Obesity is not a joking matter. People suffer with the diseases it causes and the country is much disadvantaged by it. It costs the United States more than $700 billion per year – 5 percent of all of our gross domestic product – in medical costs due to Type 2 diabetes, cancer, dementia, heart disease, arthritis and other diseases triggered by obesity, and lost productivity due to medical issues. 

Our politicians need do something about this epidemic. Obesity is much worse than opioids in the number of people affected and in the long-term disability it causes. Yet, we see no national issue or bill to fight it.   

It is a culture change that occurred in 1983 when personal responsibility went away, apparently and it became OK to eat anytime, anywhere, and anything from the then-new fast food and convenience stores on every corner and at every gas station (33 percent of Americans eat fast food every day which contributes to hooking you to it). And now more than 50 percent of Americans do less than 10 minutes of any physical activity, including walking, any day of the week.   

Our genes haven’t changed, but the food we eat turns on the genes that make us addicted to some of those foods that foster weight gain. But our culture has changed since 1983, and that change needs to be reversed. Work sites need to take action too – by changing the culture and incentivizing proper weight.

Recently, The New York Times questioned the need for and wisdom of extra vitamin D testing and supplement use. So let me summarize the data 

As to vitamin D2 and vitamin 3, I think the data are much stronger than in the article, which indicated the doctor who had done most of the work to encourage you to get tested had a conflict of interest. Never mind the conflict, he was right as I think much benefit is likely by measuring your vitamin D level and getting it to where it should be. No doubt the level of vitamin D2 and vitamin D3 to shoot for is controversial. But in intervention studies in women and men we know that levels above 35 are associated with substantially less breast cancer than below 35 mg/dL.  

More than 67 percent of those living in Pittsburgh have levels less than 23. The controversy is: is vitamin D the active substance promoting health or is a low vitamin D level a marker of a gene or genes that promote cancer and dementia risk. To summarize studies of more than 95,000 people with 10,000 deaths, the genes associated with lifelong low vitamin D levels increase cancer mortality by 40 percent. 

The side effect of vitamin D supplementation doesn’t seem to occur until levels exceed 100 mg/dL, and you absorb it’s active conversion from sun and from your GI tract as you get older. I recommend measuring it at least once every two years after age 50, and once a year after age 60 and seeking supplements that get your level to between 35 and 80. 

So to summarize, since vitamin D2 and Vitamin 3 have minimal to no risk as levels under 100, and in intervention trials decreases all cause mortality by 7 percent to 23 percent, and is associated with (and in intervention trials does) reduced dementia and cancer risk, I recommend testing and getting (through salmon or supplements) your D level over 35 and preferably between 50 and 80. But do check with your doctor.   

Dr. Michael Roizen writes about wellness for the Cleveland Jewish News. He is chief wellness officer and chair of the Wellness Institute at Cleveland Clinic.

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