In addition, during the symposium, Dr. German Kamalov and his colleagues made a presentation that addressed why patients with heart failure—especially African Americans—are prone to an imbalance of several nutrients. As they explained, with the imbalance, there is an activation of certain hormones, which leads to inflammation and wasting of soft tissues and bone. They discussed approaches to recognizing this nutritional imbalance, and suggest that a "polynutrient supplement" including calcium, magnesium, zinc, selenium, and vitamins D, B12 and B1 could potentially play a role in heart failure management. However, as Dr. Weber notes, despite the new evidence, "The role of nutrition in the causation, prevention and treatment of cardiovascular diseases is largely unexplored. Investigator-initiated, hypothesis-driven research conducted in a mode of discovery by a multidisciplinary team of basic and clinical scientists will undoubtedly open new frontiers and pave the way by identifying simple remedies that could advance the practice of medicine.”

The main risk factors for low vitamin D levels include older age, being female, living in lower latitudes, winter season, darker skin pigmentation, less sunlight exposure, dietary habits and the absence of vitamin D fortification in common foods. Additional factors include increased urbanization, where people typically live and work indoors, as well as cultural practices that encourage people to avoid the sun and wear clothing that covers the skin. Individuals with cystic fibrosis or inflammatory bowel disease such as Crohn's are also at high risk.