D: Research at MUSC
Guest: Dr. Carol Wagner - Pediatrics
Host: Dr. Linda Austin – Psychiatry
Linda Austin: I’m Dr. Linda Austin. I’m talking, today, with Dr. Carol Wagner who
is Professor of Pediatrics at the Medial University of South Carolina. Dr. Wagner, you’re engaged in some very
interesting research in the area of vitamin D and babies’ nutrition. Tell us about the clinical trials that you
have ongoing in that area.
Wagner: Sure. I work with Dr. Bruce Hollis who’s a renowned
vitamin D scientist. And, about, now,
eight years ago, we had discussions about the needs of vitamin D in pregnant
and lactating women, and we began those studies here. It is a very exciting area of research. And, in the last four years, we’ve seen,
truly, an explosion in the number of studies that have been performed
throughout the world. We are on the
forefront of this research. We are
conducting a total of three studies specifically with vitamin D, two involving
pregnant women and one involving lactating women.
very excited to have these studies. Two
are sponsored by the National Institutes of Health (NIH) and one from the
Thrasher Research Fund (TRF). It allows
us to determine what the vitamin D requirements are of pregnant women and
lactating women. The premise is that the
prenatal vitamin that’s given to pregnant women is not enough. And, in fact, what we find is, baseline
levels of vitamin D, women who’ve been on prenatal vitamins and their entry
into the study at 12 weeks gestation, so that’s the first trimester of
pregnancy, the vast majority of them, particularly if they’re African-American,
are vitamin D insufficient. And, at
least 60 percent of African-American women in our study are vitamin D
deficient. That’s a significant
lighter pigmented individuals, we find a significant number who are vitamin D
insufficient or deficient. That means
their fetus is developing in an environment of vitamin D deficiency, and we’re
just beginning to find out what the long-term health implications are of
that. We know that vitamin D deficiency
is linked with many diseases that occur later on in adulthood. That’s probably why it’s taken decades of
research to identify vitamin D as the culprit.
Linda Austin: What are those diseases
that it may be linked to?
Carol Wagner: It’s associated through
the innate immune system, which is a very important part of our immune system,
with cancer, such as breast cancer, colon cancer, prostate cancer, inflammatory
diseases like coronary artery disease.
There was a study that just came out two weeks ago that showed people
who are vitamin D deficient have an independent risk factor for heart
disease. We also know that it’s linked
with autoimmune diseases, such as lupus, rheumatoid arthritis, multiple
sclerosis. That doesn’t mean that if you
have a good level of vitamin D you won’t get these diseases, but we’re talking
about risks of these diseases.
study that’s involving breastfeeding women and their infant, it’s been long
known that milk from women from various parts of the United States have lower
levels of vitamin D. No one ever asked
why that was. And, in fact, if a woman
is vitamin D deficient, her milk is going to be deficient and, therefore, her
baby is deficient. Women who are of
darker pigmentation are at higher risk of that deficiency. So, what we see is, those babies, who are breastfed, are at higher risk for
rickets. But, rickets, as Dr. Michael
Holick at Boston University says, is the tip of the
vitamin D iceberg, and it really is.
study here, we’re studying lactating women and supplementing them with higher
doses of vitamin D; their babies are not supplemented. We’re blinded to that, so we have, of course,
a control group. We have done pilot
studies and shown very exciting results.
In women who are replete in vitamin D, their milk shows excellent levels
of vitamin D and, therefore, their babies have levels that are equivalent to
those who actually got the supplement.
And we’re now doing a much larger trial that’s taking place here and at
the University of Rochester, in Rochester,
NY. We will enroll 389 mothers and their babies
over the next, we’ve been doing it for a year, four years, and we expect
Linda Austin: I can’t resist asking this
question. As a psychiatrist, are there
any conjectures about vitamin D deficiency and behavioral problems? I’m just thinking, behavioral problems and
attention deficit disorder (ADD) are so common, such common disorders, you just
wonder what might be behind that.
Carol Wagner: I think that there are
genetic studies that they’re doing in Europe, looking for schizophrenia for the
same family linkages, where they’ve had those family members who’ve been in the
Caribbean versus those who’ve been in the United Kingdom, and seen some hints
of that. There has been some literature
to suggest that autism is linked with vitamin D deficiency. And seasonal affective disorder (SAD), of
course, the light box, which was created in Rochester, NY,
looks at it. Those individuals have a
much higher risk of vitamin D deficiency.
If you look at multiple sclerosis, which is a CNS disease, central
nervous system disease, those individuals are at risk, geographically, who’ve
been in the northern latitudes of North America.
that we’re just beginning to understand vitamin D and I expect that, within the
next five years, we’re going to have some startling results about that. And I think that it’s going to take
psychiatrists and psychologists and people who are studying brain function to
really look at it carefully. I can tell
you that vitamin D insufficiency and deficiency is not going to help your brain
because there are receptors in the brain.
We look at, in rat models, for example, the relevance of the rat to the
human. What we see is that there are
morphologic changes. If the rat mother
is deficient in vitamin D, we can see changes in the rat and in the behavior of
the offspring, in terms of locomotion and being able to go through a maze. How that extrapolates, how that extends to
the human, is unknown. But I expect that
we’re going to see some really startling results.
Linda Austin: Dr. Wagner, thanks so much
for talking with us today.
Carol Wagner: Thank you.
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