Friday, February 12, 2010
Hank Albarelli's book review of Wolf and Pack at Amazon
The hidden and secret history of this nation's so-called War on Drugs and its warriors has been waiting quite some time to be told; we are now very fortunate to have historian Douglas Valentine's two-volume set of books that provide a well-documented and robust narrative of the various government agencies that evolved into the current DEA. Valentine's first book, The Strength of the Wolf, provides us with a stunningly documented and detailed volume about the old Federal Bureau of Narcotics (FBN). The book is replete with a slew of startling facts about the FBN's connections to the CIA and the FBN's intelligence related overseas operations.Indeed, Valentine's first book was quite helpful to a section of my book just out on Dr. Frank Olson's murder, A TERRIBLE MISTAKE: The Murder of Frank Olson and the CIA's Secret Cold War Experiments.Valentine did a superb job in his first book revealing the CIA's ties to the FBN. At points, both agencies seem to merge into one and to perform as one. That the two agencies performed as one and so closely shared objectives says a lot about the overalll objectives of intelligence gathering. Valentine's excellent newer book, Strength of the Pack, moves readers into current years and delivers a cornucopia of startling and long-secret data and information that throws considerable light on the mockery of the efforts of the U.S. to rid itself of the curse of drugs. After reading Valentine's latest excellent book one does not have to contemplate very long to understand why illicit drugs will continue to flood our nation and little will be done about it. Anyone concerned about this problem, and wanting to learn about how the so-called 'War on Drugs' really operates, should read both of Valentine's very important titles.The Douglas Valentine Vietnam Collection at the National Security Archive in Washington, DC, has been open and used by researchers since early 2007. The Collection contains the research material, including original handwritten interview notes and government documents obtained through FOIA requests, for my book The Phoenix Program. The Collection can only be used in the National Security Archive's Reading Room; it is not available for interlibrary loan and an appointment must be made to use it. The "resguide" link below will help anyone who wants to read the material
Wednesday, February 10, 2010
Four Landing Spots For Julius Peppers

Philadelphia EaglesThe Eagles are loaded with depth at the defensive end position, headlined by Trent Cole and rounded out by Juqua Parker, Darren Howard, Victor Abiamiri, Chris Clemons and Jason Babin. But they still lack that playmaker opposite Cole that could really wreak some havoc in defensive coordinator Sean McDermott’s aggressive scheme. Unless a sleeper prospect falls to them in the middle rounds, it’s unlikely that the Eagles will be able to address their defensive end need via the draft. That’s where Peppers comes in. If Philly decides to be aggressive this offseason, they may try to acquire Peppers whether the Panthers decide to franchise tag him or not. (They may be in line to acquire more draft picks if/when they trade Kevin Kolb, Donovan McNabb or Michael Vick.) Paired with Cole, the Eagles would have one of the best pass-rushing tandems in the league.
Atlanta FalconsJamaal Anderson hasn’t turned out to be the pass-rushing force opposite John Abraham that the Falcons envisioned he would be when they selected the former Razorback with the eighth overall pick in 2007. Worse yet, after racking up 16.5 sacks in 2008, Abraham (the team’s best pass rusher) only produced 5.5 QB take downs last season and will turn 32 in early May. Some feel as though Abraham has lost a step, but he would flourish playing opposite Peppers on the same defensive line. Pep would also make the vastly underrated Jonathan Babineaux and 2009 first round pick Peria Jerry even more dangerous on the inside, but the question now becomes whether or not the Falcons will be active in free agency. GM Thomas Dimitroff didn’t make any significant splashes last offseason, instead opting to build his roster via the draft. But if Dimitroff decides to be aggressive, then Peppers makes a lot of sense for a team like Atlanta, which is clearly on the rise but needs to plug some of its defensive holes.
New England PatriotsRumors surfaced last offseason that New England was a possible landing spot for Peppers, so it makes sense that the Pats would be viewed as candidates again this year. The Patriots definitely have a need for a pass rusher and Peppers said last year that he wanted to play outside linebacker in a 3-4 scheme. Given that Adalius Thomas has fallen out of favor with Bill Belichick, there could be a spot opening up in the Pats’ defense. But considering players like Tom Brady, Vince Wilfork, Logan Mankins and Stephen Gostkowski all need new contracts, New England might decide to spend its money on retaining its own players instead of acquiring outside help like Peppers. Plus, keep in mind that the Patriots were burned in the Thomas deal, so they may be reluctant to shell out big bucks for another pass-rusher.
Carolina PanthersThere’s still a possibility that the Panthers will franchise Peppers again like they did last year. The problem with that is it’ll cost them roughly $20.1 million and therefore, it’s unlikely that they’ll go that route. Instead, they’ll probably make Pep their best offer and if he decides that the grass is greener in another stadium, then he’ll exit Carolina stage left. Of course, they could always franchise him and then try to trade him in order to get some form of compensation, but if they don’t find a willing trade partner than they could wind up footing the $20.1 million bill for him next season. Carolina seems like an unlikely destination for Peppers next year, but given how much history the two have together nobody should be surprised if he has a change of heart and returns to the Panthers in 2010.
Atlanta FalconsJamaal Anderson hasn’t turned out to be the pass-rushing force opposite John Abraham that the Falcons envisioned he would be when they selected the former Razorback with the eighth overall pick in 2007. Worse yet, after racking up 16.5 sacks in 2008, Abraham (the team’s best pass rusher) only produced 5.5 QB take downs last season and will turn 32 in early May. Some feel as though Abraham has lost a step, but he would flourish playing opposite Peppers on the same defensive line. Pep would also make the vastly underrated Jonathan Babineaux and 2009 first round pick Peria Jerry even more dangerous on the inside, but the question now becomes whether or not the Falcons will be active in free agency. GM Thomas Dimitroff didn’t make any significant splashes last offseason, instead opting to build his roster via the draft. But if Dimitroff decides to be aggressive, then Peppers makes a lot of sense for a team like Atlanta, which is clearly on the rise but needs to plug some of its defensive holes.
New England PatriotsRumors surfaced last offseason that New England was a possible landing spot for Peppers, so it makes sense that the Pats would be viewed as candidates again this year. The Patriots definitely have a need for a pass rusher and Peppers said last year that he wanted to play outside linebacker in a 3-4 scheme. Given that Adalius Thomas has fallen out of favor with Bill Belichick, there could be a spot opening up in the Pats’ defense. But considering players like Tom Brady, Vince Wilfork, Logan Mankins and Stephen Gostkowski all need new contracts, New England might decide to spend its money on retaining its own players instead of acquiring outside help like Peppers. Plus, keep in mind that the Patriots were burned in the Thomas deal, so they may be reluctant to shell out big bucks for another pass-rusher.
Carolina PanthersThere’s still a possibility that the Panthers will franchise Peppers again like they did last year. The problem with that is it’ll cost them roughly $20.1 million and therefore, it’s unlikely that they’ll go that route. Instead, they’ll probably make Pep their best offer and if he decides that the grass is greener in another stadium, then he’ll exit Carolina stage left. Of course, they could always franchise him and then try to trade him in order to get some form of compensation, but if they don’t find a willing trade partner than they could wind up footing the $20.1 million bill for him next season. Carolina seems like an unlikely destination for Peppers next year, but given how much history the two have together nobody should be surprised if he has a change of heart and returns to the Panthers in 2010.
Scott Boras Is Just Making Stuff Up Now

Scott Boras is the guy at the bar right now, who after already being turned down by the hottest girl in the joint, is just determined to go home with somebody. He's found his target, she's not gorgeous by any means, but she's there and she'll have to do.It's nearly last call, so if he's going to get this done, he's going to have to work quickly."You like Project Runway? OH. MY. GOD. So do I! In fact, and I haven't told many people this, but I just feel a real connection with you, when I was a kid, I wanted to grow up to be a fashion designer. Seriously, I still sometimes think about just dropping everything to chase the dream, you know?" Right now that girl is the Detroit Tigers, his bedroom is Johnny Damon, and Boras is pulling out all the stops to put those two together.Last week Boras told the Tigers that his client, Damon, wanted to play for them going as far as saying that the only thing keeping a World Series title from Detroit was not having Johnny Damon on the team.This caught the Tigers' interest, but they were still somewhat wary of this man trying to seduce them, and a week later no deal has been signed by either side. So Boras is amping things up.If Steve Yzerman wasn't busy running Team Canada for the Olympics, perhaps he could help persuade free agent Johnny Damon to sign with the Tigers despite a lower offer than he'd like.Damon has rooted for the Red Wings for years. He started doing so because of how much he likes Yzerman. Damon's agent, Scott Boras, talked Monday about Damon's fervor for the Red Wings."When he and I go to a Greek restaurant, he always orders octopus," Boras said.See what Boras did there? Go back up and read what I had Boras telling the girl at the bar, and replace Project Runway with Steve Yzerman and the Detroit Red Wings. Just find the thing that people in Detroit really like and then say "Holy shit! What a coincidence, so does Johnny Damon!"I'm surprised he didn't go on to say that Damon's iPod is filled with nothing but Motown, Ted Nugent, Eminem and Kid Rock.The other lie that Boras told was that immediately after it was clear that the Yankees didn't want Damon, he received "four or five offers right away" from teams for Damon.There were just so many people making contract offers that Boras couldn't remember how many there were! Too many to count! It could have been four or five. Maybe even six! Who's counting? Not Scott Boras! Johnny only wants to play for Detroit!Now Boras may have received four or five calls from teams inquiring about Damon, but I'll guarantee you he didn't get a single offer. All you need to do is look at his constant courting of Detroit to know that's not true.
Sunday, February 7, 2010
Mandela office Nelson

The Andrew Harding finds that long-stalled plans to turn it into a centre for black lawyers say a lot about the pace of change in modern South Africa.The Johannesburg building that once housed Nelson Mandela's law firm is now a derelict squat.George Bizos shuffles slowly across Fox Street, in the centre of Johannesburg. A lunchtime crowd is clogging the entrance of a shabby-looking cafe. Mr Bizos slips inside - unnoticed at first. But within seconds there are nods and smiles of recognition.
The Chinese man behind the till is complaining about the criminals in the area.
"There's a derelict building on the next block. Chancellor House. It's full of criminals," he says sharply. Mr Bizos' crumpled, 82-year-old back straightens - his barrister's instincts alerted.
"That house," he explains patiently, "is occupied by dozens of squatters who have no alternative accommodation. They should not be casually categorised as criminals."
It is a good 50 years now since Mr Bizos first bought lunch at this cafe.
He and his friend Nelson Mandela used to come at least once a week to grab a couple of pies and take them back to Mr Mandela's office around the corner. As a white man, born in Greece, Mr Bizos could have eaten at the cafe. But in those days black people were not allowed to sit down here. On the way out today, two men in workmen's clothes stop Mr Bizos and ask if they can shake his hand.
Historic placeOne block down Fox Street, opposite the Magistrate's court, is the derelict, three-storey building the Chinese man was complaining about. The walls are blackened by fire. Half a dozen young men are standing outside it. There is a strong smell of marijuana and rubbish. "A lot of memories," says Mr Bizos, smiling at the crowd then slowly climbing the pitch-black stairwell of Chancellor House, up to the water-logged landing on the first floor.
At the far end, a makeshift door opens into what was once Mr Mandela's office - the very first black law firm in South Africa and a place that used to be besieged by clients.
Today it is occupied by a 38-year-old unemployed electrician, Dick Macomary, and his growing family. There is a mattress on the floor, pots and pans, and some clothes drying by the boarded-up windows. "Sorry," says Mr Macomary, clearing away some old newspapers. "It's a special place. I just don't have the power to make it more nicely."
Mr Bizos looks around in the gloom. "If we brought Mr Mandela here now, it would break his heart," he says. To the Mandela family, Mr Bizos is Uncle George. Although he is still very active as a human rights lawyer, he is often interrupted by telephone calls asking him to come to a house in the elegant northern suburb of Houghton.
That is where Nelson Mandela is in deep retirement - 10 years older than Mr Bizos, and now rarely seen in public. Occasionally he slips out to attend a grandchild's graduation or to visit his home village near the coast. But he tires quickly, and his short-term memory is fading.
The Chinese man behind the till is complaining about the criminals in the area.
"There's a derelict building on the next block. Chancellor House. It's full of criminals," he says sharply. Mr Bizos' crumpled, 82-year-old back straightens - his barrister's instincts alerted.
"That house," he explains patiently, "is occupied by dozens of squatters who have no alternative accommodation. They should not be casually categorised as criminals."
It is a good 50 years now since Mr Bizos first bought lunch at this cafe.
He and his friend Nelson Mandela used to come at least once a week to grab a couple of pies and take them back to Mr Mandela's office around the corner. As a white man, born in Greece, Mr Bizos could have eaten at the cafe. But in those days black people were not allowed to sit down here. On the way out today, two men in workmen's clothes stop Mr Bizos and ask if they can shake his hand.
Historic placeOne block down Fox Street, opposite the Magistrate's court, is the derelict, three-storey building the Chinese man was complaining about. The walls are blackened by fire. Half a dozen young men are standing outside it. There is a strong smell of marijuana and rubbish. "A lot of memories," says Mr Bizos, smiling at the crowd then slowly climbing the pitch-black stairwell of Chancellor House, up to the water-logged landing on the first floor.
At the far end, a makeshift door opens into what was once Mr Mandela's office - the very first black law firm in South Africa and a place that used to be besieged by clients.
Today it is occupied by a 38-year-old unemployed electrician, Dick Macomary, and his growing family. There is a mattress on the floor, pots and pans, and some clothes drying by the boarded-up windows. "Sorry," says Mr Macomary, clearing away some old newspapers. "It's a special place. I just don't have the power to make it more nicely."
Mr Bizos looks around in the gloom. "If we brought Mr Mandela here now, it would break his heart," he says. To the Mandela family, Mr Bizos is Uncle George. Although he is still very active as a human rights lawyer, he is often interrupted by telephone calls asking him to come to a house in the elegant northern suburb of Houghton.
That is where Nelson Mandela is in deep retirement - 10 years older than Mr Bizos, and now rarely seen in public. Occasionally he slips out to attend a grandchild's graduation or to visit his home village near the coast. But he tires quickly, and his short-term memory is fading.
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Mandela office Nelson
Iran new makes enrichment uranium challenge

Iran's President Mahmoud Ahmadinejad has asked the country's nuclear chief to begin enriching uranium to 20%. The US defence secretary urged the world to "stand together", saying there was still time for sanctions to work. The West fears Iran is trying to develop nuclear weapons - and have threatened new sanctions. Iran insists its programme is peaceful.
The US defence secretary urged the world to "stand together", saying there was still time for sanctions to work. "Pressures that are focused on the government of Iran, as opposed to the people of Iran, potentially have greater opportunity to achieve the objective," Robert Gates said during a visit to Italy. In London, the Foreign Office said Mr Ahmadinejad's announcement was "clearly a matter of serious concern". "This would be a deliberate breach of five UNSCRs [United Nations Security Council Resolutions]," it said in a statement. In January, diplomats said Iran had informed the International Atomic Energy Agency (IAEA) that it did not accept the terms of the deal agreed in October by Iran, the IAEA and the P5+1 - the US, Russia, China, UK and France plus Germany. Earlier this week, the US, Britain and France circulated a discussion paper on further possible sanctions against Tehran. But China says the P5+1 must remain patient and keep pursuing a diplomatic solution to the issue. Red lineMr Ahmadinejad made the announcement on Iranian state television - two days after his foreign minister said a deal on swapping enriched uranium for nuclear fuel was close - a claim greeted with scepticism by Western powers. "I had said let us give them [Western powers] two to three months, and if they don't agree, we would start ourselves," Mr Ahmadinejad said in a speech broadcast live.
"Now Dr [Ali Akbar] Salehi, start to make the 20% with the centrifuges," the president said, addressing Iran's nuclear chief who was sitting in the audience at a laser technology plant in Tehran. Civilian nuclear power requires uranium enriched to about 3%. Weapons grade uranium needs to be enriched to 90%.
The Tehran correspondent Jon Leyne, reporting from London, says Mr Ahmadinejad's announcement crosses a significant red line. Iran says it wants to supply a research reactor with highly enriched uranium following the breakdown of the international deal to provide fuel for it.
But some Western analysts say Iran does not possess the technical know-how to make fuel rods for the reactor, our correspondent says, and Western countries fear this could be a stepping stone towards the manufacture of weapons-grade material.
At the very least, this is a provocative act which will make negotiations more difficult, our correspondent says. Existing UN sanctions are meant to prevent the flow of any items or technology which might aid Iran in enriching uranium or developing nuclear weapon delivery systems. The sanctions range from actual sales or supplies to dealings with named individuals.
The US defence secretary urged the world to "stand together", saying there was still time for sanctions to work. "Pressures that are focused on the government of Iran, as opposed to the people of Iran, potentially have greater opportunity to achieve the objective," Robert Gates said during a visit to Italy. In London, the Foreign Office said Mr Ahmadinejad's announcement was "clearly a matter of serious concern". "This would be a deliberate breach of five UNSCRs [United Nations Security Council Resolutions]," it said in a statement. In January, diplomats said Iran had informed the International Atomic Energy Agency (IAEA) that it did not accept the terms of the deal agreed in October by Iran, the IAEA and the P5+1 - the US, Russia, China, UK and France plus Germany. Earlier this week, the US, Britain and France circulated a discussion paper on further possible sanctions against Tehran. But China says the P5+1 must remain patient and keep pursuing a diplomatic solution to the issue. Red lineMr Ahmadinejad made the announcement on Iranian state television - two days after his foreign minister said a deal on swapping enriched uranium for nuclear fuel was close - a claim greeted with scepticism by Western powers. "I had said let us give them [Western powers] two to three months, and if they don't agree, we would start ourselves," Mr Ahmadinejad said in a speech broadcast live.
"Now Dr [Ali Akbar] Salehi, start to make the 20% with the centrifuges," the president said, addressing Iran's nuclear chief who was sitting in the audience at a laser technology plant in Tehran. Civilian nuclear power requires uranium enriched to about 3%. Weapons grade uranium needs to be enriched to 90%.
The Tehran correspondent Jon Leyne, reporting from London, says Mr Ahmadinejad's announcement crosses a significant red line. Iran says it wants to supply a research reactor with highly enriched uranium following the breakdown of the international deal to provide fuel for it.
But some Western analysts say Iran does not possess the technical know-how to make fuel rods for the reactor, our correspondent says, and Western countries fear this could be a stepping stone towards the manufacture of weapons-grade material.
At the very least, this is a provocative act which will make negotiations more difficult, our correspondent says. Existing UN sanctions are meant to prevent the flow of any items or technology which might aid Iran in enriching uranium or developing nuclear weapon delivery systems. The sanctions range from actual sales or supplies to dealings with named individuals.
Digital Economy Bill Bill would be a "violation"

An influential group of MPs and colleagues said that the government tackle illegal file-sharing can be violated rights of Internet users.Select Joint Committee on Human Rights said the Government Bill in the digital economy should be clarified.He said that the technical measures - which fixed reserve pirates - "were not specific enough."Besides, he said he was concerned that the bill could lead to "over-broad powers.""The Internet constantly new challenges for policymakers, but this can not justify the ill-defined or sweeping legislative responses, especially when an opportunity to freedom of expression or the privacy of individual users to reduce," said Andrew Dismore MP and chairman of the Committee.A spokesman for the Department of Business, Innovation and Skills (a), which oversees the digital economy, Bill, said the government "always been clear that [the] proposals to combat illegal file-sharing should not be incompatible with human rights.
Wednesday, February 3, 2010
The Miracle of Vitamin D: Sound Science, or Hype?

Imagine a treatment that could build bones, strengthen the immune system and lower the risks of illnesses like diabetes, heart and kidney disease, high blood pressure and cancer.
Some research suggests that such a wonder treatment already exists. It’s vitamin D, a nutrient that the body makes from sunlight and that is also found in fish and fortified milk.
Yet despite the health potential of vitamin D, as many as half of all adults and children are said to have less than optimum levels and as many as 10 percent of children are highly deficient, according to a 2008 report in The American Journal of Clinical Nutrition
As a result, doctors are increasingly testing their patients’ vitamin D levels and prescribing daily supplements to raise them. According to the lab company Quest Diagnostics, orders for vitamin D tests surged more than 50 percent in the fourth quarter of 2009, up from the same quarter a year earlier. And in 2008, consumers bought $235 million worth of vitamin D supplements, up from $40 million in 2001, according to Nutrition Business Journal.
But don’t start gobbling down vitamin D supplements just yet. The excitement about their health potential is still far ahead of the science. Although numerous studies have been promising, there are scant data from randomized clinical trials. Little is known about what the ideal level of vitamin D really is, whether raising it can improve health, and what potential side effects are caused by high doses.
And since most of the data on vitamin D comes from observational research, it may be that high doses of the nutrient don’t really make people healthier, but that healthy people simply do the sorts of things that happen to raise vitamin D. “Correlation does not necessarily mean a cause-and-effect relationship,” said Dr. JoAnn E. Manson, a Harvard professor who is chief of preventive medicine at Brigham and Women’s Hospital in Boston.
“People may have high vitamin D levels because they exercise a lot and are getting ultraviolet-light exposure from exercising outdoors,” Dr. Manson said. “Or they may have high vitamin D because they are health-conscious and take supplements. But they also have a healthy diet, don’t smoke and do a lot of the other things that keep you healthy.” Dr. Manson is leading a major study over the next five years that should provide answers to these questions and more. The nationwide clinical trial is recruiting 20,000 older adults, including men 60 and older and women 65 and older, to study whether high doses of vitamin D and omega-3 fatty acids from fish-oil supplements will lower risk for heart disease and cancer. (Learn about taking part in the study at www.vitalstudy.org )
Dr. Manson said fish-oil supplements were included in the study because they are another promising treatment that suffers from a dearth of clinical trial evidence. In addition, both vitamin D and fish oil are known to have an anti-inflammatory effect, but each works through a different pathway in the body, so there may be an added health benefit in combining them. Study participants will be divided into four groups. One will take both vitamin D and fish oil pills. Two will take either a vitamin D or a fish-oil supplement and a placebo. The fourth will take two placebo pills.
Vitamin D is found throughout the body and acts as a signaling mechanism to turn cells on and off. Right now, the recommended dose from food and supplements is about 400 internationa units a day for most people, but most experts agree that is probably too low. The Institute of Medicine is reviewing guidelines for vitamin D and is expected to raise the recommended daily dose. Study participants will take 2,000 I.U.’s of vitamin D3, believed to be the form most easily used by the body. The study will use one-gram supplements of omega-3 fish oil, about 5 to 10 times the average daily intake.
The vitamin D dose is far higher than what has been used in other studies. The well-known Women’s Health Initiative study for instance, tracked women taking 400 units of vitamin D and 1,000 milligrams of calcium. The study found no overall benefit from the supplements, although women who consistently took their pills had a lower risk of hip fracture. Even so, many experts think 400 units is far too low for any additional health benefits.
Another study, of 1,200 women looked at the effects of 1,500 milligrams of calcium and 1,000 units of vitamin D. Women who took both supplements showed a lower risk for breast cancer over the next four years, but the numbers of actual cases — seven breast cancers in the placebo group and four in the supplement group — were too small to draw meaningful conclusions. Although consumers may be tempted to rush out and start taking 2,000 I.U.’s of vitamin D a day, doctors warn against it. Several recent studies of nutrients, including vitamins E and B, selenium and beta carotene, have proved disappointing — even suggesting that high doses do more harm than good, increasing risk for heart problems, diabetes and cancer, depending on the supplement.
Despite the promise of vitamin D in observational studies, research into other supplements shows it’s difficult to document a benefit in otherwise healthy people, and virtually impossible to predict potential harms, notes Dr. Eric A. Klein, chairman of the Glickman Urological and Kidney Institute at the Cleveland Clinic. Dr. Klein recently worked as national coordinator for Select, a study of vitamin E and selenium for prostate cancer .The study seemed promising, but in the end it showed no benefit from the supplements and a potentially higher risk for diabetes in selenium users.
“My sentiment is that the lesson we have learned form large trials with other vitamin supplements, including Select, is that there is no proven health or preventative benefit for dietary supplements in nutritionally replete populations, which accounts for most of the people who enter this sort of clinical trial,” Dr. Klein said. “It makes more sense to me to study dietary supplements or vitamins in populations who are deficient.” People most at risk for vitamin D deficiency are older, have diabetes or kidney disease, stay indoors or have darker skin. African-American teenagers are at particularly high risk, possibly because in addition to their dark skin, they are less likely at that age to drink milk or play outside.
Some research suggests that such a wonder treatment already exists. It’s vitamin D, a nutrient that the body makes from sunlight and that is also found in fish and fortified milk.
Yet despite the health potential of vitamin D, as many as half of all adults and children are said to have less than optimum levels and as many as 10 percent of children are highly deficient, according to a 2008 report in The American Journal of Clinical Nutrition
As a result, doctors are increasingly testing their patients’ vitamin D levels and prescribing daily supplements to raise them. According to the lab company Quest Diagnostics, orders for vitamin D tests surged more than 50 percent in the fourth quarter of 2009, up from the same quarter a year earlier. And in 2008, consumers bought $235 million worth of vitamin D supplements, up from $40 million in 2001, according to Nutrition Business Journal.
But don’t start gobbling down vitamin D supplements just yet. The excitement about their health potential is still far ahead of the science. Although numerous studies have been promising, there are scant data from randomized clinical trials. Little is known about what the ideal level of vitamin D really is, whether raising it can improve health, and what potential side effects are caused by high doses.
And since most of the data on vitamin D comes from observational research, it may be that high doses of the nutrient don’t really make people healthier, but that healthy people simply do the sorts of things that happen to raise vitamin D. “Correlation does not necessarily mean a cause-and-effect relationship,” said Dr. JoAnn E. Manson, a Harvard professor who is chief of preventive medicine at Brigham and Women’s Hospital in Boston.
“People may have high vitamin D levels because they exercise a lot and are getting ultraviolet-light exposure from exercising outdoors,” Dr. Manson said. “Or they may have high vitamin D because they are health-conscious and take supplements. But they also have a healthy diet, don’t smoke and do a lot of the other things that keep you healthy.” Dr. Manson is leading a major study over the next five years that should provide answers to these questions and more. The nationwide clinical trial is recruiting 20,000 older adults, including men 60 and older and women 65 and older, to study whether high doses of vitamin D and omega-3 fatty acids from fish-oil supplements will lower risk for heart disease and cancer. (Learn about taking part in the study at www.vitalstudy.org )
Dr. Manson said fish-oil supplements were included in the study because they are another promising treatment that suffers from a dearth of clinical trial evidence. In addition, both vitamin D and fish oil are known to have an anti-inflammatory effect, but each works through a different pathway in the body, so there may be an added health benefit in combining them. Study participants will be divided into four groups. One will take both vitamin D and fish oil pills. Two will take either a vitamin D or a fish-oil supplement and a placebo. The fourth will take two placebo pills.
Vitamin D is found throughout the body and acts as a signaling mechanism to turn cells on and off. Right now, the recommended dose from food and supplements is about 400 internationa units a day for most people, but most experts agree that is probably too low. The Institute of Medicine is reviewing guidelines for vitamin D and is expected to raise the recommended daily dose. Study participants will take 2,000 I.U.’s of vitamin D3, believed to be the form most easily used by the body. The study will use one-gram supplements of omega-3 fish oil, about 5 to 10 times the average daily intake.
The vitamin D dose is far higher than what has been used in other studies. The well-known Women’s Health Initiative study for instance, tracked women taking 400 units of vitamin D and 1,000 milligrams of calcium. The study found no overall benefit from the supplements, although women who consistently took their pills had a lower risk of hip fracture. Even so, many experts think 400 units is far too low for any additional health benefits.
Another study, of 1,200 women looked at the effects of 1,500 milligrams of calcium and 1,000 units of vitamin D. Women who took both supplements showed a lower risk for breast cancer over the next four years, but the numbers of actual cases — seven breast cancers in the placebo group and four in the supplement group — were too small to draw meaningful conclusions. Although consumers may be tempted to rush out and start taking 2,000 I.U.’s of vitamin D a day, doctors warn against it. Several recent studies of nutrients, including vitamins E and B, selenium and beta carotene, have proved disappointing — even suggesting that high doses do more harm than good, increasing risk for heart problems, diabetes and cancer, depending on the supplement.
Despite the promise of vitamin D in observational studies, research into other supplements shows it’s difficult to document a benefit in otherwise healthy people, and virtually impossible to predict potential harms, notes Dr. Eric A. Klein, chairman of the Glickman Urological and Kidney Institute at the Cleveland Clinic. Dr. Klein recently worked as national coordinator for Select, a study of vitamin E and selenium for prostate cancer .The study seemed promising, but in the end it showed no benefit from the supplements and a potentially higher risk for diabetes in selenium users.
“My sentiment is that the lesson we have learned form large trials with other vitamin supplements, including Select, is that there is no proven health or preventative benefit for dietary supplements in nutritionally replete populations, which accounts for most of the people who enter this sort of clinical trial,” Dr. Klein said. “It makes more sense to me to study dietary supplements or vitamins in populations who are deficient.” People most at risk for vitamin D deficiency are older, have diabetes or kidney disease, stay indoors or have darker skin. African-American teenagers are at particularly high risk, possibly because in addition to their dark skin, they are less likely at that age to drink milk or play outside.
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