Shining the Light on the Benefits of Vitamin D

Sun Exposure Provides Health Benefits for Those at Risk for Osteoporosis, Some Cancers, and Cardiovascular Disease

Evelyn Smith

While the risk of skin cancer has sent fair-skin sun worshippers in recent years scurrying for their SPF 15 suntan lotion, medical science is just now beginning to rediscover the benefits of sunlight, or rather researchers now correlate Vitamin D deficiency with a lack of sunlight as well as a failure to include foods rich in Vitamin D in the diet.  Some individuals who  show signs of a Vitamin D deficiency are predictable—elderly women with dowager humps and urban populations living in polluted areas. However, some are surprising.  For example, prostate cancer correlates not only with older males, but with dark skin, and northern latitudes (Hubday, n. d., para. 47).   Nevertheless, since correlation is not necessarily causation, further studies need to research the role exposure to sunlight plays in the prevention of disease. 

In the meanwhile, a walk around the block during lunch hour or taking  elderly nursing home residents out to sunbathe for approximately 10 to 15 minutes daily on a pleasant spring or summer day along with diet and regular weight-bearing exercise might help prevent coronary heart disease and guard against osteoporosis in both women and men as well as other diseases associated with the lack of Vitamin D.  However, as a general rule, the further away from the equator someone lives, the more likely he or she is likely to suffer from a lack of Vitamin D particularly during the winter months or if he or she seldom participates in outdoor activities. The overweight and the elderly are also more likely to be deficient in Vitamin D.

How Much Sunlight Is Necessary to Provide Adequate Amounts

of Vitamin D in the Elderly—

and Everyone Else?

Elderly need more “sun vitamin”. (2009, May 16).  BBC News.  Retrieved from http://news.bbc.co.uk/2/hi/health/8043297.stm

Older individuals generally suffer from a deficiency of Vitamin D because the skin’s aging process leads to the risk of metabolic syndrome, a condition increasingly linked to diabetes and heart disease and associated with increased insulin resistance (BBC, 2009, para. 2-3).  Metabolic syndrome also shows a correspondence with obesity, high blood sugar, high blood pressure, high cholesterol—all of which result in heart disease, strokes, and diabetes (BBC, 2009, para. 9-10).

Jegtvig, S. (2013, March 3).  Nutrition FAQ: How much sun exposure do I need for Vitamin D? About.com Retrieved from http://nutrition.about.com/od/askyournutritionist/f/sunlight.htm

Jegtvig recommends 5 to 30 minutes of sunlight on face, arms, back, or legs without sunscreen twice weekly, although she also notes that tuna, salmon, fortified milk and fortified breakfast cereals also contain Vitamin D. 

Sunlight: How much do I need? (2012). Riverside. Mayo Clinic.com. Retrieved from

http://www.riversideonline.com/health_reference/Cancer/AN01081.cfm

The Mayo Clinic recommends 10 to 15 minutes of sun exposure daily on face, arms, hands, or back without sunscreen (Sunlight, 2012, para. 1) and notes that fortified milk, cereals, salmons, herring, eggs, and mushrooms also are sources of Vitamin D (Sunlight, 2012, para 2).  The Mayo Clinic, however, does not differentiate the age, gender, or race of individuals, nor does it determine how their latitude might affect their need for sunlight.

Weil, A. (2010, May 17).  How much sun exposure for Vitamin D?  Q & A Library.  Dr. Weil.com Retrieved from http://www.drweil.com/drw/u/QAA400732/How-Much-Sun-Exposure-for-Vitamin-D.html

Writing from the perspective of a researcher living in Pennsylvania, Dr. Weil recommends 20 to 30 minutes of sun exposure for fair skin individuals on arms and legs between 11 A.M. and 3 P.M. for two to three days weeks from March through May and in September and October.  In July and August, only 15 to 20 minutes are necessary.

Facts on Vitamin D



Vitamin D has many health benefits!

Dietary supplement fact sheet: Vitamin D. (2011, June 24).  Office of Dietary Supplements. National Institutes of Health. Retrieved from http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/

Adults 70 and older need 800 International units of Vitamin D daily, and infants under the age of one need 400 International Units, but everyone else needs 600 International Units of Vitamin D each day (ODS, 2011, para. 3). Since seniors don’t absorb Vitamin D through the skin as efficiently as younger individuals do, their kidneys are less able to convert Vitamin D to its active form.   Individuals of Sub-Saharan African descent and other dark skinned people as well as the obese are less likely to absorb Vitamin D into the blood (ODS, 2011, para. 11), so—reading between the lines—they may need longer  exposure to sunlight, have a greater need for supplements, or should add more omega 3 fatty fish to their diets than other individuals. Prednisone and corticosteroids also impair the body’s ability to absorb Vitamin D (ODS, 2011, para. 15).  Aside from preventing osteoporosis, Vitamin D helps to prevent colon, prostate, and breast cancer; however, too high a level of Vitamin D can result in pancreatic cancer (ODS, 2011, para. 13). 

The  ODS fact sheet gives a slightly different list of foods that furnish Vitamin D than the Mayo Clinic does: fatty fish—salmon, tuna, and mackerel; beef liver, cheese and egg yolks, mushrooms, fortified milk, and fortified breakfast cereal (ODS, 2011, para. 4).

Online Medical Sources &

Nutrition Websites



Elderly women at risk from lack of sunlight. (2003, December 1).  Aphrodite Women’s Health.  Retrieved from http://www.aphroditewomenshealth.com/news/20031030204818_health_news.shtml

Since the skin of the elderly is less effective at producing Vitamin D [and nursing home residents rarely go outside], 45 percent of nursing home patients are deficient in Vitamin D.  The elderly need Vitamin D for muscle strength which keeps them from avoiding falls (para. 1, 2, and 4).

Grimes, D. S., Hindle, E., and Dyer, T. (1996, August).  Sunlight, cholesterol and coronary heart disease [Abstract only]. QJM: Monthly Journal of the Association of Physicians, 89(8), 579-89. http://dx.doi.org/10.1161%2FCIRCULATIONAHA.107.7061274 and

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726624/

Grimes and associates, observing the higher concentration of blood cholesterol in winter months and the lower concentration of blood cholesterol in the summer along with an increase in outdoor activities, theorize that sunlight deficiency increases blood cholesterol by allowing squalene metabolism to progress to cholesterol synthesis instead of Vitamin D synthesis.

Hubday, R. (n. d.).  How sunlight can prevent serious health problems. Lifestyle Laboratory.  Retrieved from http://www.lifestylelaboratory.com/articles/hobday/sunlight-prevent-problems.html

Hubday furnishes a synopsis of all the ills associated with lack of sunlight—fractures and osteoporosis, a greater chance of developing breast, colon, and lung cancer, prostate cancer, coronary and heart disease, multiple sclerosis (MS), and psoriasis, as he cites studies from both the present day and as far back as the 1930s.  He argues that the elderly need as much as 800 International Units of Vitamin D, daily, but he also cites studies that prove that younger individuals who either don’t go outside much, live in extreme northern or southern latitudes, or in polluted urban areas also may suffer from Vitamin D deficiency (Hubday, n. d., para. 3-6).

Kent, S. T., McClure, L. A., Judd, S. E. et al.  (2012, December 7).  Short-and-long-term sunlight radiation and stroke incidence [Abstract only].  Annals of Neurology, 73(1), 32-7.  doi: 10.1002/ana.23737.  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/?term=Kent+AND++Short-and+long-term+sunlight+radiation+and+stroke+incidence

Alabama researchers discover a relation between lower-levels of sunlight and a higher percentage of strokes.

Lack of Vitamin D may increase heart disease risk. (2008, January 8). Reprinted from the

Journal of the American Heart Association.  Massachusetts General Hospital.  Heart Center News. Retrieved from http://www.massgeneral.org/heartcenter/news/newsarticle.aspx?id=1073

Medical research associates Vitamin D deficiency with high blood pressure and “increased cardiovascular risk above and beyond already established cardiovascular risk” (Massachusetts General, 2008, para. 1—2).   Even when research adjusts for traditional risk factors like high cholesterol and high blood pressure and diabetes, individuals who lack of Vitamin D have a 62 percent higher risk of cardiovascular disease than those that don’t have a shortage (Massachusetts General, 2008, para. 3).  In areas without much sunshine, approximately 20 to 30 percent of the population may be moderately or severely deficient in Vitamin D (Massachusetts General, 2008, para. 11).
 

Lack of sun does not explain low Vitamin D in elderly who are overweight. (2013). Tuffs University. Newswise.  Retrieved from http://www.newswise.com/articles/lack-of-sun-does-not-explain-low-vitamin-d-in-elderly-who-are-overweight

Researchers at the USDA Human Research Center on Aging at Tuffs University note that obese individuals over age 65 have lower levels of 25-hydroxyvitamin D, the storage form of Vitamin D, than individuals of normal weight (Tuffs, 2013, para. 2).   When they consider gender, age, the season of the year and the amount of dietary Vitamin D intake, they determine that as body fat increases, 25-hydroxyvitamin D decreases (Tuffs, 2013, para. 5).   If the low-level of Vitamin D storage cannot be attributed to low sunlight exposure, they theorize that Vitamin D remains stored in the fat tissue rather than being converted by the liver into 25-hydroxyvitamin D (Tuffs, para. 6-7).

Lehman, M. (2011, May 23).  Vitamin D deficiency and risk of cardiovascular disease. Livestrong. Retrieved from http://www.livestrong.com/article/449058-vitamin-d-deficiency-and-risk-of-cardiovascular-disease/

Lehman notes that individuals with a Vitamin D deficiency have a two times higher cardiovascular risk than others since Vitamin D slows the production of renin, an enzyme that constricts the arteries, while a lack of Vitamin D results in high levels of renin and high blood pressure (2011, para. 2-3).  Additionally, researchers correlate an overproduction of the parathyroid hormone with the narrowing of the blood vessels (Lehman, 2011, para. 3). As for reducing this risk, Lehman recommends engaging in outdoor activities and taking Vitamin D supplements of 600 International Units for individuals under age 70 and 800  International Units for those under age 70.

Addendum

Long, Larissa. (2014, August 27).  Low vitamin D linked to premature death.  Whole Health Insider.  Retrieved from
http://www.wholehealthinsider.com/newsletter/low-vitamin-d-linked-premature-death/?utm_source=WHI&utm_medium=house_email&utm_term=all&utm_content=news&utm_campaign=WHI_20140828

Upon comparing the statistics for 500,000 patients and 32 studies, researchers at the University of California, Sa Diego, discovered a correlation between mortality and low levels of vitamin D, for in those patients diagnosed as "prematurely dead", the risk of death is twice as high when vitamin D levels fell below 30 ng/mL. Moreover, this finding is particularly disturbing since 66 percent of all Americans are deficient in vitamin D (Long, 2014, August 27, para. 2-4).

For most people, however, the cure is a simple and economic once since 15 to 20 minutes of sunlight daily is all most people need to obtain their daily quota of vitamin D.  As for supplements, 4,000 I.U. is the upper "safe" daily limit prescribed, although under a physician's supervision no adverse effects are felt if the individual takes 10,000 I.U. levels daily(Long, 2014, August 27, para. 5-7).

Bottom Line:  Pregnant women, older adults whose skin doesn't absorb enough vitamin D, those diagnosed with type 1 diabetes, and individuals contemplating surgery should consult their physician about taking vitamin D supplements.

When it comes to raises vitamin D levels, anesthesiologists advised--”Don't be wimpy!” (21 August 2014). Anesthesia & Analgesia. Retrieved from http://www.newswise.com/articles/when-it-comes-to-raising-vitamin-d-levels-anesthesilogists-advised-don-t-be-wimpy

Vitamin D supplements reduce surgery complications

Observational studies evidence that raising vitamin D levels improve health, so the father and son team of Michael F. Roizen of the Cleveland Clinic and Jeffrey D. Roizen of the Children's Hospital in Philadelphia propose randomized trials to see if vitamin D can reduce complications following surgery (Anesthesia & Analgesia, 2014, August 21, para. 1 & 2).

Alparstan Turan and his colleagues at the Cleveland Clinic have already published a study that showed lower postoperative death rates and complications in patients with adequate vitamin D levels. Moreover, the Roziens' point to “a long series of studies” that show that vitamin D improves bone density resulting in fewer falls and less fractures, as well as reducing the chance of heart attack and stroke and death from colon, breast and prostate cancer (Anesthesia & Analgesia, 2014, August 21, para. 3-5). 

Therefore, the Roziens propose that a randomized trials be conducted to determine whether giving vitamin D supplements before surgery can decrease complication afterward in addition to determining what vitamin D levels will most benefit  candidates for surgery. In the meanwhile, they recommend that potential surgery patients with low levels of vitamin D in their blood take supplements for at least six weeks before surgery.  The doctors also take their own advice, for they keep a tab on their own vitamin D levels (Anesthesia & Analgesia, 2014, August 21, para. 7-9).

Conclusion

Old-fashioned preventive measures just might protect at-risk populations from Vitamin D deficiency, which in turn, corresponds with a greater risk not only of osteoporosis, but also with cardiovascular disease and some forms of cancer. While supplements are helpful, adequate exposure to sunlight and a diet might provide a better quality of life as well as lengthen it. Unfortunately, however, the skin of older adults doesn't absorb as much vitamin D as it did when they were younger.

The medical links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.