Skin cancer fears may increase risk of bone thinning disease

British people may not be not getting enough sunlight to generate sufficient levels of vitamin D, as they are worried about the possibility of skin cancer, according to a poll by the National Osteoporosis Society. The poll found that awareness of the importance of wearing sunscreen is high, with 74 per cent of people believing you should always apply sunscreen when going out in the sun in the UK.

However, a small amount of regular exposure to the sun is important as sunlight is one of the best natural sources of vitamin D, which is important for strong bones and reduces the risk of the bone thinning disease osteoporosis.

We all need a bit of sunshine in our lives, but it's important to remember that the amount of sun needed to make enough vitamin D is always less than the amounts that cause reddening of the skin or sunburn. - Caroline Cerny, health campaigns manager, Cancer Research UK

Professor Roger Francis, chair of the National Osteoporosis Society's Medical Board, commented: "High profile skin cancer campaigns have made people far more aware of the dangers of overexposure to the sun.

"However, an unanticipated side-effect may be that people now feel that they shouldn't spend any time in the sun at all. Potentially, this could result in a lack of vitamin D and increased risk of osteoporosis."

The professor noted that too much sun causes skin cancer and ageing and advised against spending lengthy periods in the sun.

"However, we feel that people should be able to get out and enjoy some summer sunshine over the next couple of months," he claimed, adding: "We can use the summer months to build up our levels of vitamin D so that we have enough stored to last us through winter."

Cancer Research UK's health campaigns manager, Caroline Cerny, said that by enjoying the sun sensibly, it is possible for everyone to make enough vitamin D while not increasing their risk of skin cancer.

"The amount of time in the sun required to make enough vitamin D changes from person to person and depends on things like skin type, time of day, time of year, and where you are in the world," she noted.

Ms Cerny advised: "We all need a bit of sunshine in our lives, but it's important to remember that the amount of sun needed to make enough vitamin D is always less than the amounts that cause reddening of the skin or sunburn."

Simple ways to get enough sunshine without increasing the risk of overexposure include hanging the washing outside to dry or watering the garden while your face and arms are bare.

However, people who are fair-skinned, have lots of moles and freckles, or who have a family history of skin cancer should take particular care and everyone should avoid the strong sunshine in the middle of the day.

News provided by Adfero in collaboration with Cancer Research UK. Please note that all copy is © Adfero Ltd and does not reflect the views or opinions of Cancer Research UK unless explicitly stated.

Vitamin D and Breast Cancer Risk

Moderate exposure to sunlight promotes good health

Who says vitamin D is just for kids? Certainly not Dr. Northrup! Research is now revealing a far greater role for vitamin D—including the prevention of breast, ovarian, prostate, and colorectal cancer.¹

In fact, Dr. Northrup says that suboptimal levels of vitamin D may be one of the reasons why breast cancer incidence is higher in northern latitudes than near the equator. Research has shown that women who have blood levels of vitamin D above 52 ng/ml have half the risk of breast cancer as those with lower levels. Most women have to take 1,000 IU of vitamin D per day (either from sunlight, eating fish, or supplementation) to get this level.² Adequate vitamin D would also prevent scores of women from getting the brittle bones associated with aging.

It’s even estimated that additional exposure to vitamin D would save more than 23,000 American lives per year due to the reduction in cancer mortality.³

“Though today we’re taught to be afraid of the sun, all of us, including children, need regular sunlight to be healthy,” Dr. Northrup explains. “Our inner wisdom knows this, and that’s why despite all the propaganda about the dangers of sun exposure, millions of people still flock to the beach. The sun just feels too good to be all that bad!”

In addition to increasing serotonin levels in our blood and helping to balance melatonin, the sun’s UV rays enable our bodies to manufacture vitamin D in the fat layer under the skin.⁴ Exposure to outdoor sunlight is a much more reliable predictor of vitamin D levels in your blood than your dietary intake.

The body can make enough vitamin D from sun exposure to last the entire year! The more body area that’s exposed the better. Full-body exposure to sunlight on clear days at equatorial latitudes can easily provide the equivalent of 4,000 to 20,000 IU in less than 30 minutes in those with lightly pigmented skin. Those with darker pigmentation need more.

The key is moderation and avoidance of sunburn. Early morning or late afternoon sun is the safest. Avoid midday sun whenever possible. When I sunbathe, I always stop before getting any sign of a burn.

Need more vitamin D in your life? Here are a few tips from Dr. Northrup:

• Take your vitamin D supplement.
  (minimum of 1,000 IU per day)
  
• Get additional vitamin D by eating fish.
  Wild sockeye salmon, silver salmon, and albacore tuna contain anywhere from 300-700 IUs of vitamin D per 3.5 oz. serving, depending on the supplier. Consider eating these types of fish regularly.
  
• Consider a series of short visits to the tanning booth if you live in the North.
  (Don't get red!)
  
• Take a sunbath when you can.
  I'd recommend using sunscreen on your face. The rest of your body can absorb the UV light and make the vitamin D.

References

1. Holick MF. 2004. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr, 79:362-71.
2. Garland CF, Mohr SB, Gorham ED, Grant WB, Garland FC. Evidence of need for increased vitamin D fortification of food based on pooled analysis of studies of serum 25-hydroxyvitamin D and breast cancer. Proc Amer Assoc Cancer Res 2006;47:[Abstract 4008]
3. Northrup, Christiane, M.D., 2005. Mother-Daughter Wisdom: Creating a Legacy of Physical and Emotional Health, Bantam: New York. p. 217.
4. Ibid., 216.

Sunny outlook for vitamin D lab testing

Testing for vitamin D levels once was uncommon. But as more and more studies raise awareness about vitamin D deficiencies, testing for the vital vitamin is skyrocketing.

Tests ordered for vitamin D grew by about 80 percent between May 2007 and May 2008, according to Richard Reitz, a medical director with Quest Diagnostics of Madison, N.J., one of the country's largest diagnostic labs. Another top lab -- Burlington, N.C.-based Lab Corporation of America -- saw a 90 percent leap in D test requests between 2007 and 2008, says Eric Lindblom, a company executive. Neither firm would release the actual numbers.

The testing hoopla is due to emerging research that links vitamin D deficiency with some infectious diseases, cancers, cardiovascular disease and autoimmune disorders, says Patsy Brannon, professor of nutritional sciences at Cornell University.

Other research indicates that many Americans are deficient in vitamin D, says Catherine Gordon, director of the bone health program at Children's Hospital Boston.

Supplements and D-rich foods, such as fortified milk, may be recommended for patients with low D levels, Gordon says. Sunshine's UV rays also activate one form of vitamin D in the body.

The Institute of Medicine recommends 200 IUs a day for children and 400 IUs daily for adults, though some experts recommend more.

Gannett News Service

Review of vitamin D guidelines urged

A flurry of research indicating that vitamin D may have a dizzying array of health benefits has reignited an intense debate over whether federal guidelines for the "sunshine vitamin" are outdated, leaving millions unnecessarily vulnerable to cancer, heart disease, diabetes and other ailments.

The studies have produced evidence that low levels of vitamin D make men more likely to have heart attacks, breast and colon cancer victims less likely to survive, kidney disease victims more likely to die, and children more likely to develop diabetes. Two other studies suggested that higher vitamin D levels reduce the risk of dying prematurely from any cause.

In response to these and earlier findings, several medical societies are considering new recommendations for a minimum daily vitamin D intake, the American Medical Association recently called for the government to update its guidelines, and federal officials are planning to launch that effort.

But many leading experts caution that it remains premature for people to start taking large doses of vitamin D. While the new research is provocative, experts argue that the benefits remain far from proven. Vitamin D can be toxic at high doses, and some studies suggest it could increase the risk for some health problems, experts say.

"The data are intriguing and serve as, no pun intended, food for further fruitful research," said Mary Frances Picciano, at the Office of Dietary Supplements of the National Institutes of Health. "But beyond that, the data are just not solid enough to make any new recommendations. We have to be cautious."

The clash is the latest in a long, often unusually bitter debate. Some skeptics question whether funding by the tanning, milk and vitamin industries is biasing some advocates. Frustrated proponents accuse skeptics of clinging to outdated medical dogma.

Reinhold Vieth, a professor of nutritional sciences and pathobiology at the University of Toronto, is one of a small but vocal cadre of researchers pushing doctors and patients to stop waiting for new official guidelines. Physicians should routinely test their patients for vitamin D deficiencies, and more people - especially African Americans - should take supplements and increase their exposure to the sun, they say.

"The bottom line is we now recognize that vitamin D is important for health for both children and adults and may help prevent many serious chronic diseases," said Michael Holick, a professor of medicine, physiology and biophysics at Boston University.

Scientists have long known that vitamin D is a vital nutrient the skin produces when hit by ultraviolet light from sunlight and other sources. The amount of vitamin D produced varies, depending on where the person lives, skin pigment, age and other factors. African Americans and other dark-skinned people, and anyone living in northern latitudes, make far less than other groups.

With people spending more time indoors surfing the Web, watching television, working at desk jobs, and covering up and using sunblock when they do venture outdoors, the amount of vitamin D that people create in their bodies has been falling. Milk and a few other foods are fortified with vitamin D, and it occurs naturally in others, such as fatty fish, but most people get very little through their diets.

Studies have found that deficiencies may be common, with perhaps half of adults and children having what some consider inadequate levels. Federal guidelines call for people to get 200 to 600 international units a day, depending on age and other factors. But those recommendations were last updated in 1997 and were aimed primarily at preventing bone diseases, such as rickets in children and osteoporosis in the elderly.

Since then, studies have indicated that vitamin D offers a plethora of health benefits, possibly protecting against heart disease, many forms of cancer, immune system disorders such as multiple sclerosis and rheumatoid arthritis, infectious diseases such as tuberculosis and the flu, and perhaps mental illnesses including schizophrenia and depression.

The Canadian Cancer Society upped its recommendation to 1,000 units a day last year. Some believe Americans should routinely consume at least 2,000 international units a day.

But others have reservations. Dermatologists worry that encouraging people to get unprotected sun exposure or use tanning salons may increase the rate of skin cancer.

"We're in the middle of a skin cancer epidemic," said C. William Hanke, president of the American Academy of Dermatology. "Tanning is risky and dangerous behavior. Ultraviolet light is classified as a carcinogen. We need to protect our skin."

This article appeared on page A - 5 of the San Francisco Chronicle