Insights from the Editor

How much vitamin D should you get every day: 200 units, 600 units or 2000 units? Confused? We're not surprised. New government guidelines have a lot of people scratching their heads.

The Institute of Medicine (an arm of the nonprofit National Academy of Sciences that, among other things, sets governmental nutrient levels) tripled the recommended amount of vitamin D most Americans should get every day to 600 international units (IUs)—that's up from 200 IUs set in 1997.

But many in health care advocate getting even more. Vitamin D (which is found in a few foods like salmon, but is mainly produced by the body through sun exposure) has been proven to help keep bones strong. Recent studies have also found links between low vitamin D levels and a host of other ills, including: certain cancers, heart disease and stroke, diabetes, depression and cognitive decline, and auto-immune disorders.

So, how much vitamin D do we really need? Sometimes it's hard teasing out hard-core science from trends and wishful thinking. Remember the oat-bran craze? And the antioxidant (vitamins C and E) craze? None of these turned out to be the so-called "magic pill" that would keep us healthy. Is vitamin D overrated, or should we really be getting more?

Everwell asked Dr. Melina Jampolis, a physician nutrition specialist, about getting the right amount of vitamins and minerals in general, and vitamin D in particular.

Question: What can the average person do when it comes to recommendations for daily allowances of vitamins and minerals?

Dr. Jampolis: I think the best approach for most is to take a complete daily multivitamin and eat a well balanced diet with plenty of fruits, veggies, low fat dairy and whole grains.

We know that getting nutrients from food is the best—and it is getting easier to do so with vitamin D-fortified foods as well. The multi will ensure that you are getting minimum adequate amounts for disease prevention and the balanced diet will help you attain nutrients including vitamins and minerals, necessary for optimal health.

Q: With respect to vitamin D, did the Institute of Medicine (IOM) go far enough? Does policy lag behind science?

Dr. Jampolis: I was a bit surprised that they was not a bigger change since there is constantly emerging science on the numerous benefits of vitamin D and there appears to be minimal downside to supplementation, which is suggested by the fact that they increased the tolerable upper limit to 4000 IU per day.

The IOM felt that the data on chronic diseases such as cancer, diabetes, and heart disease were not definitive and so they made their recommendations based solely on bone health. This is reasonable but it will take quite a while to do convincing long-term studies looking at the role of vitamin D in these diseases.

So in my opinion, if there is potential benefit, minimal risk, and it is not expensive, I'd rather go a bit higher, especially since we clearly avoid the sun more than we did 50 years ago due to skin concerns (leading to a clear potential drop in naturally-produced vitamin D in most people).

Q: What about people who promote taking megadoses of certain vitamins ? Is that safe? Wise? Helpful?

Dr. Jampolis: Megadosing is not a good idea in most cases. Vitamin E megadoses have actually been found to increase risk of death in some.

Vitamin C does not appear to increase risk of death but excess supplementation may not have any effect at all. It is really safest to get most of these things from foods because they come in packages with numerous other complementary and protective nutrients and it is virtually impossible to take in megadoses from food. It is important to understand that many nutrients work together so taking megadoses could lead to imbalances. This is particularly true with minerals such as calcium, iron and zinc.

To read more on the new government recommendations for vitamin D intake, visit the Institute of Medicine's website.