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Kift RC, Webb AR. Globally Estimated UVB Exposure Times Required to Maintain Sufficiency in Vitamin D Levels. Nutrients 2024; 16:1489. [PMID: 38794727 PMCID: PMC11124381 DOI: 10.3390/nu16101489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
A paucity of vitamin D is a common deficiency globally, with implications for many aspects of health besides the well-known impact on musculoskeletal health. The two sources of vitamin D are through oral intake, or through endogenous synthesis in the skin when exposed to ultraviolet radiation in sunlight. Assessing nutritional needs, whether by food, food fortification or supplementation, is aided by an understanding of local potential for cutaneous synthesis of the vitamin, dependent on latitude and climate, personal skin type and local culture. To aid these discussions we provide indicative exposure times for the maintenance of vitamin D status as a function of latitude, month and skin type, for the clear-sky case and all-sky conditions, for an ambulatory person wearing modest skirt/shorts and T-shirt. At latitudes greater than ±40 degrees, lack of available sunlight limits vitamin D synthesis in some months for all, while at the equator exposure times range from 3 to 15 min at noontime, for white and black skin, respectively. Rather than a sun exposure prescription, the data are intended to show where nutritional vitamin D intake is necessary, advisable, or can be mitigated by sun exposure, and allows for such advice to be personalized to account for different sub-groups in a multicultural population.
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Affiliation(s)
| | - Ann R. Webb
- Department of Earth and Environmental Sciences, University of Manchester, Manchester M13 9PL, UK;
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Borecka O, Dutton JJ, Tang JCY, Fraser WD, Webb AR, Rhodes LE. Comparative Study of Healthy Older and Younger Adults Shows They Have the Same Skin Concentration of Vitamin D 3 Precursor, 7-Dehydrocholesterol, and Similar Response to UVR. Nutrients 2024; 16:1147. [PMID: 38674838 PMCID: PMC11053405 DOI: 10.3390/nu16081147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Vitamin D3 synthesis in human skin is initiated by solar ultraviolet radiation (UVR) exposure of precursor 7-dehydrocholesterol (7DHC), but influence of age on the early stage of vitamin D3 metabolism is uncertain. We performed a prospective standardised study in healthy ambulant adults aged ≥65 and ≤40 years examining (1) if baseline skin 7DHC concentration differs between younger and older adults and (2) the impact of older age on serum vitamin D3 response to solar simulated UVR. Eleven younger (18-40 years) and 10 older (65-89 years) adults, phototype I-III, received low-dose UVR (95% UVA, 5% UVB, 1.3 SED) to ~35% of the body surface area. Biopsies were taken for 7DHC assay from unexposed skin, skin immediately and 24 h post-UVR, and blood sampled at baseline, 24 h and 7 d post-UVR for vitamin D3 assay. Samples were analysed by HPLC-MS/MS. Baseline skin 7DHC (mean ± SD) was 0.22 ± 0.07 and 0.25 ± 0.08 µg/mg in younger versus older adults (no significant difference). Baseline serum vitamin D3 concentration was 1.5 ± 1.5 and 1.5 ± 1.7 nmol/L in younger versus older adults, respectively, and showed a significant increase in both groups post-UVR (no significant differences between age groups). Thus, skin 7DHC concentration was not a limiting factor for vitamin D3 production in older relative to younger adults. This information assists public health guidance on sun exposure/vitamin D nutrition, with particular relevance to the growing populations of healthy ambulant adults ≥65 years.
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Affiliation(s)
- Oktawia Borecka
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK; (O.B.); (A.R.W.)
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Photobiology Unit, Dermatology Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester M6 8HD, UK
| | - John J. Dutton
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (J.J.D.); (W.D.F.)
| | - Jonathan C. Y. Tang
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (J.J.D.); (W.D.F.)
- Departments of Clinical Biochemistry and Endocrinology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - William D. Fraser
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (J.J.D.); (W.D.F.)
- Departments of Clinical Biochemistry and Endocrinology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Ann R. Webb
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK; (O.B.); (A.R.W.)
| | - Lesley E. Rhodes
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Photobiology Unit, Dermatology Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester M6 8HD, UK
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Zaremba SMM, Conduit-Turner K. Knowledge of vitamin D and practices of vitamin D supplementation in a Scottish adult population: A cross-sectional study. Nutr Health 2024:2601060241238824. [PMID: 38497198 DOI: 10.1177/02601060241238824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background: Vitamin D supplementation practices (dose and frequency) are relatively unknown in the Scottish population, with no recent up-to-date data available. Reassessing current knowledge, practices, and awareness of vitamin D supplementation following a national health campaign in 2020 by Food Standards Scotland on vitamin D is warranted. Aim: This article aims to present the knowledge and awareness of vitamin D, and current vitamin D supplementation practices in adults living in Scotland. Methods: A cross-sectional study was performed between June and July 2022 using an online survey adapted from previous work on assessing knowledge of vitamin D in adults. Participants aged 18+, living in Scotland for ≥6 months were eligible to participate. Scores for knowledge were calculated as a percentage. Univariate associations between demographic and supplement use were established by χ2-test and logistic regression performed to predict factors associated with daily vitamin D intake. Results: Four hundred and three participants (72.7% female), mean age 36.4 (±14.2 years), completed the study. Awareness of vitamin D was very high (99.5%) but the mean overall knowledge score was poor (31.4 ± 15.3%), with those with a university degree more likely to have knowledge scores at/above the mean compared with those with lower levels of education, χ2(1, N = 393) 10.7, p = 0.001, odds ratio (OR) = 2.1 (95% confidence interval (CI) 1.7-2.7). Finally, 64.3% took vitamin D supplements, of which 37.5% took them daily during winter months, with only 7.4% taking the recommended daily dose. Conclusion: The current study highlights the need to improve both knowledge of vitamin D and practices of vitamin D supplementation during the autumn and winter months in Scotland.
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Affiliation(s)
- Suzanne M M Zaremba
- Division of Population Health & Genomics, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
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Darraj H, Hakami KM, Maghrabi R, Bakri N, Alhazmi MH, Names AA, Akkur A, Sayegh M, Alhazmi A, Khubrani SM, Gohal G, Alomar AH, Alhazmi AH. Nutritional Rickets Among Children: A Retrospective Study from Saudi Arabia. Pediatric Health Med Ther 2023; 14:301-308. [PMID: 37849986 PMCID: PMC10577373 DOI: 10.2147/phmt.s425459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
Background Nutritional rickets remains a significant concern in certain countries, with increasing prevalence attributed to factors such as limited sunlight exposure and undernourishment. This study aimed to identify the factors associated with rickets due to nutritional deficiency in children from Jazan Province, southwestern Saudi Arabia. Methods A retrospective cross-sectional study was conducted using descriptive data from medical records at a tertiary hospital in Jazan Province. Records of patients diagnosed with rickets between January 2010 and December 2020 were analyzed. Symptomatic rickets cases from pediatric clinics were included, and diagnoses were based on biochemical and clinical tests. Risk factors were assessed using patient medical records. Data were analyzed using percentages, mean, and standard deviation. Results The study included 84 patients with rickets (53 females and 31 males), primarily between 11-18 years old. The mean body mass index (BMI) of the participants was 21.21. The most common risk factor was nutritional deficiencies, including vitamin D deficiency or calcium deficiency, with 75 patients reporting a family history of vitamin D deficiency. The children had limited sunlight exposure and low levels of calcium and vitamin D. Malnutrition was identified as the highest risk factor for rickets in the study population. Conclusion Nutritional rickets appears to be prevalent in the Jazan Province, emphasizing the need for government organizations to address this preventable disease. Adequate sun exposure and recommended dietary vitamin D intake are crucial to prevent rickets, as this study detected inadequate levels of calcium and vitamin D in children. National studies are required to further identify risk factors and develop appropriate strategies.
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Affiliation(s)
- Hussam Darraj
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Khalid M Hakami
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Rawan Maghrabi
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Nawaf Bakri
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | | | - Abdellh A Names
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Ahmed Akkur
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Maram Sayegh
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Asma Alhazmi
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Saad M Khubrani
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Gassem Gohal
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Amro H Alomar
- King Fahad Central Hospital, Ministry of Health, Jazan, 85534, Saudi Arabia
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Alsaidan MS, Alsohaimi A, Alanazi ZG, Alnefea AZ, Alanazi RM, Algraene TS. Current practice and beliefs of parents toward sunscreen use for their children: A cross-sectional study. Prev Med Rep 2023; 34:102237. [PMID: 37214162 PMCID: PMC10199206 DOI: 10.1016/j.pmedr.2023.102237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
Parents are generally influencing the sun protection behaviors of their children, including sunscreen use. In Saudi Arabia, sunscreen use was estimated in adults but not children. The objective was to estimate the prevalence and predictors of sunscreen use among parents and their children. An observational cross-sectional study was conducted in April 2022. Parents who were visiting outpatient clinics at a university hospital in Al-Kharj city, Saudi Arabia, were invited to complete an online questionnaire. A total of 266 participants were included in the final analysis. The mean age of parents was 39.0 ± 8.9 years, and the mean age of children was 8.2 ± 3.2 years. The prevalence of sunscreen use was 38.7% in parents and 24.1% in their children. Females had higher sunscreen use than males in both parents (49.7% versus 7.2%, p < 0.001) and in children (31.9% versus 18.3%, p = 0.011). The most frequent sunburn protection measures practiced by children were wearing long-sleeved clothes (77.0%), sitting in the shade (70.6%), and wearing hats (39.2%). In multivariable analysis, predictors of sunscreen use in parents included female sex, history of sunburn, and sunscreen use by children. Independent predictors of sunscreen use in children included a history of sunburn, wearing hats, and practicing other sunburn protection measures on risky occasions, and sunscreen use in parents. Sunscreen use in parents and children in Saudi Arabia is still inadequate or limited. This calls for community/school intervention programs using educational activities and multimedia promotion. Further studies are needed.
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Affiliation(s)
- Mohammed Saud Alsaidan
- Internal Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, AlKharj, Saudi Arabia
| | - Aziz Alsohaimi
- Department of Medicine, Al-Baha University, Saudi Arabia
| | - Ziad Ghanem Alanazi
- College of Medicine, Prince Sattam Bin Abdulaziz University, AlKharj, Saudi Arabia
| | | | | | - Turky Saad Algraene
- College of Medicine, Prince Sattam Bin Abdulaziz University, AlKharj, Saudi Arabia
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Webb AR, Alghamdi R, Kift R, Rhodes LE. 100 YEARS OF VITAMIN D: Dose-response for change in 25-hydroxyvitamin D after UV exposure: outcome of a systematic review. Endocr Connect 2021; 10:R248-R266. [PMID: 34519278 PMCID: PMC8558903 DOI: 10.1530/ec-21-0308] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
A systematic review of publications addressing change in vitamin D status (25-hydroxyvitamin D (25OHD)) after exposure to UV radiation identified 2001 independent peer-reviewed publications. Of these, 21 used artificial sources of UV radiation, met all inclusion criteria and were quality assured; 13 publications used solar radiation and met sufficient inclusion criteria to be retained as supporting evidence; 1 further included publication used both solar and artificial sources. The review consistently identified that low dose, sub-erythemal doses are more effective for vitamin D synthesis than doses close to a minimum erythema dose; increasing skin area exposed increases the amount of vitamin D synthesised although not necessarily in a linear manner; constant dosing leads to a dose-dependent plateau in 25OHD, and dose-response is greatest at the start of a dosing regime; there is a large interpersonal variation in response to UV exposure. Fourteen of the studies using artificial sources of radiation were used to determine a dose-response relationship for change in 25OHD on whole-body exposure to repeated sub-erythemal doses of UV radiation, taking the form Δ25OHD (nmol/L) = A ln(standard vitamin D dose) + B. This helps quantify our understanding of UV as a source of vitamin D and enables exposure regimes for safe synthesis of vitamin D to be assessed. Specific studies of people with pigmented skin (Fitzpatrick skin types 5 and 6) were rare, and this dose-response relationship is only applicable to white-skinned individuals as skin type is a determinant of response to UV radiation. Findings provide information for vitamin D guidance updates.
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Affiliation(s)
- Ann R Webb
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Rehab Alghamdi
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Richard Kift
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Lesley E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, UK
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A revised action spectrum for vitamin D synthesis by suberythemal UV radiation exposure in humans in vivo. Proc Natl Acad Sci U S A 2021; 118:2015867118. [PMID: 34580202 PMCID: PMC8501902 DOI: 10.1073/pnas.2015867118] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 11/24/2022] Open
Abstract
Solar UV radiation (UVR) causes sunburn but initiates the first step of vitamin D synthesis, which is the formation of previtamin D3 (pre-D3) in skin. The gold standard for assessing vitamin D is serum 25-hydroxyvitamin D3 [25(OH)D3]. Public health advice for optimal solar exposure requires UVR wavelength-dependence (action spectrum) data on risks and benefits. An action spectrum for pre-D3 in human ex vivo skin was established over 30 y ago, but its validity has been questioned. We tested this action spectrum in healthy volunteers using serum 25(OH)D3 as the endpoint. Our analysis shows that the pre-D3 action spectrum can be improved with a systematic correction. This will result in better risk–benefit calculations for public health advice on solar exposure. Action spectra are important biological weighting functions for risk/benefit analyses of ultraviolet (UV) radiation (UVR) exposure. One important human benefit of exposure to terrestrial solar UVB radiation (∼295 to 315 nm) is the cutaneous synthesis of vitamin D3 that is initiated by the photoconversion of 7-dehydrocholesterol to previtamin D3. An action spectrum for this process that is followed by other nonphotochemical steps to achieve biologically active vitamin D3 has been established from ex vivo data and is widely used, although its validity has been questioned. We tested this action spectrum in vivo by full- or partial-body suberythemal irradiation of 75 healthy young volunteers with five different polychromatic UVR spectra on five serial occasions. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels, as the most accurate measure of vitamin D3 status, were assessed before, during, and after the exposures. These were then used to generate linear dose–response curves that were different for each UVR spectrum. It was established that the previtamin D3 action spectrum was not valid when related to the serum 25(OH)D3 levels, as weighting the UVR doses with this action spectrum did not result in a common regression line unless it was adjusted by a blue shift, with 5 nm giving the best fit. Such a blue shift is in accord with the published in vitro action spectra for vitamin D3 synthesis. Thus, calculations regarding the risk (typically erythema) versus the benefit of exposure to solar UVR based on the ex vivo previtamin D3 action spectrum require revision.
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Lin L, Shen L, Zhang J, Xu Y, Fang Z, Müller-Buschbaum P, Zhong Q. Ionic Hydrogels Based Wearable Sensors to Monitor the Solar Radiation Dose for Vitamin D Production and Sunburn Prevention. ACS APPLIED MATERIALS & INTERFACES 2021; 13:45995-46002. [PMID: 34524812 DOI: 10.1021/acsami.1c13027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Wearable solar radiation sensors based on ionic hydrogels are facilely prepared to simultaneously monitor the radiation dose for the production of vitamin D and the prevention of sunburn. Tetramethylethylenediamine (TEMED) is neutralized with acrylic acid (AA) to obtain tetramethylethylenediamine acrylate (TEMEDA), which is further polymerized with acrylamide by a free radical reaction. By simply adding MB or NR during the polymerization, the final obtained ionic hydrogels can indicate solar radiation. Due to the extent of discoloration, the discoloration speed of MB and NR is correlated to the radiation dose. This wearable sensor can indicate the solar radiation dose required by the human body to synthesize vitamin D through the discoloration of the ionized hydrogel of MB, whereas those with NR are able to illustrate the threshold of radiation dose that causes potential skin hurt. Therefore, the benefit and drawback of solar radiation can be well balanced by optimizing the exposure time to solar irradiation. In addition, polyurethane cross-linked with a thermoresponsive coating is used as band for this wearable sensor. Due to the hydrophilicity below its transition temperature, the cross-linked band possesses the easy cleaning capability of stains after the daily wear. Such type of wearable sensor can be broadly used for monitoring the solar radiation, especially in outdoor activities.
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Affiliation(s)
- Li Lin
- Key Laboratory of Advanced Textile Materials & Manufacturing Technology, Ministry of Education, Zhejiang Sci-Tech University, 928 Second Avenue, 310018 Hangzhou, China
| | - Liangen Shen
- Zhejiang Hexin Holdings Co. Ltd., 1568 Dongfang Road, 314003 Jiaxing, China
| | - Junfeng Zhang
- Hexin Kuraray Micro Fiber Leather (Jiaxing) Co. Ltd., 777 Pingnan Road, 314003 Jiaxing, China
| | - Yiyan Xu
- Zhejiang Hexin New Material Co. Ltd., 1568 Dongfang Road, 314003 Jiaxing, China
| | - Zheng Fang
- Key Laboratory of Advanced Textile Materials & Manufacturing Technology, Ministry of Education, Zhejiang Sci-Tech University, 928 Second Avenue, 310018 Hangzhou, China
| | - Peter Müller-Buschbaum
- Technische Universität München, Physik-Department, Lehrstuhl für Funktionelle Materialien, James-Franck-Str. 1, 85748 Garching, Germany
- Heinz Maier-Leibnitz Zentrum (MLZ), Technische Universität München, Lichtenbergstr. 1, 85748 Garching, Germany
| | - Qi Zhong
- Key Laboratory of Advanced Textile Materials & Manufacturing Technology, Ministry of Education, Zhejiang Sci-Tech University, 928 Second Avenue, 310018 Hangzhou, China
- Technische Universität München, Physik-Department, Lehrstuhl für Funktionelle Materialien, James-Franck-Str. 1, 85748 Garching, Germany
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HARRISON SOPHIEE, OLIVER SAMUELJ, KASHI DANIELS, CARSWELL ALEXANDERT, EDWARDS JASONP, WENTZ LAURELM, ROBERTS ROSS, TANG JONATHANCY, IZARD RACHELM, JACKSON SARAH, ALLAN DONALD, RHODES LESLEYE, FRASER WILLIAMD, GREEVES JULIEP, WALSH NEILP. Influence of Vitamin D Supplementation by Simulated Sunlight or Oral D3 on Respiratory Infection during Military Training. Med Sci Sports Exerc 2021; 53:1505-1516. [PMID: 33481482 PMCID: PMC8208091 DOI: 10.1249/mss.0000000000002604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine the relationship between vitamin D status and upper respiratory tract infection (URTI) of physically active men and women across seasons (study 1) and then to investigate the effects on URTI and mucosal immunity of achieving vitamin D sufficiency (25(OH)D ≥50 nmol·L-1) by a unique comparison of safe, simulated sunlight or oral D3 supplementation in winter (study 2). METHODS In study 1, 1644 military recruits were observed across basic military training. In study 2, a randomized controlled trial, 250 men undertaking military training received placebo, simulated sunlight (1.3× standard erythemal dose, three times per week for 4 wk and then once per week for 8 wk), or oral vitamin D3 (1000 IU·d-1 for 4 wk and then 400 IU·d-1 for 8 wk). URTI was diagnosed by a physician (study 1) and by using the Jackson common cold questionnaire (study 2). Serum 25(OH)D, salivary secretory immunoglobulin A (SIgA), and cathelicidin were assessed by liquid chromatography-mass spectrometry LC-MS/MS and enzyme-linked immunosorbent assay. RESULTS In study 1, only 21% of recruits were vitamin D sufficient during winter. Vitamin D-sufficient recruits were 40% less likely to suffer URTI than recruits with 25(OH)D <50 nmol·L-1 (OR = 0.6, 95% confidence interval = 0.4-0.9), an association that remained after accounting for sex and smoking. Each URTI caused, on average, three missed training days. In study 2, vitamin D supplementation strategies were similarly effective to achieve vitamin D sufficiency in almost all (≥95%). Compared with placebo, vitamin D supplementation reduced the severity of peak URTI symptoms by 15% and days with URTI by 36% (P < 0.05). These reductions were similar with both vitamin D strategies (P > 0.05). Supplementation did not affect salivary secretory immunoglobulin A or cathelicidin. CONCLUSION Vitamin D sufficiency reduced the URTI burden during military training.
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Affiliation(s)
- SOPHIE E. HARRISON
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - SAMUEL J. OLIVER
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - DANIEL S. KASHI
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Faculty of Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM
| | - ALEXANDER T. CARSWELL
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
| | - JASON P. EDWARDS
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Faculty of Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM
| | - LAUREL M. WENTZ
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | - ROSS ROBERTS
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - JONATHAN C. Y. TANG
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
| | - RACHEL M. IZARD
- Headquarters Army Recruiting and Initial Training Command, Upavon, Wiltshire, UNITED KINGDOM
- Defence Science and Technology, Porton Down, Wiltshire, UNITED KINGDOM
| | - SARAH JACKSON
- Army Health and Physical Performance, Army HQ, Andover, Hampshire, UNITED KINGDOM
| | - DONALD ALLAN
- Medical Physics Department, Salford Royal NHS Foundation Trust, and University of Manchester, Manchester Academic Health Science Centre, Manchester, UNITED KINGDOM
| | - LESLEY E. RHODES
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UNITED KINGDOM
| | - WILLIAM D. FRASER
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
- Departments of Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospitals Trust, Norwich, UNITED KINGDOM
| | - JULIE P. GREEVES
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
- Army Health and Physical Performance, Army HQ, Andover, Hampshire, UNITED KINGDOM
- Division of Surgery and Interventional Science, UCL, London, UNITED KINGDOM
| | - NEIL P. WALSH
- Faculty of Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM
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10
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Neville JJ, Palmieri T, Young AR. Physical Determinants of Vitamin D Photosynthesis: A Review. JBMR Plus 2021; 5:e10460. [PMID: 33553995 PMCID: PMC7839826 DOI: 10.1002/jbm4.10460] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D synthesis by exposure of skin to solar ultraviolet radiation (UVR) provides the majority of this hormone that is essential for bone development and maintenance but may be important for many other health outcomes. This process, which is the only well-established benefit of solar UVR exposure, depends on many factors including genetics, age, health, and behavior. However, the most important factor is the quantity and quality of UVR reaching the skin. Vitamin D synthesis specifically requires ultraviolet B (UVB) radiation that is the minority component (<5%) of solar UVR. This waveband is also the most important for the adverse effects of solar exposure. The most obvious of which is sunburn (erythema), but UVB is also the main cause of DNA damage to the skin that is a prerequisite for most skin cancers. UVB at the Earth's surface depends on many physical and temporal factors such as latitude, altitude, season, and weather. Personal, cultural, and behavioral factors are also important. These include skin melanin, clothing, body surface area exposed, holiday habits, and sunscreen use. There is considerable disagreement in the literature about the role of some of these factors, possibly because some studies have been done by researchers with little understanding of photobiology. It can be argued that vitamin D supplementation obviates the need for solar exposure, but many studies have shown little benefit from this approach for a wide range of health outcomes. There is also increasing evidence that such exposure offers health benefits independently of vitamin D: the most important of which is blood-pressure reduction. In any case, public health advice must optimize risk versus benefit for solar exposure. It is fortunate that the individual UVB doses necessary for maintaining optimal vitamin D status are lower than those for sunburn, irrespective of skin melanin. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jonathan J Neville
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
| | - Tommaso Palmieri
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
| | - Antony R Young
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
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11
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Kim KB, Kim HW, Lee JS, Yoon SM. [Inflammatory Bowel Disease and Vitamin D]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2020; 76:275-281. [PMID: 33361704 DOI: 10.4166/kjg.2020.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022]
Abstract
Vitamin D contributes to bone metabolism and acts as an immune modulator for both innate and adaptive immunity. The serum level of vitamin D has been associated with inflammatory diseases, such as inflammatory bowel disease (IBD). In epidemiologic studies, IBD patients have been shown to have low levels of vitamin D. The suboptimal circulating levels of vitamin D in IBD patients may be caused by low exposure to sunlight, dietary malabsorption, and the impaired conversion of active metabolites (1,25[OH]2D). Recent studies have demonstrated that vitamin D deficiency in IBD can increase the chance of disease recurrence, IBD-related hospitalization or surgery, and deterioration of quality of life. Supplementation with vitamin D is therefore thought to reduce the risk of flare-ups and the improvement of the quality of life in IBD patients. This review aims to summarize the latest knowledge on the effects of vitamin D deficiency on IBD and the possible benefits of vitamin D supplementation in IBD patients.
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Affiliation(s)
- Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyoung Woo Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jun Su Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
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12
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Burchell K, Rhodes LE, Webb AR. Public Awareness and Behaviour in Great Britain in the Context of Sunlight Exposure and Vitamin D: Results from the First Large-Scale and Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6924. [PMID: 32971923 PMCID: PMC7557888 DOI: 10.3390/ijerph17186924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022]
Abstract
In recent years, UK public health messages about the risks of sunlight exposure (skin cancer) have been increasingly balanced by messages about its benefits (vitamin D production). Currently, data about the effects of this shift on public knowledge, awareness, and behaviour are scant. Thus, the objective of this paper is to report the findings of the first large-scale and representative survey of the awareness, knowledge, and behaviour of adults in Great Britain (England, Scotland, and Wales) (n = 2024) with respect to sunlight exposure, vitamin D, and sunburn and skin cancer. The findings suggest that the public in Great Britain is much more aware of public promotion of the risks of sunlight exposure than its benefits. That said, knowledge about sunlight exposure and vitamin D is fairly strong, though not with respect to the detail of the 'little and often' approach. However, the survey also suggests that levels of sunlight exposure among the public are often excessive. The survey indicates that knowledge and behaviour are both less satisfactory among men and people in lower socio-economic groups. The paper concludes with recommendations for public health communications and for research in this area.
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Affiliation(s)
- Kevin Burchell
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK;
| | - Lesley E. Rhodes
- Faculty of Medicine Biology and Health, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester M13 9PL, UK;
- Photobiology Unit, Dermatology Research Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK
| | - Ann R. Webb
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK;
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13
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Kim S, Carson KA, Chien AL. Prevalence and correlates of sun protections with sunburn and vitamin D deficiency in sun-sensitive individuals. J Eur Acad Dermatol Venereol 2020; 34:2664-2672. [PMID: 32453868 DOI: 10.1111/jdv.16681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sun sensitivity is an inherent risk factor for skin cancer. Sun protection is important in sun-sensitive individuals to reduce sunburns for skin cancer prevention. However, concerns have arose regarding the possible impact of sun protection on vitamin D deficiency. OBJECTIVE To examine the prevalence and correlates of sun-protective behaviours (staying in the shade, using sunscreen and wearing long sleeves) with sunburn and vitamin D deficiency in sun-sensitive individuals. METHODS This was a cross-sectional study of 2390 US non-Hispanic white adults aged 20-59 years in the National Health and Nutrition Examination Survey 2011-2014. Sun sensitivity was defined as self-reported tendency to severe sunburn when exposed to the sun for half an hour after months of non-sun exposure, and single serum 25(OH)D levels less than 50 nmol/L was determined as vitamin D deficiency. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) using multivariable logistic regression taking into account the complex survey design. RESULTS Sun-sensitive individuals had higher odds of frequently staying in the shade (aOR = 3.08; 95% CI 2.19-4.33) and using sunscreen (aOR = 1.93; 1.44-2.59) but not associated with sun exposure time (aOR = 0.91; 0.62-1.32). Yet, sun-sensitive individuals had significantly higher likelihood of sunburns (aOR = 1.93; 1.45-2.55), and no increased likelihood of vitamin D deficiency (aOR = 1.15; 0.84-1.58). Among sun-sensitive individuals, being younger, male and spending more time outdoors were associated with increased odds of sunburns and the risk of sunburn was reduced with frequently staying in the shade and engaging in multimodal sun protections. CONCLUSION Sun-sensitive individuals more frequently used sun protection methods yet they still were significantly more likely to experience sunburns and the risk of vitamin D deficiency was not increased. Education on proper application of sunscreen combined with other sun-protective techniques is important to reduce sunburn in sun-sensitive populations.
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Affiliation(s)
- S Kim
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Dermatology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - K A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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14
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Abstract
Respiratory and gastrointestinal infections limit an athlete's availability to train and compete. To better understand how sick an athlete will become when they have an infection, a paradigm recently adopted from ecological immunology is presented that includes the concepts of immune resistance (the ability to destroy microbes) and immune tolerance (the ability to dampen defence yet control infection at a non-damaging level). This affords a new theoretical perspective on how nutrition may influence athlete immune health; paving the way for focused research efforts on tolerogenic nutritional supplements to reduce the infection burden in athletes. Looking through this new lens clarifies why nutritional supplements targeted at improving immune resistance in athletes show limited benefits: evidence supporting the old paradigm of immune suppression in athletes is lacking. Indeed, there is limited evidence that the dietary practices of athletes suppress immunity, e.g. low-energy availability and train- or sleep-low carbohydrate. It goes without saying, irrespective of the dietary preference (omnivorous, vegetarian), that athletes are recommended to follow a balanced diet to avoid a frank deficiency of a nutrient required for proper immune function. The new theoretical perspective provided sharpens the focus on tolerogenic nutritional supplements shown to reduce the infection burden in athletes, e.g. probiotics, vitamin C and vitamin D. Further research should demonstrate the benefits of candidate tolerogenic supplements to reduce infection in athletes; without blunting training adaptations and without side effects.
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15
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Felton SJ, Shin BB, Watson REB, Kift R, Webb AR, Rhodes LE. Photoprotection conferred by low level summer sunlight exposures against pro-inflammatory UVR insult. Photochem Photobiol Sci 2020; 19:810-818. [PMID: 33856672 DOI: 10.1039/c9pp00452a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/31/2020] [Indexed: 11/21/2022]
Affiliation(s)
- S J Felton
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - B B Shin
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - R E B Watson
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - R Kift
- School of Earth and Environmental Sciences, Faculty of Science and Engineering, The University of Manchester, Manchester, UK
| | - A R Webb
- School of Earth and Environmental Sciences, Faculty of Science and Engineering, The University of Manchester, Manchester, UK
| | - L E Rhodes
- Dermatology Research Centre, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
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16
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Lanham-New SA, Webb AR, Cashman KD, Buttriss JL, Fallowfield JL, Masud T, Hewison M, Mathers JC, Kiely M, Welch AA, Ward KA, Magee P, Darling AL, Hill TR, Greig C, Smith CP, Murphy R, Leyland S, Bouillon R, Ray S, Kohlmeier M. Vitamin D and SARS-CoV-2 virus/COVID-19 disease. BMJ Nutr Prev Health 2020; 3:106-110. [PMID: 33230499 PMCID: PMC7246103 DOI: 10.1136/bmjnph-2020-000089] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Ann R Webb
- Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Kevin D Cashman
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | | | | | - Tash Masud
- Department of Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Martin Hewison
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Mairead Kiely
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Ailsa A Welch
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology, NIHR Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Pamela Magee
- School of Biomedical Sciences, Ulster University at Coleraine, Coleraine, UK
| | - Andrea L Darling
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Tom R Hill
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Carolyn Greig
- School of Sport, Exercise and Rehabilitation Sciences and MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Colin P Smith
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Richard Murphy
- Centre for Environment & Sustainability, Faculty of Engineering & Physical Sciences, University of Surrey, Guildford, UK
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium
| | - Sumantra Ray
- School of Biomedical Sciences, Ulster University at Coleraine, Coleraine, UK
- School of Humanities and Social Sciences, University of Cambridge, Cambridge, UK
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
| | - Martin Kohlmeier
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
- School of Medicine & Gillings School of Global Public Health, University of North Carolina at Chapel Hill & UNC Nutrition Research Institute, Chapel Hill, North Carolina, USA
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17
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Kashi DS, Oliver SJ, Wentz LM, Roberts R, Carswell AT, Tang JCY, Jackson S, Izard RM, Allan D, Rhodes LE, Fraser WD, Greeves JP, Walsh NP. Vitamin D and the hepatitis B vaccine response: a prospective cohort study and a randomized, placebo-controlled oral vitamin D 3 and simulated sunlight supplementation trial in healthy adults. Eur J Nutr 2020; 60:475-491. [PMID: 32390123 PMCID: PMC7867563 DOI: 10.1007/s00394-020-02261-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/24/2020] [Indexed: 01/25/2023]
Abstract
Purpose To determine serum 25(OH)D and 1,25(OH)2D relationship with hepatitis B vaccination (study 1). Then, to investigate the effects on hepatitis B vaccination of achieving vitamin D sufficiency (serum 25(OH)D ≥ 50 nmol/L) by a unique comparison of simulated sunlight and oral vitamin D3 supplementation in wintertime (study 2). Methods Study 1 involved 447 adults. In study 2, 3 days after the initial hepatitis B vaccination, 119 men received either placebo, simulated sunlight (1.3 × standard-erythema dose, 3 × /week for 4 weeks and then 1 × /week for 8 weeks) or oral vitamin D3 (1000 IU/day for 4 weeks and 400 IU/day for 8 weeks). We measured hepatitis B vaccination efficacy as percentage of responders with anti-hepatitis B surface antigen immunoglobulin G ≥ 10 mIU/mL. Results In study 1, vaccine response was poorer in persons with low vitamin D status (25(OH)D ≤ 40 vs 41–71 nmol/L mean difference [95% confidence interval] − 15% [− 26, − 3%]; 1,25(OH)2D ≤ 120 vs ≥ 157 pmol/L − 12% [− 24%, − 1%]). Vaccine response was also poorer in winter than summer (− 18% [− 31%, − 3%]), when serum 25(OH)D and 1,25(OH)2D were at seasonal nadirs, and 81% of persons had serum 25(OH)D < 50 nmol/L. In study 2, vitamin D supplementation strategies were similarly effective in achieving vitamin D sufficiency from the winter vitamin D nadir in almost all (~ 95%); however, the supplementation beginning 3 days after the initial vaccination did not effect the vaccine response (vitamin D vs placebo 4% [− 21%, 14%]). Conclusion Low vitamin D status at initial vaccination was associated with poorer hepatitis B vaccine response (study 1); however, vitamin D supplementation commencing 3 days after vaccination (study 2) did not influence the vaccination response. Clinical trial registry number Study 1 NCT02416895; https://clinicaltrials.gov/ct2/show/study/NCT02416895; Study 2 NCT03132103; https://clinicaltrials.gov/ct2/show/NCT03132103. Electronic supplementary material The online version of this article (10.1007/s00394-020-02261-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel S Kashi
- College of Human Sciences, Bangor University, Bangor, LL57 2PZ, UK.,Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Samuel J Oliver
- College of Human Sciences, Bangor University, Bangor, LL57 2PZ, UK.
| | - Laurel M Wentz
- Beaver College of Health Sciences, Appalachian State University, Boone, USA
| | - Ross Roberts
- College of Human Sciences, Bangor University, Bangor, LL57 2PZ, UK
| | | | | | - Sarah Jackson
- Department of Army Health and Physical Performance Research, Army HQ, Andover, UK
| | - Rachel M Izard
- Occupational Medicine, HQ Army Recruiting and Initial Training Command, Upavon, UK
| | - Donald Allan
- Medical Physics Department, Salford Royal NHS Foundation Trust, and University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Lesley E Rhodes
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Julie P Greeves
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Army Health and Physical Performance Research, Army HQ, Andover, UK
| | - Neil P Walsh
- Faculty of Science, Liverpool John Moores University, Liverpool, UK
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18
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Śliwicka E, Cisoń T, Straburzyńska-Lupa A, Pilaczyńska-Szcześniak Ł. Effects of whole-body cryotherapy on 25-hydroxyvitamin D, irisin, myostatin, and interleukin-6 levels in healthy young men of different fitness levels. Sci Rep 2020; 10:6175. [PMID: 32277130 PMCID: PMC7148349 DOI: 10.1038/s41598-020-63002-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Skeletal muscle and adipose tissue play an important role in maintaining metabolic homeostasis and thermogenesis. We aimed to investigate the effects of single and repeated exposure to whole-body cryotherapy in volunteers with different physical fitness levels on 25-hydroxyvitamin D (25(OH)D) and myokines. The study included 22 healthy male volunteers (mean age: 21 ± 1.17 years), who underwent 10 consecutive sessions in a cryogenic chamber once daily (3 minutes, −110 °C). Blood samples were collected before and 30 minutes and 24 hours after the first and last cryotherapy sessions. Prior to treatment, body composition and physical fitness levels were measured. After 10 cryotherapy treatments, significant changes were found in myostatin concentrations in the low physical fitness level (LPhL) group. The 25(OH)D levels were increased in the high physical fitness level (HPhL) group and decreased in the LPhL group. The HPhL group had significant changes in the level of high-sensitivity interleukin-6 after the first treatment. The LPhL group had significant changes in 25(OH)D, irisin, and myostatin levels after the tenth treatment. Our data demonstrated that in healthy young men, cryotherapy affects 25(OH)D levels, but they were small and transient. The body’s response to a series of 10 cryotherapy treatments is modified by physical fitness level.
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Affiliation(s)
- Ewa Śliwicka
- Poznan University of Physical Education, Department of Physiology and Biochemistry, Poznań, Poland.
| | - Tomasz Cisoń
- State University of Applied Science in Nowy Sącz, Department of Physiotherapy, Nowy Sącz, Poland
| | - Anna Straburzyńska-Lupa
- Poznan University of Physical Education, Department of Physical Therapy and Sports Recovery, Poznań, Poland
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19
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Effect of sun exposure versus oral vitamin D supplementation on serum 25-hydroxyvitamin D concentrations in young adults: A randomized clinical trial. Clin Nutr 2020; 39:727-736. [DOI: 10.1016/j.clnu.2019.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/07/2019] [Accepted: 03/14/2019] [Indexed: 01/09/2023]
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20
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de Gruijl FR, Webb AR, Rhodes LE. Everyday sunscreen use may compromise vitamin D in temperate climes. Br J Dermatol 2020; 182:1312-1313. [PMID: 31853945 DOI: 10.1111/bjd.18811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F R de Gruijl
- Department of Dermatology, Leiden University Medical Center, 2333 ZA, Leiden, the Netherlands
| | - A R Webb
- Centre for Atmospheric Sciences, School of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - L E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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21
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Jindal AK, Gupta A, Vinay K, Bishnoi A. Sun Exposure in Children: Balancing the Benefits and Harms. Indian Dermatol Online J 2020; 11:94-98. [PMID: 32055519 PMCID: PMC7001416 DOI: 10.4103/idoj.idoj_206_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
There is a common belief among the laity and even physicians that sun exposure is a useful source of vitamin D. However, despite the fact that sun exposure occurs almost throughout the year in India, vitamin D deficiency is widely prevalent. Although several authors have reported on the duration of sun exposure required to synthesize adequate amounts of vitamin D in the human body, they have not followed a standard and uniform protocol for measurement of sun exposure and vitamin D synthesis. For these and many other reasons, the results are difficult to interpret. The American Academy of Pediatrics (AAP) has clearly stated that infants should be protected from the sun as much as possible and vitamin D requirements should be met through diet and fortified foods rather than deliberate sun exposure. However, this recommendation is frequently ignored in clinical practice. This review aims to summarize the available literature on benefits and harm of unprotected sun exposure in infants and children with a focus on skin phototype IV to VI. Dermatologists and pediatricians in India should counsel parents about the need for sun protection, especially in fair-skinned infants and children.
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Affiliation(s)
- Ankur K Jindal
- Allergy Immunology Unit, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aman Gupta
- Allergy Immunology Unit, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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22
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Ultraviolet Exposure Scenarios: Balancing Risks of Erythema and Benefits of Cutaneous Vitamin D Synthesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:387-405. [PMID: 32918230 DOI: 10.1007/978-3-030-46227-7_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exposure to sunlight is a major source of vitamin D for most people. Yet public health advice has focused overwhelmingly on avoiding exposure of unprotected skin because of the risks of erythema and skin cancer. Given that there are also health risks associated with low vitamin D status, we explore the possibilities of achieving a range of targets associated with vitamin D and the accompanying erythema risk. We have calculated the exposure required to gain a number of proposed oral-equivalent doses of vitamin D, as functions of latitude, season, skin type and skin area exposed, together with the associated risk of erythema, expressed in minimum erythema doses. The model results show that a recommended daily intake of 400 IU is readily achievable through casual sun exposure in the midday lunch hour, with no risk of erythema, for all latitudes some of the year, and for all the year at some (low) latitudes. We also show that such daily, sub-erythemal doses at lunchtime during the summer months is sufficient to avoid winter-time vitamin D deficiency for the UK all-weather climate, provided that lower arms and legs are exposed in the warmer months. At the higher proposed vitamin D dose of 1000 IU, lunchtime sun exposure is still a viable route to the vitamin but requires the commitment to expose greater areas of skin and is effective for a shorter period of the year. The highest vitamin D requirement considered was 4000 IU per day. For much of the globe and much of the year, this is not achievable in a lunchtime hour and where it is possible large areas of skin must be exposed to prevent erythema. When the only variable considered was skin type, latitudinal and seasonal limits on adequate vitamin D production were more restrictive for skin type 5 than skin type 2.
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23
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Young AR, Morgan KA, Ho TW, Ojimba N, Harrison GI, Lawrence KP, Jakharia-Shah N, Wulf HC, Cruickshank JK, Philipsen PA. Melanin has a Small Inhibitory Effect on Cutaneous Vitamin D Synthesis: A Comparison of Extreme Phenotypes. J Invest Dermatol 2019; 140:1418-1426.e1. [PMID: 31883961 DOI: 10.1016/j.jid.2019.11.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 01/04/2023]
Abstract
Epidemiology suggests that melanin inhibits cutaneous vitamin D3 synthesis by UVR. Laboratory investigations assessing the impact of melanin on vitamin D production have produced contradictory results. We determined the effect of melanin on vitamin D3 photosynthesis in healthy young volunteers (n = 102) of Fitzpatrick skin types II-VI (white to black). Participants, irrespective of skin type, were exposed to the same suberythemal UVR dose, to 85% body surface area, using solar simulated UVR or narrowband UVB (311 nm). This was repeated five times with intervals of 3-4 days between UVR exposures. Blood was taken before, during, and after the irradiation and assessed for serum 25-hydroxyvitamin D3 (25[OH]D3) as a marker of vitamin D3 status. Linear UVR dose-dependent increases in 25(OH)D3 were highly significant (P ≤ 7.7 x 10-11). The ratios of regression slopes of the different skin type groups were compared, and only skin type II was significantly steeper than the other groups. Comparisons between extreme skin types II and VI showed melanin inhibition factors of approximately 1.3-1.4, depending on the UVR source. We conclude that the inhibitory effect of melanin on vitamin D3 synthesis is small, compared with erythema, but that this difference may be sufficient to explain the epidemiological data.
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Affiliation(s)
- Antony R Young
- St John's Institute of Dermatology, King's College London, London, United Kingdom.
| | - Kylie A Morgan
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Tak-Wai Ho
- Department of Nutritional Science, Division of Life-Course Sciences, King's College London, London, United Kingdom
| | - Ngozi Ojimba
- Department of Nutritional Science, Division of Life-Course Sciences, King's College London, London, United Kingdom; Dietetics Department, Homerton University Hospital NHS Foundation Trust, London, United Kingdom
| | - Graham I Harrison
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Karl P Lawrence
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | - Nihull Jakharia-Shah
- St John's Institute of Dermatology, King's College London, London, United Kingdom
| | | | - J Kennedy Cruickshank
- Department of Nutritional Science, Division of Life-Course Sciences, King's College London, London, United Kingdom
| | - Peter A Philipsen
- Department of Dermatology D92, Bispebjerg Hospital, Copenhagen, Denmark
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24
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A Critical Appraisal of Strategies to Optimize Vitamin D Status in Germany, a Population with a Western Diet. Nutrients 2019; 11:nu11112682. [PMID: 31698703 PMCID: PMC6893762 DOI: 10.3390/nu11112682] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/26/2019] [Accepted: 10/30/2019] [Indexed: 12/12/2022] Open
Abstract
During the last decade, our scientific knowledge of the pleiotropic biological effects of vitamin D metabolites and their relevance to human health has expanded widely. Beyond the well-known key role of vitamin D in calcium homeostasis and bone health, it has been shown that vitamin D deficiency is associated with a broad variety of independent diseases, including several types of cancer, and with increased overall mortality. Moreover, recent findings have demonstrated biological effects of the vitamin D endocrine system that are not mediated via activation of the classical nuclear vitamin D receptor (VDR) by binding with high affinity to its corresponding ligand, the biologically active vitamin D metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D). In contrast, many of these new biological effects of vitamin D compounds, including regulation of the circadian clock and many metabolic functions, are mediated by other vitamin D metabolites, including 20-hydroxyvitamin D and 20,23-dihydroxyvitamin D, and involve their binding to the aryl hydrocarbon receptor (AhR) and retinoid-orphan receptor (ROR). In most populations, including the German population, UVB-induced cutaneous vitamin D production is the main source for fulfilling the human body’s requirements of vitamin D. However, this causes a dilemma because solar or artificial UVR exposure is associated with skin cancer risk. In addition to UVB-induced vitamin D production in skin, in humans, there are two other possible sources of vitamin D: from diet and supplements. However, only a few natural foods contain substantial amounts of vitamin D, and in most populations, the dietary source of vitamin D cannot fulfill the body´s requirements. Because an increasing body of evidence has convincingly demonstrated that vitamin D deficiency is very common worldwide, it is the aim of this paper to (i) give an update of the vitamin D status in a population with a western diet, namely, the German population, and to (ii) develop strategies to optimize the vitamin D supply that consider both the advantages as well as the disadvantages/risks of different approaches, including increasing vitamin D status by dietary intake, by supplements, or by UVB-induced cutaneous synthesis of vitamin D.
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Carswell AT, Oliver SJ, Wentz LM, Kashi DS, Roberts R, Tang JCY, Izard RM, Jackson S, Allan D, Rhodes LE, Fraser WD, Greeves JP, Walsh NP. Influence of Vitamin D Supplementation by Sunlight or Oral D3 on Exercise Performance. Med Sci Sports Exerc 2019; 50:2555-2564. [PMID: 30048414 PMCID: PMC6282681 DOI: 10.1249/mss.0000000000001721] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose To determine the relationship between vitamin D status and exercise performance in a large, prospective cohort study of young men and women across seasons (study 1). Then, in a randomized, placebo-controlled trial, to investigate the effects on exercise performance of achieving vitamin D sufficiency (serum 25(OH)D ≥ 50 nmol·L−1) by a unique comparison of safe, simulated-sunlight and oral vitamin D3 supplementation in wintertime (study 2). Methods In study 1, we determined 25(OH)D relationship with exercise performance in 967 military recruits. In study 2, 137 men received either placebo, simulated sunlight (1.3× standard erythemal dose in T-shirt and shorts, three times per week for 4 wk and then once per week for 8 wk) or oral vitamin D3 (1000 IU·d−1 for 4 wk and then 400 IU·d−1 for 8 wk). We measured serum 25(OH)D by high-pressure liquid chromatography tandem mass spectrometry and endurance, strength and power by 1.5-mile run, maximum dynamic lift and vertical jump, respectively. Results In study 1, only 9% of men and 36% of women were vitamin D sufficient during wintertime. After controlling for body composition, smoking, and season, 25(OH)D was positively associated with endurance performance (P ≤ 0.01, ΔR2 = 0.03–0.06, small f2 effect sizes): 1.5-mile run time was ~half a second faster for every 1 nmol·L−1 increase in 25(OH)D. No significant effects on strength or power emerged (P > 0.05). In study 2, safe simulated sunlight and oral vitamin D3 supplementation were similarly effective in achieving vitamin D sufficiency in almost all (97%); however, this did not improve exercise performance (P > 0.05). Conclusions Vitamin D status was associated with endurance performance but not strength or power in a prospective cohort study. Achieving vitamin D sufficiency via safe, simulated summer sunlight, or oral vitamin D3 supplementation did not improve exercise performance in a randomized-controlled trial.
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Affiliation(s)
- Alexander T Carswell
- College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - Samuel J Oliver
- College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - Laurel M Wentz
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | - Daniel S Kashi
- College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - Ross Roberts
- College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - Jonathan C Y Tang
- Faculty of Medicine and Health Science, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
| | - Rachel M Izard
- Occupational Medicine, Headquarters Army Recruiting and Training Division, Upavon, Wiltshire, UNITED KINGDOM
| | - Sarah Jackson
- Army Personnel and Research Capability, Army HQ, Andover, Hampshire, UNITED KINGDOM
| | - Donald Allan
- Medical Physics Department, Salford Royal NHS Foundation Trust, and University of Manchester, Manchester Academic Health Science Centre, Manchester, UNITED KINGDOM
| | - Lesley E Rhodes
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UNITED KINGDOM
| | - William D Fraser
- Faculty of Medicine and Health Science, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
| | - Julie P Greeves
- Army Personnel and Research Capability, Army HQ, Andover, Hampshire, UNITED KINGDOM
| | - Neil P Walsh
- College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
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Lithgow HM, Florida-James G, Leggate M. The combined effect of high-intensity intermittent training and vitamin D supplementation on glycemic control in overweight and obese adults. Physiol Rep 2019; 6:e13684. [PMID: 29707918 PMCID: PMC5925425 DOI: 10.14814/phy2.13684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 01/12/2023] Open
Abstract
High-intensity intermittent training (HIIT) has been shown to reduce the risk of chronic conditions including the development of type 2 diabetes mellitus (T2DM). Independently, a low vitamin D status has also been linked to the prevalence of T2DM. The aim of this study was to investigate if there was a synergistic metabolic effect of HIIT and vitamin D supplementation on glycemic control. A total of 20 male and female participants (age, 34 ± 9 year; BMI, 31.4 ± 2.8 kg·m-2 ) completed 6 weeks HIIT, and were randomized to ingest 100 μg·day-1 of vitamin D3 or placebo. Response to an oral glucose tolerance test (OGTT) was determined at baseline and at 72 h postintervention. Glucose tolerance was improved as a result of the HIIT intervention, shown through a reduction in glucose and insulin concentrations during the OGTT, accompanied by a decrease in glucose (829 ± 110 to 786 ± 139 mmol·h-1 ·L-1 ; P = 0.043) and insulin (8101 ± 4755-7024 ± 4489 mU·h-1 ·L-1 ; P = 0.049) area under the curve (AUC). Supplementation increased 25-hydroxyvitamin D3 concentration by 120% to a sufficiency status (P < 0.001). However, the consumption of vitamin D3 seemed to attenuate the glucose response during an OGTT. Triglyceride content was lowered following the intervention (P = 0.025). There was no effect of the intervention on insulin sensitivity (IS) indices: ISIMatsuda and HOMA-IR. Our findings demonstrate that HIIT improves glucose tolerance in nondiabetic overweight and obese adults; however vitamin D3 supplementation did not proffer any additional positive effects on the measured indices of metabolic health.
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Affiliation(s)
- Hannah Margaret Lithgow
- Department of Sport and Exercise Science, School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Geraint Florida-James
- Department of Sport and Exercise Science, School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Melanie Leggate
- Department of Sport and Exercise Science, School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
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Fletcher J, Cooper SC, Ghosh S, Hewison M. The Role of Vitamin D in Inflammatory Bowel Disease: Mechanism to Management. Nutrients 2019; 11:E1019. [PMID: 31067701 PMCID: PMC6566188 DOI: 10.3390/nu11051019] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 02/07/2023] Open
Abstract
Vitamin D has been linked to human health benefits that extend far beyond its established actions on calcium homeostasis and bone metabolism. One of the most well studied facets of extra-skeletal vitamin D is its activity as an immuno-modulator, in particular its potent anti-inflammatory effects. As a consequence, vitamin D deficiency has been associated with inflammatory diseases including inflammatory bowel disease (IBD). Low serum levels of the major circulating form of vitamin D, 25-hydroxyvitamin D (25-OH-D) are significantly more prevalent in patients with IBD, particularly in the winter and spring months when UV-induced synthesis of vitamin D is lower. Dietary malabsorption of vitamin D may also contribute to low serum 25(OH)D in IBD. The benefits of supplementation with vitamin D for IBD patients are still unclear, and improved vitamin D status may help to prevent the onset of IBD as well as ameliorating disease severity. Beneficial effects of vitamin D in IBD are supported by pre-clinical studies, notably with mouse models, where the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25-(OH)2D) has been shown to regulate gastrointestinal microbiota function, and promote anti-inflammatory, tolerogenic immune responses. The current narrative review aims to summarise the different strands of data linking vitamin D and IBD, whilst also outlining the possible beneficial effects of vitamin D supplementation in managing IBD in humans.
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Affiliation(s)
- Jane Fletcher
- Nutrition Nurses, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2TH 1, UK.
| | - Sheldon C Cooper
- Gastroenterology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB 2, UK.
| | - Subrata Ghosh
- NIHR Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2TH, UK.
- Institute of Translational Medicine, University of Birmingham, Birmingham B15 2TH, UK.
| | - Martin Hewison
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham B15 2TT, UK.
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Fayet-Moore F, Brock KE, Wright J, Ridges L, Small P, Seibel MJ, Conigrave AD, Mason RS. Determinants of vitamin D status of healthy office workers in Sydney, Australia. J Steroid Biochem Mol Biol 2019; 189:127-134. [PMID: 30831196 DOI: 10.1016/j.jsbmb.2019.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/06/2019] [Accepted: 02/28/2019] [Indexed: 01/04/2023]
Abstract
Low vitamin D status, measured as 25-hydroxyvitamin D (25OHD), has been linked to increased risk of osteoporosis and other disorders. Due to the indoor nature of office work, there may be an increased risk of 25OHD deficiency in this group. The aim of the current study was to evaluate seasonal variations of 25OHD in a population of healthy office workers, and to assess the effect of sun exposure behaviour, skin pigmentation, physical activity (PA) and dietary intake on serum 25OHD concentrations. We assessed the vitamin D status of healthy office workers in Sydney, Australia, at the end of summer (n = 103) and then at the end of winter (n = 71). Data on anthropometry, PA, dietary intake, sun exposure and skin phototype were collected along with blood samples. Serum 25OHD was measured by radioimmunoassay. Mean 25OHD concentration in late summer was 68 ± 27 nmol/L (range: 24-160 nmol/L), and in late winter was 59 ± 32 nmol/L (range: 15-174 nmol/L). 25OHD deficiency (<50 nmol/L) was observed in 29% and 42% of participants at end-summer and end-winter, respectively. Almost 10% of individuals were extremely deficient (<25 nmol/L) at end-winter, particularly those with dark skin (phototypes 5 and 6). Independent predictors of end-summer 25OHD were skin phototype (p < 0.02), summer sun exposure (p < 0.001) and skin area exposed (p = 0.005). The strongest predictor of end-winter 25OHD was end-summer 25OHD concentration (p < 0.001). If this was excluded from the model, the independent predictors of end-winter 25OHD were skin phototype (p < 0.01), sun exposure in winter (p = 0.01) and oily fish consumption (p < 0.05). Sunscreen use was significantly associated with higher vitamin D status (p < 0.05) as those who used sunscreen were also more likely to spend time outdoors. We conclude that sun exposure is beneficial for vitamin D status even with sunscreen use. Vitamin D supplements should be targeted to individuals who are darker skinned or unable to obtain adequate sun exposure, particularly during the winter months.
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Affiliation(s)
- Flavia Fayet-Moore
- School of Molecular Bioscience, University of Sydney, NSW, 2006, Australia; Nutrition Research Australia, Sydney NSW, 2000, Australia
| | - Kaye E Brock
- Faculty of Health Sciences, University of Sydney, NSW, 2006, Australia; Physiology, School of Medical Sciences, University of Sydney, NSW, 2006, Australia
| | - Jutta Wright
- Nestlé Australia Ltd., Rhodes NSW, 2138, Australia
| | - Leisa Ridges
- Nestlé Australia Ltd., Rhodes NSW, 2138, Australia
| | | | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, University of Sydney, NSW, 2006, Australia
| | - Arthur D Conigrave
- School of Molecular Bioscience, University of Sydney, NSW, 2006, Australia; Bosch Institute for Medical Research, University of Sydney, NSW, 2006, Australia
| | - Rebecca S Mason
- Bosch Institute for Medical Research, University of Sydney, NSW, 2006, Australia; Physiology, School of Medical Sciences, University of Sydney, NSW, 2006, Australia.
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Baldermann C, Lorenz S. [UV radiation in Germany: influences of ozone depletion and climate change and measures to protect the population]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:639-645. [PMID: 30989260 DOI: 10.1007/s00103-019-02934-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Ultraviolet radiation (UV radiation) can lead to numerous skin and eye diseases, both immediately and later in life. The most serious consequence is skin cancer. The risk of skin cancer increases, among other things, with increasing UV irradiance and/or with increasing outdoor exposure times. Due to the fact that UV radiation is carcinogenic, protection of the population against harmful UV exposure is an important radiation protection and health objective.In Germany, ozone depletion and climate change can also influence the UV irradiance and outdoor exposure times to such an extent that the UV exposure of the population and thus the skin cancer risk can increase. This is why protection against harmful UV exposure is even more important. Since ozone depletion and climate change can further increase the UV exposure of humans, protection against high UV exposure is even more important. A country's adaptation strategies to the health consequences of ozone depletion and climate change should therefore also include strategies to reduce UV exposure.In this review, the health effects of UV radiation and the risk factors for UV-related skin cancer are first presented. The measurement of UV irradiance and exposure in Germany is explained. The effects of ozone depletion and climate change on UV exposure are then described and measures to protect the population are presented.
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Affiliation(s)
- Cornelia Baldermann
- Bundesamt für Strahlenschutz, Ingolstädter Landstraße 1, 85764, Neuherberg, Deutschland.
| | - Sebastian Lorenz
- Bundesamt für Strahlenschutz, Ingolstädter Landstraße 1, 85764, Neuherberg, Deutschland.
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O'Sullivan F, Raftery T, van Weele M, van Geffen J, McNamara D, O'Morain C, Mahmud N, Kelly D, Healy M, O'Sullivan M, Zgaga L. Sunshine is an Important Determinant of Vitamin D Status Even Among High-dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients. Photochem Photobiol 2019; 95:1060-1067. [PMID: 30649836 DOI: 10.1111/php.13086] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
Abstract
Sunshine is considered to be the most important source of vitamin D. Due to an increased risk of skin cancer, sun avoidance is advised, but this directly contributes to the high prevalence of vitamin D deficiency. The simple solution is to advise vitamin D supplementation. The aim of this study was to examine the absolute and relative contribution of sunshine and supplementation to vitamin status. This study was a secondary analysis of an RCT of 92 Crohn's disease patients in remission (49% female, median age = 44). Participants were randomized to 2000 IU day-1 of vitamin D3 or placebo for 1 year, with 25-hydroxyvitamin D (25(OH)D) being measured at baseline and every 4 months. Based on participant's place of residence, daily ambient UVB dose at wavelengths that can induce vitamin D synthesis (D-UVB) was obtained. Cumulative and weighted ambient D-UVB (cw-D-UVB) exposure prior to each blood draw was calculated for each participant. Linear regression analysis and multilevel modeling were used to examine the association between UVB exposure, supplementation and 25(OH)D concentration. There was considerable annual variation in D-UVB, cw-D-UVB and 25(OH)D. Both supplementation and cw-D-UVB were found to be strongly associated with 25(OH)D: in multilevel model, an increase of approximately 6 nmol L-1 for every 100 kJ m-2 in cw-D-UVB was found, among those receiving placebo and supplementation (P < 0.0001). Treatment was associated with increase of 23 nmol L-1 (P < 0.0001). Sunshine is an important determinant of 25(OH)D concentration, even in those who are taking high-dose vitamin D supplements and reside at a higher mid-latitude location.
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Affiliation(s)
- Fiona O'Sullivan
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Republic of Ireland
| | - Tara Raftery
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Michiel van Weele
- Royal Netherlands Meteorological Institute (KNMI), De Bilt, The Netherlands
| | - Jos van Geffen
- Royal Netherlands Meteorological Institute (KNMI), De Bilt, The Netherlands
| | - Deirdre McNamara
- Department of Gastroenterology, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Colm O'Morain
- Department of Gastroenterology, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Nasir Mahmud
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Dervla Kelly
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Republic of Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Trinity College Dublin, Dublin, Republic of Ireland
| | - Maria O'Sullivan
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Lina Zgaga
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Republic of Ireland
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Mishra NK, Mishra JK, Srivastava GN, Shah D, Rehman M, Latheef NA, Maurya A, Rajak BK. Should vitamin D be routinely checked for all chronic obstructive pulmonary disease patients? Lung India 2019; 36:492-498. [PMID: 31670296 PMCID: PMC6852226 DOI: 10.4103/lungindia.lungindia_141_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Aims and Objectives: This study aimed to compare the vitamin D levels between chronic obstructive pulmonary disease (COPD) patients and healthy controls and to describe the correlation between vitamin D levels and lung functions. Methods: Fifty COPD patients (cases) and 30 healthy volunteers (controls) were recruited and their serum vitamin D level was measured together with lung function (forced vital capacity and forced expiratory volume in 1 s [FEV1]) by spirometry. vitamin D was categorized as ≤20 nmol/l: deficient, 21–50 nmol/l: inadequate, and ≥51 nmol/l as sufficient. Results: In this case–control cross-sectional study, lower vitamin D levels were associated with lower lung function in both cases as well as controls, the effect being more pronounced in cases. Mean FEV1 at vitamin D ≤20 nmol/l (0.98 ± 0.40 vs. controls 1.93 ± 0.24 with P = 0.006), mean FEV1 at vitamin D 21–50 nmol/l (1.55 ± 0.54 vs. 2.20 ± 0.31 with P = 0.000), and mean FEV1 at vitamin D ≥51 nmol/l (2.06 ± 0.54 vs. 2.20 ± 0.31 with P = 0.002). Moreover, the severity of predicted postbronchodilator FEV1% was also much lower among COPD cohort versus healthy volunteers (mean FEV1%: cases 47.88 ± 14.22 vs. controls 58.76 ± 15.05 with P = 0.002). Conclusions: Importantly, lung function in both the groups was affected by decreased vitamin D level; decrease in FEV1 was more pronounced among COPD patients compared to controls showing more expiratory airflow limitation. Vitamin D levels are associated with changes in lung function in cases of COPD as well as healthy controls. Larger studies to confirm the association in Indian context are required and routine assessment of vitamin D may be undertaken to obviate the effects of low vitmain D level on lung function.
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Affiliation(s)
- Navin Kumar Mishra
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Jai Kishan Mishra
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - G N Srivastava
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - D Shah
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - M Rehman
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - N A Latheef
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - A Maurya
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Bhupendar K Rajak
- Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Lucas RM, Neale RE, Madronich S, McKenzie RL. Are current guidelines for sun protection optimal for health? Exploring the evidence. Photochem Photobiol Sci 2018; 17:1956-1963. [PMID: 29904757 DOI: 10.1039/c7pp00374a] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Exposure of the skin to ultraviolet (UV) radiation is the main risk factor for skin cancer, and a major source of vitamin D, in many regions of the world. Sun protection messages to minimize skin cancer risks but avoid vitamin D deficiency are challenging, partly because levels of UV radiation vary by location, season, time of day, and atmospheric conditions. The UV Index provides information on levels of UV radiation and is a cornerstone of sun protection guidelines. Current guidelines from the World Health Organization are that sun protection is required only when the UV Index is 3 or greater. This advice is pragmatic rather than evidence based. The UV Index is a continuous scale; more comprehensive sun protection is required as the UV Index increases. In addition, a wide range of UVA doses is possible with a UVI of 3, from which there may be health consequences, while full sun protection when the UVI is "moderate" (between 3 and 5) may limit vitamin D production. Finally, the duration of time spent in the sun is an essential component of a public health message, in addition to the intensity of ambient UV radiation as measured by the UV Index. Together these provide the dose of UV radiation that is relevant to both skin cancer genesis and vitamin D production. Further education is required to increase the understanding of the UV Index; messages framed using the UV Index need to incorporate the importance of duration of exposure and increasing sun protection with increasing dose of UV radiation.
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Affiliation(s)
- Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia.
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Zürcher SJ, Quadri A, Huber A, Thomas L, Close GL, Brunner S, Noack P, Gojanovic B, Kriemler S. Predictive Factors for Vitamin D Concentrations in Swiss Athletes: A Cross-sectional Study. Sports Med Int Open 2018; 2:E148-E156. [PMID: 30539132 PMCID: PMC6259462 DOI: 10.1055/a-0669-0791] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/13/2018] [Accepted: 07/18/2018] [Indexed: 12/15/2022] Open
Abstract
Vitamin D concentrations corresponding to 75 nmol/L 25(OH)D have been associated with maintained muscle function, growth and regeneration, optimal bone health and immunology in athletes. The objective of this study was to investigate the prevalence and predictors of insufficient 25(OH)D concentrations in athletes. Six hundred three Swiss athletes were assessed. 25(OH)D was analysed by high-performance liquid chromatography (HPLC). A standardized questionnaire was used to gather information about potential predictors for 25(OH)D concentrations; 50.5% showed insufficient 25(OH)D concentrations. Differences in predicted probability of insufficient 25(OH)D were found for those vitamin D supplemented (42%) versus not supplemented (52%), in those performing indoor (58%) versus outdoor sports (43%), and during the sun-deprived seasons of fall (49%), winter (70%) and spring (57%) compared with summer (17%). Higher BMI z-scores and age were associated with higher 25(OH)D concentrations. In conclusion, insufficient 25(OH)D concentrations were common among athletes especially at a younger age, among those not supplemented, in athletes who trained indoors, and during the sun-deprived seasons. Because the prevalence of insufficient 25(OH)D concentrations in this study was high, regular supplementation in athletes may be indicated, except perhaps during the summer season. Further research is needed to determine which 25(OH)D concentrations lead to optimal health and performance in athletes.
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Affiliation(s)
- Simeon Joel Zürcher
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Andrea Quadri
- Spital Bulach, Internal Medicine, Bulach, Switzerland
| | - Andreas Huber
- Kantonsspital Aarau, Labaratory Medicine, Aarau, Switzerland
| | - Lothar Thomas
- Klinikum der Johann-Wolfgang-Goethe Universität, Central laboratory for Clinical Chemistry and Hematology, Frankfurt am Main, Germany
| | - Graeme Leonard Close
- LJMU, Sports Science, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Saskia Brunner
- Kantonsspital Aarau, Labaratory Medicine, Aarau, Switzerland
| | - Patrik Noack
- Medbase Abtwil, Swiss Olympic Medical Center, Abtwil, Switzerland
| | - Boris Gojanovic
- Hopital de la Tour, Swiss Olympic Medical Center, Meyrin, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
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Hicks A, Healy E, Sandeman N, Feelisch M, Wilkinson T. A time for everything and everything in its time - exploring the mechanisms underlying seasonality of COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2018; 13:2739-2749. [PMID: 30233164 PMCID: PMC6130531 DOI: 10.2147/copd.s146015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Across Europe, COPD affects 23 million people leading to annual health care costs of ~€25.1 billion. This burden is particularly severe during winter months in association with the peak incidence of exacerbation events. Seasonal variation in the health status of patients with COPD places additional and often critical pressure on already strained health care resources. COPD exacerbations are characterized by worsening day-to-day symptoms of an individual and often triggered by respiratory infections, but the process by which this occurs in a seasonal fashion is likely to be multifactorial. In this review, we discuss recent population studies that highlight the impact of seasonality in COPD and review the proposed biological mechanisms underlying this. An appraisal of the role of the host susceptibility and response, environmental triggers and the biology of respiratory pathogens is detailed. The impact of each aspect is considered, and an integrated model of the context for the whole individual and society in general is explored.
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Affiliation(s)
- Alexander Hicks
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK, .,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton General Hospital, Southampton, UK,
| | - Eugene Healy
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK,
| | - Natasha Sandeman
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK,
| | - Martin Feelisch
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK,
| | - Tom Wilkinson
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK, .,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton General Hospital, Southampton, UK, .,Wessex Investigational Sciences Hub, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK
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Lucas RM, Rodney Harris RM. On the Nature of Evidence and 'Proving' Causality: Smoking and Lung Cancer vs. Sun Exposure, Vitamin D and Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081726. [PMID: 30103527 PMCID: PMC6121485 DOI: 10.3390/ijerph15081726] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 07/20/2018] [Accepted: 08/07/2018] [Indexed: 12/19/2022]
Abstract
If environmental exposures are shown to cause an adverse health outcome, reducing exposure should reduce the disease risk. Links between exposures and outcomes are typically based on 'associations' derived from observational studies, and causality may not be clear. Randomized controlled trials to 'prove' causality are often not feasible or ethical. Here the history of evidence that tobacco smoking causes lung cancer-from observational studies-is compared to that of low sun exposure and/or low vitamin D status as causal risk factors for the autoimmune disease, multiple sclerosis (MS). Evidence derives from in vitro and animal studies, as well as ecological, case-control and cohort studies, in order of increasing strength. For smoking and lung cancer, the associations are strong, consistent, and biologically plausible-the evidence is coherent or 'in harmony'. For low sun exposure/vitamin D as risk factors for MS, the evidence is weaker, with smaller effect sizes, but coherent across a range of sources of evidence, and biologically plausible. The association is less direct-smoking is directly toxic and carcinogenic to the lung, but sun exposure/vitamin D modulate the immune system, which in turn may reduce the risk of immune attack on self-proteins in the central nervous system. Opinion about whether there is sufficient evidence to conclude that low sun exposure/vitamin D increase the risk of multiple sclerosis, is divided. General public health advice to receive sufficient sun exposure to avoid vitamin D deficiency (<50 nmol/L) should also ensure any benefits for multiple sclerosis, but must be tempered against the risk of skin cancers.
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Affiliation(s)
- Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 2600, Australia.
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth 6009, Australia.
| | - Rachael M Rodney Harris
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 2600, Australia.
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Narbutt J, Philipsen PA, Lesiak A, Sandberg Liljendahl T, Segerbäck D, Heydenreich J, Chlebna-Sokol D, Olsen P, Harrison GI, Pearson A, Baczynska K, Rogowski-Tylman M, Wulf HC, Young AR. Children sustain high levels of skin DNA photodamage, with a modest increase of serum 25-hydroxyvitamin D 3 , after a summer holiday in Northern Europe. Br J Dermatol 2018; 179:940-950. [PMID: 29691848 DOI: 10.1111/bjd.16668] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Childhood solar ultraviolet radiation (UVR) exposure increases the risk of skin cancer in adulthood, which is associated with mutations caused by UVR-induced cyclobutane pyrimidine dimers (CPD). Solar UVR is also the main source of vitamin D, essential for healthy bone development in children. OBJECTIVES To assess the impact of a 12-day Baltic Sea (54° N) beach holiday on serum 25-hydroxyvitamin D3 [25(OH)D3 ] and CPD in 32 healthy Polish children (skin types I-IV). METHODS Blood and urine were collected before and after the holiday and assessed for 25(OH)D3 and excreted CPD, respectively, and personal UVR exposure was measured. Diaries were used to record sunbathing, sunburn and sunscreen use. Before- and after-holiday skin redness and pigmentation were measured by reflectance spectroscopy. RESULTS The average ± SD daily exposure UVR dose was 2·4 ± 1·5 standard erythema doses (SEDs), which is borderline erythemal. The mean concentration of 25(OH)D3 increased (× 1·24 ± 0·19) from 64·7 ± 13·3 to 79·3 ± 18·7 nmol L-1 (P < 0·001). Mean CPD increased 12·6 ± 10·0-fold from 26·9 ± 17·9 to 248·9 ± 113·4 fmol μmol-1 creatinine (P < 0·001). Increased 25(OH)D3 was accompanied by a very much greater increase in DNA damage associated with carcinogenic potential. Overall, skin type had no significant effects on behavioural, clinical or analytical outcomes, but skin types I/II had more CPD (unadjusted P = 0·0496) than skin types III/IV at the end of the holiday. CONCLUSIONS Careful consideration must be given to the health outcomes of childhood solar exposure, and a much better understanding of the risk-benefit relationships of such exposure is required. Rigorous photoprotection is necessary for children, even in Northern Europe.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-419, Łódź, Poland
| | - P A Philipsen
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - A Lesiak
- Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-419, Łódź, Poland
| | - T Sandberg Liljendahl
- Karolinska Institute, Department of Biosciences and Nutrition, S-141 83, Huddinge, Sweden
| | - D Segerbäck
- Karolinska Institute, Department of Biosciences and Nutrition, S-141 83, Huddinge, Sweden
| | - J Heydenreich
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - D Chlebna-Sokol
- Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Łódź, 90-419, Łódź, Poland
| | - P Olsen
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - G I Harrison
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
| | - A Pearson
- Public Health England, Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, OX11 ORQ, U.K
| | - K Baczynska
- Public Health England, Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, OX11 ORQ, U.K
| | | | - H C Wulf
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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Kift R, Rhodes LE, Farrar MD, Webb AR. Is Sunlight Exposure Enough to Avoid Wintertime Vitamin D Deficiency in United Kingdom Population Groups? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1624. [PMID: 30071636 PMCID: PMC6121420 DOI: 10.3390/ijerph15081624] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 11/17/2022]
Abstract
Solar ultraviolet radiation (UVR) is required for cutaneous vitamin D synthesis, and experimental studies have indicated the levels of sun exposure required to avoid a vitamin D deficient status. Our objectives are to examine the sun exposure behaviours of different United Kingdom sectors and to identify if their exposure is enough to maintain winter circulating 25-hydroxyvitamin D above deficiency (>25 nmol/L). Data are from a series of human studies involving >500 volunteers and performed using the same protocols in Greater Manchester, UK (53.5° N) in healthy white Caucasian adolescents and working-age adults (skin type I⁻IV), healthy South Asian working-age adults (skin type V), and adults with photodermatoses (skin conditions caused or aggravated by cutaneous sun exposure). Long-term monitoring of the spectral ambient UVR of the Manchester metropolitan area facilitates data interpretation. The healthy white populations are exposed to 3% ambient UVR, contrasting with ~1% in South Asians. South Asians and those with photodermatoses wear clothing exposing smaller skin surface area, and South Asians have the lowest oral vitamin D intake of all groups. Sun exposure levels prevent winter vitamin D deficiency in 95% of healthy white adults and 83% of adolescents, while 32% of the photodermatoses group and >90% of the healthy South Asians were deficient. The latter require increased oral vitamin D, whilst their sun exposure provides a tangible contribution and might convey other health benefits.
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Affiliation(s)
- Richard Kift
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
| | - Lesley E Rhodes
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
| | - Mark D Farrar
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
| | - Ann R Webb
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
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Khan SR, Whiteman DC, Kimlin MG, Janda M, Clarke MW, Lucas RM, Neale RE. Effect of solar ultraviolet radiation exposure on serum 25(OH)D concentration: a pilot randomised controlled trial. Photochem Photobiol Sci 2018; 17:570-577. [PMID: 29619453 DOI: 10.1039/c7pp00378a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sunlight generates vitamin D, but there are scant human data from randomised trials on which to base health policy advice about how much sun exposure is necessary to change 25(OH)D concentrations. The purpose of the study was to evaluate the feasibility of using solar ultraviolet (UV) radiation exposure to generate a change in 25(OH)D concentration in a randomised controlled trial (RCT). The intervention tested in this RCT was supervised exposure to one standard erythemal dose (SED; 100 J m-2) of solar UV radiation three days per week for three weeks with approximately 35% of the body surface area not covered by clothing. Thirty-six fair-skinned (skin type II and III) indoor workers from Brisbane, Australia were randomised into either the intervention group (n = 16) or the control group (n = 20); the latter did not receive any supervised sun exposure. We asked both groups to use sunscreen and to minimise time outdoors during the study period. We collected blood samples at baseline, once per week during the three week intervention period, and four weeks after the intervention finished. The cumulative UV radiation exposure over the intervention period measured using polysulphone badges was higher in the intervention group than in the control group (median 8 vs. 4 SEDs, p = 0.14). After three weeks, the mean serum 25(OH)D concentration increased from 60 to 65 nmol l-1 in the intervention group and from 55 to 57 nmol l-1 in the control group. After adjustment for baseline 25(OH)D, the mean change per week during the intervention phase was non-significantly higher in the intervention than in the control group (0.7 vs. 0.3; p = 0.35). This difference was not sustained during the follow-up period. Large field trials are needed to inform policy about how much natural sun exposure is required to raise 25(OH)D concentrations. This pilot identified key issues that need to be considered in the design of such a trial.
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Affiliation(s)
- Shanchita R Khan
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia and Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
| | - David C Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
| | - Michael G Kimlin
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Monika Janda
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia and Centre for Health Services Research, The University of Queensland, Woolloongabba, QLD, Australia
| | - Michael W Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, WA, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, ACT, Australia and Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
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Zhang B, Wang Y, Zhong Y, Liao S, Lu Z. Serum 25-hydroxyvitamin D deficiency predicts poor outcome among acute ischemic stroke patients without hypertension. Neurochem Int 2018; 118:91-95. [PMID: 29729873 DOI: 10.1016/j.neuint.2018.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/15/2018] [Accepted: 05/02/2018] [Indexed: 10/17/2022]
Abstract
25-Hydroxyvitamin D (25(OH)D) deficiency is a frequent condition in patients who suffer acute ischemic stroke (AIS), and several studies suggested that it may be associated with a poorer prognosis. Whether this association is affected by hypertension is unclear. Our aim was to investigate the association between 25(OH)D levels and both clinical severity and outcome after 3 months in AIS patients stratified by the history of hypertension. Consecutive first-ever AIS patients admitted to the Third Affiliated Hospital of Sun Yat-sen University, China were identified. Clinical information was collected. Serum 25(OH)D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome was evaluated after 3 months of onset using the modified Rankin Scale (mRS). Multivariate analyses were performed using logistic regression models. During the study period, 377 patients were diagnosed as AIS and were included in the analysis. 25(OH)D deficiency was not associated with the risk of NIHSS at admission and 3 months mRS both in total patients and the hypertension subgroup. Among AIS without hypertension, 25(OH)D deficiency subjects had a significantly higher of NIHSS at admission and 3 months mRS compared with those with 25(OH)D ≥ 50 nmol/L. The odds ratios (95% confidence interval) were 5.51(1.83-16.60) and 4.63(1.53-14.05) in the multivariable adjusted model (P for linear trend < 0.05). Serum lower 25(OH)D levels can be seen as an independent prognostic factor of functional outcome in AIS without hypertension. Additional studies about improving prognosis of AIS by vitamin D supplementation could be first applied to these patients.
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Affiliation(s)
- Bingjun Zhang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yi Zhong
- Department of Dermatology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Siyuan Liao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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40
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Shih BB, Farrar MD, Cooke MS, Osman J, Langton AK, Kift R, Webb AR, Berry JL, Watson REB, Vail A, de Gruijl FR, Rhodes LE. Fractional Sunburn Threshold UVR Doses Generate Equivalent Vitamin D and DNA Damage in Skin Types I-VI but with Epidermal DNA Damage Gradient Correlated to Skin Darkness. J Invest Dermatol 2018; 138:2244-2252. [PMID: 29730334 PMCID: PMC6158343 DOI: 10.1016/j.jid.2018.04.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/19/2018] [Accepted: 04/01/2018] [Indexed: 11/27/2022]
Abstract
Public health guidance recommends limiting sun exposure to sub-sunburn levels, but it is unknown whether these can gain vitamin D (for musculoskeletal health) while avoiding epidermal DNA damage (initiates skin cancer). Well-characterized healthy humans of all skin types (I–VI, lightest to darkest skin) were exposed to a low-dose series of solar simulated UVR of 20%–80% their individual sunburn threshold dose (minimal erythema dose). Significant UVR dose responses were seen for serum 25-hydroxyvitamin D and whole epidermal cyclobutane pyrimidine dimers (CPDs), with as little as 0.2 minimal erythema dose concurrently producing 25-hydroxyvitamin D and CPD. Fractional MEDs generated equivalent levels of whole epidermal CPD and 25-hydroxyvitamin D across all skin types. Crucially, we showed an epidermal gradient of CPD formation strongly correlated with skin darkness (r = 0.74, P < 0.0001), which reflected melanin content and showed increasing protection across the skin types, ranging from darkest skin, where high CPD levels occurred superficially, with none in the germinative basal layer, to lightest skin, where CPD levels were induced evenly across the epidermal depth. People with darker skin can be encouraged to use sub-sunburn UVR-exposure to enhance their vitamin D. In people with lighter skin, basal cell damage occurs concurrent with vitamin D synthesis at exquisitely low UVR levels, providing an explanation for their high skin cancer incidence; greater caution is required.
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Affiliation(s)
- Barbara B Shih
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Mark D Farrar
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Marcus S Cooke
- Department of Environmental & Occupational Health, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Joanne Osman
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Abigail K Langton
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Richard Kift
- School of Earth and Environmental Sciences, The University of Manchester, Manchester, UK
| | - Ann R Webb
- School of Earth and Environmental Sciences, The University of Manchester, Manchester, UK
| | - Jacqueline L Berry
- Specialist Assay Laboratory, The University of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rachel E B Watson
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Andy Vail
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Frank R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Lesley E Rhodes
- Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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41
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Webb AR, Kazantzidis A, Kift RC, Farrar MD, Wilkinson J, Rhodes LE. Meeting Vitamin D Requirements in White Caucasians at UK Latitudes: Providing a Choice. Nutrients 2018; 10:E497. [PMID: 29673142 PMCID: PMC5946282 DOI: 10.3390/nu10040497] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 12/25/2022] Open
Abstract
The body gains vitamin D through both oral intake (diet/supplementation) and synthesis in skin upon exposure to ultraviolet radiation (UVR). Sun exposure is the major source for most people even though sun exposure is complex and limited by climate and culture. We aimed to quantify the sun exposure required to meet vitamin D targets year-round and determine whether this can be safely achieved in a simply defined manner in the UK as an alternative to increasing vitamin D oral intake. Data from observation (sun exposure, diet, and vitamin D status) and UVR intervention studies performed with white Caucasian adults were combined with modeled all-weather UVR climatology. Daily vitamin D effective UVR doses (all-weather) were calculated across the UK based on ten-year climatology for pre-defined lunchtime exposure regimes. Calculations then determined the time necessary to spend outdoors for the body to gain sufficient vitamin D levels for year-round needs without being sunburnt under differing exposure scenarios. Results show that, in specified conditions, white Caucasians across the UK need nine minutes of daily sunlight at lunchtime from March to September for 25(OH)D levels to remain ≥25 nmol/L throughout the winter. This assumes forearms and lower legs are exposed June-August, while in the remaining, cooler months only hands and face need be exposed. Exposing only the hands and face throughout the summer does not meet requirements.
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Affiliation(s)
- Ann R Webb
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
| | - Andreas Kazantzidis
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
- Physics Department, University of Patras, 265 00 Patras, Greece.
| | - Richard C Kift
- School of Earth and Environmental Science, Faculty of Science and Engineering, University of Manchester, Manchester M13 9PL, UK.
| | - Mark D Farrar
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
| | - Jack Wilkinson
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester M13 9PL, UK.
| | - Lesley E Rhodes
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
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42
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Colour Counts: Sunlight and Skin Type as Drivers of Vitamin D Deficiency at UK Latitudes. Nutrients 2018; 10:nu10040457. [PMID: 29642423 PMCID: PMC5946242 DOI: 10.3390/nu10040457] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 03/29/2018] [Accepted: 04/03/2018] [Indexed: 12/31/2022] Open
Abstract
Sunlight exposure, with resulting cutaneous synthesis, is a major source of vitamin D for many, while dietary intake is low in modern diets. The constitutive pigment in skin determines skin type, observed as white, brown, or black skin. The melanin pigment absorbs ultraviolet radiation (UVR) and protects underlying skin from damage caused by UVR. It also reduces the UVR available for vitamin D synthesis in the skin. It has been shown that the white-skinned population of the UK are able to meet their vitamin D needs with short, daily lunchtime exposures to sunlight. We have followed the same methodology, based on a 10-year UK all-weather UVR climatology, observation (sun exposure, diet, vitamin D status), and UVR intervention studies with Fitzpatrick skin type V (brown) adults, to determine whether sunlight at UK latitudes could provide an adequate source of vitamin D for this section of the population. Results show that to meet vitamin D requirements, skin type V individuals in the UK need ~25 min daily sunlight at lunchtime, from March to September. This makes several assumptions, including that forearms and lower legs are exposed June-August; only exposing hands and face at this time is inadequate. For practical and cultural reasons, enhanced oral intake of vitamin D should be considered for this population.
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43
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Felton SJ, Kendall AC, Almaedani AFM, Urquhart P, Webb AR, Kift R, Vail A, Nicolaou A, Rhodes LE. Serum endocannabinoids and N-acyl ethanolamines and the influence of simulated solar UVR exposure in humans in vivo. Photochem Photobiol Sci 2018; 16:564-574. [PMID: 28138687 DOI: 10.1039/c6pp00337k] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Solar ultraviolet radiation (UVR) exposure of human skin has beneficial and harmful effects on health, including impact on immune function, inflammation and reportedly mood, but these are not fully elucidated. Since the endocannabinoid system is implicated in many activities including mood alteration, our objective was to (i) determine and quantify circulating levels of a wide range of endocannabinoid and N-acyl ethanolamine (NAE) species (ii) evaluate whether these are modulated by cutaneous UVR exposures, as attained through repeated low level summer sunlight exposure. Wearing goggles to prevent eye exposure, 16 healthy volunteers (23-59 y; 10 light skin, phototype II, and 6 dark skin, phototype V) received the same UVR exposures (1.3 SED, 95% UVA/5% UVB) thrice weekly for 6 weeks, whilst casually dressed to expose ∼35% skin surface area. Blood samples were taken at baseline, days 1, 3 and 5 of week one, then at weekly intervals, and analysed by LC-MS/MS. Eleven endocannabinoids and NAEs were detected and quantified at baseline, with N-palmitoyl ethanolamine the most abundant (30% of total). Levels did not vary according to phototype (p > 0.05), except for the NAE docosapentaenoyl ethanolamide, which was higher in phototype II than V (p = 0.0002). Level of the endocannabinoid, 2-AG, was elevated during the UVR exposure course (p < 0.05 vs. baseline for all subjects; p < 0.01 for each phototype group), with maximum levels reached by week 2-3, while NAE species did not significantly alter. These findings suggest differential involvement of the cutaneous endocannabinoid system in low dose solar UVR responses in humans.
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Affiliation(s)
- Sarah J Felton
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
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Serrano MA. Contribution of sun exposure to the vitamin D dose received by various groups of the Spanish population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 619-620:545-551. [PMID: 29156273 DOI: 10.1016/j.scitotenv.2017.11.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/03/2017] [Accepted: 11/03/2017] [Indexed: 06/07/2023]
Abstract
Although the harmful effects of excessive exposure to solar ultraviolet (UV) radiation are well known, the recommended dose of UV radiation is beneficial for the synthesis of vitamin D by the skin, in addition to being useful in the treatment of various illnesses and mental problems. Numerous studies have shown that vitamin D performs important functions in the human organism, such as absorbing calcium and phosphorous and contributing to the immune system, among others. Several studies have found that a high percentage of various groups of the Spanish population suffer from vitamin D deficiency, and since very few natural foods contain vitamin D, it was considered important to determine whether groups such as schoolchildren, outdoor workers and athletes, receive enough solar radiation to produce adequate levels of vitamin D in their daily activities. It was found that the amount of vitamin D (in IU) produced by personal effective solar UV doses could exceed the recommended dose of 1000IU/day in spring and summer, while the winter estimate (about 220IU/day) is only one quarter of the recommended dose. These results suggest that most people would not receive the recommended daily vitamin D dose in winter from exposure to solar UV radiation, the main source of vitamin D.
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Affiliation(s)
- Maria-Antonia Serrano
- Departamento de Física Aplicada, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
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Abstract
This article summarizes presentations of a symposium on bone health-related hot topics of the 2016 Basic Science Focus Forum. Taken together, these topics emphasize the critical importance of bone health in fracture management, the systemic factors that influence fracture healing, and the need to focus on issues other than simply the technical aspects of fracture repair.
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Bais F, Luca RM, Bornman JF, Williamson CE, Sulzberger B, Austin AT, Wilson SR, Andrady AL, Bernhard G, McKenzie RL, Aucamp PJ, Madronich S, Neale RE, Yazar S, Young AR, de Gruijl FR, Norval M, Takizawa Y, Barnes PW, Robson TM, Robinson SA, Ballaré CL, Flint SD, Neale PJ, Hylander S, Rose KC, Wängberg SÅ, Häder DP, Worrest RC, Zepp RG, Paul ND, Cory RM, Solomon KR, Longstreth J, Pandey KK, Redhwi HH, Torikai A, Heikkilä AM. Environmental effects of ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2017. Photochem Photobiol Sci 2018; 17:127-179. [PMID: 29404558 PMCID: PMC6155474 DOI: 10.1039/c7pp90043k] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022]
Abstract
The Environmental Effects Assessment Panel (EEAP) is one of three Panels of experts that inform the Parties to the Montreal Protocol. The EEAP focuses on the effects of UV radiation on human health, terrestrial and aquatic ecosystems, air quality, and materials, as well as on the interactive effects of UV radiation and global climate change. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously held. Because of the Montreal Protocol, there are now indications of the beginnings of a recovery of stratospheric ozone, although the time required to reach levels like those before the 1960s is still uncertain, particularly as the effects of stratospheric ozone on climate change and vice versa, are not yet fully understood. Some regions will likely receive enhanced levels of UV radiation, while other areas will likely experience a reduction in UV radiation as ozone- and climate-driven changes affect the amounts of UV radiation reaching the Earth's surface. Like the other Panels, the EEAP produces detailed Quadrennial Reports every four years; the most recent was published as a series of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). In the years in between, the EEAP produces less detailed and shorter Update Reports of recent and relevant scientific findings. The most recent of these was for 2016 (Photochem. Photobiol. Sci., 2017, 16, 107-145). The present 2017 Update Report assesses some of the highlights and new insights about the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. A full 2018 Quadrennial Assessment, will be made available in 2018/2019.
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Affiliation(s)
- F. Bais
- Aristotle Univ. of Thessaloniki, Laboratory of Atmospheric Physics, Thessaloniki, Greece
| | - R. M. Luca
- National Centre for Epidemiology and Population Health, Australian National Univ., Canberra, Australia
| | - J. F. Bornman
- Curtin Univ., Curtin Business School, Perth, Australia
| | | | - B. Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - A. T. Austin
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. R. Wilson
- School of Chemistry, Centre for Atmospheric Chemistry, Univ. of Wollongong, Wollongong, Australia
| | - A. L. Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State Univ., Raleigh, NC, USA
| | - G. Bernhard
- Biospherical Instruments Inc., San Diego, CA, USA
| | | | - P. J. Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - S. Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - R. E. Neale
- Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, Australia
| | - S. Yazar
- Univ. of Western Australia, Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, Australia
| | | | - F. R. de Gruijl
- Department of Dermatology, Leiden Univ. Medical Centre, Leiden, The Netherlands
| | - M. Norval
- Univ. of Edinburgh Medical School, UK
| | - Y. Takizawa
- Akita Univ. School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - P. W. Barnes
- Department of Biological Sciences and Environment Program, Loyola Univ., New Orleans, USA
| | - T. M. Robson
- Research Programme in Organismal and Evolutionary Biology, Viikki Plant Science Centre, Univ. of Helsinki, Finland
| | - S. A. Robinson
- Centre for Sustainable Ecosystem Solutions, School of Biological Sciences, Univ. of Wollongong, Wollongong, NSW 2522, Australia
| | - C. L. Ballaré
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. D. Flint
- Dept of Forest, Rangeland and Fire Sciences, Univ. of Idaho, Moscow, ID, USA
| | - P. J. Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - S. Hylander
- Centre for Ecology and Evolution in Microbial model Systems, Linnaeus Univ., Kalmar, Sweden
| | - K. C. Rose
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - S.-Å. Wängberg
- Dept Marine Sciences, Univ. of Gothenburg, Göteborg, Sweden
| | - D.-P. Häder
- Friedrich-Alexander Univ. Erlangen-Nürnberg, Dept of Biology, Möhrendorf, Germany
| | - R. C. Worrest
- CIESIN, Columbia Univ., New Hartford, Connecticut, USA
| | - R. G. Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - N. D. Paul
- Lanter Environment Centre, Lanter Univ., LA1 4YQ, UK
| | - R. M. Cory
- Earth and Environmental Sciences, Univ. of Michigan, Ann Arbor, MI, USA
| | - K. R. Solomon
- Centre for Toxicology, School of Environmental Sciences, Univ. of Guelph, Guelph, ON, Canada
| | - J. Longstreth
- The Institute for Global Risk Research, Bethesda, MD, USA
| | - K. K. Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - H. H. Redhwi
- Chemical Engineering Dept, King Fahd Univ. of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - A. Torikai
- Materials Life Society of Japan, Kayabacho Chuo-ku, Tokyo, Japan
| | - A. M. Heikkilä
- Finnish Meteorological Institute R&D/Climate Research, Helsinki, Finland
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Majeed H, Moore GWK. Impact of Multidecadal Climate Variability on United Kingdom Rickets Rates. Sci Rep 2017; 7:15764. [PMID: 29150647 PMCID: PMC5693953 DOI: 10.1038/s41598-017-16058-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/06/2017] [Indexed: 11/12/2022] Open
Abstract
Children who receive inadequate exposure to sunlight have reduced levels of vitamin D, resulting in rickets, a disease that is characterized by bone deformity, stunted growth, and long term pronounced disability. The United Kingdom rickets incidence rates declined from the early 1960’s to mid-1990’s, after which there was a dramatic increase. The reason for this change is not well understood. Here we show that an important low frequency mode of climate variability, the Atlantic Multidecadal Oscillation (AMO), with a period of ~60–80 years, has an impact on rickets incidence rates in the United Kingdom through changes in sea level pressure, cloud cover and sunshine duration. This research highlights the important role that multidecadal climate variability can play in human morbidity and suggests that future changes in the AMO may modulate rickets incidence rates throughout the United Kingdom.
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Affiliation(s)
- Haris Majeed
- Institute of Medical Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada. .,Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
| | - G W K Moore
- Department of Physics, University of Toronto, 60 St. George Street, Toronto, ON, M5S 1A7, Canada.,Department of Chemical & Physical Sciences, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada
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Scragg RKR, Stewart AW, McKenzie RL, Reeder AI, Liley JB, Allen MW. Sun exposure and 25-hydroxyvitamin D 3 levels in a community sample: Quantifying the association with electronic dosimeters. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:471-477. [PMID: 27599885 DOI: 10.1038/jes.2016.51] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/02/2015] [Indexed: 06/06/2023]
Abstract
There is uncertainty about the amount of sun exposure required to increase low blood 25-hydroxyvitamin D (25(OH)D3) levels, a possible disease risk factor. The study aimed to quantify the association between sun exposure and serum 25(OH)D3 concentrations in a multiethnic community sample (n=502) living in Auckland (37°S) and Dunedin (46°S), New Zealand, aged 18-85 years. They wore electronic ultraviolet dosimeters between March and November (autumn, winter and spring) for 8 weeks to record their sun exposure. This was converted to standard erythemal doses (SEDs), corrected for clothing to generate equivalent full-body exposures, SEDEFB. Blood samples were collected at the end of weeks 4 and 8 to measure 25(OH)D3. Median weekly SEDEFB was 0.33 during weeks 1-4 and 0.34 during weeks 5-8. Weekly exposures <0.5 SEDEFB during weeks 5-8 were associated with decreasing 25(OH)D3 concentrations at the end of week 8. There was a non-linear association between sun exposure and 25(OH)D3, with most of the increase in 25(OH)D3 being at exposures <2 SEDEFB per week. This finding suggests that vitamin D status is increased by regular small sun exposures (<2 SEDEFB per week), and that greater exposures result in only small additional increases in 25(OH)D3.
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Affiliation(s)
- Robert K R Scragg
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alistair W Stewart
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Richard L McKenzie
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - Anthony I Reeder
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - J Ben Liley
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - Martin W Allen
- Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
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Rutkowski D, Farrar MD, Osman JE, Webb AR, Rhodes LE. A qualitative study of the knowledge, behaviour and attitudes of patients with skin cancer regarding sunlight exposure and vitamin D. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:203-208. [PMID: 28449308 DOI: 10.1111/phpp.12311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Solar UVR is a major cause of skin cancer but also an important source of vitamin D (VitD), essential for musculoskeletal health. Conflicting public health messages may confuse patients with skin cancer prone to further skin cancer. OBJECTIVE To explore the knowledge, behaviour and attitudes of patients with skin cancer to sunlight exposure and VitD sources. METHODS Patients (n = 10) previously treated for multiple basal cell cancer in a hospital setting participated in focus group sessions with semi-structured discussions to explore: knowledge of VitD, sun-avoidance behaviour and attitude towards sunlight exposure messages. Thematic data analysis was performed using software programme MAXQDA11. RESULTS Pre-existing knowledge of VitD was low. Most patients practised sun avoidance and were not inclined to increase exposure. Patients did not perceive VitD deficiency as a substantial risk to their own health, or a need to take VitD supplements. They aimed to increase VitD status through dietary intake, but knowledge of food VitD content was lacking. CONCLUSIONS The patients with skin cancer, appropriate to their heightened skin cancer risk, appeared unlikely to increase their sun exposure to gain VitD. However, education is required regarding the generally low levels of VitD in foodstuffs, and the requirement for supplements/fortified foods if strict sun avoidance is employed.
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Affiliation(s)
- David Rutkowski
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Salford Royal Hospital, Manchester, UK
| | - Mark D Farrar
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Salford Royal Hospital, Manchester, UK
| | - Joanne E Osman
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Salford Royal Hospital, Manchester, UK
| | - Ann R Webb
- Faculty of Science and Engineering, School of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Lesley E Rhodes
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Salford Royal Hospital, Manchester, UK
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