November 23, 2016

Director's Letter 
Carole Baggerly 
Director, GrassrootsHealth 

Is Sun Exposure Unquestionably Deadly? 

Has the Pendulum Swung too far?

GrassrootsHealth has reported the benefits of the sun, beyond vitamin D. We held a seminar in Fall 2014, addressing sunshine, supplements and measurement for optimal health. We authored a paper based on the findings of that seminar, Sunlight and Vitamin D: Necessary for Public Health. We have resource web page to use as a resource to understand regular, non-burning sun exposure. 

Why would anyone still recommend sun avoidance? 

Because somewhere along the line, sun was associated with cancer. And it does increase skin cancer risk - primarily if you burn. 

We don't have to be an all or nothing civilization. 

Has the National Institute of Health (NIH) told us to quit sugar cold turkey? They have told us that added sugars contribute to obesity, type 2 diabetes and other chronic diseases, yet we are being told to allow sugar in moderation. 

NIH also gives very moderate exercise recommendations for weight loss with a goal of 30 minutes a day, every day. This is not an extreme recommendation. 

We are working hard to help shift the strict recommendation for sun avoidance towards a sun policy of trying to achieve regular, non-burning sun exposure for optimal health. 

Not avoidance. Avoidance simply isn't healthy. In fact, the latest research says it is almost as unhealthy as smoking. Let's get back to times when we were allowed to enjoy the sun for what it is - a valuable part of the environment - and one of many parts of the earth used to optimize our health.

Help spread the word!

Carole Baggerly
Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research into Practice  NOW!
New Research Calls for a Change to National Health Policy

Replace sun avoidance with routine, non-burning sun exposure.
The Risks and Benefits of Sun Exposure 2016
David G. Hoel et al.
October 2016

This paper references 141studies, concluding that Americans are not getting enough sun exposure and that public health advice needs to be overhauled to embrace routine, moderate sun exposure rather than strict avoidance. 
This paper reports 70% prevalence of vitamin D insufficiency in the United States, marked by a vitamin D serum level less than 30 ng/ml (75 nmol/L). Recent estimates are that about 13% of all U.S. deaths (330,000 deaths per year) could be attributable to vitamin D insufficiency, similar in magnitude to deaths attributable to smoking (20%, 450,000 deaths).  

Studies show risk of melanoma being reduced with non-burning sun exposure and outdoor occupations. Melanoma incidence has increased 23-fold since 1935, with the move indoors and the edict on sun avoidance. There is also no consistent evidence that chemical sunscreens reduce the risk of melanoma. 

Authors call for medical guidelines to be overhauled and the general public retrained - routine, moderate sun exposure does not cause melanoma and has a positive effect on overall health.

How do you get adequate sun exposure? 

It is important to know your skin type and the strength of the sun in your location (is it high noon during summer or 4pm in the winter?). Use this sunshine calendar to see if the sun is strong enough to produce vitamin D, and ensure you are out between 11am and 3pm or when your shadow is shorter than your height. If you expose enough skin, for long enough, that you are *slightly* pink the next day then you will have achieved a minimal erythema dose, or the equivalent of about 20,000 IU vitamin D. You can use apps such as dminder to approximate this time for you until you are familiar with how your skin reacts to the sun. Use this GrassrootsHealth resource page to learn more.  
For medical practitioners interested in learning more about sunlight and vitamin D, three different 1 hour CMEs on sunshine are available free of charge from GrassrootsHealth.
Are you getting enough sun?

Even with sensible sun exposure, it is important to test vitamin D levels twice a year - preferably in March and September. The GrassrootsHealth panel of 48 international scientists agree that vitamin D levels in the range of 40-60 ng/ml (100-150 nmol/L) are good for bone health and overall disease prevention. 

This paper summarized many conditions for which risk can be reduced by vitamin D levels within 40-60 ng/ml including cancer, multiple sclerosis, metabolic syndrome, type 1 and 2 diabetes, Alzheimer's, rheumatoid arthritis, obesity, psoriasis and more. 

Read the paper and decide for yourself - what do you want your vitamin D blood level to be?

About the Authors
The authors of this paper come from four distinct backgrounds - but all come to the same conclusion. 

Dr. David Hoel, recognized as one of the world's leading experts on the health effects of radiation, served on the World Health Organization's International Agency for Research on Cancer (IARC) panel of experts which in 2009 classified ultraviolet radiation (UVR) as a carcinogen. Dr. Hoel has since called this classification widely misunderstood, noting that UVR is associated with skin cancer only if it results in sunburn or if it is in very large lifetime amounts.



Dr. Marianne Berwick, Distinguished Professor of Dermatology and Internal Medicine at the University of New Mexico, is widely regarded as one of the world's leading experts on melanoma epidemiology.



Dr. Frank de Gruijl, Associate Professor of Dermatology at Leiden University in the Netherlands, is considered one of the world's leading pigment cell/melanogenesis researchers.



Dr. Michael Holick


Dr. Michael Holick, Professor of Medicine, Physiology and Biophysics at Boston University, is perhaps the world's most recognized vitamin D researcher. Dr. Holick was on the research team that first discovered the active form of vitamin D in 1969.

Routine, Moderate Sun Exposure


It is important to get vitamin D daily as explained by Dr. Bruce Hollis. Daily vitamin D is protective for your immune system. Get sun or supplement everyday for optimal health.


A minimal erythema dose (MED) is equivalent to about 20,000 IU vitamin D. When in the sun, this is the amount of time it would take for your skin to be *slightly* pink 24 hours later. 

A MED is the maximum you would need daily. 

Your skin type and acclimation to the sun are the key variables that tell you how long you should stay in the sun. This is different for everyone!

Sun Exposure...

Check the Sunshine Calendar or dminder app to make sure there is adequate UVB in the sunlight. This depends on location, time of year, and time of day. 

You must be out when your shadow is shorter than you are tall, typically between 11am - 3pm in the summer.
Editor's Letter
Susan Siljander
Marketing Director, GrassrootsHealth

Thanksgiving - a time to give thanks for all the wonders that we have.  This year, please join us in being thankful for the sun.  For the ongoing benefits of the natural things in life. We, GrassrootsHealth, are most appreciative of the sun, of the health benefits, and, for the researchers who are bringing the information to our attention so we can be informed about our actions!  And, for all the people like you who are helping the world be a healthier place. 
Wouldn't it be great if the government read this research and made a change of policy before next spring?
Our options are still supplements, indoor tanning and some fortified foods for getting adequate vitamin D, even in the winter.   
Take your time reading this research and answer this question: 
"Is it better to get routine, non-burning sun exposure - or to stay out of the sun?"
If being well-versed will help others - then study up today!
Have a great week,
Susan Siljander
Marketing Director, GrassrootsHealth
A Public Health Promotion & Research Organization
Moving Research Into Practice NOW!
Order Now
Order Your Home Vitamin D Test TODAY!
Your participation in this project helps provide answers to your D questions and funds all the GrassrootsHealth research and promotion.

We've Won an Award!

The American College of Nutrition has awarded us with the Humanitarian Award in recognition of our dedication to moving public health messages regarding vitamin D from science into practice.

Carole accepting the award from Michael Stroka, Executive Director, ACN

The Risks and Benefits of Sun Exposure 2016

David G. Hoel
Medical University of South Carolina
Marianne Berwick
University of New Mexico
Frank R. Gurijl
University Medical Center, Leiden, The Netherlands
Michael F. Holick
Boston Medical Center
October 2016

The Importance of Vitamin D

Movie star and icon, Gwyneth Paltrow, was diagnosed with vitamin D deficiency in 2010, which she attributes to sun avoidance. She now spreads the word about the importance of routine, moderate sun exposure and vitamin D sufficiency.

"Like all living things, we need sunshine, and it feels good for a reason."

- Dr. Frank Lipman

Research on Sunlight & Vitamin D

Sunlight and Vitamin D: Necessary for Public Health
GrassrootsHealth paper on the findings from our seminar,  Vitamin D for Public Health: Integrating Sunshine, Supplements and Measurement for Optimal Health
In conjunction with the UC San Diego School of Medicine
Fall 2014

Regular sun exposure benefits health
H. V. Van der Rhee et al.
Department of Dermatology
Haga Teaching Hospital
The Netherlands
Medical Hypotheses
October 2016

Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort.
PG Lindqvist et al.
Karolinska University Hospital, Sweden
J. Intern Medicine
October 2016

Sunlight has cardiovascular benefits independently of vitamin D 
Richard Weller
University of Edinburgh, UK
Blood Purification
March 2016
Read Paper
Read Newsletter Review

GrassrootsHealth Newsletters on
Sun Exposure

Harness the Power of the Sun for Health
Introduction to routine, moderate sun exposure
May 5, 2016

Harness the Sun: Skin Type and Overall Health
Explanation of skin type. How to acclimate to the sun, how much time in the sun does your skin need?
May 11, 2016
Read Newsletter

Harness the Sun: UV Strength
Explanation of when to be in the sun - when will you produce vitamin D?
May 18, 2016
Read Newsletter

Harness the Sun: Duration
How long should you be in the sun?
May 25, 2016 
Read Newsletter

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