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Vitamin D

Deborah Gesensway
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Copyright ©2004 by the American College of Physicians


Ann Intern Med. 2000;133(4):318. doi:10.7326/0003-4819-133-4-200008150-00103
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At the peak of sunscreen season in the United States, an old debate continues. Should people ensure adequate intake of vitamin D by exposing themselves, even minimally, to sunlight? Many experts say yes, citing evidence that anywhere from 9% to 40% of Americans—depending on age, ethnicity, and locale—are deficient in vitamin D. Michael F. Holick, MD, professor of medicine and dermatology at Boston University Medical Center and one of the nation's top vitamin D researchers, recommends that people expose their face and arms to the sun for 5 to 10 minutes two to three times per week before applying sunscreen. The recommended amount of unprotected sun exposure depends on skin tone—a darker person needs more—and on the intensity of the sun. Holick explained that this method takes advantage of the beneficial effects of sunlight while preventing any damage. “We know that if you use a sunscreen properly, it will reduce your vitamin D synthesis to almost nothing,” he stated (Figure). Holick's recommendations are based on the fact that almost no vitamin D occurs naturally in the typical U.S. diet and that many fortified foods do not contain the quantity of vitamin D advertised on their labels.

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vitamin d

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Figure.
Circulating concentrations of vitamin D in young adults with sunscreen (sun protection factor of 8) and without (topical placebo cream) after a single exposure to one minimal erythernal dose of simulated sunlight.

(Reproduced with permission from Holick MF. McCollum Award Lecture, 1994: Vitamin D—new horizons for the 21st century. Am J Clin Nutr. 1994;60:619-30.).

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