February Summary

An overwhelming amount of readers suggested that conclusions cannot be drawn off this single article. Some of you pointed out the great design of the study including choice of fats, number of blood draws, and diet history. Others made great points about the limitations of this study such as choice of fats, time period, and limited cause and effect relationship. Many also made suggestions about future research and manipulations of this study that would allow us to infer more conclusive answers. Vivian, however, suggested that these manipulations would make this research study very tedious and difficult to trial. 

Most of you felt that the study was ethical in the choice to supplement with such high levels of vitamin D and pointed out that had it not been, the IRB would not have approved it. A valid point was also made that even though it was a blind study, subjects should be made known their potential risks. Most of you also stated that this was appropriate for one day, however should the study be extended, alternate methods should be considered. It was made clear by the researchers that a high level of vitamin D supplement was used in order to identify grave changes in serum vitamin D levels. However, as John pointed out, we must be careful not to assume the take away message. Tuft’s is not suggesting this high level of supplementation.

In the final question, most agreed supplementation is appropriate for deficient populations. There was a hint of hesitation from all with our strong tendency to eat first and in this case expose yourself to sun. However as most of you pointed out, the colder months pose a challenge. Some felt it was hard to recommend a supplement due to the general lax in regulation.

Recommendations for Practice:

 Supplements continue to be a tricky area for dietitians who focus on food first and ethical practices. It is important to reinforce to patients that we need to know what supplements or drugs they are on, so we can provide the best nutrition prescription. At this point in the game, I think we would all agree it’s too early to draw generalizable conclusions on dietary fat intake and vitamin D absorption. At this time for those taking Vitamin D supplements, it would be my recommendation to educate the client about side effects or toxicity warning signs, and advise them to take the supplement at meal time.