Scientists are excited about a vitamin
again. But unlike fads that sizzled and fizzled, the evidence this time
is strong and keeps growing. If it bears out, it will challenge one of medicine’s
most fundamental beliefs: that people need to coat themselves with sunscreen
whenever they’re in the sun. Doing that may actually contribute to far more
cancer deaths than it prevents, some researchers think.
The vitamin is D, nicknamed the “sunshine vitamin” because the skin makes
it from ultraviolet rays. Sunscreen blocks its production, but dermatologists
and health agencies have long preached that such lotions are needed to prevent
skin cancer. Now some scientists are questioning that advice. The reason
is that vitamin D increasingly seems important for preventing and even treating
many types of cancer.
In the last three months alone, four separate studies found it helped protect
against lymphoma and cancers of the prostate, lung and, ironically, the
skin. The strongest evidence is for colon cancer.
Many people aren’t getting enough vitamin D. It’s hard to get from food
and fortified milk alone, and supplements are problematic. So the thinking
is this: Even if too much sun leads to skin cancer, which is rarely deadly,
too little sun may be worse. No one is suggesting that people fry on a beach.
But many scientists believe that “safe sun” – 15 minutes or so a few times
a week without sunscreen – is not only possible but helpful to health.
One is Dr. Edward Giovannucci, a Harvard University professor of medicine
and nutrition who laid out his case in a keynote lecture at a recent American
Association for Cancer Research meeting in Anaheim, Calif. His research
suggests that vitamin D might help prevent 30 deaths for each one caused
by skin cancer. “I would challenge anyone to find an area or nutrient or
any factor that has such consistent anti-cancer benefits as vitamin D,”
Giovannucci told the cancer scientists. “The data are really quite remarkable.”
The talk so impressed the American Cancer Society’s chief epidemiologist,
Dr. Michael Thun, that the society is reviewing its sun protection guidelines.
“There is now intriguing evidence that vitamin D may have a role in the
prevention as well as treatment of certain cancers,” Thun said. Even some
dermatologists may be coming around. “I find the evidence to be mounting
and increasingly compelling,” said Dr. Allan Halpern, dermatology chief
at Memorial Sloan-Kettering Cancer Center in New York, who advises several
cancer groups.
The dilemma, he said, is a lack of consensus on how much vitamin D is needed
or the best way to get it.
No source is ideal. Even if sunshine were to be recommended, the amount
needed would depend on the season, time of day, where a person lives, skin
color and other factors. Thun and others worry that folks might overdo it.
“People tend to go overboard with even a hint of encouragement to get more
sun exposure,” Thun said, adding that he’d prefer people get more of the
nutrient from food or pills. But this is difficult. Vitamin D occurs naturally
in salmon, tuna and other oily fish, and is routinely added to milk. However,
diet accounts for very little of the vitamin D circulating in blood, Giovannucci
said.
Supplements contain the nutrient, but most use an old form – D2 – that is
far less potent than the more desirable D-3. Multivitamins typically contain
only small amounts of D-2 and include vitamin A, which offsets many of D’s
benefits.As a result, pills might not raise vitamin D levels much at all.
Government advisers can’t even agree on an RDA, or recommended daily allowance
for vitamin D. Instead, they say “adequate intake” is 200 international
units a day up to age 50, 400 IU for ages 50 to 70, and 600 IU for people
over 70.
Many scientists think adults need 1,000 IU a day. Giovannucci’s research
suggests 1,500 IU might be needed to significantly curb cancer. How vitamin
D may do this is still under study, but there are lots of reasons to think
it can:
•Several studies observing large groups of people found that those with
higher vitamin D levels also had lower rates of cancer. For some of these
stud ies, doctors had blood samples to measure vitamin D, making the findings
particularly strong. Even so, these studies aren’t the gold standard of
medical research — a comparison over many years of a large group of people
who were given the vitamin with a large group who didn’t take it. In the
past, the best research has deflated health claims involv ing other nutrients,
including vitamin E and beta carotene.
•Lab and animal studies show that vitamin D stifles abnormal cell growth,
helps cells die when they are supposed to, and curbs formation of blood
vessels that feed tumors.
•Cancer is more common in the elderly, and the skin makes less vitamin D
as people age.
•Blacks have higher rates of cancer than whites and more pigment in their
skin, which prevents them from making much vitamin D.
•Vitamin D gets trapped in fat, so obese people have lower blood levels
of D. They also have higher rates of cancer.
•Diabetics, too, are prone to cancer, and their dam aged kidneys have trouble
converting vitamin D into a form the body can use.
•People in the northeastern U.S. and northerly regions of the globe like
Scandinavia have higher cancer rates than those who get more sunshine year-round.
During short winter days, the sun’s rays come in at too oblique an angle
to spur the skin to make vitamin D. That is why nutrition experts think
vitamin D-3 supplements may be especially helpful during winter, and for
dark-skinned people all the time. But too much of the pill variety can cause
a dangerous buildup of calcium in the body. The government says 2,000 IUs
is the upper daily limit for anyone over a year old. On the other hand,
D from sunshine has no such limit. It’s almost impossible to overdose when
getting it this way. However, it is possible to get skin cancer. And this
is where the dermatology establishment and Dr. Michael Holick part company.
Thirty years ago, Holick helped make the landmark discovery of how vitamin
D works. Until last year, he was chief of endocrinology, nutrition and diabetes
and a professor of dermatology at Boston University. Then he published a
book, “The UV Advantage,” urging people to get enough sunlight to make vitamin
D. “I am advocating common sense,” not prolonged sunbathing or tanning salons,
Holick said.
Skin cancer is rarely fatal, he notes. The most deadly form, melanoma, accounts
for only 7,770 of the 570,280 cancer deaths expected to occur in the United
States this year. More than 1 million milder forms of skin cancer will occur,
and these are the ones tied to chronic or prolonged suntanning. Repeated
sunburns – especially in childhood and among redheads and very fair-skinned
people – have been linked to melanoma, but there is no credible scientific
evidence that moderate sun exposure causes it, Holick contends.
“The problem has been that the American Academy of Dermatology has been
unchallenged for 20 years,” he says. “They have brainwashed the public at
every level.”
The head of Holick’s department, Dr. Barbara Gilchrest, called his book
an embarrassment and stripped him of his dermatology professorship, although
he kept his other posts. She also faulted his industry ties. Holick said
the school has received $150,000 in grants from the Indoor Tanning Association
for his research, far less than the consulting deals and grants that other
scientists routinely take from drug companies. In fact, industry has spent
money attacking him. One such statement from the Sun Safety Alliance, funded
in part by Coppertone and drug store chains, declared that, “sunning to
prevent vitamin D deficiency is like smoking to combat anxiety.”
Earlier this month, the dermatology academy launched a “Don’t Seek the Sun”
campaign calling any advice to get sun “irresponsible.” It quoted Dr. Vincent
DeLeo, a Columbia University dermatologist, as saying: “Under no circumstances
should anyone be misled into thinking that natural sunlight or tanning beds
are better sources of vitamin D than foods or nutritional supplements.”
That opinion is hardly unanimous, though, even among dermatologists. “The
statement that ‘no sun exposure is good’ I don’t think is correct anymore,”
said Dr. Henry Lim, chairman of dermatology at Henry Ford Health System
in Detroit and an academy vice president.
Some wonder if vitamin D may turn out to be like another vitamin, folate.
High intake of it was once thought to be important mostly for pregnant women,
to prevent birth defects. However, since food makers began adding extra
folate to flour in 1998, heart disease, stroke, blood pressure, colon cancer
and osteoporosis have all fallen, suggesting the general public may have
been folate-deficient after all.
With vitamin D, “some people believe that it is a partial deficiency that
increases the cancer risk,” said Hector DeLuca, a University of Wisconsin-Madison
biochemist who did landmark studies on the nutrient. About a dozen major
studies are under way to test vitamin D’s ability to ward off cancer, said
Dr. Peter Greenwald, chief of cancer prevention for the National Cancer
Institute. Several others are testing its potential to treat the disease.
Two recent studies reported encouraging signs in prostate and lung cancer.
As for sunshine, experts recommend moderation until more evidence is in
hand.
“The skin can handle it, just like the liver can handle alcohol,” said Dr.
James Leyden, Professor Emeritus of Dermatology at the University of Pennsylvania,
who has consulted for sunscreen makers.
“I like to have wine with dinner, but I don’t think I should drink four
bottles a day.”
Hey! Here’s some GOOD press about indoor
tanning! This article was originally published
on May 10, 2005 in The Citizen, a newspaper
in Auburn, NY and is reprinted with permission.
TANNING’S
by Jennifer Hogan
LIGHT SIDE
With the temperature rising and clothes slowly shedding,
it is normal to want a healthy-looking tan. In recent years, researchers
have found that tanning in moderation can be beneficial, as well as help
treat certain medical conditions. The tanning of the skin is the body’s
natural defense against sunburn. When the skin experiences sunburn, there
is damage to small blood vessels and elastic fibers, causing a breakdown
of collagen. The darkening of the skin acts as a barrier of further damage
to the skin caused by sunburn.
A recent national study found that Americans are not getting the recommended
daily levels of vitamin D, an essential nutrient necessary for healthy bones.
“Vitamin D deficiency is something that is diagnosed in our office everyday,”
said Lisa Doyle, a physician’s, assistant at Auburn Orthopedic Specialists.
“It is especially apparent here in the northeast where we do not get enough
sunlight. Vitamin D deficiency can lead to osteoporosis, bone and muscle
pain. I have seen this deficiency in patients in their 20s, as well as older
patients who are more prone to it.”
According to Doyle, people with dark skin are at the most risk for vitamin
D deficiency, and a lot of their patients are African-American. “Dark skin
doesn’t absorb the light efficiently, causing the deficiency to be more
of a problem for darker skins,” Doyle said. Unlike other vitamins, D is
not found in many of the foods we eat. Sunlight is the body’s only natural
and reliable source of Vitamin D.
The skin soaks up the ultraviolet rays in the sunlight and converts them
into the much-needed vitamin D. The body needs vitamin D to better absorb
calcium. It has long been known that vitamin D is necessary to rid of bone
diseases such as rickets, a bone-bending disease caused by vitamin D deficiency.
“Rickets is on the rise again,” Doyle said. “It was a big thing long ago,
but we are now seeing a resurgence of it.”
There has been increasing evidence that vitamin D may protect against several
cancers including breast and colon cancers, as well as many other medical
conditions such as diabetes, hypertension, osteoporosis and heart disease.
Sunlight can also have positive effects on certain skin conditions. Doctors
often prescribe tanning for chronic acne and psoriasis. “One thing that
I have noticed about tanning is that my skin doesn’t seem to get as oily
as it used to,” said Angela Barbagallo of Locke. “I don’t seem to experience
as many acne breakouts since I have been going to the tanning salon.” Barbagallo
has been tanning for two years and says that she visits the tanning salon
three days a week.
Experts now believe that tanning in moderation can have health benefits
that far outweigh the risks. That is not to say that people should all go
out and get as much sun as possible; tanners must still use caution. Too
much exposure to the sun still carries health risks. “It is recommended
that 15 minutes of sunlight, without the use of sunscreens, every couple
of days can be enough to sustain adequate vitamin D levels,” Doyle said.
“The use of sunscreens and sunlight through glass can prevent ultraviolet
rays from penetrating the skin. There has not been any scientific or medical
proof, but we suspect that indoor tanning may offer similar positive effects
as direct sunlight.”
Healthy, glowing skin is essential to maintaining positive self-esteem.
Tanned skin has been found to create the illusion of health and success.
Barbara Switzer, owner of Barb and Company tanning salon believes indoor
tanning is a stress-reliever for many of her clients. “Several of my clients
refer to their tanning sessions as mini vacations,” Switzer said.
In addition to health benefits, exposure to the sun’s ultraviolet rays can
have a positive psychological affect as well. Sun exposure is often a prescription
given to depression patients. Experts have said that ultraviolet rays found
in moderate exposure to sunlight may increase the release of feel-good endorphins,
causing a boost in emotional good health.
“I mainly tan for beauty reasons,” Barbagallo said. “I think that it makes
me look thinner and healthier. When I feel that I look good, it boosts my
self-esteem and makes me feel good about myself. The tanning experience
is very relaxing, and it has a soothing effect on me. I feel invigorated
when I am through with a tanning session.” Bravo!–IST
THAT’S
TANTASTIC!
Couple Adds Two
Salons to Chain
by John P. Ribner
MONROEVILLE, PA – Bob and Stephanie English recently opened two new salons, bringing the number of their TanTastic Tanning locations to five.
Three years ago, Bob and Stephanie English, saw the writing
on the wall. “We noticed a trend toward regional operators playing a significant
role in the industry because they’re able to quickly adjust to changes in
their markets,” Bob recalled. “Since we already had the benefit of brand
recognition in our area with our first three salons, we decided to capitalize
on that by opening two more stores.” The fourth TanTastic location, which
is located in Harmarville, opened January 2, and the fifth store opened
on February 28 in Murrysville.
Going from three stores to five, the couple quickly realized that they couldn’t
operate all the salons on their own. To help things run smoothly in their
quickly growing empire, the couple hired Rachel Deklevar as manager of their
Harmarville salon. “This is the first time we’ve hired a manager, and Rachel
is doing a fantastic job with us,” Stephanie commented. “She comes from
the finance industry, and indoor tanning is a bit new to her, but she’s
made the transition very well. We’re very happy to have her.”
When it comes to location, Bob says he and Stephanie couldn’t have done
better with their two new TanTastic salons. The Harmarville store is connected
to an athletic club, which he says has provided a built-in clientele, while
the Murrysville salon is located in a recently constructed strip mall. “We
were the first business in there and we definitely paid the price for everyone
else who would later come in,” he laughed. “We fought the battles with utility
companies, signage and township zoning issues, but it was worth it because
we’re happy with the location. The developers have also attracted a good
mix of local and national businesses to help fill out the rest of the plaza.”
Bob and Stephanie credit their success to their partnerships with California
Tan, Inc. and PC Marketing, Inc./UWE. The salons exclusively offer tanning
units from PC Marketing, and the entire TanTastic chain sells California
Tan lotions, exclusively. “With-out the help and guidance of PC Marketing
and Cal Tan, we couldn’t have done it,” Bob commented. “Over the years,
their knowledge and experience helped us to develop a sound strategy and
plan well for the future. We’re very fortunate to have met some great people
in this industry over the years who have helped us to enjoy the success
that we do.”
Congrats, Bob & Steph!–IST
