Dear all:

I want to point out that the origination of the US recommendations by the Centers for 
Disease Control and Prevention actually came from PARENTS who had children that 
developed rickets.  Rickets is a serious and entirely preventable condition.  The last time 
I asked about this, I was given an estimate was over 100 light-skinned (Caucasian) 
infants in Manhattan that developed rickets in a year.  I was shocked.  When a child has 
rickets it is the tip of the iceberg of other children that have "sunlight deficiency".  As you 
can see by the numbers this is not most of the population.  It is a very tiny proportion of 
the population.  Yet, for those whose children develop "sunlight deficiency" the problem is 
very very serious.  I do not know enough about the new recommendations for a higher 
level of "vitamin" D.

The dilemma is that there is very little choice in substitutes for "sunlight" when the 
environmental conditions make it challenging to get adequate sunlight in ways that don't 
also increase the risk of skin cancer.  Most of the substitutes that are available here in 
the United States have additives and unnecessary vitamins and marketing practices in 
other arenas that interfere with breastfeeding.  I'm not sure what could be done at all to 
fix the hole in the ozone.  And if all of us who lived in the more extreme northern and 
southern lattitudes moved to the equator, we would merely facilitate the degradation of 
the rain forests that is already progressing at a very rapid pace.  

Again and again we decry the "industry" for promoting their own preparations that may 
have additives and vitamins that are unnecessary, marketing tactics that are misleading, 
and research on their products that is likely to be biased by conflicts of interest.  Even 
my dentist complains about her journals because she cannot get to the bottom of which 
research is subject to tremendous conflicts of interest and which is not.  What we have 
not realized, at least broadly in the United States is that this is a direct result of our anti-
tax revolution.  When funds are decreases services must be cut.  Who cares about basic 
research that doesn't immediately seem to directly provide a product or service to us?  
Yet it is this basic research that is unfettered from the profit motive that is most likely to 
develop the very creative solutions that we may need to improve human health.  More 
and more scientists either have to give up doing research and move on to another 
profession or take money from sources that clearly have a huge investment in getting 
particular results.  At the heart of this phenomenon, if one really wants change, we need 
to consider what political and legislative steps would foster basic research from grants 
that are untainted by a profit motive for the results of the research to reach a 
predetermined conclusion.

As with many of our comments about conflicts of interest, we are not seeing the big 
picture.  Only one piece of it would be to regulate the marketing of products more tightly.  
This would be insufficient to fix the problem that is widespread in many arenas that affect 
our health.  The other piece of the picture is to provide adequate funds to attract 
thoughtful scientists who would look more broadly and deeply into issues of human health 
than the "magic bullet" or as the NY Times Sunday magazine article put it a month or so 
ago the "nutrification of foods" approaches.

Best, 

Susan Burger

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