The following g slides are a gra g p phic representation of the - PowerPoint PPT Presentation

The following g slides are a gra g p phic representation of the material pr presen esent te ed d in in Re Rep p. Sea Seaton on’s s St Sta at te e of of Reform 2014 booklet which can be foun d online at: http://akhouse.org/rep_seaton/

State of Reform 2014 Representative Paul Seaton Evidence Based Medicine?

Worsening Severity of Vitamin D Deficiency is Associated with Increased Length of Stay, Surgical Intensive Care Unit Cost, and Mortality Rate in Surgical Intensive Care Unit Patients – American Journal of Surgery, Matthews, et. al. 2012 Survival

HospitalizedDays HospitalizedDays

Grady Memorial Hospital Atlanta, Georgia Treatment Costs Treatment Costs Per Patient 60% Lower Lower

Incidence of In ‐ Hospital Mortality and Cardiovascular and Infectious Morbidities for 3409 Noncardiac Surgical Patients by Quintiles of Serum Vitamin D Concentrations 14 Anesthesia Patient Safety Foundation ‐ The Association of Serum Vitamin D f y Concentration with Serious Complications after Noncardiac surgery – Turan et. al. September 2014 12 Mortality Mortality 10 cidents Cardiovascular Infectious Infectious entage of Inc 8 6 Perce 4 2 0 20.5 ‐ 27.3ng/ml 27.4 ‐ 36.2ng/ml <13ng/ml 1 13.1 ‐ 20.4ng/ml 2 3 4 >36.2ng/ml 5 Vitamin D Serum Levels

Treatment with Oral Active Vitamin D is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis Peritoneal Dialysis ‐ Kerschbaum et. al. PLOS ONE, July 2013 Kerschbaum et al PLOS ONE July 2013 49% Reduced 66% Reduced 16% Reduced 57% Reduced 54% Reduced 100% Incidence Incidence Incidence Incidence Incidence 80% isk ve Ri 60% Relati 40% No Vitamin D R Treatment 20% Regime Received Oral Vitamin D 1 st Episode Gram ‐ Negative Sterile All ‐ Cause Gram ‐ Positive Peritonitis Peritonitis Peritonitis Death Peritonitis

Treatment with Oral Active Vitamin D is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis ‐ Kerschbaum et. al. PLOS ONE, July 2013 Other Outcomes Months to first episode of peritonitis with no oral active vitamin D: 5.5 Months to first episode of peritonitis with oral active vitamin D: 16.3 Episodes of peritonitis per patient ‐ year with no oral active vitamin D: 0 45 Episodes of peritonitis per patient ‐ year with no oral active vitamin D: 0.45 Episodes of peritonitis per patient ‐ year with oral active vitamin D: 0.29

TYPE 2 DIABETES 48 48 ng/ml 22 ng/ml / l

Type 2 Diabetes Incidence in GrassrootsHealth (N=4,933) and NHANES (N=4,078 Cohorts 79% Lower 22 22 41 ng/ml ng/ml Median 25 (OH)D concentration in GRH cohort was 41 ng/ml and in NHANES was 22 ng/ml Median 25 (OH)D concentration in GRH cohort was 41 ng/ml and in NHANES was 22 ng/ml Data from GrassrootsHealth presentation at the June 2014 International Vitamin D Workshop

Recommended Daily Dose in Finland Cohort Study: 2000 IU in first year of life 80% Lower Lower

Vitamin D and the risk of dementia and Alzheimer disease Neurology published online August 6, 2014 Clear Link Found Between Vitamin D Deficiency and Alzheimer s Disease – Yahoo Health Alzheimer’s Disease Yahoo Health -Yahoo! Health Severely Deficient S l D fi i Deficient Severely D fi i Deficient Sufficient Deficient Sufficient Notes by the office of Rep. Seaton

Crews, M. et. al. Vitamin D deficiency in first episode psychosis: A case ‐ control study – Schizophrenia Research (2013) Vitamin D level at first episode psychosis p p y vs. control group 30 ml el in ng/m Combined Relative Risk of being Vitamin D deficient is 2.99 times higher in first episode psychosis n D Leve 20 g/ml n Vitamin 26.8 ng 6 ng/ml 4 ng/ml g/ml /ml 10 ml 21.6 14.7 ng/ Mean 15.7 ng 18.4 14.3 ng/ 0.1 ng/ml .7 ng/ml 9. 1 White Black Asian All N= 39 N=20 N=10 N=69

Association of Serum 25 ‐ Hydroxyvitamin D with Symptoms of Depression after 6 months in Stroke Patients – Neurochemical Research, August 2014, Wei Yue et. al. Odds Risk for Post Stroke Depression (PSD) increased by 21.12 times if vitamin D levels were below 11.2 ng/ml and still increased 10.32 times when fully adjusted for all confounders – notes by office of Representative Paul Seaton

Breast Cancer Relation to Vitamin D 5 2014 Preliminary GrassrootsHealth Data at 1 1/2 Year Follow ‐ Up 0f 844 Women s rson ‐ Years O Over 60 60 4 Median of 50 ng/ml 1,000 Per 3 82% Risk Reduction ncers Per 2 New Can 1 0 2007 ‐ 2011 Alaska Study Rate Study Rate Breast Cancer Rate <50ng/ml >50ng/ml Hazard ratio of breast cancer for those with serum 25(OH)D <50ng/ml was 5.1 times more compared to those with > 50ng/ml, adjusting for age and BMI. Chart arranged by the office of Representative Seaton

GrassrootsHealth Prospective Study 2009 ‐ 2014 From Grassroots Health and U.C. San Diego

Anticancer Research, March 2014 2014 Mohr et. al.: 25 ‐ Hydroxyvitamin D and Survival in Breast Cancer Cancer 50% Lower 50% Lower Mortality Risk Anticancer Research 2014 Mar;34(3):1163 ‐ 6. Meta ‐ analysis of vitamin D sufficiency for improving survival of patients with breast cancer. Mohr SB 1 , Gorham ED, Kim J, Hofflich H, Garland CF.

US A US Average Low Serum 25 Hydroxyvitamin D level and Risk of Upper Respiratory tract infection in Children and Adolescents Science et. al. Journal of Clinical Infectious Diseases, August 2013 volume 57 . Slide prepared by the office of Representative Paul Seaton