Vitamin D deficiency has been recognised as a global concern, with an estimated one billion people worldwide experience vitamin D deficiency. These deficiencies exist across ethnicities and age groups.

Various factors may contribute to vitamin D deficiency. However, recent findings from a study by Kim M. Pfotenhauer and Jay H. Shubrook showed that the widespread use of sunscreen can contribute to this deficiency.

Sun exposure as source of Vitamin D

As the body produces vitamin D from cholesterol by a process that triggers the action of sunlight on skin, the importance of moderate sun exposure to get adequate levels of vitamin D is clear. The amount of vitamin D needed varies depending on the individual, which also relates to the efficiency of production of vitamin D.

This process depends on the number of UVB photons that can penetrate the skin, and this can be dampened by factors such as clothing, excess body fat, sunscreen and skin pigment melanin. Also, certain higher-risk populations may benefit more when it comes to vitamin D requirements, including pregnant and breastfeeding women as well as the elderly.

Over the years, society has repeatedly been made aware of the harmful consequences of excessive exposure to the sun, particularly concerning the dangers of skin cancer. As a result, many people are more conscious about putting on sunscreen when going outdoors.

According to Pfotenhauer, assistant professor at Touro University, people are spending less time outside and when they do, they typically wear sunscreen. He says that this nullifies the body’s ability to produce vitamin D.

Sunscreens are designed to absorb the radiation in the UVB range. However, this can reduce the capacity of skin to produce vitamin D.

Vitamin D deficiency linked to various diseases

Vitamin D deficiency has been associated with various diseases. For instance, people living at higher latitudes have a higher risk of dying from Hodgkin lymphoma and various types of cancers, compared to people who live at lower latitudes.

In fact, a clinical trial revealed that consuming 200 to 600 IU vitamin D3 and calcium two to four times daily resulted in a 50% to 77% reduction in expected incidence rates of cancers over a four-year period. This was conducted by Joan Lappe, a medical professor at Creighton University, together with other colleagues.

Previous studies have also linked vitamin D deficiency with other health disorders, including multiple sclerosis, diabetes, and cardiovascular disease. In addition, sun exposure has been found to have the potential to protect against illnesses such as rheumatoid arthritis, asthma and infectious diseases.

Addressing the problem

A 2016 study suggested a significant initiative to address the issue of vitamin D deficiency due to widespread sunscreen use. This is through optimising sunscreen for producing pre-vitamin D3 and simultaneously retaining its sun protection factor.

The basis would be designing the sunscreen with compounds that have differing filter compositions to maximise pre-vitamin D production, while maintaining protection for reducing erythema. Dieter Kockott and four other researchers found that the SPF 15 used in the study resulted in as high as 50% enhancement in pre-vitamin D production.

However, it is also important to recognise the foods that are naturally rich in vitamin D, such as dairy products and breakfast cereals as well as fatty fish such as salmon and tuna. Many people would also find vitamin D supplements as a good source, especially for those who do not spend much time in the sun.

Overall, healthcare professionals can play a role in educating the public on the excessive use of sunscreen. It is essential to highlight the pros and cons of sun exposure in a balanced way, while also taking into account individual variations and susceptibilities. MIMS

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