The Human Practice group coordinated with individuals in and out of our
team. The human practice reached out to specialists and professionals to
gain more insights into probiotics and vitamin D for our project.
We started off with a public opinion survey to investigate people’s
current understanding of vitamin D and vitamin D deficiency in order to
gain feedback on our project. The Human Practice team also arranged
several educational forums where we presented to a wide range of
audiences about the importance of vitamin D. According to our survey,
very few people are aware of the importance of vitamin D. Therefore, we
posted several posts on Instagram about vitamins in hopes to reach a
larger audience to educate. Currently, Tik-Tok is a rising social media
platform where people all around the world are using. Therefore, we
decided to spread the importance of vitamin D by filming short
educational videos on tik tok!
Survey
In June, we made a survey to collect data on the demand for our product
and the public’s knowledge on vitamin D deficiency. The survey was sent
out to different regions around the world, including Asia, North
America, Europe, etc. We post an Instagram story to announce the survey
and post the link in our account profile to welcome everyone to fill it
out for us. Our members also sent it to our classmates, teachers, and
relatives in different countries, asking them to share the survey to
people around them. We received a total of 1355 anonymous responses in
12 days and collected the data in the following graph below.
The majority of our participants’ ages lie between 18 to 55, and only
some participants are 0~17 years old or 56~75 years old. More than half
of our participants(63.8%) are female, while the rest 35.5% being males
and 0.7% of participants who are unable to disclose. As all of our team
members are from Taiwan, we lived in a Taiwanese community. Thus, the
majority of our participants currently live in Taiwan as well, the
survey results are more likely to reflect the situation in Taiwan.
*Referring to Fig 1., 2., 3.
*Fig. 1 Age of Participants
*Fig. 2 Gender of Participants
*Fig. 3 Where did you take the survey?
Most of our participants (74.2%) responded that they are aware of their
vitamin D intake, and know vitamin D is essential for their health.
However, due to the pandemic, people tend to have fewer chances to go
outdoors. Out of 1355 responses, 71.2% of the participants spent less
than 3 day outdoors within the past 2 weeks, indicating how people have
less exposure to sunlight, a vital source of vitamin D. Our survey also
shows 36.0% of the participants rely on sunlight as their main vitamin D
source; 18.3% of the participants, on the other hand, are unclear on how
they receive vitamin D on a daily basis.
*Referring to Fig 4.,5., 6., 7.
*Fig 4. Have you ever paid attention to your intake amount of Vitamin D?
*Fig 5. On a scale of 1-10, how important do you think Vitamin D is for
your body?
*Fig 6. Time spent outdoors in last 2 weeks
*Fig 7. How do you usually take in Vitamin D?
While most individuals take vitamin D on a regular basis, 58.9% of
people are not sure whether or not supplements work, and only 26.6% of
them think it does make a difference. We can infer from the results how
a majority of individuals are unsure about vitamin D supplements’
utility, proving the necessity of our product. Since our product can be
seamlessly incorporated into people’s daily diets, it can have a much
greater impact than supplements and other current solutions.
*Referring to Fig 8. & 9.
*Fig 8. How often do you take Vitamin D supplements?
*Fig 9. Do you feel that Vitamin D supplements work?
86.9% of communities acknowledge vitamin D deficiency as a serious
problem. For the following question in the survey, we asked for a free
response answer on why vitamin D is a problem. Out of 1355 responses,
more than half (51.7%) are unsure, while 43.3% focus on its negative
impacts on bone growth.
*Referring to Fig 10. & 11.
*Fig 10. Do you think Vitamin D deficiency is a serious issue for human
health?
*Fig 11. Why do you think Vitamin D is a problem?
Fermented foods are habitually eaten around the world. In Asia, there is
kimchi for Korean, and miso for Japanese, while in western countries
there is Greek yogurt for Greece, and pickles in America. Our survey
reassured our assumption that fermented food is consumed on a global
scale. More than half of the participants (51.5%) eat more than one kind
of fermented food on a daily basis. The internationally spread culture
assists our product to be used world-widely, helping to prevent the
patient of vitamin D deficiency effectively.
*Referring to Fig 12. & 13.
*Fig 12. What kind of fermented food do you eat?
*Fig 13. Do you eat any fermented food in your daily life?
In the survey, 28.7% of the population ate fermented products for more
than one meal a week, while another 20.2% ate these products for more
than four meals a week. Although 48.7% of them consume one meal or less
of fermented food within a week, we still see most of all the
participants take fermentation food as part of their diets.
*Referring to Fig 14.
*Fig 14. How often do you eat fermented food?
56.3% of the population does not take probiotic supplements. 54.4% of
the population remains neutral about trying our probiotics, and 25.6% of
them are eager to try them. 70.1% of total responses keep a reserved
attitude of using our product, most of the population claim they need
more information before trying our product. Thus, the certified
documents for our final products are mandatory to gain trust from the
public.
*Referring to Fig 15. & 16. 17.
*Fig 15. Do you take any probiotic supplements?
*Fig 16. Would you incorporate our probiotics in your meals as a source
for Vitamin D?
*Fig 17. Why or why don’t you choose our product?
Education
In our survey, 86.8% of the population agreed on the severity of vitamin
D deficiency in regards to human health. But on the follow-up question,
51.7% were unsure, suggesting that the majority of individuals are still
not sure what Vitamin D deficiency is and why it is an issue. Realizing
this, our education plan aims to increase public awareness on the
importance of vitamin D to human health. For more information, Click
here.
Entrepreneurship
To successfully promote our project to the public, we analyze market
trends to determine what methods best fit today's markets. We researched
and collected information from our survey,organized the results, and
analyzed the data.
You can find more details on our entrepreneurship page found
here.
Interviews
Interviewing professionals not only increases the overall credibility of
our project’s concept, but also ensures the solution’s feasibility. By
discussing our experiment and implementation ideas for combating vitamin
D deficiency with doctors, we can gain more constructive feedback with
ways of possible improvements. For interviewing professionals, our team
interviewed three professionals in medicine and nutritional science: Dr.
Edward Huang, Dr. Michael F. Holick, and Dr. Joseph L. Napoli.
Dr. Edward Huang
Edward Huang, MD, MPH, is a physician at Palo Alto Medical Foundation's
gastroenterology department. He has done research on gut microbiota and
its relations with gastrointestinal (GI) conditions.
Through our interview with Dr. Edward Huang, MD, MPH, we learned
valuable knowledge regarding probiotics, a key aspect of our project. We
learned that in general, it takes 3 years for bacteria to reach a mature
state in which the gut microbiome remains constant. Dr. Huang stated how
the types of bacteria in one’s microbiome vary according to geographical
location. For example, the microbiome of someone who lives in Uganda
would look different from that of someone who lives in the United
States. Furthermore, suggested probiotic intake depends on the treatment
or disease of that patient. People should take probiotics regularly in
order to maintain the positive benefits as most probiotic strains last
1-4 weeks in the GI tract after their consumption. In fact, when
determining gut microbiome makeup, we can measure the amount from stool.
Also, butyrate is found in stool since it is a short chain fatty acid
which is the energy substrate for the whole colon. Finally, Dr. Huang
concluded that our project solution is very interesting since utilizing
probiotics to treat vitamin D deficiency is not a current strategy. He
also informed us on the health issues that we should consider for our
project. For example, if butyrate is being overexpressed then it can
cause the bacteria to die or proliferate less.
Dr. Michael F. Holick
Michael Holick, Ph.D., M.D, a professor specializing in fields of
medicine, physiology, and biophysics, has changed the old understanding
of vitamin D. His work includes several papers regarding the topic of
vitamin D, such as reemphasizing on the issue of vitamin D deficiency,
warning against dangers of lacking sunlight exposure, and isolating
active forms of vitamin D, 1,25(OH)2D (Holick Receives Linus Pauling
Prize for Health Research, 2009).
After our interview with Dr. Holick, we gained a deeper insight into our
project. According to Dr. Holick, most probiotics reside in the GI
system, including the ileum, jejunum, and colon. Yet, as 1,25(OH)2D
functions in the duodenum, the butyrate and VDR produced by engineered
probiotics therefore, might not end up increasing activation efficiency
of vitamin D as it is more likely to reside in a different place in the
human body. Furthermore, unlike 25(OH)D that can be produced locally,
1,25(OH)2D is only synthesized in the kidneys raising another question
mark towards our project’s feasibility. Through the interview, Dr.
Holick also stated how while our project does consist of clever
concepts, it does not cure the root cause of vitamin D deficiency as it
only solves calcium absorption issues. This interview with Dr. Michael
F. Holick brought our team new perspectives on the topic of vitamin D
deficiency and raised new questions we need to explore further.
Further Research
How will butyrate produced by the engineered probiotic affect VDR
expression in the duodenum?
Butyrate increases Vitamin D Receptor expression level in a time and
dose manner (Gaschott & Stein).
Dr. Joseph L. Napoli
Joseph L. Napoli, Ph.D., a professor under the department of nutritional
sciences & toxicology at University of California Berkeley, has done
research in metabolism, fat-soluble vitamins, vitamin D, and vitamin A.
He has done research on the topic of vitamin D throughout his career.
In the interview with Dr. Napoli, we confirmed on, discovered errors in,
and gained deeper insights for our original research. Firstly, Dr.
Napoli mentioned that the issue of overdose of vitamin D is
overexaggerated and rarely happens in real life. As Dr. Napoli stated,
1,25(OH)2D induces the transcription of certain genes. Yet, as soon as
transcription starts, a specific gene is expressed to inactivate
1,25(OH)2D. This helps the ethical and safety aspect of our final
product of fermentation starter as we do not need to stress too much
about problems with overexpressing vitamin D. Secondly, we realized a
greater issue is that overproduction of calcium contributes to causes of
gastric reflux diseases, kidney stones, and other diseases. Thirdly, we
were able to get confirmation that sunlight and food products have no
sufficient amounts of vitamin D the human body requires for proper
regulations. Lastly, new questions arose about the metabolic pathways
set up for our probiotic, the survival conditions of probiotics, the
butyrate dose response curve, butyrate dosage, and certain safety
margins we must consider for our project. By having this interview with
Dr. Joseph L. Napoli, it allowed us to get one step closer to a more
feasible project as we will continue to build on the research based on
feedback given.
Further research
Does VDR increase impact on signalling?
Vitamin D is either activated by vitamin D receptors (VDR) or by
heterodimers consisting of VDR and the retinoid-X-receptor-α
(RXR-α)(Carlberg et al., 1993). All the genomic actions of 1, 25(OH)2D
all are controlled by and dependent on transcription factor vitamin D
receptors (VDR). Therefore, the signalling for any vitamin D most likely
suggests molecular actions of VDR in the human body (Carlberg &
Campbell, 2013).
Conclusion
Looking at all three interviews, not only did we gain professional
feedback from different doctors specializing in different fields, but
also gained more insight into probiotics, Vitamin D, and VDR. By
connecting different information collected from the interviews, our team
had a better understanding of how our project will process and what we
need to improve on for a better solution to vitamin D deficiency.
References
Holick Receives Linus Pauling Prize for Health Research | School of
Medicine. (2009). Www.bumc.bu.edu.
https://www.bumc.bu.edu/busm/2009/05/18/holick-receives-linus-pauling-prize-for-health-research/
Joseph L. Napoli | Research UC Berkeley. (2021).
Vcresearch.berkeley.edu.
https://vcresearch.berkeley.edu/faculty/joseph-l-napoli
Gaschott, Tanja,
and Jürgen Stein. “Short-chain fatty acids and colon cancer cells: the
vitamin D receptor--butyrate connection.” Recent results in cancer
research. Fortschritte der Krebsforschung. Progres dans les recherches
sur le cancer vol. 164 (2003): 247-57. doi:10.1007/978-3-642-55580-0_18
Carlberg, C., Bendik, I., Wyss, A., Meier, E., Sturzenbecker, L. J.,
Grippo, J. F., & Hunziker, W. (1993). Two nuclear signalling pathways
for vitamin D. Nature, 361(6413), 657–660.
https://doi.org/10.1038/361657a0
Carlberg, C., & Campbell, M. J. (2013).
Vitamin D receptor signaling mechanisms: Integrated actions of a
well-defined transcription factor. Steroids, 78(2), 127–136.
https://doi.org/10.1016/j.steroids.2012.10.019
