A No Brainer: Teens Deficient In Vitamin D
Taking supplements and absorbing a little bit of sunshine each day may help prevent colorectal and breast cancers. According to two studies conducted by a core team of cancer prevention specialists at the Moores Cancer Center at University of California, San Diego (UCSD), a high blood level of vitamin D could help reduce the risk of breast cancer by half and of colorectal cancer by two-thirds. Vitamin D is a fat soluble vitamin that is found in food and is made in the body because sunlight's UV rays trigger vitamin D synthesis in the skin.
For the breast cancer study, published online in the Journal of Steroid Biochemistry and Molecular Biology, researchers analyzed data from two earlier studies on the response to vitamin D doses among 1,760 people. "The data were very clear, showing that individuals in the group with the lowest blood levels had the highest rates of breast cancer, and the breast cancer rates dropped as the blood levels of 25-hydroxyvitamin D increased," said study co-author Cedric Garland. "The serum level associated with a 50 percent reduction in risk could be maintained by taking 2,000 international units of vitamin D3 daily plus, when the weather permits, spending 10 to 15 minutes a day in the sun," he said.
The colorectal cancer research, published online in the American Journal of Preventive Medicine, analyzed five studies on 1,448 individuals that explored the association of blood levels of vitamin D with colon cancer risk. The incidence rate of colorectal cancer could be reduced by half with a serum level 34 nanograms per milliliter (ng/ml), the study found. "We project a two-thirds reduction in incidence with serum levels of 46ng/ml, which corresponds to a daily intake of 2,000 IU of vitamin D3. This would be best achieved with a combination of diet, supplements and 10 to 15 minutes per day in the sun," said study co-author Edward Gorham.
The researchers highlighted the importance of limiting sun exposure to avoid skin cancer risks. They said a fair-skinned white person could get an adequate dose of vitamin D by spending 10 to 15 minutes in the noontime sun on a clear day with 50 percent of skin area exposed to the sun, while darker skinned people may need to stay as long as 25 minutes under the sun to achieve a similar benefit.
info from Breitbart.com
In April 2005, a virulent strain of influenza hit a maximum-security forensic psychiatric hospital for men that's midway between San Francisco and Los Angeles. John J. Cannell, a psychiatrist there, observed with increasing curiosity as one infected ward after another was quarantined to limit the outbreak. Although 10 percent of the facility's 1,200 patients ultimately developed the flu's fever and debilitating muscle aches, none did in the ward that he supervised.
Cold-weather wear and the sun's angle in the winter sky limit how much ultraviolet light reaches the skin. This can add up to a deficiency in production of vitamin D, which might explain why respiratory infections are common and severe in winter.
"First, the ward below mine was quarantined, then the wards on my right, left, and across the hall," Cannell recalls. However, although the 32 men on his ward at Atascadero (Calif.) State Hospital had mingled with patients from infected wards before their quarantine, none developed the illness. Cannell's ward was the only heavily exposed ward left unaffected. Was it by mere chance, Cannell wondered, that his patients dodged the sickness.
A few months later, Cannell ran across a possible answer in the scientific literature. In the July 2005 FASEB Journal, Adrian F. Gombart of the University of California, Los Angeles (UCLA) and his colleagues reported that vitamin D boosts production in white blood cells of one of the antimicrobial compounds that defends the body against germs.
Immediately, Cannell says, the proverbial light bulb went on in his head: Maybe the high doses of vitamin D that he had been prescribing to virtually all the men on his ward had boosted their natural arsenal of the antimicrobial, called cathelicidin, and protected them from flu. Cannell had been administering the vitamin D because his patients, like many other people in the industrial world, had shown a deficiency.
The FASEB Journal article also triggered Cannell's recollection that children with rickets, a hallmark of vitamin D deficiency, tend to experience more infections than do kids without the bone disease. He shared his flu data with some well-known vitamin D researchers, and they urged him to investigate further. On the basis of more than 100 articles that he collected, Cannell and seven other researchers now propose that vitamin D deficiency may underlie a vulnerability to infections by the microbes that cathelicidin targets. These include bacteria, viruses, and fungi, the group notes in a report available online for the December Epidemiology and Infection.
This is only a hypothesis, "but a very credible one" that deserves testing, says immunologist Michael Zasloff of Georgetown University in Washington, D.C. Behind the hypothesis are recent studies that link vitamin D intake to revved-up cathelicidin production. These investigations point to an infection-fighting role for vitamin D, which is produced in skin exposed to sunlight but is present in few foods.
A study published earlier this year that investigated the relationship between vitamin D and susceptibility to tuberculosis also bolsters the idea proposed by Cannell's team. Scientists have already planned a handful of clinical trials to evaluate the antimicrobial benefits of vitamin D supplementation. Zasloff argues that if studies support the hypothesis, "we can imagine one day treating infections not by giving somebody a drug, but by giving them safe and simple substances&emdash;like a vitamin."
from Deficiency In Vitamin D May Predispose People To Infection by Janet Raloff (10/06 ScienceNews.org)
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from Science News,
Dr. Reinhold Vieth and his colleagues at the University of Toronto have given hope to millions of people across the world who are suffering from the debilitating symptoms of depression.
In a paper published in July (2004), Vieth and co-workers showed that vitamin D significantly improves mood and helps relieve the symptoms of depression in patients with vitamin D levels most doctors would mistakenly consider to be normal.
Vieth studied a total of 130 patients with summertime vitamin D blood levels less than 24 ng/ml (61 nmol/L) from an endocrinology clinic in two separate studies. During the winter, they treated half the patients with 4,000 units of cholecalciferol a day while treating the control group with 600 units a day (this lower dose is the one recommended officially, by the Food and Nutrition Board, for the elderly). Ethical considerations prior to the study were, that the medical literature is now so clear on the dangers of vitamin D deficiency that no one selected for research because of low vitamin D levels should be denied vitamin D treatment.
Other authors have called for an end to placebo studies on people who are likely to benefit from a treatment. However, Vieth is the first vitamin D scientist to risk studying vitamin D using an active agent in the control group instead of placebo. Studies using active agents as controls are much less likely to show positive differences between treatment groups, thus the researcher risks getting negative results. As usual, Vieth, who started the current vitamin D renaissance with his masterful 1999 paper dispelling the myths surrounding vitamin D toxicity, Vitamin D supplementation, 25-hydroxyvitamin D concentrations and safety , remains on the forefront of the revolution.
Vieth measured various symptoms of depression before and after treatment in both groups of patients using a rating scale that contained typical questions assessing depression, such as:
1. Has your general
energy level been less than average lately?
Both groups of patients improved with treatment. Those taking 4,000 units of vitamin D improved more than those on 600 units. As expected, 600 units a day left a number of patients vitamin D deficient while the patients taking 4,000 units a day for six months ended up with acceptable vitamin D blood levels. There were no signs of toxicity and none of the patient's blood tests showed any ill effects from the treatment. In fact, the treatment lowered parathormone levels (PTH) &endash; a good thing because high PTH is associated with bone loss. Most importantly, the patients felt much better.
Vieth's important work adds to the growing possibility that many patients suffering from depression, or just not feeling well are, in fact, simply suffering from undiagnosed and untreated vitamin D deficiency. For a more thorough review of vitamin D and depression, see one of our previous newsletters at: http://www.cholecalciferol-council.com/Depression.pdf
Dr. Vieth's paper can be accessed in its entirety at http://www.nutritionj.com/content/pdf/1475-2891-3-8.pdf
Press Release provided by John Cannell, MD (The Vitamin D Council)
Breast cancer is the most common form of cancer in women, causing about 370,000 deaths annually worldwide. Each year some 220,000 women in Europe and 180,000 women in North America are diagnosed with the disease. About 15,000 British women die of breast cancer annually, a death rate that is higher than elsewhere in Western Europe.
The reasons for this are not altogether clear, but lack of sunlight could be a factor. In 1989 Drs. Frank and Cedric Garland, together with Dr Edward Gorham, published the first ever epidemiological work on the relationship between sun exposure and breast cancer. Their research demonstrated that, as in the case of colon cancer, there was a strong negative correlation between available sunlight and breast cancer death rates. The chances of women from areas of the United States with less available sunlight dying of breast cancer were 40 per cent higher than those of women who lived in Hawaii or Florida.
Since vitamin D can be toxic in doses that greatly exceed this value, researchers have developed synthetic analogues of vitamin D that retain the ability to inhibit cancer cell growth without the toxicity associated with high doses. These analogs have been successfully used in animal models of leukemia and breast cancer. Vitamin D may be related to other cancers. One study found that women who get low levels of sunlight experience high rates of breast cancer, suggesting that low vitamin D levels may play a preventive role in the disease. Low blood levels of vitamin D have also been found in people with colon cancer.
As far as internal cancers are concerned, few physicians seem to have actually used sunlight therapeutically. One notable exception is the American physician Dr Zane Kime. In his book, sunlight Could Save Your Life, which was published in 1980, Dr Kime describes how he encouraged one of his patients with breast cancer to sunbathe. He took this rather unusual step following a consultation with a 41-year-old woman whose breast cancer had spread to her lungs and bones. She had already undergone a mastectomy and chemotherapy but to no avail. Dr Kime did not treat the cancer directly but instead, introduced a program to improve the general health of his patient. She was only allowed to eat whole foods, and all of the refined polyunsaturated oils and fats were removed from her diet. She was also encouraged to spend time sunbathing; and the combination of diet and sunlight seems to have achieved remarkable results. Within a few months the patient was back at work and in the years that followed there were no apparent symptoms of her metastasized cancer. Unfortunately Dr Kime did not devote much of his book to this episode, nor did he state how many years of remission his patient enjoyed and, sadly, Dr Kime died in 1992.
A landmark article published in Cancer Epidemiology, Biomakers and Prevention in May 1999 (Vitamin D and Breast Cancer Risk: The NHANES 1 Epidemiologic Follow-Up Study, 1971-1975 to 1992 by Ester M. John et al) provided valuable information regarding the beneficial "link" between ultraviolet radiation exposure (UVR) and the prevention of breast cancer.
John reported that "several measures of sunlight (UVR) exposure and dietary vitamin D intake were associated with reduced risk of breast cancer. However, the associations with vitamin D exposures varied by region of residence. The risk reductions were highest for women who lived in the United States regions of high solar radiation. No reductions in risk were found for women who lived in regions of low solar radiation. The authors concluded their abstract by stating, "These data support the hypothesis that (exposure to) sunlight and dietary vitamin D reduce the risk of breast cancer."
Based on the results of the John study, increased sensible, moderate and responsible exposure to UVR alone potentially could reduce the incidence and mortality of breast cancer by 35 to 75 per cent.
A new "wonder drug" promising to reduce breast cancer incidence by 100,000 cases and deaths by 38,000 would certainly create a buying frenzy of major proportions in the U.S. What women wouldn't want to get a prescription? Yet, why would those same women be reluctant to increase their sensible, moderate and responsible exposure to UVR? The reason they may not do so is because they have been brainwashed by the dermatology community and the sunscreen industry that any and all UVR exposure is harmful. Yet, the facts clearly and convincingly show that 55 women die prematurely from breast cancer each year because of underexposure to UVR for every one woman who dies prematurely because of overexposure to UVR.
From Looking Fit (January,2002) Good News For Women by Donald L. Smith and July, 2005 by Jessica Fraser, News Target Network (www.newstarget.com)
As reported in ScienceNews.org (9/06), a lotion that stimulates production of the skin pigment melanin induces a deep tan in specially bred laboratory mice. Those mice have skin similar to that of red-headed, fair-skinned people, who are notoriously poor tanners. The animals developed their tans without being exposed to the sun and its ultraviolet (UV) rays. Further tests showed that the additional melanin protected the mice against UV-induced DNA damage, sunburn, and skin cancer.
The active ingredient in the lotion is forskolin, an Asian plant extract that has been used to treat health problems. But scientific studies of the compound in the past few decades have shown no clear benefit, says study coauthor David E. Fisher, an oncologist at the Dana-Farber Cancer Institute and Children's Hospital in Boston. Nevertheless, past tests had shown that forskolin can rev up production of cyclic AMP, a molecule that's instrumental in producing melanin.
Normally, melanin manufacture requires several steps. When sunlight's UV rays hit the skin, cells release a signaling compound that binds to proteins on the surface of melanocytes, the cells that make melanin. This docking activates cyclic AMP production inside the melanocyte, which spurs the cell to make melanin and distribute it to nearby skin cells. There, melanin forms an array of microscopic parasols over the skin cells' nuclei, shielding the DNA from ultraviolet rays. The melanin darkens the cell and reduces burn risk.
In the new study, Fisher and his team used mice that, like red-headed people, have surface proteins on their melanocytes that are poor docking stations for the signaling compound. That interrupts melanin production. Mice coated with the forskolin lotion for 3 weeks made more melanin and became dramatically darker than mice getting a neutral lotion. Untreated mice exposed to UV rays for 24 hours had more than 20 times as much DNA damage and sunburn as did mice that had been treated with forskolin. After 20 weeks of exposure to UV rays for an hour or so each day, untreated mice developed nearly twice as many skin tumors as did the treated mice, the scientists report in the Sept. 21 Nature.
The results show that "the reduced DNA damage has a [positive] biological consequence," says molecular biologist Richard A. Sturm of the University of Queensland in Brisbane, Australia. Increased melanin reduced death among skin cells. Studies had previously established that people with dark skin are less likely to become sunburned or get skin cancer than fair-skinned people are. With the new work, Sturm says, Fisher and his team "display the tangible proof ... for a photo-protective role of melanin."
Sturm is cautious about the possibility of providing people with a forskolin-containing cream. He notes that cyclic AMP can stimulate cell growth, so increased amounts of that molecule might pose a cancer risk. Fisher is cautious too. "I am far from certain [that such a cream] would have activity in human skin," he says. Still, the findings suggest that intervening in the melanin-production process has potential as a cancer preventive, he says.
from UV Blocker:
Lotion yields protective tan in fair-skinned mice
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by Mike Adams News Target (8/06) http://www.NewsTarget.com/019908.html
A new study published in the Archives of Disease in Childhood has found that more than 70 percent of British teenage girls are deficient in vitamin D -- an essential nutrient for proper growth and development.
Researchers from St. Mary's Hospital for Women and Children in Manchester studied around 50 15-year-old girls, of which 14 were white and 37 were non-white. Using blood samples and questionnaires about diet and sunlight exposure, researchers found that 73 percent of the girls were deficient in vitamin D. "Vitamin D deficiency during childhood and adolescence might impair the acquisition of peak bone mass at the end of skeletal growth and maturation, thereby increasing the risk of osteoporatic fracture later in life," the researchers write.
Osteoporosis -- which affects more than 75 million people in the United States, Europe and Japan -- is a costly disease generally combated with dietary supplements. However, the simplest way to prevent the disease is to get adequate levels of natural sunlight exposure, which naturally produces vitamin D in the skin. The researchers say because 35 percent of an adult's peak bone mass is built up during puberty, it is essential for teenagers to get enough vitamin D to support healthy bone growth.
The researchers noted that the white girls in the study had higher levels of vitamin D than non-white girls, likely because of increased skin exposure and lighter skin pigmentation. Experts recommend that people with darker skin get more sunlight than light-skinned people, because it takes longer for dark skin to develop vitamin D. "This finding is alarming not only because it shows such a high percentage of teenage girls are deficient in this essential nutrient," explained Mike Adams, a consumer health advocate and holistic nutritionist, "but also because health authorities like the American Cancer Society continue to scare people away from sunlight exposure with fear-mongering public service announcements that claim sunlight may kill you. In reality, sunlight exposure could save hundreds of millions of people from suffering the well-documented effects of vitamin D deficiency, which include osteoporosis, cancer, depression and calcium deficiency."
"Today, we are raising a generation of vitamin D deficient children and teenagers," Adams added. "And the future health care costs of such short-sighted public health policies are incalculable."
Research Supports Teen Tanning - NH Regs Do Not
The New Hampshire State Legislature passed House Bill 729, which became effective January 2005. The bill requires the Board of Barbering, Cosmetology, and Esthetics to regulate tanning facilities. 313-A:31 pertains to tanning of minors:
I. No person under the age of 18 shall be allowed to utilize a tanning device at a tanning facility without the written consent of that person's parent or legal guardian and without an operator present. Proof of age shall be satisfied with a driver's license or other government issued identification containing date of birth and a photograph of the individual. This consent requirement shall be satisfied only if the parent or legal guardian is physically present at the time of the initial use of the tanning device, and the responsible adult signs a document declaring that he or she is the parent or legal guardian of the minor and attesting to the age of the minor. The consent of the parent or legal guardian shall be valid for 12 subsequent uses of the tanning device by the minor.
But, is suntanning really more dangerous for teenagers?
Anti-tanning lobbyist efforts are not supported by data, according to Joe Levy, vice president of the International Smart Tan Network. Levy also serves as executive director of the UV Light Research and Education Foundation, which commissioned an independent, nationally representative population study of 500 teenage girls aged 15 to 17. The project was conceived and co-directed by Levy with UV Foundation President Jim Shepherd. The two wrote a white paper on the results with International Communications Research, the research firm hired to independently collect the data.
The study's findings concluded that:
Levy points out that this study suggests strongly that restricting teenage access to tanning facilities is not the answer to reducing teenage sunburn incidence. Educating teens about sunburn prevention, rather than overstating the risks in an attempt to scare them out of the sun entirely, is what will prove effective in the long term.
from Tanning Trends May 2004 "What The Research Really Says About teenage Tanning"
The American Cancer Society (ACS) and 7 other health groups, including the Canadian Cancer Society, issued statements of findings (05/06) from the first North American conference on vitamin D, a nutrient most people get though exposure to sunlight. The conference, held in March, brought together experts in nutrition, sun exposure, skin cancer, and other diseases to discuss what is and isn't known about vitamin D and its effect on human health.
The consensus: There is still much to learn about how much vitamin D people need for good health, how much might be too much, and -- perhaps most importantly -- the best way to get enough.
"There is no dispute among medical professionals that vitamin D is beneficial for our health, and there is no dispute that sun exposure is the major source of vitamin D for most of us," said ACS deputy chief medical officer Len Lichtenfeld, MD, who participated in the conference. "But there is also no dispute that exposure to ultraviolet (UV) rays from the sun and other sources can be harmful."
Ultraviolet light in the form of UVA and UVB is known to raise the risk of melanoma and non melanoma skin cancers, as well as cataracts. But vitamin D is crucial to bone health and there is growing evidence that it may have a role in preventing some cancers, especially colorectal cancers. Because vitamin D occurs naturally in only a few foods and is added to just a handful of others, many experts worry that Americans get too little vitamin D to reap these potential benefits. Yet few are willing to encourage sun exposure with its well-known dangers.
Until more research is done, the key is to use common sense when deciding what constitutes a "small amount" of sun exposure, Lichtenfeld said. Five minutes may be enough for some, but not others. How much sun any single person might need depends on many things: how old they are, how much vitamin D they get from their diet, how dark their skin is, and how intensely the sun shines where they live. It will take more research to figure out specifics. "Avoiding the sun at all costs, for most of us, simply doesn't make sense," Lichtenfeld acknowledged. But that doesn't mean people should bake themselves outside or in a tanning booth.
The American Cancer Society is in the process of updating its skin cancer prevention guidelines, and currently recommends reducing sun exposure to reduce the risk of skin cancer. While the guidelines note that vitamin D is important to good health, ACS does not have a recommendation about vitamin D as a way to treat or prevent cancer.
The key findings announced as a result of the first North American Conference on UV, Vitamin D and Health are also welcomed by the Canadian Cancer Society.
"These findings are a good step forward in providing information and direction to Canadians about this important health issue," says Heather Logan, Director, Cancer Control Policy, Canadian Cancer Society. "The challenge for the Society is to balance the risk of skin damage and skin cancer from unprotected sun exposure with the benefits of getting enough Vitamin D." Experts from around the world came together at the conference, organized by the Canadian Cancer Society in March, to discuss the beneficial health effects of Vitamin D. Sunlight is one source of Vitamin D.
There is strong evidence that Vitamin D is needed for healthy bones and muscles and to prevent fractures in the elderly. There is also growing evidence that Vitamin D may reduce the risk for some types of cancer, particularly colorectal cancer.
Another key finding from the conference identifies Canadians as being at risk of not getting enough Vitamin D during winter when the UV radiation from the sun's rays are weak. (Sunlight contains both UVA and UVB radiation; UVB radiation promotes Vitamin D production in the skin.) "As a result, Canadians may want to consider taking Vitamin D supplements during the winter," says Logan. Many experts now consider these doses to be too low for optimal health. The safe upper limit is 2,000 IU daily. "Most likely the right amount is somewhere between 200 and 2,000 international units of Vitamin D," says Logan. "At this point, we can't be more precise as more research is needed to determine how much Vitamin D is needed for optimal health benefits."
Logan says that the Society will be updating information on its website about sun protection and Vitamin D based on the continuing work of the health groups. In addition, as more information is available about this topic through research, Canadians will be informed. "We are committed to relaying current information about cancer to Canadians so they can make informed choices." In the meantime, because of the risk of skin cancer (which is the most common cancer in Canada), the Society will continue to advise Canadians to protect themselves from the sun, particularly between 11 a.m. and 4 p.m. when the sun's rays are at their strongest, or any time of the day when the UV index is three or more. The CCS recommends seeking shade and using an SPF of 15 or higher.
While the majority of dermatologists and many medical practitioners promote "sun and tanning abstinence", a growing number of doctors, scientists, and researchers are finding that moderate uv exposures from the sun and tanning is proving to be a preventer of far more cancer deaths than it claims to cause. This is primarily due to the production of vitamin D, known as the "sunshine vitamin" because the skin makes it from ultraviolet rays.
The reason is that vitamin D increasingly seems important for preventing and even treating many types of cancer. In the recent months alone, several separate studies found it helped protect against lymphoma and cancers of the prostate, lung and, ironically, the skin. The strongest evidence is for colon cancer.
As reported in Looking Fit (6/06), two studies presented at the April 11th meeting of the American Association for Cancer Research suggest women who get lots of vitamin D are less likely to develop breast cancer. One study indicated that high levels of vitamin D translated into a 50% lower risk of breast cancer. Even modest levels of D resulted in a 10% less risk of developing the disease. If this were true of all American women it would translate into 20,000 fewer breast cancer cases a year. In a second study, Canadian researchers found that women who spent time outdoors or had a high dietary intake of vitamin D, especially as teens, were 25-45% less likely to develop breast cancer than women with a lower intake of the nutrient.
Here are just a few of the numerous articles indicative of mounting research supporting sunlight and uv for health:
Scientists Say Sunshine May Prevent Cancer by Marilyn Marchione (The Associated Press 5/21/05)
Many people aren't getting enough vitamin D. It's hard to do from food and fortified milk alone, and supplements are problematic. So the thinking is this: Even if too much sun leads to skin cancer, which is rarely deadly, too little sun may be worse.
No one is suggesting that people fry on a beach. But many scientists believe that "safe sun" 15 minutes or so a few times a week without sunscreen is not only possible but helpful to health. One is Dr. Edward Giovannucci, a Harvard University professor of medicine and nutrition who laid out his case in a keynote lecture at a recent American Association for Cancer Research meeting in Anaheim, Calif. His research suggests that vitamin D might help prevent 30 deaths for each one caused by skin cancer. "I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D," Giovannucci told the cancer scientists. "The data are really quite remarkable."
The talk so impressed the American Cancer Society's chief epidemiologist, Dr. Michael Thun, that the society is reviewing its sun protection guidelines. "There is now intriguing evidence that vitamin D may have a role in the prevention as well as treatment of certain cancers," Thun said.
Even some dermatologists may be coming around. "I find the evidence to be mounting and increasingly compelling," said Dr. Allan Halpern, dermatology chief at Memorial Sloan-Kettering Cancer Center in New York, who advises several cancer groups. The dilemma, he said, is a lack of consensus on how much vitamin D is needed or the best way to get it.
Put Away the Sunblock? Scientists Say Moderate Amounts of Sunshine May Prevent Cancer...The evidence this time is strong and keeps growing. If it bears out, it will challenge one of medicine's most fundamental beliefs: that people need to coat themselves with sunscreen whenever they're in the sun. Doing that may actually contribute to far more cancer deaths than it prevents, some researchers think. Sunscreen blocks its production, but dermatologists and health agencies have long preached that such lotions are needed to prevent skin cancer. Now some scientists are questioning that advice.
Sunlight May Have Unexpected Anti-Cancer Effects By Anthony J. Brown, MD (Journal of the National Cancer Institute, 2/02/05)
Two new studies suggest that exposure to sunlight might not be as risky for cancer as is generally believed.
Scandinavian researchers show that high UV radiation exposure is associated with a reduced risk of lymphoma, while another team reports that sunlight-related melanoma skin cancers appear to be inherently less aggressive than those that arise in non-exposed areas.
Dr. Karin Elkstrom Smedby, from the Karolinska Institute in Stockholm, and colleagues investigated ultraviolet radiation exposure as a possible cause for the increasing rates of malignant lymphoma seen in recent decades. Instead, the researchers found that high UV radiation exposure, as measured by frequent sunbathing and sunburns, cut the risk of the non-Hogkins type of lymphoma by up to 40 percent depending on the level of exposure.
The study involved 3740 patients with malignant lymphomas who were compared with 3187 matched "controls" from the general population. High UV radiation exposure also seemed to protect again the Hodgkin's type of lymphoma, but the association was weaker than with non-Hodgkin's disease.
In another study, also reported in the Journal of the National Cancer Institute, researchers note that sun exposure has been linked to better survival in patients with melanoma. The new research suggests that this is due, at least in part, to sunlight-related tumors being inherently less aggressive than those not tied to sun exposure.
"Our findings provide the strongest evidence to date that the better prognosis of (sunlight-related) melanomas is not simply due to earlier detection of these types," Dr. Marianne Berwick told Reuters Health.
Berwick, a researcher from the University of New Mexico in Albuquerque, noted that "further studies are needed to determine how sun exposure might reduce melanoma aggressiveness," but said that it could have something to do with increased production of vitamin D, or involve an enhanced ability of cells to repair DNA damage.
The findings stem from a study of 528 melanoma patients who were entered in the Connecticut Tumor Registry.
Sunburn, high intermittent sun exposure, self-reported skin awareness, and solar elastosis -- a marker of sun damaged-skin -- were all linked to increased survival from melanoma.
Upon analysis, skin awareness was a strong predictor of better survival, consistent with the belief that earlier detection leads to better outcomes. However, solar elastosis, which does not relate to detection, was found to be an even stronger predictor of increased survival.
Berwick emphasized that these findings have no bearing on current recommendations that "avoiding sun exposure reduces the risk of melanoma." Moreover, she added that they also do not suggest that exposing melanomas to sunlight after they've developed will improve survival.
Study Shows Sunlight Prevents Cancer as published by Dr. William Grant in Cancer (3/02; 94:1867-75)
Dr. Grant's research examined cancer mortality in the United States. Deaths from a range of cancers of the reproductive and digestive systems were approximately twice as high in New England as in the southwest, despite a diet that varies little between regions. An examination of 506 regions found a close inverse correlation between cancer mortality and levels of ultraviolet B light. The likeliest mechanism for a protective effect of sunlight is vitamin D, which is synthesized by the body in the presence of ultraviolet B. According to Dr. Grant's study, northern parts of the United States may be dark enough in winter that vitamin D synthesis actually shuts down completely.
There are 13 malignancies that show this inverse correlation, mostly reproductive and digestive cancers. The strongest inverse correlation is with breast, colon, and ovarian cancer. Other cancers apparently affected by sunlight include tumors of the bladder, uterus, esophagus, rectum, and stomach.
Although the study focused on white Americans, the same geographical trend affects black Americans, whose overall cancer rates are significantly higher. Darker skinned people require more sunlight to synthesize vitamin D.
Here are some of our recommended website dedicated to the latest research on sunlight and vitamin D:
The Vitamin D Council is a group of concerned citizens, headed by John Jacob Cannell, MD, that believe many humans are needlessly suffering and dying from Vitamin D deficiency. Their goal is to educate the public and professionals about vitamin D deficiency and the numerous diseases associated with that deficiency. They publish a free newsletter with a circulation of over 24,000. Sign up on their website.
Natural sunlight news and the healing power of sunshine and the sun's rays. No banners, no pop-ups, no registration, just great, original content on sunlight.
Sunlight, Nutrition and Health Research Center (SUNARC) is an organization devoted to research, and education relating to the prevention of chronic disease through changes in diet and lifestyle. Founded by William B. Grant, Ph.D.
by John Jacob Cannell, M.D. (The Vitamin D Council 1/05)
We all know that vitamin D (cholecalciferol) is crucial to health. But is vitamin D really a vitamin? Is it in the foods humans normally consume? Although there is some in fatty fish, vitamin D is not in our diets unless humans first fortify a food, like vitamin D fortified milk. Nature intended you to make it in your skin, not put it in your mouth. So is vitamin D really a vitamin?
Unlike any other vitamin, vitamin D is actually a prehormone; it is your body's only source of potent steroid hormone called calcitriol. First, your skin makes vitamin D when sunlight strikes a precholesterol molecule. Then your liver converts vitamin D into the storage form of vitamin D, called calcidiol (25-hydroxy vitamin D). The body stores calcidiol in the blood and fat for later use. Your doctor can measure calcidiol with a blood test to find out if you are vitamin D deficient. Ideal calcidiol (25-hydroxy vitamin D) levels are between 35 to 65 ng/ml (87 to 162 nm/L), year around. If you have enough calcidiol in your blood, then the real action starts. Some calcidiol goes to the kidneys to help maintain blood calcium levels but the real story is in your tissues. Tissues all over your body convert calcidiol into calcitriol. Calcitriol, or activated vitamin D, is the most potent steroid hormone in the human body. Again, calcitriol is the most potent steroid hormone in your body; it is active in picogram quantities or 1/1,000,000,000,000 of a gram. Like all steroid hormones, calcitriol works by turning your genes on and off. That is, in hundreds of tissues throughout your body, calcitriol demasks your genome! It signals your genes to make hundreds of enzymes and proteins crucial to maintaining health and fighting disease. All this happens if, and only if, you get enough vitamin D from sunshine or from supplements. Recent research indicates you need about 4,000 units of vitamin D a day. You can't get enough vitamin D from milk (unless you drink 40 glasses a day) or from a multivitamin (unless you take about 10 tablets a day), neither of which is recommended. If you don't get vitamin D the way Mother Nature intended, from sunshine, you need to take vitamin D supplements. As most of us get a lot more vitamin D from sunshine than we think, most of us need about 2,000 units a day extra. More and more Internet and health food stores are selling vitamin D. Make sure the vitamin D you buy is cholecalciferol. Also, buy pure cholecalciferol, don't buy a preparation with vitamin A added. Just plain cholecalciferol.
Many of the diseases of modern civilization, such as cancer, heart disease, diabetes, hypertension, periodontal disease, depression, and even obesity, are now clearly associated with vitamin D deficiency. But association is not the same as causation. Does vitamin D deficiency cause many cases of cancer, heart disease, diabetes or obesity, these diseases of modern civilization? We just don't know. We need the National Institutes of Health to fund more research on vitamin D. So far, they refuse.
If you want to understand vitamin D, you need to understand three facts. All three facts have been generally ignored by all but a few vitamin D scientists. Aldous Huxley once said, "Facts do not cease to exist, just because they are ignored." Two of these ignored facts are simple and one is more complex.
The first fact you already know. The active form of vitamin D is a steroid hormone, a very potent steroid hormone, the most potent steroid hormone in the body. Steroid hormones work by demasking the genome, that is, they enable the manufacturing of proteins and enzymes by your genetic material, the stuff of life. So the active form of vitamin D acts by enabling genetic expression of proteins and enzymes crucial to health in hundreds of tissues throughout the body. This fact explains why vitamin D deficiency is involved in so many different diseases.
The second fact changed my life. It made me ask why? The fact is this: most of us make about 20,000 units of vitamin D after about 20 minutes of summer sun. [For most skin types, a full body minimal erythemal (slight redness) dose of UVB light results in the production of about 20,000 units of cholecalciferol]. This is about 100 times more vitamin D than the government says you need every day. Ask yourself why? Why would humans make so much vitamin D, so very quickly? I have thought about it, studied textbooks, researched the medical literature, asked all the experts, and dedicated the rest of my professional life to getting others to ask themselves "why." Why would we have a steroid hormone system that makes so much substrate so very quickly? The only answer anyone can come up with is: "Probably for a good reason." Science does not know why. Zoologists know nature does not design systems as complex as the vitamin D steroid hormone system for no reason. Medical science simply doesn't know why we have the capacity to make so much vitamin D so quickly. If you think about it long enough, you too will conclude it is probably for a good reason. Although we don't know why, a few scientists have been trying to find out why -- and gasping at the breathtaking implications. This second fact (20,000 units in a few minutes fact) also tells you something about the normal human condition -- and the current deviant one. Before we started living in buildings and cars, and wearing sun-protective clothes and lathering on the sunblock, we farmed and hunted. Before then we scavenged naked in the subequatorial African sun (for more than a million years). How much vitamin D did we get then? A lot.
We started moving inside during the industrial revolution and now the move is almost complete. Some of us go for days, weeks, or even months without letting sunshine strike our skin and make vitamin D. If we do go in the sun, our dermatologist chides us. Whether good or bad, this existence is aberrant to the species; modern sun-avoidance is deviant for homo sapiens. Since we make about 20,000 units of vitamin D with a few minutes of sunshine (perhaps 10,000 units after our skin tans) then human beings are used to getting a lot of vitamin D every day, until very recently. Now, most of us get very little. This is simply deviant.
The third fact is more complex and has to do with the unique regulation of the vitamin D steroid hormone system. Steroid hormones are molecules manufactured from cholesterol and which act by effecting a receptor on the genome. Steroid hormone systems are tightly regulated by the body. When the levels are too low, the body manufactures more hormone; when levels are too high, the body makes less. Not so with vitamin D. First, unlike other steroid systems, the vitamin D system needs both cholesterol and sunlight to get started. The body has no way of obtaining vitamin D unless you go into the sun or take supplements. That is, unlike all other steroid hormones, the body cannot manufacture its own vitamin D from cholesterol. It needs sunshine as well. Of course, until about 300 years ago, humans always had plenty of sunshine. Remember, the real action is in the tissues. The autocrine (in the cell) and the paracrine (around the cell) vitamin D systems appear to be turned on full bore, all the time. [In scientific terms, the Michaelis Menton constant is never approached throughout the full range of physiological substrate concentrations for both calcidiol production in the liver and for calcitriol production in the tissues]. Direct negative feedback does not appear to be operating at physiological substrate levels for both calcidiol production in the liver and calcitriol production in the tissues. This implies that tissue levels may be chronically depleted in modern humans. Furthermore, we'd have no easy way of knowing we are depleted because depletion has become the normal human state. If the tissue production of calcitriol is turned on full, all the time, what prevents vitamin D toxicity in humans living in the sun? First of all, much of the vitamin D you make is excreted in the bile. The same may be true for much of the calcidiol your liver makes. In addition, there are numerous other metabolites of vitamin D. So only about 1/1000 of your calcidiol is turned into calcitriol. That said, the tissue production of calcitriol is still running full bore at normal calcidiol substrate concentrations. So what limits the amount of tissue calcitriol? The skin.
After you make about 20,000 units, sunshine begins to destroy vitamin D in the skin. The same sunlight that makes vitamin D in the first place begins to degrade it. Production equals destruction. As calcitriol production in the tissues and calcidiol production in the liver always function below their biochemical capacity, this means that the rate limiting step for the most potent steroid hormone in the human body appears to lie in the skin. In a way, it lies in your behavior, you choice to step into the sun. This is biologically unique for any and all steroid hormones. This third complicated set of facts strongly implies widespread severe deficiency in modern humans. When steroid hormone systems are turned on full bore, without periodically turning off, this usually means the body is asking for more hormone. Since few of us live naked in the sun, our vitamin D systems are dry, our calcidiol tanks are running on low, our tissues are starved for more of the most potent steroid hormone in the body, and, perhaps, just perhaps, diseases of civilization are rampant.
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The Most D-Deficient Found In The Northeast
In 1980, epidemiologists Frank and Cedric Garland produced the theory that some forms of cancer were brought on by inadequate sun exposure and lack of vitamin D. The two researchers proposed that vitamin D, which the skin produces when exposed to sunshine, somehow prevents the growth of malignant cells. The work of Dr. Gary Schwartz (epidemiologist at the Wake Forest School of Medicine), since then, has shown at the cellular level that the Garlands' theory makes sense.
The Garland brothers were intrigued by maps showing the rate of colon cancer in the United States was roughly twice as high in the Northeast when compared to the southern climates. The Garlands were the first medical experts to offer the theory linking vitamin D and cancer. This was supported by further studies that revealed that people with higher levels of vitamin D in the bloodstream had a lower risk for colon cancer.
The research centers on "calcitriol", the hormone that is the activated form of vitamin D. Vitamin D's inactive form is produced naturally when the skin is exposed to sunlight. That substance is then activated by organs in the body. Dr. Schwartz and other researchers have determined that calcitriol plays a roll in controlling cell growth and that colon, prostate and breast cells are all capable of activating pre-vitamin D into its active form. In petri dish experiments, vitamin D and calcitriol have both been successful in inhibiting the growth of cancer cells.
The National Cancer Institute investigated the links between breast, ovarian, and prostate cancer and the lack of vitamin D. After reviewing death certificates from 24 states, it was determined that the chances of dying from those types of cancers was 10 to 27 percent less likely for people living in sunny climates.
A Readers Digest article by Susan Freinkel (The Healing Vitamin, June,2003) suggests that many medical experts are convinced that vitamin D deficiency has become "a modern epidemic" still unrecognized by most. Supporting this trend is the resurgence in cases of rickets. Rickets, a bone disease traced to low levels of vitamin D, that most commonly affected children living in the world's largest industrial cities at the turn of the 20th century.
Dr. Michael Holick, director of the General Clinical Research Center at the Boston University School of Medicine, is one of the world's leading authorities on vitamin D. In the Digest article, Dr. Holick said "More and more evidence is mounting that vitamin D plays an absolutely pivotal role in all aspects of human health." He recommends ten to twenty minutes of UV exposure, without sunscreen, to take in the required amount of vitamin D. The skin soaks up the rays, which travel throughout the body and are transformed into a hormone called "calcitriol", which researchers determined has disease-fighting capabilities.
Extensive research by Dr. Holick and others suggest a link between vitamin D and lower incidences of serious illnesses such as cancer, diabetes, hypertension, and osteoporosis. In studying the link between UV rays and hypertension, Dr. Holick exposed 18 volunteers with mild hypertension to UVB lights for six minutes three times a week. Six weeks later the volunteers had more than doubled the amount of vitamin D in their systems, and their blood pressure dropped to near normal. Researchers in Finland, which has the highest incidence of Type I diabetes in the world, conducted a study of 10,000 children. Their findings showed that those who got regular doses of vitamin D during infancy were roughly 80 percent less likely to contract the disease.
Based on information from Tanning Trends July, 2003
"Americans may be overdoing their sun protection and denying their bodies important vitamin D", according to Boston University's Dr. Michael Holick. 'I believe that Americans have gone overboard with their fear of the sun. I think that sensible exposure to sunlight is really important for your overall health and well-being, Dr. Holick told NBC on their Nightly News program last year.
Holick discovered the active form of vitamin D in the 1970s, and is widely regarded as the world's leading vitamin D expert. Holick pointed out that people need 1,000 units of vitamin D a day, but a glass of milk supplies only 100 units and a multivitamin only 400. Our richest source of vitamin D is the sun. Most of us need only a few minutes a day of sun exposure during the summer months to maintain healthy vitamin D levels throughout the year, according to Dr. Holick. Other than sunlight, the three principal sources of vitamin D are food and drink, supplements in pill form and artificial sources of UVB radiation.
The research conducted by Dr. Holick acknowledges that:
It is quite impractical to get 1,000 IU of vitamin D from diet alone since you would have to eat large quantities of vitamin D rich foods, like sardines.
'Most people need the sun in order to avoid vitamin D deficiency,' the network reported. The consequences of low vitamin D levels start with low bone density, a condition that is a precursor to osteoporosis, a disease that affects 25 million Americans. Recent research suggests that other diseases, such as breast cancer, prostate cancer, colon cancer and ovarian cancer, may in fact be inhibited by vitamin D.
Holick's work shows that vitamin D deficiency is nearly epidemic in American society today, but those who get regular UV exposure, including those who use indoor tanning equipment, have higher vitamin D levels and higher bone density.
The professional indoor tanning industry promotes sunburn prevention as the best way to harness any benefits of regular UV exposure while minimizing the risks and teaches tanners the proper use of sunscreen outdoors. But, as Holick points out in the story, over-using sunscreen can inhibit or prevent vitamin D production.
from NBC News: Are Americans Getting Too Little Sun? (4/28/04) & Tanning Trends (5/04) Sunshine: It's All About The D
Credible studies continue to support the importance of sensible, moderate tanning exposures.
One of many significant benefits of tanning, the development of a natural defense against overexposure, was substantiated in the September 1999 issue of the Symposium Proceedings (1999) of the Journal of Investigative Dermatology in a published article by Barbara A. Gilchrest, M.D. and Mark S. Eller, M.D., of the Department of Dermatology at the Boston University School of Medicine.
The article supports beliefs that the skin darkens and thickens in response to UV radiation, generating a natural SPF(sun protection factor) of approximately from 3 to 5, depending on the individuals genetically determined ability to tan.
In the words of Gilchrest and Eller, "two photoprotective mechanisms have been recognized: (1) Melanin pigmentation, both constitutive (baseline) and facultative (inductable), is the major recognized form of protection against UV-induced damage. Photoprotection is attributable to the fact that the melanin polymer can directly absorb UV photons, dissipating the otherwise injurious energy as heat, and can further absorb free radical species generated by interaction of UV photons with cellular lipids and other molecules that otherwise cause oxidative damage. (2) Scattering and reflection of UV photons by proteins in the stratum corneum is known to thicken following UV radiation, particularly in poorly melanized skin."
The findings also indicate that the darkening of the skin during the tanning process and the enhanced DNA repair capacity that results (and possibly other unknown factors) can be presumed important in protecting the skin from both acute (sunburn) and chronic (including the development of skin cancer) UV damage.
Whether an individual is born with darker natural skin color or acquires and maintains a tan at an indoor tanning salon, the photoprotective benefits are the same. And, according to Gilchrest and Eller, the benefits are not just limited to the prevention of erythema (sunburn), but specifically include preventing the development of skin cancer.
Based on "UVR Induced Melanogenesis Provides Photoprotection", Looking Fit Magazine January,2000 by Donald L. Smith, executive director of The North American Alliance Of Tanning Salon Owners.
Vitamin D is best known for its role in healthy bones. But there is growing evidence that it is also essential for muscle and brain function as well. It has been found that a decrease in either of these could cause old people to fall.
As reported in NewsScientist.com news service (12/03), researchers in Australia have discovered that being severely deficient in vitamin D increased the risk of falls and that supplements reduced their number. The study of over 1500 women, led by Leon Flicker of the University of Western Australia in Perth, also found that severe vitamin D deficiency is surprisingly common in Australia.
Vitamin D is produced in the skin when it is exposed to sunlight, so the assumption had been that deficiency would not be a problem in sunny countries. But the new study found that almost half of elderly women in high-level residential care, though not bedridden, were severely deficient. Furthermore, a fifth of elderly women who were healthy enough to live in low-level residential care were also severely deficient. Both groups of women had an average age of 84 years. The deficient women had blood levels so low that the same levels in a growing child would cause bone abnormalities such as rickets, says research team member Caryl Nowson, of Deakin University in Melbourne.
Women in the study who were less severely vitamin D deficient were less likely to fall, with a doubling of vitamin D levels reducing their risk by 20 per cent. That association existed even when other risk factors, such as the use of sedatives, were taken into account. An unpublished study by the same team shows that supplements reduce the number of falls and the number of breaks caused. The supplements only need to be given every few months because the body can store vitamin D.
Falls are a leading cause of death and disability in old people. When a person in their eighties breaks a hip, there is a 30 percent chance they will die within a month. In the UK and the US, where people are exposed to less sun, vitamin D deficiency is recognized as a potential problem, and food is fortified.
However, elderly people, have a greater requirement for vitamin D, because they do not make it so efficiently. "We're discovering that Vitamin D deficiency is the deficiency of the elderly," says Nowson. The cause, believes osteoporosis expert Philip Sambrook, of the University of Sydney, is "partly because the women were stuck in nursing homes, and partly because of the strong Australian public health message about sun and skin cancer risk". But 20 minutes of sunlight, which can be taken at the beginning and end of each day when the sun is less strong is still required, he says.
Journal reference: Journal of the American Geriatrics Society (vol 51, p 1533)
Fear of the sun and an "indoor" culture were both said to have contributed to vitamin D deficiency in Britain and other western countries. About 80% of the vitamin obtained in the body is synthesized through the conversion of chemicals in the skin by sunlight. But in Britain, from October to the end of March, the sun is too weak to produce any vitamin D.
Professor Graham Bentham, from the University of East Anglia, said: "During these winter months we rely on what we have stored in our body from summer exposure and what we get from diet." Although oily fish and egg yolk are good sources of the vitamin, it is not abundant in many foods. The importance of vitamin D to all-round good health has only come to be recognized in the last two decades, the experts said. Before then it was only thought to benefit the bones, and in particular protect against rickets. Today it was clear that vitamin D deficiency was associated with a wide range of diseases, and that the vitamin was needed in higher doses than previously thought.
Dr Birgit Teucher, from the Institute of Food Research in Norwich, who joined three colleagues to talk about vitamin D in London, said: "Shortage of vitamin D may be associated with a whole range of diseases, including muscle weakness, hypertension, auto-immune diseases including multiple sclerosis, certain types of cancer, and cardiovascular disease." There was evidence that the vitamin protected against breast, prostate ovarian and colon cancer, and had a major impact on diabetes. It also reduced tissue damage caused by certain infections such as tuberculosis, leprosy and gum disease, as well as rheumatoid arthritis.
Diabetes expert Dr Barbara Boucher, from St Bartholomew's and the London Queen Mary School of Medicine and Dentistry, said vitamin D was needed for insulin to be released effectively. Worldwide there had been an "explosion" of Type 2 diabetes, which was four times greater in black and Asian people living in the West. People with dark skins were less able to manufacture their own source of vitamin D from the sun. Rates of insulin-dependent Type 1 diabetes were also rising "like mad", said Dr Boucher. Three different studies had shown that vitamin D supplements given to breastfeeding mothers and young children reduced the incidence of Type 1 diabetes by 60% between birth and the age of 30. Dr Boucher also pointed to increased rates of colon and prostate cancer as evidence of a lack of vitamin D in the population.
Professor Brian Wharton, from the Institute of Child Health in London, said there were many reports of rickets making a comeback, especially among Asian and Afro-Caribbean children. He believed an over-reaction to "cover up" campaigns aimed at protecting people from skin cancer was partly responsible for the nationwide lack of vitamin D. "I think it has played a role," he said. "There's certainly no doubt that if you wear sunscreen vitamin D conversion goes down. "I'm certainly not promoting sun 'bingeing' but we do need some sensible use of the sun, and we've been swinging too strongly against it." Dr Boucher said the way many people spent much of their lives indoors may be another factor. "Indoor activities, such as working out in the gym or sitting at computers all day, might contribute to vitamin D deficiency," she said. Lack of exercise could also be involved, since fat acted as a "sink" which soaked up and stored vitamin D.
Based On An Article By John von Radowitz, Science Correspondent, PA News (Scotsman.com 9/04)
Recommended website for vitamin D research: The Vitamin D Council
Dr. Anne Kricker, of the University of Sydney, and colleagues investigated the possibility that high sun exposure is associated with an increased risk of non-Hodgkin's lymphoma (NHL) -- and found the opposite -- according the results of a study published in the International Journal of Cancer.
One effect of sunlight is to stimulate the body's production of vitamin D. The Austrailian researchers say that "increasing evidence that vitamin D may protect against cancer makes ultraviolet-mediated synthesis of vitamin D a plausible mechanism whereby sun exposure might protect against NHL." Sun exposure apparently has a protective effect against the development of NHL, a blood cancer."
The team's population-based study involved adults between the ages of 20 and 74 years. In total, 704 cases of NHL and 694 randomly selected matched controls were enrolled. The researchers used a questionnaire and a telephone interview to estimate details of typical sun exposure over as long as 6 decades. These took into account factors such as working, non-working and vacation days. The risk of NHL decreased with increasing hours of sun exposure. With the highest exposures, the odds of having NHL decreased by 35 percent compared with the lowest exposure level.
from Sunshine May Ward Off Lymphoma (Reuters 12/04)
As reported in the British Medical Journal (August, 2003), Children and adolescents who had high sun exposure had a decreased risk of multiple sclerosis (MS) later in life. Researchers concluded that insufficient exposure to ultraviolet radiation or vitamin D might therefore increase the risk of MS. Other studies have had similar results, indicating that ultraviolet radiation may be beneficial against multiple sclerosis.
As documented in the publication Sunlight Robbery by Oliver Gillie, a freelance medical researcher and writer - It has been known for many years that MS occurs more frequently at high latitudes and is less frequent in sunny countries such as South Africa. However the first suggestion that vitamin D deficiency might explain these observations was made in 1997. Since then a case/control study in Australia has found that risk of MS is reduced by exposure of children to sunlight, especially in winter. Other evidence from the Nurses' Health Study has shown that total ingested vitamin D may significantly reduce the risk of MS.
In the UK a record linkage study of people with non-melanoma skin cancer, an indication of extended sun exposure, has found that they have 50% of the risk of developing MS compared with healthy controls. Observation of MS lesions in the brain has shown that they increase during the winter when MS symptoms are also known to worsen. Furthermore it has been found that vitamin D supplements will reduce symptoms of MS.
People in Britain, Sweden, Denmark or Canada who develop MS are more likely to have been born in spring, particularly May, and less likely to be born in November suggesting that low vitamin D levels in the last three months of pregnancy are important in development of this disease. And so it seems wise to advise pregnant women to sunbathe whenever possible, while taking care not to burn, and to take vitamin D supplements in winter. Any advice that may discourage pregnant women from sunbathing, such as the current government campaign against skin cancer, may have unfortunate consequences for the health of babies in later years.
"It is widely known that the risk of MS increases the farther away one goes from the equator," according to Dr. Joseph Mercola (www.mercola.com). "Scientists believe the mechanism that affects MS is secondary to decreased ultraviolet radiation. Ultraviolet radiation increases vitamin D levels and may have a protective role in T helper cell type 1 mediated autoimmune disease. To me the take-home message is loud and clear. Sun exposure is not the evil it is made out to be. It is clearly important to get regular sun exposure in order to have optimum health and to avoid these types of autoimmune diseases. So parents, let your kids out in the sun, just monitor them carefully to make sure they don't get burned. Additionally, sunscreen is not likely to be a good idea. Sunscreen may actually cause cancer and will actually block the beneficial UV rays that produce vitamin D and protect against autoimmune disease.
Health Research Forum Occasional Reports: No 2
Multiple sclerosis linked to long winters
Insufficient exposure to the sun is also associated with a higher risk of multiple sclerosis. Evidence from Australia suggests that exposure to the sun during childhood and adolescence is particularly important for reducing the risk of MS (BMJ 2003; 327-316), and low exposure to the sun in winter was found to be associated with an increased risk of MS in Australia. Above latitude 37°North the sun is not strong enough to provide any vitamin D in winter. The further north a country is the less sun it gets in summer and the shorter its summer season. This explains why Scotland, which also has a cloudy maritime climate that obscures the summer sun, has probably the highest incidence of MS in the world.
Much other evidence shows a link between MS and latitude. In France, as explained by George Ebers on page 41, the incidence of MS in French farmers is significantly greater in the north than in the south of the country. Extensive studies of twins, adopted children and half-siblings by George Ebers and colleagues have shown that MS is not caused primarily by risk factors within families such as diet or infection. Heredity influences a person's susceptibility to MS, but the place where a person is born and the time of year that they are born seems to be crucial in deciding whether or not they develop the disease. Risk of MS is greatest for those born in May, at the end of the winter when vitamin D levels are lowest.
The epidemiological findings on MS may be explained by insufficient sunlight causing low levels of vitamin D that prevent normal development of the nervous system early in life. The link with insufficient sun now seems beyond doubt. But it remains to be proved that lack of vitamin D is the actual cause of MS, although this seems likely.
The importance of this research on MS, which has taken many years to reach this stage, cannot be underestimated. The disease strikes people in the prime of life and after 15 years half of them are unable to walk without assistance. In Scotland as many as one in 400 people may be affected. The lifetime cost of caring for each person with MS comes to around £1.5m. So the annual cost of caring for the 70,000 people in the UK with MS comes to several billion pounds. If this disease can be prevented by more exposure to sunlight in the early years, as seems likely, it will be an astounding achievement for medical science to have shown the way.
In the words of John Cannell, M.D. (Vitamin D Council): Eighteen months ago, after she (Professor Barbara Gilchrest) fired Professor Michael Holick , I was livid. I sent her a registered letter , threatening to file complaints with the AMA's Council on Ethical and Judicial Affairs for violating the Principles of Medical Ethics, and with Board of Registration in Medicine of the Commonwealth of Massachusetts for dispensing harmful medical advice. I also threatened to run ads in Boston newspapers to find patients who had developed life-threatening cancers due to her sunphobe advice, patients who could sue her should she not educate herself about vitamin D. After I calmed down, and after Michael Holick calmed me down, I didn't do any of these things.
One of the harshest critics of sun exposure, Dr. Gilchrest fired Dr. Holick for writing a book. Holick's book simply questioned current dermatology dogma that sunlight is evil and she fired him: Boston University's version of academic freedom. Dr. Gilchrest and Dr. Deon Wolpowitz wrote an attack on vitamin D and sunlight "Supplements Not Sun Best For Boosting Vitamin D". The two authors have something in common: neither had ever published a peer-reviewed paper about vitamin D (just search PubMed):
After reading Professor Gilchrest's paper twice, I found so many inaccuracies that I can't list them all. Some of the errors are basic. Professor Gilchrest, cholecalciferol is not previtamin D; it is vitamin D. Professor Gilchrest, vitamin D is not in the "superfamily of steroid hormones that includes vitamin A and thyroid hormone," its receptor is in that family. Professor Gilchrest, vitamin D is not a steroid hormone; it is a prehormone. Professor Gilchrest, vitamin A is not a steroid hormone; it has a retinol base, not a sterol one. Professor Gilchrest, thyroid hormone is not a steroid hormone; it has a tyrosine base, not a sterol one. When she makes basic mistakes on freshman biochemistry, how can readers trust her interpretation of scientific studies with immense medical and social consequence?
Her first argument is sunlight and sunbeds kill people, mainly due to malignant melanoma. However, she failed to cite the two biggest and best studies! A large, multi-center European study, perhaps the best one ever done, "found no association between melanoma and risk factors related to UV exposure such as sunbed use, sunbathing, or number of weeks of holidays in sunny areas." The authors actually found sunbeds were associated with a small decreased risk for melanoma! They also found that sun bathing and sunburns were not associated with melanoma. Fair skin and the number of moles were the major risk factor for melanoma, not sunbeds or sunshine. They even found some evidence of decreasing risk with increasing sunbed use, concluding "The observed decrease in risk (of melanoma) with increasing use (of sunbeds) suggest either a protective effect or could be explained by recall bias with cases under reporting their true exposure." Actually, recall bias (errors due to what patients tell researchers they remember), as the authors admit, will likely skew the results the other way. Patients with melanoma are more likely to report sun exposure or sun bed use in an "effort after meaning." That is, humans to explain their problems by falsely remembering factors they believe might explain their melanoma.
Gilchrest also ignored another recent large European study looking at melanoma and sun/sunbed exposure. The British authors concluded, "This case-control study of melanoma did not find that exposure to natural or artificial radiation was significantly associated with an increased melanoma risk in the population overall." Although they found ten or more sunburns and exposure to sunbeds for individuals with fair skin yielded significant but small melanoma risks, they found no overall risks. "The fact that no dose response was found for hours and years of exposure to sunbeds, even in young subjects, suggests that the use of sunbeds is unlikely to be a major environmental risk factor for melanoma."
After she ignores the two best, biggest, and most recent studies of melanoma and UV light, she argues sunlight is largely responsible for the 8,000 melanoma deaths per year. It is more likely that the current epidemic of melanoma, like many other cancers, is partially due to vitamin D deficiency. Vitamin D is such a stellar anti-carcinogen, doing everything an ideal anti-neoplastic drug should do, it is likely that dermatologists' advice to melanoma patients -- avoid the sun at all costs -- is actually killing patients. A recent large multi-center trial (another one Professor Gilchrest ignored) looked at the effects of ongoing sun-exposure in melanoma patients. "Sun exposure is associated with increased survival from melanoma."
Professor Gilchrest then argues that the health benefits of vitamin D beyond bone disease are unproven. She explains that controlled interventional trials using vitamin D are rare, which is true. However, it is also true that science never proved that low fat diets prevent heart disease or stroke with good controlled interventional trials. The lack of good interventional trials did not prevent modern medicine from advising low fat diets -- uselessly it seems.
In implying physicians should not act until scientists conclusively prove a point, Professor Gilchrest misses the point. Sometimes physicians must act before scientists conclusively prove a point. Physicians can't wait. Scientists can wait. Physicians are obligated to perform a risk benefit analysis based on available data and treat their patients accordingly. If a new therapy is risky (like a new cancer chemotherapy with numerous side effects), then physicians should only use the drug on patients facing death. If the therapy or advice is safe (drink eight glasses of water a day), it can be recommended although I dare the reader to find a single controlled interventional trial showing eight glasses of water a day does anything other than increase bottled water sales.
Unlike advising a low fat diet (assuming one warns against trans-fats and excess omega 6 consumption), advising people to avoid the sun is risky advice. Why is it risky? First, it is unnatural advice for a species that evolved in the sun. Second, it goes against mammalian instincts, as any pet owner will verify. Third, it goes against human instincts -- the sun draws humans to it -- and such instincts evolved for a reason. Finally, it goes against a large body of data that associates both sun exposure and low latitude with reduced incidence of many diseases. Thus, sun avoidance is risky advice and physicians should dispense it only after science has conclusively proven the benefits outweigh the risks.
Consider the advice of the Lancet Editorial Board, commenting on a petition to set aside public land for nude sunbathing! "On first consideration, the idea of a community of people deliberately practicing nudity, especially with public encouragement, strikes the average person as ridiculous. . . But the discovery that the rays of the sun on the skin exert a beneficent effect on health has done something to undermine these prejudices." Granted, the Lancet proffered this advice in 1932, when organized medicine knew the health benefits of sun exposure and before dermatologists scared us out of the sun. Whatever you think of the government sponsoring nudist colonies, you should know that the best physicians in the 20's and 30's routinely recommended sun exposure for a wide variety of diseases; many of the same diseases have now been associated with vitamin D deficiency.
She goes on to say that if science eventually proves that vitamin D is important, then supplementation, not sunshine, is the answer. That is risky advice. How does she know all the sun does? She correctly thinks that sun exposure increases the risk of non-melanoma skin cancers and ages the skin. She incorrectly thinks sun exposure is the major risk factor for melanoma. She overlooks the benefit side of the safe sun exposure equation. The sun provides vitamin D, which looks as if it may help protect humans from most of the diseases of civilization. What else does the sun do? Before I told someone to avoid the sun, I would wait until science completely understood the relationship between the sun and humans. Until then, supplementation in the colder months, moderate safe sun exposure in the warmer ones, and visits to the dermatologists should you develop signs of skin cancer, is the safest advice. Remember, non-melanoma skin cancers are mostly a nuisance, unless you ignore them. I have a few frozen every year. I thank my dermatologist and then go out to celebrate, knowing that long ago science associated non-melanoma skin cancers, a marker for sun exposure, with a reduced risk of dying from internal cancers.
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