Dr Michael Evans talks about the single best thing someone can do for their health and in only 30 minutes a day…

If you spent any time on Google today (September 16th), you may have noticed the Google Doodle with the oranges and other fruit as part of the Google logo.

Is Google entering the health food market?

Nope. ITs just Google’s way of bringing attention to the 118th birthday of Albert Szent-Gyorgyi, the Nobel prize winning Hungarian scientist credited with the discovery of Vitamin C.

Read more about Albert Szent-Gyorgyi at the Wall Street Journal and on Wikipedia

A new study from Kaiser Permanente Medical Care Program in Northern California suggests that women who take a specific class of anti-depressant medications, the selective serotonin reuptake inhibitors (SSRI), have a higher risk of having a child with autism or autism spectrum disorder such as Aspberger’s Syndrome than women that didn’t take anti-depressants either in the 3 months during, or during their pregnancy.

The study authors did not feel that the actual diagnosis of depression or similar mental illnesses had a significant impact on the development of autism spectrum disorders. A separate arm of the study compared women with depression that either took SSRI anti-depressants or did not take the SSRIs and still found a higher incidence of autism related illnesses in the group of women that were taking the SSRI anti-depressants.

Commentary:

There has been a continuing amount of research on autism and the possible reasons for its increase over the past forty years from 4 to 5 cases per 10,000 (or 0.04%) births in 1966 to approximately 100 cases per 10,000 births (or 1% of births) in 2006 based on the CDC published data.

While environment factors have been touted as one possibility, some studies have shown that the women that have the highest rate of autistic children tend to be somewhat older, highly educated and with a higher household income. A surprising finding since other disorders tend to have the opposite findings, with a higher prevelance in children born to women with less education and a lower economic status.

References:

Archives of General Psychiatry
Wisconsin Medical Journal

In case you were wondering what disease followed October’s Breast Cancer Awareness Month, November is the American Diabetes Month (as well as “Movember” – a prostate cancer awareness campaign where guys get to grow really cool mustaches in order to raise money for prostate cancer). We’ll be highlighting both diabetes and prostate cancer awareness for this month, primarily focusing on…prevention, since I feel that is the most important aspect of medicine. If we can prevent it, then I don’t have to talk to you as a patient about how to treat it or attempt to cure it.

And how cool would that be?

Want more info on American Diabetes Month? Check out the American Diabetes Association

Find out more about “Movember” and raising awareness for prostate cancer.

Very interesting lecture by Robert H. Lustig, MD from University of California San Francisco on “Sugar: The Bitter Truth”

The New York Times reports on a Massachusetts program to give food vouchers to low-income families that are redeemable at local farmers markets for fresh fruits and vegetables in an effort to battle the ever expanding epidemic of childhood obesity.

http://www.nytimes.com/2010/08/13/business/13veggies.html?src=me&ref=business

One common question we receive is “How much vitamin D should I be taking…”

And to answer that question honestly, we really don’t know the exact dose of Vitamin D required by each individual since absorption and storage of Vitamin D can differ (as well as how much vitamin D is produced from daily sun exposure – which is an entire post all together).

The current recommendations for vitamin D supplementation in the U.S. are based on the RDA (Recommended Daily Allowances)

Two studies that I use to justify my recommendations to patients for taking at least 2000 IU per day of vitamin D on most days.

The first study looked at researchers in Antartica during the winter when there is essential no or minimal sunlight. This 2009 study looked at the difference in the researchers’ vitamin D levels over 5 months (March through August of 2007) and found that the group that supplemented with 2000 IU/day were able to increase their average serum vitamin D (25-OH) levels from 45 nmol/L to 71 nmol/L while the 1000 IU/daily of vitamin D group only increased their serum vitamin D levels form 44 nmol/L to 63 nmol/L and the 400 IU/day group had a measurable increase of vitamin D (25-OH) levels from 44 to 57 nmol/L.

The second study I use to justify a higher vitamin D supplementation is a 2008 study that looked at Long Island residents (mixed population of Causasians and African-American) that received vitamin D supplementation with close monitoring and adjustment of their vitamin D supplement dosage to try to raise and maintain their blood serum vitamin D (25-OH) levels above 75 nmol/L. This study found that the patients with lighter pigmented skin required on average, about 3000 IU/day of vitamin D and African-American patients required a higher dose of almost 4000 IU/day to reach the target goal of a serum vitamin D (25-OH) level of 75 nmol/L without anyy reported cases of hypercalcemia among the test subjects.

So based on these two studies as well as personal experience with my patients, I typically recommend that they start at a 2000 IU/day vitamin D supplement and then follow their serum vitamin D (25-OH) levels every two to three months until they reach 75 nmol/L or higher of serum vitamin D (25-OH)

The President’s Cancer Panel has released ther 2008-2009 Annual Report on Reducing Environmental Cancer Risk: What We Can Do Now.

The 150 page report details environmental and chemical exposure as it may increase Americans risk of developing cancer as a result of long-term exposures. Study raises interesting questions regarding the efficacy of government regulation and oversight in United States.