Black Power Pill?

It is well known that blacks experience higher rates of certain diseases and that there are disparities in their access to quality healthcare. Some black university-based health authorities suggest greater proportions of blacks among health care professionals would help to remedy disparities in health care. [J Natl Med Assoc. 93:1S-5S, 2001; Theoretical Medical Bioethics. 23:499-518, 2002] While greater participation by blacks in health care delivery and management should be encouraged, this doesn't necessarily increase the percentage of blacks who are healthy.

More medicine and doctoring are not likely to improve the health status of blacks. For example, even when medical care is available, only about 6 in 10 hypertensive blacks receive medical treatment and only 25 percent taking medications have their blood pressure under control. [Ethnic Diseases 13: 456-62, 2003]

Dietary Measures not put into Practice
A cursory effort to examine elevated health risks among blacks reveals that most of the health risks rampant in this group of Americans are modifiable, often through dietary measures or other health practices such as avoidance of tobacco or excessive alcohol. However, only a small percentage of Americans (any groupings by age, sex or skin color) actually consume the recommended minimum of five daily servings of fruits and vegetables to maintain health. The National Cancer Institute now suggests nine servings of fresh plant foods per day to reduce health risks, a goal which is not likely to be achieved by a significant percentage of the population, let alone among minority groups in society. [British Medical Journal 326: 1003, 2003] National Institutes of Health 9-A-Day Program]

What about a Pill?

It becomes obvious that a dietary supplement of some kind may be of value here to make up for nutritional gaps in the diet. Dr. Bruce Ames of the University of California at Berkeley has suggested that a well-designed vitamin pill, particularly one featuring folic acid, may make up for the nutritional deficiencies of the population, particularly those who are most in need. [Ann N Y Acad Sci. 889:87-106, 1999] Homocysteine, an undesirable protein in the blood circulation, is linked with cardiovascular disease and brain dementia. Blacks, particularly blacks with low intakes of folic acid (green leafy vegetables) have higher homocysteine levels. [Am J Clin Nut 77: 826-33, 2003]

Nutrition and Blacks

It is alarming to estimate the impact of poor nutrition upon blacks. Yet at the same time it is encouraging to realize that nutritional strategies could be employed to eradicate or reduce common health risks in the family of black Americans, at very little cost.
The connection between skin color, nutrition and disease is exemplified by the role of vitamin D, the "sunshine vitamin," among blacks. Dark melanin skin pigment slows the natural production of vitamin D in the skin upon exposure to the sun. Blacks may require as much as ten times more sun exposure to produce the same vitamin D as Caucasians. Virtually no vitamin D is produced with sun exposure in the winter months at northern latitudes (Alaska, Canadian border states) and blacks exhibit far lower vitamin D levels than whites regardless of geography. Shortages of vitamin D are causally linked to high blood pressure, stroke, cancer (colon, breast, prostate, ovarian, lymphoma), Crohn's disease, immune problems and osteoporosis, health problems that are common in the black community.

One study uncovered a profound shortage of vitamin D among black females, 42.4%, compared to just 4.2% among white females. Black women who do not drink much milk (usually less than 3 servings of breakfast cereal a week) are more likely to exhibit vitamin D deficiency. Even among African American women who do consume 200 IU of vitamin D from supplements, still 28% had a shortage of this vitamin. [Am J Clin Nut 76: 187-92, 2002]

In Boston, a wintertime study revealed 21% of elderly blacks age 64-100 had vitamin D deficiency compared to 11% of whites. [J Clin Endocrinol Metab 85: 4125-30, 2000] While blacks are strongly encouraged to increase vitamin D intake during winter, evidence of public health announcements appears to be few.

One of the problems is the historical reluctance of health authorities to recommend dietary supplements over dietary measures. However, the simple fact is that it is unlikely that blacks, particularly blacks living in northern latitudes, will acquire sufficient amounts of vitamin D from dietary sources to maintain health.

Fortified Milk Was Designed for Infants, not Adults

Long ago health authorities fortified milk with vitamin D to prevent childhood rickets. But this fortification program was not designed for adults, particularly adults living in northern latitudes.
To add to the problem, due to the absence of an enzyme (lactase) after the growing years, blacks notoriously exhibit intolerance to milk products. In one study abnormal lactose tolerance was found among 81% of blacks and only 12% of whites of Scandinavian or Northwestern European extraction. [New Eng J Med 292: 1156-59, 1975] This explains their avoidance of dairy products.

In northern climates blacks are at greater risk for vitamin D deficiency and fortification of milk with vitamin D is not an effective way of preventing this vitamin deficiency. [Nutrition Reviews 61: 107-13, 2003] Additionally synthetic vitamin D2 in milk is not equal in nutritional value to the natural vitamin D3 in dietary supplements. Vitamin D3 is the preferred form.

FDA Authorities Confirm Milk Is not an Adequate Delivery System
A recently published report, written by authorities at the Food & Drug Administration is presented below for your review. It is obvious that dairy products are not an adequate delivery system for vitamin D among adults, particularly among adults of any skin pigmentation living in northern latitudes.

Nutrition Reviews 61:107-13, 2003
Prevalence of vitamin D insufficiency in Canada and the United States: importance to health status and efficacy of current food fortification and dietary supplement use. Calvo MS, Whiting SJ.; Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, Food and Drug Administration, HFS- 025, 8301 Muirkirk Road, Laurel, MD 20708, USA.

Several recent studies have identified a surprisingly high prevalence of vitamin D insufficiency in otherwise healthy adults living in Canada and the United States. Most striking are the effects of latitude, season, and race. Also noteworthy is that dietary vitamin D is not reaching the population in greatest need, nor is it very protective against insufficiency. Fluid milk, as the predominant vehicle for vitamin D fortification, is apparently not very effective in staving off vitamin D insufficiency in adults in all populations at all times of the year.
You can see for yourself here that the problem has been adequately described, but little or no action is being taken. It is obvious that the promotion and even provision of a vitamin D pill, particularly to the black community at large, is overdue.

Dairy Products Industry Influence
The dairy products industry has influence and keeps steering health authorities away from any recommendation for dietary supplements. The National Dairy Council doggedly continues to overemphasize the health benefits of calcium and claims that blacks can overcome their intolerance to dairy products by employing "a few simple dietary strategies." [J Natl Med Assoc. 94 :55-66, 2002] These measures include use of enzyme fortified milk and slow re-introduction of dairy products to reactivate the lactase enzyme. However, these strategies are obviously not working and milk simply is not fortified with enough vitamin D to improve the health of blacks at any geographical latitude. Health authorities and politicians who continue to capitulate to the dairy industry are not serving their country well.

It is obvious blacks are genetically different (not inferior) and due to their melanin skin pigmentation exhibit special health and nutritional needs that are not being adequately addressed by the medical community nor the food industry.

The National Dairy Council continues to emphasize dairy calcium as a preventive measure for hypertension, stroke, colon cancer and obesity, and claims that "a low intake of dairy food nutrients, such as calcium, potassium, and magnesium, may contribute to the high risk of hypertension seen in African Americans." However, milk is a very poor source of magnesium and potassium.

Blacks Have Greater Shortages of Magnesium than Calcium
Far more Americans, about 8 in 10, consume lower amounts of magnesium than calcium. Over 100 years ago the US dietary intake of magnesium was around 500 milligrams. Today median intake of dietary magnesium is only 237 mg per day among black men versus 326 for white males and 237 mg for white females versus 177 mg for black females. A substantial percentage of US adults fail to consume sufficient amounts of magnesium, more so among blacks, which may help explain disparities in health. [J Nutrition 133: 2879-82, 2003] One study revealed about 1 in 5 urban black females have low magnesium levels. [J Family Practice 48: 636-39, 1999]
Lower magnesium intake is associated with diabetes, high blood pressure and cardiovascular disease as well as abnormal heart rhythm. [J Natl Med Assoc 95: 257-62, 2003; Am Heart J 143: 535-40, 2002; Arch Int Med 159: 2151-59, 1999] Low magnesium levels are directly linked to sudden-death heart attack. [J Am Coll Cardiol. 27:1771-6, 1996; Angiology 46:145-9, 1995] Widespread fortification of the diet of black Americans with magnesium has been proposed, but no action has been taken.

A Black Power Pill?

A typical multivitamin contains only 400 international units (IU) of vitamin D, which is the daily dose recommended by the U.S. Food and Drug Administration. Conventional multivitamins are not an answer to this problem. [Eur J Clin Nutr. 55:1091-7, 2001] Research suggests that people actually need 1000 IU of vitamin D a day, blacks even more, at least 2000 IU per day. That may be the minimum. One report suggests 2000 IU per day is 5 times too low to improve human health. [Am J Clin Nutr. 69: 842-56, 1999]

But here again blacks run into a roadblock. Health authorities mistakenly claim that 2000 IU is the tolerable upper limit. This makes it sound like toxicity begins at 2000 IU per day. But Reinhold Vieth PhD, an expert on vitamin D and health, points out that Caucasians who obtain an hour of sun in the summer at noontime in southern latitudes will naturally produce about 10,000 IU of vitamin D, so 2000 IU simply could not be toxic. Dr. Vieth's own studies have proven that 4000 IU of daily vitamin D is not toxic and that oral doses of 40,000 IU for prolonged periods would be required to produce any toxicity. [Am J Clin Nutr. 73: 288-94, 2001; Am J Clin Nutr. 69: 842-56, 1999]

The provision and consumption of at least 2000 IU vitamin D3, 200 mgs of elemental magnesium and 400-800 mcg of folic acid in a dietary supplement may go a long way towards disease prevention in the American black community. [Am J Clin Nutrition 77: 1318-23, 2003] Inferior forms of magnesium should be avoided (magnesium oxide only 4% absorbed) in order to produce effective results. [Magnes Res 14: 257-62, 2001]

Such a pill would be inexpensive and could dramatically improve measurable health parameters in the American black community.
Foot Dragging, Conflict of Interest, or Racism?

Some articles published in medical journals suggest racism is at the root of health care inequalities between groups in society. [Am J Med Sci 325: 315-31, 2003] It would be easy to see how the combined lack of nutritional training by physicians, the commercial conflicts of interest by food providers, their exertion of political influence, along with indecision by health authorities, could be construed by the black community as another example of racism. Once informed of the nutritional origins of their health problems, blacks are likely to demand action. Such a racist label can only be avoided by prompt action to correct these overt nutritional deficiencies in an often disadvantaged segment of the American population.

The advent of a specially formulated dietary supplement for this easily identifiable group in American society should proceed without delay. Neither should informed blacks wait for government to take action and delay practicing self care. Magnesium, folic acid and vitamin D3 pills are inexpensive and widely available. In this case, private entrepreneurship may be able to move much faster than government health authorities or politicians. [Bill Sardi 2004]