Sunshine of Your Love Part 4: Supplementation

Okay after a brief hiatus, now for the another installment of our vitamin D saga.  If you missed parts 1-3, please check them out:

• Sunshine of Your Love Part 1: Safely Getting What You Need
• Sunshine of Your Love Part 2: The D Factor
• Sunshine of Your Love Part 3: What is e-D-ible?

Our conclusions were:

• Go natural with the sunscreen--it pays to look into the ingredients just as you do your food.  If you don't want to eat chemicals, don't put them on your skin either.  

• Regular sun exposure up to pink gets you the vitamin D you need.  BUT it is HIGHLY unlikely that you can get all the vitamin D you need from the sun alone.  

• Why?  Because geographical location, time of year, time of day, duration of exposure, age, and skin color all must be in perfect alignment for you to meet your requirements.  And you must be as close to the Full Monty as possible--sorry, naked hands and face are NOT going to cut it.  AND you can't bathe or wash it off for at least an hour (some reports say up to 48 hours! See Dr. Mercola) after exposure to absorb it from the surface of your skin.  
• Bottom line: I would love for more people to get some sun exposure if they safely can.  There is a LOT more to gain from regular sunning than just vitamin D--like photoproducts we hardy know anything about for one (read newly released The Vitamin D Solution by Michael Holick, one of the Vitamin D Council doctors).  Unfortunately, it is also a reality that most of us find it difficult (perchance even impossible) to get outside as much as we should to meet our vitamin D requirements.    

• What are the requirements?  50-80 ng/ML of 25(OH)D in your blood according to the Vitamin D Council.  Keep reading for other recommendations given below.  

• And NO, you can't get all the vitamin D you need from whole food sources since those with the highest concentrations still only have a drop in the bucket, and you probably don't want to eat fish at every single meal.  

• NO, fortified foods aren't the answer either because they are processed and we are trying to move away from laboratory creations to eat real food again, you know: plants and animals.  

• Oh and still eating grains, other refined carbohydrates, and sugar?  Clean up your diet first.  Grains, especially wheat, contain nasties that muck up absorption.  Gluten gets its sticky hands all over nutrient, vitamin, and mineral absorption.  To add insult to injury, carbohydrate overload makes you store fat, which stores more of your vitamin D (fat-soluble, remember?) than it allows to circulate AND since you are in storage mode, you can't use that vitamin D because you aren't using your fat (NO you are NOT feeling the burn) (ref: Health Correlator).  Therefore, getting your vitamin D in check if you are a refined carbohydrate- or sugar-eater requires a heck of a lot more finagling.   

So if we can't meet our vitamin D needs from the sun alone or from food alone, what are we left with?  Supplementation (or as Dr. Harris from PaNu likes to call it: replacement, since we are just trying to get it back up to where it should be from the significant portion of our evolutionary past spent in the sun).

Here is a cute video from those fantastic Paleo in a Nutshell peeps over at Pay Now, Live Later.  Great summary of the sunshine topic thus far in our quest:



Vitamin D from Supplementation

Here are the guidelines:

1.  Take vitamin D as a liquid or gel/liquid capsule.  The tablets do NOT work unless you have them with fat.  Keep that liquid refrigerated to avoid oxidation (gel caps probably don't need to be, but I wouldn't leave them out in warm places or in clear containers, just in case).

2.  Take vitamin D3 from an animal source (usually fish or wool (lanolin)) NOT vitamin D2 from plants (it is NOT the same and is much less efficiently processed in your body).  You want cholecaliferol, which is also the form your skin makes naturally.  Nerdy interlude: The animal source for vitamin D3 is often wool since fur or feathers make animal vitamin D just as our skin does for us.  Furred and feathered animals get their vitamin D from grooming.  Unlike them, we don't have to lick our skin to ingest our vitamin D (but I guess you could...mmmnnn salty); we simply absorb it if we don't bathe or swim for at least an hour after sun exposure, if not more (try up to 48 hours more recommended by some sources, like Dr. Mercola).  Bring on the funk!

3. Do NOT rely on fish oil for your vitamin D unless it specifically says it contains vitamin D and even then, there is some controversy (ex. vitamin A toxicity with high dosage).  Read What about cod liver oil? in an upcoming installment.

4.  Do NOT compromise with additives.  Check ingredients so you don't sell your soul to get your D along with grain or soy or unpronounceable chemicals.

5.  Get the dosage YOU need.  How do you find this?  Get TESTED (We'll tackle how and where to get tested in another installment--it deserves its own time in the sun).  For now, I'd stick with the Vitamin D Council's suggestion to start supplementing if your sun exposure is inadequate and then test your vitamin D levels in two to three months.  For more details: read What We Recommend at the bottom of the linked page on the Vitamin D Council website.  If you do know your current vitamin D level and need to raise it, keep in mind that about 1,000 IU of D3 supplement for 3-4 months will raise your ng/mL count by 10.  Check out the information below on recommended levels and supplementation amounts.

6.  Take your vitamin D on schedule.  Most sources advise morning or daytime supplementation so that you aren't kept awake at night.  You can choose to take a large dose every other day or a daily dose, but I have seen some mixed reviews on the megadose-once-a-week plan.  It is skirting with toxicity (we'll delve into that another day).  To be safe, NEVER take more than 10,000 IU a day for any prolonged period.  For me, I like the routine of having my vitamin D with my morning fish oil--I'd probably forget if it wasn't ritual.

Dosing the D

Dosage recommendations vary and most advisors would rather you use a combination of sun, food, and supplementation/replacement.  If you have darker skin, you need to supplement (see this recent Journal of Nutrition article).  NOTE: it takes a good few weeks to months for supplementation to have its maximum effect on your blood levels of 25(OH)D--that is how vitamin D levels are measured--so be patient and, again, get TESTED and RETESTED.

NOTE: Some people are hypersensitive to vitamin D, but full blown toxicity cases are rare if you stick to supplementation guidelines.  Read what the Vitamin D Council has to say about toxicity and hypersensitivity here.

From the literature, it seems that instead of being overly concerned about toxicity, we should be more concerned about deficiency because it is so rampant.  Think that might be overly dramatic?  Try nearly 3 out of every 4 adolescents and adults in the US and nearly all non-Hispanic blacks and Mexican-Americans according to a report published in the Archives of Internal Medicine on data collections from 1988-2004.  Unfortunately, a big contributor to our deficiency is the inadequacy of our medical standards.  A growing consensus in the medical community has deemed the standards for vitamin D intake and blood levels epically inadequate for most people.  Here is the standard right now:

• Dietary Supplement Fact Sheet: Vitamin D from the Office of Dietary Supplements and National Institutes of Health (our current medical standards):
• Dosage: 200 IU for children to age 50, 400 IU for ages 51-70, and 600 IU for ages 71+ with a safe upper limit of 2,000 IU for adults (1,000 IU for infants)
• Blood levels of 25(OH)D: less than or equal to 15 ng/mL is "adequate" but less than 10-15 ng/mL is considered "inadequate" and greater than 200 ng/mL is "potentially toxic"  
• Testing: Testing?  Um, didn't find this even mentioned.  

And here is what some influential dissenters recommend (numbers given are for adults unless stated otherwise):

• Vitamin D Council: 
• Dosage: 5,000 IU a day for 2-3 months if you don't get regular sun
• Blood levels of 25(OH)D: 50-80 ng/mL is optimal 
• Testing: after 2-3 months of supplementation

• Marks Daily Apple: 
• Dosage: 4,000 IU a day to supplement (if you can't get adequate sun)
• Blood levels of 25(OH)D: 50-60 ng/mL levels recommended
• Testing: before supplementation and again in two months

• The Heart Scan Blog: 
• Dosage: 6,000 IU a day for most people (because you likely can NOT get your D from the sun, especially if you are over 40 years old)
• Blood levels of 25(OH)D: 60-70 ng/mL levels are optimal 
• Testing: every six months (summer and winter)

• Animal Pharm (and Track Your Plaque):
• Dosage: 2,000 to 10,000 IU daily (in the morning or daytime) (Track Your Plaque more specifically states: typically 4,000-5,000 for females, 5,000-6,000 for males but a range of 1,000-24,000 depending upon blood levels)
• Blood levels of 25(OH)D: 60-70 ng/mL goal 
• Testing: every six months of 25(OH)D (vitamin D), calcium, magnesium, and parathyroid hormone once optimal levels are reached (summer and winter testing)

• Dr. Mercola:
• Dosage: 5,000 IU daily but only after you've ruled out his preferred source: sun exposure 
• Blood levels of 25(OH)D: 50-70 ng/mL ideally
• Testing: before you begin and at regular intervals once supplementing 

• Dr. Miller, Cardiac Surgeon and Professor of Surgery:
• Dosage: 5,000 IU a day without sun exposure
• Blood levels of 25(OH)D: 50-99 ng/mL
• Testing: unclear frequency but especially if mixing high supplementation levels with sun exposure

• PaNu:
• Dosage: 4,000 IU daily in general, but see the quote that follows for more specificity
• Blood levels of 25(OH)D: above 50 ng/mL is optimal
• Testing: at least yearly and both vitamin D and ionized calcium should be measured

Ideally, get your 25(OH)D level and ionized calcium measured, and if it is less than 40 ng/ml, take 8000 iu/day for two months and measure it again. If  40-50, take 6000 iu/day. Any day you get full-dose sun, skip the oral dose. If still below 50 ng/ml, add 2000 iu/day with each two month increment until your interval two month reading is above 50 ng/ml. Once you are stabilized above 50ng/ml, check your levels annually

A Little More Conservative:

• Weston A. Price Foundation (see specific references listed at the end of this post): 
• Dosage: 1,000-2,000 IU cod liver oil to supplement vitamin D from other sources (sun and food)
• Blood levels of 25(OH)D: 40-50 ng/mL is optimal     
• Testing: seasonally if possible, especially if getting large dosages from any sources 

• Primal Wisdom:
• Blood levels of 25(OH)D: 40-60 ng/mL instead of higher levels (click on the link for his cautions)

• Dr. Weil, MD, Arizona Center of Integrative Medicine 
• Dosage: 2,000 IU daily and most people need to supplement
• Blood levels of 25(OH)D: 30-74 ng/mL
• Testing: not stressed

BIG MEDICAL NOTE:
This is NOT medical advice to take vitamin D or any other supplements.  Consult your doctor (and try to educate him/her with this information), do some research, get tested, and formulate your OWN plan.

In addition to all the references already cited, here are some more specific ones from the Weston A. Price Foundation:

Are Some People Pushing Their Vitamin D Levels Too High?

The Miracle of Vitamin D

Cod Liver Oil Basics and Recommendations

From Seafood to Sunshine: A New Understanding of Vitamin D Safety

And two more excellent resources:
Gibson Research Corporation's Vitamin D collection
SpectraCell Laboratories links to Vitamin D journal articles

Stay tuned for more yet to come on the Big D!  Here is the next installment:
Sunshine of Your Love Part 5: Toxicity

Roasted Garlic Pesto

So you have dutifully read Sunshine of Your Love Part 1: Safely Getting What You Need and Sunshine of Your Love Part 2: The D Factor AND Sunshine of Your Love Part 3: What is e-D-ible?

And your bonus for being such a good listener?  A recipe!  

Today's treat is a recipe (Finally!  I know, I talk/write way too much, but you should see me in person--I'm quiet, really!).  I made the most awesomely delicious pesto known to man.  I know, you are groaning, "Not another pesto recipe!  Dude, everybody has their own pesto recipe!"  Well, that is what you might think and if you leave now, your loss.  Seriously.  THIS pesto is worth the read and try.  And why is pesto related to our vitamin D post?  Just Because.  No, actually I'll serve it on shrimp and salmon, which if you remember, are good animals sources of vitamin D (although they will NEVER meet your vitamin D needs alone).

Method to the Madness: Roasting

The Garlic:  From America's Test Kitchen/Cooks Illustrated, I learned that roasted garlic tastes yummier than raw garlic in pesto.  It just adds a nuttier, richer, and less sharp, strong taste.  Since I have been buying the pre-peeled, packaged garlic (yes, convenience has done me in, just shoot me now!), I used that and roasted it in aluminum foil as I have seen other cooks do.  Don't worry, I'll go over this in the recipe.  If you have unpeeled garlic, try the America's Test Kitchen method of toasting it in a naked skillet over medium or low heat til just browning, not burning, on the outside.  If you have chopped/minced garlic, perhaps you can toast it in a skillet with some olive oil.  Whatever your method, we are after roasted garlic.  That makes all the difference here.

The Nuts:  I roast my nuts ALL the time ;)  So this application is no different.  It makes them more digestible than raw, but if you still have trouble with nuts (not an allergy, just upset digestion), try soaking and then roasting your nuts.  If you have an allergy, well, it sucks to be you.

The Basil:  Okay, this isn't roasted, but it has a method too.  I have read that bruised basil releases more flavorful oils than simply cutting it because more cells are ruptured to release their aromatic oils.  I suspect, but have yet to confirm, that cell processes are at work recruiting more liquid to the areas under duress, so more oil is released than during a quick chop.  Bruising herbs and letting them sit for a few minutes until you use them seems like it would lend itself to more flavor.  So I tried that with success.  Just be sure to use your bruised basil because it will not store this way.

Roasted Garlic Pesto

What can be more versatile than a rich, roasted garlic-infused pesto spreadable on any flat surface, pair-able with any meat, and dip-able by an array of veggies?  This classic pesto is a refrigerator staple!

Cooking Time: zero to pesto in 15 minutes or less

Quantity Achieved: about 1 to 1.5 cups (more is possible if you use more greens or oil)

Storage: air-tight in the refrigerator for about a week or measure out and freeze in muffin tins, then empty frozen pesto hockey pucks into a freezer-safe container and they'll keep for months.  Simply defrost and serve! 

You can make this with different greens and oils.  Here are two divine variations using the same basic recipe.

Classic Basil Roasted Garlic Pesto (pictured above)

Ingredients:

• about 2 cups (4oz before de-stemmed) fresh basil (I used the packaged variety since it isn't in season here yet)
• about 10-12 cloves of garlic (fits in 2T, packed), peeled (if unpeeled or minced/chopped already, read The Garlic section above) (For the peeled, sealed garlic, I used half a garlic packet per batch of pesto)
• 1/2 cup almonds or another nut of your choice (no, not peanuts, silly)
• 1/4 cup extra virgin olive oil (the good stuff), more if you desire a creamier consistency, + a little drizzle for the roasted garlic
• 2T freshly squeezed lemon juice (one pithy lemon or half a juicy one--or use more to taste)
• kosher salt
• freshly ground black pepper

NOTE: No cheese here and you will NOT miss it!

Method:

First, dump your almonds onto one half of a baking sheet and grab a large-ish square of aluminum foil.  Place the unpeeled garlic cloves in the center of the foil, drizzle on a little olive oil, sprinkle a little salt and grind a little pepper on top.  Mix to coat evenly.  Now, take two opposite sides of foil, connect them and bend over the edge.  Continue folding the edge over itself until you have reached the garlic.  Then, take one long side and fold it up and do the same to the other side to form a nice little garlic pouch.  Isn't that cute?  Place the pouch on the other side of the baking sheet from the nuts and place the sheet in a 350 degree oven, preheating doesn't matter.  Set a timer for 5 minutes and check the nuts.

In the meantime, prepare the basil by rinsing, drying, tearing leaves from large stems (some small stems and buds are fine), and squashing the leaves between your fingers.  Nothing too violent, just enough to bruise it.  Yeah, bruise that basil!  Bruise it good!  Isn't that a nice stress reliever?  Okay, now I am feeling mean.  Respectfully bruise that basil and tell it you'll relish every bite of its gracious contribution to your plate.  There.  Better.  

Have you checked your nuts?  If your nuts aren't done after 5 minutes, leave them in for another five or less if you feel they're close.  Done for those almonds means slightly more brown and some looking closer to burn, but not there yet.  It is difficult to tell; they never really look all that different to me (brown to more brown isn't very obvious), but I usually wind up getting anxious about burning and notice a fragrant, nutty smell.  They should be hot and start crackling when you take them out of the oven.  I love the sound effects!  So cute!  I err on the side of perhaps not all the way roasted brown, rather than risking burnage, because I too often become it's prey.

So once your nuts are done, put the foil pouch back in on the rack by itself, it shouldn't fall through unless you were really crazy with your folding.  Let it roast for at least 20 minutes total (don't forget the time it took the nuts to roast or the oven to preheat).  One time I let it go for 45min to an hour,  and that was an utter disaster.  So, now I err on the side of caution and say just roast until soft (you can mash them with a fork).  That varies depending upon your oven, how many times you checked your nuts, and other such unseen variables, so check the pouch (carefully unfold to look inside) after about 20 minutes and see if they are squashable.  If not, seal it back up and continue roasting another five minutes.  Watch the bottoms for browning or burning.  They are tricksy.

Okay, now we have roasted nuts and roasted garlic.  Awesome.  Your basil is bruised and bleeding, ready to get pulverized.  Let's get this party started!  Add basil, nuts, garlic, lemon juice, and 1/8 cup of extra virgin olive oil to the food processor and pulse to chop a few times, then let 'er whirl.  Scrape down the sides periodically and see how it's going in there.  The sides will probably be a green blur.  Once it is pretty well incorporated, add the remaining 1/8 cup of extra virgin olive oil, process for a good few minutes uninterrupted, then add more oil if desired to make your ideal consistency--for me, I like a thicker, paste-like pesto I can spread, more like hummus.  Others like theirs like soup.  Your choice!

When you are finished, add salt and pepper to taste.  Go easy with the salt--just a 1/8t to start.  One time I added a whole teaspoon and regretted it instantly.  If you don't use salt all that much, you grow much more sensitive to it!  If you do add too much salt, don't cry.  Just make another batch and now you have enough seasoning for both, or starting adding to the batch you already have.  Try some sun dried tomatoes, roasted bell peppers, more leafy greens, or if you want to be decadent, make Alton Brown's skillet mushrooms and add that.  Never heard of them?  Oh, that is a treat for another day, then!

Variation:  Arugula Roasted Garlic Pesto (pictured on the salmon below)
The peppery bite of the arugula pairs really well with the sweet roasted garlic, rich walnut oil, and lemon juice kick.  Delicious!

Ingredients and Method:
Same as above except use walnut oil instead of olive oil and 2 cups, packed, fresh baby arugula instead of basil (or in combination).

Pesto Serving Suggestions:

Damn near impossible to serve pesto wrong--it goes well on any meat I can think of (pesto bacon would be a neat one to try) and any veggie delivery device like celery or romaine.  Additionally, here are some great ways to make pesto a part of your main dish:

Classic Basil Roasted Garlic Pesto coated Shrimp

Pesto Shrimp

Want to get some vitamin D in the process?  Make a pound of shrimp and add a 1/4 to 1/2 cup of pesto to them  (right after cooking so it is easier to coat them).  Serve warm or cold.  OMG delicious!

If you don't know how to cook shrimp, here is a little primer for basic shrimp prep.  You can also grill them or saute in garlic, oil, and ginger (fan-freakin'-tastic, but perhaps not best for mixing with this pesto).

1. Keep the tails on for more flavor, but devein them before cooking.  Rinse them and try to pat dry so they're not sopping wet.
2. Get a skillet hot, add oil of your choice (for the pesto shrimp, I used olive oil, but I don't cook with it that often--avocado or coconut oil are better for high heat).  Then, add the shrimp.
3. Here is the tricky part: You have to move FAST.  Get turning those little shrimps as soon as they start to turn pink and curl, which is nearly immediately.  Seriously, move FAST!  Use tongs or a fast-flipping spatula that you don't have to fuss with.  I love to cook shrimp because they are the cook's dream--they have a color changing doneness indicator! They're like little reverse Freezy Freakies (remember those? We'd store ours in the freezer).  Nice to have a clear signal for doneness visible across the room.  But you shouldn't be across the room, should you?  Get flipping!
4. Once both sides have turned pink, immediately evacuate to a bowl or plate.  Don't wait for them to curl up into a nice little ball--just get them the hell out!  They'll continue cooking out of the pan.  I just make sure I don't see any obvious blue, see-through parts that show they're underdone.  The tails should be pink to red.  Err on underdone; they'll cook more on the plate. 
5. Once they are out, now's your time to add the pesto.  Mix well to incorporate.
6. Feast!

Pesto Salmon with Arugula Roasted Garlic Pesto

Pesto Salmon

Want more vitamin D for your buck, how about salmon?  There are a couple ways to do this: 1) broil with pesto on top (might make the pesto a little crunchy on top--could be good or bad), 2) broil halfway, then add pesto for the remainder, or 3) add pesto after the fish is done (you might not want to use cold pesto though).  Either way, broil until just done (it turns opaque from translucent, here is a good description--flaking is too long), then let it rest before serving.  I usually use the toaster oven and it's done in less than 10 minutes.  Great lunch!  If you want to get fancy, you can cook your salmon in a parchment or aluminum foil pouch with pesto on top, like this recipe from Kalyn's Kitchen that should be DELICIOUS with my pesto.  Give it a try!

Classic Basil Roasted Garlic Pesto smothered Roasted Turkey Breast

Pesto Roasted Turkey Breast
Yeah, I know, not really a great vitamin D-giver, but roasted turkey is a staple in this household.  It's super easy to prepare and gives us lunchmeat for a week when I make two at a time.  I buy the split breasts with bone in and skin on and prepare them using pesto rubbed under the skin, over the skin, inside the cavity along the tenderloin, even in slits cut into thick parts.  Basically, I want this turkey to be a pesto delivery system :)  Roast at 425, uncovered for 35-45 minutes (less if small), then check the temperature for 150 degrees (big double batches take up to an hour) and let it rest before diving in.  Makes a great meal or can be refrigerated for a week and served as lunchmeat alone or in salads.  Yum!  Here's my original Roasted Turkey Breast recipe.

Inspired?  I hope so!  Tell me about your pesto adventures!

Sunshine of Your Love Part 3: What is e-D-ible?

This is the third installment in our series about the sun.  For context, please read 
Sunshine of Your Love Part 1: Safely Getting What You Need and 
Sunshine of Your Love Part 2: The D Factor.  

After our last discussion of the inherent problems with getting your vitamin D from the sun alone, we were left with the question: So where can we get the vitamin D we need?  Today, let's talk food.  

Getting Your Vitamin D From Food

The vitamin D humans (and all animals) produce from a chemical reaction in our skin under UVB rays is D3, in the form of cholecalciferol, the most readily usable form by our bodies.  If we eat animals, we get the same form of vitamin D that we make ourselves.  Another form, vitamin D2, is produced by plants and fungi, but you're unlikely to ingest much of it when you eat the plant or fungus.  Special treatment of plants and fungus can extract the vitamin D for use in fortified foods and supplementation.  However,  since plants and animals are vastly different creatures down to the cellular level, their form of vitamin D isn't an equivalent to ours.  That is why if you are outsourcing your vitamin D needs, you must choose vitamin D from animal sources.  We'll discuss this more below under Fortified Foods: The Right Stuff.  Thus, our sources for vitamin D from food are: animals or fortified foods.

Fortified Foods: Frankenfoods

You've seen them before.  Cartons of milk and orange juice, containers of yogurt and margarine, and boxes of breakfast cereal all telling us they are a source of vitamin D.  On the surface, the game plan seems solid.  These are foods built from the ground up, combining numerous distilled ingredients to craft a whole new food novel to any creature in existence.  In theory, you would think the builders have your best interests in mind: they have the power to create super-nutritious super-foods.

For example, Total Cereal tells us they offer "100% Nutrition" by giving us 100% of the Daily Value of 12 vitamins and minerals.  How responsible of them!  One hitch: sugar is their number two ingredient and corn syrup, number three.  In each 3/4 cup serving, I repeat: 3/4 cup serving, there are 5 grams of sugar, or just over one teaspoon or sugar packet.  Exactly how does that contribute to total nutrition?

Unfortunately, the arms race in the processed food industry isn't to create a more nutritious product giving lasting health benefits; it's for profit and convenience (which leads to more profit).  The old saying rings true once more: 'You can have it cheap, you can have it good, or you can have it fast.  Choose two.'  Unfortunately, high quality, nutritional "goodness" has been sacrificed for cheap, fast food.

Just browsing through your average supermarket would make our ancestors weep.  Where the hell is the real food?  Oh yeah, tucked away on the periphery are the meats, fruit, and veggies, outliers of the industrial complex.  Even these aren't immune to commodification as we reconfigure and patent genetic codes creating genetically modified organisms, industrialize even "organic" farming, and feed waste products and surplus into animal "products" through CAFOs (Concentrated Animal Feeding Operations, also known as factory farms) producing meat instead of raising animals.  Food is being redefined away from its biological roots and into products that can be produced, refined, and commodified.    

Processed foods, a multitude of refined parts compressed into one whole, are less than ideal for many reasons.  One, they're made to sell.  Profit comes before any altruistic desires for the betterment of human health.  Perhaps this isn't true for every product out there, but certainly most.  Tell me how these products were created to nourish us: pancake batter in an aerosol can, fruit-flavored products without any real fruit, or meat substitutes with ingredient lists longer and more unpronounceable than those of beauty products, just to name a few.  To show just how abhorrent the whole creation of a food marketed as "healthy" really is, take the following passage from The Omnivore's Dilemma by Michael Pollan.  Let's play, What Am I?

...four cents' worth of commodity corn (or some other equally cheap grain) transformed into four dollars' worth of processed food.  What an alchemy!  Yet it is performed straightforwardly enough: by taking several of the output streams issuing from a wet mill (corn meal, corn starch, corn sweetener, as well as a handful of tinier chemical fractions) and then assembling them into an attractively novel form.  Further value is added in the form of color and taste, then branding and packaging.  Oh yes, and vitamins and minerals, which are added to give the product a sheen of healthfulness and to replace the nutrients that are lost whenever whole foods are processed.

So, what am I?  See the answer at the end of this post.  And even if you are okay with the whole frankenfood thing, there are other pitfalls to fortified foods.  Does it even give you what you need?  Is it even worth it?  Let's explore dairy, next.    

Fortified Foods: Does Milk Really Do a Body Good?

What about dairy products?  Although processed, they are closer to the source--their ingredient lists are short.  Can't I get my vitamin D from milk like the ads tell me?  No, because:
1.  Milk and dairy products aren't for everyone.  You can be healthy without them in your diet.
2.  Milk alone doesn't have the amount of vitamin D you need even when it's fortified.
3.  Skim milk doesn't have the fat you need to absorb vitamin D.  
4.  The trans fat in margarine totally gunks up the process of utilizing vitamin D.    

One, dairy may not "do a body good," at least not for every body.  There is definitely some debate about the healthiness of milk.  See Mark's Daily Apple for a good summary.  We'll hit that one another day, but for now, read up on why The Paleo Diet doesn't like dairy.  For more depth, check out founder Dr. Loren Cordain's argument at his website.  For as many opponents, there are just as many proponents of full-fat dairy like PaNu, The Weston A. Price Foundation,  The Heart Scan Blog, and Whole Health Source, to only name a few.  For me, I'll probably continue to partake in high fat dairy like butter and cream and try to mininmize my dairy that isn't full fat, raw, and grassfed.  Although I know dairy has many benefits, it also has some detriments I've seen firsthand in my N=1 experiments: I get plegmy, wake up congested, get a runny nose, and sometimes get a sore throat.  And that is dairy alone--no grains to confound these results.  The severity depends on the quantity, source, and form of dairy.  Definitely something is at work here.  And remember, on a paleo-style diet you are absorbing your calcium from your veggies (because a clean digestive system is an efficient one) and your vitamin D from other sources we'll discuss below.  So no one NEEDS milk to survive, except breastfeeding babies.  Just saying.

Okay, dairy is a personal choice, but as our second problem can it even provide the vitamin D you need?  This discussion of Vitamin D and Milk from a UC Riverside professor that we cited in our first installment is a good resource to answer this question.

Milk from all lactating animals, including humans, contains vitamin D3 that has been produced photochemically from 7-dehydrocholesterol present in the skin. In cow's milk it has been determined that the concentration of vitamin D3 in milk provided by the cow is roughly 35-70 International Units per quart as determined via biological assay and approximately 50-80 International Units as determined by modern chemical mass spectrometric procedures. However these are rather low levels of vitamin D3 from the perspective of providing the 200-400 IU per day as recommended by the Food and Nutrition Board of the Institute of Medicine. 

And remember, that 200-400 IU recommendation is way below that suggested by The Vitamin D Council to achieve 50-80 ng/mL blood levels.  They say to take 5k daily and recheck in 2-3 months.  Since milk isn't a great source for vitamin D naturally, it's fortified.  According to the article cited above, every quart is fortified with 400 IU of vitamin D.  So to drink your 5K a day, that would be 12 and a half quarts a day.  Even a more conservative dosage of 1k a day would be two and a half quarts.  Thirsty?  

Another problem, we've been told fat is bad for us, so we switched to heart-healthy skim.  But on this blog we've time and again taken skim milk to task for not containing the healthiest part: the fat!  Fat is where the vitamin D and other vitamins, essential fatty acids, and important constituents reside.  Fat is necessary for absorption of fat soluble vitamins like...say it with me now...Vitamin D!  And other forms of commercial milk aren't off the hook even if they DO contain fat because they are pasteurized and homogenized.  There is a LOT to say about these processes and how they destroy everything sacred about milk, so read the Weston Price Foundation's treatise: Milk: It Does a Body Good?  

Does that mean our precious, fortified, non-butter, saving-us-from-the-evils-of-saturated-fat spread (also known as margarine) is out too?  Um, YES.  Besides being a processed product made from an array of chemicals, margarine is mostly trans fat (trans fatty acids are made from the hydrogenation of vegetable oils and there is little argument about them NOT being the least bit healthy).  And why is trans fat a problem specifically with vitamin D fortification?  It interferes with the conversion of vitamin D into calcidiol in the liver.  Maybe the producers know it screws up the process, so they are just hedging their bets and dumping more vitamin D in there to hopefully balance it all out.  And you would think that with all the effort we put into refining and producing products based on their constituent parts that we could actually craft healthy products.  Silly me, it's a sci-fi pipe dream to think that food production is out to meet our nutritional needs.  Guess I'll have to wait for Asimov's yeast products and Star Trek's replicators.... Sigh.  

Fortified Foods: The Right Stuff

But other foods are fortified besides dairy, you say?  How about heart-healthy OJ fortified with calcium and vitamin D?  Even if everything seems "right" with vitamin D-fortified foods, other problems emerge.  Take that fortified OJ.  According to Minute Maid, it's just juice, calcium sources, and vitamin D3 (good for them!).  What's the problem?  The juice.  What's wrong with juice?  The fact that in 250ml or ONE cup there are 120 calories, 28g of carbohydrate (25 of which is sugar), and NO satiating fiber.  That's three Zone blocks right there and it's certainly NOT a low glycemic food.  One cup of orange juice is over 50 times the calories of an orange.  While it is difficult to overeat fruit because of their fibrous bulk, it's effortless to down a big glass of OJ and feel like you are doing your body good.  And good luck feeling full; without significant protein, any fat, or any fiber, you're just fanning the flames.  The worst part?  That sugar load, calories and all, isn't so different from soda.  In fact, 240ml of Coca-Cola Classic is only 96 calories and 27g of carbohydrate/sugar.  Are those vitamins and minerals in fortified OJ really enough to make it healthier?  For more on why juice is a no-go, please read my article: Just Say No...to Juice?

Another pitfall?  Fortification with vitamin D often involves the form vitamin D2, which comes from plants or fungi.  One catch, plants/fungi are entirely different beings than animals.  Our bodies are wired very differently, down to the cellular level (cell walls in plants and cell membranes in animals are quite different).  Plant vitamin D, D2, is not the same as our vitamin D, D3, so it is much less efficient to use the plant form to get what we need.  This study calls for an end to vitamin D2 fortification and supplementation because it is NOT an equivalent to D3.  The authors state that vitamin D2 is NOT as effective at raising vitamin D levels, has a shorter shelf life, may lead to incorrect circulating vitamin D measurements, and is metabolized differently, thereby it doesn't assume the same functions as vitamin D3.  Dr. Davis from The Heart Scan Blog concurs.  He discusses how D2 is a cheaper supplement than D3, but it pales in comparison to the effectiveness of D3 in the body.  

Insult to injury?  Even if producers fortify foods with the most bioavailable form of vitamin D, D3, the source is up for grabs.  Just because they are fortifying cow's milk, doesn't mean that added D3 is from a cow.  It could be from any animal used to make that source.  There are NO requirements to identify the source of ingredients like vitamin D.  Isn't that a little disturbing?

Animal Sources of Vitamin D

So where can you get natural animal sources of vitamin D?  Fish, for one.  Salmon, sardines, and shrimp are very good to excellent sources according to The World's Healthiest Foods (a nutritional database) and eggs follow close behind (and yes, you have to eat the yolk, which contains all the nutritional goodness like the vitamin D!).  That website also lists vitamin D-fortified cow's milk as a very good source, but we are going for whole foods, not processed, and I already discussed it's detriments above.  

Meat quality matters.  Wild-caught fish has significantly more vitamin D than non-organic farm-raised, which lends more evidence to support our preference for sustainable wild-caught, grass-fed, and pasture-raised sources of meat.  For more information on sustainable fish, check out the Monterey Bay Aquarium's Seafood Watch list.  The Weston Price Foundation article further elaborates that the plankton and other fish in the diets of the fish we eat provide their vitamin D (that they cannot synthesize it from the sun themselves).  Thus, farm-raised fish on a processed (usually grain-based) diet are not getting the dietary vitamin D to become as rich a source as their wild brethren.  Unless, of course, we fortify their grain-based diet, which leads us back around to the argument above: we CANNOT make better foods than those found in nature.  The Weston Price Foundation article also mentions that we aren't even exploiting the real WHOLE foods that contain the most vitamin D, like the organ meats, skin, fat, and insects that are uncommon modern foods. 

Unfortunately, getting the vitamin D you need is NOT as simple as just eating your fill of fish.  The quantity of vitamin D in different foods varies.  It even varies for the SAME foods!  Argh!  For instance, mackerel cooked 3 to 3.5oz is 388 IU here (for 3oz) and 345 IU here (for 3.5oz).  Either way, even the best food sources (one 3-4 oz serving of salmon with up to 794 IU, although most charts have it closer to 400 IU) are a drop in the bucket for what you need.  And if what I have read is right, we do NOT want to listen to the daily recommended values given on those sites (400 IU a day, are you serious?).  Remember, we are shooting for 5000 IU a day according to The Vitamin D Council.  But the real number you need depends entirely upon your own vitamin D level, so get checked!  The Vitamin D Council recommends 50–80 ng/mL (or 125–200 nM/L) year-round.  Taking the average 400IU in 4oz of the best food source (salmon), that would take 12 and half servings a day.  Hungry?

Additionally, there is also a whole can of worms to explore with vitamin D's cofactors (read more about them at the Vitamin D Council): those vitamins and minerals necessary for it to do it's many jobs.  Any deficiencies and you're screwed.  This is more detail than we can handle today, so it suffices to say that you should eat REAL FOOD and make sure your diet is full of variety and rich sources of vitamins and minerals, including sustainable wild-caught fish, pasture-raised poultry and eggs, grass-fed meat, and local and seasonal vegetables, fruit, and nuts.  

And what about getting the vitamin D you need?  Well, that question has not been answered yet.  I guess it's to be continued:

Sunshine of Your Love Part 4: Supplementation

References

General references used extensively (in addition to those cited above):
The Omnivore's Dilemma by Michael Pollan

The World's Healthiest Foods: Vitamin D

Weston Price Foundation's article: The Miracle of Vitamin D and Milk: It Does a Body Good?

The Vitamin D Council

Answer to What Am I: breakfast cereal.  Still think it's a healthy start to your day? 

Sunshine of Your Love Part 2: The D Factor

Sunshining sea lion soaking up some vitamin D.

This is the second installment in our series about the sun.  For context, please read Sunshine of Your Love Part 1: Safely Getting What You Need.

So today, let's talk vitamin D.  We all know about vitamin D.  It's in the milk ads, in the news, and in steadfast nutritional pillars of our society: breakfast cereal, milk, margarine, and orange juice.  According to The Washington Post:

Vitamin D is shaping up to be the nutrient of the year, if not the decade.

This vitamin is common dinner table and water cooler conversation.  When the sun kisses your face, you likely think of it and then think of sunburn.  Vitamin D is the puffy white cotton candy cloud top, while it's alter ego, sunburn, is the thunderous underbelly, a raging tempest.  And with such mixed consensus about the sun, fortified foods, and supplementation, vitamin D sits right in the middle, teetering on the seesaw between nourishment and harm.

There are a lot of questions about vitamin D and today is it's time in the sun ;)

1.  What is it?


Short answer: a fat soluble, essential vitamin that acts as a hormone.

2.  Why do you need it?


Short answer: it has a multitude of roles to play and protects against cancer.

3.  Where do you get it?


Short answer: from the sun on your skin, from certain foods with animal origin, and from supplementation.  But whether or not any of these sources alone can meet your needs requires further discussion.

Now for the elaboration.  Why?  I don't want to provide Just Because kinds of answers--I want you to learn something and understand it so that you can discuss the subject intelligently.  For example, how do you respond when someone says that they get all the vitamin D they need from their fortified skim milk and from their sunscreen-lathered sunbathing?  Curious?  Read on.

What is Vitamin D?

Vitamin D is classified as a vitamin, but also as a hormone, or "pro-hormone," since it is synthesized by body tissues like a hormone as well as ingested through the diet like most other vitamins.  As a hormone, vitamin D regulates growth, development, and metabolism, whereas most other vitamins play bit parts in these processes.  Vitamin D enters the body either through synthesis in our skin cells or through foods (and supplements) we eat (for more see Where Do You Get Vitamin D? below).  Whatever the source, it must be transported to the liver where it is hydroxylated and circulated as hydroxyvitamin (which is the substance we measure to obtain vitamin D levels), called calcidiol.  Calcidiol is the storage form of vitamin D in your body and it is used to make calcitriol either in the kidneys or, if any is left over, directly in the cells.  This form enters cells and regulates gene expression.  As a hormone, vitamin D transports signals and messages; cells even have receptors for it just like they do for cortisol.  Hence, with vitamin D there is definitely more than meets the eye (did you say that in your mind with a robotic voice?  Yeah, I thought so :) ).  Vitamin D plays a host of roles, discussed in the next section.

Why Do You Need Vitamin D?

One of the most important jobs of vitamin D in the body is to maintain calcium levels.  It does this by reclaiming circulating calcium and increasing calcium absorption in the small intestine or, if dietary calcium is insufficient, by leaching calcium from the bones (ever hear of osteoporosis?).  That is why vitamin D and calcium fortification go together--you need adequate dietary calcium or vitamin D will get it by any means necessary.  This is a Clear and Present Danger sort of situation.  We'll go into just when this "no holds barred" presidential order is issued in a future installment on exactly how much vitamin D is adequate (that's a whole 'nother can of worms).  In addition to maintaining healthy bones, vitamin D also plays a role in insulin secretion, muscle health, metabolism, immunity, and blood pressure regulation.  Bottom line: it earns it's title as Essential.

An additional benefit of vitamin D is that it protects against cancer.  Vitamin D increases cellular differentiation, the specialization of cells to their specific functions, at the cost of decreasing cellular proliferation, the creation of new cells.  How does this relate to cancer?  Well, the chances of error (mutation) increase the more copies are made of any one thing.  Ever play the Telephone Game?  Then, you know of what I speak.  Cell proliferation increases the chance of mutation, thus, the formation of cancerous cells, a possible outcome of mutation.  Proliferation also makes matters worse once cancer cells are formed because it rapidly spreads them.  So the more vitamin D, the better your chance not to develop or to spread cancerous cells (to a point--we'll discuss toxicity concerns another day).  Interested in more about vitamin D's protective role?  Free the Animal summarized an incredible study on the Dose-Response of Vitamin D and a Mechanism for Prevention of Cancer.  Check out the charts to visualize it.

Without adequate vitamin D, infants and children can develop rickets, a bone growth impairment leading to deformity (softened bones bow out during development).  Surprisingly, even with vitamin D fortification of foods, rickets is still being reported in cities.  That is why our next section is so critical.  Other signs of deficiency are increased fractures, bone pain, and muscle pain and weakness.  Sounds fun!

Where Do You Get Vitamin D?

There are three main places to get vitamin D when you live paleo-style: one is through your skin, another through your food, and the third is through supplementation.  I would rather get my vitamin D from my skin and from whole foods, but there is debate about whether the sun or whole foods can supply us with the amount we need, thus, the need for supplementation.  Of course, if you eat processed foods, many are fortified with the vitamins and minerals you need despite the fact that the are ALSO full of everything you do NOT need, like ubiquitous grains, vegetable oils, sugars, and chemicals.  You can't make up for nutrient-poor foods, their constituent parts striped of any nutritional value during refining, by pumping them full of refined vitamins and minerals.  Processed foods do NOT do a body good.  In our evolutionary past, eating vitamin D-rich foods and spending ample time exposed to the sun allowed us to get what we needed, but in today's 9-5 world, getting sun is limited, and getting it from whole foods is difficult, if not impossible.

From The Sun

So how does your body synthesize vitamin D?  The ultraviolet radiation from the sun hits your skin in two main wavelengths: UVA and UVB (there is a third wavelength, UVC, that is mostly absorbed by the ozone and is actually given off by artificial lighting like fluorescent and halogen bulbs, so be wary).  UVA is the kind that penetrates into deep skin layers and creates free radicals.  According to the Weston Price Foundation's The Miracle of Vitamin D article, UVA leads to tanning, but not burning unless excessive, while UVB readily leads to burning (which is a flush of blood to the surface of the skin to repair damaged cells).  UVB also provides the necessary cue for our skin's production of vitamin D, but it too is harmful and can cause skin damage.

So how is vitamin D actually made?  UVB rays activate vitamin D synthesis by turning a certain cholesterol in our skin cells into cholecalciferol, or vitamin D3 (See? ALL cholesterol is NOT bad!  We make and need our own!).  Since the vitamin D needs to be absorbed from the oils on the surface of your skin, you shouldn't bathe or swim within one hour of sun exposure if you are trying to get your vitamin D primarily from the sun.  Thus, you need UVB to synthesize vitamin D in your skin, but not too much that you damage cells and increase your risk of skin cancer.  Talk about a balancing act!

What could make this even worse?  How about not only do you have to be careful not to burn, but the amount of vitamin D you can synthesize from the sun varies tremendously by time of day, time of year, latitude, age, skin exposure and duration, and skin color?  Let me explain.

• Time of Day

UVB (the one leading to vitamin D AND sunburn AND skin cancer) is most intense at midday, but UVA (the tanning one that also contributes to skin cancer) is equally intense throughout the day--and both are even present on light cloudy days (hence my mom always telling me to wear sunscreen even when it's cloudy, which I thought was just being mean.  I think parents get a perverse enjoyment out of slathering sunscreen on wiggly children who pucker their faces with annoyance and can't believe the audacity of their parents to delay their play.  It's a ritual.).  So you have to get your vitamin D from sunbathing at midday, the time that ALSO puts you at the most risk.  Great.

• Latitude and Time of Year

The further you are from equatorial regions, the less intense the UVB rays.  You need a UV index of 3 or more to kickstart your vitamin D synthesis, and while that is daily in the tropics, it's only daily in the the spring and summer in temperate regions, and almost never in the arctic.  According to Weston Price Foundation's article on The Miracle of Vitamin D:

Latitude and altitude determine the intensity of UV light. UV-B is stronger at higher altitudes. Latitudes higher than 30° (both north and south) have insufficient UV-B sunlight two to six months of the year, even at midday. Latitudes higher than 40° have insufficient sunlight to achieve optimum levels of D during six to eight months of the year. In much of the US, which is between 30° and 45° latitude, six months or more during each year have insufficient UV-B sunlight to produce optimal D levels. In far northern or southern locations, latitudes 45° and higher, even summer sun is too weak to provide optimum levels of vitamin D. 

• Age

The older you are, the less efficient your vitamin D synthesis, so you need to stay in the sun longer to generate vitamin D.  But older skin is also more susceptible to burning, so it's a wash.

• Skin Exposure and Duration

Weston Price Foundation's article on The Miracle of Vitamin D says that the current prescription of 10 minutes of midday sun exposure a day is not enough.  And remember, you can't wash your skin, bathe, or swim for at least an hour if you want to absorb that vitamin D.  

The current suggested exposure of hands, face and arms for 10-20 minutes, three times a week, provides only 200-400 IU of vitamin D each time or an average of 100-200 IU per day during the summer months. In order to achieve optimal levels of vitamin D, 85 percent of body surface needs exposure to prime midday sun. (About 100-200 IU of vitamin D is produced for each 5 percent of body surface exposed, we want 4,000 iu.) Light skinned people need 10-20 minutes of exposure while dark skinned people need 90-120 minutes.

• Skin Color

 The lighter your pigmentation, the more quickly you'll burn.  We'll discuss this more in our final chapter:

Hey Chorles?  

Okay, Chucky D, so if the sun KILLS us, how the hell did we survive this long?  If it is that dangerous, wouldn't our ancestors all have had skin cancer and never have survived?  The evolutionary answer is skin pigmentation.  Melanin, the pigment in the skin, protects us by absorbing UV rays and disbursing them as harmless heat.  The more melanin, the darker the skin, and the more UV protection.  However, this UV protection comes at the cost of less vitamin D synthesis since it relies upon those UV rays to kickstart the process.  Accordingly, the distribution of skin pigmentation before modern transportation generally followed latitude: darker where the sun is brighter to protect the skin from the more intense rays, lighter where the sun is less bright and more intermittent, so that any sun exposure can get vitamin D synthesis activated post-haste.  Tanning is a second defense and one that depends on environmental cues.  It can be both adaptive and detrimental.  When UV rays damage your skin, they trigger more production of melanin to protect it from further assault.  So while it is a good thing to have more melanin to protect your skin if you are often out in the sun, also keep in mind that tanning shows damage already done and slows vitamin D synthesis, since the melanin is absorbing the UV before it can activate vitamin D synthesis.  See, even the biological world lives in shades of grey and defies a good/bad dichotomy.     

It's a trade-off: the evolution of darker skin pigmentation around equatorial regions allowed for more sun exposure before burning, but resulted in slower vitamin D production and required longer duration of exposure.  And vice versa: lighter skin pigmentation evolved farther from the equator to allow for quick vitamin D synthesis where there was reduced solar intensity, but came with the cost of greater susceptibility to sunburn.  You're damned if you do and if you don't.  Interestingly, there are a few exceptions to the generality, such as the Eskimo, who have darker skin than expected at such a sunlight-poor latitude.  How were they not vitamin D deficient?  Fish.  They ate lots of fish, which have the vitamin D they needed to survive.  

While skin pigment gradation by latitude was once useful, since we have migrated, it has become an issue.  Today, those with darker pigmentation are more likely to be vitamin D deficient without ample sun exposure, which is difficult to achieve at any latitude in today's working 9-5 world.  Between melanin levels, all the factors associated with sun exposure, and our prodigious use of sunscreen, it is highly unlikely that we are meeting our vitamin D needs through the sun alone.

All of these confounding factors add up, which is why many are deficient even in sun-soaked regions.  This study from sunny Florida, and this one from Hawaii show that even where there is adequate sunlight, people are still deficient.  So we're still left with the question: where can we get the vitamin D we need?

And that, my friends, is a tale for another day.  This story is NOT over yet!

Here is our next installment: Sunshine of Your Love Part 3: What is e-D-ible?

References

General references used extensively:

Micronutrient Information Center at the Linus Pauling Institute of Oregon State University

The World's Healthiest Foods: Vitamin D

Weston Price Foundation's article: The Miracle of Vitamin D

The Vitamin D Council, especially vitamin D physiology

Ultraviolet Radiation from The University of Minnesota School of Public Health
Wikipedia entries on Vitamin D and Melanin and Ultraviolet

Sunshine of Your Love Part 1: Safely Getting What You Need

The sun is here again, hopefully to stay.  My cats, eternal sun worshipers, show their devotion as they migrate room to room chasing its rays throughout the day.  Nothing quite mimics that swaddling warmth of the sun.

A la Monty Python and the Holy Grail: "Winter changed into spring, spring changed into summer, summer changed back into winter, and winter gave spring and summer a miss and went straight on into autumn... until one day... " the sun came back and Summer-Spring was here.  The days are sunny and warm flitting back and forth between spring chilly and summer hot.  And with the sun comes CANCER, or so I have been taught.

Okay, knee-deep in research and trying to craft a post scrolling out to book length, I decided to attack this topic in parts.  One part is NEVER enough to say what I want to say and really educate you or my own self about nutrition issues as important as this.  So I'll save you the reading and try to make this as user-friendly and as concise as possible.

Today, let's give the meat: what you need to do to protect yourself from CANCER while still getting what you need, precious vitamin D, a vitamin-hormone essential to your inner workings and protective against cancer.  I'll go into specifics another day, but suffices to say it's IMPORTANT STUFF.  Even if cancer doesn't fall from the sky, those pesky cancer-causing UV rays do, who on one hand they activate your skin cells to synthesize vitamin D while on the other they damage your DNA, which spawns its own two hands: on one DNA damage causes your skin cells to produce more protective melanin to absorb the harmful UV and on the other hand it produces free radicals and oxidative damage that increases risk of cancer.  So as this four-armed creature we've created illustrates, it's complicated.

But I am really curious about what I should do about all this, as I imagine you are too unless you know everything about everything.

From my research, here are my friendly suggestions (and remember I am no Nurse Jane Fuzzy Wuzzy, so this is just my two cents):

• Get tested.  Find out your vitamin D level to decide your next step.  The Vitamin D Council recommends (and Dr. Davis of The Heart Scan Blog concurs through his patients) (emphasis mine):

take 5,000 IU per day for 2–3 months, then obtain a 25-hydroxyvitamin D test. Adjust your dosage so that blood levels are between 50–80 ng/mL (or 125–200 nM/L) year-round.

• Find "natural" sunscreens that DON'T contain these harmful (if not toxic) chemicals:  

octyl methoxycinnamate (OMC)

butyl methoxydibenzoylmethane

para amino benzoic acid

octyl salicyclate

avobenzone

oxybenzone

cinoxate

padimate O

dioxybenzone

phenylbenzimidazole

homosalate

sulisobenzone

menthyl anthranilate

trolamine salicyclate

octocrylene

benzophenone-3

titanium dioxide  

4-Aminobenzoic acid (also known as para-aminobenzoic acid or PABA) 

• Use sunscreen with zinc oxide, which seems like a safe ingredient.  Rules: Apply 15-30 minutes before sun exposure, then reapply after 15-30 minutes of sun exposure.  Afterwards, only reapply as needed due to sweating, swimming, rubbing it off.  

• If you do have to use commercial sunscreen, wash it off with soap as soon as possible after sun exposure.  The chemicals can leach into your skin and produce free radicals with exposure to the sun.  So, in fact, the sunscreen supposedly protecting you from skin cancer can actually lead to skin cancer itself.  Great!

• If trying to synthesize vitamin D from the midday sun: expose as much of your skin as possible.   Cover up your skin after you've had only enough exposure to turn pink (NOT red).  And DON'T wash your skin or go swimming until at least an hour after exposure to absorb the vitamin D.  DON'T rely on this as the only way to get your vitamin D unless you validate that assumption with a vitamin D test.  Note: the UVB rays you need to synthesize vitamin D are most intense at midday and vary by time of year and latitude, so don't go sunbathing at 8am in the winter and expect to get your vitamin D!

• Avoid overexposure during the midday sun.  Even with "protection" this is dancing-around-in-your-underwear-and-pink-dress-shirt kind of Risky Business.  While some types of skin cancer are clearly blocked by UVB-blocking sunscreen, melanoma (the Big Bad) confounds researchers by showing up in those who have used adequate sunscreen or who avoid UVB rays.  Even "broad spectrum" sunscreen may not block enough.  

• Use high SPF and follow the directions for recommended amount.  SPF provides a multiplier for how much time it takes you to burn.  Me?  I'm a zero to 15 sort of girl ;) so I shoot for high numbers and usually try to find baby sunscreen that won't sting in my eyes and is supposedly more "gentle."  You'll be happy to know that many paleo/primal eaters (like this one) have seen an increase in the time it takes them to burn now that they are on clean fuel.  According to Mark's Daily Apple, the difference between SPF diminishes with higher numbers so that while an SPF of 30 is blocking 96.7% of UVB radiation, an SPF 50 is blocking 98% and an SPF 100 is blocking 99% (so keep that in mind when you price-shop).  And if you don't apply the required amount, you don't get the protection: using half of what is recommended does not mean you get half the protection--in fact you get much less.  In reality, there are so many factors to take into account that the higher the better (to a point), but don't bank on that number actually panning out.   

• Eat plenty of veggies (and some fruit is okay too, especially berries) for antioxidants that decrease free radicals and their damage.  Specifically, there is evidence of carotenoids protecting against sunburn, especially with vitamin E (found in nuts).  

• For dietary sources of vitamin D, eat plenty of fish, especially oily fish and salt water fish.  Eat whole eggs--the vitamin D (along with all the other nutrients) are in the yolk.  If your diet includes dairy, enjoy full fat dairy from pastured, grass-fed animals--preferably raw. 

• Take a vitamin D3 supplement from an animal source (NO D2 is NOT the same thing and you can't get D3 from a vegan source) and have it with fat.  How much D3 do you need to take?  Get tested (and see our first bullet point).  One caveat, and one I am wrestling with myself, is that we are trying to get away from processed foods and supplementation introduces another processed food into our diet.  Is it a necessary evil?  Looks like you can get vitamin D3 from fish oil and from sheep's wool.  Either way it is processed and unfortunately my fish oil brand doesn't tell me the vitamin D content, so I use a separate D3 supplement from sheep's wool.  An article entitled "Vitamin D and Milk" by Professor Norman at UC Riverside (emphasis mine) explains the production process:

The commercial production of vitamin D3 is completely dependent on the availability of either 7-dehydrocholesterol or cholesterol. 7-Dehydrocholesterol can be obtained via organic solvent extraction of animal skins (cow, pig or sheep) followed by an extensive purification. Cholesterol typically is extracted from the lanolin of sheep wool and after thorough purification and crystallization can be converted via a laborious chemical synthesis into 7-dehydrocholesterol. It should be appreciated that once chemically pure, crystalline 7-dehydrocholesterol has been obtained, it is impossible to use any chemical or biological tests or procedures to determine the original source (sheep lanolin, pig skin, cow skin, etc.) of the cholesterol or 7-dehydrocholesterol.

Next the crystalline 7-dehydrocholesterol is dissolved in an organic solvent and irradiated with ultraviolet light to carry out the transformation (similar to that which occurs in human and animal skin) to produce vitamin D3. This vitamin D3 is then purified and crystallized further before it is formulated for use in dairy milk and animal feed supplementation. The exact details of the chemical conversion of cholesterol to 7-dehydrocholesterol and the method of large-scale ultraviolet light conversion into vitamin D3 and subsequent purification are closely held topics for which there have been many patents issued (2).

So there you have it.  Nice and neat.  This discussion is not over, but I encourage you to ask if you have questions and seek out more information through the links given above and below.  Happy sunshining!

Resources used: 

The Vitamin D Council 

Dr. Mercola's sunscreen information (NOTE: he is trying to sell sunscreen and bug spray, so there is definitely a "pitch," but I tried to fact check everything I used.)

Weston Price Foundation's The Miracle of Vitamin D article

Wikipedia entries on melanin, vitamin D, sunburn, melanoma, ultraviolet, sunscreen controversy, and sunscreen. 

Next up:
Sunshine of Your Love Part 2: The D Factor