The skin is our body’s largest organ and serves as the interface between our internal and external world. It gives rise to our sense of touch, the only sense that does not diminish with age. Because our skin is what we present to the world, billions of dollars are spent every year on creams, lotions, and cosmetic surgeries. I have long been fascinated with the world of skin care, learning a great deal about the physiology of the skin.
I have shared my knowledge of how plants could be used to restore barrier function and reduce oxidative damage, inflammation, and irritation. But over the many years, I’ve cared for those with skin problems, I’ve also learned that it takes more than just applying moisturizer to have healthy skin.
Safe in the Sun: Balancing the Benefits and Risks of Sun Exposure
Balancing the risks and benefits of sun exposure can be difficult when looking at the shocking rates of skin cancer diagnoses and soaring numbers of vitamin D deficiency. Not so surprisingly, the answer to this debate lies not in the sun, but in the way we live our lives.
When was the last time you let yourself feel the sun on your face without worrying about the damage it may be doing? Before fear of skin cancer sent us all scurrying for the shade, people used to be outside all throughout the day, working in the garden or playing in the backyard. Now we spend most of our lives indoors, except when we choose to sunbathe during the hours of the day when the sun is most intense—a practice that actually increases skin cancer risk. Far from protecting our health, avoiding the sun completely can have serious consequences. As Robyn Lucas, an epidemiologist at Australian National University who led a study on sun exposure and disease points out in an interview with U.S. News & World Report, more lives are lost to diseases caused by a lack of sunlight than those caused by too much.
Importance of Vitamin D
Called the sunshine vitamin because it’s made when solar energy converts a chemical in our skin to D3, vitamin D’s importance to the body can’t be overestimated. In addition to keeping our bones healthy, it increases our resistance to infections, protects the heart, and may help prevent some types of cancer. This is why it’s so disturbing to consider how many people have vitamin D insufficiency—more than 66 million Americans, according to the CDC Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population. As I discuss in my blog about vitamin D and children, studies show that obese, minority children are hit especially hard. Why are we seeing such dangerously low levels of vitamin D? Compared to our ancestors, we get a lot less sun. While sunscreen protects us against the damaging effects of UV radiation, an SPF of 8 blocks the production of vitamin D by a whopping 95 percent.
Nature’s Healing Power
Growing up, I loved to play outside with the neighborhood kids. When I came home from school, Mom would say, “Take off your school clothes, then go outside and play. Be home for dinner.” How different would my life be if I’d spent my afternoons indoors staring at a screen rather than running free under the sun? I believe that for us to be whole human beings, we must be mindful of our deep and intimate relationship with nature. This is especially true for children. In his book Last Child in the Woods, Richard Louv uses the phrase “nature-deficit disorder” to describe the increasing separation kids have from natural spaces when they grow up in urban areas and/or spend a lot of time indoors. He cites a number of studies showing the positive effects of nature on the behavior and attention of kids with ADHD. This is confirmed by other research where the inclusion by schools of green space and environment-based education leads to improved test scores and a reduction in classroom discipline problems. Consider how peaceful you feel after soaking up the beauty of a summer day, and how well your little ones sleep after time spent tumbling around in the grass. A little sunshine goes a long way toward boosting our well-being.
Safe in the Sun
Knowing the benefits of being outside versus the risk of overexposure, how do we keep ourselves and our kids safe in the sun? Your needs will vary based on circumstances like skin color, geographic location, and time of the year. People with very light skin may require only ten minutes of sun exposure three or four times per week to make the necessary amount of vitamin D, while those with very dark skin might need one to two hours. If you’re close to the equator and/or it’s summer when the sun’s rays are strongest, you should modify accordingly. Also, try to avoid spending too much unprotected time in the sun between the hours of 10 and 2 when its radiation is strongest. If you are out during this time of day or you’ll be in the sun for a while, use a safe, chemical-free sunscreen. The Environmental Working Group offers an excellent guide (see below), as well as tips for making sure to wear sunglasses to protect your eyes from UV damage. By using a common sense approach, you and your family can play at the park, splash in the pool, or simply enjoy the sensation of sunshine on your shoulders without fear.
To Learn More:
Interested in learning more about the healing power of nature? The book Life Is Your Best Medicine is a great resource:
For more information on vitamin D and other nutrients, see the book Fortify Your Life:
Vitamin D and Children: A Good Idea?
It’s well established that vitamin D is paramount to bone development, bone fracture resistance, and mood regulation. This “sunshine” vitamin also supports our immune and cardiovascular systems, and endocrine function, so it’s vitally important that we maintain adequate blood levels. Children especially need vitamin D to develop strong, healthy bones.
In a nation struggling with obesity, it’s hard to believe that we are once again seeing borderline deficiencies. Though rickets, scurvy, and pellagra seem like stories from the days of pirates and early settlers, modern science shows that we are now seeing borderline and frank deficiencies of many vitamins and minerals in the American population. It is clear that though we are overfed, we are undernourished. Furthermore, our messages regarding low-salt and skin-cancer awareness have decreased consumption of iodine and significantly impacted vitamin D levels.
Perhaps the most concerning take away from modern nutritional data is that children, particularly obese, minority children, seem to be heavily impacted. The National Health and Nutrition Examination Survey (NHANES) study found that a large number of children 6-18 years of age are deficient in vitamin D. The deficiency percentage goes way up in children who are overweight, and amongst obese kids – one-third of white, 50% of Latino, and 87% of African American children – were deficient in vitamin D.
Why are we lacking?
With so many fortified foods in our grocery stores and the ability of our body to make vitamin D with exposure to sunlight, why are so many kids lacking?
The most obvious answer is probably the fact that all of us, including our kids, are spending more and more of our lives indoors and engaged in sedentary pursuits, such as watching TV and working/playing on our computers and smartphones. Not only are we spending less time outdoors, we are also much more aggressive about using sunscreen to protect our skin, which dramatically decreases our ability to make vitamin D.
While vitamin D is found in some foods, it is not easy to get adequate amounts in our diet. For example, to get just 600 IU of vitamin D in your diet you would need to eat one of the following every day:
* 3–4 ounces sockeye salmon, cooked
* 11.4 ounces water-packed tuna
* 26 oil-packed sardines
* 15 large eggs
* 5 cups fortified milk OR
* 30-45 ounces yogurt
In the case of vitamin D, the best bet to ensure adequate intake is probably through the use of supplements, which are readily available at pharmacies and natural foods stores. In general, breastfed infants should be given 400 IU per day; older children 1000 IU per day, while obese children probably need closer to 2000 IU per day. Talk to your pediatrician to know what is best for your child. When choosing a vitamin D supplement, look for those that contain D3 (cholecalciferol), the most bioactive form, and take with dinner for optimal absorption.
More is not better
While you want to make sure you and your kids are getting adequate vitamin D – more is not better. The Institute of Medicine has set the following upper limits for vitamin D, meaning you should NOT exceed these amounts unless under the supervision of your healthcare provider.
* 1,000 IU/day for infants to age 6 months
* 1,500 IU/day for ages 6 months to 1 year
* 2,500 IU/day ages 1 to 3 years
* 3,000 IU/day for ages 4 to 8 years
* 4,000 IU/day anyone older than 8 years
Vitamin D, like most nutrients, does best when it is taken with its partner nutrients. Vitamin D partners well with calcium and vitamin K2. Vitamin D allows calcium to be absorbed and vitamin K2 directs it to the bone.
Turer CB, et al. Prevalence of vitamin D deficiency among overweight and obese US children. Pediatrics 2013; 131(1):e152-61