Vitamin D and Cholesterol: The Importance of the Sun (2009) by David Grimes, a British doctor, contains more than a hundred graphs and tables. Most of the book is about heart disease. Grimes argues that a great deal of heart disease is due to too little Vitamin D, usually due to too little sunlight. I recently blogged about other work by Dr. Grimes — about the rise and fall of heart disease.
Part of the book is about problems with the cholesterol hypothesis (high cholesterol causes heart disease). One study found that in men aged 56-65, there was no relationship between death rate and cholesterol level over the next thirty years, during which almost all of them died (Figure 29.2). There is a positive correlation between death rate and cholesterol level for younger men (aged 31-39). The same pattern is seen with women, except that women 60 years or older show the “wrong” correlation: women in the lowest quartile of cholesterol level have by far the highest death rate (Figure 29.5). A female friend of mine in England, who is almost 60, was recently told by her doctor that her cholesterol is dangerously high.
The book was inspired by Grimes’ discovery of a correlation between latitude and heart disease: People who lived further north had more heart disease. This association is clear in the UK, for example (Figure 32.4). Controlling for latitude, he found a correlation between hours of sunshine and heart disease rate (Table 32.3): Towns with more sunshine had less heart disease. No doubt you’ve heard that dietary fat causes heart disease. In the famous Seven Countries study, there was indeed a strong correlation between percent calories from fat and heart disease death rate (Figure 30.2). You haven’t heard that in the same study there was a strong correlation between latitude and dietary fat intake (Figure 30.8): People in the north ate more fat than people in the south. The fat-heart disease correlation in that study could easily be due to a connection between latitude and heart disease. The correlation between latitude and heart disease, on the other hand, persists when diet is controlled for.
Grimes convinced me that the latitude/sunshine correlation with heart disease reflects something important. It is large, appears in many different contexts, and has resisted explanation via confounds. Maybe sunshine reduces heart disease by increasing Vitamin D, as Grimes argues, or maybe by improving sleep — the more sunshine you get, the deeper (= better) your sleep. Sleep is enormously important in fighting off infection, and a variety of data suggest that heart disease has a microbial aspect. As long-time readers of this blog know, I take Vitamin D3 at a fixed time (8 am) every morning, thereby improving my Vitamin D status and improving my sleep.
Grimes and his book illustrate my insider/outsider rule: To make progress, you need to be close enough to the subject (enough of an insider) to have a good understanding but far enough away (enough of an outsider) to be able to speak the truth. As a doctor, Grimes is close to the study of disease etiology. However, he’s a gastroenterologist, not a cardiologist or epidemiologist. This allows him to say whatever he wants about the cause of heart disease. He won’t be punished for heretical ideas.
Excellent summary. I find some people have stomach trouble with vit D tablets, and that getting more sunshine works just as well.
If you haven’t come across it before Stephanie Seneff (https://people.csail.mit.edu/seneff/) has some interesting theories on vitamin d3 and its relationship w/ cholesterol and sulfer.
Seth: No, I hadn’t, although I linked to one of Seneff’s articles here.
This is further illuminated by the experience of cardiologist William Davis (also author of Wheat Belly), who has found great success reversing arterial calcification with a protocol that includes D3 supplementation until blood levels reach 60-70.
This is a link to his greatest circulatory calcification turnaround “success story”:
https://www.trackyourplaque.com/forum/topics.aspx?ID=7520
Interestingly, the individual who improved so much is an African American male who upon starting the program had NO measurable Vitamin D in his blood. Yep, ZERO.
African Americans are known to be more susceptible to heart disease than whites, and they are also known to produce less D in response to a given level of sunlight. This makes me wonder is another possible confounder of the heart disease epidemic (in addition to latitude) is an increasingly urbanized black and brown population (with concomitant undiagnosed low D3 status) in northern cities.
Of course, this issue is risky for a professional scientist to study, as even looking into the matter could end a career.
Seth: “increasingly urbanized black and brown population”…the incidence of heart disease is going down, not up. Your possible confounder is changing in the wrong direction.
“possible confounder of the heart disease epidemic”: then why has the epidemic occurred in other countries too?
Seth: I am a long time reader and huge fan of your blog. Thank you so much for all you bring to the community.
I’m particularly interested in understanding these issues related to diet, but at the same time feel the same frustration that–I assume–many others feel because people with credible credentials seem to be taking diametrically opposed positions on issues that are crucial to my day to day decisions regarding my diet. Decisions on questions like, “how often should I eat eggs?” “how much sun should I expose myself too?”
A google search on Stephanie Seneff turned up (1) a number of interesting powerpoint presentations and essays but also (2) at least one blog post, from someone who appeared to have relevant background in nutrion, who was extremely critical of her approach and her claims. https://carbsanity.blogspot.com/2012/03/low-fat-vitd-and-stephanie-seneff.html
Of course, the fact that someone, somewhere has criticized her does not mean she’s wrong. But I find myself very frustrated trying to evaluate all of this and would appreciate your take.
Seth: I find CarbSane’s criticism unconvincing. I do not get alarmed that someone “learned from Gary Taubes”. I do not consider it a big deal that Seneff’s Ph.d. is in a different area. I don’t care whether Seneff’s blog has “a feminist angle”. I suppose my take is: ignore ad homineum criticism.
Carbsane has said that she herself has no PhD and that her Masters is in Materials Science & Metallurgy.
Seth, re: urbanization, I should have added that the 2010 census found that African Americans have subsequently been moving out of urban areas, reversing the earlier concentration:
https://usatoday30.usatoday.com/news/nation/census/2011-05-20-chicago-blacks-exodus_n.htm
Hi Seth
Not sure if you have seen this:
Sunshine Could Benefit Health and Prolong Life, Study Suggests
https://www.sciencedaily.com/releases/2013/05/130507195807.htm
The effect appears to be due to increased nitric oxide level and may
not be related to vitamin D levels.
All the Best