Let the sunshine in

The quick answer:  Aside from a healthy diet and exercise, the next best thing you can do is to get enough sunshine to maintain a healthy serum vitamin D level.  It’s good for your mood and can help prevent a long list of diseases.


About Vitamin D

It’s essential to eat vitamin-rich food because the body can’t produce them, with one exception:  With a little sunshine, the body can make it’s own vitamin D.  Unfortunately, the weathermen and dermatologists have scared us out of getting enough sunshine.  Ever had your vitamin D level tested?

Sufficient D is essential to good health; vitamin D receptors are found in cells all through your body.  The growing list of conditions where vitamin D deficiency is a risk factor includes seasonal affective disorder (SAD), osteoporosis, muscle and joint pain including back pain, certain cancers (breast, ovarian, colorectal, and prostate), obesity and diabetes, stroke or heart attack, G.I. diseases like inflammatory bowel disease (IBD) or Crohn’s disease, and immunological diseases such as MS and Parkinson’s disease.  It’s a long list. 

Vitamin D deficiency increases as you move away from the equator.  In the Sunbelt you can get adequate D year around, though it takes longer in winter.  But if you live above the 40th latitude parallel, roughly a line through Portland, OR, Salt Lake City, and New York City, you can ski all winter in your bathing suit and not get enough D.

There’s an annual cycle to your vitamin D level.  For most, our D level peaks in the last sunny days of summer, then hits rock bottom as winter turns to spring.  This is the point when you feel the blues, lack energy, or suffer muscle aches.  Because spring just started, your D is likely at its annual low-point (unless you’ve just back sunbathing on a beach in Costa Rica). 

IOM Report

Americans love to take pills.  Maybe it’s because we’re in a rush and taking a pill is a quick fix, but we eat a lot of pills, including vitamin pills.  We get into vitamin fads—remember the vitamin C and E eras?   Usually these end badly; the hoped-for benefit proves elusive, or side effects present.  Because of the growing interest in vitamin D, the Institute of Medicine, perhaps the world’s most prestigious scientific body, was asked to study the vitamin D issue lest we run off on another pill fad.

The IOM report, issued in late 2010, disappointed many because of its cautiousness.  Basically, if you set the minimum level for serum vitamin D at 20 nanograms/mL, most people are OK.  But if you set the level at 30, as some labs do, then up to 80% are deficient.  Some doctors argue that 40-50 is a good range but the IOM couldn’t find sufficient evidence to support a target higher than 20-30.  (The IOM report also looked at calcium supplements and found little support, with the exception of girls in their teens.)

The N. Y. Times ran an article on the IOM report, repeating the message that vitamin D and calcium pills may not be indicated for most.  The article unleashed a torrent of reader comments, many from thoughtful people in the Northeast, the region with the least sunshine for vitamin D.  Readers expressed real anger that there wasn’t better guidance on the optimum vitamin D level, or on the best methods to maintain vitamin D in the winter.  This is a common problem in nutrition—after the billions spent on research, we have these basic questions without a clear answer.

The Vitamin D Solution

The best book I’ve seen on vitamin D is The Vitamin D Solution, written by Dr. Michael Holick, PhD, MD.  Holick suggests a 3-step solution of 1) testing, to know where you are, 2) sensible sunshine, and 3) safe supplementation when sunshine isn’t available. 

The book makes two remarkable statements about vitamin D and cancer:

First, on the benefit of getting sensible sunshine: “vitamin D could be the single most effective medicine in preventing cancer, perhaps even outpacing the benefits of . . . a healthy diet”.  We hear all the time that we should avoid avoid sunshine to prevent skin cancer, which brings us to the second point.

Second, the book quotes Dr. Edward Giovannucci on the benefits of sunshine for vitamin D versus the risk of skin cancer:  sufficient “vitamin D might help prevent 30 deaths for each one caused by skin cancer”.    I like those odds: 30 better outcomes at the risk of one bad outcome.

I recently saw my dermatologist.  She’s a charming woman who cares about her patients.  We talked about the trade-off between getting enough vitamin D the natural way—by sunshine—versus the risk of skin cancer.  The good doctor pointed out that in southern California, you could get sufficient vitamin D with 15 minutes of sunshine on most days.  Of course you have to show a little skin, so I do my workouts outdoors around noontime, wearing shorts and shirts without sleeves (except when it’s cold).  When no one’s around I take off my shirt, but I try to avoid the “pinkness” that’s the first stage of a sunburn. 

I’ve got a physical check-up scheduled that includes a test for vitamin D.  I’ll let you know how it comes out.  I’ll be happy if I have a serum level of 30 ng/mL, the upper range recommended by the IOM.  A number of people have told me their vitamin D levels—I’m forward about asking—and I’ve yet to meet anyone with a value of at least 30.  Per the IOM, this is a big problem, which brings us to this week's Healthy Change:

Please note the term "a little" sunshine, sun that burns or turns the skin pink may be harmful and should be avoided.  (If you live in the northern latitudes, don’t tolerate the sun, or are concerned about your vitamin D, consult your doctor.)

Please comment:  Want to share your experience with vitamin D, or how you tested?  Do you live in the northern latitudes?  If so, what do you do in winter to maintain vitamin D. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

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Reader Comments (22)

My wife showed me your website a few days ago. I absolutely appreciate it. I took a personal vow two years ago this month to completely stop the intake of candy, fast food, soda, cookies, cakes (even on holidays) etc. I have been victorious since, and I feel great. Thank you for all of your information thus far. It is very informative.

January 24, 2011 | Unregistered CommenterRyan

I'm a friend of Brooke's from NYC and I really love your blog. Thanks for all your effort. I read it through my Google Reader - so if your visitor number doesn't seem high - don't forget all of us "Readers". Thanks again.

January 24, 2011 | Unregistered CommenterMichelle

Okay, I have to say I am loving you blog. I have not eaten any fried foods even when the temptation is right in front of me, I am loving my breakfast every morning and soda was luckily never a problem for me... I feel great!

This change is perfect for me because I have already been trying to do this with my baby. I like to take him out in the warm afternoon and hang out in the grass.
I had no idea you would be blogging about more than just a diet and I think this is great! I know with the help of your knowledge I will be feeling so much healthier! Thank you!!1

January 24, 2011 | Unregistered CommenterRandi

Randi, what a lucky baby. It's true the blog is mostly about diet, but five related health topics are too important to not include: vitamin D (some comes from diet), exercise (next week), sleep, natural light, and harmful stress. Best to you, Skip

January 24, 2011 | Registered CommenterSkip Hellewell

My kids' pediatrician told me that letting my kids (and myself) get about 20 minutes of direct sunlight a day is optimal. At about 20 minutes is when you generally start to turn pink. At this point she suggested putting on the sunscreen and covering up.

I also read or heard somewhere that you only absorb Vitamin D from the sun via your head/face and hands? Not sure if/why that would be the case, but there it is.

Anywho, that's the little strategy I try to live by - 20 minutes a day. Also, even if it's overcast you can get the benefit of Vitamin D, I believe, so go ahead and take that walk!

January 24, 2011 | Unregistered CommenterJoy Fisher

This is a fascinating post to me. Last summer, while testing my blood for a couple of other things, my doctor also tested for vitamin D. The result was that I was highly deficient--even with daily outdoor exercise and daily trips to the pool with my kids. She put me on 2000 I.U.s each day to supplement. Can too much vitamin D harm you? I think I need to do a little more reading on this.

I am really enjoying your blog, by the way. Thank you for passing along all your research!

January 25, 2011 | Unregistered CommenterChristina

This is interesting, Skip. I am currently being diagnosed with an auto-immune disease and the biggest suggestions from my neurologist are getting more vitamin D (both sunlight AND supplement), getting in "easier" exercise daily, and cutting out red meat. I think it is fascinating as a child of the sunblock era to be told NOW that sunblock also cuts out absorption of essential vitamins. People will get a little eraser-sized skin cancer and SHOUT: WEAR YOUR SUNBLOCK! But the message should rather be: DON'T SUNBATHE! Enjoy a little sun everyday for emotional and physical wellness, not for tanning your skin.

I think we are going to see more and more diseases caused from vitamin D deficiencies because of the social pressures of sunblock and the lessened amount of time children spend outside.

January 25, 2011 | Unregistered CommenterAnna M

Last year my dad went to a new cardiologist who tested his vitamin D levels and found him very deficient. After supplementing (fair skin and years of lots of outside activity have already led to multiple skin non-malignant skin cancers), he was able to reduce his Lipitor dose by half and his cholesterol numbers are lower than they've ever been. Have you seen research about vitamin D and cholesterol? My dad also reports that the ranch work no longer makes his muscles sore.

After blood work done last year, I was told to supplement. Despite very fair skin and living in Arizona, my body was making no vitamin D. The only time I worry about putting sunscreen on my kids is when we spend an afternoon at the pool (see again, fair skin and Arizona).

January 25, 2011 | Unregistered CommenterLainey

Christina, if you've had your blood vitamin D level checked, you have a better than average doctor. The 2000 I.U. prescribed by your doctor are under the maximum dose per the IOM guidelines. For those who feel better getting some or all of their vitamin D from the sun, you can find online calculators. One is offered by he Norwegian Institute for Air Research and guidance in using it can be found if you Google "How much sunshine do you need to get your vitamin D".

After my research on the benefits of vitamin D, including protection from breast, prostate, and colorectal cancers, I moved my outdoor exercise time from morning to midday. Incidentally, older people need more sun than the younger.

January 25, 2011 | Registered CommenterSkip Hellewell

Hi Skip! I found your blog via your daughter's blog and I love them both! I'm excited to implement your tips as the year goes on. Now for a suggestion - I think you should make a button for Word of Wisdom Living that bloggers could add to their sidebars. I would love to be able to share your healthy changes with my readers that way. Just a thought, and thanks for the tips!

January 25, 2011 | Unregistered CommenterTara

I stumbled upon your blog via your daughter's. I wanted to add my recommendation for Stephen Ilardi's book "The Depression Cure". Much of it is about Vitamin D, the evolutionary changes that cause us to not get enough, and how to implement a plan to change the deficiency. While I did not use the book as a depression cure, but rather I looked at it as a health book, I can truly say when I was following it to a T, I was the happiest and healthiest me. I thought you might find it interesting!

January 26, 2011 | Unregistered CommenterBecca

Becca, thanks for sharing about vitamin D. I'll make another post and discuss the amazing health benefits of taking care of our vitamin D. When I started reading about it I moved my outdoor exercise time from the morning to midday, to assure regular sunshine. Best, Skip

January 26, 2011 | Registered CommenterSkip Hellewell

Thank you for this wonderful blog. I found ti through your daughter's blog.

January 26, 2011 | Unregistered CommenterElizabeth Louros

This is a great post. I love reading the comments as well. Hearing other stories makes me think about my own life and how to make it better.

I have a new baby - almost 3 months old. It's hard to take him outside now because of all the snow, but on sunny days I like to get outside for a little while between naps. I've heard that babies, especially, need sunscreen. Do you know why? Something about them not producing something to protect their skin. (? I'm not sure what I'm talking about, really...) I'd love to hear if you have read or researched anything about that.

Also, I'm very passionate about how sleep relates to our health. I'm so excited for the post you have in store for that topic. Thanks again for these posts! Just curious - do you take vitamin supplements? If so, which ones?

January 26, 2011 | Unregistered CommenterRikki

Rikki, thanks for your interest and for sharing this blog with your friends. Congratulations on your baby. To your question, I don't take any supplements, though I would if my doctor made a good argument. My basic goal is to get everything that might be in a pill by the traditional route—through wholesome food. That way, the vitamins and minerals come surrounded by all the nutrients needed for life. Talk to your pediatrician about sun for your baby, he can give the best advice. Best to you, Skip

January 26, 2011 | Registered CommenterSkip Hellewell

I live in a country with very little sunshine during the winter, and over here basically every child under 3 gets a vitamin A and D supplement, just because it can be quite difficult to get enough sunshine. I know that I try to get some sunshine every day, but when dawn comes as late as 11 am and and dusk starts as early as 2 pm, it can get tricky at times. So I don't se any problems with supplementing with vitamin D during the dark months if it is difficult to get enough through sun.

January 28, 2011 | Unregistered CommenterMims

Mims, thanks for writing. Vitamin D during a winter with just three hours of sunshine is a real challenge. Thanks for sharing your approach. Do you supplement with synthetic vitamin D, or with fish oils? Best to you, Skip

January 28, 2011 | Registered CommenterSkip Hellewell

As a fairly fair person (lol) who has had 2-3 BAD burns as a, um, youth, back in the 80s I wear sunscreen a lot and avoid the sun during the peak hours, etc. However, I find that in the winter, i'm very much affected by the lack of light here in the north, esp this winter with the non-stop snow and grey skies. The past few weeks, i've been pulling the blinds up in my office for about 20min each day when the sun is blasting through the window. It helps my mood and I'm sure my vit D levels. My doc has me taking a hefty dose but I've been cutting back to every other day or so since my new found love of the sunbeam. :)

Thank you for sharing all this information in a concise and easy to understand way! Invaluable.

January 29, 2011 | Unregistered Commenterpixie

Pixie, congratulations on having a window office. One problem, glass filters out the UVB rays that make vitamin D. The sun feels good, but you need to get outside to get vitamin D. Perhaps a lunchtime walk with some skin exposed. Clouds pass most of the UVB. Talk to your doc about combining sun with pills. Best to you, Skip

January 29, 2011 | Registered CommenterSkip Hellewell

Hi Skip! I supplement with fish oil capsules all year round, I get enough sun in summer to produce enough vitamin D (and then some), but I find that the fish oil also helps with "brain fatigue" (don't know how else to put it), make my movements feel smoother (I dance a lot, which is not always the best for your joints) and just make me feel better. In fact (and relating to Becky here) I suffer from a mild, stress related depression, and it gradely deteriorated when I ran out of fish oil capsules in May and thought I could do without them for a couple of months. Once I started with them again in August I felt so much better in just a week or two that I decided never to stop again.

January 31, 2011 | Unregistered CommenterMims

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