Follow The 8 Sources I Posted And Write At Least 10 Pages Research task

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Length

1.The essay is 10 or more pages of paragraph text long (with Works Cited starting on page 11 or after page 11)

Research

1. All essay arguments are firmly grounded in credible research.
2. At least two-thirds of the research used in essay text is scholarly and traditional.
3. Works Cited contains at least seven entries (sources) that include two journal articles and one non-traditional source.

Form

1.The essay contains an introduction that connects to the world and is attention-grabbing.

1. The thesis is a one-sentence statement at the bottom of the introduction that describes the myth and truth.
2. The essay convincingly proves the myth exists.
3. The essay convincingly proves the myth is false.
4. The essay shows why the myth matters/has a consequence.
5. The essay’s conclusion gives something back to the world.

MLA

1.MLA heading is correctly formatted.

2.All MLA formatting (fonts, margins, line spacing, etc) is followed to a very high degree of precision.

1. Works Cited is nearly flawless.
2. All in-text citations (paraphrasing, quotations, author tags, page numbers, parenthetical citations) are accurate, with no information taken from someone else left uncited.
3. All sources used in-text are found in Works Cited, and all Works Cited entries are found in-text.

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Essay-English homework Assignment

Princeton University Press

Chapter Title: SELLING CONSUMPTION

Book Title: The Bon Marche Book Subtitle: Bourgeois Culture and the Department Store, 1869-1920 Book Author(s): MICHAEL B. MILLER Published by: Princeton University Press. (1981) Stable URL: http://www.jstor.org/stable/j.ctt7zv9g3.11

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PART THREE ) . ^

Public Relations

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SELLING CONSUMPTION

AMONG THOSE PHRASES so readily associated with the new department stores, and so loosely turned to as though their very mention was sufficient to raise the tone of the discussion to a plane of significance, was the “democratization of lux­ ury.” The term itself is a superficial one, and in some ways misleading. Although mass retailing gave way to stores ex­ pressly directed at a lower-class clientele, the principal firms like the Bon Marche remained middle-class institutions. The bourgeoisie more so than the working classes were the chief beneficiaries of the revolution in marketing before the First World War.

But “democratized luxury,” the puffery and misguided no­ tions aside, did stand for something in the minds of men who were grasping for some means of expressing, conveniently and compellingly, the implications of grands magasins selling vast quantities of merchandise to vast numbers of people at considerably lower prices than ever before. It stood for a market that was now prepared to turn practically any retail article into a mass-consumer good. And thus, at a more fun­ damental level, it stood for the realization that bourgeois cul­ ture was coming more and more to mean a consumer culture, that the two were, in fact, becoming interchangeable.

The department store alone did not lead to the appearance of a consumer society, but it did stand at the center of this phenomenon. As an economic mechanism it made that soci­ ety possible, and as an institution with a large provincial trade it made the culture of consumption a national one. Above all, as a business enterprise predicated upon mass re-

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166 PUBLIC RELATIONS

tailing, it played an active role in cultivating consumption as a way of life among the French bourgeoisie.

This promotion of a consumer culture was to raise issues as vital as those of the bureaucratization of careers and the transformation of entrepreneurial roles. In the following chapter we shall see how these issues fit into a larger complex of social concerns that once again obliged the grands magasins to seek an accommodation between tradition and change. For the moment, however, we must consider how the Bon Marche set about selling not only merchandise, but consump­ tion itself.

AN EIGHTH WONDER

In one respect, selling consumption inherently followed from the new merchandising practices that differentiated the de­ partment store from the traditional small shop. The concen­ tration of services, integration of operations, and especially the stress on rapid turnover expanded markets by lowering prices.1 Deliveries, returns, and conscientious service made shopping a pleasurable experience. Fixed prices decreased consumer suspicions and quickened the pace of shopping.

Yet these were only the preconditions upon which a con­ sumer culture could be built. More than price and service in-

1 How much lower prices were in department stores was a matter of de­ bate. Small shopkeepers contended that only leader items were sold at ad­ vantageous prices, and Zola once noted that while leader items were offered at 20 percent less than similar goods in small shops, other articles were sold at prices similar to those of the boutiques. However, in another note, Zola reversed himself, maintaining that “there is at least an 18 percent margin be­ tween the prices of thepetit commerce and those of the grands magasins.” Other commentators offered comparative mark-up rates for department stores and small shops of 14 and 41 percent respectively in one case and 12 and 36 per­ cent in another. Altogether, the consensus among contemporaries, depart­ ment store critics aside, was that better buys could be had at the new stores than ever before; and, given the stores’ organization and marketing philoso­ phy, it is difficult to believe that this was not the case. Zola, NAF10278, pp. 75, 201; A. de Foville, “Les causes generates des variations des prix au XIX siecle,” VEconomiste Franfais (1 June 1878), pp. 684-85; G. Michel, “Le com­ merce en grands magasins,” Revue des Deux Mondes (1 January 1892).

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SELLING CONSUMPTION 167

centives, mass marketing demanded a wizardry that could stir unrealized appetites, provoke overpowering urges, create new states of mind. Selling consumption was a matter of seduction and showmanship, and in these Boucicaut ex­ celled, enveloping his marketplace in an aura of fascination that turned buying into a special and irresistible occasion. Dazzling and sensuous, the Bon Marche became a permanent fair, an institution, a fantasy world, a spectacle of extraordi­ nary proportions, so that going to the store became an event and an adventure. One came now less to purchase a particu­ lar article than simply to visit, buying in the process because it was part of the excitement, part of an experience that added another dimension to life. This ambiance, in conjunction with the powerful temptation of vast, open displays,2 was to be the great luring feature of the Bon Marche.

The new building itself was designed for this effect. Pro­ vided with a stately fagade of stone and topped with cupolas, the exterior belied the commercial machine within. This was particularly true of the main gateway on the rue de Sevres. Monumental and ornate, it rose the entire height of the build­ ing and was seated under a cupola, crowned with a pedi­ ment, conceived as an archway for the first two stories, and decorated with caryatids and reclining statues of the gods. The impression was that of entering a theatre, or perhaps even a temple.

Inside, the monumental and theatrical effects continued. The iron columns and expanse of glass provided a sense of space, openness, and light. Immense gallery opened upon immense gallery, and along the upper floors ran balconies from which one could view, as a spectator, the crowds and activity below. Three grand staircases, elegant and sweeping, conveyed the public to these floors as if they were climbing to

2 The role of the open displays themselves cannot be minimized. Zola wrote that “women are thus dazzled by the accumulation of merchandise. This is what has made the success of the grands magasins.” Later d’Avenel noted that “it seems that one sale begets another and that the most dissimilar goods, juxtaposed, mutually support each other.” Zola, NAF10278, p. 201, D’Avenel, “Le mecanisme,” p. 356.

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168 PUBLIC RELATIONS

loges at the opera, while on the second floor could be found a reading room with the major newspapers and journals of the day, and a great hall in which the paintings of contem­ poraries (second-rate artists, Zola tells us) were exhibited for free. Later the two rooms were merged into a single salon, twenty meters long and eight meters high, and conceived in the grand style of a Louvre Museum gallery. Nearby was a buffet, a room whose fine furnishings, curtains, and palm leaves made it not unlike the lounge of a theatre.3

Part opera, part theatre, part museum, Boucicaut’s eclectic extravaganza did not disappoint those who came for a show. Merchandise heaped upon merchandise was a sight all its own. Bargain counters outside entryways produced a crush at the doors that attracted still larger crowds, thus creating for all the sensation of a happening without and within. Inside, the spectacle of flowing crowds intensified, orchestrated by barred passages, by cheap, tempting goods on the first floor that brought still another crush to the store’s most observable arena, and by a false disorder that forced shoppers to travel the breadth of the House.4 The oft-frenzied actions of thousands of employees, the din of calls about the cashiers, and the comings and goings of gargons in bright livery were the tumultuous accompaniment of a sensational proceeding.

Everywhere merchandise formed a decorative motif con­ veying an exceptional quality to the goods themselves. Silks cascaded from the walls of the silk gallery, ribbons were strung above the hall of ribbons, umbrellas were draped full blown in a parade of hues and designs. Oriental rugs, rich and textural, hung from balconies for the spectators below.5

Particularly on great sales days, when crowds and passions

3 Gargons in the buffet served Bordeaux and Madeira wine to adults,

syrups to children. 4 Boucicaut was, for example, fond of placing women’s dresses in one sec­

tion of the store, coats and ready-to-wear in another. Zola, NAF10278, pp. 59-61.

5 In an observation that may have been taken from the Bon Marche, Zola remarked in Au bonheur des dames that Mouret primarily was concerned with their decorative and exotic appeal, selling his rugs practically at cost. Zola,

Au bonheur, pp. 290-91.

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SELLING CONSUMPTION 169

were most intense, goods and decor blended one into another to dazzle the senses and to make of the store a great fair and fantasy land of colors, sensations, and dreams. White sales, especially, were famous affairs. On these occasions the entire store was adorned in white: white sheets, white towels, white curtains, white flowers, ad infinitum, all form­ ing a single blanc motif that covered even stairways and balconies.6 Later, Christmas displays became equally spec­ tacular. In 1893 there was a display of toys representing an ice-skating scene in the Bois de Boulogne. In 1909 plans in­ cluded a North Pole scene in the rue du Bac section, a Joan of Arc display in the rue de Babylone area, and an airplane “with turning propellor and luminous toys” above the rue de Sevres staircase.7

So the store, monumental, theatrical, fantastical, became an attraction in its own right to entice the public to visit the displays and to make of their trip an extraordinary experi­ ence. As early as 1872 Boucicaut was billing the Bon Marche as “one of the sights of Paris.” Soon after he offered daily tours of the House. Each day at three o’clock shoppers, or mere visitors, were invited to assemble in the reading room. From there a guide conducted them throughout the building, visiting behind-the-scenes activities and passing through the great galleries and their displays of merchandise.

It is in this role of impresario that we must also see Boucicaut’s inauguration of House concerts within and with­ out the store. The very inspiration was suggestive of the di­ rections in which bourgeois society was moving—and being moved. The presentation of concerts as regularly scheduled public events was itself of recent date, developing rapidly along these lines only in the second quarter of the nineteenth century. But their growing proliferation under middle-class sponsorship for predominantly middle-class audiences pointed to the extent to which an enterprising bourgeoisie, cognizant of a growing bourgeois demand, was coming to or-

6 Recall Karcher’s reaction in Chapter III. 7 B.M., Conseils Generaux, 18 October 1909.

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170 PUBLIC RELATIONS

ganize the nation’s leisure and arts, as well as its industrial output, into marketable commodities. The scale remained limited, but the tendency was undeniable: middle-class cul­ ture, even in the narrowest definition of its artistic pursuits, was assuming a consumer mentality. Still, the step from promoting entertainment events as a consumer event in themselves to exploiting them for substantially wider com­ mercial purposes was a considerable one, and it is here that Boucicaut’s productions take on significance, standing as it were on the threshold of modern marketing techniques.8

The implications of these concerts were staggering. Music and shows had a long history as come-ons, but never had the connections been quite so sweeping. Now anything partak­ ing of middle-class identities and middle-class tastes, or even simply of public fads, could become a means to a totally unin­ tended and disassociated end: the promotion of a consumer society. If music could be sold to the middle classes either be­ cause there was a market that wished it aesthetically or that wished it socially as a sign of refinement—one of those ways by which the upper levels of the bourgeoisie sought to distin­ guish themselves from the lower orders, thereby setting the tone by which the lower bourgeois strata would just as ea­ gerly seek to assert their distinction and hence their claim to middle-class status—then it could also be sold to the middle classes as an inducement to consumption of a very different sort. And if formal choral societies had equally become a widespread phenomenon over the past forty years, to be found largely among artisans and clerks but encouraged by middle-class audiences who warmed to this exhibition of sol­ idarity with their own image of themselves (a side that did not escape the Boucicauts), then these societies too could be turned to the mass marketer’s account, selling far more than good cheer and bad music.9

8 On the evolution of concerts, their sponsorship and their audience in the first half of the nineteenth century, see William Weber, Music and the Middle

Class (New York: Holmes and Meier, 1975). 9 On choral societies, see ibid., pp. 100-08; Zeldin, France, vol. 1, pp. 483-

85.

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SELLING CONSUMPTION 171

Thus Boucicaut began his series of concerts. The first per­ formance within the store was held in 1873, and until the death of Madame Boucicaut there would generally be one or two such events a year, usually in November and January. Saturday evening summer concerts in the square outside the Bon Marche began in the same year. Until the First World War these took place weekly, from June to September, except when the House societies were performing outside of Paris, or during inventory or Assumption.

The productions were grand and well-planned affairs. For the summer concerts, open to the general public, the House printed about 1,600 programs in advance. These were dis­ tributed at the cashiers, at entry ways, or in the reading room. Winter concerts—far more lavish in their conception, attended by invitation only, and apparently something of a society event—10 played to as many as 7,000 persons (of whom several thousand were employees). Rehearsals, for which performers were released early from work, were scheduled several times a week. Later, in the 1880s, well- known singers, including several from the opera, were added to the program. On the nights of the concerts themselves, large numbers of counters were dismantled, seats and special decorations set in place. Expenses ran into the thousands of francs.

As another of Boucicaut’s showcase orchestrations, Bon Marche concerts played a dual role. On one level, they were presentations to the public of a new kind of employee: disci­ plined, cultivated, gentlemanly. This was important, because retail clerks in the past had acquired a disreputable image. Referred to by the derogatory term of “calicot,” a title that had stuck from an unflattering portrait in a play by Scribe,

10 Invitation lists reveal large numbers of addresses from the fashionable districts of Paris. Deputies, military officers, and occasionally barons also re­ ceived invitations. At the same time the House was careful to invite the heads of railway stations and officials well-placed in the post office, all of whom could be of considerable importance to a store with such a large mail­ order trade. Invitations were also sent regularly to the press. B.M., Concert Materials.

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172 PUBLIC RELATIONS

clerks were notorious for their disorderly behavior, their un- trustworthiness, and their claims to a status they did not have.11 Such an image could be acceptable in a small shop where neither service, nor ambiance, nor even necessarily trust was critical to a sale. But in a retail world that now stressed shopping as a pleasure in itself, the image had to change, and to this end House concerts provided a promo­ tional device that displayed for once not the salesgoods, but the sellers themselves.12

But it was again the ability to make of the store something it was not that was most important here. As one reviewer remarked:

“When one leaves a concert given by the Bon Marche, it is truly difficult to gather together all of one’s impressions, the program having undertaken all that is possible, and even the impossible.

“The lights, flowers, and splendors heaped beneath the eyes of the guests, the eminent artists one has applauded, all in the end shimmer, sound, and run together in the memory of someone the least distracted, and one remains dazzled, dazed for some time while trying to recover the necessary stability to arrive at some sort of judgment.

“Let us speak first of the hall. In less than an hour the store, glutted with merchandise, abandoned to a world of gnomes or genies, is rapidly transformed, as in a fairyland, into a bewitching palace, dazzling with its lights, filled with flowers and exotic bushes whose effect is splendid. Every­ where carpets and silk tapestries from the Orient are flung and hung in abundance, forming charming salons, hallways, and retreats, all embellished by the good taste of the tapestry-

11 In “Le Combat des Montagnes ou La Folie-Beaujon,” M. Calicot (named for a type of muslin) is an employee masquerading as a veteran of the Grande Armee. The play was first presented in 1817. See Avenel, Les calicots, pp. 15-16; J. Valmy-Baisse, Les grands magasins (Paris: Gallimard, 1927), p. 145. According to Zola, it was said that “le calicot est bon a tout et propre a rien.” Zola, NAF10278, p. 213. See also “Le calicot,” Gil Bias, 26 November 1881.

12 Press reaction was not oblivious to this side of the concerts. See for example L’Orphion, 5 December 1887.

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SELLING CONSUMPTION 173

workers. Immense departments, earlier filled with cus­ tomers, soon will serve as an altar to the cult of music….”13

It was, then, on concert evenings that image and reality at last blended into one. Merchandise counters gave way to a stage, salesclerks transformed themselves into performers, the building became a deluxe concert hall. So ready to portray his emporium as a theatre, or the opera, or a land of en­ chantment, Boucicaut had found the supreme effect. Specta­ cle and entertainment, on the one hand, the world of con­ sumption, on the other, were now truly indistinguishable.

In still other ways the Bon Marche sought to call attention to itself and to create about it a special air. To present itself as a city and national institution while simultaneously display­ ing to mass audiences the best of its wares, the House partic­ ipated in all major international fairs, including those of Chicago and St. Louis. At the 1900 world’s fair in Paris, it had its own pavillion. The store was equally fond of publishing descriptions of itself and its wonders. At first the firm relied upon the national press, which has never been known for its high standard of ethics. Articles on the Bon Marche, most likely prepared in the offices of the same, appeared in L’lllus- tration and Le Monde lllustre throughout the 1870s and early 1880s.14 Later in the 1890s, the House began to publish its own pamphlets, in foreign languages as well as in French,

13 L’Orpheon, 5 January 1886. 14 See the following: “Les nouveaux magasins du Bon Marche,” Le Monde

lllustre, 23 March 1872; Llllustration, 23 March 1872; “Les nouveaux magasins du Bon Marche,” Le Monde lllustre, 30 March 1872; Llllustration, 30 March 1872; Llllustration, 10 October 1874; “Magasins du Bon Marche,” Llllustra­ tion, 6 March 1875; “Le Bon Marche,” Le Monde lllustri, 13 March 1875; “Les agrandissements du Bon Marche,” Llllustration, 2 October 1880; “Les agran- dissements du Bon Marche,” Le Monde lllustre, 2 October 1880; “Les agran­ dissements du Bon Marche,” Le Monde Illustri, 9 October 1880; “Les agrandis­ sements du Bon Marche,” Llllustration, 9 October 1880. Suspicions about the origins of these articles are raised by the fact that: (1) articles in both journals were often the same; (2) the articles frequently were filled with blatant adver­ tising content; (3) handwritten copies of the articles exist in the Bon Marche Archives. For a further discussion of collusion between the Bon Marche and the press, see Chapter VI.

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174 PUBLIC RELATIONS

usually under the rubric of An Historical Account of the Bon Marchi or A Visit to the Bon Marche.

Printed in the thousands and passed out to House visitors, particularly to persons who took the House tour, these pam­ phlets, along with the articles, were written in a tone of fasci­ nation with the store and its workings. The Bon Marche was an “establishment without parallel,” the “most unique estab­ lishment in the world,” a “monument,” a “commercial in­ stitution,” a “palace.” White sales were a “feerie,” the open­ ing of a perfume department “the great attraction of the season” (how the public relations men must have choked over that one). One article, recounting a sale of Oriental rugs and porcelain, exclaimed that “all artistic Paris gathered at the Bon Marche that day, and the store offered the sight of a vast Oriental museum . . . transporting the imagination to the sunny land of a thousand and one nights.”

Everything about the store was “immense,” “vast,” “gigantic.” In particular, articles and pamphlets delighted in accounts of the size and scope of behind-the-scenes opera­ tions and projected an image of an incredible commercial ma­ chine that could impress the wildest of imaginations. Base­ ments were a “veritable labyrinth.” Giant electrical machines producing light for thousands of lamps were described in meticulous detail. Statistics abounded on the hundreds of employees in various services or on the thousands of letters the store received daily. And always there were descriptions of the kitchens, of their enormous equipment that could roast 800 beefsteaks at a single time, or that could prepare more than 5,000 meals in a single day. “It is necessary, if one wishes a comparison, to return to the descriptions of Homer who recounted in the Iliad how warriors roasted entire cows,” remarked one pamphlet of a store never restrained in its analogies.

Perhaps more than anything else the Bon Marche con­ ducted its self-promotion campaign through the immediacy of pictures. In House pamphlets, House agendas (calendar books), House catalogues, free picture cards passed out to

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SELLING CONSUMPTION 175

children in the hundreds of thousands15 in sets or series (so that cards became collectors’ items and return visits were ob­ ligatory), or even simply in children’s games, the Bon Marche used the medium of pictures to play up the monumental and spectacular side of its image. There were pictures of the en­ trances and reading rooms that accentuated their splendor. There were pictures of behind-the-scenes operations, vast kitchens, and the sliding chutes down which packages were sent spiralling. There were maps of the Paris region, with a picture of the Bon Marche in the circle of Paris. There were centerpiece foldouts in agendas entitled “Monuments of the Paris Region” or “Paris/Picturesque and Monumental,” the one a colored map of churches, bridges, and chateaux outside Paris, with the capital itself represented solely by the store, the other a set of colored postcards of the Opera, the Hotel de Ville, Notre Dame, and the Bon Marche. A children’s game from the turn of the century consisted of a maze of the city, winding from the Bon Marche to the Arc de Triomphe.

The role of illustrated cards here was especially interesting. At least as far back as the sixteenth century, peddlers had passed from village to village selling cheap images of royal personnages, famous villains, customs, costumes, and a mul­ titude of other subjects. In particular they sold images of reli­ gious scenes, pictures of saints to hang on one’s wall or to carry on one’s person.16 These were the distractions of an ear­ lier time, the medium for transporting oneself beyond the realm of the ordinary, the paraphernalia of a child’s magical world. In the mid-nineteenth century the trade grew enor­ mously,17 again, as with the concerts, to be appropriated by

15 These figures are from the mid-1890s on. Distribution figures for illus­ trated cards before this time are not available.

16 John Grand-Carteret, Vieux papiers, Oieilles images (Paris: A Storck, 1902), p. 42, Eugen Weber, Peasants into Frenchmen (Stanford: Stanford University Press, 1976), pp. 455-59.

17 Two firms alone from Epinal—the center of such illustrated productions—may have turned out as many as 17,000,000 cards during the Second Empire. Weber, Peasants, p. 457.

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176 PUBLIC RELATIONS

those with wider commercial interests.18 But there was more. To present these now with pictures of the Bon Marche on the back, or as a series of scenes of sights of Paris that included a view of the Left Bank emporium, or simply to change the sub­ ject to scenes of middle-class life in which the Bon Marche might figure prominently (a theme we shall return to shortly) was to create a whole new enchanted world of association. For the bourgeois child growing up in late-nineteenth- century France, the magical, the exotic, the fantastic, and the extraordinary were still the stuff of legendary figures, fairy­ tales, and heroes of the French nation; but they had also be­ come the stuff of department stores as well.19

Indeed fantasy and the Bon Marche could be entirely in­ terwoven. One series portrayed a shipment of Bon Marche toys by desert caravan to Morocco. Another told of the return of Halley’s comet, featuring a tour of modern wonders created over the past seventy-five years.20 Pictured as a fairy queen on cards of deep purples, blues, and reds, the comet was led to the Eiffel Tower, the Opera, and finally to an im­ mense, glowing Bon Marche from an airplane overhead. A similar theme, appearing on a Christmas catalogue, pictured a clown suspended in mid-air, a magical Bon Marche below. In a triumph of silliness (by the laws of human nature cus­ tomarily all the more effective), a combination picture series and narrative produced the story of “The Wonder.” This was a tale of a sultan in the Indies whose three sons all love the same cousin. Endowed with great wisdom, the sultan de­ cides that her hand will go to whoever can show her “the latest and most useful wonder of the world.” One brother brings a magic carpet. Another brings a magic apple that

18 Department stores were not the only ones to seize on the idea. Practi­ cally any company with something to advertise began to distribute similar cards.

19 Although the Bon Marche continued to distribute cards with traditional themes, religious subjects were no longer among these. The Boucicauts were not politically naive. But then this too was reflective of the transfer of magic to secular, indeed commercial, concerns.

20 This series appeared in 1910, when the comet was to make its most re­ cent appearance.

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SELLING CONSUMPTION 177

cures all maladies and eventually saves the girl’s life. But the third brings a telescope through which she can glimpse the Bon Marche and its treasures. Dazzled by the sight, the heroine cries “yes . . . this is the wonder.” So the third brother wins a wife, and together they set off on an elephant to visit the store’s coming white sale.

Above all, the spectre of a modern wonder was to be found in the ubiquitous pictures of the building. Everywhere the Bon Marche was to be seen—on the backs of cards and cata­ logues, the frontispiece of agendas, the headings of store stationery, store order forms, and store invoices—rising from the ground as the most colossal and fabulous of palaces, wings stretched nearly to the horizon, crowds crushing along its window displays, carriages, omnibuses, and delivery wagons creating a flurry of activity on the streets before it. Or, viewed from above, its vast dimensions given full expo­ sure, the Bon Marche was like a monster exposition hall, en­ gorging crowds through its entry ways, dwarfing the city skyline as the great cathedrals had dominated Paris in earlier days. Indeed pictorially the Bon Marche was a cathedral of another sort, charismatically beckoning of its own world of entrancement.

And ultimately the store did become a new church. Dubuis- son, an authority on kleptomania, remarked that “the grand magasin finishes . . . by exercising upon certain temperaments an attraction entirely comparable to that the Church exercises on others.”21 Zola noted that: “. . . the department store tends to replace the church. It marches to the religion of the cash desk, of beauty, of coquetery, and fashion. [Women] go there to pass the hours as they used to go to church: an occu­ pation, a place of enthusiasm where they struggle between their passion for clothes and the thrift of their husbands; in the end all the drama of life with the hereafter of beauty.”22

21 Paul Dubuisson, Les voleuses de grands magasins (Paris: A. Storck, 1902), p. 42.

22 Zola, NAF10278, pp. 88-89. In his novel Zola wrote of his imaginary store: “It was the cathedral of modern commerce, solid and light, made for a people of clients.” Zola, Au bonheur, p. 275.

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178 PUBLIC RELATIONS

For increasingly large numbers of women, a new, irresistible cult of consumption had been created.

A WAY OF LIFE

The Bon Marche opened its doors to everyone, but most often it was the bourgeoisie who passed through them. A working-class clientele undoubtedly existed, but its numbers were limited by the cash-only policy. Indeed, alongside the Bon Marche, the Louvre, and other major houses, there grew up a whole subculture of department stores that specialized in credit sales for the working-class trade.23 There was, in fact, something distinctively respectable about the Bon Marche that could make it forbidding to those who lacked middle- class pretensions, let alone middle-class means. The store drew its tone from the quarter that enveloped it, one that was known for its affluence, its Catholic orders, and its bien- pensant ways. As a specialty the Bon Marche catered to the religious trade,24 an accent on propriety characteristic of the store’s custom as a whole. Fashionable but reserved, the House drew heavily among visiting provincials, while the fastest circles in Paris were likely to go elsewhere.25 Yet

23 The principal of these was the Magasins Dufayel located in the eight­ eenth arrondissement near the outskirts of Paris and claiming a sales volume of about 70,000,000 francs at the end of the century. For details see Adminis­ tration et Grands Magasins Dufayel, 1898, Archives du Departement de la Seine, D 17z; Saint-Martin, Les grands magasins (Paris: 1900), pp. 36-37, 90-95, 123-24; Georges d’Avenel, Le mecamsme de la vie modeme (Paris: A. Colin, 1900-1905), vol. 4, pp. 376-83.

24 The Bon Marche always maintained stocks of religious articles and, later, religious uniforms. Catholics themselves, the Boucicauts during the early years of the store relied on nuns of the quarter to aid them in their paternalism. See Petition, Le Gourieric. So close was the identification be­ tween the Bon Marche and this clientele that rumor-mongers suggested that the House and the Church were linked to one another. Belief in this canard extended even to the police. One agent reported at the time of Boucicaut’s funeral: “. . . no ecclesiastics were seen at the burial, even though several persons have said that the Company of Jesus had confided great sums of money to the deceased.” Prefecture de Police, Ba 967, report of 28 December 1877.

25 Zola, NAF10278, p. 209.

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SELLING CONSUMPTION 179

the common thread running through the clientele was less one of temperament than of identity. The Bon Marche sold its wares to all those who shared, or wished to share, in the middle-class way of life. Stalking grounds of both upper and lower bourgeoisie, the Bon Marche swept through its portals not only those lured by irresistible prices or by an irresistible event, but also those who saw in the emporium an irresistible linkage with their life style or their dreams. This too was to have its role in the selling of consumption.26

To leaf through the catalogues, the agendas, and the illus­ trated cards of the Bon Marche is to come upon the world of French bourgeois culture before the First World War in a way that perhaps no other medium can so vividly convey.27 It is not a comprehensive picture that these lists and illustrations offer us. There is no hint of the failings of middle-class mar-

26 In addition to the fact that the Bon Marche sold for cash only, the

bourgeois character (petite bourgeoisie included) of the Bon Marche’s clientele can also be seen in Zola’s list of prospective clients for Au bonheur des dames, containing types drawn nearly completely from the bourgeoisie (it is to be remembered that Zola’s notes were based largely on his visits to the Bon Marche and to the Louvre). In another note, Zola refers to the attraction of the petite bourgeoisie to the new stores. Zola, NAF10278, pp. 164-72, 202. For a more direct statement on the predominance of the bourgeoisie at the major stores, see Giffard, Grands bazars, p. 269. In undated minutes from assembly meetings in the early 1920s, Colledeboeuf, a man who had been with the Bon Marehe for many years, remarked that “the Bon Marche clientele is princi­ pally bourgeois.” B.M., Undated Assemblies Generates, 1920s. When the Bon

Marche absorbed the Magasins Dufayel in 1924, there were complaints from

shareholders that this would harm the reputation and standards of the Bon Marche, since the two stores were completely unlike, including their clien­ tele (the heads of the Bon Marche in turn promised that the sole connection between the two stores would be a financial one). Le Petit Economiste, 12 De­ cember 1924; La Vie Financiere, 24 December 1924. Finally, pictures in cata­ logues and agendas leave no doubt that this was a store selling, for the most part, to a bourgeois clientele. In fact not until the end of the prewar period did work clothes appear in Bon Marche catalogues, and even then these were primarily of the genre of uniforms for grooms, chauffeurs, valets, and bell boys, that is uniforms most likely bought by their bourgeois employers.

27 On catalogues: The Bon Marche printed semi-comprehensive catalogues such as a General Catalogue for Summer, but it also mailed out other catalogues throughout the year. Many were issued by departments and most were printed in conjunction with a sale. They might be simply reviews of new or traditional stocks or they might be devoted completely to specialty items.

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180 PUBLIC RELATIONS

riages, no sign of the pressures or anxieties that could weigh upon middle-class lives. It is an idealized view that one gets, but then one that for this very reason is capable of imparting the self-image of that culture. How the bourgeoisie liked to conceive of their lives, what they expected of their lives, the minimum baggage they felt they could carry along with them in their lives all come into focus in the pages and pictures of the Bon Marche. Nor are we dealing here with merely a surface phenomenon. The images and accoutrements bespeak a real­ ity all their own. It is through them that we begin to under­ stand what we mean when we refer to the respectability or to the solidity or the certainty of prewar bourgeois life. And it is thus through them that we encounter a substantial part of the way the bourgeoisie did live their lives.

In this dense world of sensations and impressions there are images that especially seem to capture the culture that they were intended to portray. There are the covers of blanc cata­ logues that itemize the details of a proper bourgeois house­ hold: the richness of collections, the richness of embroidery, the solidity of storage chests, the very indispensability of linen to the bourgeois way of life. There were certain things, these scenes remind one, that a bourgeois home could not do without. There had to be too many sheets. There had to be curtains on the windows. There had to be tablecloths on the dining table (the dining room itself being another bourgeois requisite).28 The setting of the table—a frequent cover scene—recalls still other bourgeois basics. The household had to be equipped to entertain in the proper fashion. And it had to have servants, at least one or two.

There is the precision with which the bourgeoisie defined their lives. Women did not wear just coats, but coats for visit, coats for travel, coats for ball, or coats for the theatre. When they went to town they wore a dress for the city and at night a dress for dinner. In times of mourning one dressed in mourn­ ing,29 a fact no different than that men had their shirts for the

28 Tablecloths seem to have been the most recurrent motif on the covers of these catalogues.

29 Mourning garb, in its own way, was something of a fashion item. Cata­ logues often carried several pages of selections.

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SELLING CONSUMPTION 181

day and their shirts for evening dress, their outfits for sport and their outfits for travel. This was a carefully patterned so­ ciety where appearance was always, to a point, a function of occasion, a badge that one understood what was correct and adhered to it rigorously.

The occasions themselves reveal the bourgeoisie’s world. This was also a civil, leisurely, and gregarious society, an image equally conveyed in agenda events and catalogue pic­ tures. It was a society of sociable visits or days of reception. It was a society that ate well and that held large dinners. It was a society that patronized theatres as a social event. And it was a society that traveled and played a great deal. In the summer one always seemed to be at the seashore or on a trip to the countryside. There were always badminton games and tennis games or bicycle rides or hunting forays. This was a very ac­ tive society. By the turn of the century the Bon Marche was selling gymnastic equipment for the entire family. But jt was also a very relaxed society. An 1880 summer clothing cata­ logue carried the following scenes: women sitting on a bench in a garden, women in a park, women holding parasols or fans, women painting, girls chasing butterflies, girls looking at chickens on a farm. For children it was a playful and care­ free society. Children in illustrated cards or catalogue scenes were well-fed and well-dressed (boys almost invariably in sailor suits). In Paris they visited zoos, played in the Tuileries, or went to circuses. In wintertime they attended their own fancy-dress balls, and in summer they followed their parents to the ocean or to the provinces. There were whole series devoted to vacations at the seashore or adven­ tures in the country. Life, these pictures tell us, was warm and secure, its pleasures a thing to be taken for granted.

There are the images of family life in the bourgeois manner. This was a culture where children were visible, well-scrubbed, and cared for. At the turn of the century the Bon Marche employed 80 people in its baby clothes department, 55 in knitted goods for children. In Bon Marche scenes children played among themselves, but they were as frequently ac­ companied by their parents, especially their mother, whose role was to be with her children. Children shared their own

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182 PUBLIC RELATIONS

world, but they were part of their parents’ world too. Family occasions were a fundamental part of bourgeois life. There were ordinary moments like family dinners (although blanc catalogues suggest a certain ritualization here), and there were special moments, as when children got married to begin a household of their own. In 1907 there were over 100 employees attached to the Bon Marche’s trousseaux depart­ ment.30

Family life also meant family expectations, a final image that these pictures convey. Children were expected to be bien Sieves, a concept that ranged from proper bearing to learning the social graces. Bon Marche catalogues carried back braces “recommended as a support for persons having a tendency to stoop” and support collars “to prevent children from lower­ ing their heads.” Catalogue scenes showed that gentlemen always shook hands. Illustrated cards showed that children learned how to dance and that they dressed correctly just as their parents. Most of all being well-raised meant, as the arti­ cles and clothing for school and university and later the bar make clear, preparing oneself for a proper station in life. This, along with private property, was the sine qua non of being bourgeois.

As a reproduction of bourgeois life in these years, the Bon Marche catalogues, agendas, and illustrated cards thus offer a glimpse of a world and its values that has rarely been repli­ cated. Yet there is a good deal to be found in these materials beyond simply the reflection of a class’ self-image. Far more than a mirror of bourgeois culture in France, the Bon Marche gave shape and definition to the very meaning of the concept of a bourgeois way of life.

The picture of the proper household, the correct attire, the bourgeois good life were all, to a degree, Bon Marche crea­ tions. They were the way many middle-class people did live their lives, largely because middle-class institutions like the department store told them that this was the way they should

30 Figures on employees are drawn from the Uvre d’or. Very likely these numbers included individuals attached to workshops or the reserves in the basement.

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SELLING CONSUMPTION 183

live their lives. Institutions like the Bon Marche made bour­ geois life palpable. They produced a vision of a bourgeois life style that became a model for others to follow. The relation­ ship between the Bon Marche and its culture was therefore a symbiotic one, with implications that were several and pro­ found.

In one respect the Bon Marche came to serve essentially the same role as the Republican school system, at least for those of middle-class means or middle-class aspirations. It became a bourgeois instrument of social homogenization, a means for disseminating the values and life style of the Parisian upper middle-class to French middle-class society as a whole. It did this by so lowering prices that the former’s possessions be­ came mass-consumer items. But it also did this by becoming a kind of cultural primer. The Bon Marche showed people how they should dress, how they should furnish their home, and how they should spend their leisure time. It defined the ideals and goals for French society. It illustrated how success­ ful people or people who wished to be successful or people on their way to becoming successful lived their lives. All this it did in ways that fit the upper-middle-class mold. In its pic­ tures and in its displays the Bon Marche became a medium for the creation of a national middle-class culture.

Thus, through the Bon Marche, Paris and the countryside became more alike. The millions of catalogues mailed from the center to the provinces carried the message of a set way of life, much as the textbooks the Ministry of Public Instruction sent to the communes carried a set vision of society. Bon Marche catalogues brought Parisian fashions, and the values and expectations underlying them, more directly into the homes of middle-class people in Limoges or Nimes or the small country towns of the Touraine. Provincials who shopped by mail-order or who travelled to Paris to buy di­ rectly from the store (and these must have numbered in the tens of thousands or more every year) shared in a common culture, whether they lived in the large towns of Normandy or in the small villages of Auvergne. This was not something new that the department stores initiated. But it was a process

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184 PUBLIC RELATIONS

that the grands magasins reinforced and accentuated in the course of creating a national clientele.

Perhaps more important, the Bon Marche spread bourgeois culture to the new white-collar workers, steering these float­ ers toward middle-class shores. The Bon Marche offered these people, whose formidable growth toward the end of the century was largely a product of the grands magasins themselves, a way of life to imitate and the access and iden­ tification that would enable them to do so. It was the latter of these proposals that was especially significant. Through the department store, middle-class pretensions could find satis­ faction because images and material goods were coming to constitute life style itself. Bon Marche goods were so inter­ woven with perceptions of the bourgeois way of life that a purchase of a Bon Marche tablecloth or a coat for the theatre became a purchase of bourgeois status too. One could imag­ ine that one was bourgeois by wearing the uniforms that the Bon Marche prescribed or by simply buying a tennis racket or clothes for the seashore. One could feel relatively secure that one’s children would share in bourgeois advantages if one dressed them in sailor suits or bought them trousseaux. It was the old concept of Vhabit fait Ie moine raised to a far vaster scale than ever before imaginable. Becoming bourgeois had always, to a point, been a matter of consumption, but never so clearly, never so extensively, and never at prices that made its attainment so comparatively easy.

This meant something else again. As bourgeois culture be­ came a purchasable commodity, so too did it become a mere matter of consumption. Bourgeois culture could be sold in the marketplace because over the course of the century it was coming to be more and more a culture of consumption. This also was a process the department store had not initiated, but one that it had accentuated to such a degree that the very scope of quantitative change made it qualitative as well. It was the department store that was largely responsible for lowering prices and for creating overpowering urges to con­ sume. Even more, the department store turned the bourgeois model in a likeminded direction. The very definition of

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SELLING CONSUMPTION 185

bourgeois that appeared in the pages and displays of the Bon Marche was no longer sharing a certain life style but rather buying certain goods in order to live that way of life. By Bon Marche standards, identity was to be found in the things one possessed. Consumption itself became a substitute for being bourgeois. All of which implied that the principal medium of consumption—the department store—now became the arbi­ ter of bourgeois identity, defining it accordingly with what the House had to sell.

Here lies the fullest meaning of the idea that the Bon Marche shaped the bourgeois way of life. The images the Bon Marche spread to the middle-class masses were not simply drawn from the values and habits of the Parisian haute bour­ geoisie. They were also a Bon Marehe creation that translated those values and habits into marketable goods. In Bon Marche pictures and on Bon Marehe counters the concepts of a proper household or proper dress or being a leisure class were transformed into so many linens, so many dresses, and so many sporting goods. At the same time, new needs were created almost systematically, so that the definition of life style was kept fluid and open in accordance with changes in the consumer goods available. Fashions were the clearest example of this. It was not simply that clothing styles varied from year to year or that complete changes occurred, as in the early years of this century. There were also entirely new kinds of clothing to fit entirely new kinds of wants. By the 1890s the Bon Marche was selling cyclist apparel for both men and women. A decade later it was carrying coats for the au­ tomobile. By 1913 the House carried the trend further, mail­ ing out a fifty-page catalogue entitled “Clothing and Goods for Travel and the Automobile, Bicycles and assorted acces­ sories, Games for Open Air, Sports.” Any craze, or even any event, became an occasion for consumption. As Franco- Russian relations drew closer together, Russian toy soldiers began to appear on Bon Marche counters. In 1892 a Bon Marche gift catalogue pictured French and Russian soldiers saluting each other, thus placing bourgeois consumption at the service of public policy, and public policy at the service of

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186 PUBLIC RELATIONS

bourgeois consumption. Later, in 1905, there were special of­ ferings of Russian and Japanese toy soldiers, and in 1913 there were toy soldiers from the Italo-Turk War. Or new con­ sumer needs might mean simply a replacement of the old with the coming of the new. In 1910 the Bon Marche adver­ tised “complete installations for modern kitchens,” perhaps one of the first instances in the creation of what was to become the most powerful urge behind the culture of consumption—the belief that new meant better, and hence indispensable.

But there was still more. To sell a consumer culture, the Bon Marche sold itself as an integral part of bourgeois life in France. Much like the theatre, whose image the Bon Marche was always ready to assume, the House offered itself as a bourgeois social fixture, a meeting ground and a place to be seen as well as a place of entertainment. This was why the Bon Marche provided a reading room with newspapers and writing paper, and a buffet with wines and syrups. Shop­ ping, as the Bon Marche presented it, was now a full-time preoccupation. Shoppers were expected to spend their day at the store; and if they needed a place to leave aged parents or restless children, a place to meet friends or to arrange ren­ dezvous, or simply a place to repose and prepare themselves for a return to the galleries, the House was willing to provide for these needs.

The conjunction of consumption, life style, and the life of the store could also be found in the special sales and the pro­ motions that came in their wake. Yearly rhythms, the Bon Marche suggested, were now structured in the sequence of Bon Marche events. Months were no longer consequential, and even seasons lost much of their former meaning. Instead, the year now progressed from a clearance sale in early Janu­ ary to the Christmas and New Year’s sale in December. Along the way were the blanc (late January or early February), a sale of gloves, flowers, lace, and perfume (late February), sea­ son’s novelties (March), a summer clearance sale, and a spe­ cial sale of carpets and furniture (September). Summer fash­ ions sales took place in April or early May, winter fashions

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SELLING CONSUMPTION 187

sales in October. Like the Revolutionaries of 1793, the Bon Marche created a calendar all its own. Winter was a time when white goods and New Year’s gifts were bought, spring and fall a time when old fashions were discarded and new styles adopted. For all those persons who read newspapers or received catalogues or in some way or other were exposed to the sales, it was not difficult to conceive of the year as a con­ tinual scheduled visit to the store on the Left Bank.

Cards for children served much the same function. Just as pictures of the store were integrated into sets on the institu­ tions of Paris, so too were there series that portrayed a visit to the House as part of a child’s daily adventures. There were cards that pictured buying trips at the Bon Marche and cards that showed children and their mothers riding omnibuses and carrying bundles with Bon Marche labels. One series, devoted to the end-of-the-year sale, showed children hawk­ ing signs of the coming exposition. Other cards portrayed Bon Marche delivery boys bringing Bon Marche packages, or even children receiving cards as they left the Bon Marche. Cards of this sort, along with those of visits to the Tuileries or trips to the seashore, were all of the same genre. Each de­ picted a side to growing up in France, each was a device to shape a bourgeois child’s image of his world.

Most interesting of all, in this vein, were the agendas. Like illustrated cards, these too were deeply rooted in the popular culture of France, having as forerunners the almanacs of ear­ lier days. Almanacs as simple calendars, listing the days of the year, the phases of the moon, and church holidays can be traced as far back as Roman times.31 Almanacs in book form, published annually and containing diverse information in addition to calendars, date from the end of the fifteenth cen­ tury. In 1679 the first Almanack Royal appeared, offering pre­ dictions for the year’s weather and information on the phases of the moon, mail service, palace holidays, and the principal fairs of the kingdom. By 1697 it was also listing state dig-

31 Outside Western civilization, still earlier calendars were produced by the Egyptians and the Chinese.

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188 PUBLIC RELATIONS

nitaries and important civil servants. The Almanack Gotha, dating from the eighteenth century, was still more diverse. Here one could find statistics on various countries, advice on personal hygiene, articles on the human body, and details on the peoples of the world. For the semi-literate and beyond, there was a whole genre of almanacs, largely astrological and sensational, but also offering advice on health, farming, and cooking. During the reign of Louis XV, almanacs, doubling as calendars or books for noting dates and expenses, became a phenomenon of enormous proportions. There were proph­ ecy almanacs, astronomical almanacs, medical almanacs, al­ manacs of fashion, of songs, of religious holidays, and so on, until practically every subject became the excuse, or the mate­ rial, for another almanac.

Almanacs were probably the most widely read of publica­ tions, often the only literary contact for great numbers of in­ dividuals. Their popularity led propagandists, as well as pub­ lishers, to issue almanacs in abundance. In earlier days state decrees had forbade political use of the medium. But by the nineteenth century the restrictions had gone, and political almanacs were once again common. Another form of prop­ aganda was commercial. This took two directions. First, there were professional almanacs, listing the merchants of a par­ ticular profession along with the usual almanac offerings. The Livre Commode began this tradition as early as 1691 and was later succeeded by the Almanach du Commerce de Paris and then the Didot-Bottin. Second, some individual merchants is­ sued their own almanacs, like La Faye the perfumer, who in 1772 published a combination catalogue-almanac, or Bresson, who sold designs to be sewn on screens and furniture, and who published an almanac containing information about his work.32

Bon Marche agendas emanated from this second strain.

32 Emile Mermet, La pubhcite en France, histoire et jurisprudence (Paris: 1879), pp. 125-45; Victor Champier, Les anciens almanacks illustres (Paris: Bi- bliotheque des Deux Mondes, 1886), pp. 46-47; John Grand-Carteret, Les al­ manacks frangais (Paris: J. Alisie, 1896); Genevieve Bolleme, Les almanachs populaires aux XVII et XVIII si’ecles (Paris: Mouton, 1969).

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SELLING CONSUMPTION 189

Perhaps the first of their kind offered by the new grands maga- sins, the agendas basically were calendar books with space to jot down daily engagements. Like earlier almanacs they con­ tained a range of information and amusing diversions. There were cartoons, menus, and extracts of articles and engravings from encyclopedias or other books. There were also theatre plans and lists and information on the postal system, lycees, museums, churches, hospitals, police commissariats, and oc­ casionally notaries. In the 1890s, centerfold texts with colored pictures on “The Cries of Paris” or on world affairs or on co­ lonial possessions became a standard feature. And there were also publicity and information about the Bon Marche, a good deal in fact. Pictures of the store with House slogans were common. So too were full-page announcements of sales dates, information on mail-order, details on deliveries, and directions for omnibus lines leading to the Bon Marche.

In one sense, then, Bon Marche agendas were a brilliant ve­ hicle for store self-promotion. Trading on the popularity of almanacs in France, and serving a variety of functions, they were assured of a market that would swallow them whole and accept the information they offered on store and city life. But, in a still larger sense, they were another means of iden­ tifying the Bon Marche with the bourgeois way of life. By placing store news alongside details on churches, theatres, lycees, and notaries, agendas implied that the Bon Marche was another bourgeois social institution of Paris. And by placing pictures of the House and reminders of special sales along­ side “Reception Day” pages and monthly dinner menus, agendas further suggested that a visit to the Bon Marche was another part of the bourgeois social calendar. Indeed, by creating an image in which bourgeois society could not be conceived of apart from the Bon Marche, these calendar books proposed that a trip to the store was simply another of one’s daily comings and goings. Like catalogues, sales, and picture cards, agendas told their readers that the life of the bourgeois and the life of the department store had become one and the same.

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Effects of vitamin D on patients with fibromyalgia syndrome

Vitamin D: The Many Roles In Our Bodies

Abstract

Vitamin D is a fat soluble vitamin that contributes to overall health. Health professionals promote its importance due to its function in the human body. Several studies and research observe vitamin D’s effects on health and its possible impact with certain diseases/illnesses; leukemia, hypertension, sickle cell anemia, and breast cancer to name a few. Findings include pro-founding information on vitamin D. There seems to be a coalition between vitamin D deficiency/toxicity and certain diseases/illnesses. Research has shown that vitamin D dosage does have an effect on health. However, there remains a gap in research and uncertainty on vitamin D’s role in diseases and illnesses not related to bone health.

Keywords: Vitamin D, deficiency, disease, health, effects, research

Introduction

Essential vitamins are what our bodies need at most to function on a daily basis. They may or may not be as easily accessible as one would think; depending on the region we live in, along with the conditions and resources provided, as well as the physical state an individual might be in pertaining to health. Being one of the macronutrients that is globally considered to be a deficiency prone vitamin for some groups or individuals. Mathebula (2015) states that the versatility of this vitamin in the human body along with functional roles goes down to the deepest level. In the long run it will be beneficial for those individuals who will be needing it more than those who would be considered at a healthy status. Individuals who are at a predisposition to chronic health related issues and more commonly diseases are more likely to not be well aware of some of the attributes that come with changing something as significant to their lifestyle. Vitamin D not only utilized for optimal health in absorption, but also versatile in many of the major systemic functions, which includes but is not limited to; muscular, oncological, neurological and vascular functions, all working together to maintain a balance within one another even through critical or difficult conditions. They somehow manage to overcome circumstances that puts health related issues that are on the rise become more known but more so relevant and current topics of discussion.

The essentiality of vitamin D and how it plays a key role in maintenance of cell to cell association along with communication throughout entire systems of the body to keep levels at a stagnant state. When it comes to Physiological aspects of vitamin D and conditions related to various body systems, specifically blood and how toxicity levels can be altered, maintaining consistency in absorption levels is impertinent. In regards to muscular health, but more specifically skeletal muscle, the absorption of vitamin D is crucial for both the skeletal and muscular aspect, with consumption of this vitamin, status of previous or known complications can be monitored to measure levels of pain or previous health related issues. This not only applies to this systemic aspect, but is interrelated to all other systemic functions in some way shape or form.

According to research, the role of vitamin D in individuals with certain cancers is beneficial to the point where increasing intake or decreasing exposure can be helpful in the form of preventative measures. How much vitamin D the body produces or absorbs and is distributed is based on many factors, demographically speaking where one lives and how they accommodate to that living arrangement is based on beliefs and what one does to improve lifestyle for improvement. Dietary intake, such as consumption of vitamin D rich foods or food sources that contain this essential macronutrient, is also a key player as to how people view or believe that vitamin D can affect them. According to Holman et al. (2017) affects on how one’s body, specifically skin, reacts to conditions such as skin cancer in the case of vitamin D absorption from sun exposure. In this case, being outside in conditions that individual put themselves in stresses out the body in which it has to acclimate under circumstances that are foreign or extreme and whether the certain limitations affect one’s health in the certain situations as well as long term status.

Without sufficient nutrient absorption needed to maintain performance of habitual and consistent tasks, insufficiency intervenes not only on a systemic but also physical and physiological level as well. According Gonzaga, & Gadini (2013) and the National Academy of Sciences, some individuals may be surpassing the safe limit of the daily vitamin D intake, which indicates toxicity levels over 2000 IU. This not only alters how one feels internally but externally some features or details are more prominent to intoxication or deficiencies in the case of someone not reaching the required needs or levels of vitamin D resulting in certain health related issues that affect prolonged overall health.

Improvement of conditions that affect one’s health, as well as promotion in prevention of health related issues, are key players in awareness of the limitations that come with deficiencies that are related to vitamin D and conditions of inadequate absorption for certain macronutrients. Several vitamin D health related issues and possible factors that affects its function in the human body will be discussed in this review. Vitamin D’s effect on bone health is a well known factor, however will not be discussed in this review.

Vitamin D a Versatile Function

Vitamin D is not just a vitamin that is essential for bone health, it also has significant roles in non-skeletal health, organ functions and prevention of disease. Vitamin D is a nutrient that is needed for optimal health. It is a group of fat-soluble secosteroids that is derived from cholesterol. Its main function is to aid in the absorption of phosphate, magnesium and calcium in the intestines. The ways vitamin D is acquired is through diet, supplements and from sunlight exposure. Normally we obtain our vitamins from the foods we eat, but with vitamin D there is no food source high enough in this nutrient to solely sustain our bodies requirement. So, in addition to diet the major natural source is acquired through sunlight under the skin using a process called ultraviolet B sunlight exposure.

Vitamin D has two major chemically distinct forms which are D2 ergocalciferol (comes from plant sources) and D3 cholecalciferol (comes from animal sources). Vitamin D will be converted into a hormonal activity form calcitriol. The vitamin D prohormone compound plays an important role in the production of various physiological functions. It is so viable that most cells in the human body have a receptor for it. An adequate vitamin D status is important for optimal function of many organs. The action of vitamin D by the active metabolite 1,25-dihydroxyvitamin D [1,25(OH)2D] behaves as a hormone and binds to the vitamin D receptor (VDR) Stöcklin & Eggersdorfer (2013). All tissues and cells in the body, including immune, brain, colon, prostate and breast cells, among many others, have a vitamin D receptor (VDR) that coincides with 1,25(OH)2 D3. Since the VDR is widely expressed, 1,25(OH)2D3 has effects on many tissues.

It is now known that 1,25(OH)2D3 plays a role in the immune system and has effects on differentiation and proliferation of various cell types. Vitamin D is also known to regulate the immunity by increased production of antimicrobial peptides and subsequent killing of bacteria. The innate immune system serves as the first barrier of defense against invading microorganisms. It is to identify foreign organisms and stimulate a cascade of events that result in the removal or destruction of the invading organism. Pattern recognition receptors are expressed by cell of the innate immune system to identify molecular patterns that are reserved amongst different classes of pathogens. These patterns are known as pathogen associated molecular patterns (PAMPs). Different forms of PAMPs are lipopolysaccharides (LPS), viral proteins and single/double stranded RNA. The innate immune system response depends on the specific toll like receptors (TLRs) or the TLRs that stimulate PAMPs. TLRs include TLR2 which responds to gram-positive bacteria and mycobacteria, TLR4 which responds to gram-negative bacteria and TLR3 which responds to double-stranded RNA associated with viral infections. The response to TLR signaling produces the production of anti-microbial peptides, cytokines and apoptosis of the host cells among responses (Stöcklin & Eggersdorfer, 2013).

The major form of anti-microbial peptides in humans is cathelicidin. Cathelicidin serve as a critical role in innate immune defense against bacterial infection. Cells of the immune system including neutrophils and macrophages and cells lining epithelial surfaces that are constantly exposed to potential pathogens (skin, respiratory tract and gastrointestinal tract) produce cathelicidin. Cathelicidin plays an integral part of the innate immune response due to its anti-microbial activity against gram positive and negative bacteria as well as certain viruses and fungi. Vitamin D activates macrophages and induces them to increase their production of the antimicrobial peptide cathelicidin. This breaks down pathogens once the macrophage has consumed them. It also creates a recursive effect whereby vitamin D both generates more innate immune cells and makes them more effective at destroying harmful organisms. The effect of vitamin D is in connection with the stimulation of these antimicrobial proteins and UVB radiation, which induces the production of the vitamin.

The association between vitamin D deficiency and autoimmune disease is the anti-inflammatory and immunomodulatory functions, as well as the presence of VDRs on most immune cells. The most established link between environmental factors and autoimmunity is within the interactions between infections and autoimmunity. Vitamin D deficiency is common in patients with autoimmune diseases. As seen in patients with Multiple sclerosis (MS), type 1 diabetes, irritable bowel disease and rheumatoid arthritis, vitamin D seems to affect the activity and outcomes of the autoimmune diseases. MS is an autoimmune demyelinating disease in which the insulating covers of the nerve cells in the brain and spinal cord are damaged. MS is most common in women, that are in certain ethnic populations and living in high altitudes with low sun exposure. Several genetic and environmental facts have been implicated in its development. It appears that low levels of vitamin D are common in patients with MS and has been identified with the increase relapse of MS (Levin, Theodor, Segal, et al., 2013). Vitamin D was reported to induce changes in the gene expression of immune cells within patients with MS. The autonomic dysfunctions combined with inflammation is a critical factor in the development of MS. The autonomic dysfunctions were found to be altered by environmental factors such as the Epstein-Barr virus and vitamin D and possible the combined effect of both (Sternberg, 2012).

Several tests were performed on patients with MS and doses of vitamin D. The first test identified low doses for 6 months and there were no significant or radiological effects. Another test was performed with the increase dose for over a 28-week period followed by and additions 10,000 IU/day for 12 weeks. According to Levin et al. (2013), This dose appeared to be safe and the relapse rate showed an apparent decline. Supplementation was suggested to be beneficial for the primary prevention of autoimmune diseases as MS and diabetes mellitus.

In the past, the major source if Vitamin D was exposure of sunlight. One possible cause of vitamin D deficiency is the lack of unprotected sun exposure. Current barriers to sunlight are the fear about attaining melanoma and other types of skin cancer which warrants the avoidance of midday sun exposure. This has led to an increase in sunscreen, hats and other sun barriers. Environmental factors such as pollution and fewer hours in the winter months decrease exposure and ultimately contributes to the loss of vitamin D synthesis from sunlight exposure. The sun exposure helps satisfy the body requirements. For people who live at 33° Latitude these observations in particularly strengthen the argument for supplementation (Grant, et al., 2009). Another possible cause is lack of dietary source of vitamin D. It is difficult for adults and children to obtain high levels of vitamin through a dietary source without supplementation. Currently there has not been a specific amount established for a regimen of vitamin D therapy for immunological homeostasis. Numerous epidemiological studies have suggested that a 25(OH)d blood level above 30 ng/ml may have additional benefits in reducing the risk of common cancers, autoimmune disease, cardiovascular disease and infectious diseases. (Holick, et al., 2011)

Vitamin D and Diabetes

According to The International Diabetes Federation, diabetes affects 425 million adults worldwide, with the total set to reach 629 million by 2045. In the United states, an estimated 79 million people have prediabetes. There is growing evidence that deficiency of vitamin D is a large contributing factor in the development of both type 1 and 2 diabetes. Vitamin D improves glucose tolerance and improved insulin secretion. The b-cells in the pancreas that secretes insulin express the VDR and respond to 1,25(OH)2D by increasing insulin production. It does not participate in generating the new β-cells. Therefore, 1,25(OH)2D3 seems to have a role in the prevention of diabetes in early age and/or improving of diabetes rather than treating the disease. The indirect effects of vitamin D may be mediated via its important well-recognized role in regulating extracellular calcium and calcium flux through betta cells. Insulin secretion is a dependent upon calcium process. Alterations in calcium flux can have effects on b-cell secretory function through the cell membranes. Therefore low vitamin D may affect calcium’s ability to affect insulin secretion (Martin & Campbell, 2011).

There is research that speculates the relation between vitamin D and gestational diabetes mellitus (GDM). Like other changes that occur during pregnancy, GDM is a common condition in which many women are diagnosed with. There is little evidence that links genetics to the occurrence of GDM of some women. Therefore, diet is the main factor that affects women’s risk of developing GDM; before and during pregnancy. However, there are patterns that speculate risk factors for women before and during pregnancy. Women are often encouraged by health care professionals to maintain their health during childbearing years. GDM occurs during pregnancy in which women develop insulin resistance correlated with carbohydrate consumption intolerance (Alzaim & Wood, 2013). Individuals diagnosed with GDM have a fasting plasma glucose level that reads 126mg/dl and an initial plasma glucose level that reads 200 mg/dl. Women with GDM also are shown to be vitamin D deficient, thus raises the possibility of a relationship between the two. This is furthered explained when considering the role vitamin D plays during pregnancies.

The placenta, in which the fetus receives nutrients, contains vitamin D receptors and activating enzyme 1-α-hydroxylase (Maysa et al., 2013). Despite this knowledge, there is not enough scientific evidence to prove that vitamin D affects pregnancy. Therefore, the question still remains as to why vitamin D is a major nutrient requirement for the fetus, as well as why many pregnant women have low vitamin D levels and are diagnosed with GDM. It is also argued that the fetus requires certain vitamin D dosage throughout development. This dosage requirement peaks during the third trimester, thus increases the fetus’ needs of the vitamin. Confusion over the importance of vitamin D during pregnancy has also affected people’s knowledge of the benefits of taking vitamin D supplements while pregnant (Mitchell & Sanders, 2018).

Early prevention and becoming informed as to what certain diagnosis for these life altering conditions such as diabetes mellitus or gestational diabetes mellitus; as well as making changes to previous habits, significantly can bring on a better outcome. Taking preventative measures to ensure one doesn’t acquire this diseases as well as other diseases alike early on, but also maintaining a consistent routine that brings awareness, are indicators that health status should be a more concerning topic of discussion.

Blood Health and Vitamin D

Vitamin D plays major physiological roles in the body as a steroidal hormone. It is critical to note that the Deficiency or in excess the imbalances result in blood-related problems. When In excessive amounts within the human body, Vitamin D results in a rare but potentially serious condition called Hypervitaminosis D. This condition is popularly known as the “Vitamin D toxicity”. This type of Vitamin D toxicity is caused by large amounts of Vitamin D in the body which results from mega-doses of Vitamin D supplements. It is critical to note that Vitamin D toxicity is not caused by the conventional ways of obtaining the nutrient through diets and sun exposure. This is because the body has mechanisms in place that regulate the amount of vitamin D produced and obtained through the sun exposure or continuous intake of fortified foods and diets. These two sources do not contain copious amounts of the mineral and hence cannot results in Vitamin D toxicity. Vitamin D toxicity is characterized by consequences such as an excessive buildup of calcium in the circulatory system affecting the blood . This is a condition referred to as Hypercalcemia. Hypercalcemia is characterized by symptoms such as nausea, vomiting, weaknesses and frequent urination. Healthy blood contains the right amount of calcium hence a deviation affects functionality and can result in disorders that are systemic such as formation of calcium stones.

The normal human has a blood pressure of between 120/80 mmHg and 140/90 mmHg. A deficiency in Vitamin D disrupts this normalcy to levels that are considered high blood pressure. Vitamin D deficiencies in Healthy people have been linked with the development of stiffer arteries and the inability of some blood vessels to relax. This results in deteriorating vascular health. A problem in the vascular system affects what is referred to as healthy blood or circulatory system. According to these assertions, it is reasonable to infer that lack or efficiencies of vitamin D impair the individuals vascular health which contributes to high blood pressure as well as risks of cardiovascular disorder. Higher blood pressure is linked to several blood complications such as the formation of blood clots. Blood clots, or as commonly referred to as a thrombus, obstructs the flow of blood to other areas and is defined as the final product of coagulation step in hemostasis. The process of hemostasis in uninjured vessels is a critical health concern considering it obstructs blood flow and can result in lower levels of blood flow into the brain. Another growing blood health issue is leukemia. Leukemia is known as that the cancer of the body’s red blood cells. Leukemia has in the recent past been linked to Vitamin D deficiency. This is mainly associated with people who are exposed to minimal or no sunlight at all. A number of studies has shown that vitamin D metabolites have something to do with the growing cases of Leukemia in people living far from the equator. This is because Vitamin D has a metabolite in blood known as the 25-hydroxyvitamin D, or 25(OH)D. This is the indicator used to measure the levels of Vitamin D levels in a human body. These metabolites interact with the Acute Myeloid Leukemia cells (AML). To add to this argument majority of the studies involving people with Leukemia have noted a lower level of Vitamin D. Skin photosynthesis accounts for a large proportion of 25(OH)D concentration. As a result, the inverse association between cloud-adjusted solar UVB exposure and incidence rates is likely to be mediated by circulating 25(OH)D, which is highly dependent on solar UVB irradiance. In simpler terms, this study suggests that an increased level of UVB irradiance and Vitamin D are critical in ensuring that people away from the tropics and the equator who receive minimal sunlight can prevent the development of Leukemia. It is critical to note that Vitamin D has been known for its role in Calcium regulation. However, the implications in hematological cancer pathogenesis have provided a major challenge and an insight into anti-cancer therapy. Serum levels of 25(OH)D3, the precursor to the active form of vitamin D, calcitriol, are frequently lower in patients with the hematological disease compared to healthy individuals. This correlates with the worst of the disease outcomes. In the same context, the diseased cells also exhibit a higher level of Vitamin D reception which causes abnormalities in blood cells. However, not all side effects of the lack or presence of vitamin D are bad. This is because supplementation of Vitamin D improves apoptosis which is a systematic and body induced cell death especially damaged or worn out cells, induces differentiation of cells in the body, prohibits proliferations and most importantly Vitamin D in blood health helps to sensitize the tumor cells in conjunction with other cancer therapies. It is however notable that the control of Vitamin D levels is critical because the amounts that are required to achieve these functions listed successfully can induce hypercalcemia in humans. It is critical to note that blood health is dependent on the health of individual cells. For example, a small deviation from the normal blood cells is considered abnormal. A good example is a change in the shapes of red blood cells in sickle cell anemia patients. This is a genetic disease that is characterized by abnormal hemoglobin which is the primary constituent of the red blood cells. It is notable that people with Sickle cell disease have severe nutritional deficiencies. One of these deficiencies is Vitamin D. The symptoms of Vitamin D deficiency in sickle cell patients include chronic pain. This means that the levels of Vitamin D in the system affect the severity of sickle cell anemia resulting in more complications. Considering the basic fact that Vitamin D deficiency and sickle cell anemia share the same clinical manifestations for bone health, chronic inflammation, and pain, it is reasonable to infer that the Vitamin D deficiency contributes to the growth of the sickle cell anemia condition. In simpler terms, by optimizing Vitamin D nutrition, we achieve an inexpensive strategy to improve blood health as far as sickle cell disease is concerned.

Lastly, it is important to consider the effects of Vitamin D deficiency on the basic functionality of blood clotting. As explained before Vitamin D is associated with the regulation of calcium levels in the system. Calcium ions are critical for the entire process of clotting. Calcium ions are basic elements for clotting to occur. Lower levels of Vitamin D means that there will be lower levels of calcium which results in hemophilia commonly referred to as the bleeder disease. This affects the entirety of blood health in several aspects; entry of microorganisms considering that clotting blocks entry of pathogens and the loss of blood which is also a critical element of blood health and general blood health. This is because the basic elements of the human immune system are anchored in the blood which holds the white blood cells.

Vitamin D and Skeletal Muscle Tissue

Vitamin D has been established for some time as an important factor for bone mineralization however, when it comes to the skeletal muscle tissue, new research on vitamin D’s positive functions and effects are still being uncovered. The method researchers are using to uncover the process of communication between skeletal muscle and vitamin D is VDR (Vitamin D Receptor). The VDR is a transcription factor that is activated by 1,25-dihydroxyvitamin D that regulates gene transcription in the body. Depending on the amount of 25(OH) D in the tissue they can focus in on that specific location to examine VDR’s process. VDR however, is difficult to find which is why this method of confirming a deficiency of vitamin D in skeletal tissue remains in its experimental phase. Limited research have been published that examines an association between muscle pain and vitamin D stores in humans, in addition to lab mice.

In one study, they conducted an uncontrolled study that examined 150 patients with chronic, musculoskeletal pain that uncovered 96% of the patients had vitamin D deficiency, with a mean of 25(OH) D of 10.49 ng/ml. (S. Bobo Tanner and Susan A. Harwell, 2015). This allowed the researchers to gather data on patients that were at higher risk of hypovitaminosis D meanwhile, extending the risk for deficiencies of vitamin D in other populations as well. In another randomized trial that contained a sample size of 30 women with fibromyalgia, that ensues widespread muscle pain and tenderness, also measured 25(OH) D levels. Depending on the womens vitamin D baseline levels they were either given 1 of 2 doses of 1200-2400 IU cholecalciferol (Vitamin D3) a day. This study however did uncover a decrease in pain in relation to vitamin D status compared to the control group. The researchers concluded that the patients in the experimental group has less muscle pain overall. The researchers however, did comment on the limitation of their 30 person sample size and how improving health-related quality of life and disease impairment scores were not statistically significant for reducing overall pain with the supplementation of vitamin D (Wepner, et al. 2014).

Myopathy and sarcopenia also remain as a focal point for certain studies that associate vitamin D and the benefits the vitamin can do for the tissue. These ailments pertain to muscle weakness and low muscle mass in the skeletal tissue. As a population continues to grow old and or living farther from the equator, bone mass decreases in density and strength due to reduced sun exposure and non fortified vitamin D foods. Researchers are exploring vitamin D’s benefits and effects on the muscle tissue by uncovering the physiology of vitamin D receptors (VDR) in the skeletal muscle and how vitamin D is being used by these receptors. This however remains as an area for opportunity for researchers because certain studies question that VDR even exists in the muscle tissue.

A very thorough continuous three part study decided to look into the presence of VDR in human myoblasts in addition to the relationship of vitamin D. The initial study harvested and cloned human myoblasts from healthy volunteers that were supplemented with 1 of 3 doses of 1,25-dihydroxyvitamin D. The researchers used polymerase chain reaction (PCR) to measure VDR in the myoblasts before and after supplementation. They discovered that they were able to measure VDR with PCR in the myoblasts. The second part of the study was a randomized controlled intervention study. It also had positive results by doing a similar vastus lateralis muscle biopsy on 20 women over the age of 65 with a semi deficient baseline of 25(OH)D levels and mobility restraints. They examined the supplementation of 4000 IU’s of vitamin D3 and a placebo for skeletal muscle morphology and VDR protein concentration. They were able to detect much more active VDR in the experimental group by conducting PCR, immunoblotting and immunofluorescent markers. The third final study, had a sample size of twenty mobile limited adults. They found that at fasting baseline levels of 25(OH)D and muscle biopsies, VDR protein expression by immunoblotting consisted of positive results of VDR detection in the skeletal muscle. The researchers did not find a correlation between VDR mRNA expression nonetheless, there was a larger VDR concentration in those with adequate amounts of 25(OH)D compared to those with deficient levels. S. Bobo Tanner and Susan A. Harwell. (2015).

Vitamin D is used in a variety of molecular pathways in the human body that can benefit skeletal muscle, bone formation and hormonal communication. The role of vitamin D is also suggested to mediate calcium and phosphate functions in the muscle regarding plasticity, contraction, mitochondrial function and insulin signaling. The researchers of this study tested supplementation of 20,000 IU cholecalciferol (vitamin D3) alternating days for 10-12 weeks in vitamin D deficiency individuals. It resulted in greater mitochondrial oxidative function as it pertained to phosphorus-31 magnetic resonance spectroscopy (P-MRS). The P-MRS is a noninvasive method that is used to assess mitochondrial processes by measuring the kinetics of high energy phosphate metabolites involved in ATP metabolism during and after exercise (Sinha, A., et al. 2013).

Vitamin D’s role in the skeletal tissue can take a variety of pathways that can associate it attributing to muscle weakness or myopathy. The functions in the body with the dosages that were used in the presented research clearly varies across the board from 4000 IU to 20,000 IU however the data may prove to be useful in future studies that pertain to myopathy and other illnesses relating to skeletal muscle. It would be safe to say to adequately consume vitamin D foods daily and if possible be in the sun for periods in a day. Another recommendation would be to do some form of physical activity because it would synergistically benefit skeletal muscle strength, bone mineral density, and overall wellness.

Vitamin D and Cancer

Vitamin D is an interesting and unique vitamin because it is considered a nutrient and a prohormone and is strongly known for its effects on building and maintaining strong bones. However, recent studies have observed a link between low vitamin D levels and an increase in cancer risk and progression. Specifically, research suggests that women with low levels of vitamin D have a higher risk of breast cancer and men and women with low levels of vitamin D have a higher risk of developing colorectal cancer. Vitamin D plays an important role in stimulating immature cells to become mature functioning cells. It transfers into the nucleus of a cell and up regulates selected genes coding for specific proteins involved in cell differentiation. Some evidence suggests that the function of vitamin D may help prevent certain types of cancers. Although this connection warrants further investigation, Vitamin D’s role in cell differentiation may highly be involved.

Breast cancer is one of the most commonly diagnosed cancers among women. O’Brien et al. (2017) demonstrates how effective serum vitamin D levels and supplemental intake of vitamin D has on women who are at risk of developing breast cancer and women who were diagnosed with breast cancer. 50,884 U.S. women ages 35 to 74 were enrolled in a sister study from having a sibling who has had breast cancer, but has never developed breast cancer themselves. Of the 50,884 women, 1,611 women who later developed breast cancer and 1,843 randomly selected cohort participants were selected to be in a five year study. Each participant filled out a questionnaire about their race, if they were on birth control/ hormonal supplements, menopausal status, alcohol consumption levels, physical activity, BMI, and family history. They also evaluated the relationship between breast cancer and vitamin D sources, including supplements, diet, and sunlight exposure. The root of the study is the concentration of vitamin D found within blood. Researchers referred to it as serum 25(OH)D, which is the main indicator of vitamin D in blood. All participants were given vitamin d supplementation and were contacted each year to make certain of any major health changes. Overall, women with low levels of Vitamin D are at higher risk for developing breast cancer. As a result 38.0 ng/mL of calcifediol was connected with a lower risk in breast cancer by twenty one percent compared with levels less than 24.6 ng/mL. The association with lower risk of breast cancer was most strongly evident for postmenopausal and obese women. It was also noticed that a lower risk of cancerous cells associated with regular vitamin D supplement consumed more than four times a week was more beneficial than average users. In fact, these results are quite consistent with those of the Recommended Daily Allowance of 400 IU/day. The results support the theory that supplements of Vitamin D could be effectual in preventing breast cancer by controlling normal breast cell growth and stopping breast cancer cells from progressing. In another study, Hamada et al. (2018) observed if high levels of vitamin D is linked with a decrease in colorectal cancer. Colon cancer is also a highly common cancer and is the top leading cause of cancer-related deaths in the United States. In this study, 869 participants with colon cancer were evaluated of an association of post diagnosis Vitamin D scores which came from diet and lifestyle factors in order to guess plasma 25(OH)D levels. They hypothesized that the survival colon cancer rate and connection with Vitamin D with is possibly stronger for tumors with lower lymphocytic response than tumors with a higher lymphocytic response. Each patient was followed up upon until death or end of the study. Post diagnosis predicted calcifediol score fairly correlated with pre diagnosis predicted calcifediol score. During the median follow-up time there were 480 all-cause deaths. Of the 480 deaths, 122 of them were from colorectal cancer. As a result, they did not observe a statistically significant interaction between post diagnosis predicted vitamin D score and lymphocytic reaction in relation to overall mortality. Assuming that predicted vitamin D levels can possibly have an effect on any other factors used in the prediction model, they included the patients physical activity level as a further outcome. They concluded that the beneficial survival connection of post diagnosis predicted Vitamin D worked better for patients with colon cancer who have lower peritumoral lymphocytic reaction. However, they did not observe a difference in overall mortality rate. To determine if their theory is valid, they performed this study on two large prospective cohort studies. The predicted vitamin D score came from dietary and lifestyle data, which included both endogenous and exogenous sources of vitamin D and estimates of long-term plasma levels. The association of Vitamin D levels with the mortality of colon cancer varied by levels of peritumoral lymphocytic reaction. The multiple adjusted transience ratios for five equal groups increase of Vitamin D levels were 0.69 and had ninety five percent confidence interval. Other findings with lower peritumoral lymphocytic reaction were 1.08 and ninety five percent confidence interval. The survival association of the 25(OH)D score was not notably different by Crohn’s-like lymphoid reaction, tumor-infiltrating lymphocytes. In conclusion, the connection between Vitamin D levels and success rates of colon cancer is stronger for carcinomas with lower peritumoral lymphocytic reaction. Their results suggested a correlation of vitamin D and immune response may contribute to their own diet and lifestyle. This newest study does not show that there is a benefit to supplementation, however it does show a positive association with higher levels.

Lastly, studies show Vitamin D may protect someone against the development of skin cancer. Vitamin D which is also known as the sunshine vitamin can be made in large amounts when exposed to the sun. The sun’s UVB rays hit cholesterol in the skin cells, providing the energy for vitamin D synthesis to occur. Once Vitamin D is activated it influences the genes in your skin and helps prevent the type of abnormalities that ultraviolet light causes. As a result, sun avoidance becomes the factor that ironically activates skin cancer.

       Park et al. (2016) evaluated 63,760 women and 41,530 men from for 26 years to determine if dietary and supplemental intake of Vitamin D correlated with skin cancer. They acquired information by doing food frequency questionnaires, dosages of multivitamins every four years, and physical activity levels. Once dietary Vitamin D nutrients were calculate, they conducted stratified analysis according to major sun exposure variables, such as history of sunburns and the average amount of time in the sun since high school.

       In conclusion, higher levels of vitamin D intake was positively associated with risk of Basal Cell Carcinoma while a non-significant increased risk was found with melanoma. Participants with higher intake of total vitamin D tended to be older, participate in regular physical activity, and used more sunscreen. Both men and women with lower total vitamin D intake were more likely to smoke, and consumed higher amount of alcohol intake. Evidence suggests it would be best to get a reasonable amount of unprotected sun exposure on a large amount of bare skin just before your skin starts turning pink, and then cover up with a thin layer of clothing. Like any other cancer, breast, colorectal, and skin cancer is caused by multiple issues such as diet, exercise, lifestyle choice, and genetics. Vitamin D is just one part of that solution to possibly help prevent it. The safest things to do to avoid these types of cancer would be to ensure that there is adequate vitamin D in the diet. Until better evidence emerges, continuing to take a cautious approach to vitamin D supplementation seems the most reasonable approach. Although findings are solely observational, there is no conclusions about the link between vitamin D and cancer risk. There is an optimal level of vitamin D that protects against cancer, but an overconsumption of this level offers no further benefit.

Conclusion

Being that vitamin D is an essential vitamin, it is not surprising to know that deficiencies and overdosage will have a major impact on health. As discussed, vitamin D can be obtained from the diet, sunlight, and supplementation. More than just a vitamin that supports bone health, vitamin D has other benefits which is associated with different conditions and functions in the body. For example, a contributing factor to vitamin D’s importance is its impact on regulating the immune system. Individuals with deficiencies of vitamin D can be linked to the development of autoimmune diseases. Autoimmune diseases involve healthy living cells being killed off by the immune system; instead of the immune system strengthening the body’s defenses in fighting bacteria and illnesses.

It is argued that when proper dosages are not reached individuals can develop illness and diseases such as hypercalcemia, leukemia, breast cancer, diabetes, and sickle cell anemia. Although vitamin D deficiency is a major issue in our health, toxicity of this vitamin is also a cause for concern; toxicity in this form is referring to the excess amount of vitamin D in the body. As mentioned earlier, hypercalcemia is the result of calcium buildup in the blood resulting in vitamin D toxicity, and ultimately affecting our circulatory system. In addition to this, the structure and function to blood vessels relies on the intake of vitamin D leading to cardiovascular disease or related disorders. High blood pressure is the result of abnormal functions of blood vessels and can further lead to the formation of blood clots, thus inevitably increase chances of a stroke. While there are other factors that affect stroke risks, it cannot be ignored that vitamin D may also play a role in its formation. In this case, prevention measures must be taken place.

Because Vitamin D is known as the “sunshine vitamin” it would be appropriate to contemplate the implications and diseases that occurs with the lack of sunlight. Previously mentioned, leukemia is blood cancer that can be linked to lack of sunlight. Therefore, in certain regions of the world where there is limited sunlight, it would be expected that individuals who reside in these regions are prone to develop leukemia; proper UVB exposure can prevent leukemia for these individuals.

However, as beneficial sunlight can be, it is also important to take proper precautions when out in the sun because too much sunlight can also cause negative effects. It is important to consume water to prevent dehydration and even apply sunscreen when exposed to the sun for a long period of time (Bentley, 2013). It should be noted that this is only in the case of potentially too much sun exposure, thus normal exposure will not warrant these measures and in fact decrease sun exposure when it is needed. It was further discussed that other cancers such as breast cancer maybe linked to low doses of vitamin D. Inadequate vitamin D can further affect already existing diseases, such as individuals with sickle cell anemia who state that under these conditions they suffer from chronic pain. By contrast, adequate amounts of vitamin D would improve the condition of patients who suffer from sickle cell anemia.

The importance on vitamin D for bones has always been highly discussed and encouraged by health professionals. However as indicated above, currently it is speculated that vitamin D also impacts skeletal muscle. Although several studies and research were conducted testing this knowledge, and some that concluded with some convincing results, there is little profound evidence or explanation to make this discovery undoubtedly true. This can be an area for further research in which researchers discover how skeletal muscle and vitamin D are related; more information on the vitamin D receptor. This discovery would be a breakthrough in research because it would explain certain individuals who suffer from muscular pain and weakness. Also, it would give individuals more incentive to include vitamin D in their diet and from other sources.

There is even more room for further research. Unfortunately, there is little evidence that supports vitamin D’s role in preventing cancer, thus should not be used as a preventive measure (Bentley, 2013). Therefore, researchers and scientists need to find further information that supports their theories on cancers and disease such as HIV and cardiovascular disease. Furthermore, additional research can include vitamin D deficiency in different age groups and how it affects development in children as well as mental and physical capabilities in adults. There is definitely a gap in research as far as vitamin D’s role in pregnancy and its effects on GDM. Health professionals need to develop a strategy to effectively promote vitamin D for pregnant women when research shows that it has no substantial effect on pregnancy. Lastly, the costs of research as far as prevention and other measures should be discussed (Aguiar et al., 2017). It should be indicated if such prevention will be beneficial in the long run and its impact on the economy and health care facilities.

It is imperative to know the implications that arise from lack of or excessive vitamin D. For instance, it is suggested that by knowing the results of improper vitamin D dosage it can then be prevented and studied further. One obvious measure to prevent vitamin D deficiency is through implementation in the diet. Diets should include tuna and salmon, dairy products that have been fortified with vitamin D, and egg yolks. Ultimately, there is not enough evidence that proves vitamin D as a prevention to many cancers, diseases, and illnesses. However, it is found that a person’s overall health will improve with adequate vitamin D. Although vitamin D is just one of the factors that affect the diseases and illnesses discussed earlier, it is still worth observing and realizing its impact on overall health. It is especially important in underdeveloped countries where there is high occurrence of vitamin D deficiency. Health professionals in these countries can take this research to encourage implementation of vitamin D in patients’ diet, as well as promote it in the community. Undoubtedly if there is more knowledge and resources, deficiency in these countries and around the world will greatly reduce.

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Discuss two actions you would take to improve the health issue.

Please visit the website and write about substance abuse.

Please follow the instructions .

Visit Healthy People.gov site https://www.healthypeople.gov/ then you will

Select a leading health indicator and discuss why you think this health issue is a priority.

Discuss two actions you would take to improve the health issue.

The post should be between 350-500 words ( no longer)

Use Headings ( example health indicator and Importance and Actions )

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-Choice of topic and discussion of importance in our society

-Two actions for change

-Use of headings

Use of APA in-text citations

Adherence to rubric and word limit ( under or over)

Please include 1 reference

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