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Is the Risk of Skin Cancer From Sun Exposure Overblown?

By the turn of the 20th century, rickets, the vitamin D deficiency disease, was rampant, thanks to city life with the shade of buildings and coal soot in the air. The dairy industry jumped at the opportunity to fortify milk with vitamin D, and so did the beer industry. According to one print ad: “Beer is good for you—but Schlitz, with Sunshine Vitamin D, is extra good for you…[so] drink Schlitz regularly—every day.” There are, of course, healthier fortified options, like vitamin D-fortified orange juice, but to reach recommended intake levels, it could take 15 to 20 cups of fortified milk, beer, and/or juice a day. As I discuss in my video The Risks and Benefits of Sensible Sun Exposure, to get those kinds of doses, it really comes down to sun or supplements.

Sunlight supplies 90 to 95 percent of vitamin D for most people. The threat of skin cancer is real, however it’s mostly from chronic excessive sun exposure and sunburns. “There is little evidence that minimal sensible exposure to sunlight will considerably increase the risk of skin cancer”—though why accept any risk when we can get our vitamin D just from supplements?

For the sake of argument, what if there were no supplements available? What if we were just trying to balance the positive and negative effects of sun exposure? On one side, we have entities like the American Academy of Dermatology that recommend that “no one should ever be exposed to direct sunlight without sun protection.” After all, the UV rays in sun are proven carcinogens, responsible for more than half of all Caucasian malignancies, blaming the tanning industry for downplaying the risk.

Even those who accept research dollars from the tanning industry acknowledge that excessive sun exposure can increase skin cancer risk, but argue for moderation, advocating for “sensible sun exposure” and blaming the sunscreen industry for overinflating the risk. However, it’s harder to impugn the motives of the dermatologists, who are essentially arguing against their financial interest since skin cancer is their bread and butter. The concern raised by UV advocates is that “sunphobic propaganda” may do more harm than good, pointing to studies such as this one from Sweden that found that those diagnosed with skin cancer tended to live longer and have less heart attacks and hip fractures. Not surprisingly, the media loved this and ran headlines like “Sunbathers live longer.” Only natural UV exposure was associated with reduced mortality, however; artificial UV exposure, like from tanning beds, was associated with increased mortality. This probably has nothing to do with vitamin D, then. Why then would those who run around outside enough to get skin cancer live longer? Maybe it’s because they’re running around outside. More exercise may explain why they live longer. And here in the United States, more UV exposure was associated with a shorter, not longer, lifespan.

There are modeling studies that suggest that at least 50,000 American cancer deaths may be attributable to low vitamin D levels that could be avoidable with more sunlight exposure that would kill at most 12,000 Americans from skin cancer. So, on balance, the benefits would outweigh the risks—but, again, why accept any risk at all when we can get all the vitamin D we need from supplements? In fact, where did they get those estimates about vitamin D preventing internal cancers? From intervention studies involving giving people vitamin D supplements, not exposing them to UV rays. So, it’s not much of a controversy after all. “In essence, the issue is framed as needing to choose between the lesser of two evils: skin cancer…versus cancer of various internal organs and/or the long list of other ailments” from vitamin D deficiency. The framework ignores the fact that there’s a third way. When we were evolving, we didn’t live long enough to worry about skin cancer, and vitamin “D was not available at the corner store.”

If we just want to look more attractive, how about eating more fruits and vegetables? When high kale models were pitted against high UV models, the golden glow from carotenoid phytonutrients won out, and the same result has been found in Caucasian, Asian, and African American faces. So, may I suggest the produce aisle to get a good healthy tan…gerine?

That’s the gist of what the last 15,950 studies on vitamin D have added to our understanding. Unless something particularly groundbreaking comes out, you can expect the next update in 2021. If you missed the first five videos in this series, see:

I also explore vitamin D as it relates to specific diseases:

The physical attractiveness is from carotenoid deposition in the skin. For more on this, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

90 responses to “Is the Risk of Skin Cancer From Sun Exposure Overblown?

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  1. So it seems that moderation is the key.
    If I’m just getting brief bits of sun exposure, like walking to the store, either from my car or home, I’m not going to worry about slathering on sunscreen.

    A long hike or bike ride, or hours of outside work, then yeah, I’ll put some sunscreen on, wear a hat, maybe more covering clothing.

    The sunscreen manufacturers and dermatologists tell you to put on sunscreen every day, year round.

    And BTW, do we really know what those chemical sunscreens long-term effects are?

      1. Since I live in a high altitude desert, and have very fair skin, I also use nutrient ‘sunscreens’.
        Normally eat about 10 servings of vegetables, some fruit, a day.

        Starting early spring, I add tomato paste daily,

        note they mixed it with olive oil to improve absorption. I add it to beans, or lentil pastas. Some fat in the meal is probably necessary.

        And astaxanthin,

        I do not burn too easily now. But last yearI was on vacation in the deep south before I started this regimen, and burned after only 20 minutes in the sun. And that was thru my clothes.

        1. And astaxanthin,

          I do not burn too easily now. But last yearI was on vacation in the deep south before I started this regimen, and burned after only 20 minutes in the sun. And that was thru my clothes.
          So happy to read the link for astaxanthin. I’ve been taking that for quite a few years now and was unaware of its protective effects on skin. I suppose I should have deduced that as it was touted to be better than Vitamin C as an anti-oxidant from what I read… but the link you shared said it was x-times better than Co-Q10

          Like you I no longer burn easily, after being quick to sunburn my whole life. It seems the astaxanthin may be the reason why.

          On another note, the one I buy contains both astaxanthin and zeaxanthin, presumably for eye health, as well.

          I’m curious if there is a synergistic result for the pairing of the two?

          1. Something else just came to mind. The original item I read in re: astaxanthin said it was found in salty conditions and that a lake in Africa I think is where pink flamingos would come to rest during a migration.

            They also said it was the astaxanthin producing substance that gave the flamingos their pink color.

    1. Many of them we do know quite a bit. Many of the chemical sunscreens are xenoestrogens and hormone disruptors and may even contribute to skin cancer. And even if they don’t they are a disaster for coral reefs and fish when people wear them swimming in the ocean.

      1. Yeah, in fact, I was just browsing my newsfeed, and there was an article about chemical sunscreens and how much gets absorbed into the bloodstream.
        Some of these chemicals are just now being tested. It doesn’t look good.
        The fact that they are so bad for corals and fish should tell us something!

        I’m glad I’ve not been a heavy user of these chemical sunscreens. I use a zinc based one to prevent sunburn if I’m gonna be outside for prolonged periods. I don’t like the feel of any sunscreens, but at least the zinc ones seem to be pretty safe.

  2. Dr. Greger,
    I have followed you for years and I also follow a plant-based nutrition program. I also follow John McDougall and have been a speaker at his forums. I have written the most comprehensive book on sun exposure. It is called Embrace the Sun. I would strongly suggest you read it. Vitamin D supplements can in no way replace the sun. My book can be found on Amazon. Keep up the great work, but learn the facts about sun exposure and health. You do not yet have a full understanding yet. Sun exposure, in its healthful benefits, goes far beyond vitamin D. In fact, vitamin D is really a surrogate for sun exposure, which produces many other vital photoproducts.
    Marc Sorenson, EdD

  3. Speaking of melanoma only a large percentage of occurrences have no relationship at all to sun exposure, my doctor estimated more than 50%. It can occur just like any other cancer and frequently in places of the body with little or no sun exposure, so partly genetic partly diet and lifestyle etc.

    Those with regular moderate exposure such as outdoor / semi-outdoor workers tend to have lower rates of melanoma than indoor folk – the ones at real risk are either genetically susceptible (eg redhead, pale skin) or have occasional major overexposures i.e. sunburns.

    1. Chris,

      A UK study found that about 86 percent of melanomas can be attributed to exposure to UV radiation from the sun.

      Other things like X-Rays and chemical exposure can cause it, too.

      1. In the last century melanoma rates in western countries have gone up like five times! Yet we are indoors more than generations past. Care to explain?

        1. With growing wealth and cheap air travel, the number of people in Europe and the US etc who can afford to, and do, have vacations on sun-drenched beaches in exotic locales has increased exponentially, compared to previous generations.

          1. Dear Dr. Greger,

            We agree that humans need vitamin D, but in almost all cases supplement pills have been proven harmful e.g. vitamin A, E, calcium pills etc. or useless, an exception is B12 (produced by bacteria).

            People cannot let their children eat only candy and argue that taking a vitamin C pill will prevent scurvy, which it probably would.
            An apple has thousands of active ingredients not only the vitamin C, that is one of the main arguments of nutritionfacts -> to eat more real fruits and vegetables and Dr. T. Colin Campbell’s book “Whole”.

            Sun exposure produces much more than Vitamin D [in the skin], also Q10 in the brain and many other reactions in the body e.g. nitric oxide etc. Should we also take those supplements?

            To just ignore that and take a supplement pill is the same reductionism thinking the book Whole argued against. So in the same way people are only sitting inside and tending to their computers & smartphones and hoping to get all health benefits from taking a vitamin D supplement pill.

            New research from Sweden came to the conclusion, “Avoidance of sun exposure is a risk factor of a similar magnitude as smoking, in terms of life expectancy.”
            The following article gives a good overview:

    2. >>>Those with regular moderate exposure such as outdoor / semi-outdoor workers tend to have lower rates of melanoma than indoor folk

      I’ve heard this before and believe it.

      Another key issue so far unaddressed by Dr. Greger is the role a nutrient-dense WFPB with lots of phytonutrients might play in reducing risk to reasonable sun exposure.
      Studies on populations that both eat a SAD diet do not necessarily apply to those people.

      “This review considers the studies that have shown a wide range health benefits from sun/UV exposure. These benefits include among others various types of cancer, cardiovascular disease, Alzheimer disease/dementia, myopia and macular degeneration, diabetes and multiple sclerosis. The message of sun avoidance must be changed to acceptance of non-burning sun exposure sufficient to achieve serum 25(OH)D concentration of 30 ng/mL or higher in the sunny season and the general benefits of UV exposure beyond those of vitamin D.

      “Studies have shown that substances called antioxidants, including vitamins and other nutrients, may help fight off free radicals and prevent the damage they do that can cause skin cancer. A 2002 study in the Journal of Investigative Dermatology found that UV exposure greases the wheels for skin damage partly by depleting antioxidants in the body. So, it makes sense that replacing these protective substances could bolster the weakened defenses.

      After years of debate about whether antioxidants could indeed spell the difference between someone developing or not developing skin cancer, recent research has tipped the scales in their favor. More dermatologists than ever now advise patients to feast on foods high in these nutrients. Many also suggest applying topical products containing them, including sunscreens.”

  4. This is the sentence that helps me the most.

    “There are modeling studies that suggest that at least 50,000 American cancer deaths may be attributable to low vitamin D levels that could be avoidable with more sunlight exposure that would kill at most 12,000 Americans from skin cancer.”

    Some of us burn without suntan lotion and some of us don’t want to use them.

    And some of us know that we don’t get sun all year round makes it so likely that I would get the risk of skin cancer, which I probably already have, and which relatives of mine who go to doctors have had removed, plus, I would be deficient 3 seasons of the year and would ALSO have the risk of the cancer deaths from low Vitamin D.

  5. I live at the bottom of the USA map… in the middle. And growing up we went shirtless or sleeveless as we worked. No sun tan lotion… just a vinegar/starch paste if we blistered (which I often did on my upper arms.) Later in life I started wearing long sleeves and long pants, sunglasses and always a brimmed hat if going out of doors.

    Luckily I haven’t gotten skin cancer even though I’m light complexioned. I once read that there was a theory that being exposed to lots of sunshine early in life causes the skin to build up a defense against skin cancer so maybe that was it.

    But I think it was the water blisters and the pain of the sunburn that steered me to wear long sleeves, hat and sunglasses that may have made the difference. Maybe I was able to repair any DNA damage at the early age and any mutations didn’t remain.

    Anyway, knowing what nutrients are good at DNA and or protein folding repair could be a way of holding down melanoma.

    1. Yes, I have had severe sunburn with blistering, too.

      I heard the opposite of what you heard. I heard that if you get blistering burns as a youth that you are more likely to get melanoma later in life.

      That is partly why I hate that people are acting like supplements are worthless.

      1. >>> I heard that if you get blistering burns as a youth that you are more likely to get melanoma later in life.

        This is what I have heard to. Also diet is never considered in these studies. Dr. Fuhrman claims those on a WFPB diet very high in phytonutrients are less susceptible to skin damage/cancer although I have no idea what studies he is basing that on

        1. Actually, according to Dr. Mirkin:

          “How to Avoid Skin Cancer
          Almost all skin cancers are caused by excessive exposure to sunlight and/or exposure to the sexually-transmitted virus called HPV. Basal and squamous cell skin cancers are caused primarily by ***cumulative exposure*** to sunlight over a lifetime, so every time you expose any part of your skin to direct sunlight for more than 10 minutes, you may be adding to the damage that you have received from previous exposures. ***Melanomas are different. They can be caused by a single sunburn at any age.***”

        2. Gengo,

          In the documentary, “Healing Cancer From The Inside Out” (free with Amazon Prime) they said that early stage Melanoma responds really well to dietary interventions with WFPB or Gerson.

          I had a dear relative who died of Melanoma on his face.

          He was someone who sat outside 20 minutes a day probably most of his life – until the Melanoma.

          He went through ridiculously disfiguring surgery, followed by even more disfiguring radiation where he ended up losing his eye and having oozing pus, which smelled like rotting flesh to those of us who had to clean the area and change the bandages daily.

          I was able to get his cancer to stop growing, verified by all the cat scans, but he died after being exposed to pneumonia from an aide. He wasn’t strong enough to fight it.

          1. Nurses aides and other aides show up sick all of the time in the Winter.

            By the time I took care of my grandmother, I had professional air purifiers and all sorts of things and they didn’t get the 2 of us sick.

          2. Deb,
            Sorry to hear that!

            >>>I was able to get his cancer to stop growing
            How did you manage that?

            1. He ended up going vegan but this was before I learned any of this. I was searching online and was seeing these ridiculous videos saying that people cut drink tomato juice or drink carrot juice and he mostly was sick enough that he no longer cared about what he ate.

              There was probably something specific I heard to try, but I can’t remember. I just specifically remember the doctors were surprised that it stopped growing after it had grown back. (Or never was gotten rid of in the first place is accurate. It was visible the whole time and they said, “Oops, we are so sorry. It looks like we missed some.”

              That they missed some doesn’t surprise me. It was more that the cells which they missed were in the exact spot which I looked at every day and thought, “Is that cancer?” Then, I would tell myself, “They look at it every time all of these doctors see him and none of them think it is cancer. It must be that I am a worry wart or don’t know what I am looking at.” But, then, suddenly that lump needed to be removed, too and by then the cancer had spread throughout his brain.

              But it stopped spreading. I didn’t know about slowing doubling times back then, but I believe that the stupid internet videos taught me how to slow doubling times enough that it stopped spreading.

              1. Yes I had stage 3 melanoma diagosed last year… but only diagnosed by chance after three doctors and a dermatologist had assured me that despite growing rapidly it was nothing to worry about. Well in fairness it was a rare type I guess. All good for now.

                1. Chris,

                  That tells me that it must be confusing.

                  I don’t mind if it is confusing but I am afraid of closed-mindedness and arrogance and not acknowledging things.

                  My dog’s vet won’t acknowledge even that it is interesting that my dog is still alive or that any of my efforts might have contributed.

            2. Actually, sickness itself is probably what caused the cancer to stop spreading.

              Thinking about it now, his face became paralyzed around then and eating anything he had to chew may have been too difficult.

              It is possible that he just stopped having the IGF-1 by accident and we still needed to feed him.

          3. I left out that he got twice disfigured and it still grew back because they missed some in surgery and the thing is, it was a visible bump, which was there the whole time, which they missed and I worried about the bump but thought they knew what they were doing leaving it there.

            They apologized but I have learned that when something looks wrong it probably is.

            That bump started growing.

            And I am going to tell you that such a big part of his head was disfigured that disfiguring the rest of it by removing the bump would have been nice.

            They don’t warn you about it.

            You go in for a biopsy and come out with such big deformity and they don’t prepare them at all.

        3. gengo-gakusha, I personally don’t believe that the sun’s effects upon the skin and the body’s processes can be duplicated and manufactured in a pill. Dr G’s video about the sun acting upon the greens we eat in our diet is still one of the most amazing videos he’s made imo. There are no substitutes. Getting outside for at least an hour a day regardless of weather, all year long has served me well, along with the good food we eat.

          1. Barb,
            I agree!

            >>Dr G’s video about the sun acting upon the greens we eat in our diet is still one of the most amazing videos he’s made imo

            Right that was very interesting indeed.

            1. My relative would have said the same sentence as you, but he did get melanoma and he did die from it and after he got it, he changed perspectives.

              1. Deb, There are a number of risk factors. Note the family history and large number of sizeable moles risk factors. I have none of those, so don’t feel getting lightly tanned over the summer is a very high risk. But who knows…

                Melanoma is different. The sun exposure pattern believed to result in melanoma is that of brief, intense exposure — a blistering sunburn — rather than years of tanning. (Some studies now indicate that BCC also may be triggered by this exposure pattern.) Other risk factors are also associated with melanoma, such as a family history and having a large number of sizable moles on the body. Like nonmelanoma skin cancer, melanoma can arise on any area of the body, regardless of whether or not a sunburn occurred in that location.

          2. Here is the link for the coq10 video if anyone is interested. I posted the topic page for exercise also because as you can see from the links included, it is integral to our good health and overall well-being. From supporting breast cancer survival rates, to preventing cognitive decline, supporting heart health, warding off depression etc. walking an hour a day does so much.




            We get an annual skin cancer check at the dermatologist which is well worth the peace of mind.

  6. This topic is something of a shock to me as I’ve lived my life extremely careful of sun exposure because my mom died of melanoma (mole on her neck, very accessible to sun rays).

    So I can go out for 5 minutes? 10 minutes? Direct mid-day sun and be OK?

    1. The recommendations regarding very short exposure to sunlight are based on studies of a general population and so their applicability to those with special circumstances like yours cannot be assumed. According to Dr. Mirkin even one sunburn can lead to melanoma.

      So whatever you do, do not get sunburned. He also recommends protecting more sensitive parts of your body such as face (particularly around the mouth, eyes, ears). Recommend reading his article.

  7. Aren’t there (many) other benefits of sunlight, other mechanism by which our body makes use of sunlight, other receptors to make use of light for the conversion of molecules. I heard for example about the conversion of cholesterol in cholesterol sulfate, which for a part is then converted in vitamin-D sulfate, a form of vitamin D that is supposed to have different characteristics than the form of vitamin D that is being supplemented (and which will never be converted in vitamin D sulfate). I heard also of other enzymes using sunlight, but I don’t remember what exactly. Could you please review this work of Stephanie Seneff. The second usage of light may also have been mentioned by her. Her information convinced me that wise sun exposure is much better than supplementation. So to me this seems to be another example where we abnegate 100 benefits to avoid 1 risk. We just have to expose our skin sensibly.

    1. Yes, our skin also produces Nitric Oxide from sun exposure and other compounds as yet unknown. We were not designed to live permanently in caves or work night shift all our lives. Midday sunlight is essential for health and there is no way this benefit can be replicated in a pill at this point. Which is I suspect why many Vitamin D supplement studies have been a wash.

    2. Seeneff is a notorious crank. Caveat emptor.

      You should subject any and all of her claims to rigorous fact-checking.

  8. There is more evidence coming out about the risks of sunscreen. Some people might have no alternative and so for them, the risk is well worth it. But as far as I am concerned (even though I had what was evaluated to be some pre-melanoma cells in a lesion on my shoulder), I am not about to use sunscreen or give up having fun outside (hiking, jogging, etc). Of course I usually wear a hat with a brim or at least a baseball cap, and UV blocking sunglasses but other than that it’s short sleeves and short pants. Over the summer I get somewhat tan and I refuse to worry about it (but then I have no one in my family who has died from skin cancer, either). I just get a full body skin check once per year and relax (I am actually more concerned it. My dermatologist does not bug me about getting somewhat tan.

  9. Do the people in the blue zones take supplements? What are their skin cancer rates? How big of a role does diet play in the development of skin cancer? Is it possible that we expose ourselves to the sun, produce vitamin D, and then let our bodies do what they are supposed to do (when fueled by a healthy diet) and repair the damage? Are there studies that control for diet? I’m confused why supplements are hailed as our saving grace when the last video said most supplements didn’t even come close to meeting the levels of vitamin d they claim.

    1. Maribeth- You’ve asked many questions and I’ll try to tackle a few. I searched for specific studies on skin cancer rates in the Blue Zones and found none, although specific Blue Zones have studies demonstrating lower cancer rates, esp. of breast cancer. Blue Zone elders spend much of their days in the sun and do not supplement generally, as alluded in the following article on Blue Zones Food Guidelines which would seem to argue for depending solely on sun exposure for Vit D.
      On the decision to supplement or not- There are no simple answers with Vitamin D. which is why there are so many NFO video on this topic This is a complex issue and the answer may vary from one person to the next. You are wise to learn what the science has to say and then determine what is the best response for you. For many, as Dr. Greger has indicated supplementation is appropriate. this video may be helpful if you haven’t already viewed it:

    2. Blue zones are typically rural, so they do not take supplements and usually don’t even have access to them (except for maybe those in Loma Linda). Sun exposure does not cause skin cancer. EXCESS sun exposure causes skin cancer (i.e. melanoma rates correlate with # of sun burns prior to age 18). Diet does have an effect on skin cancer rates. More fruits and veggies = less skin cancer risk. Also, most cancers are seen at lower rates and have a better prognosis in those that get some sun exposure. Those that get no sun exposure experience higher rates of all cancers and they tend to have a worse prognosis. Certain supplements are important for vegans such as B12, and vitamin D for those that get no sun exposure. Almost all other supplements have been shown to INCREASE the risk for disease and premature death. Yes, you read that correctly: taking no supplements is lower risk than taking some supplements. Even excess B12 supplementation has been associated with increased disease risk.

      1. Re: EXCESS sun exposure causes skin cancer

        Yes there is a small factor coming from the sun but I am with Dr Colin Campbell who states that most cancers are caused by all the animal food we consume. The animal food does not cause DNA damage, it undermines the immune system through cancer stimulation. “Most” means more than 50%. The figure I could measure was 65% but no countries are completely vegan hence the real figure should be higher still.

        I’m happy to sent anybody interested the summary of a summary of my five years research. Peter Strous theidealdiet (AT)

        Melanoma mortality rates went up by a whopping 2400% over a 65 year period in The Netherlands. There was a 24 fold increase!!! There is more to the story than sunshine and Campbell would appear to be correct on multiple cancer perspectives.

        1. I think that it has more to do with gmo’s and roundup. Cows were never designed to eat GMO corn. Monsanto got hit with a $2 billion verdict. A court ruled against the agrochemical giant and in favor of a couple who said long-term exposure to weed killer Roundup left them with cancer. Parent company Bayer insists the product is safe, but it has lost a string of recent cases, with thousands still pending.

  10. 20 minutes in the sun and I burn, not badly but still redness that last over a day. Vitamin D supplements give me horrible headaches. I have very low vitamin d levels. Not really sure how to increase my vitamin d.

    1. Lynn,

      I burn and don’t really tan.

      Can you take a smaller dose at a time?

      Cereals and plant mills and irradiated mushrooms help some.

      Also try a different brand?

      It could be a filler.

      1. I don’t get headaches from vegan d3 from lichen that’s in my whole food multi vitamin, but anything over and above I get very bad headaches. I’ve tried many brands both liquid and pills. Both vegan and not. I haven’t however taken cod liver and don’t plan to.

    2. I have very low vitamin d levels. Not really sure how to increase my vitamin d.
      This sounds like a crisis… As a last resort I suggest you get your D from Cod Liver Oil. There are flavored ones that make a spoonful a day tolerable. Personally, I would not accept very low vitamin d levels.

    3. Go out for a walk every day wearing long sleeves and long pants plus a wide-brimmed hat. There’s no need to ‘sunbathe’. .

      If our cousins can go out every day in North America wearing head-to-toe fur suits and still see their vitamin D levels increase, I am pretty sure that we can too.

      1. Assuming you were talking about bears (the link wouldn’t allow me to read) keep in mind they are notorious for eating fish which probably stores Vitamin D in their fat.

          1. Interesting article, Tom. Did you happen to notice the elderly chimpanzees did not signicantly increase their vit D levels from outside exposure: 18.4 +/- 2.4 (inside) v 18.9 +/- 5.5 (outside). That’s consistent with observations that elderly human primates are less able to produce vit D from UV.

            1. Well, yes but the authors also noted that their vitamin levels did not decrease when they remained indoors either.

              It is interesting but elderly primates – ourselves included – are also more likely to suffer from chronic diseases which may produce systemic inflammation. And inflammation reduces vitamin D levels:

              ‘Some authorities now believe that low 25(OH)D is a consequence of chronic inflammation rather than the cause. Research points to a bacterial etiology pathogenesis for an inflammatory disease process which results in high 1,25(OH)2D and low 25(OH)D. Immunotherapy, directed at eradicating persistent intracellular pathogens, corrects dysregulated vitamin D metabolism and resolves inflammatory symptoms.”

              Other explanations include that older people are more likely to have kidney disease and impaired kidney function which results in reduced vitamin D production.

              This of course is a key problem with associational studies. They seldom unequivocally show us which is cause and which is effect. The authors might make assumptions (and often do) but that is not the same thing as actually demonstrating cause and effect. Also, it is quite possible that the inflammtion and consequent decline in vitamin D levels may precede a clinical diagnosis of arthritis by several years Yet because the decine in vitamin D levels precedes the diagnosis, we assume the decline shows causality.

              1. Further to this point is eg

                ‘Genetically lowered 25OHD levels were not associated with increased risk of CAD in a large, well-powered study, suggesting that previous associations between circulating 25OHD levels and CAD are possibly confounded or due to reverse causation.’

                Whether this also applies to things like cancer, ckd and eg T2D I don’t know because i haven’t had the time to look at it. However, the point remains that it is possoble that low vitamin D levels are simply a marker of disease states rather than a causal factor.

                Low levels of ivtamin d may often precede a formal diagnosis but that is not proof of causation.Things like CAD, CKD, T2 D and cancer take decades to develop to a stage when a formal clinical diagnosis can be made. Vitamin d may begin declining when the disease forst begins to develop rather than when it is sufficiently advanced to be diagnosed.

                As for the odd RCT that indicates a protective effect for vitamin D supplementation, we need to remember that the 5% test for statitical significance suggests that one in 20 positive findings are therefore likely to be statistical artifacts. I’d like to see multiple studies demonstrating the same thing to be confident that such results in a very few studies are not just statistical flukes.

                1. That’s very interesting, Tom.

                  Reminds me of the low cholesterol / disease state association found in some older people and used as an unjustified argument for higher cholesterol levels being healthy.

        1. If our cousins can go out every day in North America wearing head-to-toe fur suits and still see their vitamin D levels increase, I am pretty sure that we can too.
          Assuming you were talking about bears (the link wouldn’t allow me to read) keep in mind they are notorious for eating fish which probably stores Vitamin D in their fat.

          Thanks Lonie but it was actually chimpanzees – no fish involved (the same thing occurs with gorillas too).

  11. “When we were evolving, we didn’t live long enough to worry about skin cancer…” From an evolutionary standpoint: What else would explain the increased melanin in the skin of those from regions with the highest sun exposure? It certainly can’t be from too much Vitamin D, as that could hardly be a negative. Conversely it makes sense that areas of less sun, produce people with lighter skin to absorb more of the sun’s rays, not enough raising your odds of dying, reducing your odds of reproducing. People that have genetic baldness like the good doctor and myself may have a gene that makes us more susceptible to prostate cancer – preventable with Vit. D from sun exposure, so being bald really is an evolutionary adaptation, solar collectors for us sex machines, as the T-shirts used to read. Seriously, though, dark skin adaptation could very likely be from a time of unusual solar activity, killing off all those that did not have enough melanin, enough to make a marked difference in pigmentation around the world in our human species.

  12. I recall reading stories regarding the Church of Scientology and their insistence that their membership take a lot of Niacin on a daily basis, demanded by L Ron Hubbard himself.

    Invariably when one of their membership leaves they bring this up. When further prodded, they do admit their skin gets better.

    I personally add Niacin powder to things like gelatin (just started) along with other nutrients… including blueberries, sweet cherries, tart cherry juice and beet juice. Along with that I also take a Niacin tablet (with food) late morning. (I notice after doing this and after the flush I’ll doze off in front of the computer more often than not.)

    What I’m driving at is: Is it possible the way to get D without getting cancer is to supplement with Niacin? Small sample size but there does seem to be a protective effect for me.

    1. Guess I also should mention that I wet my skin with Guava Leaf tea once or twice a week, so that could be a confounding factor.

  13. This may be simplistic but we evolved spending time daily under the sun and gathering the foods that grew there. These days we mostly stay inside and deplete our Vit D resources, then overexpose, slather on chemicals, buy fake food from inside grocery stores or take out joints then wonder why cancer rates are high? I’m not even comfortable with D3 supplements because every time I’ve tried them I get lower back/kidney area pain, and investigating it, apparently I’m not alone. We’ve gotten supplements wrong so many times before I’ll just stick to the “old fashioned” way of getting it, besides, seems to me we get a lot more than vitamin D from being outside.

  14. Im confused about.conflicting advice in this series of videos, and others. In one we are advised to take supplements, in others just eat veg, and another that.there is no proof taking vit d helps any condition.

    1. Stephanie,

      Dr. Greger is not giving conflicting advice. I don’t understand that you have watched his videos or read his blogs if you are saying that they have no benefit.

      There is an 11% improvement in mortality levels with Vitamin D supplements.

      “56 randomized clinical trials, involving nearly 100,000 people between the ages of 18 and 107, mostly women, randomized to four years of vitamin D supplements or sugar pills. Put all the studies together, and those given vitamin D supplements lived longer, also specifically lowering the risk of dying from cancer. Note this effect appeared limited to vitamin D3, though, the type derived from plants and animals—not vitamin D2, the type derived from yeast and mushrooms.”

      1. Once you reach a serum vitamin D level of 40 ng/ml, your risk for cancer plunges by 67 percent, compared to having a level of 20 ng/ml or less. The Health and Medicine Division (HMD) of the National Academies of Sciences has reported an association between vitamin D and overall mortality risk from all causes,including cancer. Vitamin D also increases your chances of surviving cancer if you do get it, and this includes melanoma patients.

    2. Stephanie,

      Sorry that I worded things as if you weren’t following what Dr. Greger is saying. It was the wrong thing to say.

      Dr Greger believes that people should not be deficient. That is the main point.

      The most recent studies from last year still showed a decrease in mortality benefit from supplementation. There was also a statistically significance prevention of cancer for dark-skinned people. There was a small, not statistically significant prevention of cancer for white people.

      I personally am more interested if there were lurking variables that confounded the study like they didn’t correct enough for obesity or age which are variables which change every year, but most of the WFPB leaders want people to just get more sun, but studies in the Fall and Winter on children show that even kids get deficient in the Fall and Winter and it is May and the Northeast hasn’t strung together any good weather yet.

      I wear long sleeves 9 months out of the year. And hide in air conditioning 2 months of the year.

      I am post-menopausal and overweight and wear long pants and never go sleeveless and i would have to spend hours outside to not be deficient and when I go outside without high spf sunscreen I burn and never tan.

      The leaders tell me not to use sunscreen and then they tell me not to burn and I find most of the leaders of WFPB unrealistic about this area.

      You find Dr G confusing and I find every body else confusing.

      1. I feel like the Vitamin D supplement studies are different than every other study because of the sun and fortified milks.

        For instance, it might prevent a higher percentage of cancer for deficient people, but there might not be extra advantage over correcting for deficiency.

        1. If people got nervous about deficiency or just became mentally Vitamin D focused from being part of a study, that might be enough to change behaviors just enough to move them toward more sun exposure and then suddenly then suddenly it accidentally becomes testing a supplement versus the sun and then I would expect the supplement would lose.

          There could even be confounding factors like retirement. The wealthy people around me go to Florida all Winter.

  15. So how much vitamin D should we be taking a day. Should it be D3 instead of D2? What supplement is best? Just wondering.

    1. “Vitamin D (daily recommendations for those in the Northern Hemisphere; D3 from animal or plant sources may be preferable to the D2 sourced from fungi)

      Below approximately 30°latitude (south of Los Angeles/Dallas/Atlanta/Cairo)
      15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      or 2,000 IU supplemental vitamin D

      Between 30° latitude (sample cities above) & 40°latitude (Portland/Chicago/Boston/Rome/Beijing)
      From February through November
      15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      or 2,000 IU supplemental vitamin D
      From December through January
      2,000 IU supplemental vitamin D

      Between 40° latitude (sample cities above) & 50°latitude (Edmonton/London/Berlin/Moscow)
      From March through October
      15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      or 2,000 IU supplemental vitamin D
      From November through February
      2,000 IU supplemental vitamin D

      Above approximately 50°latitude (north of Edmonton/London/Berlin/Moscow)
      From April through September (or even briefer above 60°latitude (Anchorage/Stockholm))
      15-30 minutes of midday sun (15 for those with lighter skin; 30 for those with darker skin)
      or 2,000 IU supplemental vitamin D
      From October through March (or even longer above 60°latitude (Anchorage/Stockholm))
      2,000 IU supplemental vitamin D”

    2. Hello Red,

      Dr. Greger has spoken on this topic suggesting 2000IU/day as lower intakes may not be sufficient and higher intakes can actually have negative effects. This would be the form of D3. D2 is no the active form; however, if we double the dose it can be sufficient because we can convert it to D3.

      I hope this helps,

      Matt, Health Support

  16. We got sunshine for a few hours today. It is my coworkers birthday and we walked out into the parking lot and just looked at the day.

    A customer came and said, “Don’t get too excited, it is only for a few minutes. People didn’t give enough money to Al Gore and someone has outlawed Fall and Spring. Now, we get a very long Winter and then it turns 90 degrees.”

    He said it and the sun disappeared behind the clouds, but I got to see the sun today.

    I am still wearing long sleeves and my Winter coat when I go outside, but seeing the sun helped so much.

  17. Most of us live a life in the great indoors and when doctors say we need the rays of the sun to get enough natural vitamin D, we try and play catch up. During our sheltered lives our skin adapts reducing melanin in the skin in attempt to access the scarce sunlight available. So, when we go on a sunshine binge our very open skin gets an overdose of sun through our unprotected skin before we our skin gets a chance to adapt.

    1. George,

      I am not sure if that is real or not.

      But I do know that you are right. If I believed the people that I can only get benefit from the sun, it would still not be Fall, Winter or early Spring because of weather and temperature and time light is available, so it would be making up for lost time late Spring and Summer.

      I genuinely did have elderly relatives get sunstroke and seriously burned trying to do that process.

      I remember getting pretty sick after sun exposure. I remember being freezing cold and vomiting.

      Those aren’t the symptoms of sunstroke, but it was what I had.

      1. I found out that people really do die from humid weather.

        I didn’t know that.

        I always had the thought, “I feel like I can’t breathe with the humid heat” in July and August, but nobody ever talked about it as potentially dangerous. Just uncomfortable.

        Last Summer, it was so bad that I felt like that at even in the middle of the night.

  18. This doesn’t acknowledge at all how much sun is ok. I do eat lots of greens, but I don’t want to get sunburn. It hurts.

  19. Fascinating interaction between UVB exposure, skin pigmentation, Vit D synthesis, folate degradation, and cholesterol.

    The Vitamin D⁻Folate Hypothesis as an Evolutionary Model for Skin Pigmentation: An Update and Integration of Current Ideas.
    Review article
    Jones P, et al. Nutrients. 2018.

  20. The melanoma mortality rate in The Netherlands went up 2400% over a 65 year period.

    After 5 years of research I agree with Dr Campbell that most cancers are caused by the animal food we consume, including melanoma. However, there is a sun component to it as well.
    Just like there is a smoking component to lung cancer as well as a food component.

    The animal food does not cause DNA damage, it undermines the efforts of our immune system and as such it multiplies cancer rates rather than being additive to the mutagen’s efforts.

    Interested in my cancer research? Sent me an email and I will respond with a (free) pdf. Peter theidealdiet (AT)

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