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trash canIf you’ve been reading this blog for a while, you’ll know I’m not a big fan of supplements. I’ve always believed that it’s preferable to get the nutrients we need from whole foods, as they’re found in nature, rather than from isolated, synthetic sources (i.e. supplements).

Unfortunately, modern medicine is obsessed with isolated, synthetic nutrients and has convinced itself that they have the same beneficial properties as nutrients found in whole foods.

A gigantic dietary supplement industry has arisen from this misguided belief. A 2006 National Institute of Health (NIH) conference (PDF) revealed that 20-30% of Americans use a multivitamin daily, forking over $23 billion a year to supplement manufacturers for the privilege. Many more Americans effectively take a multivitamin by eating fortified grain products, like Shredded Wheat cereal and Wonder Bread.

Most supplements don’t work

With these statistics in mind, you might be surprised (or even shocked) to learn that clinical trials have shown that most of these supplements not only don’t work as intended, they actually make things worse. The NIH conference examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials.

First the positive results:

  • A combo of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
  • There was some evidence that selenium reduces risk of certain cancers.
  • Vitamin E may decrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
  • Vitamin D showed some cardiovascular benefit.

Um, not too impressive considering the near universal faith considering how many people are popping these pills on a daily basis.

Now for the negative results:

  • Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
  • There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
  • High-dose vitamin E supplementation increased the risk of death from all causes.

Then there’s the now infamous JAMA meta-analysis on antioxidants. They looked at 68 trials with over 230,000 participants. Here’s what they found:

Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.


(Re)-introducing the concept of food synergy

It’s crazy to me that so many health care practitioners – both conventional and alternative – tell their patients to take multivitamins and antioxidants when their is little support for that position in the medical literature.

That’s why I was so happy to come across a study in the American Journal of Clinical Nutrition addressing this issue. It’s called “Food synergy: an operational concept for understanding nutrition” and it’s one of the most encouraging pieces of research I’ve seen in a while. I’m relieved to learn that their are researchers working in the nutrition field that don’t buy into the synthetic nutrient hype, and understand the importance of whole food.

Since it’s such a great article, I’m going to quote from it and riff off of a few passages.

A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference Intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health. This review argues for the primacy of food over supplements in meeting nutritional requirements of the population.

This is the crux of the authors’ argument, which I’m 100% behind. They congratulate science on the discovery of fundamental nutrients such as vitamin C, and clarifying their role in health and disease. The realization that scurvy is caused by vitamin C deficiency has saved a lot of lives. But, the approach to nutrition that is fundamentally guided by nutrients has a dark side:

The aspect of science that reduces to fundamental principles, however, can lead to oversimplification and ultimately stifle understanding and progress.

Translation: reductionistic thinking can get us in trouble if we’re not careful.

The concept of food synergy is based on the proposition that the interrelations between constituents in foods are significant. This significance is dependent on the balance between constituents within the food, how well the constituents survive digestion, and the extent to which they appear biologically active at the cellular level.

Yes! It makes me so happy to see this in a major, peer-reviewed journal. The authors go on to define several aspects of food synergy:

  • A buffer effect, i.e. the effect of a large intake of a particular nutrient may vary depending on if it is taken in concentrated form or as part of a whole food.
  • Nutrients can affect each other’s absorption, such as copper-inc and magnanese-iron. These interdependent nutrients tend to appear together in foods, but not necessarily in isolated supplements.
  • It matters whether the nutrients have been produced by technologic or biological processes. Trans fat produced in ruminant animals (such as conjugated linoleic acids in dairy products) are beneficial to health, whereas trans fats produced in the processing of industrial seed oils are highly toxic.

Then they provide evidence that whole foods are more effective than supplements in meeting nutrient needs:

  • Tomato consumption has a greater effect on human prostrate tissue than an equivalent amount of lycopene.
  • Whole pomegranates and broccoli had greater antiproliferative and in vitro chemical effects than did some of their individual constituents.
  • Free radicals were reduced by consumption of brassica vegetables, independent of micronutrient mix.

Note: In the supplement world, the idea is that “a nutrient is a nutrient, a molecule is a molecule” regardless of what source it comes from. These folks claim that it doesn’t matter whether a nutrient comes from a whole food complex or a laboratory. Did you know that most vitamin B1 supplements are made from derivatives of coal tar? That ascorbic acid (vitamin C) is made by reacting high-fructose corn syrup with sulfuric acid? That many iron supplements are made from rusty nails? I don’t know about you, but I’d rather eat some meat and vegetables to get those nutrients.

Should we all take a daily multivitamin as “insurance” against a nutrient deficiency? Here’s how the authors respond to that question:

In our view, the better “insurance” would be to eat food with a broad coverage of nutrients and take no supplements at all, unless they are deemed necessary to fix a specific medical problem.

Hallelujah! I’d like to buy these researchers a beer.

Okay, not all supplements are bad

Now that I’ve made my point (or at least I hope I have), I need to add a qualifier or two.

There are a few supplements that I do recommend – in certain situations.

Vitamin D may be necessary for those who live in northern latitudes, especially during the winter months. Low vitamin D is associated with so many diseases that it’s probably a good idea to keep levels up. The first choice would be to do this by eating seafood, but that’s not always practical or desirable for a number of reasons. Cod liver oil is my second choice for maintaining D levels. But note that this is more of a whole food than it is a supplement. In some cases when people are very deficient, i.e. under 25 ng/ml, I may suggest adding a D3 supplement in addition to the cod liver oil.

Fish oil has been shown to provide great benefit for cardiovascular disease and other inflammatory conditions. My preference here is that people reduce their intake of omega-6 fats and simply eat cold-water, oily fish a couple times a week to meet their omega-3 needs. Unfortunately, people have been scared away (unnecessarily, which is a topic for a future post) from eating fish, or perhaps it’s difficult for them to find or afford wild fish on a regular basis. In this situation I may recommend a fish oil. My favorites are whole-food based oils such as Green Pasture’s Fermented Cod Liver Oil and Vital Choice Wild Salmon Oil.

Magnesium is one of the most crucial nutrients in our diet, and many people are deficient. It protects against nearly every modern disease, and can be therapeutic for difficult to treat inflammatory conditions such as fibromyalgia, irritable bowel syndrome, arthritis, etc. Seaweed and various nuts and seeds are high in magnesium, but occasionally supplementation may be useful. I suggest using a highly-absorbable form such as magnesium glycinate.

Vitamin K2 has recently been revealed as an important nutrient in protecting against heart disease. It does this by telling the body to put calcium in the bones and teeth where it belongs, and not in the arteries and soft tissue. K2 is found in the fat of grass-fed animals and certain fermented foods like natto and hard cheese. I recognize that not everyone eats these foods for various reasons, so if someone has heart disease or is at risk for it I may recommend either Fermented Cod Liver / Butter Oil from Green Pastures, and/or an MK-4 supplement. For more on vitamin K, see my post Vitamin K2: The Missing Nutrient.

But even in these cases, I only suggest that people take these if they need them, and if they can’t (or won’t) get the nutrients from foods.

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Today I will summarize the approach to preventing heart disease I’ve been writing about for the past couple of years. If you’re new to the blog and haven’t seen those articles, there’s an index of them here.

After today’s post I’m going to move on to some new topics. There are so many mainstream health myths out there it’s hard to cover them all! In the next few months we’re going to shift our attention to the digestive system. We’ll talk about the real cause of acid reflux (GERD), the high rates of gluten intolerance in the US and its consequences when undiagnosed and untreated, the hidden problem underlying Irritable Bowel Syndrome (IBS), and more.

As you know if you’ve been following this blog, heart disease is primarily caused by inflammation and oxidative damage. This is now well-accepted amongst medical researchers, though many physicians and medical professionals are still unfortunately focused on cholesterol.

It follows, then, that to prevent heart disease our primary goal should be to reduce inflammation and oxidative damage. How do we do that? Follow these nine steps:

1. Don’t eat industrial vegetable oils.

Industrial vegetable oils like corn, soy, cottonseed, sunflower, and safflower are high in omega-6 polyunsaturated fatty acids (n-6 PUFA). Countless studies show that n-6 PUFA promote both oxidative damage and inflammation, and significantly raise the risk of heart disease. Industrial vegetable oils are found in nearly all processed and packaged foods, and in most foods cooked in restaurants. My rule here is simple: if it comes in a package, don’t eat it. And make eating out a special occasion, not a daily ritual.

For more on the danger of vegetable oils, see How to Increase Your Risk of Heart Disease.

2. Eat traditional, saturated fats.

For more than five decades we’ve been brainwashed to believe that saturated fat causes heart disease. It’s such a deeply ingrained belief that few people even question it. It’s just part of our culture now.

But several recent studies have confirmed what many researchers have known all along: that eating saturated fat doesn’t cause heart disease. Saturated fats are protected against oxidative damage – one of the primary causes of heart disease. What’s more, saturated fats have numerous health benefits.

For more on this, see New Study Puts Final Nail in the “Saturated Fat Causes Heart Disease” Coffin, and The Most Important Thing You Probably Don’t Know About Cholesterol, and Have Some Butter with your Veggies!

3. Eat less sugar (including simple carbs).

Most people know that eating sugar wreaks havoc on their health. But what many don’t understand is that all carbohydrates eventually break down into sugar in the body. Simple carbohydrates such as rice, potatoes, pasta and bread can cause spikes in blood sugar and insulin, both of which contribute to oxidative damage and inflammation – and consequently increase the risk of heart disease.

For decades the American Heart Association and American Diabetes Association have been promoting a low-fat, high-carb diet. Research has shown that this diet actually increases the risk of both heart disease and diabetes! If you want to steer clear of these conditions, a high-fat, low-carb diet is your best choice.

The average American gets 57% of his/her calories from highly refined cereal grains and polyunsaturated (PUFA) oils. The #3 source of calories, behind grains and PUFA, is sugar and high-fructose corn syrup. Refined grains, polyunsaturated oils and sugar are all major contributors to both inflammation and oxidative damage. Clearly the low-fat, high-carb diet has been a failure.

For more on this, see The Most Important Thing You Probably Don’t Know About Cholesterol and, Low-Carb Diet Best for Weight Loss.

4. Eat nutrient dense foods (especially organ meats and egg yolks!)

The key to proper nutrition is eating nutrient-dense foods. Most people think about vegetables when they think of vitamins and minerals. However, a serving of beef liver has between 10-100 times the amount of key vitamins and minerals than those found in carrots or apples.

Egg yolks are another of nature’s superfoods. One egg provides 13 essential nutrients, all in the yolk (contrary to popular belief, the yolk is far higher in nutrients than the white). And despite conventional wisdom, it’s entirely safe to eat three eggs a day. In fact, studies show that egg consumption actually increases large, buoyant LDL cholesterol – which is the type that doesn’t cause heart disease!

Grass-fed, organic animal products and raw dairy (butter, milk) are also high in health promoting nutrients, and should be eaten liberally.

For more on this, see Three Eggs a Day Keeps the Doctor Away, Cholesterol Doesn’t Cause Heart Disease and Liver: Nature’s Most Potent Superfood.

5. Eat fermented foods.

Almost all healthy, traditional cultures that have been studied regularly consume fermented foods like yogurt, kefir, sauerkraut, kim chi and kombucha. These foods have numerous health benefits, but in the context of heart disease one of the most important reasons to include them in the diet is that they are one of the few dietary sources of vitamin K2.

Unfortunately, many people are not aware of the health benefits of vitamin K2. The K vitamins have been underrated and misunderstood up until very recently in both the scientific community and the general public. While K1 is preferentially used by the liver to activate blood clotting proteins, K2 is preferentially used by other tissues to deposit calcium in appropriate locations, such as in the bones and teeth, and prevent it from depositing in locations where it does not belong, such as the soft tissues.

A 1993 study showed that those in the highest third of vitamin K2 intake were 52 percent less likely to develop severe calcification of the arteries, 41 percent less likely to develop heart disease, and 57 percent less likely to die from it.

For more on this, see Vitamin K2: The Missing Nutrient.

6. Take your high-vitamin cod liver oil.

Cod liver oil is one of the only supplements I recommend to people. It’s a great source of long chain omega-3 fatty acids (EPA and DHA), which protect against inflammation. But even more importantly, cod liver oil is one of the few dietary sources of vitamin D. Low vitamin D levels associate with nearly every common non-communicable disorder, including obesity, diabetes, cardiovascular disease, autoimmune disease, osteoporosis and cancer.

But not all cod liver oils (CLOs) are created equal. Most commercially available CLOs are processed with heat and chemicals. Because heat and chemicals destroy the naturally occurring vitamins, synthetic vitamins are then added back in. Synthetic vitamins don’t have the same benefits as naturally occurring vitamins, and in fact they can be toxic at high doses (hence the hysteria of vitamin A toxicity from taking too much cod liver oil).

The only brand I know of that is cold-processed and contains the naturally occurring vitamins A & D in high amounts is Green Pastures Fermented Cod Liver Oil. Even better, because it’s fermented you’ll also get vitamin K2, which we know from step #5 protects against heart disease.

For more on this, see Separating Fact from Fiction on Cod Liver Oil, and Vitamin D: The New Super-Nutrient?.

7. Be active & go outside.

Physical inactivity is likely a major causative factor in the explosive rise of coronary heart disease in the 20th century. During the vast majority of evolutionary history, humans have had to exert themselves to obtain food and water. Even at the turn of the 20th century in the U.S., a majority of people had jobs that required physical activity (farmers, laborers, etc.) Now the majority of the workforce has sedentary occupations with little to no physical activity at all.

Currently more than 60% of American adults are not regularly active, and 25% of the adult population is completely sedentary. People that are physically inactive have between 1.5x and 2.4x the risk of developing heart disease.

On the other hand, regular exercise reduces both inflammation and oxidative damage. Even relatively low levels of activity are protective – as long as they are consistent. A public review at Harvard University showed that 30-minutes of moderate physical activity on most days of the week decreases deaths from heart disease by 20-30%.

It’s also important to spend time outdoors and get some sun. In addition to the obvious psychological and even spiritual benefits, sunlight exposure will boost your vitamin D levels. Just remember that sunscreen blocks your body from making vitamin D from sunlight.

For more on this, see Throw Away the Sunscreen!

8. Maintain a healthy weight (not too fat or thin)

Countless studies show that obesity causes both inflammation and oxidative damage, and significantly raises the risk of heart disease. For those who are obese, losing weight is perhaps the most important first step to take to reduce their risk profile.

However, most people aren’t aware that being too skinny can also increase the risk of heart disease.

It is also important to keep in mind that where you store body fat is probably more important than how much body fat you have. For example, body fat stored in the legs has consistently been shown to protect against metabolic risk in longitudinal studies. In contrast, abdominal fat, and in particular visceral fat, is independently associated with increased risk of morbidity and mortality.

For more on this, see this excellent offsite article: Get Fat, Live Longer.

9. Don’t smoke and minimize exposure to other toxins

Smoking promotes both oxidative damage and inflammation. Smoking as few as one cigarette a day can increase the risk of heart disease by 40 percent, while smoking 40 cigarettes a day increases the risk by 900 percent.

Over 70,000 synthetic chemicals are used commercially and approximately 1,000 new chemicals are introduced into our environment each year. These include insecticides, herbicides, gasoline, dry cleaning chemicals, personal care products, and more.

Environmental toxins cause both inflammation and oxidative damage, which as you certainly know by now, cause heart disease. Avoid exposure to these toxins as much as possible. Using environmentally friendly cleaning and personal care products in your home is a great start.

10. Manage stress & enjoy life

In the famous INTERHEART study, stress tripled the risk of heart disease. This was true across all countries and cultured that were studies. The primary mechanism by which stress causes heart disease is by dysregulating the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is directly intertwined with the autonomic nervous system, and it governs the “fight-or-flight” response we experience in reaction to a stressor.

Continued activation of this “fight-or-flight” response leads to hyper-arousal of the sympathetic nervous system, which in turn leads to chronically elevated levels of cortisol. And elevated levels of cortisol can cause both inflammation and oxidative damage.

Stress management, then, should be a vital part of any heart disease prevention program. In fact, some researchers today believe that stress may be the single most significant factor in the cause and prevention of heart disease. There are several proven methods of stress reduction, including mindfulness-based stress reduction (MBSR), acupuncture and biofeedback. It doesn’t matter which method you choose. It just matters that you do it, and do it regularly.

If you follow these ten steps, you will dramatically reduce your risk of not only heart disease, but also diabetes, metabolic syndrome and almost every non-communicable modern disease. You’ll also have more energy, sleep better and improve your quality of life. So what do you have to lose? Sure beats taking dangerous statin drugs.

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tropical paradiseIn the last two weeks alone three articles have appeared in the scientific press about new studies reporting on vitamin D’s many crucial roles in the body. Along with promoting strong bones, a healthy immune system and protection against some types of cancer, recent studies suggest vitamin D can treat heart failure, protect against heart attacks and reduce the risk of death from both cardiovascular and overall causes.

Back in April I wrote an article called “Throw Away Your Sunscreen” about the protective effects of exposure to sunlight against melanoma. Despite conventional wisdom that tells us to avoid sun exposure at all costs, it turns out that the vitamin D our bodies synthesize when exposed to UV light is a first line of defense against developing melanoma.

In an article published on June 9 in Archives of Internal Medicine, scientists reported that low levels of vitamin D are associated with a higher risk of myocardial infarction (heart attack) in men. The study showed that rates of cardiovascular disease-related deaths are increased at higher latitudes and during the winter months, and are lower at lower altitudes.

In an article published in the July issue of the Journal of Cardiovascular Pharmacology, on June 12, researchers found that vitamin D directly contributes to cardiovascular fitness. In fact, University of Michigan pharmacologist Robert U. Simpson, Ph.D. thinks it’s apt to call vitamin D “the heart tranquilizer”. Simpson and his team discovered that treatments with activated vitamin D prevented heart muscle cells from hypertrophy, a condition in which the heart becomes enlarged and overworked in people with heart failure.

Finally, in a study published on June 23 in the Archives of Internal Medicine, a team of Austrian scientists revealed that low blood levels of vitamin D appear to have an increased risk of death overall and from cardiovascular causes. Harald Donbig, M.D. and his colleagues studied 25-hydroxyvitamin D and 1,25 dihydroxyvitamin D levels in 3,258 consecutive patients (average age 62 years) who were scheduled for coronary angiography testing at a single medical center between 1997 and 2000.

During 7.7 years of follow-up, death rates from any cause and from cardiovascular causes were higher among individuals in the lower one-half of 25-hydroxyvitamin D levels and the lowest one-fourth of 1,25-dihydroxyvitamin D levels. These associations remained when researchers controlled for other factors such as coronary artery disease, physical activity and co-occurring diseases.

So what does all this mean to you? A recent consensus panel estimated that about 50 – 60 percent of older individuals in North America and the rest of the world do not have satisfactory vitamin D status, and the situation is similar for younger individuals. Blood levels of vitamin D lower than 20 to 30 nanograms per milliliter have been associated with falls, fractures, cancer, autoimmune dysfunction, cardiovascular disease and hypertension.

To put it blankly, that means half of all people around the world are deficient in vitamin D and therefore at increased risk for serious and potentially fatal conditions.

Low 25-hydroxyvitamin D levels are also correlated with markers of inflammation such as C-reactive protein, as well as signs of oxidative damage to cells, Donbig’s study revealed. In a previous article, I explained that inflammation and oxidative damage (not cholesterol) are the primary causes of the worldwide heart disease epidemic. Inflammation and oxidative damage are also contributing factors to diabetes, metabolic syndrome, cancer and many other diseases.

So how does vitamin D work its magic? It acts as a potent hormone in more than a dozen types of tissues and cells in the body, regulating expression of essential genes and rapidly activating already expressed enzymes and proteins. In the heart, vitamin D binds to specific vitamin D receptors and produces its “calming”, protective effects.

There are essentially three ways to obtain vitamin D: exposure to UV light, food and supplements. The most effective of all of these methods is exposure to sunlight. Full-body exposure of pale skin to summer sunshine for 30 minutes without clothing or sunscreen can result in the synthesis of between 10,000 and 20,000 IU of vitamin D. At most latitudes outside of the tropics, however, there are substantial portions of the year during which vitamin D cannot be obtained from sunlight; additionally, environmental factors including pollution and the presence of buildings can reduce the availability of UVB light.

In northern latitudes or during winter months when the sun isn’t shining, I recommend taking 1 tsp./day of high-vitamin cod liver oil (Green Pasture or Radiant Life are two brands I recommend) to ensure adequate vitamin D (and vitamin A) intake. You can also eat vitamin D-rich foods such as herring, duck eggs, bluefin tuna, trout, eel, mackerel, sardines, chicken eggs, beef liver and pork. If you follow this approach further supplementation should not be necessary.

Before closing, I must mention (briefly) the issue of vitamin D toxicity. Vitamin D is widely considered to be the most toxic of all vitamins, and dire warnings are often issued to avoid excess sun exposure and vitamin D in the diet on that basis. The discussion of vitamin D toxicity has failed to take into account the interaction between vitamins A, D and K. Several lines of evidence suggest that vitamin D toxicity actually results from a relative deficiency of vitamins A and K.
So, the solution is not to avoid sun exposure or sources of vitamin D in the diet. Rather, it ensure adequate vitamin D intake (through sunlight and food) and to increase the intake (through diet and/or supplements) of vitamins A & K. Stay tuned for a future post on the interaction between vitamins A, D & K and their relevance to human health.

THS recommendations:

  • Throw away your sunscreen. Use coconut and sesame oil if needed, and moderate your exposure to sun to avoid frequent sunburn.
  • Get an hour or two of exposure to sunlight each day if possible. Don’t cover your skin (or your child’s skin) completely when out in the sun.
  • In northern latitudes or during winter months when the sun isn’t shining, take 1 tsp./day of high-vitamin cod liver oil (Green Pasture or Radiant Life are two brands I recommend) to ensure adequate vitamin A & D intake.
  • Eat vitamin D-rich foods such as herring, duck eggs, bluefin tuna, trout, eel, mackerel, sardines, chicken eggs, beef liver and pork.
  • Make sure to eat enough vitamin K. Primary sources in the diet are natto, hard and soft cheeses, egg yolks, sauerkraut, butter and other fermented foods. Make sure to choose dairy products from grass-fed animals if possible.

Suggested Links

  • The Vitamin D Miracle: Is it For Real?
  • From Seafood to Sunshine: A New Understanding of Vitamin D Safety
  • Vitamin D Toxicity Redefined

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Throw away the sunscreen!

Exposure to sunlight prevents melanoma.

Yes, you did read that correctly.

Two independent studies published in the Feb. 2005 issue of the prestigious Journal of the National Cancer Institute (JNCI) squarely contradict the popular myth that UV light causes melanoma.

The first study evaluated the hypothesis that UV radiation increases your risk of developing lymphoma – a hypothesis that had become widely accepted in the 1990s and early 2000s. After studying nearly 7,000 subjects, the authors concluded that the opposite is actually true: increased sun exposure reduces the risk of non-Hodgkin’s lymphoma (NHL) by up to 40%. What’s more, the reduction in risk was dose-related, which means that the more sun exposure someone got, the lower their risk of cancer was.

The second study looked at the link between sun exposure and the chances of surviving melanoma, which is the deadliest form of skin cancer. Guess what? The researchers concluded that increased sun exposure decreases the chance of dying from skin cancer by approximately 50%.

At this point you might be scratching your head and wondering how this could possibly be true, in light of what we’ve been told all these years about the relationship between sunlight and skin cancer. Let’s take a closer look at what explains this phenomenon, and why you likely haven’t heard about it on the news.


An editorial published in the same issue of JNCI begins with this statement:

“Solar radiation is a well-established skin carcinogen, responsible for more cancers worldwide than any other single agent.”

This is true. But what the authors neglect to mention is that the type of cancer they are referring to is not melanoma but other types of cancer. Melanoma is the most serious form of skin cancer because it is malignant and can metastasize (spread) to other areas of the body, often leading to death.

But 90 percent of skin cancers are not melanomas. Rather, the most common forms are basal and squamous cell carcinomas, which are often benign and easily cured by simple outpatient surgery. These non-malignant forms of skin cancer are indeed caused by solar radiation (at least according to current research). Melanomas, however, are most likely caused by lack of sunlight or excess exposure to artificial light!

The editorial mentioned two other very important facts that you aren’t likely to hear about from mainstream media sources: that melanoma is normally found in areas of the body that are not typically exposed to sunlight at all (use your imagination), and that vitamin D may be important in preventing melanoma.

Here’s what they actually had to say:

“Evidence is beginning to emerge that sunlight exposure, particularly as it relates to vitamin D synthesized in the skin under the influence of solar radiation, might have a beneficial influence for certain cancers.”

Umm, like, we already knew that.

The role of Vitamin D

It has been known for several years that sun exposure might have a beneficial effect on certain cancers. A 1999 publication of the National Institute of Health (NIH) entitled Atlas of Cancer Mortality in the United States revealed that among caucasians in the United States, cancer mortality for several prominent cancers, including cancer of the breast, prostate and colon, shows a striking latitudinal gradient. Specifically, people living in northern states have much higher rates of these cancers than those residing in the southern states.

The reason for this? Northern states get a whole lot less sunshine than southern states.

As early as 1990 it was proposed that vitamin D, which is synthesized in the skin upon exposure to UV light, might be the agent that accounts for these geographical patterns. (Garland et al. 1990) Less exposure to sunshine means less production of vitamin D. It is known that calcitriol, the active form of vitamin D3, has multiple cellular affects that could confer protection against cancer. The ability to convert the precursor to vitamin D to the active form of D3 (calcitriol) is greatly reduced at northern latitudes, and populations living far from the equator are at increased risk of vitamin D deficiency during the winter months. (Tangpricha et al. 2002)

Even more significant may be the observation that patients with malignant melanoma exhibit low levels of vitamin D3 in their blood, and that others have a problem with the receptor for vitamin D. (Hutchinson et al. 2000; Green et al. 1983) The incidence of melanoma of the skin on sites of the body intermittently exposed to sunlight is reduced among outdoor workers compared with indoor workers. (Elwood et al. 1985)

All of this points to a protective role for vitamin D against cancer in general, and melanoma in particular. But the final nail in the coffin of the “sunlight causes melanoma” hypothesis is this:

A comprehensive review of research studies from 1966 through 2003 failed to show any association between melanoma and sunscreen use! (Dennis et al. 2003)

Say what? Sunscreen doesn’t prevent skin cancer, that’s what.

Does sunscreen contribute to skin cancer?

One thing sunlight does cause is an injury to the inner layer of the skin (called the “dermis”), which leads to a wrinkling of the outer layer (called the “epidermis”). This phenomenon, which happens naturally with age but is accelerated by sun exposure, is called “solar elastosis”, or SE.

Sounds like a bad thing, right? But when researchers at the University of New Mexico studied melanoma, they found a marked decrease in the disease in patients with SE. (Berwick et al. 2005). To put it simply: more sun exposure equals lower risk of melanoma. For patients who already had melanoma, the subsequent death rate from the disease was approximately one-half as high in the group of patients with signs of SE.

I’ll give you a minute to finish cursing the “medical authorities” that have been admonishing us to slather ourselves and our children with sunscreen for decades in order to “prevent skin cancer”. As it turns out, if we followed this advice (and why wouldn’t we have? It sounded logical…) we have actually increased our chances and our children’s chances of developing not just skin cancer, but other cancers as well.

I’m sorry to scare you like that, but I feel I must in order to make this point as clearly as I can:

Exposure to sunlight decreases your risk of cancer, and using sunscreen increases your risk of cancer.

As we have already discussed, sunlight is a major source of vitamin D. Insufficient levels of vitamin D can result in osteoporosis, autoimmune diseases and rheumatoid arthritis – among other equally unpleasant and life-threatening conditions. When you put on those high-SPF sunscreens, not only are you increasing your risk for melanoma, you are increasing your risk of developing all of the conditions that can arise from vitamin D deficiency because you are blocking your body’s ability to synthesize vitamin D.

And while it is possible to obtain vitamin D from food, it is only present in large amounts in certain kinds of seafood – which many people do not consume regularly. The highest sources for vitamin D in food are anglerfish liver, cow’s blood (I’m not joking) and high-vitamin cod liver oil (HVCLO). It is also present in more modest amounts in chum salmon, Pacific marlin, herring, bluefin tuna, duck eggs, trout, eel, mackerel and salmon.

I’m going to go out on a limb and guess that most Americans aren’t eating these foods on a regular basis. The lack of adequate intake of vitamin D in the diet, combined with habitual use of high-SPF sunscreen and/or lack of exposure to the sun is a perfect recipe for increasing the risk of cancer for children and adults alike.

But you will not hear the sunscreen manufacturers telling you to stop using their product, and you probably won’t hear it from dermatologists in the field who have a reputation (and a history of telling people to wear sunscreen) to protect. They’ll tell you that sunburn is an important factor in melanoma formation since that’s really all they have left in terms of support for selling sunscreen. What they neglect to mention is that 1) millions of people get sunburned every year but very few develop melanoma, and more importantly, 2) if melanoma does appear, it’s most likely to appear in areas not exposed to the sun.

Nevertheless, it’s still probably a good idea to avoid getting sunburned – especially on a regular basis. But it is not a good idea to wear sunscreen, nor is it a good idea to avoid sun exposure.

The idea that sunlight causes cancer and sunscreen prevents it is another mainstream myth that has no support in the scientific literature. Just like the idea that cholesterol causes heart disease, eating fat makes you fat, and fluoride is good for your teeth. (If you still believe any of those statements, check my archives and sign up for my free email digest!)

Before closing, I must mention (briefly) the issue of vitamin D toxicity. Vitamin D is widely considered to be the most toxic of all vitamins, and dire warnings are often issued to avoid excess sun exposure and vitamin D in the diet on that basis. The discussion of vitamin D toxicity has failed to take into account the interaction between vitamins A, D and K. Several lines of evidence suggest that vitamin D toxicity actually results from a relative deficiency of vitamins A and K.
So, the solution is not to avoid sun exposure or sources of vitamin D in the diet. Rather, it ensure adequate vitamin D intake (through sunlight and food) and to increase the intake (through diet and/or supplements) of vitamins A & K. Stay tuned for a future post on the interaction between vitamins A, D & K and their relevance to human health.

In the meantime, this is what I recommend for protecting against cancer and both deficiency and toxicity of vitamin D:

THS recommendations:

  • Throw away your sunscreen. It contributes to cancer.
  • Get an hour or two of exposure to sunlight each day if possible. Don’t cover your skin (or your child’s skin) completely when out in the sun.
  • Avoid frequent sunburn
  • In northern latitudes or during winter months when the sun isn’t shining, take 1 tsp./day of high-vitamin cod liver oil (Green Pasture or Radiant Life are two brands I recommend) to ensure adequate vitamin A & D intake. You can also eat vitamin D-rich foods such as herring, duck eggs, bluefin tuna, trout, eel, mackerel, sardines, chicken eggs, beef liver and pork.
  • Make sure to eat enough vitamin K. Primary sources in the diet are natto, hard and soft cheeses, egg yolks, sauerkraut, butter and other fermented foods. Make sure to choose dairy products from grass-fed animals if possible.

As always, leave a comment or contact me with questions!

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