How Dermatologists Fuel Chronic
Disease Rates With Their Flawed Sun Exposure Guidelines
March 14, 2016
Story at-a-glance
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The U.S. Surgeon General, the American Academy of
Dermatology, and The Skin Cancer Foundation all view
sunlight irrationally as a dangerous skin cancer risk
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Sun avoidance fuels health problems associated with vitamin
D deficiency, including hypertension, cardiovascular
disease, cancer, depression, and poses special health risks
to pregnant mothers and their children
-
The evidence supporting sensible sun exposure is strong and
clear, while there’s little evidence that sunscreen use
protects against skin cancer, or that vitamin D supplements
are bioequivalent to sunshine
By Dr. Mercola
In July 2014, the interim U.S. Surgeon General Dr. Boris
Lushniak, who is also a dermatologist, issued a "Call to Action to
Prevent Skin Cancer,"1,2
in which he declared UV radiation harmful and said sun exposure
should be avoided altogether.
The American Academy of Dermatology and The Skin Cancer
Foundation also advocate avoiding all sun exposure — regardless of
the color of your skin — saying vitamin D supplementation can
address any deficiencies.
This is an irrational and shortsighted position that lacks any
credibility. The scientific evidence, now running in excess of
34,000 studies, detail that UV exposure is essential, both for
vitamin D production and other benefits unrelated to vitamin D.
The color of your skin is a significant factor to determine
appropriate exposure times and any advice that does not take this
into consideration is illogical. We are not nocturnal beings,
avoiding the sun entirely is horrible advice that should not be
followed.
Dermatologists' Position on Sun Exposure Riddled With Fatal Flaws
Let's remember that, because of their irrational concern, they
were able to convince public health officials and media to convince
people to use sunscreens.
What happened as a result of the public adopting this proactive
"preventive" approach? Skin cancers actually increased.
Why? Because the dermatologists did not do their homework. Most
sunscreens blocked UVB, which causes vitamin D levels to increase
and lower cancer rates, but they let UVA, which can cause skin
cancer when excessively exposed, to shine right through like a hot
knife through butter.
What's worse, they never admitted to their egregious mistake.
Ironically, the only location dermatologists approve of UV light
treatment is in their office under costly supervision.
Avoiding Sun Exposure Radically Worsens Disease Rates
Advocating abstinence from UV light is undoubtedly fueling many
health problems associated with vitamin D deficiency, including
cancer, cardiovascular disease, autoimmune diseases and depression.
UVB exposure is essential for optimal health, and any risks of
exposure are related to over exposure and burning. Research
shows vitamin D is involved in the biochemical regulation of nearly
every cell in your body, including your immune system.
Vitamin D deficiency can deteriorate your health in a number of
different ways, as your cells need the active form of vitamin D to
optimally regulate genetic expression.
As noted by William Grant, Ph.D., head of the Sunlight, Nutrition
and Health Research Center (SUNARC), staying indoors to avoid sun
exposure is "not particularly good advice," adding that:3
"There are several papers indicating that occupational
exposure to sunlight reduces the risk of melanoma. It is having
fair skin, a high-fat, low fruit and vegetable diet, sunburning,
etc., that are more linked to melanoma than total UV exposure."
Vitamin D Is Crucial for Pregnant Women
Vitamin D is particularly important for pregnant women, as
deficiency affects both the mother and her child in the short and
long term, including raising the child's long-term risk for
diabetes, allergic rhinitis,4
arthritis, stroke, and cardiovascular disease.
Recent research shows that raising maternal vitamin D levels
helps children born in winter months develop stronger, healthier
bones.5
Lead researcher Professor Nicholas Harvey, Ph.D., of the University
of Southampton, also notes that sun exposure is the most important
source of vitamin D.
Health initiatives such as GrassrootsHealth D*Action study,6
and the
Protect Our Children NOW! campaign are both based on these
fundamental and scientifically proven facts.
Dermatologists Ignore Skin Color
The fact that the American Academy of Dermatology issues the same
recommendations for everyone, without regard for skin type, is
telling. Despite overwhelming evidence to the contrary, they view
sun exposure as nothing but a dangerous cancer risk to be avoided at
all costs.
This is a really nonsensical, and most definitively
nonscientific, stance. According to their advice, even if you have
the darkest skin, you should always seek shade and wear protective
clothing and/or sunscreen when outdoors.
The notion that supplements are bioequivalent to sunshine is
lacking. While I recommend supplements if UVB exposure is not
available, to suggest that vitamin D can replace all the benefits of
sun exposure is ridiculous.
In fact, each of us responds quite differently to vitamin D
supplementation - there is a 6 to 10 times difference in dosage
response between individuals. If you are supplementing
with vitamin D, you should have your levels checked twice per year
to ensure you stay above 40ng/ml.
Because of this, vitamin D experts such as Grant and Dr. Michael
F. Holick note that sensible sun exposure is far preferable to
vitamin D supplementation.
Oversimplifying the Issue Is Not a Good Public Health Policy
The Skin Cancer Foundation echoes the American Academy of
Dermatology's recommendations.
When questioned about this philosophy and asked why the
recommendations fail to take into account skin type and color, Dr.
Henry Lim, who sits on The Skin Cancer Foundation's photobiology
committee, replied that such information is irrelevant because
vitamin D supplements can address deficiency.
According to Lim:7
"We want to make it simple as a public health message —
as to what the public should reasonably be able to absorb and
understand. To fine tune it is just too complicated we feel."
But by oversimplifying the matter, dermatologists place
a great number of people at grave risk for vitamin D deficiency,
which may not be identified until health problems have already set
in. Moreover, the advice to use sunscreen is also on shaky
scientific ground.
According to an analysis by epidemiologist Marianne Berwick,
Ph.D., there's very little evidence to suggest that sunscreen use
will prevent skin cancer.
After analyzing a dozen studies on basal cell carcinoma, which is
typically non-lethal, and the more deadly melanoma, Berwick found
that people who use sunscreen tend to be more likely to
develop both of these conditions.
Only 2 of 10 melanoma studies found that sunscreen was protective
against this condition; three found no association either way. None
found sunscreen use protected against basal cell carcinoma.8
Your Body Is Designed to Optimize Health Effects of Sun Exposure
While you certainly need to
avoid the skin damage associated with sunburn, sun exposure is
required for optimal health, and your skin type plays a major role
in how much UVB exposure you need and can safely tolerate.
Darker-skinned people not only need more sun exposure to produce
sufficient amounts of vitamin D, they're also more protected from
skin cancer due to their skin pigmentation. Yet this important
reality is simply ignored by dermatologists, resulting in most
African Americans being at a radically increased risk of cancers and
heart disease from vitamin D deficiency.
As noted in a previous article by Nautilus:9
"How the sun affects you depends on your complexion, the
shade of which is determined by melanin ... The anti-oxidizing
molecule is so versatile at protecting and repairing DNA from UV
solar radiation that creatures from humans to fungi deploy it
... [T]he melanin sits atop cellular DNA like tiny umbrellas
pointed ... out to shield from incoming rays ...
[T]he same ultraviolet wavelengths in the 290 to 400
nanometers range that trigger melanin production also spark
vitamin D creation. You cannot make one without the other.
Humans evolved to produce two kinds of melanin ... The
MC1R gene determines the type of melanin the body produces. In
the mid-zone such as the Mediterranean region, people ...
produce eumelanin, the pigment responsible for brown or black
hair and for dark skin that tans easily ...
[I]n far northern Europe, humans paled, adapting to lower
light ... with a different type of melanin, called pheomelanin,
associated with fair skin and blonde and red hair with minimal
protective value, but allowing more UV to penetrate to make
vitamin D. "
Sun Avoidance Raises Risk of Internal Cancers
Dermatology is focused on one primary outcome — avoiding skin
damage and skin cancer. But by focusing on just one side of the UV
exposure issue, they're actually promoting a lifestyle that may
raise your risk of other lethal cancers and chronic
diseases. Not only have higher vitamin D levels been shown to offer
significant protection against a number of internal cancers, there's
also evidence showing higher levels offer protection against
melanoma.
In fact, higher rates of
melanoma are found among those who have low vitamin D levels;
among indoor occupations; and in areas of the body that rarely or
never see the light of day. In short, the vitamin D your body
produces in response to UVB radiation is protective against skin
cancer. As noted in The Lancet:10
"Paradoxically, outdoor workers have a decreased risk of
melanoma compared with indoor workers, suggesting that chronic
sunlight exposure can have a protective effect."
Even more importantly, vitamin D has been shown to significantly
reduce internal cancers, along with chronic diseases such
as heart disease, which kill far more people than melanoma
does. Breast11
and prostate12,13
cancers are just two examples where low vitamin D renders you more
vulnerable to more aggressive forms of the disease. Recent research14
has also found that low vitamin D levels are associated with more
severe peripheral neuropathy in cancer patients.
Reporting on recent research linking low vitamin D levels to an
increased risk for aggressive breast cancer, Medical Daily writes:15
"The researchers linked vitamin D levels to the ID1 gene,
which at high levels of expression is associated with breast
cancer tumor growth. Past studies have shown that vitamin D is
linked to inhibiting the expression of this gene, and that low
vitamin D levels have been associated with more aggressive
tumors. "
Public Health Messages Should Be Based on All-Cause Mortality
Reduction
According to a scientific review16
by Dr. Richard Weller, a dermatologist, sun exposure also has
cardiovascular benefits independent of vitamin D. One of the key
messages presented in his paper states that: "All-cause
mortality should be the primary determinant of public health
messages. Sunlight is a risk factor for skin cancer, but sun
avoidance may carry more of a cost than benefit for overall good
health."
Another study17
published in the journal Public Health Nutrition in 2012 concluded
that: "The overall health benefit of an improved vitamin D status
may be more important than the possibly increased CMM (cutaneous
malignant melanoma) risk resulting from carefully
increasing UV exposure. Important scientific facts behind this
judgment are given."
In short, if you're concerned about mortality, and not
just mortality from one disease, the scales are decidedly
tipped toward sun exposure being of tremendous benefit — despite a
minor risk of melanoma, should you accidentally end up getting
burned one or more times in your life. Unfortunately, the field of
dermatology refuses to take the entire picture into account
when making its recommendations about UV exposure.
UV Light Is Essential for Human Health
We are not nocturnal beings, and while high intermittent and/or
overexposure to UV light can cause potentially serious harm, it's a
manageable risk provided you use common sense and pay careful
attention to some basic elements. The advice to completely avoid UV
light is quite dangerous, and one that extends far beyond just
vitamin D deficiency, as sunlight has health benefits that go beyond
vitamin D production.
To mitigate the risks of UV exposure while maximizing the
benefits, here are some factors to consider:
- Our skin pigmentations are linked to ancestral latitudinal
proximities that optimized our ancestors' skin for sun exposure.
The further from the equator our ancestors lived, the lighter
their skin, allowing them to biologically maximize the limited
availability of the sun, and UV light specifically. Remember:
Your body produces vitamin D through exposure to UVB light. For
those living in northern latitudes, this may only be an option
for a few short months each year.
- If you accept the essential nature of UV light, then you can
conclude that safe exposure to sunshine is possible by
understanding your skin type, the UV strength at the time of
exposure, and your duration of exposure. My advice has been
clear: Always avoid sunburn.
- Pay close attention to your vitamin D levels. Ideally,
get your vitamin D tested during the peak of summer and at
the end of winter to help guide your UV exposure and vitamin D
supplementation.
- UVB exposure on bare skin is required for your body to
produce vitamin D. The more skin that is exposed when UVB is
available, the less time you need. Since few foods contain any
significant amount of vitamin D, and your body certainly was not
designed to get its vitamin D from supplements, which are a
modern invention, the only rational conclusion is that sun
exposure is the ideal way to raise your vitamin D level.
- UV light has benefits beyond vitamin D. For more
information, see the TED Talk above, or read through "Sunlight
Has Cardiovascular Benefits Independently of Vitamin D,"
19,20
produced by Richard B. Weller Medical Research Council Centre
for Inflammation Research, University of Edinburgh.
The Role of Vitamin D in Disease Prevention
A growing body of evidence shows that vitamin D plays a crucial
role in disease prevention and maintaining optimal health. There are
about 30,000 genes in your body, and vitamin D affects nearly 3,000
of them, as well as vitamin D receptors located throughout your
body.
According to one large-scale study, optimal Vitamin D levels can
slash your risk of cancer by as much as 60 percent. Keeping your
levels optimized can help prevent at least 16 different types of
cancer, including pancreatic, lung, ovarian, prostate, and skin
cancers.
How Vitamin D Performance Testing Can Help Optimize Your Health
Is it any wonder then that no matter what disease or condition is
investigated, vitamin D appears to play a crucial role? This is why
I am so excited about the
D*Action Project by GrassrootsHealth. Dr. Robert Heaney is the
research director of GrassrootsHealth and is part of the design of
the D*action Project as well as analysis of the research findings.
GrassrootsHealth shows how you can take action today on known
science with a consensus of experts without waiting for
institutional lethargy. It has shown how by combining the science of
measurement (of vitamin D levels) with the personal choice of taking
action and, the value of education about individual measures that
one can truly be in charge of their own health.
In order to spread this health movement to more communities, the
project needs your involvement. To participate, simply purchase the
D*Action Measurement Kit and follow the registration
instructions included. (Please note that 100 percent of the proceeds
from the kits go to fund the research project. I do not charge a
single dime as a distributor of the test kits.)
As a participant, you agree to test your vitamin D levels twice a
year during a five-year study, and share your health status to
demonstrate the public health impact of this nutrient. There is a
$65 fee every six months for your sponsorship of this research
project, which includes a test kit to be used at home,
and electronic reports on your ongoing progress. You will get a
follow up email every six months reminding you "it's time for your
next test and health survey."
© Copyright 1997-2016 Dr. Joseph Mercola. All Rights Reserved.
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