UV-exposure and Vitamin D must be addressed in parallel.
That seems to be the only thing that the experts on the adverse effects from UV-exposure and the experts on vitamin D can agree upon.
The dilemma of Vitamin D and UV-exposure becomes bigger and bigger for every day as the mountain of evidence of the health benefits of vitamin D continues to grow.In an exclusive interview for the Tanning Blog, one of the most active researchers on vitamin D, gives his view on the UV-exposure and vitamin D standstill. Scroll down or click on the image and listen to the interview. The two sides of the UV-light and vitamin D dilemma are:
- A group of scientists who have their interests tied to the funding from “Big Cosmetics” and “Big Pharma”. They and are dedicated to wipe out skin cancer, or at least they claim to be. They are telling us to stay away from sunlight and tanning beds and to always cover our bodies with sun-screen cosmetics from head to toe. They have been doing so for more than 30 years without a sign of reduction of melanoma or other, less fatal, skin-cancers. They are using the UV-Index to scare us away from the sun.
- A variety of scientists, doctors and researchers who are finding more and more proof of the benefits from higher levels of vitamin D for better health. Many of them want to use the UV-Index to show us when we can get vitamin D from the sun.
- The funding of researchers who try to prove how dangerous sunshine and tanning beds are.
- The funding of leading persons in the UVI-Working Group (and in IARC and ICNIR)
- The sponsoring of early detection campaigns like “the melanoma days”, which fuels the statistics with a totally unrealistic amount of new skin-cancer cases every year.
- Organizing and funding PR-campaigns around every new piece of “evidence” (found by their paid researchers as above) of how sunlight and tanning beds create the skin-cancer “epidemic”.
- Sponsoring of cancer societies and groups of politicians involved in health care (which really creates a shockingly unbalanced view on the enigma of skin-cancer)
VIDEO: “The UV-Index & Vitamin D Standstill” – An Interview with Dr William B. Grant
Time-line: 0:47 – Introduction from Dr William Grant; 2:31 – the inside story from the UVI-Working group; 6:30 – The reasons for the standstill; 8:00 – Double standards applied to research evidence; 10:00 – Millions dies every year while waiting for new UV-recommendations; 13:00 – Is the involvement of politicians needed? 15:00 – The truth about tanning beds, vitamin D and skin cancer.
Göran Olson: I’m very happy to welcome William B. Grant, one of the foremost specialists on vitamin D in the world. There are also many papers you have written, Dr. Grant that it’s almost impossible to mention them all without having a couple of hours only for that. Would you mind to make a short introduction of yourself and your work before we dive into the specific questions for tonight’s subjects? William Grant: Yes. First of all, Goran, thanks for inviting me to do this interview. As for my background, I have a PhD in physics followed by a 30-year career in using lasers for remote sensing of the atmosphere. I participated on many field missions with NASA to study ozone and aerosols, and then starting in 1996 I turned my attention to health studies. I wrote the first paper on the role of dietary factors in risk of Alzheimer’s disease and dementia. I then studied diet and cancer, and in 1999, when the new maps for cancer mortality rates in the United States were published, I started investigating the role of ultraviolet radiation and vitamin D in reducing the risk of cancer, and identified ten types of cancer towards which ultraviolet radiation was protecting. I retired from NASA in 2004 and have spent my full time since then studying health issues, primarily the role of ultraviolet radiation and vitamin D in reducing the risk of many types of chronic and infectious diseases and like you say I published many papers. I have 170 publications including full length articles and letters to the editor on vitamin D listed at PubMed. So I consider this the golden age of vitamin D research and I’m very happy to be a part of that research effort. Göran Olson: Thank you, and you really do a good job also to explain for us non-scientists the practical implementations of the use in UV light in the correct way to make vitamin D in the way that nature intended it. But what we should touch upon tonight is – I call it a little bit your frustration of how slow health authorities are to adopt the new findings from you and your colleagues about vitamin D. In a recent blog post you actually give us a unique insight into the work of the subgroup to WHO, to the World Health Organization, which has the task to give recommendations to health authorities all around the world on how to handle the delicate balance between too much and too little UV exposure. With a few words in such as non-scientific language as you can, tell us a little bit about that work. How long has it been going on and what’s the result so far? William Grant: Okay. We can go back to the beginning of the concern about skin cancer, ultraviolet radiation from the sun. I think the public became aware of the role of UV and the risk factor from skin cancer probably around the mid-1970’s when it was first announced that chlorofluorocarbons or CFCs were destroying the stratosphere’s ozone layer, which is our shield against solar ultraviolet B-radiation or UVB. Turns out that claiming that loss of the ozone layer would greatly increase the risk of skin cancer was a simple message that could engage the public in a campaign to stop producing CFCs, and about that time or shortly thereafter sunscreen sales began increasing rapidly. For example in Australia in the early 80’s they introduced the program Slip, Slap, Slop to encourage everybody to put on sunscreen and try to avoid the sun. Interestingly apparently as a result, squamous cell carcinoma rates decreased but melanoma rates increased. The reason for the divergent trends is that sunscreen blocks the UVB which is both an important factor for squamous cell carcinoma but also a source of vitamin D, yet sunscreen has very little effect on UVA which is the important risk factor for melanoma. Using sunscreen it lets people stay in the sun longer without burning so they get more UVA. So the more melanoma rates increased, the stronger the message from the dermatologist to stay out of the sun and wear sunscreen. So that was the early history. Now in 2005 the International Commission on Non-Ionized Radiation Protection held an international workshop on UV exposure guidance: “A balanced approach between health risks and health benefits of UV and vitamin D.” They invited many of the leading vitamin D researchers to attend along with those interested in protecting you against skin cancer and melanoma. I participated in that meeting and found it very worthwhile. Many good papers were published as a result of that workshop. Now moving ahead to 2011 and this same organization convened another workshop but did not invite the vitamin D researchers. Despite the fact that evidence of UVB and vitamin D are required for optimum health is increased in the minds of the 2011 workshop participants, the strength of the evidence has decreased based on a couple reviews, one by the International Agency of Research and Cancer and one of by the Institute of Medicine in the United States. Never mind that the reviews they mentioned were made by those trying to protect skin cancer or protect any interest in big pharma. Göran Olson: Okay, big Pharma or big Cosmetic, maybe that’s the same thing. So what you mean that of the sixth year of work and in spite of a mountain of evidence of the benefits of vitamin D from sunlight, this working group has not been able to move from the position that sunlight is only bad from us and nothing good at all comes from it? William Grant: Yes. Göran Olson: So what could be the reasons for this in your opinion? You mentioned in your blog post that the majority of the participants in the working group are the same people that actively have been collecting evidence during more than 20 years about how dangerous it is, and even participate in the work to get sunlight and tanning beds classified as carcinogens in the most dangerous group. In what way can this influence on their reluctance now to too slowly admit that some sunlight might be good and even necessary for us? William Grant: Well they’ve invested lots of time and energy in researching the adverse effects of UV. So they have a mindset that readily accepts the evidence of harm from UVA, UVB but generally discounts the evidence of health benefits. This is easy for them to do since nearly all the studies of health benefits have some flaws. However, taken as a whole the evidence is very strong. Göran Olson: That’s true of course and you know all about that side, but what was interesting of course is that you write that in their answer to you they are claiming that the way you and your colleagues on the vitamin D side, let’s call like this, the way you have conducted your research, in principle by case control studies, is not acceptable, but at the same time as I understand that is the way that all research of the connections between the sunlight and tanning beds and melanoma and other skin cancers, they’re also based on the same kind of research. Is that true? William Grant: I emphasize the ecological approach, which is where the geographical distribution of, say, cancer, and the geographic distribution of solar ultraviolet UVB doses and we see those correlations. That approach is not viewed very favorably by the health establishments. What you see for the population as a whole compared to individuals or their compounding factors that might play a role. But in my comment on their finding I said that that’s the strongest evidence, but nonetheless there’s other evidence from the case control studies, the cohort studies, randomized trial studies and so on, and that all together it finds that fact. The strongest evidence for the health field is randomized controlled trials, but of course randomized controlled trials using ultraviolet radiation would be unethical, so they have to go with observational studies, case control or cohort studies. So indeed essentially they’re applying two standards. They wanna have one standard for the benefits, another standard for the adverse effects. Göran Olson: Yeah. That sounds a little bit strange to a layman like me of course. So would you say that the vested interest by the people in the working group into scaring us away from sunlight and some of them, actually, like you write, are being paid by a large manufacturer of sunscreen cosmetics, do you think that that might prevent and delay the health authorities to be able to say – I think you mentioned this in some of the papers that at a minimum 400,000 people could be saved from dying in cancer every year if even the minimum of vitamin D levels would be raised. William Grant: Yeah. I think my 400,000 people a year is probably all-cause mortality rate in the United States per year and vitamin D which includes cardiovascular disease and infectious diseases. Göran Olson: Okay, not only cancers but everything, but only in the States? William Grant: Yeah. Then you go to Europe you’ve got many more. In fact what I show is that if the vitamin D concentrations would double in the population worldwide, mortality rate would decrease by about 15 percent and the life expectancy would increase by about two years. Certainly in terms of vested interest, whether or not these people who are trying to protect the world from skin cancer get paid by commercial interest, they certainly have a lot of personal investment in their research career. They’ve made a stand that their goal is to reduce the risk of skin cancer. Unfortunately most of them are only concerned about the skin and are not concerned about the internal workings of the body, internal cancers, the cardiovascular disease and so on. In fact one of the things I take delight in showing is that people who get basal cell carcinoma in Denmark have a 9 percent lower mortality rate than people who don’t get basal cell carcinoma. I showed in Spain that the provinces that have more non-melanoma skin cancer mortality rates have reduced risk of internal cancer mortality rates of 15 types of cancer. So this is just sort of water off a duck’s back to the dermatologists. They don’t know how to deal with something outside their field. Göran Olson: Yeah. That’s really amazing to many people to see how narrow view health authorities are applying. There seem to be some people working with the skin cancers and other people working with other types of cancers and they are not coordinated in between them with regards to vitamin D, but we have a parallel that happened a couple years ago, the H1N1 swine flu vaccine was a big clash, big scandal you can call it in the European Commission and the World Health Organization. What we can say is that the members of the European parliament at that time was extremely critical towards how WHO handled the vaccine distribution or let’s call it sales. Do you think that it’s needed the involvement of politicians also in this case to make a change to the stand of WHO regarding UV exposure and vitamin D? William Grant: Possibly. Let me just mention that I went to Warsaw, Poland in October to attend the Vitamin D Conference that attracted 550 people, and the upshot of the conference is that they’re preparing recommendations for central European countries of 30 to 50 nanogram per milliliter, which is quite a bit higher than what the concentrations are for most people. This has been sponsored by the university. I think it’ll take a little while to get to the government level, but that could be part of the nucleus, part of the effort to get things changed around a bit. Göran Olson: Yeah. Actually Poland was the only country in Europe that thanks to a very knowledgeable minister of health, that was the only country in Europe that refused to buy the vaccine towards the swine flu, which his quite interesting. There’s a nice video on You Tube about that. Okay, enough about the swine flu. Anyhow, it seems that it’s definitely needed a wider view upon the dilemma between sunlight and vitamin D, right? William Grant: Right. Göran Olson: So just a final question then before we wind up. I’m sitting in a very dark place of the world right now. The sun that could give me UVB disappeared already some three months ago and the same with a lot of people living north of 40, 45 degrees of latitude. Of course tanning beds is almost like a swear word today. In Belgium advertisement on busses claiming that tanning beds are cancer machines and so on and so on. What is your take on the possibility to fill up our vitamin D levels from tanning beds during the time with the UVB from the natural sun is not available? William Grant: Okay. The lamps in tanning beds generally have the same ultraviolet spectrum as the mid-day, mid-latitude sun hitting their surface. So the same is in Florida or Mediterranean. That includes 3-5 percent UVB, which produces vitamin D. There have been a number of papers showing that tanning beds do produce a lot of vitamin D, that a typical session will produce 10,000 to 20,000 international units. We consider that the daily requirement is maybe 2,000 to 4,000 international units, so one session, perhaps one session, maybe two sessions a week could produce all the vitamin D that a person needs. It turns out though that the amount of time required for vitamin D production is probably in the order of a minute or two, which is much less than the time required for tanning. Now there have been a number of health benefits found from indoor tanning. They include certainly higher vitamin D concentrations, increased bone strength, reduced risk of endometrial cancer, and thrombosis, and I think diabetes recently. As far as the risks go, there may be a little bit increased risk in melanoma or skin cancer, but I think it would be very similar to what would happen from the sun. We know that the health benefits from being in the sun are much, much stronger than the adverse effects. The important thing is that people with very, very fair skin, it’s called type one skin, should avoid indoor tanning because they just can’t tan. If they’re gonna go in they’ve got to go in for a very short amount of time and it reduces vitamin D. The other thing is one should never stay in a tanning bed long enough to start turning pink and burn. The primary risk factors for basal cell carcinoma and melanoma is the burning from too much UV. So certainly in a place such as northern Europe where you cannot produce vitamin D from the sun for four, five, six months of the year, indoor tanning makes sense. Göran Olson: Yeah, and northern North America too I suppose. So yeah, that I think is good advice, short sessions maybe a couple times a week should be minimum risk and maximum benefits to put it slowly, and as much UVB as possible in the beds. Dr. Grant, I, my readers, listeners in this case – thank you very much for taking your time this evening to answer these questions and we can only say that I think that all healthy tanners, those who really want to tan for vitamin D and maybe not mainly to get as brown as possible, really support your work and think that what you and your colleagues are doing is tremendously important so that more can get the benefits of vitamin D, not only through pills but also through the UV exposure. So thank you very much. Good luck in your future work and we will look forward to hear what your next paper will bring to us. William Grant: All right. Thanks very much.