January 26, 2017


Director's Letter 
Carole Baggerly 
Director, GrassrootsHealth 

Racial disparity in health is brought up in many public health forums, especially for cities or regions that have a high African American population. Last week's newsletter brought up some points, and we wanted to expand on that information with a webinar from 2013 that is still very relevant today.

In addition to this video on Vitamin D & Race, GrassrootsHealth has a number of informational videos on a wide range of specific topics. I encourage you to go to our video web page and browse through what we have available. You may find one on a topic or condition that is important to you, or you may find one that you can use to introduce someone you care about to vitamin D.

For example, if you have a friend or family member suffering with diabetes, why not send them a link to a video on vitamin D and diabetes? Include information about your vitamin D level and the last time you tested (i.e. I last tested in November and my D level was 50 ng/ml). That way you can encourage them to test through daction.org and can help them raise their D levels to the recommended 40-60 ng/ml.

Please forward this email to all who would be interested
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Carole Baggerly
Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research into Practice NOW!

     Vitamin D & Race

Racial & Ethnic Disparities in Infant Mortality... a vitamin D problem?

Vitamin D & Race
William B. Grant, PhD
Sunlight, Nutrition and Health Research Center
February 2013

Dr. William Grant is an epidemiologist and founder of the nonprofit organization Sunlight, Nutrition and Health Research Center (SUNARC). Grant holds a PhD in Physics from UC Berkeley and worked as a senior research scientist in the field of optical and laser remote sensing of the atmosphere and atmospheric sciences at SRI International, the Jet Propulsion Laboratory, and the NASA Langley Research Center. His career included pioneering development of laser remote sensing instrumentation, while the latter half included participating on many NASA-led airborne atmospheric chemistry field missions to the far corners of the world. Since 2000, he has focused on ultraviolet-B (UVB) radiation and vitamin D and their relation to cancer and other diseases. He has written over 140 peer-reviewed articles and editorials on vitamin D and health, edited two books, and contributed half a dozen chapters to other books.

What is the cause of black-white disparities in infant mortality rates?

Hauck et al., in their paper Racial and ethnic disparities in infant mortality, cited that black infants are 2.5 times more likely to die than white infants. MacDoman et al. cite this elevated mortality is due to higher preterm birth rates in non-Hispanic blacks. Grant cites that preterm birth and low birth weight are very closely related. Being born small and early are both risk factors for infant mortality.

Effects of vitamin D deficiency during pregnancy

Low vitamin D levels during pregnancy are associated with increased risk of preterm birth and low birth weight and factors linked to gestational diabetes, preeclampsia, and bacterial vaginosis.

A study by Zhang et al. concluded that pregnant women with lower vitamin D levels had a greater risk of gestational diabetes, even to the point of every drop of 5 ng/ml was related to an increase of 30% in gestational diabetes risk.

A study by Bodnar et al. showed as vitamin D levels increase from low to high, the risk of preeclampsia decreases. Since the time of this webinar a new study by Mirzakhani et al. found that women who had vitamin D levels above 40 ng/ml at conception had virtually no preeclampsia.

An ongoing field trial at the Medical University of South Carolina has been running for over a year. More than 3000 women in this predominantly black community had their vitamin D levels tested at their first prenatal visit and were given supplements and information on the importance of having a vitamin D level of at least 40 ng/ml. Pregnancy outcomes including gestational diabetes, preeclampsia and preterm birth have been measured and preliminary results will be reported in the coming months.

Differences in vitamin D levels between black and white women

Grant shows vitamin D levels collected in the National Health and Nutrition Examination Survey (NHANES) from 2004-2008. Black women had an average of 14 ng/ml, and white women had double that amount, 28 ng/ml. Since then GrassrootsHealth has reported on the new NHANES data and the most compelling chart shows that almost all black women are below the recommended 40 ng/ml (100 nmol/L).

Alternate explanations?

Other maternal risk factors for infant mortality include smoking, obesity, exposure to outdoor air pollution, having had 2 or more previous pre-term births, low water intake, and heavy alcohol or cocaine use. Grant notes that obesity seems to be a more important risk factor for whites than blacks.


Vitamin D deficiency is a significant risk factor for pregnancy outcomes and is more common in dark skinned ethnic groups.

Based on the randomized controlled trial by Hollis et al., we recommend all pregnant women test and raise vitamin D levels to at least 40 ng/ml. For most women, this requires vitamin D supplementation of approximately 4,000-5,000 IU/day. 

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Racial and ethnic disparities in infant mortality
Hauck FR et al.
Seminars in Perinatology
August 2011
Read Paper

Early pregnancy vitamin D status and risk of preeclampsia
Mirzakhani H. et al.
Brigham and Women's Hospital
The Journal of Clinical Investigation
November 14, 2016
Read Paper

Understanding racial and ethnic disparities in US infant mortality rates
MacDorman MF et al.
NCHS Data Brief
September 2011
Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis
Wei SQ et al.
The Journal of Maternal-Fetal & Neonatal Medicine
January 2013
Read Paper

Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus
Zhang C et al.
November 2008

Maternal Vitamin D deficiency increases the risk of preeclampsia
Bodnar LM et al.
Journal of Clinical Endocronology
September 2007

Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness
Hollis BW et al.
Journal of Bone and Mineral Research
October 2001

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