March 30, 2017

Director's Letter 
Carole Baggerly 
Director, GrassrootsHealth 

Since 2007, GrassrootsHealth's mission has been to bring the research of vitamin D into practice. Last week was a major milestone in that process. Over 70 doctors and medical students heard the latest research on vitamin D and pregnancy, from many different aspects - rat models, DNA, field trials, and more. Here is a picture of the group making it happen in South Carolina!

What hit home with me was how many dedicated researchers there are in vitamin D research currently and how research in vitamin D has exploded. This is due in part to the pioneers in the field - names like Michael Holick, Robert Heaney, Cedric Garland, and Martin Hewison. And those that are taking the torch and implementing research findings - like Carol Wagner and Bruce Hollis to help implement and study vitamin D and pregnancy at the Medical University of South Carolina. And attending was another generation of researchers, medical students - who
 will carry the torch further yet.
  • We have the research.
  • We have the project implementation methodology.
  • We will see more places conduct nutrient field trials with vitamin D.
  • We will see field trial results confirm research.
Thank you for being part of this journey - you are helping move vitamin D into practice by your membership in D*action. By testing your vitamin D levels every 6 months and providing your health information. You are taking charge of your health.

Carole Baggerly 
Director, GrassrootsHealth 
A Public Health Promotion & Research Organization 
Moving Research into Practice NOW!
  How Much Longer Will We Wait Until We Act?

Results are in from the first nutrient field trial on vitamin D and pregnancy - Protect our Children NOW! This program changed the standard of care for all pregnant women at the Medical University of South Carolina (MUSC). The goal was to screen all pregnant women for vitamin D deficiency, provide free vitamin D supplements (donated by Bio-Tech), and achieve blood serum levels greater than 40 ng/ml (100 nmol/L). While this level is higher than the IOM's recommendations, it is based on research that found vitamin D levels greater than 40 ng/ml reduced preterm birth and many pregnancy conditions such as preeclampsia, post-partum depression, and gestational diabetes. 

GrassrootsHealth designed Protect our Children NOW! to bring vitamin D research into practice - research that showed 4,400-6,400 IU/day was not only safe in pregnancy, but also effective in raising vitamin D levels and improving birth outcomes. Research has also shown that a set supplement amount is not adequate for all women, it is important to test blood levels as everyone processes vitamin D differently. GrassrootsHealth designed the education, implementation, and analysis to change the standard of care and take public health action. Protect our Children NOW! can be replicated in any certified medical center across the globe.

Why do we believe in this research?

Click to Enlarge

Let's Wait until we are sure...

It is widely known today that folic acid can reduce over 50% of neural tube defects and over 28% of congenital heart defects. Currently, all pregnancy literature and articles recommend taking folate at pre-conception. But it wasn't always that way... it took 30 years between research and standard practice. How many children's and parent's lives could have been different if we had acted faster? 

Another example is the delay in changing standard of care for preterm infants in incubators. Between 1941-1951 over 12,000 children were blinded due to oxygen tanks connected to incubators. Doctors in England and Australia were not using oxygen tanks and tried to tell the medical community to change practices - but it took 10 years and blindness in 12,000 children before they did - and oxygen tanks are no longer attached to incubators. 

Why are we slow to act when people's lives are at stake?

We Have Enough Research to Act Now

Bring this information with you to your local hospital and ask them to take action! 

Tell pregnant women you know not to wait for their OB, instead to join the free online program if they are 12-17 weeks pregnant, or if they are beyond that point to join D*action and take charge of their pregnancy today!
Better yet, give them a gift of D*action at their baby shower!

60% Reduction in Preterm Birth

Preliminary Results from a Vitamin D Screening and Supplementation Field Trial to Prevent Preterm Birth
Roger Newman, MD - Professor, OB-GYN, MUSC
(Starting at 4:55 in conference)

Early results from the Medical University of South Carolina between September 2015 and December 2016 found a 60% lower preterm birth risk with maternal vitamin D levels above 40 ng/ml, as compared to vitamin D levels below 20 ng/ml. These findings align closely with those from previous studies showing a 59% lower preterm birth risk when comparing the same vitamin D serum level groups (≥ 40 ng/ml vs. <20 ng/ml). 

In this talk, Dr. Newman states that the goal should be for pregnant women to achieve greater than 40 ng/ml - explaining how vitamin D works within the body for optimal effect and citing results from previous studies to validate this claim.

Why is this significant?

With vitamin D and pregnancy we have progressed to the point that results from initial studies in limited RCT settings and those from a larger clinical setting, a nutrient field trial, have all shown the same thing - an approximate 60% lower risk of preterm birth for women with vitamin D levels greater than 40 ng/ml, as compared to those with vitamin D levels less than 20 ng/ml. 

Below you will see a chart that shows just that - the similar results from the RCT and from this latest nutrient field trial.


The preterm birth rate at MUSC before starting this program was 18%, which is higher than the national rate of 12%.
So, you can imagine there is a great desire at MUSC to reduce preterm birth. 

One subgroup of interest was women with a history of preterm birth as they have an increased risk of preterm birth with subsequent pregnancies. With this nutrient field trial it was shown that women in this high-risk group with vitamin D levels at or above 40 ng/ml, as compared to less than 20 ng/ml, had an 80% lower risk of preterm birth.

Going Forward

There was not complete implementation of the methodology at MUSC in the early stages. Many women received only one vitamin D test, as opposed to multiple tests to be able to help determine the correct supplementation amount per individual. 

MUSC expects better compliance moving forward as the order for the first vitamin D test is now automated and follow-up testing will also be automated rather than simply recommended. 

In addition, MUSC is looking for other departments within the hospital to make a similar change to standard of care with regard to vitamin D - Some prospects being Cardiology, ER, and Neurology.
Editor's Letter
Susan Siljander
Marketing Director, GrassrootsHealth

We always knew this day would come, those of us at the beginning of this journey when Protect our Children NOW! was born. It always had such promise and hope - a study that was timebound (9-10 months) with very tangible outcomes (a baby either is or isn't preterm, born before 37 weeks). That was the beauty of Protect our Children NOW!

But we couldn't have written a better script. The timeline image above is my favorite - the circles with dates - that show vitamin D in pregnancy from conception to proof. 

So, join us in yelling from the rooftops - we are here! We are here! ("Who" gets that reference?). This is just the beginning.

Next will come more institutions. Then more proof. Then, finally the government entities and big fundraising organizations will have to listen. It will be too much to bear.

Have a great week!

Susan Siljander
Marketing Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research Into Practice NOW!

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2017 Scientific Workshop on Vitamin D

South Carolina Clinical & Translational Research Institute
Medical University of South Carolina
March 23, 2017

Couldn't make it? 

Examples Where the Medical Community Waited a Long Time to Make a Change

The History of Folic Acid
British Journal of Haematology

Cedric Garland , Dr PH FACE
UC San Diego School of Medicine
Editorial - Smoking in public & Neonatal Blindness

How one man saved a generation of premature babies
BBC News
May 2016

Top Pregnancy & Vitamin D Research

Vitamin D Supplementation During Pregnancy: Double-Blind, Randomized Clinical Trial of Safety and Effectiveness
Bruce W. Hollis et al.
Journal of Bone and Mineral Research
October 2011
Read Paper
German Translation of the Abstract

Post-hoc comparison of vitamin D status at three timepoints during pregnancy demonstrates lower risk of preterm birth with higher vitamin D closer to delivery
Carol L. Wagner et al.
Journal of Steroid Biochemistry & Molecular Biology
April 2015
Read Paper

Post-Hoc analysis of vitamin D status and reduced risk of preterm birth in two vitamin D pregnancy cohorts compared with South Carolina March of Dimes 2009-2011 rates
Carol L. Wagner et al.
Journal of Steroid Biochemistry & Molecular Biology
January 2016
Read Paper

Early-Pregnancy Vitamin D Deficiency and Risk of Preterm Birth Subtypes
Lisa M. Bodnar et al.
Obstetrics & Gynecology
February 2015
Read Paper

High-Dose Vitamin D3 Supplementation in a Cohort of Breastfeeding Mothers and Their Infants: A 6-Month Follow-Up Pilot Study

Carol L. Wagner et al.
Breastfeeding Medicine
July 2006
Read Paper

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial
Bruce W. Hollis et al.
October 2015
Read Paper

Maternal 25-Hydroxyvitamin D and Preterm Birth in Twin Gestations
Lisa M. Bodnar et al.
Obstetrics & Gynecology
July 2013
Read Paper

Does Maternal Vitamin D Deficiency Increase the Risk of Preterm Birth: A Meta-Analysis of Observational Studies
Lu-Lu Qin et al.
May 2016
Read Paper

Effect of Prenatal Supplementation With Vitamin D on Asthma or Recurrent Wheezing in Offspring by Age 3 Years
Augusto A. Litonjua et al.
January 26, 2016
Read Paper

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