|Why is the public misinformed about UV and vitamin D?
There are a number of reasons why public health policies regarding UV irradiance and vitamin D are not where they should be. Here is a partial list.
1 – The adverse effects of UV irradiance are easy to see and relate to UV; the beneficial effects are difficult to determine as they occur after many years, and may be masked by other factors such as diet, smoking, etc. However, the health benefits are much stronger [Grant, 2009].
2 – The sunscreen industry funds the American Academy of Dermatology to promote the idea that people should avoid the sun and wear sunscreen. As a result, serum 25-hydroxyvitamin D concentrations have decreased in the United States [Ginde, 2009] and elsewhere [Glass, 2009; Van der Mei, 2007].
3 – The Institute of Medicine (IoM) convened a committee to review the evidence for beneficial effects of vitamin D and make recommendations. According to prevailing medical practice, types of evidence were ranked from low (ecological studies) to high (randomized controlled trials). This ranking may be appropriate for pharmaceutical drugs, which are artificial compounds, but not for vitamin D, for which the primary source is the sun. However, at least one of the committee members is conducting a randomized controlled trial of vitamin D supplementation, using 2000 IU/d vitamin D3. If the committee had recommended an adequate vitamin D oral intake of 1000-2000 IU/d, such trials might be jeopardized. The Office of Dietary Supplements/National Institutes of Health, the Public Health Agency of Canada, Health Canada, and Food and Drug Administration requested and provided funding for this report. The U.S. funding agencies largely represent Big Pharma. Big Pharma sees vitamin D as a threat to their profits. Thus, it should not be surprising that the committee recommended only 600 IU/d vitamin D3 and serum 25-hydroxyvitamin D concentration of 20 ng/ml (50 nmol/l) [Ross, 2011]. This recommendation flies in the face of recommendations by vitamin D researchers [Holick, 2011; Souberbielle, 2010].
4 – We have a disease treatment health care system, not one based on prevention of disease. In an ancient Chinese system, doctors were only paid when the patients were healthy. When they were sick, the doctors had to work without pay to make them healthy again. Imagine what our health care system would look like if that system were in effect today.
5 – The corporate media represent corporations, so largely report what corporations want the public to hear or read. Thus, the New York Times carried a story in November or December 2010 defending the IoM report on vitamin D. The Wall Street Journal had better coverage.
6 – Many of the adverse effects of vitamin D deficiency occur late in life: cancer, cardiovascular disease, falls and fractures, etc. Older people generally don't work but, instead, live on savings, retirement programs, and/or Social Security, thereby being a net drain on society's resources. Many organizations that should be looking out for people at increased risk of cancer, cardiovascular disease, etc., are generally allied with Big Pharma and don't try to eliminate the diseases they are associated with. My favorite health organization was the March of Dimes. It helped wipe out polio, then turned its attention to birth defects.
7 – The best information regarding vitamin D is found at the Internet and in the health or medical journals, such as those listed at www.pubmed.gov. This information is publicly available, but one has to make an effort to find it. Some of the better vitamin D information websites and their principals are:
grassrootshealth.net - Carole Baggerly
www.healthresearchforum.org.uk - Oliver Gillie
www.vitamindcouncil.org - John J. Cannell, MD
vitamindhealth.or/ - Michael F. Holick, MD, PhD
www.VitaminDWiki.com – Henry Lehore
In conclusion, the evidence for health benefits of UVB irradiance and vitamin D is strong and growing rapidly. In the absence of public health policies recommending more UV irradiance and higher serum 25-hydroxyvitamin D concentrations, individuals will have to take it upon themselves to maintain high serum 25-hydroxyvitamin D concentrations. Both Grassrootshealth.net and VitaminDCouncil.org offer mail-in kits for serum 25-hydroxyvitamin D testing for a reasonable cost.
Ginde AA, Liu MC, Camargo CA Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009 Mar 23;169(6):626-32.
Glass D, Lens M, Swaminathan R, Spector TD, Bataille V. Pigmentation and vitamin D metabolism in Caucasians: low vitamin D serum levels in fair skin types in the UK. PLoS One. 2009 Aug 3;4(8):e6477.
Grant WB. In defense of the sun: An estimate of changes in mortality rates in the United States if mean serum 25-hydroxyvitamin D levels were raised to 45 ng/mL by solar ultraviolet-B irradiance. Dermato-Endocrinology, 2009;1(4):207-14.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, "The Journal of clinical endocrinology and metabolism." 2011 Jul;96(7):1911-30.
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011 Jan;96(1):53-8.
Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guérin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: Recommendations for clinical practice. Autoimmun Rev 2010;9:709-15.
van der Mei IA, Ponsonby AL, Engelsen O, Pasco JA, McGrath JJ, Eyles DW, Blizzard L, Dwyer T, Lucas R, Jones G. The high prevalence of vitamin D insufficiency across Australian populations is only partly explained by season and latitude. Environ Health Perspect. 2007 Aug;115(8):1132-9.