Vitamin D and the Sun

By Jane Sylvestre, RD - 6/30/2016

Enjoy a Little Bit of Sun this Summer!

Vitamin D for Bariatric Surgery

I recently attended a conference where I heard a lecture from a vitamin D expert, Monica Nelson, PhD, MPH, RD.  She was amazing and shared so much great information that I would love to recap for you.

Most people are aware that our bodies make vitamin D from the sun.  The speaker reminded us that most people, especially those that live in New England, tend to be vitamin D deficient.  We just don’t get outside enough.  That means that patients may even be low in vitamin D before having bariatric surgery.  Here is a new fact that I learned myself.  The amount of vitamin D that a person absorbs depends on their latitude in relation to the sun.  In Massachusetts, we are at 42% which means that we absorb ZERO vitamin D in the winter.  Summer is a different story and a person can meet their requirements of vitamin D with just 10 minutes per day of just the hands and face to meet their needs.  The most updated recommendation is 1,000-2,000 IU of vitamin D/day.  Our patients should shoot for 3,000 IU per day based on some reasons noted below.  Keep reading…   After that, be sure to put on some sunscreen, you don’t want skin cancer either!  Another good point is that you cannot overdose on vitamin D from the sun.    Toxicity may occur with over 10,000 IU from supplements and/or diet.  

We always recommend that our patients take 500-600 mg calcium citrate with vitamin D twice per day.   Most calcium supplements come with vitamin D already added.  The reason for this is that vitamin D actually helps you absorb calcium better.  Also, the twice per day is important.  Both calcium and vitamin D are absorbed better in more frequent smaller doses.  Read the label for directions.  The directions always suggest that you split your dose with at least 4 hours in between.  You can’t absorb it all at once.  The higher the dose you take at once, the less you will absorb!  We suggest the form of calcium as calcium citrate and the form of vitamin D as vitamin D3 which is also called cholecalciferol.  Vitamin D2, also known as Ergocalciferol, is not absorbed as well as the D3.  Here are some interesting stats:  only 10-15% of calcium is absorbed without vitamin D, 30% is absorbed with optimal vitamin D and 80% is absorbed during growth years.  The body is so miraculous.  The body takes what it needs, when it needs it!  

An interesting note is that obese patients are more likely to be vitamin D deficient because vitamin D is a fat absorbable vitamin and the excess fat stores higher levels of vitamin D.  This means that the vitamin D does not get to the liver and is not as readily available for bones and its functions as needed.  Also note that many obese people do not get as much exposure to the sun.  As a patient loses weight, vitamin D is released from the fat stores and becomes mobilized and able to be used as needed.  

Why is vitamin D more likely to be deficient in our patients?  With the Sleeve Gastrectomy surgery, vitamin D is accelerated through the GI track which decreases the amount of time the vitamin D has to be absorbed.  The Lap-Band does not affect absorption.   Absorption would be affected more so depending on the amount of body fat.  

So why is vitamin D so important?  Vitamin D may help prevent breast, prostate and ovarian cancer.  Vitamin D helps to control, and may even decrease, the incidence of autoimmune diseases such as multiple sclerosis, type 1 DM, and rheumatoid arthritis.  Vitamin D may also decrease inflammation, improve immune function, help control irritable bowel disease and have a role in managing autism.  Most importantly vitamin D helps in the management of maintaining bone density.  Remember our bone density tends to decline significantly after age 35.  Build up your bones until then and then keep getting enough vitamin D to maintain your bone stores.  

There you have it…You now have a reason to spend a little time in the sun… that would be about 10 minutes per day before you add that sunscreen!  Lose weight and get adequate vitamins and minerals to be strong, healthy and your personal best!  Happy summer.  Jane

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