Solar UV Doses of Young Americans and Vitamin D3 Production

Background: Sunlight contains ultraviolet B (UVB) radiation (290–315 nm) that affects human health in both detrimental (skin cancers) and beneficial (vitamin D3) ways. Serum 25-hydroxyvitamin D concentrations from young Americans (≤ 19 years) show that many have deficient (< 50 nmol/L, 20 ng/mL) or insufficient (< 75 nmol/L, 30 ng/mL) vitamin D levels, indicating that they are not getting enough sun exposure. Those findings are in conflict with some calculated, published values that suggest people make “ample” vitamin D3 (~ 1,000 IU/day) from their “casual,” or everyday, outdoor exposures even if they diligently use sunscreens with sun protection factor (SPF) 15. Objective: We estimated how much vitamin D3 young Americans (n = ~ 2,000) produce from their everyday outdoor ultraviolet doses in the North (45°N) and South (35°N) each season of the year with and without vacationing. Methods: For these vitamin D3 calculations, we used geometric conversion factors that change planar to whole-body doses, which previous calculations did not incorporate. Results: Our estimates suggest that American children may not be getting adequate outdoor UVB exposures to satisfy their vitamin D3 needs all year, except some Caucasians during the summer if they do not diligently wear sunscreens except during beach vacations. Conclusion: These estimates suggest that most American children may not be going outside enough to meet their minimal (~ 600 IU/day) or optimal (≥ 1,200 IU/day) vitamin D requirements.

[1]  P M Stewart,et al.  Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. , 2001, The Journal of clinical endocrinology and metabolism.

[2]  L. Ben-Porat,et al.  Sun exposure and mortality from melanoma. , 2005, Journal of the National Cancer Institute.

[3]  M. Holick,et al.  Regular use of sunscreen on vitamin D levels. , 1995, Archives of dermatology.

[4]  M. Holick,et al.  Vitamin D intake in the United States. , 2003, Journal of the American Dietetic Association.

[5]  J. Janosky,et al.  Vitamin D Insufficiency in Preadolescent African-American Children , 2005, Clinical pediatrics.

[6]  B. Cromer,et al.  Vitamin D deficiency in adolescent females. , 2005, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[7]  T. Dwyer,et al.  A Case–Sibling Assessment of the Association Between Skin Pigmentation and Other Vitamin D‐related Factors and Type 1 Diabetes Mellitus , 2009, Photochemistry and photobiology.

[8]  W. Willett,et al.  Vitamin D intake and incidence of multiple sclerosis , 2004, Neurology.

[9]  J. Eisman,et al.  Suppression of in vivo growth of human cancer solid tumor xenografts by 1,25-dihydroxyvitamin D3. , 1987, Cancer research.

[10]  M. Holick,et al.  Evolutionary importance for the membrane enhancement of the production of vitamin D3 in the skin of poikilothermic animals. , 1995, Proceedings of the National Academy of Sciences of the United States of America.

[11]  H. Minne,et al.  Vitamin D and Muscle Function , 2002, Osteoporosis International.

[12]  N. Bundred,et al.  1α,25-Dihydroxyvitamin D3 Inhibits Angiogenesis In Vitro and In Vivo , 2000 .

[13]  J. Bouwes Bavinck,et al.  The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer. , 2003, The Journal of investigative dermatology.

[14]  M. Holick,et al.  Adolescent girls in Maine are at risk for vitamin D insufficiency. , 2005, Journal of the American Dietetic Association.

[15]  D. Godar,et al.  Solar UV Geometric Conversion Factors: Horizontal Plane to Cylinder Model † , 2010, Photochemistry and photobiology.

[16]  K. L. Yielding,et al.  The regulation of enzyme structure and function by steroid hormones , 1962 .

[17]  J. Slusser,et al.  Vitamin D intake needed to maintain target serum 25-hydroxyvitamin D concentrations in participants with low sun exposure and dark skin pigmentation is substantially higher than current recommendations. , 2010, The Journal of nutrition.

[18]  D. Godar UV Doses of American Children and Adolescents¶ , 2001, Photochemistry and photobiology.

[19]  C. Camargo,et al.  Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D? , 2009, Pediatrics.

[20]  Elina Hyppönen,et al.  Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study , 2001, The Lancet.

[21]  C. Garland,et al.  SERUM 25-HYDROXYVITAMIN D AND COLON CANCER: EIGHT-YEAR PROSPECTIVE STUDY , 1989, The Lancet.

[22]  T. Fitzpatrick The validity and practicality of sun-reactive skin types I through VI. , 1988, Archives of dermatology.

[23]  D. Godar UV Doses Worldwide† , 2005 .

[24]  D. Godar,et al.  Increased UVA exposures and decreased cutaneous Vitamin D(3) levels may be responsible for the increasing incidence of melanoma. , 2009, Medical hypotheses.

[25]  M. Holick,et al.  Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D. A preliminary study. , 1988, Archives of dermatology.

[26]  A. Akobeng,et al.  Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis , 2008, Archives of Disease in Childhood.

[27]  M. Holick,et al.  Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. , 2003, The American journal of clinical nutrition.

[28]  P. Boyle,et al.  Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. , 2005, European journal of cancer.

[29]  Carlos A Camargo,et al.  Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. , 2009, Archives of internal medicine.

[30]  A. Howie,et al.  Extrarenal Expression of 25-Hydroxyvitamin D3-1α-Hydroxylase1 , 2001 .

[31]  Tim K. Lee,et al.  Sunlight, tanning booths, and vitamin D. , 2005, Journal of the American Academy of Dermatology.

[32]  B. Hollis,et al.  Racial pigmentation and the cutaneous synthesis of vitamin D. , 1991, Archives of dermatology.

[33]  R. Anderson,et al.  Photosynthesis of previtamin D3 in human skin and the physiologic consequences. , 1980, Science.

[34]  M Dosemeci,et al.  Sunlight and mortality from breast, ovarian, colon, prostate, and non-melanoma skin cancer: a composite death certificate based case-control study , 2002, Occupational and environmental medicine.

[35]  E. Meese,et al.  In vitro comparison of the vitamin D endocrine system in 1,25(OH)2D3-responsive and –Resistant melanoma cells , 2007, Cancer biology & therapy.

[36]  M. Holick,et al.  Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. , 2008, The Journal of clinical endocrinology and metabolism.

[37]  Christine L. Taylor,et al.  Dietary Reference Intakes for Calcium and Vitamin D , 2016, Pediatric Clinical Practice Guidelines & Policies.

[38]  S. Harris Vitamin D in type 1 diabetes prevention. , 2005, The Journal of nutrition.

[39]  S. Mohr,et al.  Do sunscreens increase risk of melanoma in populations residing at higher latitudes? , 2007, Annals of epidemiology.

[40]  M. Holick,et al.  Vitamin D deficiency: a worldwide problem with health consequences. , 2008, The American journal of clinical nutrition.

[41]  D H Sliney,et al.  UV Doses of Americans¶ , 2001, Photochemistry and photobiology.

[42]  S. Arya Vitamin D supplementation. , 2012, Australian family physician.

[43]  R. Anderson,et al.  Spectral character of sunlight modulates photosynthesis of previtamin D3 and its photoisomers in human skin. , 1982, Science.

[44]  Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3. , 1992 .

[45]  D. Godar UV Doses Worldwide ¶† , 2005, Photochemistry and photobiology.

[46]  H. Glerup,et al.  Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited , 2000, Journal of internal medicine.

[47]  W. Parnell,et al.  Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5-14 y. , 2005, The Journal of nutrition.

[48]  D. Viswanath,et al.  Dietary Reference Intakes for Calcium and Vitamin D , 2012, Pediatrics.

[49]  K. Yudoh,et al.  1alpha,25-dihydroxyvitamin D3 inhibits in vitro invasiveness through the extracellular matrix and in vivo pulmonary metastasis of B16 mouse melanoma. , 1999, The Journal of laboratory and clinical medicine.

[50]  B. Dawson-Hughes,et al.  Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. , 2002, Bone.

[51]  Mitzi Moulds,et al.  The Skin Cancer Foundation. , 2002, Journal of drugs in dermatology : JDD.

[52]  M. Holick,et al.  Aging decreases the capacity of human skin to produce vitamin D3. , 1985, The Journal of clinical investigation.

[53]  R. Schwartz,et al.  Nutritional rickets in African American breast-fed infants. , 2000, The Journal of pediatrics.

[54]  M. Holick,et al.  Solar UV Doses of Adult Americans and Vitamin D3 Production , 2011, Dermato-endocrinology.

[55]  T. Oppé,et al.  Vitamin D deficiency. , 1979, British medical journal.

[56]  S. Emans,et al.  Prevalence of vitamin D deficiency among healthy adolescents. , 2004, Archives of pediatrics & adolescent medicine.

[57]  J. Adams,et al.  INCREASED SKIN PIGMENT REDUCES THE CAPACITY OF SKIN TO SYNTHESISE VITAMIN D3 , 1982, The Lancet.

[58]  Z. Mahfoud,et al.  Short- and long-term safety of weekly high-dose vitamin D3 supplementation in school children. , 2008, The Journal of clinical endocrinology and metabolism.

[59]  M. Holick Vitamin D: evolutionary, physiological and health perspectives. , 2011, Current drug targets.

[60]  M. Holick,et al.  Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3. , 1993, The Journal of clinical endocrinology and metabolism.

[61]  M. Holick,et al.  Low 25-Hydroxyvitamin D Levels in Adolescents: Race, Season, Adiposity, Physical Activity, and Fitness , 2010, Pediatrics.

[62]  Elizabeth A Yetley,et al.  Serum 25-hydroxyvitamin D status of the US population: 1988-1994 compared with 2000-2004. , 2008, The American journal of clinical nutrition.

[63]  R. Heaney,et al.  Why the IOM recommendations for vitamin D are deficient , 2011, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[64]  Steven J. Mackin,et al.  Action Spectrum Conversion Factors that Change Erythemally Weighted to Previtamin D3‐weighted UV Doses † , 2008, Photochemistry and photobiology.

[65]  Jeannette M. Perez-Rossello,et al.  Prevalence of vitamin D deficiency among healthy infants and toddlers. , 2008, Archives of pediatrics & adolescent medicine.

[66]  M. Holick Vitamin D deficiency. , 2007, The New England journal of medicine.