Skip to main content
SpringerLink
Log in
Book cover

Sunlight, Vitamin D and Skin Cancer pp 1–15Cite as

Sunlight, UV-Radiation, Vitamin D and Skin Cancer: How Much Sunlight Do We Need?

  • Chapter

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 624))

Abstract

Vitamin D is the sunshine vitamin for good reason. During exposure to sunlight, the ultraviolet B photons enter the skin and photolyze 7-dehydrocholesterol to previtamin D3 which in turn is isomerized by the body’s temperature to vitamin D3. Most humans have depended on sun for their vitamin D requirement. Skin pigment, sunscreen use, aging, time of day, season and latitude dramatically affect previtamin D3 synthesis. Vitamin D deficiency was thought to have been conquered, but it is now recognized that more than 50% of the worlds population is at risk for vitamin D deficiency. This deficiency is in part due to the inadequate fortification of foods with vitamin D and the misconception that a healthy diet contains an adequate amount of vitamin D. Vitamin D deficiency causes growth retardation and rickets in children and will precipitate and exacerbate osteopenia, osteoporosis and increase risk of fracture in adults. The vitamin D deficiency has been associated pandemic with other serious consequences including increased risk of common cancers, autoimmune diseases, infectious diseases and cardiovascular disease. There needs to be a renewed appreciation of the beneficial effect of moderate sunlight for providing all humans with their vitamin D requirement for health.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Holick MF. Phylogcnctic and evolutionary aspects of vitamin D from phytoplankton to humans. In: Pang PKT, Schreibman MP, eds. Vertebrate Endocrinology: Fundamentals and Biomedical Implications, Vol 3. Orlando: Academic Press, 1989:7–43.

    Google Scholar 

  2. Holick MF. Vitamin D: A millennium perspective. J Cell Biochem 2003; 88:296–307.

    Article  PubMed  CAS  Google Scholar 

  3. Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest 2006; 116(8):2062–2072.

    Article  PubMed  CAS  Google Scholar 

  4. Sniadecki J. Jerdrzej Sniadecki (1768–1838) on the cure of rickets. (1840) Cited by W. Mozolowski. Nature 1939; 143:121–124.

    Google Scholar 

  5. Palm TA. The geographical distribution and aetiology of rickets. The Practitioner 1890; XLV[4]:270–342.

    Google Scholar 

  6. Holick MF. Biologic effects of light: historical and new perspectives. In: Holick MF, Jung EG, eds. Biologic Effects of Light 1998. Proceedings of a Symposium Basel, Switzerland 1998. Boston: Kluwer Academic Publishers, 1999:10–32.

    Google Scholar 

  7. Huldschinsky K. Heilung von Rachitis durch Kunstliche Hohensonne. Deutsche Med Wochenschr 1919; 45:712–713.

    Article  Google Scholar 

  8. Hess AF, Unger LJ. The cure of infantile rickets by sunlight. JAMA 1921; 77:39–41.

    Google Scholar 

  9. Hess AF, Weinstock M. Antirachitic properties imparted to inert fluids and to green vegetables by ultraviolet irradiation. J Biol Chem 1924; 62:301–313.

    CAS  Google Scholar 

  10. Steenbock H, Black A. The reduction of growth-promoting and calcifying properties in a ration by exposure to ultraviolet light. J Biol Chem 1924; 61:408–422.

    Google Scholar 

  11. Park EA. The etiology of rickets. Physiol Rev 1923; 3:106–163.

    CAS  Google Scholar 

  12. Steenbock H. The induction of growth-prompting and calcifying properties in a ration exposed to light. Science 1924; 60:224–225.

    Article  PubMed  CAS  Google Scholar 

  13. Hess AF. Rickets including osteomalacia and tetany. Pennsylvania: Lea J. Febiger, 1929:401–429.

    Google Scholar 

  14. Holick MF, MacLaughlin JA, Clark MB et al. Photosynthesis of previtamin D3 in human skin and the physiologic consequences. Science 1980; 210:203–205.

    Article  PubMed  CAS  Google Scholar 

  15. Holick MF, Tian XQ, Allen M. Evolutionary importance for the membrane enhancement of the production of vitamin D3 in the skin of poikilothermic animals. Proc Natl Acad Sci 1995; 92:3124–3126.

    Article  PubMed  CAS  Google Scholar 

  16. Haddad JG, Walgate J, Miyyn C et al. Vitamin D metabolite-binding proteins in human tissue. Biochem Biophys Acta 1976; 444:921–925.

    PubMed  CAS  Google Scholar 

  17. Haddad JG, Matsuoka LY, Hollis BW et al. Human plasma transport of vitamin D after its endogenous synthesis. J Clin Invest 1993; 91:2552–2555.

    Article  PubMed  CAS  Google Scholar 

  18. Lamason RL, Mohideen MAPK, Mest JR et al. SLC24A5, a putative cation exchanger, affects pigmentation in zebrafish and humans. Science 2005; 310(5755):1782–1786.

    Article  PubMed  CAS  Google Scholar 

  19. Clemens TL, Henderson SL, Adams JS et al. Increased skin pigment reduces the capacity of skin to synthesis vitamin D3. Lancet 1982; 74–76.

    Google Scholar 

  20. Matsuoka LY, Ide L, Wortsman J et al. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab 1987; 64:1165–1168.

    PubMed  CAS  Google Scholar 

  21. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: Exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988; 67:373–378.

    PubMed  CAS  Google Scholar 

  22. Brot C, Vestergaad P, Kolthoff N et al. Vitamin D status and its adequacy in healthy Danish premenopausal women: relationships to dietary intake, sun exposure and serum parathyroid hormone 40. British Journal of Nutrition 2001; 86(1):S97–103.

    Article  PubMed  CAS  Google Scholar 

  23. Holick MF. Vitamin D Deficiency. N Eng J Med 2007; 357:266–281.

    Article  CAS  Google Scholar 

  24. Bouillon R. Vitamin D: From photosynthesis, metabolism and action to clinical applications. In: DeGroot LJ, Jameson JL, eds. Endocrinology. Philadelphia: WB Saunders, 2001;1009–1028.

    Google Scholar 

  25. DeLuca H. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 2004; 80(Suppl):1689S–96S.

    PubMed  CAS  Google Scholar 

  26. Holick MF, Garabedian M. Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Sixth Edition. Washington, DC: American Society for Bone and Mineral Research, 2006;129–37.

    Google Scholar 

  27. Stumpf WE, Sar M, Reid FA et al. Target cells for 1,25-dihydroxyvitamin D3 in intestinal tract, stomach, kidney, skin, pituitary and parathyroid. Science 1979; 206:1188–1190.

    Article  PubMed  CAS  Google Scholar 

  28. Nagpal S, Na S, Rathnachalam R. Noncalcemic actions of vitamin D receptor ligands. Endocr Rev 2005; 26:662–87.

    Article  PubMed  CAS  Google Scholar 

  29. Apperly FL. The relation of solar radiation to cancer mortality in North America. Cancer Res 1941; 1:191–195.

    Google Scholar 

  30. Gorham ED, Garland CF, Garland FC et al. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol 2005; 97(1–2):179–194.

    Article  PubMed  CAS  Google Scholar 

  31. Hanchette CL, Schwartz GG. Geographic patterns of prostate cancer mortality. Cancer 1992; 70:2861–2869.

    Article  PubMed  CAS  Google Scholar 

  32. Grant WB. An estimate of premature cancer mortality in the US due to inadequate doses of solar ultraviolet-B radiation. Cancer 2002; 70:2861–2869.

    Google Scholar 

  33. Garland C, Garland F, Gorham E et al. The role of vitamin D in prevention of cancer—analytic essay forum 112. Am J Public Health 2006; 96(2):252–261.

    Article  PubMed  Google Scholar 

  34. Cantorna MT, Zhu Y, Froicu M et al. Vitamin D status, 1,25-dihydroxyvitamin D3 and the immune system. Am J Clin Nutr 2004; 80(suppl):1717S–1720S.

    PubMed  CAS  Google Scholar 

  35. Ponsonby A-L, McMichael A, van der Mei I. Ultraviolet radiation and autoimmune disease: insights from epidemiological research. Toxocology 2002; 181–182:71–78.

    Article  Google Scholar 

  36. Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 1979; 30:150–156.

    Google Scholar 

  37. Krause R, Buhring M, Hopfenmuller W et al. Ultraviolet B and blood pressure. Lancet 1998; 352:709–710.

    Article  PubMed  CAS  Google Scholar 

  38. Zittermann A, Schleithoff SS, Tenderich G et al. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 2003; 41:105–12.

    Article  PubMed  CAS  Google Scholar 

  39. McGrath J, Selten JP, Chant D. Long-term trends in sunshine duration and its association with schizophrenia birth rates and age at first registration—data from Australia and the Netherlands. Schizophr Res 2002; 54:199–212.

    Article  PubMed  Google Scholar 

  40. Ahonen MH, Tenkanen L, Teppo L et al. Prostate cancer risk and prediagnostic serum 25-hydroxyvitamin D levels (Finland). Cancer Causes Control 2000; 11:847–52.

    Article  PubMed  CAS  Google Scholar 

  41. Feskanich JM, Fuchs CS, Kirkner GJ et al. Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev 2004; 13(9):1502–1508.

    PubMed  CAS  Google Scholar 

  42. Giovannucci E, Liu Y, Rimm EB et al. Prospective Study of Predictors of Vitamin D Status and Cancer Incidence and Mortality in Men. Journal of the National Cancer Institute 2006; 98:451–459.

    PubMed  CAS  Google Scholar 

  43. Chiu KC, Chu A, Go VLW et al. Hypovitaminosis D is associated with insulin resistance and β cell dysfunction. Am J Clin Nutr 2004; 79:820–825.

    PubMed  CAS  Google Scholar 

  44. Liu PT, Stenger S, Li H et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Sciencexpress 2006; 3:1770–1773.

    Google Scholar 

  45. Cannell JJ, Vieth R, Umhau JC et al. Epidemic influenza and vitamin D. Epidemiol Infect 2006; 134(6):1129–40.

    Article  PubMed  CAS  Google Scholar 

  46. Camargo Jr CA, Rifas-Shiman SL, Litonjua AA et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr 2007; 85(3)788–795.

    PubMed  CAS  Google Scholar 

  47. Bikle DD. Vitamin D: Role in skin and hair. In: Feldman et al, eds. Vitamin D. New Jersey: Elsevier Academic Press, 2005:609–630.

    Google Scholar 

  48. Zerwekh JE, Breslau NA. Human placental production of 1α,25-dihydroxyvitamin D3: Biochemical characterization and production in normal subjects and patents with pseudohypoparathyroidism. J Clin Endocrinol Metab 1986; 62(1):192–196.

    Article  PubMed  CAS  Google Scholar 

  49. Adams JS, Hewison M. Hypercalcemia caused by granuloma-forming disorders. In: Favus, MJ, ed, Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Sixth Edition. Washington, DC: American Society for Bone and Mineral Research, 2006:200–202.

    Google Scholar 

  50. Schwartz GG, Whitlatch LW, Chen TC et al. Human prostate cells synthesize 1,25-dihydroxyvitamin D3 from 25-hydroxyvitamin D3. Cancer Epidemiol Biomarkers Prev 1998; 7:391–395.

    PubMed  CAS  Google Scholar 

  51. Tangpricha V, Flanagan JN, Whitlatch LW et al. 25-hydroxyvitamin D-1α-hydroxylase in normal and malignant colon tissue. Lancet 2001; 357:1673–1674.

    Article  PubMed  CAS  Google Scholar 

  52. Cross HS, Bareis P, Hofer H et al. 25-Hydroxyvitamin D3-1-hydroxylase and vitamin D receptor gene expression in human colonic mucosa is elevated during early cancerogenesis. Steroids 2001; 66:287–292.

    Article  PubMed  CAS  Google Scholar 

  53. Mawer EB, Hayes ME, Heys SE et al. Constitutive synthesis of 1,25-dihydroxyvitamin D3 by a human small cell lung cell line. J Clin Endocrinol Metab 1994; 79:554–560.

    Article  PubMed  CAS  Google Scholar 

  54. Feldman D, Zha, XY, Krishnan AV. Editorial/Mini-review: Vitamin D and prostate cancer. Endocrinology 2000; 141:5–9.

    Article  PubMed  CAS  Google Scholar 

  55. Mantell DJ, Owens PE, Bundred NJ et al. 1α,25-dihydroxyvitamin D3 inhibits angiogenesis in vitro and in vivo. Circ Res 2000; 87:214–220.

    PubMed  CAS  Google Scholar 

  56. Pittas AG, Dawson-Hughes B, Li T et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care 2006; 29:650–56.

    Article  PubMed  CAS  Google Scholar 

  57. Chiu KC, Chu A, Go VLW et al. Hypovitaminosis D is associated with insulin resistance and β cell dysfunction. Am J Clin Nutr 2004; 79:820–825.

    PubMed  CAS  Google Scholar 

  58. Li YC. Vitamin D regulation of the renin-angiotensin system. J Cell Biochem 2003; 88:327–331.

    Article  PubMed  CAS  Google Scholar 

  59. Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 2007; 103(3–5):620–625.

    Article  PubMed  CAS  Google Scholar 

  60. Chapuy MC, Schott AM, Garnero P et al. Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. J Clin Endocrinol Metab 1996; 81:1129–1133.

    Article  PubMed  CAS  Google Scholar 

  61. Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet 1998; 351:805–806.

    Article  PubMed  CAS  Google Scholar 

  62. Holick MF, Siris ES, Binkley N et al. Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 2005; 90:3215–3224.

    Article  PubMed  CAS  Google Scholar 

  63. Dawson-Hughes B, Dallal GE, Krall EZ et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991; 115:505–512.

    PubMed  CAS  Google Scholar 

  64. Bakhtiyarova S, Lesnyak O, Kyznesova N et al. Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia. Osteoporos Int 2006; 17:441–46.

    Article  PubMed  CAS  Google Scholar 

  65. Boonen S, Bischoff-Ferrari A, Cooper C et al. Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence. Calcif Tissue Int 2006; 78:257–70.

    Article  PubMed  CAS  Google Scholar 

  66. Gloth III FM; Gundberg CM, Hollis BW et al. Vitamin D deficiency in homebound elderly persons. JAMA 1995; 274(21):1683–1686.

    Article  PubMed  Google Scholar 

  67. Sullivan SS, Rosen CJ, Halteman WA et al. Adolescent girls in Maine at risk for vitamin D insufficiency. J Am Diet Assoc 2005; 105:971–974.

    Article  PubMed  CAS  Google Scholar 

  68. Tangpricha V, Pearce EN, Chen TC et al. Vitamin D insufficiency among free-living healthy young adults. Am J Med 2002; 112(8):659–662.

    Article  PubMed  CAS  Google Scholar 

  69. Gordon CM, DePeter KC, Estherann G et al. Prevalance of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004; 158:531–537.

    Article  PubMed  Google Scholar 

  70. El-Hajj Fuleihan G, Nabulsi M, Choucair M et al. Hypovitaminosis D in healthy school children. Pediatrics 2001; 107:E53.

    Article  PubMed  CAS  Google Scholar 

  71. Marwaha RK, Tandon N, Reddy D et al. Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr 2005; 82:477–482.

    PubMed  CAS  Google Scholar 

  72. Sedrani SH. Low 25-hydroxyvitamin D and normal serum calcium concentrations in Saudi Arabia: Riyadh region. Ann Nutr Metab 1984; 28:181–185.

    Article  PubMed  CAS  Google Scholar 

  73. Lee JM, Smith JR, Philipp BL et al. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr 2007; 46:42–44.

    Article  Google Scholar 

  74. Bodnar LM, Simhan HN, Powers RW et al. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 2007; 137:447–452.

    PubMed  CAS  Google Scholar 

  75. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006; 81(3):353–373.

    PubMed  CAS  Google Scholar 

  76. Standing committee on the scientific evaluation of dietary reference intakes food and nutrition board institute of medicine 1997 Vitamin D. In: Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press: Washington, DC, 1999:250–287.

    Google Scholar 

  77. Heaney RP, Dowell MS, Hale CA et al. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 2003; 22(2):142–146.

    PubMed  CAS  Google Scholar 

  78. Bischoff-Ferrari HA, Giovannucci E, Willett WC et al. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006; 84:18–28.

    PubMed  CAS  Google Scholar 

  79. Tangpricha V, Koutkia P, Rieke SM et al. Fortification or orange juice with vitamin D: a novel approach to enhance vitamin D nutritional health. Am J Clin Nutr 2003; 77:1478–1483.

    PubMed  CAS  Google Scholar 

  80. Cooper C, Javaid K, Westlake S et al. Developmental origins of osteoporotic fracture: the role of maternal vitamin D insufficiency. J Nutr 2005; 135:2728S–2734S.

    PubMed  CAS  Google Scholar 

  81. Holick MF. Vitamin D: The underappreciated D-lightful hormone that is important for skeletal and cellular health. Current opinion in endocrinology and diabetes 2002; 9:87–98.

    Article  CAS  Google Scholar 

  82. Reid IR, Gallagher DJA, Bosworth J. Prophylaxis against vitamin D deficiency in the elderly by regular sunlight exposure. Age Ageing 1985; 15:35–40.

    Article  Google Scholar 

  83. Holick MF. Vitamin D and skin physiology: A D-lightful story. JBMR, in press.

    Google Scholar 

  84. Kennedy C, Bajdik CD, Willemze R et al. The influence of painful sunburns and lifetime of sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi and skin cancer. J Invest Dermatol 2003; 120(6):1087–1093.

    Article  PubMed  CAS  Google Scholar 

  85. Garland FC, Garland CF. Occupational sunlight exposure and melanoma in the US Navy. Arch Env Health 1990; 45:261–267.

    CAS  Google Scholar 

  86. Vieth R, Garland C, Heancy R et al. The urgent need to reconsider recommendations for vitamin D nutrition intake. Am J of Clin Nutr 2007; 85:649–650.

    CAS  Google Scholar 

  87. Tangpricha V, Turner A, Spina C et al. Tanning is associated with optimal vitamin D status (serum 25-hydroxyvitamin D concentration) and higher bone mineral density. Am J Clin Nutr 2004; 80:1645–1649.

    PubMed  CAS  Google Scholar 

  88. MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985; 76:1536–1538.

    Article  PubMed  CAS  Google Scholar 

  89. Chuck A, Todd J, Diffey B. Subliminal ultraviolet-B irradiation for the prevention of vitamin D deficiency in the elderly: a feasibility study. Photochem Photoimmun Photomed 2001; 17(4):168–171.

    CAS  Google Scholar 

  90. Berwick M, Armstrong BK, Ben-Porat L et al. Sun exposure and mortality from melanoma. J Natl Cancer Inst 2005; 97:195–199.

    PubMed  Google Scholar 

  91. Chang ET, Smedby KE, Hjalgrim H et al. Family history of hematopoietic malignancy and risk of lymphoma. J Natl Cancer Inst 2005; 97:1466–74.

    Article  PubMed  Google Scholar 

  92. Wolpowitz D, Gilchrest BA. The vitamin D questions: how much do you need and how should you get it? J Am Acad Dermatol 2006; 54:301–317.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Section of Endocrinology, Nutrition and Diabetes Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, 715 Albany Street, M-1013, Boston, MA, 02118, USA

    Michael F. Holick

Authors
  1. Michael F. Holick
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Clinic for Dermatology, Venerology and Allergology, The Saarland University Hospital, Homburg/Saar, Germany

    Jörg Reichrath

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Landes Bioscience and Springer Science+Business Media

About this chapter

Cite this chapter

Holick, M.F. (2008). Sunlight, UV-Radiation, Vitamin D and Skin Cancer: How Much Sunlight Do We Need?. In: Reichrath, J. (eds) Sunlight, Vitamin D and Skin Cancer. Advances in Experimental Medicine and Biology, vol 624. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77574-6_1

Download citation

Publish with us

Policies and ethics

Search

Navigation