British people should get out in the sun and not cover up for health reasons

Jul 5 2004

British health is being put at risk by government policy that discourages sunbathing and promotes use of sunblock products. The cost of disease caused by insufficient exposure to sunlight and consequent deficiency of vitamin D is estimated to be billions of pounds per year in Britain.

Government advice to “cover up, keep in the shade…and use factor 15 plus sunscreen” is based on outdated information, mistaken interpretation of evidence and guesswork. It ignores evidence showing that insufficient vitamin D is closely associated with, and almost certainly is a cause of, dozens of chronic diseases including 16 different types of cancers, several nervous system diseases including schizophrenia and multiple sclerosis, diabetes, raised blood pressure, polycystic ovary disease, menstrual problems, infertility, infections and dental decay.

It may seem incredible that such a long list of very different diseases could all be caused, at least in part, by insufficient vitamin D. However research accumulating over the last 10 years provides solid evidence in hundreds of scientific papers which are summarised in a new report: Sunlight Robbery: Health benefits of sunlight are denied by current public health policy in the UK, written by Oliver Gillie, a former medical correspondent on the Sunday Times and ex-medical editor of the Independent. The report is published by the Health Research Forum.

Government policy on sunlight is based on a major error, mistaken assumptions and wishful thinking

1. The major error: short periods outdoors produce sufficient vitamin D

The National Radiological Protection Board (NRPB) has asserted that “short periods outdoors, as normally occur in everyday life [in the UK], will produce sufficient vitamin D, and additional or intensive exposures will not confer further benefit”. This assertion has been adopted as a basis for UK government policy, although it is based on observations of only nine elderly patients in England over just one summer. Seven of these patients did not achieve high enough levels of vitamin D to provide enough for winter when sunlight is not strong enough to generate any of the vitamin. The NRPB assertion is simply a convenient rationalisation that has no satisfactory basis in scientific evidence – see page 11 of Sunlight Robbery for full analysis.

2. Mistaken assumption No.1: tanning is bad for you

Each year campaigners against skin cancer and sun exposure assert that “there is no such thing as a healthy tan.” Authority for this assertion comes from a “Consensus Statement of the UK Skin Cancer Prevention Working Party”. This assertion was considered to be dubious ten years ago when the Consensus was formulated and can now be seen to be without foundation.

In fact evidence suggests that a deep tan, particularly in childhood and adolescent years, protects against melanoma, the most serious form of skin cancer; and further evidence suggests that sunbathing, even when it causes sunburn, protects against diseases such as multiple sclerosis and prostate cancer. So tanning should properly be seen as a sign of health, as indeed it is by most members of the public, although care should be taken to avoid burning.

3. Mistaken assumption No.2: England is Australia

Cancer Research UK, which is paid by the government to implement policy on prevention of skin cancer, has adopted a campaign, called SunSmart, which was developed in Australia. Australia has a very sunny climate where children get twice as much exposure to the sun as children in the UK. The SunSmart policy makes no allowances for the fickle English climate which is typically cloudy even in midsummer. To ensure optimum levels of vitamin D and optimum health people in the UK need to sunbathe whenever they can wearing as few clothes as possible while taking care not to burn. Vitamin D obtained from food provides only about 10% of our needs.

4. Wishful thinking: suncream prevents skin cancer

The Department of Health recommends use of factor 15 plus sunscreen (Chief Medical Officer’s Sixth Tip for better health). However there are serious doubts whether sunscreen actually protects against skin cancer and some evidence actually suggests that use of sunscreen is associated with greater risk of cancer. To suggest that sunscreen may prevent skin cancer is wishful thinking. Furthermore use of a strong sunscreen prevents sunlight from generating vitamin D in the skin, virtually ensuring vitamin D deficiency in people who regularly use suncream. Putting on suncream regularly before going out, as recommended by Cancer Research UK, risks serious vitamin D deficiency in the long term. Suncream should only be used after about 5-10 minutes exposure to the sun according to skin type, time of day, time of year and cloud cover.

Copies of Sunlight Robbery have been sent to health ministers John Reid, Rosie Winterton, Melanie Johnson, the Chief Medical Officer, Sir Liam Donaldson, and Cancer Research UK.

The report has been peer-reviewed by experts round the world who have described it as “comprehensive”, “impressively detailed”, “excellent”. See back cover for full comments of international experts.

A new understanding of vitamin D has emerged in recent years which explains how deficiency of the vitamin can cause so many different diseases. Vitamin D is now known to act as a vital steroid hormone in 30 or more tissues of the body where it controls the activity of cells.

Vitamin D is best known for its role in regulating the absorption of calcium and the deposition of calcium in bones. It regulates calcium in other body tissues as well, including cells which, for example, control blood pressure and nerve activity. In addition vitamin D has a direct action on genes, switching them on and off and so regulating growth and activity of various organs during development and later.

These newly discovered actions of vitamin D explain how deficiency of D, which may occur during pregnancy or at any time in life, may cause such a wide spectrum of diseases. Shortage of vitamin D during pregnancy or breast feeding, for example, is associated with development of juvenile diabetes (diabetes type 1) and schizophrenia. To reduce risk of these diseases women of reproductive age, and particularly women who are pregnant or breast feeding, should be advised to sunbathe safely taking care not to burn.

This new research on vitamin D has been largely ignored by government which has been advised by, among others, the National Radiological Protection Board, the Food Standards Agency, Cancer Research UK and allied bodies. Advice produced by these bodies has been partial or incomplete.

The NRPB report, published in 2002, devoted only one page to effects of vitamin D on body tissues other than bone, a totally inadequate appraisal of research that is the subject of thousands of scientific papers. The Food Standards Agency produced a draft expert report on vitamin D, completed in November 2001 and circulated in 2002, which received such crushing criticism from at least one international expert that it has not yet been published. Cancer Research UK has based much of its advice on a Consensus Statement which is now 10 years old. Additional advice from Cancer Research UK has been based on an Australian programme called SunSmart which is designed for a country with a climate ranging from tropical to southern Mediterranean and is totally unsuited to the UK.

The full report is available here