Recommended Summer Sunlight Exposure Levels Can Produce Sufficient (≥20ngml−1) but Not the Proposed Optimal (≥32ngml−1) 25(OH)D Levels at UK Latitudes

Rhodes, Lesley E.; Webb, Ann R.; Fraser, Heather I.; Kift, Richard; Durkin, Mike; Allan, Donald; O’Brien, Sarah J.; Vail, Andy; Berry, Jacqueline

doi:10.1038/jid.2009.417

Cited by 139 publications

(123 citation statements)

References 41 publications

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“…UV lamps that simulate sunlight are very effective at producing vitamin D [106] and commercial sunbeds can also be a useful source of vitamin D [128]. However a campaign against sunbeds and tanning salons led by CR UK has emphasized risks of sunbeds without proper consideration of benefits [19].…”

Section: Other Factors Influencing Vitamin D Intake or Synthesismentioning

confidence: 99%

Sunlight robbery: A critique of public health policy on vitamin D in the UK

Gillie

2010

Molecular Nutrition Food Res

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The British Isles have a very cloudy climate and as a result receive fewer hours of clear sunlight than most other industrial regions. The majority of people in these islands have low blood levels of vitamin D [25(OH)D] all year round. Few food products are fortified with vitamin D in the UK and the government does not recommend any vitamin D supplement for most adults in the UK. Diseases associated with vitamin D insufficiency such as cancer, heart disease, diabetes (types 1 and 2) and multiple sclerosis are more frequent in the UK, and particularly in Scotland, than in many other European countries and some, such as multiple sclerosis and diabetes (types 1 and 2), are increasing in incidence. Present knowledge suggests that the risk of some chronic diseases could be reduced if vitamin D intake or sun exposure of the population were increased. Yet policy and public health recommendations of the UK government and its agencies (e.g. the Health Protection Agency, the Food Standards Agency) and of Cancer Research UK have failed to take full account of established and putative benefits of vitamin D and/or sunshine. The epidemic of chronic disease in the UK, which is associated with and caused at least in part by vitamin D insufficiency, has not been adequately recognized by these agencies, and too often measures taken by them have been misguided, inappropriate or ineffective.

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Section: Other Factors Influencing Vitamin D Intake or Synthesismentioning

confidence: 99%

Sunlight robbery: A critique of public health policy on vitamin D in the UK

Gillie

2010

Molecular Nutrition Food Res

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“…No vitamin D is produced by UVA, for example, which makes up the bulk of UV in sunlight at the earth's surface, but it is possible to develop erythema from UVA exposure. Hence, the general recommendation that exposure of around 18% of body surface (face, hands and arms, or legs) to one-third of a minimal erythemal dose of UV should produce around 1000 IU (25 mg) of vitamin D has some basis in the experimental literature (Holick, 2002;Rhodes et al, 2010), but only if the times of exposure are around midmorning to mid-afternoon in summer and around noon in winter. Even then, in winter, no vitamin D is able to be produced at high latitudes 4421 North or South (Webb and Engelsen, 2006).…”

Section: Vitamin D Production In Skinmentioning

confidence: 99%

Vitamin D: the light side of sunshine

2011

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Under normal circumstances, vitamin D is mainly obtained from skin through the action of ultraviolet B irradiation on 7-dehydrocholesterol. It is further metabolized to 25-hydroxyvitamin D (25OHD), the major circulating vitamin D compound, and then to 1,25-dihydroxyvitamin D, the hormonal form. The major function of vitamin D compounds is to enhance active absorption of ingested calcium (and phosphate). This assists in building bone at younger ages and ensures that despite obligatory urinary losses, bone does not need to be resorbed to maintain blood calcium concentrations. Vitamin D compounds appear to have direct effects to improve bone and muscle function, and there is good, although not entirely consistent, evidence that supplemental vitamin D and calcium together reduce falls and fractures in older individuals. On the basis of calcium control and musculoskeletal function, target levels for 25OHD in blood are at least 50-60 nmol/l and there may be a case for higher targets of 75-80 nmol/l. There are vitamin D receptors in most nucleated cells and some evidence, although not consistent, that adequate vitamin D levels may be important in reducing the incidence of, or mortality from, some cancers and in reducing autoimmune disease. Adequate vitamin D may also allow for a normal innate immune response to pathogens, improve cardiovascular function and mortality and increase insulin responsiveness. Vitamin D levels are maintained better in the presence of adequate calcium intakes, more exercise and less obesity. Genetic variation may have an effect on vitamin D blood levels and response to treatment with vitamin D.

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“…42 The lowest MED for the study population was 1.6 SED, showing that vitamin D sufficiency occurred without erythema. Vitamin D sufficiency should be achievable under current messages to use sun protection when the UVI is 3 or greater, provided sun protection is not complete (e.g., there is not complete clothing coverage or sun avoidance such as staying indoors).…”

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confidence: 99%

Are current guidelines for sun protection optimal for health? Exploring the evidence

Lucas

Neale

Madronich

et al. 2018

Photochem Photobiol Sci

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Exposure of the skin to ultraviolet (UV) radiation is the main risk factor for skin cancer, and a major source of vitamin D, in many regions of the world. Sun protection messages to minimize skin cancer risks but avoid vitamin D deficiency are challenging, partly because levels of UV radiation vary by location, season, time of day, and atmospheric conditions. The UV Index provides information on levels of UV radiation and is a cornerstone of sun protection guidelines. Current guidelines from the World Health Organization are that sun protection is required only when the UV Index is 3 or greater. This advice is pragmatic rather than evidence based. The UV Index is a continuous scale; more comprehensive sun protection is required as the UV Index increases. In addition, a wide range of UVA doses is possible with a UVI of 3, from which there may be health consequences, while full sun protection when the UVI is "moderate" (between 3 and 5) may limit vitamin D production. Finally, the duration of time spent in the sun is an essential component of a public health message, in addition to the intensity of ambient UV radiation as measured by the UV Index. Together these provide the dose of UV radiation that is relevant to both skin cancer genesis and vitamin D production. Further education is required to increase the understanding of the UV Index; messages framed using the UV Index need to incorporate the importance of duration of exposure and increasing sun protection with increasing dose of UV radiation.

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Recommended Summer Sunlight Exposure Levels Can Produce Sufficient (≥20ngml−1) but Not the Proposed Optimal (≥32ngml−1) 25(OH)D Levels at UK Latitudes

Cited by 139 publications

References 41 publications

Sunlight robbery: A critique of public health policy on vitamin D in the UK

Sunlight robbery: A critique of public health policy on vitamin D in the UK

Vitamin D: the light side of sunshine

Are current guidelines for sun protection optimal for health? Exploring the evidence

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