Nigel Hawkes, Health Editor
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Women who stay out of the sun are increasing their risk of developing breast cancer, a new study suggests.
The safe-tanning messages that are drummed into women each year may help to reduce their risk of skin cancer – but at the cost of increasing their risk of breast cancer.
The majority of vitamin D comes from exposure of the skin to sunlight but many women – exposed less in winter and reluctant to bare themselves in summer because of the dangers – are deficient.
There has been anecdotal evidence to suggest that breast cancer is less common among women who live closer to the Equator, where the sunshine is stronger.
However a new study provides evidence that the lower the levels of vitamin D in a woman’s blood-stream, the greater the risk of her developing breast cancer if she has passed the menopause.
Of more than 1,000 women who took part in a trial, those who were given both calcium and vitamin D supplements had less than half the chance of developing breast cancer than those given a placebo (13 cases among 446 women compared with 20 cases among 288 women.
A team from Creighton University in Omaha, Nebraska, enrolled 1,179 women all 55 or older, who had no history of cancer. The women were divided randomly into groups and given either supplements of calcium alone, calcium plus vitamin D, or a placebo for four years.
The researchers were interested primarily in the risk of the women suffering from osteoporosis, but they also looked at cancer risks.
The team, whose study was published in the American Journal of Clinical Nutrition, found that calcium alone also had a protective effect against cancer but it was not as strong.
When the researchers repeated the analysis for those women who were free of cancer after the first year of the study, the results were even more striking. By doing this, the team excluded any cases that would have been present, but undetected, before the trial began.
In this second analysis, the risks were reduced by more than three quarters.
“Our findings of decreased all-cancer risk with improved vitamin D status are consistent with a large and still growing body of epidemiologic and observational data showing that cancer risk, cancer mortality, or both are inversely associated with solar exposure, vitamin D status, or both,” the researchers said.
The findings underscored the value of achieving and maintaining a high concentration of the vitamin, they added.
The Creighton University study follows one published in May in Archives of Internal Medicine that reached similar conclusions.
This earlier one used data from the Nurses’ Study at Harvard, which followed more than 30,000 women for up to 15 years. Their dietary intake of both calcium and vitamin D was calculated from dietary questionnaires. The team, from Brigham and Women’s Hospital and Harvard Medical School, found that high levels of the two nutrients were linked with a 40 per cent lower risk of breast cancer in younger women.
The difference was more marked for aggressive cancers. But this study, unlike the Creighton trial, did not find a link among older women.
“Findings from this study suggest that higher intakes of calcium and vitamin D may be associated with a lower risk of developing premenopausal breast cancer,” the authors concluded.
Vitamin D is present in foods including milk, eggs, oily fish, green vegetables and fortified margarines. But a significant part of the vitamin D need is manufactured in the skin by exposure to sunlight.
Earlier studies have linked high levels of vitamin D to reduced risks of other cancers, including of the colon and prostate. But the advice of Cancer Research UK has long been that the risk of skin cancer from overexposure to the sun exceeds benefits achieved through higher vitamin D status.
Not all experts agree. Cedric Garland, of the University of California at San Diego, claimed in the British Medical Journalin 2003 that sun avoidance would increase the risk of cancers overall, especially among those who live at latitudes as far north as Britain.
He recommended 10-15 minutes a day of sun exposure, without sunscreen, to allow adequate synthesis of vitamin D. But this alone is not enough, he suggested, because vitamin D is not stored for long in the body and there is not enough sun during the winter to synthesise it.
He therefore recommended the use of supplements, as in the new trial, to boost levels. But the risks from overdosing are such that these must be taken with caution.
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MYH from Abilene has been in the sun too long! Got a frazzled noggin!
James McNealy, London, UK
Janey and others who shun the sun need to be aware of this research "DCs metabolize sunlight-induced vitamin D3 to 'program' T cell attraction to the epidermal chemokine CCL27" that shows how SHORT regular exposure to sunlight primes the skin to fight skin cancer.
People generally need to understand that in the UK only 2000 die from skin cancer yearly but the Breast Cancer deaths number over 12000. Cutting Breast Cancer incidence by 50% by encouraging regular, SHORT, sun exposure will save far more lives than will be put at risk by people foolish enough to get sunburnt or stay out in the sun for more than 20 minutes.
For each skin cancer death over 30 UK people die needlessly from the 17 cancers including the biggest killer Breast, Prostate, colon, lung that occur more frequently and progress more severely in vitamin D insufficient bodies. Melanoma also is inversely related as people with melanoma who continue to expose their skin have a better prognosis that those who don't.
Edward Hutchinson, Louth , UK Lincolnshire
Thanks for that Janice ,
How sad though, taking Vitamin tablets when the natural medicine is not only free , but tablets will never make them feel as good as the sunshine on the face & body. !!!
Maggie Millington, Brittany , France
Has anyone ever thought to simply look at what our CREATOR has told us -don't you think the One Who created us would KNOW what is BEST FOR US?
GENESIS 1:14-
14 And Yahweh said: Let there be lights in the expanse of the sky to separate the day from the night, and let them serve as signs to mark the Feasts, and for days and years.
15 And let them be lights in the expanse of the sky to give light on the earth. And it was so.
16 Yahweh made two great lights--the greater light to govern the day and the lesser light to govern the night. He also made the stars.
17 And Yahweh set them in the expanse of the sky to give light on the earth:
18 To govern the day and the night, and to separate light from darkness. And Yahweh saw that it was right.
Notice verse 18 "Yahweh saw that it (the SUN) was RIGHT!
That means there is no harm from the Sun, it is great for our health - try looking at unhealthy and forbidden foods such as pork, etc. - THAT is the REAL CAUSE - not the Sun!
MYH, Abilene, Texas
"I wanna soak up the sun . . . and tell everyone to lighten up."
Valerie, Atlanta, USA
Excellent, does this mean that more women may enjoy the pleasure of nude recreation? Or that the states may lessen the fines imposed for exposure?
David, Ivor, Virginia
so - what am I supposed to do, as a 52-year-old fairskinned redhead, who hasn't sunbathed for years and years, whose skin shows no sign of sun damage at all (according to the dermatologist consultant) and yet had to have two basal cell carcinomas removed last year by a plastic surgeon, leaving big scars on my back and have now been told to slap on factor 50 if I'm going to be out and about in the sun for any length of time (nb 'out and about', not sunbathing). I don't think the dangers of sun exposure have been 'demonised' or 'overly hyped' - I'm at greater risk of the more serious skin cancers as well as more minor ones, almost certainly because I occasionally caught a bit too much sun in my youth and went pink. For some of us, it's almost impossible to gauge a safe degree of exposure
Janey, Bristol, UK
There is an evolutionary balancing act that accounts for the lighter skin in the inhabitants of more northern regions. While light skin increases the risk of developing skin cancer - it increases the production of vitamin d in the skin.
Studies are coming out all the time now on vitamin d. Elderly people supplemented with a mere 800 iu's of vitamin d3 each day have been found to have a 72% decrease in falls compared to elderly people not supplemented with vitamin d.
With the exception of the Innuit, who obtain adequate vitamin d from fatty sea food, those who reside in northern or darker climates have needed to evolve light skin so as to not die prematurely from such things as cancer, ms, various autoimmune diseases, diabetes, and heart disease - all of which adequate vitamin d has been shown to give some protection against.
Vitamin d deficiency, then, like smoking, is responsible for many more deaths than the war on terror and all the havoc wreaked by terrorists
Thomas Donlon, Hagerstown , MD
I spent a year in Viet Nam where we had sun exposure almost every day. Shorts were the Uniform of the Day when we were off duty. When I returned home it took the better part of a year for my tan to fade. Many things are attributed to service in Viet Nam - skin cancer is not on the list. The fear of skin cancer is a product of sun screen manufacturers. My suggestion is get outdoors and enjoy life. Build up your tan slowly. Sun burn is painfull.
Mike, Baraboo, USA/WI
i like sunshine,luckily,i am man
roy, chongqing, china
When assessing scientific statistical surveys such as this one and in particular the ones linking solar exposure to skin cancer it is vital to know 'Who was the Paymaster'
The original 'research' linking skin moles/discolouration/spots and occasional malignant skin cancer with solar exposure was, of course, financed by the cosmetics industry. There was never any clinical trials for the extreme overdose of sun-block chemicals (factor 8 and above) that are now recommended by the cosmetics industry.
It is now becoming clear that the vitamin deficiencies (eg. the above and also rickets etc) caused by these severe sun block chemical overdoses are now becoming a serious health problem in themselves.
For sun protection, melanin, produced in your own body, is best. - Just don't go mad on your first day in the sun. (That is why tourists in Greece are known affectionally as 'Redskins'.)
Brian Vallance, LEFKIMMI, Greece
I want to meet the 150 year old man who followed every bit of dietary and behavioral advice and decreased his chances of dying from anything by 50%.
Su-Tep, Seoul, Korea
NICE! Topless sun bathing will be awesome.. Let the fun bags out baby.
Liberalism is a Mental Disorder!!
Mike Savge, USA, #1
This could be the solution of a life-time for hen-pecked men to have their GPs send their wives away for a long time on solar medication, and all on the NHS.
Great piece of research!!! Let's have more of the same.
Maxadolf, Epsom, UK
Oh yes - the U.N.! Experts at everything like - global warming. Science with no evidence to support it! Brilliant.... not.
Bill, Cincinnati, OH
Huw Sayer says "early morning and later afternoon sun is safer than mid-day sun because the rays are more filtered by the atmosphere - but does this affect how Vit-D you synthesise? " UVB is required for vitamin d synthesis and this is only present when the sun is at the right angle for it to reach the ground. This is when your shadow is shorter than your height. So the best time for Vitamin D sun exposure is around midday but providing there is an erythemal index of 3 and your shadow is shorter than your height it should be effective.
Huw Sayer says "Should I get two lots of sun (morning and afternoon) ?" 5 minutes full body prone exposure raised 1000iu 20 mins therefore provides your daily need. Further heat turns Vit d to suprasterols so best cover up/go inside and repeat when skin cool and vit d absorbed. 10,000iu/d is the usual maximum intake from sun exposure so more than 50mins daily is probably counterproductive for white skinned people.
Black/brown skins need more.
Edward Hutchinson, Louth , UK Lincolnshire
Well I spent all my summers at the lake except the past few years since my husband died and children grew up.
I was continually in the sun, when I was 14-15 yrs old I had a very bad sunburn, blisters, nausea, vomiting, fainting and diarrhea. I was sick for two weeks, couldn't stand the light and just drank water and 7UP.
I was a natural redhead, freckles. Had been swimming in and out of the water all day as it was very hot.
I have breast cancer, non invasive. Two surgeries and they are watching the other breast now. 5 weeks of radiation and taking tamoxifen for 5 yrs.
I was a complete vegetarian the first 22 yrs of my life. Then doctor told me to eat meat for protein.
I eat mostly fruit and vegetables now, meat perhaps once a month
I haven't been in the sun as much as I was a few years ago, so I think perhaps Cod Liver Oil might be in order for Vitamin D. I drink milk and eat yogurt, so I think I get quite a lot of calcium. No arthritis or rheumatism, I'm 78 yrs
-L.
Lorraine, Montreal, Canada
You'll find many Muslim women do take Vitamin D supplements for the reasons Maggie says. Their GPs will commonly test them for Vitamin D and give them supplements if necessary. I know someone who takes them for this reason.
Janice Harrison, Blackpool, UK
I think it's worth people who don't go in the sun for whatever reason getting their GP to do a simple blood test to see if they are short of Vitamin D. If they are, they can easily be prescribed Vitamin D tablets.
I've rarely been in the sun for 25 years since I began suffering from hyper-sensitivity to sunlight. This was after being given chloroquine over a long period (six months or more) as a treatment for rheumotoid arthritis when I discovered I quickly became unaturally suntanned, with yellow/white patches on my skin as well. I still have the discolouration and patches on my skin from 25 years ago.
Because of this lack of sunlight, I was taking calcium to keep my bone strength up. But I discovered this was no use without Vitamin D, and a recent blood test by my GP showed I was lacking in Vitamin D. I have since been on Vitamin D supplements, and my last blood test was normal.
Joan Chambers, Bristol, UK
Actually interruption of the first pregnancy through miscarriage or abortion can leave vulnerable the breast tissue of a women and make it more likely to develop cancer when exposed to carcinogenic factors.
Yes, sunlight on the skin can produce a form of super Vitamin D which kicks cancer's butt. I saw evidence of this by a young research scientist who gave a lecture at John McDougall's Santa Rosa Study weekend a few years ago.
Margaret Vopacke Reilly , Carmichael, California, U.S.A.
Vitamin A is the anti-cancer vitamin, but vitamin D and a little fat are also needed at the same time in order for the body to absorb vitamin A.
Ethel Smith, Encinitas, California
Does the expression 'well you just can't win ..." come to mind to all my fellow women ? - how long has the scientific community been drumming into our heads that suntans are bad, suntans are nasty, skin cancer is nasty - heck, I wear a hat all summer to keep my face from getting tanned - now they tell us ... well, you must soak up SOME sun during your short, cold summer to save you from breast cancer! All of you that live and breathe each scientific report like it was a voice from on high - tell me how do you it? one day it is one thing, next day a report comes out saying exactly the opposite. It reminds me that science is not a certainty, that it is a process of discovery and hard work. I am just waiting for the day when they find out that smoking isn't all that bad it causes lung cancer but saves you from some other horrible end ! Want to bet a report will come out saying that exact thing?
Kathleen Mary, Federal Way, USA/ WA
Fuzzy science. The U.N. has already determined the Pill as the #1 carcinogen in breast cancer.
Sarah N., Milton, USA, NH
vit d
Cailtin, Houston, TX
please let me know how much vit D to take daily? I live in Florida and have sunshine year round....if I am out for 15 min ea. day what amount of vit D should I take
anne bowden, ponte vedra, us fl.
What these scientists don't tell us is when the best time is for sun exposure.
I have always understood that early morning and later afternoon sun is safer than mid-day sun because the rays are more filtered by the atmosphere - but does this affect how Vit-D you synthesise?
Should I get two lots of sun (morning and afternoon) if possible rather than one dose at lunchtime?
Huw Sayer, Norwich, England
The differences observed in the study were NOT statistically significant at the .05 level so should be ignored
john ray, Brisbane, Australia
I've been arguing in favoUr of sunlight exposure forever. It shouldn't be regarded as rocket science, as sun exposure on the skin is the body's most common mechanism for Vitamin D production.
The tendency to demoniSe exposure to the sun has been one-sided, arbitrary, and overly hyped.
As a corollary, burka'ed women (say, in the north of England with naturally low sunlight) can and apparently do develop rickets as a function of vitamin D deficiency.
Yet another reason that slapping yourself in long ugly black bug suit is bad. news.
Virginia, Albuquerque, New Mexico
Your covers story today tells of the association between low vitamin D intake/status and breast cancer. You say that sources of the vitamin include milk, eggs, oily fish, green vegetables and fortified margarines. However, Times readers need to be told that milk is only a good source in North America where milk is fortified with vitamin D. This is not the case in the UK whwere oily fish is the only real good dietary source of vitamin D.
Professor Margaret Rayman, Guildford, UK
As the sun is the body's biggest organ I can see the sense of this research, add to that the feel good factor when the sun is warming you & it can only be a good thing.
It would be interesting to have some statistics on breast cancers among Muslim women, who are so covered the sun does not get to their bodies.
Maggie Millington, Brittany, France