|IS IT SUNNY ENOUGH IN HAWAII?|
J Clin Endocrinol Metab 2007;92,6:2130-35
It never seemed right to me to across the board tell everyone to stay out of the sun became of the fear of skin cancer. These kinds of blanket recommendations often do more harm then good. One of the most egregious examples of this kind of error was the nutritional advice 30 years ago to eat margarine instead of butter. Millions of people listened, some to their detriment. Now most people have heard of the dangers of the trans fats found in products with hydrogenated fats.
So, what's wrong with telling everyone to stay out of the sun? Actually, a lot. We're starting to see rickets again in American children after it being absent for decades. Rickets is softening of the bones in children due to vitamin D deficiency. Over the last few years we've learned that optimum Vitamin D levels prevent osteoporosis, and probably prevents, breast, colon, and prostate cancers. Vitamin D may be used to treat multiple sclerosis, autism, influenza, and other diseases. Some of the reason why this is all coming out is that 'everyone' has been staying out of the sun. But is proper sun exposure enough to create optimum vitamin D levels? Maybe not. This recent study suggests that sun exposure may not be enough. These researchers found that a large proportion of Hawaiians exposed to high levels of daily sun had low levels of vitamin D.
To evaluate the effects of daily high sun exposure on vitamin D levels, the study authors performed a serum hydroxy vitamin D test in 93 white, Asian, Hawaiian/Pacific Island, and multiracial people living in Honolulu, Hawaii. Each person's average sun exposure was nearly 30 hours per week, with an average of 11 hours unprotected by sunscreen.
50% of the participants studied had vitamin D deficiency despite high levels of sun exposure. Why was this the case? Is there something different or unknown that gave these seemingly contradictory results? Truly, if anyone should have good vitamin D levels it would be the folks living in Hawaii. If they don't, what does that say about those of us not so lucky to live on the islands? Here in cloudy north central Pennsylvania I've yet to see any of my patients have optimum vitamin D levels.
Gone are the days when anyone should believe that 400 IU per day of vitamin D is enough. In the past, when foods were 'fortified' with vitamin D, the wrong form was used. Fortified foods need to use vitamin D3 to have the correct form.
Yet this is not to say that everyone should rush out and start taking vitamin D without talking to someone trained in clinical nutrition-this isn't your health provider unless you happen to be working with a licensed naturopathic physician, or someone with comparable education. It's become a common consideration for me to ask my patients to see if they can get a vitamin D test done. Only then, knowing where you are starting from, can you accurately dose without potential problems.
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