When the Sun isn’t Enough
The exploding body of research regarding the importance of vitamin D has posed a seeming conundrum for health
professionals–adequate levels of vitamin D from the sun versus the critical need for sun protection to protect against the current epidemic of skin cancer.
The assumption in much of this research is that people live in climates where UVB from the sun is available.
But what if they don’t?
An important new study, by Dr. Gregory A. Plotnikoff, in the November edition of Minnesota Medicine, examines this question in the state of Minnesota, where Plotnikoff found that in 2008, fewer than half the days offered enough sun to make vitamin D at noon.
“The bottom line is that in Minnesota, our infamous weather significantly limits our capacity to make vitamin D,” writes Plotnikoff in his study, “Weather or Not: The Importance of Vitamin D Monitoring and Supplementation.”
As science continues to recognize the importance of vitamin D in overall health, vitamin D deficiencies are of increasing concern to clinicians. Vitamin D deficiency is associated hip fractures, metabolic syndrome, type I and type II diabetes, infectious disease, autoimmune disease, chronic pain, hypertension, and many types of cancer including the deadliest ones.
However, despite our lack of sunny days, Minnesotans do get skin cancers. In fact, the incidence of diagnosed skin cancers in the state is 18.3 per 100,000 which is higher than the national average of 17.5 of 100,000, according to the National Cancer Institutes. Moreover, a number of researchers have suggested that intermittent sun exposure may create greater risks for melanoma. For Minnesotans, this means that it is even more important to use sun protection during the warmer months.
Plotnikoff’s study lends credibility to the recommendation by the National Council on Skin Cancer Prevention, that is, avoid exposure to UVR to help prevent skin cancers and rely on supplements for vitamin D. And, please note that the recommendation focuses on supplements, not food. Very few foods contain vitamin D. And as Plotnikoff point out, “an entire gallon of milk contains less than one-tenth of the vitamin D that one would get by spending an afternoon at the beach.”
Plotnikoff recommends that Minnesota physicians monitor their patients more aggressively for vitamin D deficiencies. “Given the multitude of negative consequences tied to vitamin D deficiency, physicians in Minnesota, much more than their southern colleagues, need to consider monitoring their patients serum vitamin D levels and supplementing appropriately,” he writes.
Dr. Plotnikoff goes on to suggest that “forthcoming evidence will likely support the idea of physicians checking patients vitamin D levels as often as they check their cholesterol levels.” While some may argue that this is an expensive proposition, it is far less expensive than treating a skin cancer.
The advice contained in the SunAWARE acronym remains valid. “R – Routinely check your skin for suspicious changes and report concerns about skin or sun related issues, including vitamin D, to your health care provider.”
Be SunAWARE and be safe.