For Immediate Release

The Vitamin D Council
9100 San Gregorio Road
Atascadero, CA 93422
805 462-8129
http://www.cholecalciferol-council.com
jjcannell@charter.net

Dr. Reinhold Vieth and his colleagues at the University of Toronto have given hope to millions of people across the world who are suffering from the debilitating symptoms of depression.

In a paper published this week, Vieth and co-workers showed that vitamin D significantly improves mood and helps relieve the symptoms of depression in patients with vitamin D levels most doctors would mistakenly consider to be normal.

Vieth studied a total of 130 patients with summertime vitamin D blood levels less than 24 ng/ml (61 nmol/L) from an endocrinology clinic in two separate studies. During the winter, they treated half the patients with 4,000 units of cholecalciferol a day while treating the control group with 600 units a day (this lower dose is the one recommended officially, by the Food and Nutrition Board, for the elderly). Ethical considerations prior to the study were, that the medical literature is now so clear on the dangers of vitamin D deficiency that no one selected for research because of low vitamin D levels should be denied vitamin D treatment.

Other authors have called for an end to placebo studies on people who are likely to benefit from a treatment. However, Vieth is the first vitamin D scientist to risk studying vitamin D using an active agent in the control group instead of placebo. Studies using active agents as controls are much less likely to show positive differences between treatment groups, thus the researcher risks getting negative results. As usual, Vieth, who started the current vitamin D renaissance with his masterful 1999 paper dispelling the myths surrounding vitamin D toxicity, Vitamin D supplementation, 25-hydroxyvitamin D concentrations and safety , remains on the forefront of the revolution.

Vieth measured various symptoms of depression before and after treatment in both groups of patients using a rating scale that contained typical questions assessing depression, such as:

1. Has your general energy level been less than average lately?
2. Has your mood been less than average lately?
3. Have you had problems sleeping, either too much or too little?
4. Have you lost interest or pleasure in things you normally enjoy doing?
5. Have you had a decrease in your ability to concentrate?
6. Have you lost/gained weight?
7. Has your general health been less than average lately?
8. Have you felt less rested upon waking from sleep lately?
9. Have you experienced a down feeling or inappropriate guilt?
10. Have you felt less socially active lately?
11. Have you been indecisive lately?
12. Have you felt less productive or less creative lately?
13. Has your appetite increased or decreased?
14. Have you experienced any cravings for carbohydrates (bread, pasta, rice, sugary foods), more than normal?
15. Has it been more difficult to deal with daily stress?
16. Have you felt irritable or anxious lately?

Both groups of patients improved with treatment. Those taking 4,000 units of vitamin D improved more than those on 600 units. As expected, 600 units a day left a number of patients vitamin D deficient while the patients taking 4,000 units a day for six months ended up with acceptable vitamin D blood levels. There were no signs of toxicity and none of the patient’s blood tests showed any ill effects from the treatment. In fact, the treatment lowered parathormone levels (PTH) – a good thing because high PTH is associated with bone loss. Most importantly, the patients felt much better.

Vieth’s important work adds to the growing possibility that many patients suffering from depression, or just not feeling well are, in fact, simply suffering from undiagnosed and untreated vitamin D deficiency. For a more thorough review of vitamin D and depression, see one of our previous newsletters at: http://www.cholecalciferol-council.com/Depression.pdf

Dr. Vieth’s paper can be accessed in its entirety at http://www.nutritionj.com/content/pdf/1475-2891-3-8.pdf

John Cannell, MD July 28, 2004

Have we become too scared of the sun?
(Filed: 26/07/2004) http://www.telegraph.co.uk/

Sunburn should be avoided, but new research suggests that excessive caution could starve our bodies of essential vitamin D, reports Christine Doyle

Not so long ago, most people walked every day - not to get fit, but to get some fresh air and feel the warmth of the sun on their faces. Babies were left in the garden in their prams to sleep or were pushed round the park. At ease: 'draconian advice about covering up should be replaced with a sensible sunbathing approach'.

In our climate, regular exposure to sunlight is critical to the strength and renewal of bones. UVA, the ultraviolet rays that redden and, ultimately, burn the skin, turn a precursor of vitamin D in the skin into a form that can "hitch a lift" around the bloodstream. In the kidneys, it is converted into the physiologically active form.

The sunshine vitamin is essential for proper absorption of calcium, a bone-building block, and works in concert with other minerals and vitamins to mineralise bone. For children and adolescents, it is crucial to development. In adults, it helps to prevent our bones from going soft, and counteracts the effects of osteoporosis.

Although calcium is available in food, it is difficult to get enough this way. For the vast majority of people, the best source is sunlight. However, we are now aware of the dangers of excessive sun exposure, and, in particular, the risk of life-threatening skin melanoma. Deaths rose by 25 per cent in the five years from 1995.

About 7,000 people a year are diagnosed with melanoma, and for 1,500 it is fatal. The Government and Cancer Research UK's SunSmart Campaign are determined to get the bleak message across and to encourage people to "slip, slop and slap" on high factor sun cream.

No one would advocate sun-bingeing, which is strongly associated, especially in children and adolescents, with skin cancer in later life. But some experts now wonder whether we are getting enough sunshine.

In a recent report, "Sunlight Robbery", Oliver Gillie, a medical writer and researcher, says SunSmart is based on an assumption that conditions in Britain are similar to those in Australia and we all think we need to cover up, wear hats and sit in the shade, coated in high-factor sunscreen, at the first sight of the sun. We are putting ourselves, he says, at risk of deficient levels of vitamin D in the bloodstream.

One survey suggests that as many as one in four people now do not have the required level of the vitamin in their blood. There is, says Gillie, a mistaken and outdated assumption that any sort of sun tan is bad for us. "In fact, there is evidence to show that tanning in childhood protects against the most serious form of skin cancer later on."

Inadequate levels of vitamin D put babies at risk of developing rickets, largely considered, these days, to be a Victorian disease suffered by deprived children. Two years ago, a disturbing report charted the re-emergence of rickets in the Midlands, mainly among those with dark skins, which take longer for UVA rays to reach the vitamin D precursor.

May to September in this country is - usually - when the sun is at its most intense, and these months provide the best opportunity to squirrel away vitamin D in our fat stores for the autumn and winter ahead. The nearer to the Equator, the less anyone needs to worry about their vitamin D levels.

It is not only our bones that are at stake; vitamin D is also a substance with a wide range of interconnecting actions in tissues. Gillie's report draws together a large number of studies to show that for heart disease, cancer, multiple sclerosis, arthritis and other chronic conditions, sunlight and vitamin D are more essential than previously supposed. "Careful sunbathing could help prevent more than 25 chronic diseases," he finds.

Vitamin D supplements are available, but should be taken with caution. Side effects from overdosing include headaches, weakness, nausea and excessive thirst. Promoting vitamin D formation through sunlight is natural and safe.

Gillie would like to see what he considers the draconian advice about covering up replaced with a sensible sunbathing approach. "Take every opportunity to sunbathe, wearing as few clothes as possible, for up to half an hour or more per day," he says.

"But don't let yourself burn. Allow children to undress in the sun, but do not allow them to burn either."

For office workers, getting out to a park or a café terrace at lunch time on sunny days makes good sense.

However, skin cancer campaigners fear a less rigorous approach will weaken the impact of their message and tempt "sun lizards" to binge on sunshine.

"We accept that vitamin D has an important role, but it is not necessary to sunbathe to produce adequate amounts," says Sara Hiom, a science spokesman at Cancer Research UK.

"Most people get all they need from their daily routine and from food. We do not advocate complete avoidance of sunlight, only that people enjoy the sun safely. Our campaign is not directed at people who are at risk of deficiency, such as those with dark skin, veiled women and the elderly who live in institutions."

Sue Fairweather-Tait, head of the nutrition division at the Institute of Food Research in Norwich, says: "We need much more research to answer the many questions raised in this new report. Some skin specialists continue to say that no exposure to sunlight is best.

"But, looking at the many potential benefits that are emerging, more of us are trying to find a way of balancing the risks and benefits."

Emerging evidence of the wider benefits of exposure to sunlight
(Filed: 26/07/2004)

Mood and mental illness: most people know instinctively that sunshine can lift their mood. Reduced exposure to sunlight and low levels of vitamin D are also associated with seasonal affective disorder, depression and schizophrenia. How this might occur is not clear.

Research suggests that supplements may help to boost the spirits and ease depression - as well as protect bones - in the elderly, many of whom spend most of the time indoors.

Heart disease: less heart disease and fewer heart attacks are found in those who have adequate vitamin D levels, even in areas where heart disease rates are relatively high. In a recent study of four Lancashire towns, Blackpool, which has more hours of sunshine a year than the other three, has nine per cent fewer deaths from heart disease.

High blood pressure: raised blood pressure is linked with lower levels of vitamin D in northern hemisphere countries. Sunbathing may be a good alternative "prescription".

Diabetes: both juvenile and adult-onset diabetes are associated with inadequate levels of vitamin D. Researchers have reported reduced insulin secretion and the body's reduced ability to use insulin.

Muscle weakness: normal levels of vitamin D in the body could play an essential role in maintaining muscle strength. Difficulties in balancing, and regular falls or fractures, are signs of low levels in the elderly.

Skin conditions: many people with skin conditions see an improvement in symptoms after a holiday in the sun. Ultraviolet radiation is already used in the treatment of psoriasis.

Multiple sclerosis: there is a greater frequency of cases of MS at higher latitudes. In 1997, research suggested that the risk might be reduced by exposing children to more sunlight.

Cancers: this is a contentious issue, but mounting evidence suggests that such cancers as breast, prostate, colon and ovary might be, at least partly, influenced by vitamin D deficiency. Vitamin D might promote cancer cell death and prevent spread.

Other conditions in which sunlight and vitamin D may play a preventative role include infections, such as tuberculosis; polycystic ovarian syndrome; heart failure; Crohn's disease and other inflammatory bowel disorders.

How much vitamin D is recommended?

In Britain, the official recommendation for infants up to three years is about 300IU (international units) per day. There is no recommendation for adults, except for those over the age of 65, when 400IU is advised. Expectant mothers are also advised to take the same amount during the last three months of pregnancy to build up stores of the vitamin for the baby during development and breastfeeding.

These figures compare with the American recommendation of 200IU from birth to the age of 51, 400IU up to 70 and 600IU from 71 years. Vitamin D may appear on labels in millimicrograms (mcg). One mcg equals 40IU.

What are the best food sources of vitamin D?

The best sources are oily fish: salmon, mackerel, sardines and herring. A 3.5oz portion of salmon or herring is likely to contain up to 800IU. Butter contains a tiny amount. Some cereals are fortified with vitamin D - study the labels. The yolk of an egg contains about 20IU. A little comes from meat, but this is considered an important source, because we eat a lot of meat.

By law, all margarines and low-fat spreads are fortified, and some buns, cakes and pastries also contain vitamin D. Boiling and heating do not destroy this vitamin. Two teaspoons (10ml) of Seven Seas high strength cod liver oil contain one day's requirement.
# Sunlight Robbery (£12.50 inc p&p) is available from Health Research Forum, 68 Whitehall Park, London N19 3TN, or see www.healthresearchforum.org.uk

http://www.telegraph.co.uk/

Reduce Your Risk of Alzheimer's With Dietary and Lifestyle Changes, Part III
of a 3 part article by Dr. Grant

On Mercola.com

In response to the article "Sunshine warnings are making people ill rather than protecting them" posted 07/05/2004 on MedicalNewsToday.com :

Dietary vitamin D insufficient to prevent cancer
posted by William B. Grant on 06 July 2004 at 2:12 pm

In support of Dr. Gillie's work, a paper was just published indicating that dietary vitamin D is generally insufficient to reduce the risk of colorectal cancer, and, by implication, the risk of many types of cancer, even though total vitamin D from diet, supplements, and solar UVB radiation can reduce the risk of cancer at higher levels:

Grant WB, Garland CF. A critical review of studies on vitamin D in relation to colorectal cancer. Nutrition and Cancer, 2004;48:115-23.

For further information, please contact Robert Wagner, aegis@amexport.com, Cedric Garland, Dr. P.H., or William Grant, Ph.D., wbgrant@infionline.net

Reduce Your Risk of Alzheimer's With Dietary and Lifestyle Changes, Part II
of a 3 part article by Dr. Grant

On Mercola.com

Sunbathing can help prevent more than 25 chronic diseases and save billions

The health of people in Britain is being put at risk by official policy that discourages sunbathing and promotes use of sunblock products. The cost of disease caused by insufficient exposure to sunlight and consequent deficiency of vitamin D is estimated to be billions of pounds per year in Britain.

Government advice to "cover up, keep in the shade…and use factor 15 plus sunscreen"* is based on outdated information, mistaken interpretation of evidence and guesswork. It ignores evidence showing that insufficient vitamin D is closely associated with, and almost certainly is a cause of, dozens of chronic diseases including 16 different types of cancers, several nervous system diseases including schizophrenia and multiple sclerosis, diabetes, raised blood pressure, polycystic ovary disease, menstrual problems, infertility, infections and dental decay.

It may seem incredible that such a long list of very different diseases could all be caused, at least in part, by insufficient vitamin D. However research accumulating over the last 10 years provides solid evidence in hundreds of scientific papers which are summarised in a new report: Sunlight Robbery: Health benefits of sunlight are denied by current public health policy in the UK, written by Oliver Gillie, a former medical correspondent on the Sunday Times and ex-medical editor of the Independent. The report is published by the Health Research Forum**.

Government policy on sunlight is based on a major error, mistaken assumptions and wishful thinking

1. The major error: short periods outdoors produce sufficient vitamin D
The National Radiological Protection Board (NRPB) has asserted that "short periods outdoors, as normally occur in everyday life [in the UK], will produce sufficient vitamin D, and additional or intensive exposures will not confer further benefit". This assertion has been adopted as a basis for UK government policy, although it is based on observations of only nine elderly patients in England over just one summer. Seven of these patients did not achieve high enough levels of vitamin D to provide enough for winter when sunlight is not strong enough to generate any of the vitamin. The NRPB assertion is simply a convenient rationalisation that has no satisfactory basis in scientific evidence - see page 11 of Sunlight Robbery for full analysis.

2. Mistaken assumption No.1: tanning is bad for you
Each year campaigners against skin cancer and sun exposure assert that "there is no such thing as a healthy tan." Authority for this assertion comes from a "Consensus Statement of the UK Skin Cancer Prevention Working Party". This assertion was considered to be dubious ten years ago when the Consensus was formulated and can now be seen to be without foundation.

In fact evidence suggests that a deep tan, particularly in childhood and adolescent years, protects against melanoma, the most serious form of skin cancer; and further evidence suggests that sunbathing, even when it causes sunburn, protects against diseases such as multiple sclerosis and prostate cancer. So tanning should properly be seen as a sign of health, as indeed it is by most members of the public, although care should be taken to avoid burning. For details see pages 29 and 30 of Sunlight Robbery.

3. Mistaken assumption No.2: England is Australia
Cancer Research UK, which is paid by the government to implement policy on prevention of skin cancer, has adopted a campaign, called SunSmart, which was developed in Australia. Australia has a very sunny climate where children get twice as much exposure to the sun as children in the UK. The SunSmart policy makes no allowances for the fickle English climate which is typically cloudy even in midsummer. To ensure optimum levels of vitamin D and optimum health people in the UK need to sunbathe whenever they can wearing as few clothes as possible while taking care not to burn. Vitamin D obtained from food provides only about 10% of our needs. See pages 11-13 and 27-29 of Sunlight Robbery.

4. Wishful thinking: suncream prevents skin cancer
The Department of Health recommends use of factor 15 plus sunscreen (Chief Medical Officer's Sixth Tip for better health). However there are serious doubts whether sunscreen actually protects against skin cancer and some evidence actually suggests that use of sunscreen is associated with greater risk of cancer. To suggest that sunscreen may prevent skin cancer is wishful thinking. Furthermore use of a strong sunscreen prevents sunlight from generating vitamin D in the skin, virtually ensuring vitamin D deficiency in people who regularly use suncream. Putting on suncream regularly before going out, as recommended by Cancer Research UK, risks serious vitamin D deficiency in the long term. Suncream should only be used after about 5-10 minutes exposure to the sun according to skin type, time of day, time of year and cloud cover. See Pages 29 and 30 of Sunlight Robbery.

Copies of Sunlight Robbery have been sent to health ministers John Reid, Rosie Winterton, Melanie Johnson, the Chief Medical Officer, Sir Liam Donaldson, and Cancer Research UK.

The report has been peer-reviewed by experts round the world who have described it as "comprehensive", "impressively detailed", "excellent". See back cover for full comments of international experts.

A new understanding of vitamin D has emerged in recent years which explains how deficiency of the vitamin can cause so many different diseases. Vitamin D is now known to act as a vital steroid hormone in 30 or more tissues of the body where it controls the activity of cells.

Vitamin D is best known for its role in regulating the absorption of calcium and the deposition of calcium in bones. It regulates calcium in other body tissues as well, including cells which, for example, control blood pressure and nerve activity. In addition vitamin D has a direct action on genes, switching them on and off and so regulating growth and activity of various organs during development and later.

These newly discovered actions of vitamin D explain how deficiency of D, which may occur during pregnancy or at any time in life, may cause such a wide spectrum of diseases. Shortage of vitamin D during pregnancy or breast feeding, for example, is associated with development of juvenile diabetes (diabetes type 1) and schizophrenia. To reduce risk of these diseases women of reproductive age, and particularly women who are pregnant or breast feeding, should be advised to sunbathe safely taking care not to burn. (See pages 14-22 of report for details of diseases caused by inadequate vitamin D.)

Research ignored by agencies advising government

This new research on vitamin D has been largely ignored by government which has been advised by, among others, the National Radiological Protection Board, the Food Standards Agency, Cancer Research UK and allied bodies. Advice produced by these bodies has been partial or incomplete.

The NRPB report, published in 2002, devoted only one page to effects of vitamin D on body tissues other than bone, a totally inadequate appraisal of research that is the subject of thousands of scientific papers. The Food Standards Agency produced a draft expert report on vitamin D, completed in November 2001 and circulated in 2002, which received such crushing criticism from at least one international expert that it has not yet been published. Cancer Research UK has based much of its advice on a Consensus Statement which is now 10 years old. Additional advice from Cancer Research UK has been based on an Australian programme called SunSmart which is designed for a country with a climate ranging from tropical to southern Mediterranean and is totally unsuited to the UK (see pages 27-29 of the report).

* quote taken from the Chief Medical Officer's 'Sixth Tip' for better health published in Choosing Health? Spring 2004, Resource Pack, DoH - see also page 30 of report.

** Health Research Forum is a not for profit organisation devoted to discussion of health issues - details at www.healthresearchforum.org.uk

Contact: Oliver Gillie 020 7561 9677, email: olivergillie@compuserve.com
Further Copies: copies can be downloaded free from www.healthresearchforum.org.uk

Vitamin D experts:

Sue Fairweather-Tait, head, Nutrition Department, Institue of Food Research. Norwich. Tel: 01603 255000

Richard Strange, professor of clinical biochemistry, Keele University, Staffs. Tel: 01782 715 444

Cyrus Cooper, professor, School of Medicine, University of Southampton. Tel: 023 8077 7624

Reinhold Vieth, professor, Mount Sinai Hospital, Toronto, Canada. Tel: 001 416 586 5920

Dr Gregory Plotnikoff, associate professor of medicine and pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA. Tel: 001 612 624 9440

Bruce W Hollis, professor of pediatrics, biochemistry and molecular biology, Medical University of South Carolina, Charleston, USA. Tel: 001 843 792 6854

John McGrath, professor of psychiatry, University of Queensland, Australia. Tel: 0061 7 3271 8694

Reduce Your Risk of Alzheimer's With Dietary and Lifestyle Changes, Part I
of a 3 part article by Dr. Grant

On Mercola.com

A letter to the EPA's Sunprotection listserv regarding Vitamin D and melanoma

View the MS Word file HERE

Response to EPA and NOAA's New Global UV Index Guidelines, second round
William B. Grant, Ph.D., SUNARC

With input from:
Cedric F. Garland, Dr.P.H., F.A.C.E.
Department of Family and Preventive Medicine, 0631C
School of Medicine, University of California, San Diego
cgarland@ucsd.edu

and Gordon Ainsleigh, D.C., Auburn, Calif.,
drgordon@auburninternet.com

View the MS Word file HERE

Nutrition: The Sunny Side of the Street
By JOHN O'NEIL

Published: June 8, 2004, New York Times

Parents may worry about teenagers who spend the summer hanging out on street corners, but at least they are building up plenty of Vitamin D.

A surprising number of adolescents do not have adequate levels of Vitamin D in their blood, according to a study released yesterday.

Vitamin D is important for people of all ages, but especially for children and adolescents, because of its role in bone formation. The body depends on sunlight to make the vitamin.

In the study, published in The Archives of Pediatrics and Adolescent Medicine, 307 teenagers who were receiving physicals in a clinic in Boston were tested for blood levels of Vitamin D. They were also asked about diets and other habits.

The researchers found that 24 percent of the teenagers suffered vitamin deficiencies, under a strict definition, and that 42 percent failed to meet a broader standard.

The youths tested in the winter had lower levels than those tested in the summer, and African-American teenagers had lower levels than whites. Pigment in dark skin blocks some of the sun's rays from reaching the cells where the vitamin is produced, the article said.

A letter to the EPA's Sunprotection listserv regarding EPA and NOAA's New Global Ultraviolet Index Guidelines (Guidance helps reduce overexposure to dangerous UV rays)

View the MS Word file HERE

A letter to California State Senator John L. Burton in opposition to AB2193
The California bill, which now goes to the Senate for consideration, requires teenagers to have a doctor or surgeon's prescription before being allowed to tan indoors.

View the MS Word file HERE

Vitamin D Deficiency Called Major Health Risk
by Rob Stein
Washington Post

Download PDF file HERE

Debunking “The Myths and Realities of Vitamin D and Sun Exposure” by the American Academy of Dermatology

William B. Grant, Ph.D.

Founding Director,

Sunlight, Nutrition and Health Research Center (SUNARC)

www.sunarc.org

wbgrant@sunarc.org

(The original press release is presented with responses by SUNARC in bold type.)

American Academy of Dermatology Challenges Validity of Recent Claims Promoting 

Health Benefits of Intentional Sun Exposure

NEW YORK, May 3 /PRNewswire/ -- Recent media coverage of unsubstantiated reports linking the health benefits of vitamin D to unprotected sun exposure is leading to further confusion among the public.  For decades, dermatologists have advised the public to practice proper sun protection to prevent skin cancer -- and that same advice holds true today, despite any claims to the contrary.

Speaking today at the American Academy of Dermatology's (AAD) Melanoma/Skin Cancer Detection and Prevention Month news conference, dermatologist Darrell S. Rigel, M.D., clinical professor, New York University Medical Center in New York City, debunked the current myths about vitamin D and offered practical advice on getting an adequate supply of this nutrient.

"As a dermatologist who treats the ravages of skin cancer on a daily basis, it is appalling to me that anyone in good conscience could make the claim that intentional sun exposure -- for any length of time -- is beneficial," stated Dr. Rigel.  "The fact is, skin cancer is increasing at an alarming rate and scientific research confirms that our best defense is avoiding excessive, unprotected sun exposure."

Dr. Rigel addressed the most common myths about vitamin D and sun exposure, including:

Myth #1 -- Regular use of sunscreen blocks ultraviolet (UV) exposure to the skin and leads to decreased vitamin D levels.

Fact -- A 1997 study published in the Journal of the National Cancer Institute of patients with Xeroderma Pigmentosa (a disease that causes multiple skin cancers in persons exposed to the smallest amounts of ultraviolet radiation), who have had maximum UV protection over several years, showed that these patients have normal vitamin D levels despite virtually no UV exposure.

SUNARC’s response.  This is not a good test of the use of sunscreen and vitamin D.  A better reference is:

Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D. A preliminary study.

Matsuoka LY, Wortsman J, Hanifan N, Holick MF.

Department of Dermatology, Jefferson Medical College, Philadelphia, PA 19107.

Sunscreens block the absorption of the sunlight spectrum responsible for the cutaneous synthesis of vitamin D (ultraviolet B). The present study was prompted by our observation of suppression of cutaneous vitamin D formation by a single application of sunscreening agents. We measured the index of vitamin D body store, serum 25-hydroxyvitamin D (25-OH-D) level, in 20 long-term users of p-aminobenzoic acid (PABA) and in 20 controls matched by age and exposure to sunlight. Serum 25-OH-D levels were significantly lower among long-term PABA users than among normal controls: 40.2 +/- 3.2 vs 91.3 +/- 6.2 nmol/L. Furthermore, vitamin D deficiency, ie, 25-OH-D levels below 20.0 nmol/L, was seen in two PABA users and in none of the controls. This preliminary study suggests that long-term use of PABA may be associated with low body stores of vitamin D in some persons.

Myth #2 -- It takes a significant amount of UV exposure to maintain normal levels of vitamin D.

Fact -- Normal vitamin D levels are easily maintained through routine daily activities (even when wearing sunscreen) and a normal diet. Supplemental vitamin D tablets are typically not needed.

SUNARC’s response:  This statement is incorrect for most Americans.  First, dietary vitamin D is insufficient to reduce the risk of colorectal cancer.  A review of 11 cohort studies of dietary vitamin D and development of colorectal cancer or colorectal adenomas found only 1 for which dietary vitamin D was a significant risk reduction factor.  However, when vitamin D from all sources or serum 25-hydroxyvitamin D (25(OH)D) was studied, almost all studies found a significant protective role.  [Grant WB, Garland CF. A critical review of studies on vitamin D in relation to colorectal cancer. Nutrition and Cancer, in press (accepted mid-February 2004)]

Second, it is impossible to produce vitamin D from solar UV exposure in Boston during the 4 darkest months of the year.

Third, many people are at risk of vitamin D deficiency due to such factors as dark skin pigmentation, spending most time indoors, covering up too much, etc.

Myth #3 -- Sunscreen blocks all of the UV radiation hitting the skin, so that those wearing sunscreen cannot form vitamin D.

Fact -- There is no such thing as a total (or even near total) UV block. Even the most effective sunscreens currently on the market let through enough UV to allow for adequate vitamin D formation.

SUNARC’s response: see response to Myth #1.

Myth #4 -- Skin cancer is not a dangerous disease, so protection is not very important.

Fact -- One American dies every hour from melanoma, the most serious form of skin cancer.

SUNARC’s response.  Melanoma has a number of risk and risk reduction factors.  Those who are exposed to UVR occupationally generally have a reduced risk of melanoma.  That finding is probably due to the protective role of the melanin from tanning.  Black Americans rarely develop melanoma, and are at most risk of vitamin D deficiency.  Risk factors for melanoma include skin type that does not tan, freckles, red hair, numerous nevi, a high-fat, low fruit and vegetable diet, and, very likely, smoking.  Urging people to avoid solar UVB, the most important source for most Americans, simply because some people develop skin cancer is akin to urging people not to drive automobiles, which kill 40,000 Americans annually.  Skin cancer is due to excessive UV exposure and sunburning.  Neither is required for adequate vitamin D production, just as speeding, driving while under the influence or talking on cell phones, are not required for normal transportation.

Myth #5 -- Decreased vitamin D levels lead to increases in other cancers and other diseases.

Fact -- "There are no scientific studies that prove this statement," explained Dr. Rigel.  "The claim is based on a study that finds that overall cancer rates are higher in the northeast United States, a location with lower sunlight levels than many other places in the country.  Those making this claim conclude that since the northeast has lower UV levels, this is the reason why cancer rates are higher in this region.  However, several studies prove this theory is false.  These include studies that show that cancer rates are low in the northern plain states (areas with the lowest UV levels in the country) and small regional studies (New York state), where cancer rates are highest in areas with industrial pollutants and are not related to sunlight levels."

SUNARC’s response.  This statement is a feeble attempt to refute Grant [2002].  This paper is a highly regarded paper and has not been refuted in the scientific literature.  It is, however, being extended by consideration of other factors that affect the risk of cancer in the U.S.  The additional factors are smoking, alcohol consumption, Hispanic heritage (the category white Americans includes Hispanics), degree of urbanization, and fraction of population living below the poverty level [Grant, submitted].

Grant WB. An estimate of premature cancer mortality in the United States due to inadequate doses of solar ultraviolet-B radiation, Cancer. 2002;94:1867-75.

http://www3.interscience.wiley.com/cgi-bin/abstract/91016211/START (30 ISI citations) (note – this puts the paper in the top 1 percentile of clinical medicine papers published in 2002; threshold = 26 on May 1, 2004) http://www.in-cites.com/thresholds-highly-cited.html

The possibility that smog in urban regions could be a contributing factor to the high cancer mortality rates in the largely urban northeast was considered and found not to be the case.  There were seven cancers for which degree of urbanization was an important risk factor, such as breast, colon, and ovarian cancer.  UVB is an important risk reduction factor for all of these cancers, with lung cancer inconsistently or weakly associated [Grant, submitted].

As for the cancer mortality rates in the northern plains states (North and South Dakota), they are generally much lower than in the northeast, e.g. breast cancer 31.7 deaths/100,000/year from 1970-94 vs. 26.0 for North Dakota and 26.2 for South Dakota; colon cancer: 24.5 for NY males vs. 18.0 for ND males and 19.1 for SD males; 17.6 for NY females vs. 13.2 for ND females and 15.5 for SD females.  Thus, breast cancer rates are 21% higher in NY than the ND/SD average, while colon cancer rates for NY are 32% higher for males and 23% higher for females.  Interestingly, males in NY have 27% higher skin cancer mortality rates than males in ND and SD (1.12 vs. 0.80 and 0.94).  The skin cancer mortality rates inversely mirror the other cancer mortality rates.

A recent study found that diagnoses of breast, colon, and prostate cancer in Norway during summer and fall, the seasons with the highest level of vitamin D(3), revealed the lowest risk of cancer death. CONCLUSION: The results suggest that a high level of vitamin D(3) at the time of diagnosis, and thus, during cancer treatment, may improve prognosis of the three cancer types studied.

Robsahm TE, Tretli S, Dahlback A, Moan J. Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes Control. 2004 Mar;15(2):149-58.

As far as regional NY studies go, one recent study did find that women living within a mile of a hazardous waste site had significantly elevated breast cancer risks sue to pesticide exposure, but one such finding hardly explains the variations between states.  A search of PubMed failed to uncover any other paper related to industrial pollution and cancer in New York.

As for other diseases, multiple sclerosis (MS) is a disease with a very pronounced increase in prevalence with increasing latitude in the U.S., Europe, and Australia.  The best explanation of this relationship is that UVB exposure, through production of vitamin D, greatly reduces the risk of developing MS and even reduces the symptoms of MS.  I estimate that half of the 400,000 Americans who suffer from MS do so due to insufficient UVB/vitamin D.

In addition, a number of other diseases can be prevented or treated with adequate levels of vitamin D including muscle pain, bone diseases, psoriasis, hypertension, rheumatoid arthritis, autoimmune diseases such as type 1 diabetes and brain disorder diseases such as schizophrenia.  The health benefits of adequate UVB exposure/vitamin D greatly outweigh the adverse effects of UV exposure, which are largely due to over exposure.

"When we take a close look at these myths and evaluate the facts, the course of action is clear," said Dr. Rigel.  "Until there is science that tells us otherwise, it is imperative that people protect themselves from the sun.  Anyone concerned about not getting enough vitamin D should either take a multivitamin or drink a few glasses of vitamin D fortified milk every day. Given the fact that the U.S. Department of Health and Human Services has declared UV radiation as a known carcinogen, exposing oneself to it for the sake of vitamin D is not the answer." 

The AAD recommends that everyone practice a comprehensive sun protection program, including avoiding outdoor activities between 10 a.m. and 4 p.m. when the sun's rays are the strongest, seeking shade whenever possible, wearing a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of at least 15 and reapplying it every two hours, and wearing sun-protective clothing.

SUNARC’s response: One problem with the recommendation to avoid outdoor activities between 10:00 a.m. and 4:00 p.m. is that UVB irradiances are highest during this period, so the time required in the sun for vitamin D production is reduced.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations.  With a membership of more than 14,000 dermatologists worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails.  For more information, contact the AAD at 1- 888-462-DERM (3376) or www.aad.org .

SUNARC’s response:  The AAD is composed of dermatologists who treat people with skin conditions including melanoma and other skin cancer.  They are trying to do a public service to suggest how people can reduce their risk of skin cancer.  Unfortunately, they take a very parochial point of view and do not see the bigger picture.  I have tried unsuccessfully to engage the leadership of the AAD in a scientific debate regarding the benefits and risks of UV exposure.  I will admit risks due to sunburning and excess UV exposure, but call upon them to admit that UVB is an important source of vitamin D for most Americans.

SOURCE  American Academy of Dermatology 

CO:  American Academy of Dermatology

ST:  New York, Illinois

SU:  SVY

Web site:  http://www.aad.org

http://www.prweb.com/releases/2004/5/prweb123428.php

"Killer Tan" sees world darkly; UVB is very beneficial

Dr. Grant's response to the article "A Killer Tan" by Hallie Levine published 31 March, 2004 in Prevention Magazine.

http://forums.prevention.com/thread.jsp?forum=10&thread=53166

Re: Hallie Levine "A Killer Tan” in the May 2004 issue of Prevention
By: William B. Grant, Ph.D., founding director of Sunlight, Nutrition and Health Research (SUNARC)

Here is the paragraph with my name attached on p. 161:
"The tanning industry's other major point--that avoiding the sun (or sunlamps) may put you at increased risk of prostate, lung, breast, colon, ovarian, and pancreatic cancers--is based on research conducted by William Grant, PhD, a NASA scientist whose work is partially funded by the Indoor Tanning Association. These claims, detailed in an October 2003 industry press release, have been dismissed by the dermatology community. "It is dangerous to mislead the public into thinking sunlight is a safe and effective 'cure' for other health conditions" says Raymond L. Cornelison Jr., president of the AAD.”

I would like to take strong exception to this paragraph.

1 – There are 16 types of cancer for which ultraviolet B (UVB) radiation, through the production of vitamin D, reduces the risk. Lung cancer is not one of them. For the complete list, please visit my web site, www.sunarc.org

2 – When I did the research on cancer risk reduction by UVB radiation, I was employed by NASA. However, I did the UVB/cancer research on my own time and did not receive funding from the Indoor Tanning Association (ITA) or from anyone else during that time other than reimbursement for expenses for conference attendance and presentations. I have no association with the ITA and have never been funded by the ITA. I retired from NASA at the end of January 2004 and founded SUNARC.

3 – Dismissing my findings as Dr. Cornelison did with a cursory statement is not the same as showing in a proper scientific manner that they are incorrect. My original findings were published in the March 2002 issue of Cancer (Grant WB. An estimate of premature cancer mortality in the United States due to inadequate doses of solar ultraviolet-B radiation, Cancer. 2002;94:1867-75). This paper has received 29 citations in the peer-reviewed journal literature, which puts it in the top one percentile of clinical medicine papers published in 2002. The primary criticism of the work was that it failed to include other factors, such as smoking and alcohol, in the analysis. I have rectified that deficiency and found that living in an urban region further reduces UVB exposure, thus putting urbanites at increased risk for cancer and other vitamin D deficiency diseases. The results for smoking, alcohol, and Hispanic heritage in my latest work are very much in line with results in the peer reviewed literature, which give a high degree of confidence to the findings regarding UVB doses and urban residence. The only factor not included in the analysis is diet, but since Americans throughout the U.S. eat very similar diets, diet does not explain the large geographic variation in cancer mortality rates in the U.S. That work is currently under review by a major cancer journal. If Dr. Cornelison and members of the AAD really think my scientific findings are incorrect, they are free to submit a manuscript detailing their objections to a journal of their choice. Of course, I would be able to respond in a scientific manner as well.

I communicated my findings to Dr. Cornelison in August 2003, enclosing the issue of NewScientist with the cover story by C. Biever, Bring me sunshine, New Scientist, 2003 Aug. 9:30-33; How much is too much? New Scientist, 2003 Aug. 9:3 (www.newscientist.com) with a request that he and the American Academy of Dermatology enter into a dialog with me and others who have researched the health benefits of UVB radiation to see whether we could work out a set of guidelines for UVB exposure that would maximize the health benefits while minimizing the health risks. He did not respond. It was also interesting that when I made my presentation on the benefits of UVB radiation and vitamin D for cancer and other non-calcemic diseases at the National Institutes of Health conference Vitamin D in the 21st Century: Bone and Beyond (Bethesda, MD, Oct. 9-10, 2003), the 3-4 staff members of the AAD walked out. I suppose they didn’t want to be confused by facts that did not fit in with their organization’s stance on UV exposure. I can understand where they are coming from – they treat people who have skin cancer and want to do everything they can to help prevent skin cancer. However, they just do not see the larger picture and refuse to acknowledge the health benefits of UVB in a balanced manner. Regarding other points made or not made in the story.

4 – I told Ms. Levine that my research finds that 45,000 Americans die prematurely from 16 types of internal cancers annually due to insufficient UVB/vitamin D, which is much larger than the 10,000 who die from melanoma and skin cancer. It should be noted that there are many risk factors for these cancers other than UV radiation, such as smoking, a high-fat diet, obesity, lack of antioxidant vitamins, fair skin, sunburning, especially in youth, arsenic and other toxins, etc., so not all 10,000 are due to UV radiation. I also mentioned that half of the 400,000 with multiple sclerosis (MS) in the U.S. would likely not have MS if they had sufficient UVB/vitamin D.

5 – Ms. Levine uses anecdotal evidence on melanoma incidence by a few people who frequented indoor tanning facilities. That is akin to interviewing 2-3 people who were in serious automobile accidents and then urging people not to drive automobiles. In fact, the two studies referenced in Young’s review of the association between indoor tanning and melanoma in the U.S. found no significant risk. The one conducted in San Francisco actually found a slight but insignificant reduction in risk, while the one conducted in Connecticut found a slight but insignificant risk. These results are in sharp contrast with results from Canada and Europe, where 50% increases in melanoma risk are found. I attribute the differences to better regulations regarding usage of indoor tanning facilities in the U.S. and better adherence to these regulations.

6 – Another problem is the statement “the amount of sunlight a fair-skinned person needs to make a whole month’s supply of vitamin D is about 5-10 minutes three times a week—just on the face.” That is an often-quoted value, but it is not consistent with the facts as I see them. Cancer mortality rates for breast, colon, ovarian, rectal, etc. cancers are about twice as high in the urban northeast than in the rural southwest. Also, the prevalence of multiple sclerosis increases rapidly with latitude in the U.S., Australia, and Europe, which is due to decreasing UVB with increasing latitude. Assuming that casual solar UVB radiation exposure is the largest source of vitamin D in the U.S., then 5-10 minutes a day may be ok in the southwest, but not in the northeast. I think that 15-30 minutes a day of casual UVB exposure to hands and face daily in summer is required for those with fair skin; the time required increases with degree of pigmentation: those with very dark skin may require several hours of exposure per day. The best time of the day is midday, since the UVB to UVA ratio is higher, and one can obtain the requisite amount of UVB in a shorter time. Also, it should be noted that for 4 months of the year it is impossible to generate vitamin D from solar UV in Boston since the UVB levels are very low in the darkest months of the year. I recommend indoor UVB exposure or supplements for those who can’t get enough solar UVB.

7 – The quote Robert Heaney as saying “The same UVB rays that create vitamin D can destroy it in your skin” is correct but misleading in his opinion on the value of UVB radiation. See his recent paper, Heaney RP. Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr. 2003 Nov;78(5):912-9. Review. The abstract can be found at PubMed: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi The abstract concludes with the statement: “Because the intakes required to prevent many of the long-latency disorders are higher than those required to prevent the respective index diseases, recommendations based solely on preventing the index diseases are no longer biologically defensible.” Thus, UVB and vitamin D requirements are being revised upward.

8 – I note that on p. 197 of the May issue of Prevention there is an ad for Solumbra, “Serious Sun Protection.” It appears in the middle of “Killer Tan.”

9 – In my opinion, the article “Killer Tan” lacks objectivity and should be considered a work very likely commissioned by the AAD as an element in their ongoing but misguided effort to put Americans back in the “dark ages.”

In my opinion, “Sunshine is the best medicine.”

American Academy of Dermatology Teams Up with Drug Stores and Coppertone® to Mislead Sun-Tanners about Health Benefits of Sunshine

National Association of Chain Drug Stores, Schering-Plough, The Walt Disney Company and Roche Vitamins back controversial advocacy group —

Origianlly posted on eMediaWire.com

Atlanta, GA (PRWEB) April 5, 2004 -In an effort to sell more sun care lotions and vitamins, a new, self-serving advocacy group - “The Sun Safety Alliance (SSA),” is masquerading as an objective professional association to dissuade people from enjoying the Vitamin D health benefits associated with ultraviolet light.

SSA is being formed as a nonprofit coalition. Supported by the American Academy of Dermatology (AAD), SSA's founding members are The National Association of Chain Drug Stores (NACDS), and Schering-Plough HealthCare Products’ Coppertone® sun care products (NYSE:SGP) - and include Roche Vitamins and The Walt Disney Company’s (NYSE: DIS) DisneyHand program as members. In order to sell more products, the group is planning to launch a retail store merchandising campaign disguised as an educational program.

Outlawing Bikini’s Next?

“Short of advocating the outlawing of the bikini, both the SSA and the AAD have ignored more than 60 years of scientific research which shows no definitive link to melanoma from occasional and moderate sunlight exposure,” said Michael Stepp, a widely published UV researcher and expert, and president and CEO of Wolff System Technology. “Both groups are using fear tactics to drive the sales of sun lotions, vitamins and visits to dermatologists, which benefit their members.

In a press release issued by the SSA and Coppertone, Wolff System Technology believes SSA has misled the media by making or attributing the following false claims:

SSA Point:

The U.S. Department of Health and Human Services (HHS) recently declared UV radiation from the sun as a known carcinogen.

Wolff Counterpoint:

The descision to list this - which the FDA does not support - has raised more questions than it answers: HHS acknowledges it does not address or attempt to balance potential benefits of use of alleged carcinogen-causing products. The list does not mean that moderate tanning will cause skin cancer.

There is little support for an association between exposure to sunlamps or sun beds and non-melanocytic skin cancer. Wolff System Technology contends that responsible tanning in moderation is the answer to warnings issued by dermatologists and government agencies of potential skin damage from indoor tanning.

SSA Point:

Taking vitamin D supplements or drinking fortified milk can offset Vitamin D deficiency.

Wolff Counterpoint:

Ultraviolet rays trigger the formation of vitamin D in the skin, accounting for 90 percent of the daily-recommended intake. Vitamin D from UV light stays in your body longer. Dr. Michael F. Holick, director of the Bone Health Care Clinic at Boston University Medical Center and one of the world's foremost vitamin D experts, recommends 1,000 IU daily for everyone through a combination of safe exposure to sunlight and supplements.

An eight-ounce glass of milk only contains 100 IU. Dr. Holick’s studies revealed that most Vitamin D fortified milk contains less than 20 percent of the amount listed on the label, half contains less than 50 percent and 14 percent of skim milk samples contained no detectable vitamin D.

A typical multivitamin has 200 to 400 IU. Other good dietary sources of vitamin D include salmon, which has 425 IU per 3-ounce serving; and cod liver oil, which has 1360 IU of vitamin D per tablespoon.

The AAD claims each year that even moderate exposure to sunlight can have deadly consequences. These stories come from a professional society representing dermatologists, and are sometimes persuasive to both consumers and the media. Anti-tanning lobbyists such as the AAD have intentionally confused the public to believe that any UV light exposure is dangerous. In fact, regular moderate sun exposure is not linked to melanoma, but intermittent sunburn – particularly among those who are predisposed to sunburn - is believed to be the risk factor.

During the past several months, several important new developments have been presented to scientific forums that underscore the vital role vitamin D plays in human health. While the indoor tanning industry promotes its services for cosmetic purposes, the production of vitamin D from exposure to ultraviolet light is a well-documented side effect of tanning outdoors under the sun or indoors in a professional tanning facility. The sun's rays are a key source of vitamin D, which reduces the risk of colon, breast, prostate and other cancers.

Vitamin D, commonly known as the “sunshine vitamin,” is created in the body after exposure to sunlight and is essential for maintaining proper health, including the body's absorption of calcium and the proper function of muscles. Recent reports by The Journal of the American Medical Association, The New York Times, CNN, WebMD, The Chicago Tribune, Newsday and NBC News have been fair and balanced presenting both sides of the story, which is contrary to the ADA message of sun avoidance. Every May, the ADA has issued sun exposure warnings as part of their ”Melanoma/Skin Cancer Detection & Prevention Month” campaign.

What the SSA and the AAD Aren’t Telling You

· The cancer risk has been debunked - sunlight does not trigger deadly basil-cell melanoma, genetic risk factors and irresponsible tanning leading to a sunburn does - Cancer Journal - Journal of the National Cancer Institute, Vol. 95, No. 20, 1530-1538, October 15, 2003

· Sunlight - natural or artificial - is vital to human health, and our increase in antibiotics driven by pharmaceutical industry marketing has led to reduction in exposure to sunlight - leading to a sharp increase in the number of preventable illnesses and health problems. http://www.nichd.nih.gov/about/od/prip/index.htm

· Two just-published studies (from Harvard and Oxford universities) have established that appropriate exposure to UV-B sunlight (from natural or artificial sources) reduces the risk of developing multiple sclerosis by 40% -mitigating painful attacks that MS sufferers experience.

· A study published in the Journal of the American Medical Association links vitamin D deficiency to increased risk of colon polyps, and the maintenance of recommended levels of vitamin D to a distinct decrease in risk for the formation of these polyps, which can ultimately turn cancerous.

· The cause(s) of melanoma skin cancer is (are) unknown. Data strongly suggests that genetics has a far greater influence than do external factors such as sun exposure, though there seems to be some correlation between intermittent overexposure early in life (bad sunburns during youth) and melanoma later in life. Researchers at the University Hospital in Tuegingen, Germany, recently made a discovery confirming Australian Dr. Richard Sturm’s thesis that melanoma occurs in people who are genetically predisposed to the disease, and that little, if no evidence exists to suggest that UV exposure plays any role whatsoever in its development. Over the past 6-8 months, vitamin D studies supporting the health benefits from UV-B exposure have become more and more prevalent, culminating in the recent NIH conference held last October. http://www.carcinogenesis.com/content/2/1/7

· In October 2003, the National Institutes of Health convened a group of scientists for a conference "Vitamin D and Health in the 21st Century," aimed at exploring a troubling re-emergence of health problems, such as rickets, related to Vitamin D deficiency. Scientists there credited the "alarming prevalence" of Vitamin D deficiency in the U.S. population today mainly to weight-conscious or lactose-intolerant Americans avoiding dairy products, and those worried about skin cancer avoiding the sun. http://www.fdalistingconsultants.com/nihvitdconf.pdf.

Testifying in October at a "Vitamin D and Health in the 21st century" conference called by the National Institutes of Health's Office of Dietary Supplements, William B. Grant, a retired NASA senior scientist and solar radiation expert, said his studies determined that lack of vitamin D accounts for 45,000 cancer deaths annually and 165,000 new cancer cases.

· Earlier this year, a study published in the Journal of the American Medical Association found a diet rich in vitamin D protected people from developing potentially cancerous growths in the colon.

· The journal Neurology found that women who took vitamin D supplements were 40 percent less likely to develop multiple sclerosis. (January 2004)

· Last year the journal Mayo Clinic Proceedings reported there is new evidence that small amounts of unprotected sun exposure could be good for you.

· A University of Minnesota study linked chronic pain to an ongoing vitamin D deficiency. The study also noted that osteoporosis, hypertension, diabetes, cancer, and autoimmune diseases such as multiple sclerosis could be prevented or lessened in severity by the intake of vitamin D. It also is harmful for developing fetuses and causes rickets in children.

· According to the UVR Research Institute, for every person who dies prematurely each year as a consequence of overexposure to UVR, there are 100 people who die prematurely each year as a consequence of underexposure to UVR. Research has shown that moderate UV exposure may be associated with a decrease in the risk of breast, prostate, colon and ovarian cancer, and has also been linked to reducing high blood pressure, and to reducing the risk of osteoporosis.

· In February, Dr. Neil Walker, chair of the skin cancer prevention coalition in Britain - a visible leader in the European dermatology community - called for his colleagues to stop telling people to stay out of the sun and to completely re-examine their anti-tanning message, calling the dermatology industry's absolute anti-sun message "draconian and unnecessary."

· Epidemiologic studies linking exposures to skin cancer are limited because they lack information on the specific wavelengths of UVR to which the individuals were exposed. Tanning beds used in these studies involved the use of lamps used in the early 1970’s, which produced significant amounts of UVB and are not being sold today. Originally, tanning beds used in the study were built with mercury arc lamps, which emitted large quantities of UVB and UVC. Today’s lamps emit mostly UVA.

· According to the UVR Research Institute, unlike mice commonly used in research, humans’ own natural skin color and acquired pigmentation - better known as a "tan" - work synergistically to protect human DNA from damage. Therefore, the "core" or baseline business of indoor tanning salons delivering UVR is that they help their clients develop protective pigmentation when possible and often will protect the skin from being sunburned.

· Ultraviolet light therapy is also used to treat psoriasis, a chronic skin disease affecting millions of Americans, and other skin disorders. Exposure to UV can prevent osteoporosis as well.

· Indoor tanning is a more manageable, cautious alternative to the risks of outdoor tanning because the amount of time and the intensity of the skin's exposure to ultraviolet rays are controlled. Building a tan gradually and responsibly helps avoid damaging consequences of too much exposure to the sun.

Putting it all in proper perspective

According to the AAD there will be about 95,880 new cases of melanoma in 2004, which will claim the lives of an estimated 7,910 people during the year.

In contrast:

Despite the SSA’s special interest caused by founding member Coppertone®, sunscreen has not been shown to reduce the risk of melanoma [Dennis et al., 2003]. According to Dr. Holick’s new book, “The UV Advantage”, SPF 8 reduces Vitamin D production by 97.5 percent and SPF 15 reduces it by 99.9 percent. This blocks out the sun that humans need to produce Vitamin D.

400,000 Americans have multiple sclerosis. Recent studies indicate that 50% of the cases can be prevented through UVB exposure through the production of vitamin D. Thus, 200,000 cases of multiple sclerosis in the U.S. may have been prevented through moderate exposure to UVR.

According to published research by Dr.William Grant, 1,334,100 new cases and 556,500 deaths were expected from all types of cancer in the U.S. last year. Dr. Grant’s published scientific work analyzing the geographic variation in cancer mortality rates with respect to solar UVB indicated that there were approximately 45,000 premature deaths and 130,000 preventable cases of cancer annually through additional UVB exposure and/or vitamin D.

In conclusion, indoor tanning has been found to be loosely associated with an increase in melanoma rates in studies in Europe and Canada, while no increased risk was found in the U.S. Even if indoor tanning were associated with an increased risk of developing melanoma, the risk pales in comparison to the health benefits resulting from vitamin D production from the UVB in tanning lamps.

“We believe both sides have validity in their arguments, and even though we also have a vested interest, we are willing to provide the media with scientific evidence that the dermatologists ignore or are unaware of,” said Stepp. Since 1978, Wolff, as the founder of the indoor tanning industry in the U.S., has been the leading advocate of health related and cosmetic benefits in the U.S. for both the media and consumers alike.

Angered by research activities of professionals not under their control, medical associations such as the AAD – now in cooperation with other self-serving organizations such as SSA - are spreading misinformation in large public relations campaigns “designed to put competition from small businesses such as tanning salons and equipment suppliers out of business,” Stepp added.

Researchers and tanning salon operators advise patrons to tan responsibly – to limit exposure time and use safety goggles to protect their eyes - and to make sure they are not using medications that have warning labels noting that they make users more sensitive to sunlight.

Editors Note: Michael Stepp, a recognized expert on UV light and Vitamin D and the CEO of Wolff System Technology, the founder of the indoor tanning industry in the U.S., is available for interviews. Wolff has published a media backgrounder on the health-related benefits of Vitamin D available by emailing dtoor@wolffsys.com. In addition, helpful tanning tips and a guide to proper exposure available at http://www.wolffsys.com/faq.html.

Dr. Michael Holick, director of the Vitamin D Research Lab at Boston University Medical Center and considered by many to be the nation's leading authority on vitamin D, is available for interviews by contacting Daryl Toor at 770-777-9489.

References

About Wolff System Technology

Wolff System Technology is one of the industry’s leaders in the promotion of responsible tanning practices and has always promoted responsible tanning in moderation to protect the skin from sunburn and skin damage.

Moderate indoor tanning — for individuals who can develop a tan — is the smartest way to increase the potential benefits of sun exposure while minimizing the potential risks associated with either too much or too little sunlight.

Wolff System Technology was founded by Friedrich Wolff, "the father" of the indoor tanning industry. Since 1978, Wolff has been a leading advocate of the use of UV light for health-related benefits and a leading educator to the media and consumers of responsible tanning techniques. The company manufactures lighting systems for tanning beds and with patents in 16 countries, is the exclusive licensor of Wolff System certified tanning beds in the United States and Canada. As the leading manufacturer of lamps for indoor tanning beds, Wolff has more than 500,000 systems in use worldwide. For more information, visit www.wolffsystem.com, email dtoor@wolffsys.com.

Contact:

Daryl Toor
(770) 777-9489
dtoor@wolffsys.com

Valuable Insights Into the Importance of Vitamin D and Sun

An interview with Dr. Grant published on www.mercola.com April 03, 2004

GRANT: Let me preface this interview by qualifying my background and the information I present. I have a Ph.D. in physics and have worked for 30 years in remote sensing of the atmosphere and studying aerosols and ozone. For the past seven years, I have applied the ecologic approach for the study of dietary and environmental links to chronic diseases and have read the health literature extensively.

Thus, the information presented is based on my best understanding of the situation and may not be fully in accord with views held by others. It appears that the health care community is beginning to awaken to the great importance of vitamin D for optimal health so that better answers to these questions should be available in the next few years.

Also, a few words about “vitamin D.” When produced in the skin or ingested, it is a “vitamin” or “prehormone” and essential for life. Just as cholesterol is metabolized into testosterone, precholesterol is turned into cholecalciferol (vitamin D) which is metabolized into what now is looking more and more like a hormone [25(OH)D] which, in turn, is metabolized in the kidneys or other organs into an even more potent hormone [1,25(OH)2D]. Vitamin D is an essential part of the endocrine system [1] as it controls several of the adrenal hormones, growth of cells, production of enzymes and has other direct genomic functions. The key difference in definition is that hormones have DNA receptor sites and vitamin A is in that family as well as vitamin D and vitamins are parts of coenzyme systems (not genomic). In a way vitamins A and D are both vitamins and hormones. Vitamin D is also produced in plants such as algae, as well as mushrooms (which are neither animals nor plants) exposed to ultraviolet-B (UVB) radiation [2, 2a]. Fish obtain their vitamin D from zooplankton and, likely, phytoplankton.

1. In your estimation, how many Americans are likely to be lacking in vitamin D right now?

Based on my study of the Atlas of Cancer Mortality for the United States [3] and the geographic variation of multiple sclerosis among U.S. veterans of WWII, and a reading of the literature, I think that 80 percent to 90 percent of Americans are vitamin D deficient.

Those with the best vitamin D status live in Hawaii and rural regions of the southwest, which have the highest UVB radiation in July [4]. Those with the worst vitamin D status are those with darker skins and those who live in Alaska and urban regions of the northeast. Nearly all Americans are vitamin D deficient in winter/spring when there is not enough UVB reaching the surface.

2. What is the optimal level of vitamin D?

The current understanding is that serum 25(OH)D levels should be in the 30 to 40 ng/ml (75-100 nmol/L) range for cancer prevention and optimal health. The only way to determine one’s 25(OH)D levels is though blood tests, which can be ordered through a physician or nutritionist. However, care should be exercised in choice of a laboratory since the testing methods and quality of the tests may vary. In addition, since 25(OH)D and parathyroid hormone (PTH) are inversely correlated and have opposite effects on calcium in bones, one could also have PTH levels measured.

Dr. Mercola's Comment: I believe that Dr. Grant is a bit conservative in his recommendation here and I believe that an optimal level of vitamin D is between 45 and 50. I also highly recommend testing though as it is relatively dangerous if one exceeds a vitamin D level of 60.

3. What are some of the diseases that can result if a person’s vitamin D levels are less than optimal?
There is a large and growing list of diseases related to vitamin D deficiency. The bone diseases, rickets, osteopenia, osteoporosis and osteomalacia, are well known. The role of vitamin D here is to facilitate the absorption of dietary vitamin D and help with calcium metabolism [5].

Muscle pain and weakness is another [6]. There are about 16 types of internal cancers for which vitamin D is a risk reduction factor [7]. Other diseases include multiple sclerosis [8], type 1 diabetes mellitus [9], rheumatoid arthritis [10] and heart disease [11].

4. In your article you mention “the time required in the sun [for optimal vitamin D] is probably 15 to 30 minutes per day with at least hands and face exposed in the mid-latitudes during summer.” What do you recommend for people who cannot get outside to achieve this exposure, or who live in areas that make it difficult to make vitamin D from the sun?

First, note that the 15 to 30 minutes per day generally applies to fair-skinned, thin, younger individuals, with the more of the body exposed, the better. Darker-skinned individuals may require several hours per day. For those unable to derive sufficient vitamin D from solar UVB, artificial UVB lamps are a viable option, as are vitamin D supplements.

5. Do you think that overdosing on vitamin D is a serious concern for people taking vitamin D supplements, or is it relatively difficult to reach dangerous levels?

I do--too much can lead to bone loss [12]. In addition, a new study from Finland has shown that those with average values of serum 25(OH)D have lower risks of prostate cancer than those with lower or higher values [13].

My recent ecologic study indicates that high summertime UVB levels are a risk factor for prostate cancer, while low wintertime UVB levels are also a risk factor [14].

6. Is there an alternative to sun exposure that you feel would give the same benefits in terms of vitamin D?

The two viable options are artificial UVB and supplements. If visiting an indoor tanning salon, be sure to ask for the booth with the highest UVB (280-315 nm) to UVA (315-400 nm) ratio since only UVB produces vitamin D. UVA is useful in producing a browner tan.

Dietary sources of vitamin D are generally insufficient to produce optimal serum 25-hydroxyvitamin D (25(OH)D) since milk contains only 400 I.U. of vitamin D3 and 800 to 1000 I.U. per day are probably required. Fish oil with vitamin D can be consumed, but one should see whether and how much vitamin A is included. Vitamins A and D interact and one does not want too much vitamin A [15].

Dr. Mercola's Comment: While sun tanning booths can clearly increase one’s UVB exposure it does come with some risks. There are X-rays emitted from the ends of the bulbs so ideally lead tape should be wrapped around the bulb ends. Additionally the magnetic ballast that provides the current to the fluorescent bulbs emits high levels of EMF radiation that is likely linked to certain cancers. Because of these conditions I would strongly advise against nearly all commercial sun tanning booths. However, if the above criteria are met then they should be fine, because the actual light and UV exposure from the bulbs is relatively safe if applied with wisdom and caution.

7. Are there symptoms of inadequate vitamin D levels before a person reaches extreme deficiency or becomes sick with a related illness? In other words, would someone be able to tell if they were lacking vitamin D without receiving a blood test?

Not really, although there are several symptoms of disease onset that one can look for. One is muscle pain, especially in winter [16]. Another is easily fractured bones. However, even these symptoms are evidence of serious vitamin D deficiency and illness.

8. What is your opinion of sunscreens and sunblocks? Should they be used or do they block the beneficial effects of the sun?

The use of sunscreens is good at the beginning of the sunny season if one spends much time out of doors and also for those with fair skin in very sunny climates. The tan that develops with sun exposure is nature’s way of protecting against too much UV radiation.

However, constant application of sunscreens reduces the photoproduction of vitamin D [17]. It should be noted that skin pigmentation adapts over periods of millennia to local solar UV radiation (UVR) [18]. The problem in the United States, Australia and New Zealand is that most of the inhabitants have their ancestry in northern Europe, where pale skin is required for optimal vitamin D production.

The optimal skin pigmentation for solar UVR levels typical of the latitudes for the United States would be closer to that of those from Southeast Asia and the Middle East, i.e., more olive in complexion.

Dr. Mercola's Comment: I believe Dr. Grant is not aware of some of the other concerns about sunscreens that I presented in an earlier article. I normally advise against them

9. What food sources of vitamin D do you feel are best in terms of the quality and absorption availability of the vitamin D?

Fish--but not all types. Best are probably cold-water ocean fish such as salmon, sardines, herring, and mackerel; milk and now orange juice are now being fortified [19]. To get much D from fish requires consumption of the skin and fat under the skin, around the fins and at the tail. But while these are tidbits for grizzlies, Inuit, Eskimo and Northwest Pacific Indians and other traditional peoples they are not for most in the United States.

However, one has to consider the environmental and health consequences of drinking milk and orange juice. Fish bioaccumulate mercury and other toxins, and the world’s fish supply is rapidly being depleted. Not all people are lactose tolerant; milk fat is associated with various diseases such as breast cancer [20]. Orange juice has lots of sucrose and can give rise to reactive hypoglycemia when consumed on an empty stomach. See Fuller and Casparian [2000] for a chart showing the vitamin D content of various foods.

10. Is it possible for the body to store enough vitamin D from summer sun exposure to last through several months of winter?

Vitamin D is stored in the blood for a few weeks and in the fat for a few months. Serum 25(OH)D levels generally drop by 20 percent to 30 percent during winter in midlatitudes [21] and the prevalence of hypovitaminosis D increases markedly [22]. Low winter/springtime serum 25(OH)D levels are associated with the development of a number of autoimmune diseases (e.g., autism [23] and type 1 diabetes mellitus [24]) and schizophrenia [25]; cancer detection increases in winter/spring as well [26]).

Concluding statement

Much has been learned about the role of vitamin D in maintaining optimal health and preventing disease. Unfortunately, the health community has not given enough attention to vitamin D because for years the focus has been on its 'nutritional' role in bone, not its other genomic functions, which were basically unknown, and because when adding 'vitamin' D to foods in the early years to prevent bone problems (in the UK and later in the U.S.) there were many problems of excess, so much so that deaths occurred.

Another reason seems to be that vitamin D can be produced by solar UVB, and solar UVR is associated with skin cancer, premature skin aging and cataract formation. I plan to devote much of my efforts in the next few years to furthering the understanding of the role of vitamin D in maintaining optimal health and educating the general public and the health community.

Footnotes:

1. Holick, 1987; Zouboulis, 2000
2. Bjorn and Wang, 2000
3. Devesa et al., 1999
4. Herman et al., 1999
5. Holick, 2004
6. Plotnikoff and Quigley, 2003
7. Grant, 2002b; submitted
8. Embry, 2004
9. Zella and Deluca, 2002; Holick, 2004
10. Merlino et al., 2004
11. Holick, 2004
12. Chiricone et al., 2003
13. Tuohimaa et al., 2004
14. Grant, in press
15. Johansson and Melhus, 2001
16. Plotnikoff and Quigley, 2003
17. Matsuoka et al., 1988
18. Jablonski and Chaplin, 2000
19. Tangpricha et al., 2003
20. Grant, 2002a
21. Nesby-O'Dell et al., 2002
22. Bhattoa et al., 2003
23. Mouridsen et al., 1994
24. Hypponen et al., 2001
25. Eyles et al., 2003
26. Robsahm et al., 2004

References

Smoking overlooked as an important risk factor for squamous cell carcinoma:

Comments on "Hemminki K, Zhang H, Czene K. Time trends and familial risks in squamous cell carcinoma of the skin. Arch Dermatol. 2003;139:885-9."

Grant WB. Smoking overlooked as an important risk factor for squamous cell carcinoma. Arch Dermatol. 2004 March 15;140:362-3.

The recent paper by Hemminki et al. reported interesting results on trends of squamous cell carcinoma (SCC) of the skin in Sweden, namely that there has been a significant increase in SCC for covered skin starting in the 1980s in addition to the increases in SCC in sun-exposed skin dating back to the 1960s. The interpretation provided was that the increase in SCC for covered skin was likely due to intentional tanning, both during trips abroad and in sun beds. No data on sex differences in trips abroad were presented, but it was pointed out that women use sun beds at twice the rate of men in Sweden. However, men have twice the rate as women for SCC for covered skin. Thus, it is very unlikely that intentional tanning explains the data.

A much more likely explanation can be found in the effects of smoking, a well-known risk factor for SCC and basal cell carcinoma. Smoking gives rise to SCC though carcinogens and free radicals, even for covered skin areas. There has been an increase in smoking deaths in Sweden between 1955 (1100 men, <100 women) and 1995 (1800 men, 900 women) and the 1995 sex ratio of smoking deaths is very similar to the sex ratio reported for SCC in covered skin. Also, the adverse effects of smoking generally happen later in life, as is the case for the SCC data reported. Recent ultraviolet (UV) radiation exposure practices would not yet be reflected in SCC data.

Thus, any study trying to link UV radiation, natural or artificial, to skin cancer and, perhaps, melanoma, should carefully consider the smoking habits of those studied, as well as dietary factors that may be involved in generating or fighting free radicals.

Contact: William B. Grant, Ph.D.
William B. Grant does independent health research from his office in Newport News, Virginia. His health work is primarily related to identifying and quantifying risk and risk reduction factors from dietary factors and UVB radiation for chronic diseases. He published the first paper linking diet to Alzheimer's disease in 1997 and has published a number of papers on diet and other chronic diseases and on the health benefits of solar UVB radiation and vitamin D. He is moving to San Francisco in April and will continue such work through Sunlight, Nutrition and Health Research Center (SUNARC).

Dietary links to prostate cancer

A new multi-country study strengthens the link between animal products as risk factors for prostate cancer, and vegetable products, especially onions, as risk reduction factors. The study, published in the March 2004 issue of European Urology (Grant WB. A multicountry ecologic study of risk and risk reduction factors for prostate cancer mortality. Eur Urol. 2004;45:371-9), investigated links between national diets and prostate cancer mortality rates to identify major risk factors for prostate cancer. The indication that this might be a useful approach comes from comparing national prostate cancer mortality rates: prostate cancer mortality rates in the U.S. and northern Europe are approximately 5 times higher than in Hong Kong, Iran, Japan, and Turkey.

The strongest risk factor for prostate cancer mortality was animal products, such as meat and dairy products; the strongest risk reduction factors were onions and other protective vegetable products (cereals/grains, beans, fruits, and vegetables, but excluding alcohol, oils, and added sugar (sweeteners)). Thus, fat and protein are risk factors, while complex carbohydrates and antioxidants are risk reduction factors. This finding points to insulin-like growth factor-I (IGF-I) being an important risk factor for prostate cancer. IGF-I is also increased by total energy consumption. This study supports earlier reports that allium family vegetables (e.g., garlic, leeks, and onions) as important risk reduction factors for prostate cancer. This study also found that alcohol is a minor risk factor. No independent correlation was found for tomatoes, a source of lycopene, thought to reduce the risk of prostate cancer.

Prostate cancer mortality rates for 32 predominantly Caucasian countries for the late 1990s were obtained from the World Health Organization. Dietary supply data were obtained from the Food and Agriculture Organization. Linear and multiple linear regression analyses were conducted for all 32 countries as well as the 20 European countries. Dietary supply data for 1979-81 yielded the highest correlations, indicating that prostate cancer takes approximately 20 years to progress from initiation to death.

These results are similar to results reported by Dr. Grant last year for breast cancer, although onions were not found to play a role for breast cancer. Animal products including animal fat and alcohol are now recognized risk factors for breast cancer, and vitamin D is recognized as an important risk reduction factor. UVB radiation, the primary source of vitamin D for many people, was inversely correlated with prostate cancer mortality rates but not in a multiple linear regression with the dietary factors.

These results should provide guidance for reducing the risk of prostate and other cancers.

Contact: William B. Grant, Ph.D., sunarc@sunarc.org.