Are Vitamin D Supplements an Adequate Substitute for Sun Exposure?
Main Article Content
Abstract
It is becoming well understood that low blood levels of 25-hydroxyvitamin D (25(OH)D) are a risk factor for many diseases and other adverse health effects including hypertension, cardiovascular disease, stroke, breast cancer, colorectal cancer, metabolic syndrome, type 2 diabetes, obesity, multiple sclerosis, type 1 diabetes, rheumatoid arthritis, Alzheimer’s disease, autism, schizophrenia, asthma, preterm birth, maternal mortality, myopia and COVID-19. Levels of serum 25(OH)D are at the same time a measure of vitamin D status and, since 70-90% of this biomolecule is produced by sun exposure, a measure of sun exposure. There is some disagreement among scientists as to whether vitamin D supplements are an effective substitute for sun exposure for attenuation of these diseases and adverse health effects. In this paper we review the current state of the science on this subject and conclude that vitamin D supplements are not an adequate substitute for sun exposure for attenuation of most of these diseases and adverse health effects, particularly hypertension and cardiovascular disease, and should not be recommended in lieu of sun exposure to patients presenting with low levels of serum 25(OH)D. Vitamin D supplementation for such patients could even be harmful, because it will raise patients’ serum 25(OH)D levels, thereby giving patients a false sense of security and obscuring the best available metric for insufficient sun exposure.
Article Details
How to Cite
HOEL, David G.; MILLER, Allen.
Are Vitamin D Supplements an Adequate Substitute for Sun Exposure?.
Medical Research Archives, [S.l.], v. 11, n. 3, mar. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3635>. Date accessed: 26 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i3.3635.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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11. Ames BN, Grant WB, Willett WC. Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities? Nutrients 2021; 13:499.
12. Bustamante M, Hernandez-Ferrer C, Sarria Y, Harrison GI, Nonell L, Kang W, Friedlander MR, Estivill X, Gonzalez JR, Nieuwenhuijsen M, Young AR. The acute effects of ultraviolet radiation on the blood transcriptome are independent of plasma 25OHD3. Environ Res 2017; 159:239–248.
13. Mowbray M, McLintock S, Weerakoon R, Lomatschinsky N, Jones S, Rossi AG, Weller RB. Enzyme-Independent NO Stores in Human Skin: Quantification and Influence of UV Radiation. J Invest Dermatol 2009; 129:834-842.
14. Oplander C, Volkmar CM, Paunel-Gorgulu A, van Faasen EE, Heiss C, Kelm M, Halmer D, Murtz M, Pallua N, Suschek CV. Whole Body UVA Irradiation Lowers Systemic Blood Pressure by Release of Nitric Oxide From Intracutaneous Photolabile Nitric Oxide Derivates. Circ Res 2009; 105:1031-1040.
15. Liu D, Fernandez BO, Hamilton A, Lang NN, Gallagher JMC, Newby DE, Feelisch M, Weller RB. UVA Irradiation of Human Skin Vasodilates Arterial Vasculature and Lowers Blood Pressure Independently of Nitric Oxide Synthase. J Invest Dermatol 2014; 134:1839-1846.
16. Feelisch M, Kolb-Bachofen V, Liu D, Lundberg JO, Revelo LP, Suschek CV, Weller RB. Is sunlight good for our heart? Eur Heart J 2010; 31:1041–1045.
17. Juzeniene A and Moan J. Beneficial effects of UV radiation other than via vitamin D production. Dermato-Endocrinology 2012; 4:109-117.
18. French AN, Ashby RS, Morgan IG, Rose KA. Time outdoors and the prevention of myopia. Exp Eye Res 2013; 114:58-68.
19. Slominski AT, Zmijewski MA, Plonka PM, Szaflarski JP, Paus R. How UV Light Touches the Brain and Endocrine System Through Skin, and Why. Endocrinology 2018; 159:1992-2007.
20. Hart PH, Norval M, Byrne SN, Rhodes LE. Exposure to Ultraviolet Radiation in the Modulation of Human Diseases. Annu Rev Pathol Mech Dis 2019; 14:55-81.
21. Ponda MP, Liang Y, Kim J, Hutt R, Dowd K, Gilleaudeau P, Sullivan-Whalen MM, Rodrick T, Kim DJ, Barash I, Lowes MA, Breslow JL. A randomized clinical trial in vitamin D-deficient adults comparing replenishment with oral vitamin D3 with narrow-band UV type B light: Effects on cholesterol and the transcriptional profiles of skin and blood. Am J Clin Nutr 2017; 105:1230–1238.
22. De Fabo EC, Noonan FP. Mechanism of immune suppression by ultraviolet irradiation in vivo. Evidence for the existence of a unique photoreceptor in skin and its role in photoimmunology. J Exp Med 1983; 158:84–98.
23. Bustamante, M, Hernandez-Ferrer C, Tewari A, Sarria Y, Harrison GI, Puigdecanet E, Nonell L, Kang W, Friedlander MR, Estivill X, Gonzales JR, Nieuwenhuijsen M, Young AR. Dose and time effects of solar-simulated ultraviolet radiation on the in vivo human skin transcriptome. Br J Dermatol 2020; 182:1458-1468.
24. Cummings SR, Rosen C. VITAL Findings – A Decisive Verdict on Vitamin D Supplementation. N Engl J Med 2022; 387:368-370.
25. LeBoff MS, Chou SH, Ratliff KA, Cook NR, Khurana B, Kim E, Cawthon PM, Bauer DC, Black D, Gallagher JC, Lee I-M, Buring JE, Manson JE. Supplemental vitamin D and incident fractures in midlife and older adults. N Engl J Med 2022; 387:299-309.
26. Manson JE, Bassuk SS, Cook NR, Lee I-M, Mora S, Albert CM, Buring JE, for the VITAL Research Group. Vitamin D, Marine n-3 Fatty Acids, and Primary Prevention of Cardiovascular Disease Circ Res 2020; 136:112-128.
27. Tobias DK, Luttmann-Gibson H, Mora S, Danik J, Bubes V, Copeland T, LeBoff MS, Cook NR, Lee I-M, Buring JE, Manson JAE. Association of Body Weight with Response to Vitamin D Supplementation and Metabolism. JAMA Network Open 2023; 6:e2250681.
28. Bachmann KN. Responses to Vitamin D Supplementation in Individuals with Overweight and Obesity. JAMA Network Open 2023; 6:e2250695.
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