outdoors.

Just as moms have always said, “A little fresh air and sunshine will do you good.”

Vitamin D On The Menu

Better yet, boost your foodservice operation's production of vitamin D. While naturally occurring food sources are limited, they are all readily available to you. Oily fish such as tuna, catfish, salmon and sardines are good sources. Small amounts of vitamin D are found in beef liver, egg yolks and cheese.

Milk (dairy and soy) are “fortified” with vitamin D, meaning D does not occur naturally in these products. One cup of fortified milk provides 25% (100IU) of our daily AI. Most ready-to-eat cereals are also fortified, with 10% AI per serving.

Some juices, including orange juice and juice drinks, are now fortified with vitamin D along with calcium, usually providing 100IU per 8-once serving. (Not to worry about vitamin D food fortification over-dosing: maximum levels of vitamin D added to foods are specified by law.) Check labels or ask your distributor for this nutrition information.

One more factoid: According to the Mushroom Council, fresh mushrooms are the only fruit or vegetable with naturally-occurring vitamin D. Their preliminary research indicates that exposing those dark-room shrooms to a short burst of sunlight boosts their vitamin D content. Perhaps someday we will be able to eat a small serving of vitamin D-rich mushrooms that provide a full day's worth of vitamin D.

Increasing vitamin D levels on your menu is all about complementing flavors and textures with foods that are sources of D. To boost your operation's vitamin D menu offerings, here are some simple options (see chart, above).

Amy Muzyka-McGuire RD CD CCP owns Food & Nutrition Communications, offering nutrition, culinary and food staging expertise for marketing, recipe development and food styling projects. She can be reached at [email protected] [3].

Sources: ADA Times, July/August 2008; Food Insight, September/October 2007; Mushroom Council website; National Institutes of Health, Dietary Supplement Fact Sheet: Vitamin D, 2008; [4]; Vitamin D Council website.


Food is one of the three ways to get vitamin D. Here are some simple ideas to help you boost vitamin D for customers of all ages.

High Vitamin D Menu Offerings:

Create a canned (or smoked) Salmon and Swiss cheese Quiche, or fry up Tuna and Mushroom Frittatas.

Continue to menu your favorite fortified cereals and fat-free milk in the morning. Prepare traditional cooked oatmeal with chai milk for fabulous flavor.

Chilled Salmon Pasta Salad or a New Nicoise Salad with Hard-Cooked Egg Wedges, Cheese and Tuna make perfect salad choices.

Mid-day or small plates menus can include a Sardines, Cheese and Crudite Sampler plate, Mushroom Quesadillas and Fortified Fruit Juice Smoothies. Try Catfish ‘n Chips (or Mackerel or Salmon) as an alternative to Cod.

Offer Savory Baby Beef Liver, Onions and a Mushroom Medley to seniors.

Sandwiches such as Tuna Melt, Dilly Egg Salad, and Sensational Salmon Burgers are smart vitamin D delights.

Round out the offerings with baked custards and flans for dessert and finish with soy or dairy lattes.