Finally--- New Guidelines on Vitamin D Suggest Against What Many Have Been Told

"Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline" [Link] is free and available. Please note that these guidelines are consistent with what many have been saying for years (see my blog on 8/21/18 and 2/6/20)...the routine screening for Vitamin D in healthy adults, the target levels for 25(OH)D and the need for taking Vitamin D supplements were not based on sound science. These new guidelines will save people from unnecessary testing and reduce the out-of-pocket costs for people. Some highlights:

General Recommendations: Suggest against routine screening for 25(OH)D levels in healthy adults, adults with dark complexion, and adults with obesity. Suggest daily, lower-dose vitamin D for those aged 50 years and older who have indications for vitamin D supplementation or treatment, rather than intermittent, higher-dose vitamin D.

Thresholds for Vitamin D: The panel did not establish specific 25(OH)D thresholds for disease prevention due to the lack of supporting clinical trial evidence. Previous target levels for 25(OH)D, such as 30 ng/mL (75 nmol/L), are no longer endorsed.

Nonpregnant Adults (<50 years): Suggest against empiric vitamin D supplementation above the Dietary Reference Intakes (DRI) established by the Institute of Medicine (IOM). Suggest against routine 25(OH)D testing in this population.

Adults (50-74 years): Suggest against routine vitamin D supplementation above the DRI.Suggest against routine 25(OH)D testing in this population.

 

What women want...information and no commercials

By listening to women and working with a fabulous group of experts we found that Latinas and their health care providers want information on how to be as healthy as possible that (1) does not have any commercial interest driving the message and (2) inspires and reinforces healthy behaviors. As a result we developed a three day seminar that includes the different systems in our bodies and how they interact, risk factors you can control, seeking well-being, importance of reading food and product labels, and much more.  Over 640 community health workers and community leaders have completed the three day seminar.  

We also recognize the limited time many of us have so we distilled the information to a two hour webinar that is self-paced. We released it today to celebrate International Women's Day. It is available in English Link and Spanish Link.

Let me know what you think.

Harmful Health Outcomes (HHO)— Are All About You

To have world class science and the best health outcomes means moving forward in bold ways that will improve the lives of scientists, health care providers, and people. 

For more details read "To advance science we need to address 'otherness' " in Nature Human Behaviour published on 2/2/24. You can access the free online version here or for a free ePrint please click on this link.

Dear Patient---I Only Have Some of Your Health Record.

Most patients believe that once they grant permission that a health care provider has access to their full health history. In fact, what is shared is limited in many ways. Jack Lewin and I had our Commentary on Interoperability and the need for the full patient record published in StatNews.  

Some medical records are very lengthy and go back decades. Is all that information really necessary? It depends on the situation. One reader from Norway shared their story.

"This is interesting, since I recently witnessed how lack of available medical records may change a planned surgical procedure just minutes before an operation.

Norway has less inhabitants than Manhattan, but the principle of making medical records available to all medical health providers, is universal. Over here, Southern Norway has a system whereby all MDs and all hospitals may access any patient medical record, - if (note!) the patient has been treated in southern Norway. If a patient has had an operation in Northern Norway, a health provider in Southern Norway will not learn about this, unless the patient mentions it. And the same goes the other way around, - south vs. north. To my surprise this system has remained for the last 10 years, without health authorities doing anything about it.

On December 4 I was going to have a hernia operation in Bergen, - on the southwest coast of Norway. The hospital has a section specializing in hernia repair with 3 surgeons performing only this kind of operation. They have extensive experience with laparoscopy (lap), and as I met my surgeon on the morning of the operation, she told me that the lap method was their standard procedure, unless the patients' condition dictated otherwise. I then told her that I had been operated for intestinal loop (blockage) back in 1970 in Bodø (Northern Norway), and she was surprised. She had not read anything about that in my medical record, and I showed her the remaining sutures. That made her change her mind regarding her planned way of repairing my hernia just minutes before the operation as the 1970 operation had actually accessed both the stomach lining and cut a muscle. So she decided to make an open repair."

What do you think about the need for access to the full patient record? If AI is seen as the solution how can we expect AI to guide clinical decision making if the data on the patient are at best incomplete. 

We have a long way to go...and we need to get there soon.