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Over the decades there have been many different things said about
cod liver oil, and whether we should be taking it.
It used to be a standard supplement for children and pregnant woman,
before falling out of favour. It is interesting to note that both
Vitamin A and Vitamin D are needed for reproductive health, and
infertility is now quite common. It's certainly not the whole reason,
but it seems likely that it's part of the picture.
In Dec 08, some findings by the Vitamin D council have made this
even more contentious. The Weston A Price foundation defended cod
liver oil, while Dr Mercola has revised his recommendations and
told people not to take it.
Below is Sally Fallon's article addressing his concerns, but first,
here's my thoughts.
- Both vitamins are extremely important and the foods containing
them were considered sacred foods in traditional cultures
- They are synergistic, which means they are need to work together,
and when found in foods they are more likely to be in the right
ratio
- In our modern diet, it is possible to be deficient in either
or both of them
- In vitamin A as we are scared of animal fats, and many people
mistakenly believe that we can get Vitamin A from carrots
- In Vitamin D as we are now so scared of the sun, as well
as the fear of animal fats
- Nobody really knows what the ideal ratio is and it is probably
different for everybody
Even the best of foods isn't good for everybody, and there will
be some people who it isn't beneficial for at certain times.
I often use kinesiology and muscle test my clients to see whether
specific supplements are good for them, including CLO, so you could
find a kinesiologist in your area who can test what you need.
Otherwise, have a think about where your vitamin A and D are coming
from. Unless you're eating a lot of liver butter or seafood, it's
probably beneficial. If you are taking a multi that has lots of
vitamin A in it, or are having lots of organ meats, CLO *might*
tip your balance the wrong way. But personally, I prefer to get
my vitamins from food, so would choose nutrient dense whole foods,
including cod liver oil, and ditch the multi-vitamins. (Unless,
of course, you are taking Vitamin A or D under medical supervision.
In this case, consult your medical practitioner about using CLO.)
If you choose to take cod liver oil, the other thing to take into
account is that modern processing has ruined a perfectly good food
for us, and almost all cod liver oils now have only synthetic vitamins
in them.
To my knowledge, the only cod liver oil that still has natural
vitamin A and vitamin D is the Green Pastures fermented cod liver
oil and skate liver oil range. Dave Wetzel, the owner of Green Pastures,
has written an article about how the fermented range came about,
and the benefits of this traditional food.
So now, scroll down to read about the benefits of cod liver oil
in general, or click here to find out
why fermented is even better.
Dave's
article and two others on Cod Liver Oil appeared in Wise Traditions
in Food, Farming and the Healing Arts, the quarterly magazine of
the Weston
A. Price Foundation, Spring 2009. A pdf containing these three
articles can be downloaded
here.
UPDATE
ON COD LIVER OIL DECEMBER 2008
Sally Fallon, President, The
Weston A. Price Foundation
We are obliged
to issue another official statement on cod liver oil after the November
bulletin of the Vitamin D Council, which contains "an unprecedented
warning about the ingestion of cod liver oil and resultant vitamin
A toxicity."
The warning
accompanies a report on a review article co-authored by Dr. John
Cannell, head of the Vitamin D Council, and fifteen other researchers,
entitled "Cod Liver Oil, Vitamin A Toxicity, Frequent Respiratory
Infections, and the Vitamin D Deficiency Epidemic" in the November
issue of Annals of Otology, Rhinology and Laryngology.
NO
PROOF THAT VITAMIN A IS TOXIC
Most of this
paper is a review of studies showing the benefits of vitamin D in
protecting against various illnesses, including respiratory infection.
THIS PAPER DOES NOT PRESENT ANY INFORMATION WHATSOEVER INDICATING
THAT COD LIVER OIL IS TOXIC, and, in fact, admits that vitamin A
can significantly reduce the incidence of acute lower respiratory
tract infections in Third World children.
A portion of
the review article is an attempt to explain why a 2004 study providing
600 to 700 IU of vitamin D and 3,500 IU of vitamin A in the form
of cod liver oil and a multivitamin failed to meaningfully reduce
upper respiratory tract infections when studies from the 1930s found
that cod liver oil could reduce the incidence of these infections
by 30 to 50 percent. The authors of the recent commentary suggested
that the older studies were more effective because cod liver oil
in the 1930s contained much more vitamin D. They suggested that
modern cod liver oil is low in vitamin D because the deodorization
process removes the vitamin while manufacturers fortify the oil
with only a fraction of the original amount. As an example, they
cited cod liver oil made by Nordic Naturals, advertised as containing
only "naturally occurring vitamins A and D," which has
only 3 to 60 IU of vitamin D per tablespoon but between 150 and
12,000 times as much vitamin A.
This conclusion
is essentially the same as the conclusion reached by the Weston
A. Price Foundation and the research of Chris Masterjohn; we have
continually pointed out that vitamins A and D work together and
that without vitamin D, vitamin A can be ineffective or even toxic.
We do not recommend Nordic Naturals regular cod liver oil or any
brand of cod liver oil that is low in vitamin D. But it is completely
inappropriate to conclude from this 2004 study that cod liver oil
is toxic because of its vitamin A content. Similar reviews could
be put together showing the benefits of vitamin A and cod liver
oil in numerous studies, including the studies from the 1930s. Obviously
the solution is to use the type of cod liver oil that people took
in the 1930s, which did not have most of the vitamin D removed by
modern processing techniques.
Our recommendations
for cod liver oil brands can be found at westonaprice.org/basicnutrition/cod-liver-oil-menu.html
VITAMIN
A DOES NOT ANTAGONIZE VITAMIN D
The Vitamin
D Council report claims that the vitamin A in cod liver oil is excessive
and antagonizes vitamin D by inhibiting the binding of its active
form to DNA and thus preventing its ability to regulate the expression
of vitamin D-responsive genes.
Vitamins A and
D are both precursors to active hormones that regulate the expression
of genes. The body possesses certain enzymes that convert each of
these in a two-step process to their active forms: vitamin A is
converted to retinal and then to active retinoic acid while vitamin
D is converted to calcidiol and then to active calcitriol. While
directly consuming either retinoic acid or calcitriol would be unnatural,
consuming vitamins A and D, together, as in cod liver oil, is perfectly
natural. The enzymes involved in these conversions are responsible
for producing incredibly powerful hormones and are therefore highly
regulated.
In order for
vitamin D to activate the expression of its target genes, it must
bind to the vitamin D receptor (VDR) and then combine with the retinoid
X receptor (RXR), which is activated by a particular form of vitamin
A called 9-cis retinoic acid. RESEARCHERS FROM SPAIN RECENTLY
SHOWED THAT VITAMIN D CAN ONLY EFFECTIVELY ACTIVATE TARGET GENES
WHEN ITS PARTNER RECEPTOR IS ACTIVATED BY VITAMIN A.
In the ABSENCE
OF VITAMIN A, molecules called "corepressors" bind to
the VDR/RXR complex and PREVENT vitamin D from functioning.
The molecular
biology of 9-cis retinoic acid, however, is extremely complex, and
this has led to some confusion. The RXR and its activator 9-cis
retinoic acid partner up not only with the vitamin D receptor, but
also with the receptors for steroid hormones, thyroid hormone, and
most other nuclear receptors. In fact, if enough 9-cis retinoic
acid is present, RXRs will even partner up with themselves. Ordinarily,
this versatile form of vitamin A is gradually derived in small amounts
from the larger pool of all-trans retinoic acid as needed. When
scientists add large amounts of 9-cis retinoic acid to isolated
cells, then, it may cause effects that smaller amounts naturally
produced in the cell would not cause.
Researchers
have shown, for example, that 9-cis retinoic acid interferes with
the ability of vitamin D to stimulate the production of osteocalcin,
a vitamin K-dependent protein involved in organizing the mineralized
matrix of bone. This may have been because the excessive amount
of 9-cis retinoic acid caused RXRs to pair up with themselves and
thereby made these receptors unavailable to vitamin D. When scientists
incubate cells with activated vitamin D and all-trans retinoic acid,
ordinarily the source of 9-cis retinoic acid in the cell, the two
hormones stimulate the production of osteocalcin with remarkable
synergy.
More information
on the interactions between vitamins A and D can be found in these
articles:
http://www.westonaprice.org/basicnutrition/vitamin-k2.html
http://westonaprice.org/basicnutrition/vitamina-osteo.html
http://westonaprice.org/basicnutrition/vitamin-d-safety.html
The Spanish
research demonstrating the necessity of 9-cis retinoic acid for
the functioning of the vitamin D receptor can be found here:
http://www.ncbi.nlm.nih.gov/pubmed/16936639?
http://mcb.asm.org/cgi/content/full/28/11/3817?
PLANT
FOODS ARE NOT A GOOD SOURCE OF VITAMIN A
In the December
Vitamin D Council newsletter, Dr. Cannell further claims that consuming
preformed vitamin A is "unnatural" and that the body highly
regulates the conversion of carotenoids found in vegetables to vitamin
A as needed. However, the enzymes that convert carotenoids to vitamin
A are less critically maintained because they are unneeded when
preformed vitamin A is provided in the diet-as it usually is. They
are therefore, like the enzymes that convert essential fatty acids
in plant oils to their elongated and desaturated forms, subject
to variations in genetics, circumstantial health, and dietary and
environmental influences.
Many factors
can interfere with the conversion of carotenoids into vitamin A
including thyroid problems, liver problems, diabetes and genetics.
Babies and children convert carotenes very poorly if at all.
The statement
that preformed vitamin A is unnatural is ludicrous in the light
of what we know about traditional diets. The chief source of calories
in the traditional Inuit diet, for example, is seal oil, which Weston
Price found to be higher in vitamin A than cod liver oil. Fish heads,
extremely rich in vitamin A, are a staple in the Japanese diet.
Many cultures consume liver, often in high amounts-yet the authors
of the review paper imply that liver is toxic. Tell that to the
Frenchman enjoying his foie gras, the Englishman consuming liver
and onions, or the South Sea Islander who submits to great danger
to obtain shark liver for men and women, in order to ensure healthy
children. The truth is that pre-formed vitamin A is more plentiful
in traditional foods than vitamin D, yet politically correct nutrition
insists that we must obtain vitamin A through the laborious process
of converting carotenes.
More information
on the conversion of carotenoids to vitamin A can be found in these
articles:
www.westonaprice.org/basicnutrition/vitaminasaga.html
(see the section "Vitamin A Vagary").
westonaprice.org/basicnutrition/vitamina-osteo.html#carotenesnotad
COD
LIVER OIL IN PREGNANCY
The Annals paper
does not cite any studies showing toxic effects from cod liver oil,
but Dr. Cannell cites one study in his December newsletter associating
intake of cod liver oil with hypertensive disorders during pregnancy.
Users of cod liver oil in this study had about twice the intake
of vitamins A and D as non-users and eight times the intake of long-chain
omega-3 fatty acids. The study found the most robust association
with long-chain omega-3 fatty acids, which were associated with
lower risk between 0.1 and 0.9 grams per day and higher risk above
0.9 grams per day. The authors suggested that the association with
high blood pressure might be related to oxidative stress caused
by a high intake of polyunsaturated fatty acids.
The abstract
of the study can be found here: http://www.ncbi.nlm.nih.gov/pubmed/16487202?
The new Annals
article offers nothing new to incriminate cod liver oil. It provides
a well-written argument that vitamin D intakes need to be higher
and incriminates only highly processed modern cod liver oils that
have inadequate amounts of this critical nutrient. We recommend
only high-vitamin cod liver oils that provide abundant vitamins
A and D without an excess of polyunsaturated fatty acids.
THE
COD LIVER OIL PUBLIC HEALTH INITIATIVE
As we pointed
out in our last update on cod liver oil, during the first half of
the century, cod liver oil was the focus of a worldwide health initiative.
Parents were urged to give cod liver oil to their children by doctors,
by government officials, by teachers and principals in schools,
and even by their ministers in churches. A large portion of adults
in America born before the Second World War received cod liver oil
as children and this practice contributed to a high level of health,
intelligence and physical development in those lucky enough to receive
it. In many European countries, children received a daily ration
of cod liver oil, especially during the war years. In the UK, for
example, the government issued cod liver oil to all growing children
until the early 1950s.
What has led
to the demise of this obviously beneficial practice? Cod liver oil
is a food; it can't be patented, it can't be created in a laboratory;
it can't create millions for the drug companies. So interest in
this wonderful superfood has naturally waned. But if you are basing
your dietary habits on the principles of healthy nutritional diets,
don't hesitate to include cod liver oil-our recommended brands of
cod liver oil--as a healthy and natural food source of critical
vitamins so lacking in modern diets.
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