Tag Archives: sunlight

Of mice and men (or women): Sunlight reduces breast cancer beyond the effects of vitamin D. Another reason to embrace the sun.

Marc Sorenson, EdD, for breast cancer prevention. Prevent breast cancer with sunlight!

While many doctors know that ultraviolet radiation (UVR) from sunlight reduces risk of breast cancer, they have missed something. UVR stimulates production of vitamin D in human skin. Therefore, many health professionals assume that vitamin D is responsible for the reduced cancer risk. This may lead them to advocate the use of vitamin D supplementation and totally miss the bigger picture. In addition to vitamin D, UVR from sunlight or sunlamps produces many supplementary healthful photoproducts. Among others, nitric oxide, serotonin, endorphin and BDNF are produced by sunlight, and these photoproducts are vital to health. And, it is likely that these healthful photoproducts lead to an inhibition of breast cancer.

New research shows that sun exposure per se is capable of reducing the risk of breast cancer.

Consequently, it should not surprise us that for breast cancer, sunlight’s effects go beyond vitamin D.[1] Researchers at Children’s Hospital Oakland Research Institute, used a murine model (mice) that easily develops breast cancer, and treated them with UVR. Much as we might expect, they found that UVR treatments produced significant anti-cancer effects. Furthermore, they found that neither dietary vitamin D nor topical vitamin D influenced cancer risk. Because of their findings, they stated the following: “UVR’s inhibitory effects occur irrespective of whether or not the treatment increases circulating D3 in the mice.” Also, they made one more important comment regarding their research on breast cancer and UVR. “Therefore, supplemental D3 may not mimic all possible beneficial effects of UVR, and uncovering non-D3-mediated mechanisms of UVR tumor inhibition may lead to novel strategies for cancer prevention.”

An important point about vitamin D, sunlight and breast cancer.

Finally, there is no doubt that vitamin D has anticancer benefits. This research however, is especially relevant in that it corroborates what I have said in my soon-to-be-released book, Embrace the Sun. First of all, we must not put all of the benefits of sunlight in the vitamin D box. Secondly, sun exposure performs myriad miracles beyond vitamin D. One of those miracles may be breast cancer prevention and inhibition.  Thirdly, if we erroneously believe that we can obtain all of the sun’s benefits from popping a vitamin D pill, we may miss the holistic effects of the sun, which provide a cornucopia of salubrious results.

So, safely (without burning) embrace the sun and ease your mind about breast cancer.

[1] Anastasia M. Makarova, Flora Frascari, Parastoo Davari, Farzam Gorouhi, Philip Dutt, Lynn Wang, Akash Dhawan, Grace Wang, Jeffrey E. Green, Ervin H. Epstein, Jr. Ultraviolet radiation inhibits mammary carcinogenesis in an ER negative murine model by a mechanism independent of vitamin D3. Downloaded from cancerpreventionresearch.aacrjournals.org on April 12, 2018.

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Protect your gut! Low levels of sunlight exposure may predispose to inflammatory bowel disease (IBD), which will be accompanied by increased fracture risk.

Marc Sorenson, EdD

What is IBD?

First of all, IBD consists of two primary diseases, ulcerative colitis (UC) Prevent IBD with sunlightand Crohn’s disease (CD). UC is a chronic inflammatory condition characterized by relapsing and remitting episodes of inflammation limited to the mucosal layer of the colon.[1] Crohn’s disease, however, can involve any part of the gastrointestinal tract from the mouth to the anus. Yet, it most commonly affects the small intestine or the colon, or both.[2]

The gift of sunlight

First of all, there is a beautiful gift that may prevent or lessen IBD. The gift, (sunlight) awaits us, but if we do not accept the gift, we are no better off than if we didn’t have it. So it is in Italy, where those who suffer from IBD are shown to have far less sun exposure than those who do not have the disease.[3] Therefore, this may indicate that part of the cause of IBD is lack of sunlight. And in Italy, low sun exposure probably indicates a reluctance to step outside because, Italy is a sunny country. Maybe, many of the Italians who succumb to IBD, have obviously not accepted the gift. Either that, or they are using too much sunscreen, since sunscreen blocks the sun.

Furthermore, IBD patients are at an increased risk for fractures. Hence, one may conclude that both maladies may be due to low sun exposure.

Embrace the sun to prevent IBD

Another investigation, conducted over 12 years and involving hundreds of thousands of IBD patients produced remarkable outcomes. Hospitalizations for both UC and CD were far higher among those with low sun exposure.[4] And, the same relationship was shown between sun exposure, bowel surgeries and deaths: more surgeries were needed for those patients who experienced the lowest sun exposure. Also, more deaths occurred among those with low exposure.

And what about non-IBD patients?

Another side note to this investigation was the large number of non-IBD patients analyzed for sun exposure levels. It is most noteworthy that the same relationship existed as with the IBD patients. Low sun exposure associated with prolonged hospitalizations and more deaths when compared with high exposure. Especially relevant is other research involving the association of Crohn’s disease to surgery. It found that surgery for the disease was significantly reduced among patients who received more sun exposure.[5]

The north-south gradient

In addition, research shows that in the US, there is a north-south gradient for IBD risk.[6], [7], [8], [9]   The risk of developing the disease is significantly lower in southern latitudes (because sun exposure is greater).

An important nutritional note about IBD:

In addition to what we have heretofore described, it is especially relevant to understand that IBD causes malabsorption of nutrients in the gut. Consequently, it leads to diseases of malnutrition.[10] And, vitamin D is one of the “nutrients” that may not be absorbed efficiently. Therefore, sun exposure (or sunlamps) may be the only viable source of vitamin D for a person with IBD.

Most of all, remember that non-burning sun exposure is essential to human health. It seems like a good idea to obtain your share, and protect your gut from IBD.

[1] Peppercorn M, Cheifetz, A, Rutgeerts P, Grover S. Definition, epidemiology, and risk factors in inflammatory bowel disease. http://www.uptodate.com/contents/definition-epidemiology-and-risk-factors-in-inflammatory-bowel-disease.

[2] Web MD http://www.webmd.com/ibd-crohns-disease/crohns-disease/inflammatory-bowel-syndrome.

[3] Vernia P, Burrelli Scotti G, Dei Giudici A, Chiappini A, Cannizzaro S, Afferri MT, de Carolis A. Inadequate sunlight exposure in patients with inflammatory bowel disease. J Dig Dis. 2018 Jan;19(1):8-14

[4] Limketkai BN, Bayless TM, Brant SR, Hutfless SM. Lower regional and temporal ultraviolet exposure is associated with increased rates and severity of inflammatory bowel disease hospitalization. Aliment Pharmacol Ther. 2014 Sep;40(5):508-17.

 [5] Govani SM, Higgins PD, Stidham RW, Montain SJ, Waljee AK. Increased ultraviolet light exposure is associated with reduced risk of inpatient surgery among patients with Crohn’s disease. J Crohns Colitis. 2015 ;9(1):77-81

[6] Schultz M, Butt AG. Is the north to south gradient in inflammatory bowel disease a global phenomenon? Expert Rev Gastroenterol Hepatol. 2012 Aug;6(4):445-7.

[7] Kappelman MD, Rifas-Shiman SL, Kleinman K, Ollendorf D, Bousvaros A, Grand RJ, Finkelstein JA. The prevalence and geographic distribution of Crohn’s disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol. 2007 Dec;5(12):1424-9.

[8] Sonnenberg A. Similar geographic variations of mortality and hospitalization associated with IBD and Clostridium difficile colitis. Inflamm Bowel Dis. 2010 Mar;16(3):487-93.

[9] Holmes EA, Xiang F, Lucas RM. Variation in incidence of pediatric Crohn’s disease in relation to latitude and ambient ultraviolet radiation: a systematic review and analysis. Inflamm Bowel Dis. 2015 ;21(4):809-17

[10] Margulies SL, Kurian D, Elliott MS, Han Z. Vitamin D deficiency in patients with intestinal malabsorption syndromes–think in and outside the gut. J Dig Dis. 2015 Nov;16(11):617-33.

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The magnificent sun, UV, and what they do for our bodies and minds. Embrace the Sun!

Health benefits of UV by Marc Sorenson, Ed.D.

How important is UV? Sunlight. UV heart and mindA transcendentally important scientific paper, by Dr. AT Slominski and colleagues, has added significant information about UV (sunlight) for skin. In addition, it explains the intricate connection between sunlight and the immune, endocrine and central nervous systems.[1] The name of the research paper, published in the journal Endocrinology, is How ultraviolet light touches the brain and endocrine system through skin, and why. The authors begin the abstract by stating that “the skin is a self-regulating protective barrier organ that is empowered with sensory and computing capabilities to counteract the environmental stressors to maintain/restore disrupted cutaneous homeostasis.” In other words, the skin has the ability to take on what life deals it and maintain its equilibrium and balance. In addition, the skin communicates bidirectionally with the central nervous, endocrine and immune systems. Thus, it helps to maintain balance for all body systems.

How does UV work?

First of all, ultraviolet energy (UV and UVB light) triggers all of these marvelous processes. UV, of course is available from sunlight, sunbeds or sunlamps. Its electromagnetic energy, through the skin, converts to chemical, hormonal and neural signals. These signals promote positive effects on the immune system, the endocrine system and the brain. Furthermore, endorphins (opioid-like substances) are increased and immune-system proteins are mobilized; consequently, health improves with UV. And, sun exposure regulates the endocrine system, by way of exposure to the skin, to produce or diminish hormones as needed. Especially relevant is that these effects take place independently of vitamin D synthesis.

Health increases with UV due to the magnificent sun, and our magnificent skin. As a result of the above information, it seems like it would be a good idea to soak up some non-burning sun each day when available. And, when it is not, we should find another UV source. In our soon-to-be-published book, Embrace the Sun, we discuss many facts about the healthful effects sun exposure:

A few healthful effects of sun (UV) exposure

  • prevents and reverses obesity
  • Improves longevity by reducing the risk of death by 50% over 20 years
  • reduces the risk of hip fracture by 90% when compared to sun avoidance
  • prevents the risk of breast cancer by 90% when compared to sun avoidance
  • reduces by 50% the risk of melanoma in outdoor workers compared with indoor workers
  • increases heart and vascular strength
  • dramatically improves mood
  • reduces the risk of multiple sclerosis
  • reduces risk of most internal cancers
  • cures psoriasis and eczema
  • reduces risk of nervous system disorders
  • prevents memory loss
  • prevents myopia

The above list is not surprising in view of this new research, nor is the list complete. UV has many more healthful effects, which I’m sure the authors of this research acknowledge. Hence, the scientists sum up their research in this manner: “Thus, UV touches the brain and central neuroendocrine system to reset body homeostasis. This invites multiple therapeutic applications of UV radiation, for example in the management of autoimmune and mood disorders, addiction, and obesity.”

In conclusion, this seem like more compelling evidence to safely embrace the sun, no?

[1] Slominski AT, Zmijewski MA, Plonka PM, Szaflarski JP, Paus R. How ultraviolet light touches the brain and endocrine system through skin, and why. Endocrinology. 2018 Mar 12. [Epub ahead of print]

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Superbugs, sunlight, sanitoria and infectious diseases

sanatoria

The superbugs are among us. Should we return to the use of sanatoria?  

By Marc Sorenson, EdD

First of all, one should know that sanatoria are secluded hospitals. In addition, they usually specialize in healing through good food, fresh air and sunlight. Some scientists are now suggesting that we reestablish the use of sanatoria for healing.[1] They feel that sanatoria may be just the answer we seek for the prevention and healing of infectious diseases.

Interestingly, sanatoria were used effectively in the early 20th century (before antibiotics) and were really large outdoor solariums (sunrooms). These facilities allowed patients to be in natural surroundings, and in some cases, to expose themselves to direct sunlight. To demonstrate the efficacy of these facilities in curing tuberculosis (TB), consider the following history of Dr. Aguste Rollier:

Should we use sanatoria for healing TB?

First of all, records of 1,129 TB cases showed solariums cured 87% of “closed cases” and 76% of “open cases. “Among 158 patients with tuberculosis of the hip, 125 were cured and 102 “regained complete recovery of articular function.”[2] Dr. Rollier also had other successes. “During a time just following World War I, 1,746 of 2,167 tubercular patients under his care completely recovered. Furthermore, the only failures were among those who had allowed their tuberculosis to enter its most advanced stages.”[3]

Superbugs arrive from Peru.

In 2009, the first case of drug-resistant TB arrived in the US from Peru.[4] It was nearly 100% resistant to antibiotics. Consequently, it could cause an immense killer epidemic with the return of TB. There seems to be no answer to the “superbug” causing it. Or is there an answer? Could the sun provide a solution to this health threat? The superbugs are upon us like a bad horror movie. When they start to take over the earth, there will be few cures. But, UV light from the sun, or sun lamps, are remedies that still exist. Therefore, we would be well-advised to have our defenses set up in advance by enjoying daily sun exposure.

Another more recent historical perspective regarding sanatoria and sun exposure.

I recently happened across research that should be of interest to those who love the Sun. It gave a historical perspective of TB in the city of Bern, Switzerland. In addition, it showed how Bern wiped out most of its TB problems. Especially relevant is the fact that the city used lifestyle changes, not drugs. And, those changes included greater access to sun exposure.[5] The authors studied TB incidence during the period from 1856-1950. There were three areas of the city assessed for their historical TB problems. One was known as the Black Quarter, where during 1911-1915 there were 550 cases of TB per 100,000 people. The second was the City Center with 327 cases per 100,000 people. The third area was the Outskirts, with 209 cases per 100,000 people. There were three living conditions correlating closely to TB:

  1. The number of persons per room. A higher number predicted a greater risk of TB.
  2. A greater number of rooms without sunlight predicted a greater risk of TB.
  3. A greater number of windows per apartment predicted a diminished risk of TB

Consequently, the country worked to address these problems by reducing room crowding, providing open-air schools and building sanatoria. As a result, TB risk dropped from 330 cases per 100,000 in 1856 to 33 per 100,000 in 1950—a 90% drop! Also, I expect that health care cost dramatically decreased.

With the superbugs gaining strength each year, maybe we should reestablish the use of sanatoria?

Another thought: sun exposure probably works as well with many other diseases as it does with TB. Hence, the day may come when sanatoria, especially solariums, may be the only choice for curing infections. Finally, why not sunbathe daily in a non-burning fashion? In addition, sunlamps (in the absence of sunny days) could be valuable to the the health, because they also produce some of the same types of healing light (UVB and UBA) as the sun. Safely and regularly embrace the sun to protect your health!

[1] Greenhalgh I, Butler AR. Sanatoria revisited. Sunlight and health. J R Coll Physicians Edinb. 2017;47(3):276-280.

[2] Clark, W. Treatment of Bone and joint tuberculosis with Tuberculin and Heliotherapy. Journal of Bone and Joint Surgery 1923;5:721-39.

[3] Fielder, J. Heliotherapy: the principles & practice of sunbathing. Soil and Health Library (online) http://www.soilandhealth.org/index.html

[4] http://www.sphere.com/nation/article/first-case-of-highly-drug-resistant-tuberculosis-in-US/19294836?icid=main|htmlws-main-n|dl1|link3|http%3A%2F%2Fwww.sphere.com%2Fnation%2Farticle%2Ffirst-case-of-highly-drug-resistant-tuberculosis-in-US%2F19294836

[5] Zürcher K, Ballif M, Zwahlen M, Rieder HL, Egger M, Fenner L. Tuberculosis Mortality and Living Conditions in Bern, Switzerland, 1856-1950. PLoS One. 2016  16;11(2):e0149195

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Getting a Tan may be OK again, says new research!



Two recent scientific analyses show that years of negative press about sunbeds has been misleading at best and mendacious at worst.  

By Marc Sorenson, Ed.D.

After years of being told there is “no such thing as a safe tan”, new research is showing that exposure to sunbeds, those that mimic sunlight, may have been healthful all along. Many problems have existed with the research used to frighten the people away from sunlight and sunbeds.  Two recent peer reviewed papers have exposed the lack of scientific accuracy by large organizations—organizations that appear to have pursued not the truth, but an agenda bent on discrediting the use of sunbeds. These disclosures were published in Anticancer Research, the Journal of the International Institute of Anticancer Research. The writers concluded that two reports, one by the World Health Organization (WHO) and a second European report called the SCHEER were unbalanced, biased and inaccurate.  It is exceptionally important to understand that neither of these reports were peer reviewed. To me, this indicates that they were opinion pieces, not science. The authors of the first paper in the International Journal of Cancer Research and Treatment concluded their findings regarding the WHO and SCHEER thusly: “The stance taken by both agencies is not sufficiently supported by the data and in particular, current scientific knowledge does not support the conclusion sunbed use increases melanoma risk.” The authors of the second paper in the same Journal came to a similar conclusion after doing their analysis of the reports: “Current scientific knowledge is mainly based on observational studies with poor quality data, which report associations but do not prove causality. At present, there is no convincing evidence that moderate/responsible solarium [sunbed] use increases melanoma risk.” It’s almost as if the WHO and Scheer reports, with their twisted reasoning, were making a ridiculous argument, analogous to the following: Water causes drowning; swimming takes place in water; therefore, swimming causes drowning. None of this, of course, is meant to imply that humans should expose themselves to enough water to drown. Neither should they tan excessively. Tanning, like all other activities should be done in moderation, in other words, in a non-burning fashion.

Governments rely on research to advise the public regarding products and services. If there is a perceived risk, then they move forward with legislation to protect the consumer. But suppose that the researchers from WHO and SCHEER have already made up their minds on the risks and benefits of a product? The next step is to prove what they think they already know. That is not science! They accept every piece of research that might lend credence to their hypothesis, and they disregard or denigrate any research that disproves their hypothesis. They make sure that any benefits are removed or discredited. Of course, this allows them to form a conclusion that matches their hypothesis. This has happened with both sunlight and sunbeds. The concern about the risk of skin cancer has stopped agenda-driven “scientists” from even considering the remarkable benefits attributable to sunlight. This has given the world a biased and wholly unbalanced message.

An international group of 16 researchers headed by Professor Dr. Jörg Reichrath, Deputy Director of the Department of Dermatology, Venereology and Allergology at Saarland University Hospital in Homburg/Saar came together to review these reports that they believed to be unbalanced, biased, and full of confounders and inaccuracies. They also believe that the reports have downplayed the benefits of sunbed exposure.

Since most people don’t have the time to read the complete research paper, here are some interesting findings from the papers that I’d like to share with you. These are direct quotes from each paper:

Reichrath et al 2018

  • In conclusion, both the SCHEER (1) and WHO (2) reports claim to assess health effects of sunbed use. Unfortunately, however, as such they are partially unbalanced and inaccurate. Both documents mainly assess negative health effects of UV exposure, conceal the large body of evidence demonstrating beneficial health effects of UV radiation, and major conclusions drawn are not sufficiently supported by current scientific knowledge. It should be emphasized that the main conclusions drawn by the SCHEER (1) and WHO (2) reports are not in accordance with generally accepted principles of evidence-based medicine, they not only are not in line with recommendations of the Oxford Centre for Evidence-based Medicine
  • …the resulting evidence levels and grades of recommendation are not “strong”, as inaccurately stated in the SCHEER report (which used a highly questionable classification of evidence levels) (1), but are very weak (e.g. level 3a− for systematic reviews of case–control studies with heterogeneity, and grade of recommendation D for outcome “ever” vs. “never” use of a solarium). In conclusion, our present scientific knowledge does not support the notion that sunbed use per se may increase melanoma risk.
  • It further underlines the unbalanced view of the SCHEER and WHO reports, that they conceal the large body of evidence demonstrating beneficial health effects of UV radiation.” And “The SCHEER and WHO reports do not adequately consider the large body of evidence demonstrating the negative health consequences of vitamin D deficiency.
  • The most known and well-documented beneficial health effects of UV radiation are mediated via vitamin D. However, other factors might be involved, indicating that preventing and treating vitamin D deficiency may not account for all beneficial effects of solar or artificial UV exposure.”
  • “Therefore, we rebut these conclusions by addressing the incomplete analysis of the adverse health effects of UV and sunbed exposure (what is‘safe’?) and the censored representation of beneficial effects, not only but especially from vitamin D production.
  • While these reports were purportedly based on the best available scientific evidence, we are deeply concerned about their scientific quality and obvious lack of objectivity, most likely owing to an infusion with the laudable zeal to combat alarming increases in skin cancer. Both publications show an implicit tendency toward an unbalanced view and must be criticized because of many scientific misinterpretations and shortcomings.
  • Several meta-analyses of poor quality consolidate the observational study data and compound the flaws of these studies.
  • For example, dermatological phototherapy is often included when only sunbed use should be assessed [e.g. Landi et al.], and in many studies, subgroups of individuals with presumably high UV exposure in the past (e.g. individuals with history of ‘non-melanoma skin cancer’ or ‘dermatological conditions’) are excluded from controls but not cases (control selection bias).
  • Additionally, it should be noted that studies available are characterized by high heterogeneity and by difficulties in adjusting for important confounding factors, including solar UV and lifestyle: only a minority of studies report odds ratios (ORs) adjusted for the same confounding factors, 12 studies not for a single confounder.
  • Moreover, because individual confounders were assessed using different interrogations, these studies are only partly comparable limiting the ability to interpret results of a combined estimate. And these results should not be considered reliable (56).
  • In this context, the same results and risk estimates as given in Boniol et al. (44) and
  • Colantonio et al. could well be obtained in the following scenario, as indicated elsewhere. Sunbed use has no effect on melanoma risk, lifestyle factors such as extensive sunbathing in the summer as a sun worshipper or an ‘unhealthy lifestyle’ (e.g. alcohol, smoking use), do increase melanoma risk with true OR=1.2 (it has been reported previously that sun worshippers and individuals with an ‘unhealthy lifestyle’ go more frequently to tanning salons
  • Many of the confounding factors, including extensive sunbathing in the summer and unhealthy lifestyle, have not been adequately and systematically considered in studies performed to date. For example, the comparison of sunbed users to non-users is confounded by their lifestyle habits, with typical sunbed users found to be females who tend to smoke cigarettes and drink alcohol more frequently than non-users, as well as eating less healthy food.
  • Both the SCHEER and WHO reports underappreciate the large body of evidence from epidemiological and animal studies that demonstrates no increase in melanoma risk following chronic (moderate) UV exposure.
  • Many other studies also support the concept that sub-erythemal exposure to UV doses not only does not increase melanoma risk, but may even be protective.
  • It further underlines the unbalanced view of the SCHEER and WHO reports, that they conceal the large body of evidence demonstrating beneficial health effects of UV radiation.
  • Moreover, epidemiological evidence provides support for solar UVB protection against a number of cancer types, including breast, colorectal, lung, ovarian, pancreatic and prostate cancer.
  • Moreover, reductions of melanoma mortality rates during the past decades do not support the hypothesis that UV radiation from sunbeds may have increased melanoma risk.
  • It has been suggested that better detection methods have been in use to detect melanoma earlier, which is also a possible reason for the increased risk that has been observed.
  • Unfortunately, however, as such they are partially unbalanced and inaccurate. Both documents mainly assess negative health effects of UV exposure, conceal the large body of evidence demonstrating beneficial health effects of UV radiation, and major conclusions drawn are not sufficiently supported by current scientific knowledge.
  • With this unscientific approach, both the SCHEER (1) and WHO (2) reports are not adequate and do not properly summarize current knowledge on comparing beneficial and adverse effects of UV exposure from sunbeds.

Burgard et al 2018

  • “Moreover, in our opinion, the attempts of Boniol et al and others to attribute melanoma cases to solarium use are speculative and scientifically not sufficiently supported.”
  • “As many as 35.5% (n=11) of all the included studies did not account for a single confounder.”
  • Overall, quality of included studies was poor as a result of severe limitations, including possible recall and selection bias, and due to lack of interventional trials.
  • However, for all outcomes analyzed, overall study quality and resulting levels of evidence (3a−) and grades of recommendation (D) were low due to lack of interventional studies and severe limitations including unobserved or unrecorded confounding.
  • Many studies have investigated the impact of indoor tanning on melanoma risk (8-59), however, most of them have been criticized for limitations, unbalanced view, errors or incorrectness (11, 17). While some reports suggest that solarium use may increase melanoma risk (e.g. 19, 29, 32), other investigations found no or even a protective effect (e.g. 20-22, 24, 35).
  • It should be emphasized that the results of these cohort and case–control studies represent associations and do not prove causality.
  • According to the Oxford Centre for Evidence based Medicine, for the outcome ever-exposure to UV radiation from a solarium, we determined an evidence level of 3a− (systematic review of poor quality cohort and case–control studies) and a grade D of recommendation.
  • As an example, incorrectness in one of the main findings of the study of Boniol et al. (8) forced the authors to publish a correction (16). As Colantonio et al. point out, comparison of five previously published systematic reviews on this topic demonstrates an alarming tendency for copying data without referencing the original article, and without checking for errors (11).
  • As an example, the influential review of the IARC Working group published in 2007 (10) has been criticized for numerous errors in content and typography [e.g. giving wrong numbers for the controls reported 1989 by MacKie et al. (38) and 1981 from Adam et al. (19)], which are also present in two subsequent reviews (11). Furthermore, the numbers of participants from several included studies (31, 43) published in the IARC review could not be derived by us and others (11) from the original articles.
  • Moreover, in our opinion, the attempts of Boniol et al. (8) and others (12) to attribute melanoma cases to solarium use are speculative and scientifically not sufficiently supported.
  • For recruitment before 1991, a higher OR [increased risk] was found as compared with recruitment from 1991-1999 or since 2000.
  • Moreover, both the resulting level of evidence and grade of recommendation of studies investigating the association of melanoma risk with solarium use are weak.
  • In summary, our review has highlighted the poor quality of the evidence available at present on this topic. We conclude that (i) results of our and previously published meta-analyses most likely overestimated the association of melanoma risk with solarium use, (ii) both the level of evidence and grade of recommendation of studies published previously investigating the association of melanoma risk with solarium use are weak, and therefore (iii) present scientific knowledge does not support the hypothesis of an increased melanoma risk due to solarium use, and questions studies that try to attribute melanoma cases to indoor tanning, and does not support initiatives that aim to ban responsible/moderate solarium use for tanning purposes.

Sadly, some “science” follows the paths of deception. Many writers have let a bias toward a particular outcome color their judgement and even misinterpret their results. You can find many examples of bad science by doing an internet search for that term. Because a result was printed in a scientific journal, or stated by a multinational organization, it does not necessarily denote truth.

As you can see, the 2 reports on sunbeds have concluded that sunbeds were dangerous and would lead to cancer. The research compiled to reach this conclusion was of poor quality and biased. It also left out relevant information—information that would have completely changed the result. Obviously, these results were born of a need to produce the result they wanted, not a need to find the truth.

The statement, that there is no need to use sunbeds, as there are no health benefits, is an egregious misstatement of the facts. Here are several citations that belie the idea that there are no health benefits of sunbed use:

  1. Vitamin D production and bone strength.

In a study comparing 50 subjects who used a sunbed at least once a week to 106 control subjects who did not use sunbeds, it was shown that tanning-bed users had 90% higher 25(OH)D levels than non-users, and that they also had significantly higher bone-mineral density, indicative of stronger bones.[1] Another study showed that whereas a daily 400 IU vitamin D supplement did not maintain healthful 25(OH)D levels, sunbed use increased 25(OH)D levels by 150% in only seven weeks.[2]

  1. Sunbeds can control psoriasis and eczema.

They are often recommended by dermatologists as a way to overcome these diseases. Scientists have stated that UV light is nearly 100% effective for many dermatologic conditions, and that sunbeds are very convenient sources of UV rays for patients who cannot otherwise afford the rigorous travel and time commitments necessary to visit the dermatologist.[3] This was the conclusion they reached:  “Unsupervised sun exposure is a standard recommendation for some patients to obtain phototherapy. Selected use of commercial sunbeds in the treatment of dermatologic conditions may be another useful and effective treatment for those patients with an inability to access office-based or home-based phototherapy.”

  1. Sunbed use reduces chronic pain.

A study of pain in fibromyalgia patients, conducted by dermatologists, revealed that those who used UV-producing sunbeds experienced a decrease of 0.44 points on a 10 point scale (Likert scale) determined by subject questionnaire, when compared to those who did not receive UV light.[4], [5]

  1. Sunbeds may reduce endometrial cancer. Research from Sweden demonstrated that women who use sunbeds more than three times yearly had a 40-50% reduction of the risk for endometrial cancer.[6] The authors surmised that the effects observed were likely due to stimulating higher 25(OH)D levels in winter.
  2. Sunbed use reduces the risk of clots. In an eleven-year study of the sun-exposure habits of 40,000 women, venous thrombotic (clotting) events were measured. It was found that women who sunbathed during the summer, on winter vacations, or when abroad, or used a sunbed, had a 30% decrease in the risk of clots compared to those who did not sunbathe.[7] The authors again speculated that increased vitamin D, which has anticoagulant properties, had provided these positive results.
  3. Sunbed use is associated with lower breast-cancer risk.[8]
  4. Perhaps the most important research on sunbeds was a 20-year study in Sweden by Dr. Pelle Lindqvist and his colleagues, who showed that women who used sunbeds were 23% less likely to die from any cause than women who did not use them.[9] This research also showed that low sun exposure as a risk factor for all-cause death was comparable in magnitude to smoking, and women with active sun exposure habits were found to live 1 to 2 years longer as compared to those with the lowest sun exposure habits.

I couldn’t agree more with the latest research.

[1] Tangpricha V, Turner A, Spina C, Decastro S, Chen TC, Holick MF. Tanning is associated with optimal vitamin D status (serum 25-hydroxyvitamin D concentration) and higher bone mineral density. Am J Clin Nutr 2004;80:1645-49.

[2] Holick, M. Boston University. “Effects Of Vitamin D And Skin’s Physiology Examined.” Science Daily 21 February 2008 <http://www.sciencedaily.com¬ /releases/2008/02/080220161707.htm>.

[3] Radack KP, Farhangian ME, Anderson KL, Feldman SR. A review of the use of tanning beds as a dermatological treatment. Dermatol Ther (Heidelb). 2015 Mar;5(1):37-51.

[4] Kaur M, Feldman SR, Liguori A, Fleischer AB Jr. Indoor tanning relieves pain. Photodermatol Photoimmunol Photomed. 2005 Oct;21(5):278.

[5] Taylor SL, Kaur M, LoSicco K, Willard J, Camacho F, O’Rourke KS, Feldman SR. Pilot study of the effect of ultraviolet light on pain and mood in fibromyalgia syndrome. J Altern Complement Med. 2009 Jan;15(1):15-23.

[6] Epstein E, Lindqvist PG, Geppert B, Olsson H. A population-based cohort study on sun habits and endometrial cancer.Br J Cancer. 2009 Aug 4;101(3):537-40.

[7] Lindqvist PG, Epstein E, Olsson H. Does an active sun exposure habit lower the risk of venous thrombotic events? A D-lightful hypothesis. J Thromb Haemost. 2009 Apr;7(4):605-10.

[8] Yang L, Veierød MB, Löf M, Sandin S, Adami HO, Weiderpass E. Prospective study of UV exposure and cancer incidence among Swedish women. J Intern Med. 2014 Jul;276(1):77-86

[9] Lindqvist PG, Epstein E, Landin-Olsson M, Ingvar C, Nielsen K, Stenbeck M, Olsson H. Avoidance of sun exposure is a risk factor for all-cause mortality: results from the Melanoma in Southern Sweden cohort. J Intern Med. 2014 Jul;276(1):77-86.

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UVB, a sunlight spectrum, reduces inflammation and helps prevent atherosclerosis and heart disease.

Sunlight for the heartUVB is a spectrum of sunlight with many effects. These include the suppression of inflammation in the skin.  It has been used to very successfully treat skin diseases such as psoriasis and eczema.

Since inflammation is necessary to produce the condition of atherosclerosis (plugging of the arteries).  It would be interesting to know whether UVB might also have the same anti-inflammatory effects in the arteries. If so, the effect could inhibit or eliminate atherosclerosis, and thus provide an entirely new treatment for heart disease. It would also protect against  vascular events such as stroke and intermittent claudication.

The idea that UVB could prevent atherosclerosis by reducing inflammation in arteries was recently studied by Japanese researchers.[i] Using a mouse model, they demonstrated that UVB light irradiation, applied once a week for 14 weeks, leads to an increase in the action of T-regulatory cells, thereby inhibiting inflammation. In addition, exposure reduced the production of another type of T-cell which is pro-inflammatory and thereby pro-atherogenic (leading to the production of atherosclerosis). These two effects of UVB light reduce the development and progression of atherosclerosis.

Stated differently, the research shows that sun exposure is a critically-important therapy to reduce and prevent diseases of the heart and blood vessels. Protect your heart by being sure to obtain sufficient non-burning sunlight  from sun exposure or other sources such as sun lamps. It is also important to note that neither skin cancer nor skin inflammation were observed following UVB exposure in this breakthrough study, which again emphasizes the importance of sun exposure for human health.

If these findings are true, then we would expect that there would be fewer cardiovascular events such as heart attacks and strokes during times of less sun exposure.  Accordingly, Research has demonstrated that those below the median level of serum vitamin D suffer 57% more heart attacks than those whose levels were above the median[i] (low vitamin D levels are a surrogate for sun exposure). They also noted that the greatest number of heart attacks occurred in winter and early spring. These seasons, of course, are the times of lowest sun exposure. And, according to what we have learned, they are also the times of greatest inflammation.

Let there be light, and safely apply it to your skin. Be sure not to burn.

[i] Scragg R, Jackson R, Holdaway IM, Lim T, Beaglehole R. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol 1990;19:559-63.

 

 

[i] Sasaki N, Yamashita T, Kasahara K, Fukunaga A, Yamaguchi T, et al. UVB Exposure Prevents Atherosclerosis by Regulating Immunoinflammatory Responses. Arterioscler Thromb Vasc Biol. 2016;36:00-00

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Bowel disease rates are far higher in areas of low sun exposure

bowel diseaseNew research from New Zealand shows that children who live in South Island of New Zealand have at least three times the risk of bowel disease such as Crohn’s disease (CD) and ulcerative colitis (UC)[1] when compared to those who live on the North Island. According to an article referencing this research, these bowel diseases usually appear in the pre-teen or teenage years and are incurable. The researchers believe that sun exposure and one of its photoproducts, Vitamin D, may play a part, although the low selenium content of the soil may also have an influence on bowel diseases.

In the southern hemisphere, of course, the farther south one travels, the colder and cloudier the weather becomes. Hence, the South Island has far less sun exposure than the North Island.

Although the researchers did not know for sure that the sunlight and vitamin D hypothesis was correct regarding bowel disease, their idea certainly has plenty to back it up.  Crohn’s disease is closely correlated to vitamin D deficiency and winter season,[2] indicating an inverse relationship with sun exposure and vitamin D production. A study of female nurses in the US found that “compared with women residing in northern latitudes [in the northern hemisphere] at age 30, the multivariate-adjusted risk for UC for women residing in southern latitudes was less than half.”[3] Also, in a 12-year investigation of hundreds of thousands of bowel disease patients, hospitalizations, and prolonged hospitalizations, for both UC and CD were higher among those who had low sun exposure compared to those with very high sun exposure.[4]

It is important to understand that bowel disease causes malabsorption of nutrients in the gut, leading to diseases of malnutrition.[5] Vitamin D is one of the “nutrients” that may not be absorbed efficiently, and therefore sun exposure, not supplements, may be the only viable source of vitamin D for a person with bowel disease.

So for a healthy gut, sun exposure plays a vital role. Be sure to enjoy safe, non burning sun exposure whenever possible.

[1] http://www.radionz.co.nz/news/national/340048/shining-light-on-bowel-disease-rates

[2] Gilman J, Shanahan F, Cashman KD. Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006 Jul;60(7):889-96.

[3] Khalili H, Huang ES, Ananthakrishnan AN, Higuchi L, Richter JM, Fuchs CS, Chan AT. Geographical variation and incidence of inflammatory bowel disease among US women. Gut. 2012 Dec;61(12):1686-92.

[4] Limketkai BN, Bayless TM, Brant SR, Hutfless SM. Lower regional and temporal ultraviolet exposure is associated with increased rates and severity of inflammatory bowel disease hospitalization. Aliment Pharmacol Ther. 2014 Sep;40(5):508-17.

[5] Margulies SL, Kurian D, Elliott MS, Han Z. Vitamin D deficiency in patients with intestinal malabsorption syndromes–think in and outside the gut. J Dig Dis. 2015 Nov;16(11):617-33.

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Depressed due to suboptimal BDNF? Try a little sunshine!

BDNFSome time ago I wrote a blog on sun exposure and depression, emphasizing the importance of a protein called brain derived neurotropic factor (BDNF). This is an update.

BDNF is a factor in nerve growth and maturation, and is essential in synapse formation and plasticity. A lack of of it is implicated in psychiatric disorders such as schizophrenia, intellectual disability, autism and depression. Interestingly, it has been shown that unless there is sufficient BDNF in the brain, conventional antidepressants do not work very well,[1] and when BDNF is infused directly into the brains of rodents, it produces an antidepressant effect.[2]

It has also been shown that BDNF has a seasonal variation in concentration correlating with the amount of ambient sun; it increases in the spring and summer and decreases in fall and winter. [3]  The authors of this research described the importance of their findings thusly: “This finding is important for our understanding of those factors regulating BDNF expression and may provide novel avenues to understand seasonal dependent changes in behavior and illness such as depression.”

BDNF has been shown to increase significantly after bright light exposure,[4] and in what we would consider to be a remarkably important study, both light exposure and treadmill exercise increased its expression of
 in rats,[5] or as the researchers showed, exercise and/or bright light promoted neurogenesis (new nerve cell growth) in the adult rat brain. How important is this finding for adults who are worried about cognitive decline? We are actually seeing an example of new brain cells being built by bright light and exercise. What a wonderful way to help prevent Alzheimer’s disease and maintain mental sharpness into old age! Don’t forget your (safe) sunlight!

[1] Björkholma C, Monteggiab, L. BDNF — a key transducer of antidepressant effects. Neuropharmacology. 2016 March ; 102: 72–79.

[2] Siuciak JA, Lewis DR, Wiegand SJ, Lindsay RM. Antidepressant-like effect of brain-derived neurotrophic factor (BDNF). Pharmacol. Biochem. Behav. 1997; 56(1):131–137.

[3] Molendijk ML, Haffmans JP, Bus BA, Spinhoven P, Penninx BW, Prickaerts J, Oude Voshaar RC, Elzinga BM. Serum BDNF concentrations show strong seasonal variation and correlations with the amount of ambient sun. PLoS One. 2012;7(11):e48046.

[4] Tirassa P1, Iannitelli A, Sornelli F, Cirulli F, Mazza M, Calza A, Alleva E, Branchi I, Aloe L, Bersani G, Pacitti F. Daily serum and salivary BDNF levels correlate with morning-evening personality type in women and are affected by light therapy. Riv Psichiatr. 2012 Nov-Dec;47(6):527-34.

[5] Kwon SJ, Park J, Park SY, Song KS, Jung ST, Jung SB, Park IR, Choi WS, Kwon SO. Low-intensity treadmill exercise and/or bright light promote neurogenesis in adult rat brain. Neural Regen Res. 2013 Apr 5;8(10):922-9.

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Why Sun Exposure is Not Responsible for the Increase in Melanoma

melanoma is not caused by sun exposure

I have written several blogs making this melanoma case: not only is this deadly cancer not caused by sun exposure, but habitual, or regular, sun exposure has a protective effect against the disease. This blog will serve to reinforce and review the reasoning behind those conclusions.

A friend sent me a scientific paper[1] that I had forgotten or missed—a paper by Dr. Veronique Bataille that brought out several supportive points about how sun exposure protects against the disease. Here are a few of the salient ideas from the paper:

  1. The increase in melanoma is mostly seen for the thin types, which can’t be attributed to sun exposure but to increasing screening over the last 20 years. The fact is, that incidence appears to increase as the number of dermatologists and public health campaigns also increase. But the increase in melanoma is not real. This idea is perfectly plausible; when more dermatologists are available, and the public is driven to them by health campaigns more melanomas are found. Many “first-stage” or thin “thin” melanomas are discovered and counted that would not have been found in previous decades. This causes numbers to be highly inflated compared to the days when there were fewer dermatologists and fewer public health campaigns.

Comment: Another fact was not mentioned in the paper: Stunningly, a worldwide study of melanoma diagnosis and accuracy, published in the American Academy of Dermatology (AAD) showed that most diagnoses were incorrect.[2] Approximately 44 different authors from many different clinics and countries, including the US, contributed to the report. They made an accuracy-in-detection analysis based on the actual number of melanomas that were excised during a period of ten years, compared with the number that really needed to be excised.  Many clinics in different countries were involved in assessing the numbers. The AAD research showed that only about 3.5% of diagnoses in non-specialized clinics, and 14.7% in specialized clinics, resulted in actually being melanoma. From this information, it is evident that many melanoma surgeries are bogus and may inflate the incidence of this deadly skin cacner.

What do we take away from this? There may be no real increase in melanoma, only an increase in assessment and excision.

  1. Low vitamin D levels are common in melanoma patients and have a deleterious effect on their risk and survival.

Comment: Low vitamin D levels are caused by sunlight deprivation; we are told to avoid the sun, but sun avoidance leads to vitamin D deficiency, which further leads to melanoma. If our population regularly enjoyed non-burning sun exposure, vitamin D levels would be much higher and the risk of melanoma much lower. This is corroborated by the fact that people who habitually work outdoors have a far lower risk of the disease.  Dr. Cedric Garland and his colleagues showed that those who worked indoors had a 50% greater risk of  than those who worked both indoors and outdoors.[3]

  1. An excess of naevi (moles), not sun exposure, is the strongest risk factor for melanoma, and when comparing the risk created by sunburns and fair skin to the risk created by an excess of moles, the moles create a 15-30 times higher risk.

Comment:  Some very important research by Dr. Adele Green found that the strongest risk factor for both limb melanoma and trunk melanoma was the presence of more than 10 moles on the arm, which predicted a 42-times increased risk. [4]  This means that public health campaigns should promote mole awareness! Unfortunately, they promote sun avoidance, which increases the risk of melanoma.

  1. Attempts to decrease melanoma incidence and mortality, by reducing sun exposure, has not been proven to work and may be harmful.

Comment: the statement is obviously true. In the U.S., Sun exposure has decreased by about 90% since 1935. During that same period, melanoma has increased by 3,000%.[5] Data from the Bureau of Labor statistics showed that indoor occupations such as “professional, managerial, clerical, sales, and service workers (except private household service workers) grew from one-quarter to three-quarters of total employment between 1910 and 2000.” The BLS also stated, during the same period, the outdoor occupation of farming declined by 96% from 33% to 1.2% of total employment. The data also show approximately 66% of the decline in the occupation of farmers and 50% of the decline in the occupation of farm laborers occurred after 1935.

Further information, this time from the Environmental Protection Agency (EPA) determined as of 1986, about 5 percent of adult men worked mostly outside, and about 10 percent worked outside part of the time. The proportion of women who worked outside was thought to be even lower.[6] These data demonstrate a dramatic shift from outdoor, sun-exposed activity to indoor, non-sun-exposed activity during the mid-to-late 20th Century. This change, nonetheless, has been accompanied by a 30-times increase in risk since 1935, the MIF-baseline year.

  1. Photoageing, which is skin ageing due to sunlight exposure, is not greater in melanoma patients than patients who do not have the disease. In fact, patients with the cancer exhibit less photoageing than those who do not have the disease.

Comment: This was a new research for me and it belied the idea that sun exposure caused melanoma. If sun exposure causes skin photoageing, and there is less photoageing on cancer sites, sun exposure cannot possibly be causing melanoma. Enough said.

We need our sunshine, and one of the reasons for that need is to prevent deadly cancers.

[1] Bataille V. Melanoma. Shall we move away from the sun and focus more on embryogenesis, body weight and longevity? Medical Hypotheses 81 (2013) 846–850.

[2] Argenziano G, Cerroni L, Zalaudek I, Staibano S, Hofmann-Wellenhof R, et al. Accuracy in melanoma detection: a 10-year multicenter survey.J Am Acad Dermatol. 2012 Jul;67(1):54-9.

[3] Garland FC, White MR, Garland CF, Shaw E, Gorham ED. Occupational sunlight exposure and melanoma in the U.S. Navy. Arch Environ Health. 1990 Sep-Oct;45(5):261-7.

[4] Green AC, Siskind V. Risk factors for limb melanomas compared with trunk melanomas in Queensland. Melanoma Res. 2012 Feb;22(1):86-91.

[5] Melanoma International Foundation, 2007 Facts about melanoma. Sources: National Cancer Institute 2007 SEER Database, American Cancer Society’s 2007 Facts and Figures, The Skin Cancer Foundation, The American Academy of Dermatology.

[6] US Congress, Office of Technology Assessment, Catching Our Breath: Next Steps for Reducing Urban Ozone, OTA-O-412 (Washington, DC: US Government Printing Office, July 1989).

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Sunlight, the great healer

Leprosy: can sunlight prevent this and other bacterial diseases?

Sunlight may prevent leprosyLeprosy is a bacterial disease that has been historically mentioned as a scourge, when it was considered to be incurable and disfiguring. Symptoms that develop include granulomas (inflammation caused by a collection of immune cells) of the nerves, respiratory tract, skin, and eyes. This may result in a lack of ability to feel pain, followed by the loss of parts of extremities, due to repeated injuries or infection of unnoticed wounds.[1] About 180,000 people worldwide are diagnosed with leprosy yearly, and about 100 people are diagnosed in the U.S. each year.[2]  Leprosy has been considered to be a disease which has been eradicated, but such is not the case. For example, an article in an Indian paper shows it is much more prevalent in highly urbanized areas (areas of less sun) than in rural or less polluted areas[3] (areas of more sun). Also, when the bacteria that cause leprosy are exposed to ultraviolet light, the procedure kills half of the bacteria.[4] Therefore, sunlight may fight leprosy as it fights other bacteria, by stopping them at the source. Sun is a potent bactericide. Dr. Kime, in his book, Sunlight Could Save Your Life, reviewed the results of research conducted between 1886 and 1909. It showed the following bacteria were killed by ultraviolet light: anthrax, plague, streptococci, tubercle bacillus, cholera, staphylococcus, colon bacillus and dysentery bacillus. Sun was virtually forgotten with the advent of antibiotic drugs, but now the interest has returned. While watching a newscast, I noticed the news ticker announcing, “Sunshine is the most effective anti-infection therapy.”  I believe that is true; sun exposure is provided to the earth to help prevent myriad diseases, but many of us try to avoid its healing powers. Non-burning sun exposure is a magnificent healer, and also a preventer of disease in those cases where it cleans the environment of noxious microorganisms.Sunlight, the great healer

[1] https://en.wikipedia.org/wiki/Leprosy

[2] http://www.webmd.com/skin-problems-and-treatments/guide/leprosy-symptoms-treatments-history#1

[3] Kumar, R. Urbanites More Prone to Leprosy. Merinews April 14, 2008. (available at http://www.merinews.com/catFull.jsp?articleID=132447)

[4] Truman RW, Gillis TP. The effect of ultraviolet light radiation on Mycobacterium leprae. Int J Lepr Other Mycobact Dis. 2000 Mar;68(1):11-7.

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