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A recent study in the Journal of Internal Medicine had interesting results regarding sun exposure - more was beneficial for health.

In the study, women were followed for 20 years, and any  deaths were put into one of 3 groups: as being from: heart disease, cancer, or other (non-heart disease and non-cancer). Swedish women followed for 20 years found that the more sunlight exposure they had, the longer the life expectancy, the less death from heart disease (cardiovascular disease) and causes other than heart disease or cancer (non-heart disease and non-cancer group), but the more skin cancer (basal cell carcinoma, squamous cell carcinoma and melanoma) they developed. 

Thus the main finding is of a dose-dependent relationship between sun exposure and life expectancy.

One surprising result was that nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group. Those who avoided sun exposure had an increased risk of death mainly due to heart disease and "other causes" (non-cancer/non-heart disease).

I wondered about other cancers in this study, and this is all they had to say in the journal article:  "Thus, women with NMSC (nonmalignant skin cancer) had a 37% higher prevalence of other internal cancers than those without NMSC and a fourfold increased prevalence of MM (malignant melanoma). The incidence of other internal cancer was not increased subsequently on NMSC diagnosis."  I now have another question:  How do the women with cancer in the high and low sun exposure group do after another 10 or 20 years?  I would have liked for this study to continue longer.

The researchers felt that sunshine and vitamin D had a role in these results, and suggested that we need to rethink the "avoid sunshine" advice now given to people. In other words, some sunshine is good for health. From Science Daily:

Why do sunbathers live longer than those who avoid the sun?

New research looks into the paradox that women who sunbathe are likely to live longer than those who avoid the sun, even though sunbathers are at an increased risk of developing skin cancer. An analysis of information on 29,518 Swedish women who were followed for 20 years revealed that longer life expectancy among women with active sun exposure habits was related to a decrease in heart disease and noncancer/non-heart disease deaths, causing the relative contribution of death due to cancer to increase.

Whether the positive effect of sun exposure demonstrated in this observational study is mediated by vitamin D, another mechanism related to UV radiation, or by unmeasured bias cannot be determined. Therefore, additional research is warranted. 

"We found smokers in the highest sun exposure group were at a similar risk as non-smokers avoiding sun exposure, indicating avoidance of sun exposure to be a risk factor of the same magnitude as smoking," said Dr. Pelle Lindqvist, lead author of the Journal of Internal Medicine study. "Guidelines being too restrictive regarding sun exposure may do more harm than good for health."

 The following research finds a link (it doesn't establish cause) - but these interesting associations with vitamin D keep popping up. The research looked at leukemia rates in 172 countries and found that living closer to the equator (and assumed to have higher levels of vitamin D due to sunlight exposure) is linked to lower levels of leukemia. By far the best source of vitamin D is sunshine (and not food). From Medical Xpress:

Researchers link higher risk of leukemia to low sunlight and vitamin D

Epidemiologists at University of California, San Diego School of Medicine report that persons residing at higher latitudes, with lower sunlight/ultraviolet B (UVB) exposure and greater prevalence of vitamin D deficiency, are at least two times at greater risk of developing leukemia than equatorial populations.

These results suggest that much of the burden of leukemia worldwide is due to the epidemic of vitamin D deficiency we are experiencing in winter in populations distant from the equator," said Cedric Garland, DrPH, adjunct professor in the Department of Family Medicine and Public Health and member of Moores Cancer Center at UC San Diego Health. "People who live in areas with low solar ultraviolet B exposure tend to have low levels of vitamin D metabolites in their blood," Garland said. "These low levels place them at high risk of certain cancers, including leukemia."

According to the American Cancer Society, 54,270 cases and 24,450 deaths from leukemia occur in the United States alone each year. There is no known way to prevent most types of leukemia, though some types may be prevented by avoiding high doses of ionizing radiation, exposure to the chemical benzene, smoking and certain types of chemotherapy.

The UC San Diego study analyzed age-adjusted incidence rates of leukemia in 172 countries from GLOBOCAN, an international agency for research on cancer that is part of the World Health Organization, comparing that information with cloud cover data from the International Satellite Cloud Climatology Project. The study follows similar investigations by Garland and colleagues of other cancers, including breast, colon, pancreas, bladder and multiple myeloma. In each study, they found that reduced UVB radiation exposure and lower vitamin D levels were associated with higher risks of cancer.

Leukemia rates were highest in countries relatively closer to the poles, such as Australia, New Zealand, Chile, Ireland, Canada and the United States. They were lowest in countries closer to the equator, such as Bolivia, Samoa, Madagascar and Nigeria.

Two studies published in the British Medical Journal (BMJ) looked at Vitamin D. From NY Times:

Low Vitamin D Levels Linked to Disease in Two Big Studies

People with low vitamin D levels are more likely to die from cancer and heart disease and to suffer from other illnesses, scientists reported in two large studies published on Tuesday.

The new research suggests strongly that blood levels of vitamin D are a good barometer of overall health. But it does not resolve the question of whether low levels are a cause of disease or simply an indicator of behaviors that contribute to poor health, like a sedentary lifestyle, smoking and a diet heavy in processed and unhealthful foods.

Nicknamed the sunshine nutrient, vitamin D is produced in the body when the skin is exposed to sunlight. It can be obtained from a small assortment of foods, including fish, eggs, fortified dairy products and organ meats, and vegetables like mushrooms and kale. And blood levels of it can be lowered by smoking, obesity, and inflammation.

Vitamin D helps the body absorb calcium and is an important part of the immune system. Receptors for the vitamin and related enzymes are found throughout cells and tissues of the body, suggesting it may be vital to many physiological functions, said Dr. Oscar H. Franco, a professor of preventive medicine at Erasmus Medical Center in the Netherlands and an author of one of the new studies, which appeared in the journal BMJ.

The two studies were meta-analyses that included data on more than a million people. They included observational findings on the relationship between disease and blood levels of vitamin D. The researchers also reviewed evidence from randomized controlled trials — the gold standard in scientific research — that assessed whether taking vitamin D daily was beneficial.

Dr. Franco and his co-authors — a team of scientists at Harvard, Oxford and other universities — found persuasive evidence that vitamin D protects against major diseases. Adults with lower levels of the vitamin in their systems had a 35 percent increased risk of death from heart disease, 14 percent greater likelihood of death from cancer, and a greater mortality risk overall.

When the researchers looked at supplement use, they found no benefit to taking vitamin D2. But middle-aged and older adults who took another form, vitamin D3 — which is the type found in fish and dairy products and produced in response to sunlight — had an 11 percent reduction in mortality from all causes, compared to adults who did not. In the United States and Europe, it is estimated that more than two-thirds of the population is deficient in vitamin D. In their paper, Dr. Franco and his colleagues calculated that roughly 13 percent of all deaths in the United States, and 9 percent in Europe, could be attributed to low vitamin D levels.

In the second study, also published in BMJ, a team of researchers at Stanford and several universities in Europe presented a more nuanced view of vitamin D.

They concluded there was “suggestive evidence” that high vitamin D levels protect against diabetes, stroke, hypertension and a host of other illnesses. But they also said there was no “highly convincing” evidence that vitamin D pills affected any of the outcomes they examined.

Dr. Theodoratou was not alone in suggesting people hold off on taking vitamin D supplements for now. Even though Dr. Franco found them to be beneficial, he said that more research was needed to show what levels are best. Instead of taking pills, people could improve their vitamin D levels with an adequate diet and 30 minutes of sunlight twice a week, he said.