October 28, 2015
Director's Letter 
Carole Baggerly 
Director, GrassrootsHealth 

WHY is there so much vitamin D deficiency??

We had a news table at a large pharmacy recently where we had information about vitamin D, and of course, testing.

The most commonly heard things were:
  • I don't need any supplements. I get it all from my foods.
  • I already take vitamin D. When asked "How much?" the response was either "It's in my multi." or "2000 IU/day." (not generally enough)
  • When asked "How much time do you spend in the sun?", the responses were almost unanimous "I avoid the sun and, when necessary to be in it, I wear sunscreen."
We are creating a deficiency by misunderstanding and, lack of knowledge. Key Fact:  Our bodies' vitamin D production was programmed to be primarily through the skin, from sunshine. There are two major reasons for this deficiency epidemic:
  1. We are inside (as a result of industrialization).
  2. We have gotten a scare message about sunshine and cancer. Yes, excessive sun exposure leads to an increase in squamous and basal cell carcinomas (that can generally be cut or burned off the skin easily). The safety message should be "Don't burn!!!" and "Protect your face."

A key to resolving the deficiency is to initiate a new standard of measurement for the question "How much do I need?"  This measurement has to take into account everything from skin type to age to the availability and distribution of both UVA and UVB in the locale. This standard should ultimately be agreed upon by the various public health agencies. We're not there yet!  Stay tuned for more developments and certainly, share your information with us.   

 

Please review the information below from our paper on Sunlight and Vitamin D and the many recordings we have put together for your use. They would be excellent choices for a D*party!
 
Sunnily yours, 

Carole Baggerly
Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research into Practice NOW!
Solving vitamin D deficiency through sunlight

Can you get enough vitamin D from sunlight alone?

We know, from the 48 scientists who signed our call to action, that a vitamin D level of 40-60 ng/ml is recommended to prevent disease and improve general quality of life. Can we get to this vitamin D level from the sun? Is it safe?

You need UVB to make vitamin D

The ultraviolet-B (UVB) rays in sunlight activate the process to make vitamin D in your skin. Sunshine at midday in summer is typically composed of 95% UVA and 5% UVB. This relatively small amount of UVB is all it takes to make vitamin D in your skin.

During spring/summer the best time to make vitamin D is between 10 am and 3 pm, or as a general rule of thumb, any time that your shadow is shorter than your height. To better estimate your potential for making vitamin D there are now apps (dminder) and devices (Sunfriend) that can help you track when you can get vitamin D depending on your current location, time and sun conditions.

During the fall/winter months UVB rays do not reach the earth above a latitude of roughly 34 degrees (Los Angeles, CA and Atlanta, GA), so much of the United States and Canada enter a "vitamin D winter" where no vitamin D will be made, regardless of the time of day.

Get enough sun, but do not burn

It is important when you are out in the sun to make sure that you do not burn. One way to monitor your sun exposure is to look at your skin 24 hours after exposure. If at that time you have a light pinkness to your skin, then you received what scientists call a "minimal erythema dose" which is equivalent to about 15,000-20,000 IU of Vitamin D. This is a safe level of sun for your skin type.

The darkness of your skin affects how much sunlight you need. Darker skin contains more melanin which blocks UVB and reduces vitamin D production. A very light skinned person might reach that minimal erythema dose within 15 minutes whereas an African American might need 5-10 times that amount, up to 2 ½ hours of mid-day sun. It is important to know your skin type, not to use a blanket recommendation.

Another factor to consider is that UVB synthesis is lowered with age. An adult 70 years old makes about 25% of the Vitamin D of a 20 year old adult.

Sunscreen blocks UVB

Before we talk of sunscreen, it is interesting to note that sunscreen has only been commonly used for about 30 years and in the beginning stages, they weren't used prolifically or as strong as they are today. We were perfectly healthy (maybe more so) before sunscreen and we maybe even got more sun than we do in our indoor lives today.

Sunscreen with a sun protection factor (SPF) of 30 will absorb about 95-98% of the UVB radiation.  As a result, you reduce your ability to make Vitamin D in your skin, by about 95-98%. In other words, while sunscreen does prevent burning, it also prevents production of vitamin D. GrassrootsHealth recommends wearing sunscreen only on your face and hands, and exposing the rest of the body to sunlight for a sensible time, based on your skin type, and then going indoors or covering up. If you are outdoors all day, start without sunscreen and apply it after you have reached your erythema dose.

Ed Gorham, PhD, gives a great talk entitled Skin Cancer/Sunscreen - The Dilemma which explains the use of sunscreen and the benefits of a health amount of sunlight.

What are the other benefits of sunlight?

Vitamin D may be the best known benefit of sun exposure, but it is not the only one. Exposure to sunlight has been shown to release beta-endorphins which boost the immune system, relieve pain, promote relaxation, heal wounds, and help with cell differentiation. Exposure to sunlight has also been shown to lower blood pressure.

It has long been known that the visual affects of the sun improve sleep and seasonal affective disorder through the release of melatonin and serotonin.

Take a D*break!

Cancer Council NSW in Australia, a country with high skin cancer rates, has recently launched a campaign to advocate D breaks. They know it is beneficial to have a healthy dose of sun exposure and that most people are inside for most of the work day. This site gives tips on how to take a healthy D break during the work day. Keep in mind that the length of time will vary by skin type, this web site is geared toward those who are light-skinned.

Your Data Your Answers

We analyzed our D*action cohort in 2013 and 1542 of you did not take any vitamin D supplements. For those non-supplement takers, we looked at the average vitamin D levels compared to the average time spent outdoors over the preceding 6 months.

 
Click to Expand

As you can see it took 2-4 hours of daily sun to get the average over 40 ng/ml, the desired level. So, our cohort shows that while it is possible to maintain a vitamin D level in the 40 - 60 ng/ml range, it takes more than just a few minutes a few times a week.

Conclusion

Unless you can commit to regular time outdoors, and live within 30 degrees of the equator, GrassrootsHealth recommends that you get vitamin D from a combination of sources - food, supplements, and sun - and to test your levels to make sure they are within 40-60 ng/ml.

Paper of the Week 
Sunlight and Vitamin D: Necessary for Public Health
 
In December 2014, GrassrootsHealth held a seminar, Vitamin D for Public Health - Integrating Sunshine, Supplements, and Measurement for Optimal Health. This seminar enjoyed presentations from international vitamin D experts on sunshine, vitamin D, and disease prevention. You can view all the presentations from the seminar here.

After the seminar, GrassrootsHealth, in conjunction with all the presenters, published a commentary in the Journal of the American College of Nutrition, June 2015.

Sunlight and Vitamin D: Necessary for Public Health summarizes the following points:
  • There is a long cultural history of sun appreciation and heliotherapy
  • We have evolved with physiological adaptations to help protect our skin from the sun when we are mindful of our exposure and do not burn
  • Increased sun exposure has been associated with protection from several different types of cancer, type 1 diabetes, multiple sclerosis, and other diseases
  • Adequate vitamin D levels are important for optimal health
  • Sun has more benefit than just vitamin D
  • The cost/benefit of adequate vitamin D
The commentary ends with a call to action - to change our current sun policy:

"The current policy of sun avoidance is creating probable harm for the general population. Ignorance of the effects of portions of the solar spectrum at wavelengths longer than the ultraviolet is due mainly to lack of suitable measurement tools for cutaneous and systemic responses to those regions. We propose therefore that the US Surgeon General's office, the World Health Organization, the Institute of Medicine, and other health entities, together or separately, engage in an immediate effort both to define and quantify comprehensively the benefits and harms of sun exposure and to develop the measurement methods needed for their detection and quantification."

Read Paper
Editor's Letter 
Susan Siljander 
Marketing Director, GrassrootsHealth


The sun is a hot topic, no pun intended, especially with my age group who has young children. I am a mother of three, aged 14, 12, and 7. Two out of three of them are swimmers, we live in southern California, and I am around pools a lot. My children are fair skinned and yet I almost never sunscreen their bodies. Meanwhile I watch as an African American child has sunscreen applied before a one-hour swim lesson. 

Sometimes other parents are thankful to receive information about vitamin D and healthy sun exposure, and sometimes they are not. I found the Ed Gorham video very useful in explaining my sun position to others.

In this newsletter I tried to give you information, from start to finish, about the sun and vitamin D. For each of the topics you can go deeper, or choose to accept the information.

Maybe one of you would like to take this a step further and conduct a D*party on the benefits of sun?


"Turn your face to the sun and let the shadows fall behind you." - Maori Proverb


Susan Siljander
Marketing Director, GrassrootsHealth
A Public Health Promotion & Research Organization  
Moving Research into Practice NOW!
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All the latest research and news on breast cancer prevention
 
Vitamin D Day is coming up on November 2nd, and we want to get the word out. Support Vitamin D Council's message on Thunderclap, and if we accomplish 100% of our goal, our reach will be amplified to thousands. 
 
Support Thunderclap by clicking here. 
 
GrassrootsHealth has launched a breast cancer prevention project. Watch this video to learn more.  

 
 
Results from our Breast Cancer study show vitamin D levels > 50 ng/ml may provide additional reduction in breast cancer risk.

Open to any US woman, 18 years or older, at 12-17 weeks of pregnancy

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D*certified Practitioners

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Paper of the Week
Sunlight and Vitamin D: Necessary for Public Health
June 22, 2015
Carole A. Baggerly
Raphael E. Cuomo,
Christine B. French
Cedric F. Garland
Edward D. Gorham
William B. Grant
Robert P. Heaney
Michael F. Holick
Bruce W. Hollis
Sharon L. McDonnell
Mary Pittaway
Paul Seaton
Carol L. Wagner
Alexander Wunsch

"This is one of the best papers I have ever seen. Congratulations.You have done it! You have laid out the argument for moderate sun exposure in a way that people should be able to understand." - Vitamin D Society
References
Vitamin D Experts Speak out on Sunlight
Robert P. Heaney, MD
Reinhold Vieth, PhD
Cedric F. Garland, PhD
Michael F. Holick, PhD, MD
What does the sun do for me?
Interview with Michael F. Holick, PhD, MD
June 2013
Skin Cancer/Sunscreen - The Dilemna
Ed Gorham, PhD
February 2009
 
The Vitamin D Solution 
A 3-step Strategy to Cure our Most Common Health Problems
Michael F. Holick, PhD, MD
More Information 
 
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