SEATTLE POST-INTELLIGENCER
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Living Well: Got sun? Then milk it for vitamin D
Monday, December 5, 2005

By BOB CONDOR
SPECIAL TO THE POST-INTELLIGENCER

He's not about to tell women how to buy or apply their cosmetic products, but Dr. Charles Hildebolt does have one piece of beauty advice: beware the moisturizer or base lotion that doubles as a sunblock.

"It's healthy to use sunblock but not until you have the recommended sun exposure for the day," said Hildebolt, a radiology researcher and dentist at Washington University in St. Louis. He recently published a study linking lack of enough sun exposure to gum disease and teeth problems.

Sunlight, vitamin D and calcium form a sort of Bermuda Triangle for health consumers. We have, of course, been seeing and hearing for years that we need to lather on the sun protection factor (SPF) to prevent skin cancer. Calcium has been widely characterized as the pivotal nutrient in building and maintaining strong bones and teeth. Vitamin D has been almost forgotten by the popular media because it is available in fortified milk. It doesn't get the same attention as vitamins C (for common colds) and E (memory enhancer).

Hildebolt was "surprised" to discover that the medical research makes a strong case for vitamin D serving as a protector against certain types of cancer (prostate and, believe it or not, skin conditions), osteoporosis and autoimmune disorders, such as rheumatoid arthritis and multiple sclerosis.

His own study showed that vitamin D deficiency poses a double whammy for teeth and other bone material in the body. One, lack of vitamin D means less absorption of calcium. Two, vitamin D helps prevent inflammation that leads to periodontal or gum disease and tooth loss. Lower levels of vitamin D leads to higher production of cytokines, which are inflammatory proteins.

"Periodontal disease is a long-term chronic disease," said Hildebolt, associate professor at Washington University's Mallinckrodt Institute of Radiology. "Calcium and vitamin D deficiency are long-term chronic diseases, too. You can address calcium deficiency through foods and vitamin D deficiency through getting enough sunlight. It's a low-cost method to preventing disease."

Since 21 percent of Caucasian American women are diagnosed with osteoporosis and another 38 percent suffer from osteopenia, a milder form of bone-weakening disease, there are critical questions.

Here are a few: What's more important, calcium or vitamin D? How much sunlight do you need for the body to manufacture enough D? Can you replace sun exposure with vitamin D supplements? And just how much D is the optimal amount?

A recent study from Icelandic researchers and published in the Journal of the American Medical Association strongly suggested vitamin D drives bone health. It showed individuals consuming 800 milligrams (about two-thirds of the federally recommended amounts) is plenty to maintain bone strength if vitamin D levels are high enough.

Just how much sunlight is enough is as individual as how your skin reacts to the sun. Dr. Michael F. Holick at the Boston University School of Medicine is a pioneer in determining adequate sun exposure to trigger vitamin D production in the body. His recommendation is "one-third to one-half of the sun exposure causing erythema."

Translation: Erythema is reddening of the skin -- not to the point of sunburn. It'll take some trial and error to figure how much sun leads to a reddened face (also recommended is sunning the forearms and backs of the hands). Erythema takes longer to develop this time of year, even among the most fair-skinned. What's more, the noontime sun, even on gray days, is strongest and most efficient.

Many people, including some scientists, consider it too much bother to determine how much sun leads to skin reddening. They follow the rule of thumb that five to 15 minutes of sun between 11 a.m. and 2 p.m. a few times per week is sufficient. That prescription requires some upward adjustment in the Northwest, said Hildebolt.

"Stick to the lower amounts in spring, summer and fall," he said. "Increase exposure during winter calendar months. Some winter days you can be out all day without sunblock."

One point hotly debated among researchers is whether the body requires some measure of sunlight to process vitamin D supplements or if supplements could replace sun exposure. There is no definite answer, but there is more agreement that current vitamin D recommendations are too low.

"A lot of people contend that the current recommended daily amount (400 International Units or IU) is too low," said Hildebolt. Scientists are pushing for doubling the amount to 800 IU, especially for individuals 50 and older because our skin is less able to manufacture vitamin D as we grow older.

"Some dermatologists advise that people of all ages and ethnicities should avoid all direct exposure to sunlight and should always use sun protection when outdoors," wrote Holick in an editorial of the medical journal Mayo Clinic Proceedings.

"This message is not only unfortunate, it is misguided and has serious consequences, i.e., the risk of vitamin D deficiency and increased risk of many chronic diseases. There is little evidence that adequate sun exposure will substantially increase the risk of skin cancer; rather, long-term excessive exposure and repeated sunburns are associated with non-melanoma skin cancers."

Dietary supplements are always good insurance for not getting enough of nutrients through the diet or, in the case of vitamin D, sunlight. Hildebolt said peole adding vitamin D to their supplement list should look for vitamin D3 as the source and not synthetic varieties.

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Bob Condor writes every Monday about health and quality of life. He is editor of the Seattle-based Evergreen Monthly, which covers health, environment, food, social good, spirituality and personal growth (visit www.evergreenmonthly.com). Send e-mails to bobcondor@aol.com with any questions or ideas for the Living Well column.

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