Vitamin D, UV, and skin cancer in the elderly: to expose or not to expose?

Glossmann H.
Gerontology. 2011;57(4):350-3. Epub 2010 Dec 22.
Institute for Biochemical Pharmacology, University of Innsbruck, Innsbruck, Austria. Hartmut.Glossmann at i-med.ac.at

There is mounting concern about vitamin D insufficiency, especially in the ageing population. Increases in indoor lifestyle, obesity, car travel, clothing habits, the use of photo-protective makeup, and campaigns driven by dermatologists, governments, and the cosmetic industry to avoid or protect against the sun as much as possible are contributing to this trend.

In a recent article in Gerontology, Barysch et al. [1] recommend that the ageing population avoid any 'intentional' UV radiation as well as 'minimize sun exposure' based on known dangers of developing skin cancer. They warn that 'studies with vitamin D supplements reported increased risks of prostate and esophagus cancer as well as atopy in childhood' and concluded that 'adequate levels of vitamin D are essential for the elderly', but do not suggest which level is optimal. I will argue that the ageing population should keep their serum 25-(OH)-vitamin D(3) (25-(OH)-D) levels in the 75-100 nmol/l range. An oral cholecalciferol intake of ?2,000 IU/day is recommended as a supplement throughout the year for those who cannot enjoy the sun in summer or only during 'vitamin D winter' for the others.

Copyright © 2010 S. Karger AG, Basel.

PMID: 21196703

Interesting statements in the paper

• Intense (with sunburns) and intermittent (vacation or weekend) UVR exposure, especially in early childhood, predispose to MM
• The MM risk of the trunk and limbs increases with a higher socioeconomic status (more recreational, intermittent sun exposure) but is surprisingly largely uninfluenced by latitude and ambient UV-B radiation [15]
• . . the incidence has been rising continuously since as early as 1940, but this increase has mainly occurred in indoor but not outdoor workers. . .
• . .higher 25-(OH)-D levels at the time of diagnosis are associated with both thinner tumors and better survival . . .
• ’Nitric oxide production in the skin is increased at the same time by UV-A, which lowers the system blood pressure, indicating that there are many activities of natural sunlight extending beyond vitamin D
• Are your chances of dying – compared to a population without BCC or SCC – better or worse?
  The answer is surprising and unexpected:
  you are going to live longer, by ~9%, if you have been diagnosed with a BCC based on a 10–year mortality rate ratio (MRR = 0.91)

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See also VitaminDWiki

(all of the following are on the VitaminDWiki, but do not have time to make all of the hyperlinks)

• Seniors need 3X as much time in the sun to get same amount of vitamin D
• Need about 2X more if overweight
• Various anti-oxidants reduce the chance of sunburns
• Maximize the amount of vitamin D while minimizing the chance of sunburn
  by spending a small amount of time out in the hot sun with a minimum of clothing.
• Perhaps having enough vitamin D reduces chance of sunburning
• All items in Noontime Sun _322 items__
• Overview Suntans melanoma and vitamin D
• Overview Seniors and Vitamin D
• Search for Glossman on VitaminDWiki 32 items as of May 2013
• Seniors, like everyone else, need vitamin D and should avoid sunburns – 2011
• The statin Crestor dramatically increases levels of vitamin D in the blood – Jan 2012
• Nice Overview of Vitamin D in 64 slides - Glossmann 2013
• Pharmacology of vitamin D - April 2011 a subsequent paper by Dr. Glossmann
• No – 10 minutes per day of sun-UVB is NOT enough which has the following graphic