PREVENTION
By Stephen Donnelly, DO, FAAP Striking a Balance: Sun & Sunblock
an excessive sun exposure and repeated sunburns cause skin cancer? Yes, that has been well documented. However, an appropriate amount of sunshine actually prevents certain cancers by creating vitamin D. That is a mes- sage that needs more exposure (pun intended). We need not fear the sun, but we do need to respect it. As is often the case, balance is the holy grail of health.
C Vitamin D Deficiency
Vitamin D deficiency is a major issue in our society, and sun is the major source of this vitamin. An estimated 70 percent of the U.S. population is vitamin D deficient, especially in the northern latitudes. Reasons for this range from more time spent indoors to over-use of sunblock. The reason for the latter is the fear of skin cancer. If your vitamin D level is low your immune system may not be functioning as well as it should. As a result, you may be more vulnerable to infectious diseases than you would if your vitamin D levels were optimal. Worse, you could be at higher than normal risk of a long list of diseases including heart disease, certain auto- immune diseases, and ironically, several kinds of cancer, including a more aggressive form of melanoma. Research at the Linus Pauling Institute at Oregon State University, has shown that vitamin D induces expression of an antimicrobial peptide gene called cat- helicidin that is the “first line of defense” in the immune system’s response to minor wounds, cuts and bacterial and viral infections. The regulation of cathelicidin by vitamin D could help explain its vital role in immune function. It is believed that vitamin D is also a key cofactor in reducing inflammation, in blood pressure control and helping to protect against heart disease. Ask your doctor for a vitamin D level and don’t take “normal” as an answer. Find out the actual level. While lab reference values range from 20 - 85 (var- ies with lab), optimal levels are above 40 to 50 ng/mL. Ask your provider about vitamin D3 supplements as well.
Sensible Sun Exposure
While there is still much to explore about vitamin D’s mecha- nisms of action, its use in new treatments, and its duty in fighting infection, consider “sensible sun exposure” to boost your vitamin D levels naturally. Spend 15 - 20 minutes in late morning or mid-late afternoon without sunblock, as this blocks the rays that are needed
to make vitamin D in the body. If you’re getting “sensible sun” in the late morning, certainly be sure to apply sunblock (SPF 30-50) there- after. Unfortunately, there are also risks with sunscreens.
What do you need to know about sunscreens?
Avoid ingredients like Oxyben-
zone, Vitamin A (retinyl palmitate), and added insect repellent. Avoid products that are sprays, powders, or SPF > 50. Oxybenzone is a synthetic estrogen that penetrates
the skin and contaminates the body. While eating vegetables with vitamin A is good, new government data show that tumors and le- sions develop sooner on skin coated with vitamin A-containing lo- tions and creams. If you need bug spray, buy it separately and apply it first. Look for sunscreen ingredients like Zinc, Titanium Dioxide, Avobenzone or Mexoryl SX, as these have been found to be safe and effective. The best products are those that are creams and offer the following:
1) Broad spectrum protection (UVA/UVB). 2) Water resistance for pool, beach, and exercise. 3) SPF between 30 - 50.
For more information look at the Environmental Working
Group’s (EWG’s) 2014 Sunscreen Guide online (http://breaking-
news.ewg.org/2014sunscreen/). Yes, there is an app for that, both iPhone and Android that can
come in handy as you’re shopping. It should be mentioned that there are many other benefits
to the sun. While we are learning more about the importance of vitamin D, there are likely many more physiologic reactions that occur in response to sunlight. Spending time outdoors on a beauti- ful sunny day certainly does elevate our mood. So moving forward, get out there and find that balance between sensible exposure and smart protection. Enjoy your summer in Maine!
Dr. Donnelly practices Integrative Medicine in Portland. Information about his practice can be found at
www.theMCIM.com. Schedule an appointment today at the Maine Center for Integrative Medicine by calling 207-899-0386. See ad on page 21.
22 Essential Living Maine ~ July/August 2014
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