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:
- 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. 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.
- 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. 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.”
- 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., 
- 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. The authors surmised that the effects observed were likely due to stimulating higher 25(OH)D levels in winter.
- 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. The authors again speculated that increased vitamin D, which has anticoagulant properties, had provided these positive results.
- Sunbed use is associated with lower breast-cancer risk.
- 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. 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.
 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.
 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>.
 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.
 Kaur M, Feldman SR, Liguori A, Fleischer AB Jr. Indoor tanning relieves pain. Photodermatol Photoimmunol Photomed. 2005 Oct;21(5):278.
 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.
 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.
 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.
 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
 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.
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
New 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) 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, 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.” 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.
It is important to understand that bowel disease causes malabsorption of nutrients in the gut, leading to diseases of malnutrition. 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.
 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.
 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.
 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.
 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.
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, and when BDNF is infused directly into the brains of rodents, it produces an antidepressant effect.
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.  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, and in what we would consider to be a remarkably important study, both light exposure and treadmill exercise increased its expression of
in rats, 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!
 Björkholma C, Monteggiab, L. BDNF — a key transducer of antidepressant effects. Neuropharmacology. 2016 March ; 102: 72–79.
 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.
 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.
 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.
 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.
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 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:
- 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. 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.
- 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.
- 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.  This means that public health campaigns should promote mole awareness! Unfortunately, they promote sun avoidance, which increases the risk of melanoma.
- 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%. 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. 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.
- 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.
 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.
 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.
 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.
 Green AC, Siskind V. Risk factors for limb melanomas compared with trunk melanomas in Queensland. Melanoma Res. 2012 Feb;22(1):86-91.
 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.
 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).
Leprosy 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. About 180,000 people worldwide are diagnosed with leprosy yearly, and about 100 people are diagnosed in the U.S. each year. 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 (areas of more sun). Also, when the bacteria that cause leprosy are exposed to ultraviolet light, the procedure kills half of the bacteria. 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.
 Kumar, R. Urbanites More Prone to Leprosy. Merinews April 14, 2008. (available at http://www.merinews.com/catFull.jsp?articleID=132447)
 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.
Sun exposure is crucial to preventing multiple sclerosis (MS), the terrible, debilitating autoimmune disease in which T-cells initiate an inflammatory response against myelin, the protective cover of nerves., This leaves the nerves bare and susceptible to “short circuiting,” a process known as demyelination. This attack prevents proper functioning within the brain and body, which leads to a variety of symptoms like vision changes, muscle spasms, and numbness. These symptoms profoundly decrease the ability to function and destroy the quality of life.
We have known for decades that people who live in areas of low sun exposure, such as far-northern or far southern countries, have a far greater risk of contracting MS than those who live in countries closer to the equator. In fact, there is more than 100 times the risk of MS in far northern as in equatorial areas, where sun is intense, and the rate of MS approaches zero.,,
I ran across an interesting study demonstrating that the age at which the low sun exposure occurs is also a predictive factor in the risk of MS. It showed that in Norway, the amount of sun exposure in the period of life between 16-18 years of age was critical in predicting the disease. Those youngsters who experienced the lowest sun exposure during those ages were 83% more likely to develop MS. The same research showed that in Italy the critical period was between birth and age 5 years, with those receiving the lowest sun exposure being 56% more likely to develop MS.
I spite of incontrovertible research that proves regular, non-burning sun exposure is critical for human health, the sunscare movement continues to promote the idea that we should avoid the sun. The blood is on their hands.
 Racke, M. Immunopathogenesis of multiple sclerosis. Ann Indian Acad Neurol. 2009 Oct–Dec; 12(4): 215–220.
 Markovic-Plese S, McFarland HF. Immunopathogenesis of the multiple sclerosis lesion. Curr Neurol Neurosci Rep 2001;1:257-62
 Alter M, Yamoor M, Harshe M. Multiple sclerosis and nutrition. Arch Neuroll974;31:267-72.
 Kurtkze, J. Geography in multiple sclerosis. J Neurol1977;215:1-26.
 Hayes CE, Cantorna MT, DeLuca HF. Vitamin D and multiple sclerosis. Proc Soc Exp Biol Med 1997;216:21-27
 Bjørnevik K, Riise T, Casetta I, Drulovic J, Granieri E. et al. Sun exposure and multiple sclerosis risk in Norway and Italy: The EnvIMS study. Mult Scler. 2014 Jul;20(8):1042-9.
Diabetes and sun exposure By Marc Sorenson, EdD.
Diabetes is a disease of chronically high blood glucose leading to blindness, nerve damage, heart disease and numerous other maladies. Diabetes comes in two forms: (1) Type-one, in which there is damage to the islet cells of the pancreas. This is usually due to an autoimmune response, and the damage prevents production of insulin responsible for removing glucose from the blood. (2) Type-two, in which insulin is produced, but blood glucose remain high due to insulin resistance. In this article, we will discuss type-two, which is by far the most common type. As with heart and vascular disease, we must realize a paucity of sunlight is not the cause of either type of diabetes; rather it is caused by deleterious nutrition habits, primarily high meat consumption,   sugar consumption,  egg consumption, low consumption of fruits and vegetables, and too many fried foods. In the case of type-one, milk consumption may be the most important nutritional factor. However, sunlight may act as a prophylactic against either type of diabetes. With either type of diabetes, it is not usually the diabetes that kills, but other diseases resulting from it.
There are several studies showing a relationship between type-two diabetes mellitus (DM) and sun exposure or UVB exposure. One paper showed blood-sugar levels were lower during the summer, and another demonstrated exposure to sun lamps increased insulin secretion. It has also been found there is a direct and significant association between low 25(OH)D levels (a surrogate measure for low sun exposure) and increased risk of type-two.
In addition, a meta-analysis produced moderate evidence that recreational sun exposure is associated with a reduced risk of type-two. The study was undertaken because of the observation by researchers showing that although higher 25(OH)D levels were consistently associated with a lower risk of diabetes, supplementing 25(OH)D had shown no such effects. They hypothesized sun exposure could have influences not related to vitamin D, and such seems to have been the case.
Another of the more important investigations showed that women who had “active sun exposure habits” had a 30% reduced risk of type-two.
Diabetes is increasing very rapidly and may someday overwhelm the health-care system. In my opinion, it is the most easily reversed of all degenerative diseases, so this is a tragedy. Proper nutrition, exercise and safe sun exposure can prevent almost all type-two diabetes. At our former resort, about two-thirds of type-two diabetics were free of all medication in two weeks. It is a totally unnecessary disease. If you don’t have it, prevent it. If you have it, reverse it. Start today.
FeskensEJ, Sluik D, van WoudenberghGJ. Meat consumption is an important risk factor Meat consumption, diabetes, and its complications. Curr Diab Rep. 2013 Apr;13(2):298-306.
Kim Y, Keogh J, Clifton P. A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus. Metabolism. 2015 Jul;64(7):768-79.
Muntoni S, Mereu R, Atzori L, Mereu A, Galassi S, Corda S, Frongia P, Angius E, Pusceddu P, Contu P, Cucca F, Congia M, Muntoni S. High meat consumption is associated with type 1 diabetes mellitus in a Sardinian case-control study. Acta Diabetol. 2013 Oct;50(5):713-9.
 Imamura F, O’Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, ForouhiNG.Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ. 2015 Jul 21;351:h3576.
 Lamb MM, Frederiksen B, Seifert JA, Kroehl M, Rewers M, Norris JM. Sugar intake is associated with progression from islet autoimmunity to type 1 diabetes: the Diabetes Autoimmunity Study in the Young. Diabetologia. 2015 Sep;58(9):2027-34.
DjousséL1, Gaziano JM, Buring JE, Lee IM. Egg consumption and risk of type 2 diabetes in men and women.Diabetes Care. 2009 Feb;32(2):295-300
McEvoy CT, Cardwell CR, Woodside JV, Young IS, Hunter SJ, McKinley MC.A posteriori dietary patterns are related to risk of type 2 diabetes: findings from a systematicreview and meta-analysis.J Acad Nutr Diet. 2014 Nov;114(11):1759-75.
 Karjalainen J, Martin JM, Knip M, Ilonen J, Robinson BH, Savilahti E, Akerblom HK, Dosch HM. A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Engl J Med. 1992 Jul 30;327(5):302-7.
 Ishii H,Suzuki H, Baba T, Nakamura K, Watanabe T. Seasonal variation of glycemic control in type-2 diabetic patients. Diabetes Care 2001;24;1503.
 Colas C, Garabedian M, Fontbonne A, Guillozo H, Slama G, Desplanque N, Dauchy F, Tchobroutsky G. Insulin secretion and plasma 1,25(OH)2D after UV-B irradiation in healthy adults. Hormone and Metabolic Research 1988;21:154-155.
 Song Y, Wang L, Pittas AG, Del Gobbo LC, Zhang C, Manson JE, Hu FB. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2013 May;36(5):1422-8.
 Shore-Lorenti C, Brennan SL, Sanders KM, Neale RE, Lucas RM, EbelingPR.Shining the light on Sunshine: a systematic review of the influence of sun exposure on type 2 diabetes mellitus-related outcomes. Clin Endocrinol (Oxf). 2014 Dec;81(6):799-811.
Lindqvist PG, Olsson H, Landin-Olsson M. Are active sun exposure habits related to lowering risk of type 2 diabetes mellitus in women, a prospective cohort study? Diabetes Res Clin Pract. 2010 Oct;90(1):109-14.
By Marc Sorenson, EdD, for sun exposure…
A new research paper on sun exposure and cancer has some interesting observations and some errors. It is entitled, Does Sunlight protect us from cancer? Here is the abstract of the article, verbatim.
“The Ultraviolet (UV) radiation contained in sunlight is a powerful mutagen and immune suppressant which partly explains why exposure to solar UV is the biggest risk factor for the development of cutaneous tumors. Evidence is building that sunlight may be protective against some internal malignancies. Because patients with these tumors are often vitamin D deficient, this has led some to propose that vitamin D supplementation will be beneficial in the treatment of these cancers. However, the results from already completed trials have been disappointing which has given weight to the argument that there must be something else about sunlight that explains its cancer-protecting properties.”
The first sentence, of course, is false. The idea, that sun exposure is the biggest risk factor for skin cancer, is erroneous. We have presented materials many times, proving that melanoma is not caused by sun exposure, and that sun exposure is protective against that disease. And as regards common skin cancers, we have shown that high-fat nutrition, lack of antioxidants, meat consumption and alcohol intake are all risk factors. Search the blogs on this site to read the different articles.
The statement is correct, of course, that sunlight is protective against many internal cancers. Dr. Bill Grant and I are finishing our book, Embrace the Sun, where we present nearly all of the research on the protective influence of sun exposure against cancer.
The statement that vitamin D research has been disappointing is both true and false. Randomized controlled studies (RCTs) have shown the vitamin D supplements do have a protective effect against internal cancers, contrary to the statement by the researchers.
Finally, let’s look at the statement that there is something beyond vitamin D that explains the cancer-protecting properties of sun exposure. That is partially true. Beyond vitamin D, the sun causes the production of nitric oxide, serotonin, endorphin and BDNF, all of which are vital to human health, and may have their own cancer-protective properties.
The bottom line? Eat correctly (avoid junk), REGULARLY soak up some sun around midday and get plenty of exercise. That advice will be a boon to your health in myriad ways.
Sun and cognitive ability by Marc Sorenson, EdD, Sunlight Institute…
If you have depression, you may also have cognitive impairment, according to older research that I just became aware of. The researchers measured cognitive abilities among approximately 14,000 depressed subjects and then exposed them to either one day of sunlight or two weeks of sunlight. They then determined if cognitive disabilities were associated with the sun they obtained.
The results were impressive: Those who were sun-deprived for two weeks had 2.5 times the risk of being cognitively impaired, compared to those who had sufficient sunlight. A one-day exposure made no significant difference in cognition.
Results of other research, based on a 15-year residential history of varying degrees of sun exposure, has also shown that cognitive impairment in persons who were below the median exposure to sun, was 88% greater than those who were above the median. The researchers mentioned vitamin D as a possible mechanism by which sun positively influenced cognition, but they also remarked that regulation of the circadian rhythm by sunlight could be a factor.
Several other studies showed a close, positive association between vitamin D levels and cognition, and as we know, vitamin D levels in most cases are a surrogate measurement for sun exposure.
The message is to get plenty of sunlight to improve mental clarity. Happy thinking!
 Shia T Kent, Leslie A McClure, William L Crosson, Donna K Arnett, Virginia G Wadley and Nalini Sathiakumar. Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: a REGARDS cross-sectional study. Environmental Health 2009, 8:34
 Kent ST, Kabagambe EK, Wadley VG, Howard VJ, Crosson WL, Al-Hamdan MZ, Judd SE, Peace F, McClure LA. The relationship between long-term sun radiation and cognitive decline in the REGARDS cohort study. Int J Biometeorol. 2014 Apr;58(3):361-70.