Nurses Advancing Vitamin D Health - video GRH

FROM EVIDENCE TO IMPACT: Nurses Advancing Vitamin D Health is a two-hour GrassrootsHealth webinar for nurses.

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  • (00:49–08:59) GrassrootsHealth intro, Jen Aliano. Carol Baggerly founded GrassrootsHealth in 2007 after her breast cancer. Its call to action, agreed by 40+ researchers (now 50+), is a 25(OH)D target of 40–60 ng/mL (100–150 nmol/L). Aliano's son was born preterm with a 25(OH)D of 11 ng/mL. She surfs in San Diego and still tested at 28.

  • (11:41–22:27) Lappe's first Nebraska trial. Joan Lappe's 2000–2005 bone-fracture RCT enrolled 1,180 postmenopausal rural women. The calcium + 1,100 IU D3 group had 60% lower all-cancer risk than placebo. Excluding cancers in the first year, it was 77% lower. Because cancer was only a secondary outcome, many scientists dismissed the result.

  • (22:27–32:09) Lappe's NIH cancer trial. This 2009 trial used 2,000 IU D3 plus calcium in 2,303 women (the transcript says "233"). That dose was capped by the upper limit at the time. Cancer was 30% lower, just missing significance; one participant switching groups would have made it significant. Excluding the first year, it was 35% lower and significant. Women at a 25(OH)D of 55 ng/mL had 35% lower cancer incidence than those at 30.

  • (34:19–40:49) Pooled breast cancer data and mechanism. Pooling Lappe's trials with the GrassrootsHealth cohort (5,000+ people) showed 78% lower breast cancer risk at ≥60 ng/mL versus <20. Lappe then reviewed the endocrine and autocrine/paracrine pathways. She said 700+ genes have vitamin D response elements, controlling things like cell proliferation, apoptosis and DNA repair.

  • (44:36–55:22) Clinical gaps, Dr. Crystal Marie Ramen (name as transcribed). When she asked how to dose vitamin D during her NP residency, she was told "you'll get the hang of it." She named three barriers: deficiency that goes unnoticed, inconsistent testing and interpretation, and low provider confidence from little training. She promoted the new CE course: 11.5 nursing contact hours plus 1 pharmacology hour.

  • (57:09–1:13:09) North Dakota data, Beth Sanford. Over 50% of childbearing-age women were below 20 ng/mL, and 26% of Black women were below 10. Mean levels in nurses and nursing students were 16.2 ng/mL (Black) and 22.6 (white). She presented a "risk ecology" model with three layers: place, population factors (including occupation and night shifts) and individual factors.

  • (1:13:09–1:18:08) Policy actions. North Dakota passed a concurrent resolution on vitamin D deficiency in 2025; the only other state with one is Alaska (2011). Suggested actions include employee testing, the 3-step prenatal protocol, and QI projects tracking sick days, medication errors and retention. Direct-access testing in North Dakota is now under $50, and $15.15 at McKenzie Health.

  • (1:18:38–1:29:01) Why progress is slow, Aliano. RCTs are a poor fit for nutrients, per Robert Heaney's 2014 nutrient-study criteria. The 2011 IOM guidelines covered only bone and rest on an uncorrected statistical error. Dose response varies widely: one wife needed 2,000 IU, her husband 10,000. People not taking magnesium and K2 needed 244% more D to reach 40 ng/mL. By Gorham's shadow rule, you make vitamin D only when your shadow is shorter than your height.

  • (1:33:16–1:37:22) Results from quality-improvement projects.

    • MUSC prenatal project (Wagner/Hollis): 60% lower preterm birth at ≥40 vs ≤20 ng/mL, 80% lower with prior preterm birth, and 78% lower in non-Caucasian women.
    • Pure North (Canada): at ≥50 ng/mL, 30% lower hypothyroidism risk and 32% lower risk of elevated thyroid antibodies.
    • Vibra acute care hospital: 44% of patients were below 20 ng/mL on admission, with no C. diff cases in year 1.

  • (1:41:15–1:58:48) Q&A.

    • Normal level: based on Luxwolda's East African and outdoor-worker data. In pregnancy, conversion to 1,25(OH)₂D works best around 40 ng/mL. Hollis found breast milk gets vitamin D only above about 45–50.
    • Toxicity: comes from high calcium, not vitamin D itself. 10,000 IU/day is the no-observed-adverse-effect level.
    • Children: dose by weight to the same 40–60 target. Heaney's rule of roughly 35 IU/lb was given tentatively.
    • Skin color: Australia's 2023 guideline tells darker-skinned people to get more sun before using protection. When outcomes are analyzed by serum level, racial gaps nearly disappear.

Sources:

  • GrassrootsHealth webinar (YouTube)
    • 00:00 Welcome, Introduction & GrassrootsHealth's Call to Action – Jen Aliano
    • 09:58 Vitamin D and Cancer Prevention – Dr. Joan Lappe
    • 44:04 From Clinical Evidence to Better Practice – Dr. Crystal Marie Rahman
    • 56:52 Vitamin D Risk Ecology and the Nursing Workforce – Dr. Beth Sanford
    • 1:18:04 Moving Research Into Action & Practitioner Resources – Jen Aliano
    • 1:41:33 Live Q&A and Closing Remarks

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