Pure North (Calgary) improves health by raising vitamin D to 60 ng

http://www.purenorth.ca

• Chronic Disease Prevention – mainly through Vitamin D.
• Goal of having vitamin D level of 60 ng
• Not-for-Profit Health foundation in Calgary, Canada
• 33,000 have participated – many at no cost
• They also minimize heavy metals and dental amalgam

The Pure North S’Energy Foundation is a chronic disease prevention program that uses research-based nutritional supplements. We are Canada’s largest primary prevention focused not-for-profit organization. Our founder and Chief Accountability officer is Allan Markin, a well-known Calgarian, philanthropist and co-founder of Canadian Natural Resources Limited (CNRL). Pure North evolved from an employee health and wellness program that was offered to employees of CNRL and their families. It now operates as a separate foundation that has been expanded to include participants from the public and is offered at no charge to populations who are considered at-risk or vulnerable.

Dose to get 60 ng of vitamin D is a function of BMI (not weight)

Appears that is is rarely successful - typically 40-50 ng - see table below in the page

BMI	Dose
Underweight (<18.5)	5,000 – 9,000 IU/d
Normal (18.5-24.9)	9,000 – 10,500 IU/d
Overweight (25-29.9)	12,500 – 14,000 IU/d
Obese (30-35)	19,500 – 24,000 IU/d
Overly Obese (>35)	>20,000 IU/d

GOALS OF THE PURE NORTH FOUNDATION

• Increase vitamin D3 for Canadians
• Provide BMI-based vitamin D3 supplementation recommendations
• Safe removal of mercury dental amalgams
• Improve physical and mental health

UNIQUE FEATURES OF THE PURE NORTH PROGRAM

​​​Our primary preventive health program focuses on the provision of high quality, research-based nutritional supplementation and lifestyle recommendations. The program also offers the safe removal of mercury amalgam fillings and heavy metal treatment for the purpose of improving mental and physical health.
​
A special focus of our work on Pure North is on educating our participants about the health benefits of ‘high’ dose Vitamin D3 and then helping them to achieve an optimal blood level of Vitamin D3. This optimal target range (125 to 190 nmol/L) of vitamin D3 requires higher doses of vitamin D3, than the upper level of intake recommended by Health Canada (6,000 to 12,000 IU per day) depending on starting vitamin D3 status and Body Mass Index.

All of our participants undergo a comprehensive series of blood tests. These include testing for signs of inflammation and oxidative stress (which are known to contribute to the development of many diseases), insulin resistance and prediabetes, heart disease risk, thyroid problems, food sensitivities, as well as Vitamin D3, Vitamin B12 and iron levels. Many of our participants will also have a urine test that assesses for the presence of heavy metals, such as mercury, lead, cadmium and arsenic.

THE PROGRAM WORKS

• Within 6 months 45% of participants self-report going from poor or fair health to good or better health (in the untreated general population people who self-report poor/fair health rarely improve without intervention – in fact they often deteriorate).
• ​For those who started in poor health – after 180 days most significant positive differences: improvement in energy, depression, fatigue, anxiety, ‘stomach problems’, memory and concentration

THE PROGRAM SAVES MONEY

Investing in upstream preventive health care leads to large savings in downstream costs. Independent research has estimated the social return on investment for the Pure North program at $13 for each $1 invested.
This benefit is derived from

• $9 in quality of life improvements
  (reduced hospital utilization, freeing up of acute care beds, reduced caregiver costs),
• $2 in health care savings
  decreased utilization of hospitals and doctors,
  improved labour-force productivity,
  gain in well-being associated with changes in self-reported health
• $2 in indirect economic benefit
  (emergency department visits, use of health-care professionals, pharmaceutical care).

Toxicity - 120 ng

"The risk of vitamin D toxicity is extremely low and the benefit of having higher vitamin D3 far outweighs the risk of toxicity when serum 25(OH)D levels are below 300 nmol/L."

Cost: free or $100/month

• Vulnerable populations: Free of charge
  Homeless or in an addictions treatment facility
  Over the age of 55 years (Seniors)
  Individuals with an income < $25,000 or a household income < $41,000
  Full-time students
• All others: $1,200 per year for the first year with a possible reduction in cost in subsequent years

Published Research

Chao Y-S, Brunel L, Faris P, Veugelers PJ. 2013. Vitamin D status of Canadians employed in northern latitudes. Occupational Medicine 63:485-93.
Vitamin D levels in Canadians who work at northern latitudes are too low to support bone health, even in people taking vitamin D supplements. Optimal vitamin D levels for whole body health are not being achieved. This study found high rates of vitamin D deficiency and insufficiency in workers from northern Alberta. Canadians in general need to take more vitamin D.

Chao Y-S, Brunel L, Faris P, Veugelers PJ. 2013. The importance of dose, frequency and duration of vitamin D supplementation for plasma 25-hydroxyvitamin D levels. Nutrients 5:4067-78.
This study examined the importance of the amount of vitamin D (dose), how often (frequency) and how long it has been taken (duration). Doses of at least 5,000 IU/d for 5 months or more were needed to appreciably raise vitamin D levels.
Full text online

Heaney RP, French CB, Nguyen S, Ferreira M, Baggerly LL, Brunel L, Veugelers P. 2013. A novel approach localizes the association of vitamin D status with insulin resistance to one region of the 25-hydroxyvitamin D continuum. Advances in Nutrition 4: 303–310.
Vitamin D status has a protective role in insulin resistance, type 2 diabetes mellitus, and hypertension. This study defines a range of vitamin D status in a cohort of non-diabetic adult Canadians. Higher vitamin D levels are associated with improved insulin response and lower blood pressure. Further, the range of vitamin D status that is found to help insulin response is above the range established for bone health.

Chao Y-S, Ohinmaa A, Griener G, Veugelers PJ. 2014. Vitamin D and health-related quality of life in a community sample of elderly Canadians. Journal of Quality of Life Research
This study shows that higher vitamin D levels are related to higher quality of life in 1,493 Canadians over the age of 50 years. The results showed that participants with higher vitamin D levels were significantly less likely to report problems with mobility, usual activities, and anxiety and depression.
In VitaminDWiki

Warwick R, O`Connor A, Lamey B. 2013. Mercury vapour exposure during dental student training in amalgam removal. Journal of Occupational Medicine and Toxicology. 8:27-33.
Amalgam that is used for dental fillings contains approximately 50% elemental mercury, a metal toxic in the human body, especially in the brain and nervous system. Protective measures while removing dental amalgams are needed to prevent excessive mercury exposure to the patient as well as dental staff. This study shows that measured mercury vapor levels in the air during amalgam removal were much higher (60% higher) than levels considered acceptable or safe. To maximize safety, dental schools should train students to remove amalgam only while using water spray and high volume suction and dental staff should use appropriate personal protective equipment.

Dutton DJ, Fyie K, Faris P, Brunel L. Emery JCH. 2013. The association between amalgam dental surfaces and urinary mercury levels in a sample of Albertans, a prevalence study. Journal of Occupational Medicine and Toxicology. 8:22-29.
The objective of this study was to quantify the relationship between number of dental amalgam surfaces and urinary mercury levels. This study used Pure North data to compare urine mercury levels between people with no dental amalgam surfaces to people with one or more dental amalgam surfaces. People with amalgams have much higher mercury levels than those without, suggesting that mercury is released from dental fillings in detectable quantities.

Ekwaru JP, Zwicker JD, Holick M, Giovannucci E, Veugelers PJ. 2014. The importance of oral vitamin D supplementation and body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. PLOS One. Nov 5;9(11):e111265.
In VitaminDWiki
Various institutions recommend different amounts of vitamin D supplementation. This study examined the relationship between the amount of vitamin D supplementation (dose) and the vitamin D levels [25-hydroxyvitamin D or 25(OH)D] in the body (response). Body weight and body mass index (BMI) were found to be important in determining the appropriate vitamin D dose. The amount of vitamin D required for overweight and obese individuals is 2-3 times the amount needed by a normal weight individual. To reach optimal vitamin D levels (125 nmol/L) this means there where a normal weight individual would need 5,000 IU/d of vitamin D, but an overweight person would need 12,000 IU/d.​

Zwicker JD, Dutton DJ, Emergy JCH. 2014. Association between removal of dental amalgam, urine mercury and 14 self-reported health symptoms. Environmental Health 2014, 13:95 .
Mercury is a known health risk with no safe level of exposure. The continued use of mercury amalgam fillings is a controversial topic and one that carries significant consequences for Canadians. In this study a sample of Pure North participants were used to examine the associations of mercury amalgam fillings with adverse health risks. The number of amalgam fillings in the participants was compared with urine mercury levels and changes in 14 self-reported health symptoms.

Published Research: Social and Economic Benefits - 2013

Emery HJC, Fyie K, Brunel L, Dutton DJ. 2013. The fiscal, social and economic dividends of feeling better and living longer. University of Calgary, The School of Public Policy, SPP Research Papers 6(20):1-28.
The health care system spends very little of the budget on prevention of disease (<5%). Failure to invest in chronic disease prevention leads to increasing growth in health care spending as the prevalence of chronic disease rises. Besides the benefits to the patients, preventing poor health comes with numerous societal benefits. Keeping someone in good health can free up money to treat someone else. The social return on investment (SROI), the quantifiable economic value obtained in relation to the cost, for the Pure North program is $13 for each $1 invested. These benefits are found directly in reduced health care costs, indirectly in increased productivity and in improved quality of life.

 Download the PDF from VitaminDWiki.

Two possible conclusions from their data in table 4 – Health change after 180 days

1. People with poor response to vitamin D did not improve health
2. People only improve after getting > 45 ng of vitamin D after having a low level

Health change	Baseline nmol	Change nmol	Final ng
Poor Health ==> Good Health	67	49	46 ng
Poor Health no change	60	33	37 ng
Good Health ==> Poor Health	64	39	41 ng
Good Health no change	71	45	46 ng

Testmonials by Seniors 1 week in Nov 2014

• "Before Pure North I suffered from high cholesterol, blood pressure recovered slowing from colds and flu. Since joining, I have no troubles sleeping, my mood is better and I suffer from fewer colds and flu.."
• "Since joining the Pure North program, I have noticed a difference in my overall health and I no longer suffer from depression. It is an amazing program that I recommend to all my friends and family."
• "Since joining, my health has changed tremendously. My inflammation is down, I am sleeping better, and I have more energy and less pain."
• "Since I joined the Pure North program, I have noticed an improvement in my general health and have not suffered from any colds or flus."
• "Since joining the program I suffer from less joint pain.."
• "Since joining, my mood has improved and I have more energy; I’m physically and mentally stronger.."
• "Since joining, I have seen an improvement in my overall health and I am much more aware of what is needed to maintain it."
• "Since joining the program I have noticed an increase in my energy levels. "
• "Since suffering from a heart attack two years ago my health has been challenging. Since joining the program, my health has been more stable.."
• "Since joining the program at Pure North, I have noticed a significant improvement in my hair and nails.."
• "My health has improved for the better since joining the Pure North program. I have better digestion, less stiffness and more flexibility."
• "I thought that I had generally good health before starting on the Pure North program. Since joining, I have noticed my energy levels and overall health increase."
• "I’m feeling better every day since joining the program.."
• "Before the Pure North program I did not have the best health. The supplements provided to me have become an essential part of my lifestyle. "
• "My health before Pure North was poor. I had insomnia, depression, fatigue and dealt with a lot of stress. Since joining the program all of those problems have decreased."
• "The program at Pure North has helped with my stomach problems I was experiencing. The staff at the clinic are great and helpful."
• "I feel the best I have felt in years since joining the Pure North program. I no longer experience depression, troubles sleeping or stress.”