An article in the Journal of Internal Medicine, “Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort,” by P. G. Lindqvist, E. Epstein, K. Nielsen, M. Landin-Olsson, C. Ingvar, H. Olsson

https://doi.org/10.1111/joim.12496, deals with an issue that should be of interest to rural women who have to be outside a lot. The dangers of skin cancer are well known, but now there is a problem of people not getting enough sun, and hence stimulating the body’s production of vitamin D3, leading to the increase of diseases, and hence mortality. This relationship has been documented by Swedish research.

While not offering medical advice, common sense indicates that the rule of the happy medium, would be prudent, of moderation in all affairs. Getting some sun is needed, but protection is need against how much. To work out the individual formula, one needs to see a medical professional.

https://onlinelibrary.wiley.com/doi/full/10.1111/joim.12496

Abstract

Objective

Women with active sunlight exposure habits experience a lower mortality rate than women who avoid sun exposure; however, they are at an increased risk of skin cancer. We aimed to explore the differences in main causes of death according to sun exposure.

Methods

We assessed the differences in sun exposure as a risk factor for all-cause mortality in a competing risk scenario for 29 518 Swedish women in a prospective 20-year follow-up of the Melanoma in Southern Sweden (MISS) cohort. Women were recruited from 1990 to 1992 (aged 25–64 years at the start of the study). We obtained detailed information at baseline on sun exposure habits and potential confounders. The data were analysed using modern survival statistics.

Results

Women with active sun exposure habits were mainly at a lower risk of cardiovascular disease (CVD) and noncancer/non-CVD death as compared to those who avoided sun exposure. As a result of their increased survival, the relative contribution of cancer death increased in these women. Nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking. Compared to the highest sun exposure group, life expectancy of avoiders of sun exposure was reduced by 0.6–2.1 years.

Conclusion

The longer life expectancy amongst women with active sun exposure habits was related to a decrease in CVD and noncancer/non-CVD mortality, causing the relative contribution of death due to cancer to increase.”

Bob Livingston Alerts, via email had a commentary upon this:

“When research found that women who avoided the sun had a greater risk of dying early from "major" causes of death like cardiovascular disease, and had shorter lives — by up to 2.1 years — than women who got more sun, the mainstream was perplexed.

"Why do sunbathers live longer than those who avoid the sun?" the headlines asked.

My question was and always has been, why was there even a question? Unless of course none of them had ever done any research.

The study in the JoIM followed almost 30,000 Swedish women for 20 years. Low levels of sun exposure, not higher, increased mortality in rates similar to smoking.

Now you may be asking what about melanoma skin cancer from increased sun exposure? Shouldn't I be scared?

Research from the Dermatology Department at Norfolk and Norwich University Hospital, Norwich, UK, found that sun exposure may be just a scapegoat to explain away "diagnostic drift," instances in which doctors classified benign lesions as stage 1 melanoma.

In other words, physicians diagnosing non-cancerous lesions as cancerous accounted for a perceived rise in rates of melanoma.

One study in Medical Hypotheses found that melanoma rates were increasing in indoor workers far faster than outdoor workers. Researchers attribute this to the lack of vitamin D from sun exposure indoor workers get, along with an increase in UVA rays (which pass through windows) that cause cell mutations and break down vitamin D formed from outdoor sun exposure. Researchers also determined "inadequately maintained cutaneous levels of vitamin D3 promote" melanoma.

Vitamin D in the bloodstream is converted to calcitriol. Calcitriol is then used to repair damage to organs and cells, including damage caused by cancer cells and tumors. Vitamin D works by:

• Increasing the self-destruction of mutated cells (which, if allowed to replicate, could lead to cancer)
• Reducing the spread and reproduction of cancer cells
• Causing cells to become differentiated (cancer cells often lack differentiation)
• Reducing the growth of new blood vessels from pre-existing ones, which is a step in the transition of dormant tumors turning cancerous

Theories linking vitamin D to preventing certain cancers have been tested and confirmed in more than 200 epidemiological studies, and understanding of its physiological basis stems from more than 2,500 laboratory studies, according to epidemiologist Cedric Garland, DrPH, professor of family and preventive medicine at the UC San Diego School of Medicine.

Women with breast cancer are three times more likely to have low vitamin D levels, and a study published in  Cancer Epidemiology, Biomarkers & Prevention has found that men with the highest levels of vitamin D lived longer after prostate cancer diagnosis than those with low levels of the hormone.

What's more, vitamin D has been shown to influence dozens of other conditions including diabetes types I and II, cold and flu, aging signs, osteoporosis, seizures, Alzheimer's disease, dementia, schizophrenia, inflammation, inflammatory bowel disease, multiple sclerosis, infertility, depression and asthma.

If every U. S. citizen began taking a daily dose of 5,000 IUs per day of vitamin D3, a very large segment of the medical industry would be hurt. If vitamin D were a cancer drug made by Big Pharma, the American Cancer Society would likely be pushing it as the next "miracle" drug and calling for everyone to be put on the drug. But since it's a nutrient that cannot (yet) be patented and can actually be manufactured for free by exposing your skin to natural sunlight, the entire medical industry now laughingly pretends that vitamin D supplementation offers no benefits.

But D3 as cholecalciferol is not just a nutrient. It is the most potent immune-boosting, bone-building and cancer-preventing hormone in the human body.

Therefore, you should know the best natural sources of vitamin D in case you can't get enough from sunshine, and in the event that Big Pharma finds a way to patent it and remove the supplement from shelves.

My favorite is good old-fashioned cod liver oil. A tablespoonful has between 1,500 and 2,000 IU, which is around half a day's worth of supplementation.

Mushrooms are the only common vegetable with vitamin D. And, if you dry mushrooms for a few hours in the sun, their vitamin D content skyrockets.

Processed foods like cereal and soy that are "fortified" with vitamin D and are not good sources. They usually have synthetic D2, not natural D3.”