January 28, 2003Shining a Light on the Health Benefits of Vitamin D On the office walls are letters from sixth graders responding to a talk he gave. "The important fact I learned from you yesterday is that most living things or persons need vitamin D," one child wrote. Another added, "Even frogs need vitamin D." To advance his point, Dr. Holick — a 56-year-old endocrinologist and a professor of dermatology, biophysics and physiology — handed a reporter a copy of a paper he had recently written, "Vitamin D: The Underappreciated D-lightful Hormone That Is Important for Skeletal and Cellular Health," published in the journal Current Opinions in Endocrinology and Diabetes. Dr. Holick has spent 30 years researching the many ways that vitamin D serves the creatures of this planet. His proudest accomplishments, he says, include discoveries that show how activated vitamin D can be used to treat osteoporosis, kidney failure and psoriasis. His psoriasis finding, he notes, has become a widely employed therapy in treating some forms of the disorder. His research into the way skin converts sunlight into vitamin D has led him to a new crusade, encouraging people to let some sun shine on their skin and, thus, some vitamin D into their systems, a controversial idea in some corners of the dermatology world. Q. Would you describe vitamin D as an underrated vitamin? However, this vitamin is critically important for maintaining normal calcium in the blood and for bone health. The vitamin plays a crucial role in most metabolic functions and also, muscle, cardiac and neurological functions. Without enough of it, a child can get rickets, and an adult might suffer bone softening, a mineralization defect. Vitamin D deficiency can precipitate and exacerbate osteoporosis. Moreover, there is evidence that vitamin D may have subtle but profound effects on regulating cell growth and on our cardiovascular and immune systems. There is a strong association of sunlight exposure and increased blood levels of vitamin D with a decreased risk of many common cancers: colon, breast, prostate, ovarian. Additionally, vitamin D deficiency has been associated with an increased risk for Type 1 diabetes. The converse is also true. Adequate vitamin D equals less risk for diabetes. So yes, I would say despite being ignored, this is a very important vitamin. So sunlight is the main source of vitamin D. And there is some research that's begun to be published that shows a lot of people, particularly people who live in northerly places, just aren't getting enough sunlight to meet their vitamin D needs. The thing is a person can actually store vitamin D. You store it in your body fat! And that's why if you get adequate amount of exposure to sunlight in spring, summer and fall, you will store it in your body fat, and it will later be released during the wintertime. Our hard-working medical students just weren't getting enough sunlight, not even in the summertime. I suspect this is true for a lot of office workers and others who work at indoor jobs. Or even people who don't work. We and others have shown over and over again that older adults are prone to vitamin D deficiency. A study done in Baltimore, for example, shows that up to 50, 60 percent of free-living adults over the age of 65 were severely vitamin D deficient. The bottom line is many who live in northern places and who spend most of their time indoors need to find ways to get outdoors, so that they can get their bodies to make and store reserves of vitamin D. We say: "Go out there that 5 or 10 or 15 minutes. Make your vitamin D in your skin. Then put on your sunscreen with an S.P.F. of 15 to prevent the effects of the chronic excessive exposure to sunlight." Q. Is your 5- to 15-minute sunlight prescription something you recommend across the board to prevent vitamin D deficiency? In general, I recommend that whatever your ethnicity or skin tone, you get outdoors without a sunscreen somewhere around 20 percent of the amount of time it would take to cause a sunburn, however long that might be. I also recommend an additional daily multivitamin that contains a minimum of 400 units of vitamin D. |