The amount of discussion about Vitamin D in the media over the past two years is more than enough to leave people confused as they try to fit all the pieces together and make appropriate choices for themselves and their families. Is sun exposure safe? Should we use sunscreen? There are many questions. Let’s look at some answers.
Australia is a land known for its sunshine, beaches and outdoors lifestyle. Thus it’s surprising to know that a large proportion of our population has a deficiency of `the sunshine vitamin’, Vitamin D. Some sources say it’s around 80% of the population who are deficient in this all-important vitamin.
For the past thirty to forty years we have been so focussed on the suns’ potential for damage that we have forgotten about it’s benefits to general health and well-being. It’s also significant that in that time we have seen an increase in the incidence of melanoma and other skin cancers, and the return of rickets in children. (Rickets is a condition caused by chronic Vitamin D deficiency causing soft bones which lead to fractures and deformity.)
Why we need Vitamin D and what a deficiency means to health
It’s probably easier to look at what effects a deficiency has, and these are many. It has been linked to various types of cancer including breast cancer, prostate cancer, bowel cancer, and even melanoma. A deficiency can be associated with fatigue, depression, colds and flu, Seasonal Affective Disorder (SAD), diabetes, heart disease, arthritis, PMS, high blood pressure, osteoperosis, weight gain, various auto-immune disorders, as well as a general lack of health and vitality. That’s a long list of things that can be caused or in some way related to a deficiency of Vitamin D. Enough to make most of us want to make sure we are getting enough of it.
This BBC news item from January 2012 highlights the issue very well:The UK Chief Medical Officer is being forced to educate medical health professionals about the importance of Vitamin D supplementation after Vitamin D deficiency has been blamed for the recent deaths of at least 2 children in the UK. BBC news coverage has highlighted that Vitamin D deficiency is considered to be ‘a contributing’ factor in the deaths of a further 30 children. A recognised consequence of low vitamin D is osteomalacia in adults. It also contributes to osteoporosis, that is fragility fractures, in part through increased risk of falls. Vitamin D deficiency has also been implicated in other conditions including cardiovascular disease, increased cancer risk and mortality, falls, sarcopenia, diabetes, multiple sclerosis, osteoarthritis, epilepsy and cognitive dysfunction.
What stops us getting enough Vitamin D?
One answer to this question is our lifestyle!!!
The early 1970s was a time of radical change in western society for many reasons. As those were my young adult years I began to think about how we thought about the sun back then. I remember as a young nurse, being taught the value of sunshine in health. For example, we always took the elderly or long term patients out into the sun for a time each day. They looked forward to it because it made them feel `good’ in some undefined way. We tried to have wounds get some direct sunlight for a short period before re-applying a dressing. Then in the maternity ward, we would have all the babies lined up with their bare bottoms in the direct sunlight – for prevention (or treating) of nappy rash. Works every time.
As kids, we spent a lot of time every day outdoors and in the sun. If we happened to get sick, which didn’t happen often, Mum made sure we got to sit outside in the sun for a while. Much of that changed with the introduction of the Cancer Council’s highly successful Slip, Slop, Slap campaign in 1980. Their catchy jingle reminded us to slip on a shirt, slop on some sunscreen and slap on a hat in order to prevent skin cancer. Our kids at that time still spent a lot of time outdoors, helping in the garden or just plain play, but we began to slop on the sunscreen. I think that this was also the decade when people generally began to spend a lot more time indoors.
Wearing of sunscreen, not spending enough time in the sun, wearing of sunglasses, being behind glass, generally living and working more indoors, are all lifestyle factors that cause us not to get enough vitamin D from the sun.
There are other things that can cause us not to absorb Vitamin D, despite getting enough sun exposure. The following is quoted from Chris Kresser :
`Research over the past two decades has identified a variety of mechanisms that reduce the absorption, production and biologic activity of vitamin D in the body.
- Since vitamin D is absorbed in the small intestine, a leaky and inflamed GI tract– which is extremely common in people with low thyroid function – reduces the absorption of vitamin D.
- High cortisol levels (caused by stress or medications like steroids) are associated with lower vitamin D levels. They synthesis of active vitamin D from sunlight depends on cholesterol. Stress hormones are also made from cholesterol. When the body is in an active stress response, most of the cholesterol is used to make cortisol and not enough is left over for vitamin D production.
- Obesity reduces the biologic activity of vitamin D. Obese people have lower serum levels of vitamin D because it gets taken up by fat cells.
- Not eating enough fat or not digesting fat properly reduces absorption of vitamin D. Vitamin D is a fat-soluble vitamin, which means it requires fat to be absorbed. People on low-fat diets, and people with conditions that impair fat absorption (like IBS, IBD, gall bladder or liver disease) are more likely to have low levels of vitamin D.
- A variety of drugs reduce absorption or biologic activity of vitamin D. Unfortunately, these include drugs that are among the most popular and frequently prescribed – including antacids, replacement hormones, corticosteroids, anticoagulants and blood thinners.
- Aging reduces the conversion of sunlight to vitamin D becomes.
- Inflammation of any type reduces the utilization of vitamin D’
Loren Cordain (The Paleo Diet) says that `the most disturbing effects of whole grains is their capacity to impair Vitamin D metabolism.’ Another good reason not to be eating grains!!
The big questions now are `Where do we get it?’ and `How do we get enough?’
We can get Vitamin D from sunshine, foods, and supplements. So why not just use sunscreen, stay out of the sun, and take a supplement? It’s not that simple! Let’s look.
When it comes to Vitamin D, our bodies were designed to be a solar powered system. We do get some vitamin D from foods, but that is very limited, and we certainly can’t get it all from foods. In fact the foods that contain significant amounts of vitamin D are not ones that most of us would eat every day. Here they are (with highest content first): herring, oyster, catfish, sardines, mackeral, salmon, caviar, prawns, butter, whole egg. Beware of the foods that say they are fortified with added, usually artificial, vitamin D, which is not easily absorbed.
Here in Australia we have had the `cover up and keep out of the sun’ mantra so ingrained into our thinking that to deliberately going out to expose our skin to sunshine seems wrong.
Let’s get this right: Sun DOES NOT cause skin cancer.
It’s the burn that causes skin cancer. It seems ironic then, that some sunscreens are linked to cancer, and a deficiency of the sunshine vitamin increases the risk of melanoma. That’s right, we need to be in the sun to protect us from melanoma.
Australia has a high incidence of skin cancer, the highest in the world. The interesting this is that this has increased despite the covering up and getting less exposure to the sun!!!!
The problem we have is that people get burned quickly. Their skin is not used to consistent exposure to the sun. They spend all week in the office (factory, school, university, home, gym) and then go out in the sun on the weekend and get burned. We have to build up our exposure to the sun gradually, getting some every day.
But how much sun is enough?
We get told to get `a few minutes every day’ or `short exposure’. What does that mean??? Nothing really helpful. Firstly it means direct sun exposure without sunscreen, or glass. In fact he amount of exposure will depend on a number of factors, including your location, the time of year, your skin colour, cloud coverage, and pollution levels.
Location: If you are at latitude above 33⁰ north, or below 33⁰ south you will find it difficult to get enough vitamin D from the sun during the six months of the year when sunlight is less intense (winter months). For Australia you can draw a line from Sydney to just north of Perth, and if you’re south of that you will need to pay more attention to getting enough sunshine in the colder seasons. For mainland USA draw a line through Atlanta, Dallas, Phoenix, & Los Angeles. These places and north will have to work on getting enough sunshine.
Following is a chart which gives recommended amount of sun exposure needed for adequate production of vitamin D. (Dark skinned people will need longer.)
It’s important to remember that you need to get your vitamin D levels measured regularly, regardless of what method you use to raise or maintain your vitamin D levels. That way, if you find that sun exposure is not enough to maintain an optimal level, you may want to look into taking a supplement, for example. Without testing, you will not be able to figure out how much you need, or whether the sun exposure you get, or the supplements you take, is sufficient.
When asked sun or supplement, Mark Sisson of Marks Daily Apple says,
`Take stock of your living situation. If the sun is available regularly where you live, go that route whenever possible. It’s free, it’s safe, it’s easy, and it’s enjoyable. Avoid burning, of course, and you’ll be safe. I find it inconceivable that the amount of sun exposure necessary to produce 10,000 IU of D3 (about 20-30 minutes of afternoon sun for light skinned folks; a few times that for dark skinned folks) will also kill you and give you skin cancer.’
Again….how much is enough?
Dr. John Cannell MD, the Executive Director of the Vitamin D council stated in a recent Vitamin D Council on-line newsletter entitled ‘The Truth About Vitamin D Toxicity’ said:
`….. there is no evidence anywhere in the published literature that even 10,000 IUs per day of vitamin D is toxic to humans and that human toxicity does likely not occur until over 40,000 IUs of daily consumption. “Vieth reports human toxicity probably begins to occur after chronic daily consumption of approximately 40,000 IU/day (100 of the 400 IU capsules).” He goes on to state that “Physician ignorance about vitamin D toxicity is widespread” and concludes by stating that “In fact, living in America today while worrying about vitamin D toxicity is like dying of thirst in the desert while worrying about drowning.” In other words any danger associated with vitamin D is from deficiency NOT toxicity.
You can tell you’ve reached your optimal exposure for the day when your skin turns a very light shade of pink. After that you’re only increasing your chances of getting burned, which is something you definitely want to avoid. There is NO additional benefit to staying in the sun any longer. You only risk damage by extending your time in the sun.’
There are a LOT of different Vitamin D supplements available. Make sure you look for a D3 supplement. I’d recommend you buy the best quality you can afford. You get what you pay for!! The one we use is USANA Vitamin D which you can get from our friend Michael. (Give him a call and ask about how to get a discounted price.)
What about sunscreen?
To be honest, I was never very good at using it with my kids (as a kid I wasn’t part of the cover up culture), and I hate the feel of it on my skin, so have refused to use it for myself for most of my life. And now that I know about the negatives of it, I’m glad I don’t.
Some of the negatives of regular sunscreen include:
- It prevents the manufacture of Vitamin D by the body. It blocks the UV-B rays that are necessary to interact with the cholesterol in the skin to make Vitamin D.
- It is full of unpronounceable chemicals that are absorbed by the skin. These toxins then need to be processed by the liver.
- It contains Titanium Dioxide – a chemical that may actually increase the risk of melanoma.
My perspective on this is that we should reduce any possible of risk from un-necessary chemicals.
Australia does have a very intense sun, due to the hole in the ozone layer over much of our continent. Thus it is very easy to get sunburned in a short space of time, even in the winter. We have to work on getting a balance between getting outside and getting good sun exposure, without getting burned. It means spending the required time for Vitamin D production with as much skin exposed as possible, then covering up and enjoying time outdoors.
We are using pure coconut oil (not a manufactured coconut oil sunscreen) on our faces to moisturise and protect them. Coconut oil has an SPF of 5. Not a lot, but certainly helpful.
I realise that I have left this post with no real solution for a safe, chemical free sunscreen. I haven’t seen any (mainly because I haven’t looked). What would you use? Particularly for those Mums who have children at school….I’m sure the pressure is huge for kids to have sunscreen packed in their school bag. We know that sun exposure is safe, but what do you do in those situations? There has to be an answer. Especially let us know if you know of, or use, a chemical free, natural sunscreen.