Vitamin D and Sun Exposure

When it comes to vitamin D, consumers are bombarded with mixed messages about the best source for this essential nutrient. While some may argue that small doses of intentional sun exposure are safe, dermatologists point out that the risk of developing skin cancer from ultraviolet (UV) radiation far outweighs the benefit of stimulating vitamin D production - particularly when enriched foods and supplements are safe and effective sources of this vitamin (see also Skin Cancer).

Speaking today at the American Academy of Dermatology's SKIN academy (Academy), Washington, D.C., dermatologist Elizabeth L. Tanzi, MD, FAAD, clinical faculty in the department of dermatology at Johns Hopkins Hospital Center in Baltimore, addressed common myths about sun exposure, sunscreen and vitamin D, and announced the Academy's increased recommendation on the minimum Sun Protection Factor (SPF) of sunscreen.

"Despite years of ongoing public education efforts on the dangers of UV radiation, a number of misconceptions remain as to how to best protect ourselves from this known carcinogen and whether or not we absolutely need sun exposure for vitamin D production," said Dr. Tanzi. "The fact is these myths are harmful because sun exposure is the leading cause of skin cancer, and the consequences of this misinformation could be potentially fatal."

Myth: Sun exposure is the best source of vitamin D.

Vitamin D is an essential nutrient that is vital for strong bones and a healthy immune system. Deficiency of vitamin D is associated with bone softening in adults, rickets in children and, more recently, with high blood pressure, arthritis, type I diabetes and certain cancers.

While UV radiation is one source of vitamin D, dermatologists argue that it is not the best source because the benefits of obtaining vitamin D through UV exposure cannot be separated from an increased risk of skin cancer. Instead, the Academy recommends that an adequate amount of vitamin D should be obtained from a healthy diet that includes foods naturally rich in vitamin D (e.g., dairy products and fish), foods/beverages fortified with vitamin D (e.g., fortified milk and fortified cereals), and/or vitamin D supplements.

"Although studies showing the benefits of increased vitamin D intake have caused some to propose 'sensible sun exposure' or intentional sun exposure as a cost-effective method for preventing vitamin D deficiency, increased sun exposure is not the answer," said Dr. Tanzi. "UV radiation is the most preventable risk factor for the development of skin cancer, which is the most common form of cancer in this country. There are more than an estimated 1 million new cases of skin cancer every year. Despite this fact, there remains a tremendous amount of misinformation about UV exposure - especially in relation to vitamin D."

Myth: All sunscreens are created equal.

While on the surface most sunscreens may look the same, they are in fact quite different. One of the things that makes sunscreens different is the level of protection from UV exposure that they provide. Dr. Tanzi explained that a common misconception is that the SPF rates the degree of protection from both UVA rays (which pass through window glass, penetrate into the deepest layer of the skin and are associated with premature aging and melanoma) and UVB rays (the sun's burning rays, which are blocked by window glass, are the primary cause of sunburn, and also are linked with skin cancer). In fact, the SPF number on sunscreens only reflects the product's ability to deflect the sun's burning rays (or UVB). Sunscreens labeled broad-spectrum provide coverage against both UVA and UVB light.

"SPF may create a false sense of security about the level of protection a person is getting, because many sunscreens do not adequately protect against harmful UVA rays," said Dr. Tanzi. "The main challenge in providing effective protection from UVA rays is that traditional chemicals used in sunscreens that absorb UVA light degrade quickly and become ineffective."

Fortunately, there are ingredients that can be added to traditional sunscreen ingredients to keep them stable and provide broad-spectrum protection. For example, Dr. Tanzi noted that the ingredient oxybenzone can help stabilize avobenzone (one of the best absorbers of UVA rays that, while highly effective, breaks down quickly), which provides a longer duration of effective protection from UVA rays. Other effective ingredients that help provide broad-spectrum UV coverage include ecamsule, cinoxate, menthyl anthranilate, octyl methoxycinnamate, octyl salicylate, and sulisobenzone.

For those with sensitive skin, sunscreens with non-chemical ingredients work best and will prevent irritation. Dr. Tanzi said the ingredients zinc oxide and titanium dioxide provide both UVA and UVB protection.

Myth: Using a higher SPF will ensure you don't burn.

Dr. Tanzi explained that those who use sunscreen with a higher SPF may think they will not burn when exposed to UV light, but she said that is not true. In fact, actual sunscreen protection depends on many other factors - including skin type, the amount and frequency of sunscreen application, and the impact of activities (such as swimming and sweating). As a result, sunburn can occur even when wearing a higher SPF sunscreen.

Another important factor Dr. Tanzi emphasized is that UVB protection does not increase proportionately with a designated SPF number. For example, an SPF of 30 screens 97 percent of UVB rays, while an SPF of 15 screens 93 percent of UVB rays and an SPF of 2 screens out 50 percent of UVB rays. However, not applying enough sunscreen or not covering all exposed areas may result in a lower SPF than the product contains.

"For adequate protection, sunscreens are best applied 15-30 minutes prior to going outside, approximately every two hours or immediately after swimming or sweating," said Dr. Tanzi. "Research demonstrates that most people only apply 25 to 50 percent of the recommended amount of sunscreen, which is one ounce for the entire body or enough to fill a shot glass. Therefore, if only half the proper amount of SPF 15 is applied, the SPF has been reduced to an SPF of approximately 5, which is then inadequate protection.

Back Pain and Long Periods of Sitting

Do you get lower back pain from sitting in your office chair for hours on end?

Sitting for long periods can be a pain as you age. Long drives, bleacher seats at a football game or working at your computer can trigger back pain.

Ninety percent of Americans have some back pain at some time in their lives. It’s one of the first things I learned in my rehab studies during my residency in med school. In fact, back pain is the number two reason people visit the doctor, second only to upper-respiratory infections.

Stretching the right muscles is one of the best solutions for chronic back pain, especially if you have trouble sitting for long periods of time.

But you don’t need to spend an hour a day doing boring stretching exercises to be flexible or ease your nagging back. Today, I’ll show you an easy stretch for lower back pain, and I’ll tell you about a remarkable invention that’s helping thousands of people sit comfortably for long periods.

Losing flexibility as we age is the rule, especially if you never stretch. You make it worse if you sit at a desk all day. But some regular exercise and proper stretching can slow the decline.

An intelligent stretching regimen can prevent or even reverse stiffness and loss of range of motion. Done properly, these movements can ease your back pain and provide long-term relief. This solution is simple, pleasant and takes only a couple of minutes.

Here’s an easy one. To relieve lower back pain, stretch the front of your hips daily (or every other day).

Hip Flexors: You need to do this stretch, particularly if you sit all day at work. Sitting all day puts pressure on the hip flexor muscles. This is a major cause of minor low back pain. Stretching your hip flexors muscles several times a week will prevent this kind of lower back pain.

How To: Stand in a modified runner stance, with right foot forward and left foot back, feet flat on floor. Put your hands on your hips and keep your back and hips in straight alignment. Push forward with your hips, while maintaining your erect posture. Slowly, push your hips forward only until you feel a comfortable level of tension. Hold for a 10 count. Switch sides by reversing your leg stance and repeat.
If you have back pain and sit for long periods I have an excellent tool for you. It was invented by an office worker, Cathleen Woodall, who spends 8 hours a day sitting in front of a computer.

After years of lower back pain she created a portable seat that slopes from back to front, keeping your pelvis at the correct angle. The groove down the middle prevents impact on your spine and coccyx.

It has a layer of visco-elastic memory foam making it both supportive and comfortable.
It’s called the G-Seat. Here’s what people are saying about it:

“I like to do email on the weekend at my kitchen table. The GSeat allows me to work comfortably for hours, even while seated on an oak chair.” – J. Bloom, Ottumwa, IA

“I spend 9 to 12 hours a day sitting in front of a computer. And even though I have a nice ergo chair, it was not until I got my GSeat that I felt my sitting posture really improve. I no longer have that nagging lower back pain from sitting all day in a chair. Thanks to my GSeat, on my last trip to Arizona, a 7-hour drive, I did not experience the ‘rump fatigue’ I usually do.” – C. Watson, Orange County, CA

My friend Nan Kathryn Fuchs, PhD told me about the G-Seat and I want to pass it on to you.

I think it could be a real solution for back pain caused by long periods of sitting.

Vitamin treatment improves ED in men with elevated homocysteine

An article published online on August 17, 2009 in the Journal of Sexual Medicine describes research conducted at the University of Rome which found that it may be necessary to reduce homocysteine before treatment with erectile dysfunction (ED) can be effective.

The study included 75 men aged 25 to 65 with erectile dysfunction who were treated with sildenafil citrate (“Viagra”) for 2 months. Nonresponders to the drug were treated with a course of 600 milligrams vitamin B6 per week and 15 milligrams folic acid per day along with sildenafil for 6 weeks. Questionnaires concerning erectile function were administered before and after treatment.

Participants were evaluated for the presence of the MTHFR 677T mutation which is present in a higher percentage of heart disease patients than in those without the disease. Individuals with two copies of the mutation have levels of homocysteine that average 25 percent higher than the rest of the population, and which increase significantly when blood levels of folate are low. Twenty-seven percent of the subjects had both copies of the MTHFR 677T mutation and 48 percent had one copy, which is a greater frequency than the general populace.

All of the 18 patients who initially failed to respond to drug treatment had high levels of homocysteine and low folic acid levels. Subsequent to the 6 week course of vitamin therapy, folic acid levels increased, homocysteine concentrations declined, and all but two participants experienced improvement in ED.

The association of hyperhomocysteinemia with vascular disease supports the mechanism for homocysteine-reducing agents in improving ED, which is caused primarily by the same factors that affect the coronary arteries. “Measurement of plasma homocysteine and folic acid levels and molecular analysis of the MTHFR genotype should be added to the ED diagnostic procedure, especially in young patients or in those with a family history of cardiovascular disease," the authors conclude. "When this mechanism is implicated, treatment should first aim to reduce homocysteine levels through administration of folic acid, alone or in combination with vitamin B6 or B12, and then proceed to treatment with phosphodiesterase-5 inhibitors.”