The Vitamin “D” Dilemma

In the past few years, controversy has raged amongst physicians, scientists, and advocacy groups about whether sun exposure is a beneficial source of vitamin D.  While dermatologists and cancer groups have long argued against unprotected UV exposure, some groups contend that this advice places people at an even greater risk from vitamin D deficiency.

Vitamin D is a fat-soluble vitamin that is essential for the promotion of proper calcium absorption, maintenance of adequate phosphate concentrations, and development of bones in the body.  Additionally, evidence indicates that vitamin D may play a role in the prevention of some cancers, diabetes, arthritis, high-blood pressure, cardiovascular disease, and infection.

The relationship between sunlight and vitamin D production has long been established and many sun-advocates argue that people are at greater risk for disease, because “dermatologists have scared them out of the sun.”  Michael Holick, Ph.D, MD, author of the book The UV Advantage, claims that vitamin D deficiency is a silent epidemic and random samplings show that on average 42% of Americans are vitamin D deficient.  Dr. Holick further claims that scientific studies evaluating the efficacy of sunscreens have found that even a sunscreen with an SPF of 8 can decrease the vitamin D production in the skin by 97.5%.

However, the Sun Safety Alliance states that “sunning to prevent vitamin D deficiency is like smoking to combat anxiety.”  According to the American Academy of Dermatology, the Yale School of Dermatology and the Sun Safety Alliance, the claims  linking the health benefits of vitamin D to unprotected sun exposure are scientifically unsound and mislead the public about the very real dangers of UV radiation.  Research has clearly established a connection between unprotected sun exposure and skin cancer, as well as the development of wrinkles, brown spots, leathering, and sagging of the skin.  And the medical and cancer communities generally  agree that these dangers should outweigh the benefits that might be obtained from unprotected UV exposure.

So, what is a health-conscious woman to do, as it seems that we’re “doomed if we do, and doomed if we don’t”?  The following recommendations may help one achieve a balance between exposing oneself to enough sunlight to maintain adequate vitamin D levels and avoiding an increase in the risk of skin cancer:

• According to DermNet NZ, in most situations, sun protection to prevent skin cancer is only required during times when the UV index is raised.  “At such times when the UVI is higher than or equal to 3, sensible sun protection behavior is warranted and is unlikely to put people at risk of vitamin D deficiency.”  When the UVI is low no sun protection is generally required.
• During the summer months most people should be able to achieve adequate vitamin D levels through incidental outdoor UV exposure outside peak UV times.
• Increase your vitamin D resources through your diet—drink vitamin D-fortified orange juice or milk and eat salmon, tuna, sardines, or cod liver oil.  Small amount of vitamin D are also found in beef liver, cheese, fortified cereals and egg yolks.
• Take a daily multivitamin containing 200-600 IUs of vitamin D.  Note, however, that one should not “load up” on vitamin D, as excessive amounts of vitamin D can be toxic to the body.

By following the above guidelines, women can be assured of both obtaining the necessary amounts of vitamin D and protecting themselves from the onset of skin cancer.  As iterated by authors Deon Wolpowitz, MD, PhD and Barbara A. Gilchrest, MD, “there are effective and almost effortless noncarcinogenic alternatives” that are a lot safer than “frying your whole body.”