Notes on foods containing vitamin D, including substitutes

Patients on the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) must avoid all food and drink that contains supplemental vitamin D or high levels of naturally-occurring vitamin D. A comprehensive list of all foods containing vitamin D is available. This article is meant to provide, by food category, both context to those recommendations as well as some potential substitutes.

Patients on the MP should verify that any dairy products they consume are free of supplemented vitamin D. Some processed dairy products are made from vitamin D-fortified milk, a fact which the manufacturers are not required to disclose on the label.

Typically these dairy products are not fortified with vitamin D (but can be made from fortified milk so check with manufacturer if you aren't sure):

• butter
• cream
• half and half
• cottage cheese
• most cheeses - note that some processors add vitamin D to some of their cheeses
• sour cream
• cream cheese
• yogurt

I used to use Altadena Dairy Cottage Cheese, and after calling the company and finding out that all three of the dairy ingredients they made it out of were fortified (nothing on the label about D), it turned out to be the single item that was keeping my 25D level up at about 14 ng/ml, and after dropping the cottage cheese, my 25D fell to 10 ng/ml.

Cynthia, MarshallProtocol.com

The amount of vitamin D in a product depends on whether is was made from milk supplemented with D and how much supplemental D was fed to the animal from which the product was derived.

The primary source of vitamin D in milk is there because it has been added during processing in accordance with federal supplementation guidelines.

However, cows' milk, even if it is not fortified with vitamin D, contains a small amount of vitamin D.

Dr. Anthony Norman of University of California, Riverside offers a description of the biochemistry related to supplementing milk with vitamin D.

Sources for milk not fortified with vitamin D are listed below. Note, however, that these manufacturers can begin to add vitamin D at any time. MP patients should always check the labels each time products are purchased.

• Frontier Bulk Milk, Non-Fat Dry Powder
• Broguiere's - California-based dairy produces milk which is resold by Whole Foods and Bristol Farms
• Hartzler's Dairy
• Wakefern Food Corporation
• Straus Family Creamery

The following are some substitutes for milk acceptable for use by MP patients:

• If a recipe requires milk, half-and-half mixed with water can be used as a substitute in a 1:1 ratio. Alternatively, cream can be mixed with water in a 1:4 ratio.
• Vanilla high-protein drinks made from whey and not supplemented with vitamin D can be used. Always check the list of ingredients before buying.
• Rice milk and other grain milk are available.

Rice milk home made Rice milk

Note that soy milk is contraindicated for MP patients.

While packaged flavored yogurt is quite high in carbohydrates, plain unfortified yogurt can be used in a low-carb diet. The 12 grams per serving carbohydrate count on plain yogurt is inaccurate, however. That is how much carbohydrate - lactose - was in the milk the yogurt was made from, but the yogurt bacteria turns most of that lactose into lactic acid, giving yogurt its characteristically tangy flavor, leaving an effective four grams of carbohydrate per cup of plain yogurt.

Flavoring plus a sweetener or Splenda-sweetened drink powder can be added to plain yogurt, if desired.

These is no consensus on how much vitamin D different forms of meat typically contain. Some have suggested that factory feed, the standard diet for many livestock, increases vitamin D levels. Others have said that free-range animals are more exposed to the sun and accrue higher levels of vitamin D that way. Still others have said that fattier meats have higher levels of vitamin D.

Moderation and common sense should guide MP patients on meat consumption. Perioidic testing of 25-DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver. will help a MP patient determine if efforts to avoid ingested vitamin D have been successful or if more diligence is needed.

MP patients should not consume organ meats, such as liver.

There is no consistent indication for how much vitamin D beer contains. In fact, it may vary by the beer. Muller et al reported that vitamin D was not present in a lager, but was present in a yeast rich Weiss bier.¹⁾ If the report is valid, a full pint of Weiss beer might contain 250 IU of vitamin D, which 125% the US RDA for the substance.

Mushrooms are very high in vitamin D content and in biochemicals which can be converted to vitamin D with relatively little energy. MP patients should avoid mushroom extract unless it had been tested to make sure it had no plant sterols and none of the vitamin D metabolites.

Egg whites, as opposed to the yolks, have no vitamin D. When buying prepackaged egg whites (or ordering an egg-white omelete in a restaurant), ensure that they have not had vitamin D added to them.

Kelp is the only rich source of vitamin D from a vegetable source. It is often used a food adjuvant.

Kelp can be used in a variety of ways:

• food and cosmetic manufacturing - colloids used as thickeners and emulsifiers
• agriculture - fertilizers and growth promoters
• biomedicines - pharmaceuticals used for health care and cosmetics

There are three broad types of kelp, all of which are used for food products - green algae or Chlorophyta, red algae or Rhodophyta (used in sushi foods) and brown algae or Phaeophyta (used in soups as well as health food capsules and tablets).

Seaweed colloid manufacturing extracts three main chemicals:

• agar - whose ability to form gels at very low concentrations makes it valuable as a stabiliser in a wide variety of foods (such as pastries, confectionery and ice cream)
• carageenan - used to stabilize water/fat emulsions (used extensively in milk-based products and toothpaste, paints, inks and cosmetics)
• alginates - whose water-retention, gelling, emulsifying and stabilizing properties are used by the textile and food industries; they are the most widely used seaweed colloid

It may be unclear how much vitamin D we actually consume through other products.

Products containing kelp and seaweed or their derivatives should not be consumed by patients on the MP.

Safflower oil and many other oils are acceptable to be used by MP patients. In some sunflower oils that have been tested, they were found to not contain any vitamin D. However, manufacturers have been known supplement oils (including sunflower oil) with vitamin D.

Many brands and varieties of margarine are fortified with vitamin D. MP patients should always check the labels each time products are purchased.

There are substitutes for mayonnaise, which contains egg yolks.