Should we opt for sunshine or supplements to get our daily vitamin D?
The Vitamin D Debate - Should we opt for sunshine or supplements to get our daily vitamin D?
Tuesday, March 5, 2019
Dr Susan Mayou, Consultant Dermatologist at the Cadogan Clinic and one of the UK’s leading authorities in skin cancer, gives her view on an article published in Outside about controversial new research (due to be published later this year) on the importance of sunlight for our skin and general health.
Vitamin D is an essential nutrient for the body, enabling absorption of calcium which is essential for keeping bones strong and healthy and promoting bone growth. It also supports a healthy immune system and plays a key role in many biological systems including the heart, lungs, kidneys, brain and muscles. Vitamin D deficiency is linked with a myriad of diseases such as cancer, diabetes, depression, obesity, osteoporosis, stroke, heart attack, autoimmune diseases and cognitive impairment.
Vitamin D is technically a hormone which is synthesised in the skin when exposed to sunlight. With current lifestyles leading us to spend more time indoors and with greater precautions taken with sun protection, statistics show vitamin D deficiency is on the increase.
However, there is also an alarming rise in incidences of skin cancer. Dermatologists have been advising people to minimise sun exposure and to practice sun safety for decades and countless lives have been elongated and saved as a result of this action. Along with the increased risk of developing skin cancer, UV exposure also accelerates ageing of skin with wrinkles, fine lines, loss of elasticity, collagen reduction, sagging and pigmentation, so there are many advantages of practising “safe sun”.
The advice from leading authorities and experts has been to obtain our recommended vitamin D intake from supplements, however, the efficacy of vitamin D supplementation has failed in clinical trials and evidence is mounting that the optimum way to obtain vitamin D is through sunlight.
So just what should we be doing?!
The amount of time individuals need to spend in the sun to synthesise adequate vitamin D varies from person to person. There is no hard and fast rule; skin colour, ethnicity, genetics and skin sensitivity all play a part in our susceptibility to sunburn and developing dangerous forms of skin cancer. Whilst we must continue to be vigilant with our sun protection, we must also rethink our approach to vitamin D absorption in order to safeguard against diseases that have an increased risk with restricted sun exposure.
We certainly cannot suddenly retract the sun safety guidelines that have protected people for decades, but moderation of sun exposure is the key and individuals should approach this responsibly.
For individuals in the UK wishing to get their daily dose of vitamin D, the sun should be enjoyed safely and sensibly, factoring in the strength of the sun and the season. Altitude and reflection should also be considered due to the increased risk posed by sunburn. There are vitamin D tracking Apps available which can be a very helpful resource for those wishing to monitor their vitamin D intake, taking into consideration skin tone, age, height, weight and location. Individuals should also be vigilant with mole checks and at-home mole monitoring (a guideline can be found here)
It is also advised for people to obtain vitamin D through food sources such as oily fish, egg yolks, red meat, liver and fortified foods.
More research needs to be done about sun exposure and vitamin D including the time of day for best absorption, length of time required, skin sensitivity, ethnicity, family history, proximity to the equator, seasons etc in order for medical professionals to make more evidence-based, informed recommendations that will enhance health, rather than compromise it. The last thing we want is for a huge spike in skin cancer diagnosis or mortalities due to a change in advice.
Dermatologists always welcome new research and are constantly challenging and learning in order to give patients the very best advice and to optimise their health. It is important to review results from all medical perspectives and imperative for clinical studies to continue.