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The future in sun exposure recommendations

by Brant Cebulla, May 25, 2012

In the past 30 years, recommendations regarding sun exposure have been simple. To counteract skin cancer, public health organizations and agencies have led the charge with campaigns focusing on sun and UVB avoidance. These recommendations have always been made with skin cancer and only skin cancer in mind.

In the early 1980s, Australia led the way with the famous slogan:

Slip (on a shirt) Slop (on some sunscreen) Slap (on a hat) Soon thereafter, the World Health Organization (WHO) started a Global UV Project called INTERSUN, which aimed to encourage countries to follow this lead and take action to reduce skin cancer.

In 1992, the United Nations supported and furthered this message at the Conference on Environment and Development when they announced that the ozone layer was depleting. They claimed we would see an increase in skin cancers all around the world.

The first decade of the new millennium slowly started to challenge these recommendations with the outburst of research in vitamin D. With a general attitude to avoid the sun, researchers pointed out that the average person’s vitamin D level in the 21st century is less than half of what it would be if they got regular full body sun exposure. The question arose, if our vitamin D levels are so low, what are the health consequences?

Future research in this decade will better be able to answer this question, but to date we know that vitamin D deficiency – and sun avoidance – is a risk factor for a wide array of diseases. These diseases include major internal cancers, cardiovascular diseases like stroke and hypertension, types I and II diabetes, inflammatory bowel diseases, dementias, respiratory illnesses like asthma and COPD, and several other autoimmune diseases including multiple sclerosis.

The challenge moving forward is changing the sun exposure message. In 2005, Cancer Council Australia was the first national cancer council to recognize a balanced recommendation in a statement titled, “Risks and benefits of sun exposure.” Still, the majority of other organizations have been slow to act.

The American Cancer Society states, “It is better to get vitamin D from your diet or vitamin supplements rather than from sun exposure.” This advice ignores that sun exposure is the natural and historical source for over 90% of vitamin D production/intake. To boot, researchers believe that sun exposure is likely beneficial beyond vitamin D production.

Even when skin cancer is the only issue on the table, the vitamin D crowds and skin cancer crowds may not be so far apart. Some research has shown that chronic moderate sun exposure is protective against melanoma versus short-term intense exposure.

What we need is a clear, consistent and safe message regarding sun exposure that takes into account both the benefits of sun exposure and the risks. A message that takes into account that:

Sun exposure is the natural source for vitamin D requirements. There are many benefits in disease prevention and treatment with both sun exposure and vitamin D. There are some risks in sun exposure in regards to skin cancer, but frequent moderate exposure eases this issue. The Vitamin D Council has always believed that today, research shows that the benefits of sun exposure outweigh the risks. In the future, we find it likely that research will quantifiably show that the benefits of sun exposure outweigh the risks. Given this, the sun exposure recommendation of the Vitamin D Council today is:

Be sure to get regular and moderate sun exposure. When sunbathing, expose a good amount of your skin to the sun for just half the time it takes for your skin to turn pink. Avoid burning.