These
days, I always seem to be thinking about balance in medicine; a balance between
risk and benefit, a balanced diet and so on. So as Ireland swelters in
unusually hot weather conditions, I’ve found myself wondering about the balance
between too little or too much sunlight and the health implications. I’m not alone in this. Over-exposure to sunlight
and we need to think about skin cancers, for example. But what about too
little? Well, one issue associated with too little sunshine is low vitamin D
levels and it is suggested that a large number of the population of Ireland and
the UK are currently deficient in said “sunshine” vitamin.
Research
about vitamin D seems to be very popular at present and there seems to be an
ever increasing body of evidence that vitamin D deficiency is associated with a
multitude of illnesses. These range from the role of vitamin D in bone health,
cancers, cardiovascular diseases and auto-immune diseases. There is even a
vitamin D hypotheses in terms of explaining the increased prevalence in northern latitude
of multiple sclerosis. See Holick MF et al in the Am J Clin Nutr 2004 or
Ascherio A. Ann Neurol 2007 for more.
Low
vitamin D levels have been linked to increased coronary heart disease risk.
However, frequently the findings were in small studies. In the last fortnight
research was publish in JAMA regarding the MESA cohort. This was a large study
of ethnically diverse patients who were free of clinical heart disease at time
of enrollment. Amongst the findings it was noted that low serum levels of
25-hydroxy vitamin D independently predicted raised long-term risk of coronary
heart disease events among white participants (as opposed to African American
for example). This study was described by a JAMA editorial as being “robust”
and it is interesting that outcomes were adjusted for a multitude of CHD risk
factors: age, sex, BMI, smoking status, excercise, diabetes status, cholesterol
for example, so it appears as if the evidence is getting stronger. See here for more.
Although
it would seem that there is an increasing body of evidence linking low vitamin
D to increased coronary heart disease, a word of warning. Perhaps it might be
best to consider getting your levels checked rather than spending longer in the
sun. Skin cancer has been increasing over the past decades. According to the
World Health Organisation one in three cancers diagnosed is a skin cancer.
Reducing exposure to sunlight’s UV rays really is our own resposibility. See here.
Good advice for the current strong sunlight is don’t forget
the Australian mantra regarding adequate clothes, sun-cream and hats, “Slip-Slop-Slap” before heading out
into the sun.
For Health Screening Software that gives personalised Vitamin D advice CLICK HERE
For Health Screening Software that gives personalised Vitamin D advice CLICK HERE
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