Race and Illness and Vitamin D
By Jacob Schor, ND
For years various theories have been proposed to explain the greater frequency of many illnesses among African Americans. High blood pressure is probably the best example, but there are many others. I've heard theories that range from the plausible to the bizarre to what could be called racist.
For several years the theory was that lead in blood from living in inner cities was the cause. So were higher stress levels. Even over consumption of fried foods was suggested in a "Fried Chicken Hypothesis." None of these possible explanations lasted long. Research in the last four years has finally provided a reasonable explanation that I think will prove true. The explanation is so simple; the surprise is that no one thought of it sooner.
Skin Color and Vit. D
We made our mistake in looking for complex socioeconomic differences as the main factors causing higher rates of many illnesses among African Americans. Of course socioeconomic factors contribute to the onset, late diagnosis and poor treatment of illnesses among many African Americans, and that is a vitally important issue, but the biggest difference between African Americans and white Americans, as much as we try to ignore it, is skin color. Races that evolved further from the equator have lost some of their ability to make melanin and as a result have become pale skinned.
Paler skin allows for greater penetration of the sun's rays. Humans get most of their Vitamin D from the sun. Darker skin decreases the amount of ultraviolet light that penetrates the skin and, in doing so, results in lower Vitamin D production. This is fine if you live close to the equator or are in the sun most of the day. If you live in farther from the equator and spend much of your days indoors, you make much less Vitamin D. The darker or blacker the skin, the bigger the problem becomes.
Vitamin D deficiency is a common problem for all Americans, but far more so for African Americans. When you look at the statistics the numbers are shocking. Black Americans are about ten times more likely to be Vitamin D deficient as whites.
Black women of reproductive age are twenty times as likely to be Vitamin D deficient as white women of the same age. The average white woman has twice the amount of Vitamin D in their blood as a black woman.
Vitamin D and Illness
The list of diseases that we now associate with Vitamin D deficiency is almost identical to the list of diseases that African Americans encounter with greater than expected frequency. The following illnesses are both associated with Vitamin D deficiency and are much more common in blacks living in this country than whites: Coronary heart disease, Hypertension, Type two diabetes, Colorectal cancer, Prostate cancer, Cervical cancer, Renal disease, Metabolic syndrome, Multiple sclerosis, Rheumatoid conditions, Obesity, Periodontal disease, Rickets, and Osteomalacia.
The only disease associated with Vitamin D deficiency not more common in blacks than whites is osteoporosis. Every other disease associated with Vitamin D deficiency is more common in African Americans.
Of the children diagnosed with Vitamin D deficiency rickets in the United States over the last 17 years, 83 percent were African American. Infants derive their Vitamin D from breast milk, but most nursing moms are so low in Vitamin D that they are unable to excrete adequate amounts into their milk. Nursing women need about 4000 IU of Vitamin D a day to make breast milk adequate for their infants. The breast milk of black women often has undetectable levels of Vitamin D. It takes a white woman about five minutes of full body sun exposure a day to make this much Vitamin D.
The only significant food source for Vitamin D is milk. The government requires dairies to enrich milk with Vitamin D. Cheese, yogurt and ice cream are not enriched and are not significant sources. White people drink more milk than any other race. Northern Europeans are among the few human races that continue to produce lactase, the enzyme needed to digest milk, into adulthood. Most other races, including blacks, often stop producing this enzyme and get moderate to severe indigestion from milk, a condition referred to as lactose intolerance. As a result blacks consume less milk and get less supplemental Vitamin D from foods than whites do
The pattern is obvious: because of darker skin pigmentation and lower tolerance and consumption of milk, black people are more likely to be Vitamin D deficient than whites and as a result are far more likely to develop a range of health problems associated with Vitamin D deficiency.
The Government is Informed
The United States Food and Drug Administration (FDA) knows about this. In 2003, Dr. Mona Calvo of the FDA wrote, "In sharp contrast to their white counterparts, blacks have a much higher incidence and mortality of certain types of aggressive cancers and autoimmune diseases, including diabetes that cannot be attributed entirely to socioeconomic differences or disparities in health care. The strong association between Vitamin D insufficiency and risk of chronic diseases should raise concern about the current mechanisms in place to prevent [Vitamin D deficiency]."
The FDA also knows that the lower milk consumption by blacks contributes to the problem. Another quote from Dr. Calvo, "The racial/ethnicity groups at greatest risk of vitamin D insufficiency consume less milk … than do their white counterparts." Dr. Calvo goes on to write, "African Americans, with the greatest physiological need for dietary sources of Vitamin D, have the lowest intake from food alone and food plus supplements."
It is too soon to blame the FDA for ignoring this information. The data I'm citing come from studies published in the last four years. In the future we should expect to see a movement to fortify more foods with Vitamin D and public awareness campaigns to increase intake. In the meantime black Americans have two choices: regular sun exposure or oral supplementation with Vitamin D. In hindsight maybe we should have recognized what was going on sooner. If this theory is indeed correct, the solution couldn't have more obvious, it is a simple matter of black and white.
Note: I borrowed heavily in writing this article from John Jacob Cannell, MD, whose website www.Cholecalciferol-Council.com is an excellent source for further information. Our website version of this article is posted at: http://www.denvernaturopathic.com/news/RaceD.html and contains abstracts of references cited.
Jacob Schor, N.D. majored in Food Science and Product Development as an undergraduate at Cornell University, and received his doctorate in Naturopathic Medicine at National College in Portland, Oregon in 1991. He served as President of the Colorado Association of Naturopathic Physicians from 1992-1999 and maintains a private practice at the Denver Naturopathic Clinic.