Read Original Story

The Vitamin-D Debate

Rating

2 Star

The Vitamin-D Debate

Our Review Summary

The story documented a nutritional recommendation which has undergone noticeable change within the time period marked by the births within one family.  But the story did little to help the reader understand the strength of the evidence supporting this change or how the benefits to be obtained from increased vitamin D intake may be seen.  It relied on personal preferences (i.e. the mention that Dr. Greer takes 1000 IU vitamin D /day) rather than a description of the evidence underlying this practice, and thus failed to provide the reader with an understanding about why they may or may not want to change their vitamin D intake.

Why didn’t the piece fully examine the evidence that led to the change in advice about vitamin D supplementation?

Instead, it wandered off into speculation about how vitamin D "potentially lowers the risk of multiple sclerosis, juvenile diabetes, cancer, heart disease, colds and influenza" – without giving any explanation or evidence of this.

The role of vitamin D in health beyond frank deficiency is an interesting and active field of research and this story did not rise to the challenge of better enabling readers to make informed choices.

The story also lacked:

  • independent expert voices to put this recommendation in perspective
  • a complete list of side-effects and dangers of overdose, as well as any discussion about the paucity of long-term data on higher doses continuously in infants and youths

While taking vitamins may seem like mom-and-apple-pie no-brainers, from a societal perspective, the impact of this burgeoning market when health-care choices are becoming more critical and costly, should not be underestimated.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no indication of whether the levels of vitamin D in multivitamin preparation had any impact on its price.  Not only was the cost of the supplement ignored, so was the cost of monitoring treatment, costs of complications of overdosage, and – at the other end of the spectrum – potential savings from improved health.   Cost is a factor in such stories.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The benefits from supplementation with additional vitamin D were not quantified.  In fact, as the older offspring of the author were not reported to be suffering from rickets, one might question whether increased vitamin D intake has merit.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Although this story did mention two side effects of excessive intake of vitamin D, this list downplays the consequence of overdose.  For this, they could have simply gone to the Time archives and unearthed their piece from 1992:  http://www.time.com/time/magazine/article/0,9171,975464,00.html 

This is not a trivial point, especially since the clinician quoted in the piece mentioned personal consumption levels above those recommended.  Taking a supplement to match the intake mentioned, in concert with vitamin D containing foods, multivitamins, and exposure to sunlight – could result in people ending up with higher than intended levels.

There is also no mention of the lack of long term data on supra-therapeutic levels of the vitamin, and we can assume that the effects, good or bad, may be magnified by the longer duration of exposure and more sensitive developing body in the children and adolescents that were the focus of the piece.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This story had no information about why the recommendations about vitamin D consumption have recently been in flux.  

The story did mention that the major impact in children was the prevention of rickets. 

The story included a laundry list of conditions linked to low self-report of vitamin D consumption or sun exposure.  However the story contained no information about the nature of the studies conducted and the strength of the evidence. 

Does the story commit disease-mongering?

Not Satisfactory

We judge the story unsatisfactory on this criterion for two reasons:

  • The story says that vitamin D "potentially lowers the risk of multiple sclerosis, juvenile diabetes, cancer, heart disease, colds and influenza" but gives no explanation nor evidence of this. 
  • The "deficiency" from which most northerners suffer may be by lab test only and does not necessarily translate into disease states, such as osteoporosis.  How broad a net is this article casting? 

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The sources of information for this story were inadequate.  We learn the practice recommendations of one pediatrician (as reported by a parent) and a clinician who was reported to chair the Academy of Pediatrics nutrition committee.  There were no individuals with particular expertise in vitamin D who appeared to have been interviewed for this piece.

Does the story compare the new approach with existing alternatives?

Satisfactory

In addition to vitamin D supplements, the story mentioned food, supplemented foods, and functional foods (cod liver oil) as well as sun light exposure as options for obtaining vitamin D.

The story would have been improved with some explanation of why sunlight exposure is most often inadequate due to latitude and cloud cover in addition to the discussion in this piece about the impact of sunscreen use. 

 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story described a recommendation to ‘pick up a multivitamin’ with a given level of vitamin D, suggesting that this is a simple over the counter purchase.  That said – the article failed to distinguish among the types of vitamin D available and whether this made any difference.

Does the story establish the true novelty of the approach?

Satisfactory

This story described a change in recommendation for babies experienced by the author.

It was made a bit murky by then expanding the discussion to include a variety of maladies for which an association with vitamin D levels have been reported, without an effort to explain the strength of the data or other factors (a change in the way circulating levels of vitamin D are measured) that may affect the recommendations.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Does not appear to rely on a press release.

Total Score: 4 of 10 Satisfactory

Comments

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.