Public Health

Was Linus Pauling Off by One Letter?

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Connoisseurs of unintended consequences will appreciate this Globe and Mail story, which suggests that public health officials in Canada and the U.S. may have inadvertently caused more cancer deaths than they prevented by advising people to stay out of the sun when possible and to cover up with clothing and sunscreen if they absolutely must go outside on a beautiful summer day:

In June, U.S. researchers will announce the first direct link between cancer prevention and the sunshine vitamin [i.e., vitamin D]. Their results are nothing short of astounding.

A four-year clinical trial involving 1,200 women found those taking the vitamin had about a 60-percent reduction in cancer incidence, compared with those who didn't take it, a drop so large—twice the impact on cancer attributed to smoking—it almost looks like a typographical error….

Those studying the vitamin say the hide-from-sunlight advice has amounted to the health equivalent of a foolish poker trade. Anyone practising sun avoidance has traded the benefit of a reduced risk of skin cancer—which is easy to detect and treat and seldom fatal—for an increased risk of the scary, high-body-count cancers, such as breast, prostate and colon, that appear linked to vitamin D shortages.

The paper reports that researchers also "are linking low vitamin D status to a host of other serious ailments, including multiple sclerosis, juvenile diabetes, influenza, osteoporosis and bone fractures among the elderly." I hope some of this speculation turns out to be well-founded, because it would be nice to have an easy way to prevent so many diseases and deaths. If that can be achieved only by embarrassing the nagging know-it-alls who've been telling us to avoid sunshine, that's a cost I can live with.

[Thanks to Mark Lambert for the link.]

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  1. I always thought it was overkill to tell people to avoid sunshine or they’d get cancer.

    Telling them to avoid sunshine to avoid the fate of Robert Redford’s skin, however, is another matter altogether…

  2. I’ve got red hair and pale skin. According to the current wisdom, I shouldn’t go outside when the sun is out. Ever. That strikes me as overkill.

  3. From Quackwatch, on Pauling and C, called, The Dark Side of Linus Pauling’s Legacy

  4. See, this just depresses me because I have to avoid prolonged exposure to sunshine or I will get cancer. Stupid genetic catch-22.

  5. Do supplements work? I’m a pale demonstration of Northern European genetics living in Florida, so death by sun is a possibility. Not that I avoid exposure–I like to fish and kayak and stuff–but let us just say that Bullfrog is my friend.

  6. See, this just depresses me because I have to avoid prolonged exposure to sunshine or I will get cancer. Stupid genetic catch-22.

    You don’t need prolonged exposure to get adequate levels of Vitamin D. 10-15 minutes is sufficient.
    Take a 20 minute walk after lunch or dinner without sunscreen and you’ll be all set.

    That looks to be a fascinating study. I look forward to reading it when it comes out. I may go ahead and step up my dietary intake in the meantime.

  7. >>Telling them to avoid sunshine to avoid the fate of Robert Redford’s skin, however, is another matter altogether…

    Seriously. SPF 15 on the face and neck is the best anti-aging “skin secret” going.

    If only someone had informed the Sundance Kid about sunscreen when there was still time.

  8. Sheesh, Back in the Stone Age, Memorial Day Weekend started out at Bleach Beach and finished up at Lobster City. Then somebody invented sunscreen.

  9. Livin’ on reds, Vitamin C, and cocaine……..

  10. and heroin, lots of smack.

  11. How does binging affect the benefits of Vitamin D? E.g., say a poor sap was in a cubicle during all sunlight hours 5 days a week, then binges with several hours of consumption on weekends? But only during the 4 months of the year that anybody would want to “binge” in this frigid city?

    Moderation blows.

  12. You don’t need prolonged exposure to get adequate levels of Vitamin D. 10-15 minutes is sufficient.
    Take a 20 minute walk after lunch or dinner without sunscreen and you’ll be all set.

    At least according to the linked article, that’s ten to fifteen minutes of full body exposure. Unless you take that twenty minute walk naked, you’ll need a longer exposure than that.

    Y’know, this’d be an interesting result. The higher levels of cancer caused not by modern chemicals and diet, but by modern indoor lifestyles? Too cool to contemplate. ‘Course, I hate being outside, so this doesn’t help me much.

  13. When they prove that frequent topless sunbathing is the best way to prevent breast cancer, then you doubters will know at last that There Is A God.

  14. Amen, Brother Stevo.

  15. Take a 20 minute walk after lunch or dinner without sunscreen and you’ll be all set.

    Can I cut this to 5 minutes if I’m nekkid?

  16. Pro Libertate | May 1, 2007, 5:45pm | #
    Do supplements work? I’m a pale demonstration of Northern European genetics living in Florida, so death by sun is a possibility. Not that I avoid exposure–I like to fish and kayak and stuff–but let us just say that Bullfrog is my friend.

    From the second paragraph, the answer’s yes.

  17. At least according to the linked article, that’s ten to fifteen minutes of full body exposure. Unless you take that twenty minute walk naked, you’ll need a longer exposure than that.

    Good point. Taking the walk in shorts, sandals, and shirtless was what I had in mind, which is pretty close. Of course, if you are a woman, or fat, out-of-shape, and self-conscious, that probably wouldn’t work that great. Increasing dietary intake might be a better way to go, although I will probably stick with the 400 IU in my multivitamin and a few extra glasses of milk per day for now. As a general rule, I think it’s best to hold off on megadosing until all the data is in.

  18. Highnumber, yes.

    Stevo, also yes.

    Number 6 – Yeah, does this mean that I’m actually going to have to be awake when the sun’s up? I hate that.

  19. I wonder if I can use this to get my employer to do something about the windowless cave in which I toil during the most vitamin rich part of the day.

    1. You don’t want sunshine through windows – windows screen out UV-B, necessary to produce vitamin D, and let much more harmful UV-A on through. Direct sunlight is what you need.

  20. This is not news. I read about this two years ago; some scientists discovered that Australians had the highest rates of skin cancer in the world, but the lowest cancer death rate overall and posited that exposure to the sun was protectign them from other cancers.

  21. My grandfather spent his entire life mowing his lawn in the North Carolina sun, and died at 96 just last month. He’d had like 200 skin cancers removed before he died in his sleep.

    He also ate food that no one could possibly recommend as healthy: country ham, lard biscuits, jelly, soda, collards cooked with ham hocks and karo syrum, sweet potatoes with marshmallow… i mean it’s like the polar opposite of what people SAY you should eat.

    Its also yummy.

    I have Casper the Ghost skin and have always had a strong belief in going out and burning the shit out of myself for the pure physical feedback. Skin cancer be damned. Now that I work from home office. I get to take long strolls around the hood in my flip flops, and that in itself will probably extend my life 10 years. Nice to know i can get more sun this sping/summer and feel that it’s not a bad thing.

    1. Vitamin D is produced by the skin when exposed to UV-B radiation; the raw material utilized in the production of Vitamin D is cholesterol. So while gramps was boosting his vitamin D he was also simultaneously lowering his cholesterol. In fact, I’ve read somewhere that some folks who take statins to lower their cholesterol wind up suffering from vitamin D deficiency, since their body has insufficient levels of cholesterol to support vitamin D production.

  22. “As a general rule, I think it’s best to hold off on megadosing until all the data is in.”

    Good advice. Vitamin D is fat soluble, so you store up excess vitamin D instead of peeing it out. Taking 500% of the daily recomended dose can lead to toxic levels if I recall correctly.

    Dosage is key in biology. Calling chemicals completly good or completely bad is studying motion with just the direction of the forces and not their magnitudes.

  23. Stevo Darkly | May 1, 2007, 6:17pm | #
    When they prove that frequent topless sunbathing is the best way to prevent breast cancer, then you doubters will know at last that There Is A God.

    Amen Stevo

    Plus, we’ll discover that Bacon has the cure to all cancers in it. As long as it’s mixed with butter and jelly and sugar.

  24. Hit the beach. Go swimming for about 20 minutes, then come out and slather on the SPFage. Use the waterproof kind if you plan on taking another dip.

    Vitamin D or no, I’m still going to try to avoid sunburn. Tanning is a theoretical possibility for me, but I haven’t had mildly brown skin since I was a kid spending just about every afternoon between the end of the school year and Labor Day at the beach. We’d usually burn and peel until our skin stabilized at some lightly toasted shade. We used to joke about an “Irish Tan,” which is what you got when you freckled so much that the little buggers all merged.

    I can remember when we thought that an application of baby oil would help you tan, but keep you from burning!

    Kevin

  25. Sounds good enough for me. I plan to spend the summer sitting by the pool, smoking.

    1. Which will prevent Alzheimers, Parkinsons and some allergies.

      Good God, can you hear the health nuts howl?

  26. Yeah, it’s great to watch the health fanatics scramble to revise their verities.

  27. >I can remember when we thought that an application of baby oil would help you tan, but keep you from burning!

    Yes, and add some iodine.

    That’s what my great aunt used to do. She died in the 1950s, when she was in her 30s, of what I am told was a rare form of skin cancer. No one can tell me exactly what type of cancer it was, though.

    >Vitamin D or no, I’m still going to try to avoid sunburn.

    Me too. I don’t try to come near to total avoidance, but it doesn’t take long for me to feel the burn when I am in the sun. I don’t think I’ve ever had a genuine tan in my life.

    Still, I’m glad to hear about this study. The idea that one should avoid the sun as much as possible seems really antithetical to life. Some admonitions against sun exposure are so extreme as to seem bizarre.

  28. I can remember when we thought that an application of baby oil would help you tan, but keep you from burning!

    Auuggghhh! My girlfriend would slather up with a concoction of baby oil and iodine….

  29. I have had some righteous sunburns on my thighs and tops of my feet (from cruising around all day guzzling beer in the boat and forgetting to put on the paraminobenzoic acid, an early form of sunscreen that they kept behind the counter with the, ahh, baby preventers). As a result, the skin pigment in those areas is all screwed up anymore. Took time for it to morph, but it did.

    I still do sun, but not without sunscreen. And the boat has a Bimini top these days. Gotta keep that mid-day sun off.

    Mmmmm, love sun. Love sun. Love sun. Gimme more sun. Not enough sun here in Californicate, must move to Arizona or Hawaii.

  30. I make a motion that all C’s be augmented to D’s forthwith.

  31. The date: June 2000
    The location: Tulum, Mexico

    I forgot to put sunscreen on the tops of my feet.
    I can still see the lines from the sandal straps.
    Is that healthy?

  32. Fuck it! I’m just going to stick with my strategy of avoiding lab-rat doses of sun, shade, exercise, rest, green vegetables, yellow vegetables, red meat, white meat, gray meat, marshmallows, second-hand smoke, first-hand smoke, Republicans, Democrats, whatever.

  33. I’m gonna have to go with no on that one highnumber.

    although I am not a doctor. I did stay at a Holiday Inn Express last nite.

  34. Syd,

    How can you expect me to read? My eyes are exposed to the Florida sun each and every day.

  35. So that famous commencement address that starts by advising the grads to wear sunscreen was completely useless?

  36. I forgot to put sunscreen on the tops of my feet.
    I can still see the lines from the sandal straps.
    Is that healthy?

    Ouch. And no.

  37. Sad but true story.
    I had a little skirmish with skin cancer. My dermatologist was almost a compulsive sun avoider.
    He died a few years back, at a very young age, of a stroke. Made a pretty corpse.

  38. I’m still looking forward to that discovery that cream pies and ribeyes prevent cancer. We’ve now got sun exposure, dark chocolate, coffee, strawberries and blueberries, and liver is now bad for you. I’m getting to like the 21st century.

    That said, like about 1/2 the people who comment here, I’m a pale redhead. (There really has to be something to this. Redheads are what? .2% of the population?) I also am prone to moles, including abnormal ones, thus I am much more likely to contract melanoma instead of the milder forms of skin cancer. So, like Pro L, I’m a huge fan of Bullfrog, which must have something NASA developed to spray on the moon rockets because I can apply it once, stay at the water park all day, and not even turn pink. Kid-strength Banana Boat is good too, but does require reapplication.

  39. I watched my brother die of skin cancer in his early 30’s. What was that about easily treatable and rarely causes death? My sister has also had melanoma – may have spread. She goes in every three months for internal and external checks. She is in her early 40’s. Wear your sunscreen every day. Get your sun exposure early or late in the day. Stay out of the sun between 10am – 3pm. Melanoma is a really hard way to go.

  40. lily –

    I don’t mean to be harsh, but anecdotes don’t make truth. What’s harmful for one, might be helpful for many. (or vice versa) Thinking of giving chemo to a healthly person.

    Open minded… It is possible that sunlight is more helpful than harmful (for most).

  41. SixSigma:

    Hate to see people throw caution to the wind. The risk here is real. Most people who live in relatively warm and/or sunny climates get plenty of sun exposure just running day to day errands. Most people are not practicing extreme sun avoidance. Even I’m not, and I’m at extreme risk (so says my Dr.) This is not a time to lay by the pool for hours at at time.

  42. TWC…. “Auuggghhh! My girlfriend would slather up with a concoction of baby oil” slathered up with baby oil was a problem?

    Anecdotes… my grandfather was born in the Orkney Islands (North of Scotland) pale as a snake by nature. He retired to Florida and spent 47 years enjoying non-stop sun exposure. His skin was like leather and his doctor told him to remove lesions on his head using 600 grit sandpaper. He DID die of cancer in the end, but once you reach 97 this is not all that surprising. He also ate bacon and eggs every morning, drank whiskey and beer and smoked unfiltered Lucky Strikes from the time he was 12 so he may be something of an outlier.

  43. Bob v. Lily:

    The Globe & Mail article is from a Canadian perspective. The latitude you live at has a lot to do with the amount of sun exposure you get. What might be reckless in Florida or on the Australian coast might be OK on the shores of Lake Ontario.

    Except one winter spent in the Tampa Bay area, I’ve always lived north of 40?. In my time on the “Suncoast” I was working indoors from 9-5 (or later), and didn’t spend much time sunning myself. I rarely wore shorts or went shirtless. That was frowned on at work, and my favored modes of transport were bikes, with or without motors. Long pants and sometimes long sleeves were advisable in case of road rash. Yes, some old coot did run me off the road at least once. I probably got more direct sun in any Lawn Island summer than I did in that Florida winter.

    I did see plenty of “white folks” with skin that resembled an old football. It was one thing when it was some beachcombing retiree, quite another when it was some teens-to-twenties blonde hottie. It amazed me to see the fellows who worked construction, especially roofers, or on road crews who worked shirtless the year `round. There’s some choice. Keep covered and suffer heat prostration, or doff your shirt and deal with lesions years down the road.

    Kevin

  44. …slathered up with oil was a problem?

    Well, no, but the iodine mixed with the oil left orangish stains on my blue and white trunks and then there were those awkward questions.

    Of course, that summer was also the first time any sweet little chick who was that close to naked ever got that close to me…..didn’t need a whole lot more than just that. (closes eyes and smiles).

    Oddly enough she was the niece of a rather well known Democrat Senator from the Heart of Dixie. I’d name him but sure as hell somebody’d tell her about it and she’d sue me.

    600 Grit Sand Paper

    LOL, that’s pretty fine paper, but still….

    Bob, it’s been a long day and I’ve taken way too many breaks to banter here on this BB but I have to say thanks for the laugh. Good thing I wasn’t drinking a glass of wine or the monitor would have been covered.

  45. Six, it’s like incest, everything is relative.

    Guy like me can do a lot more sun than say Mrs TWC, who has very fair skin. She is pretty careful, espc since she had that one big brown freckle removed. It wasn’t cancer, but it gave her a scare when it quadrupled in size in about six weeks.

    I used to run into a CHP down at the Colorado River every so often. We’d have some beers and tell some lies. He got the Big C from that desert sun. Killed him like Lily’s brother. Like every libertarian on H&R, he was a red head with pale skin. By the time he took serious measures to cover up and keep out of the sun it was too late. Just saying.

    Nothing wrong with a little sun, but there’s nothing wrong with moderation neither, except for drinking red wine, but that goes without saying.

    I guess you mostly said all that anyway, but I like the sound of my own keyboard….

    Now, if you’ll excuse me, it’s wine thirty and Mrs TWC is hollering down the stairs that it’s time for Idol.

  46. WC,

    Can someone sue you for saying something that is true?

  47. lily –

    The risk might be real. Just want to be careful that we don’t disregard possible new knowledge based on anectodal evidence.

    TWC –

    Not sure I wish to compare incest and cancer 🙂

    But I certainly agree that ever person is an individual and their risks will vary dramatically due to all sorts of factors(most of which are completely unkown when it comes to cancer – but a different discussion altogether).

    This fact is demonstrated well in extreme cases where pencillin is one man’s savior, while still another man’s lethal injection.

  48. Don’t really see how this is some unintended consequences thing…probably way overstated by Sullum to make a cute point…just do get some sun each day …10 to 20 minutes..after that cover up esp if you live in someplace like AZ where after 15 minutes without protection you can literally feel your skin burn off…..no biggie

  49. Can someone sue you for saying something that is true?

    John, I dunno, but that girl might. It was this guy

  50. Six,

    Not sure I wish to compare incest and cancer

    What?

    Vice is nice, but incest is best, ain’t that how it goes?

    Thought that was pretty funny til my sister started talking trash about dad. Still weirds me out.

  51. Au, yep, Az in the summer, your skin will melt.

  52. On the other hand…

    TUESDAY, May 1 (HealthDay News) — Seniors who consume high levels of calcium and vitamin D are much more likely to have larger brain lesions that can lead to cognitive impairment, depression or stroke, new research reveals.
    […]
    “Since our study only looked at diet and brain lesions at one point in time, we cannot conclude that calcium or vitamin D caused the brain lesions that we found,” she cautioned. But she added that “our finding of a relationship between brain lesions and consumption of both calcium and vitamin D raises the question about a possible downside to high intakes of these nutrients.”

    High Calcium, Vitamin D Intake May Harm Aging Brain

  53. Latest research indicates that computer screens emit just enough D to cure everything, if a webcam is used.

  54. Will this make pasties obsolete?

  55. I suppose you could put some D-enriched filling in your pasties.

    Kevin

  56. Or Double-D.

  57. Thinking from an evolutionary perspective, it seems that some measure of sunlight should have a benefit. The adaptations of different peoples to different skin tone according to light conditions and even the ability to tan surely suggest that there is some “good” amount of exposure which is most beneficial for survival. If only too much light was bad, we would all be darker skinned for protection.
    Doesn’t the fact that we have adaptations to allow a certain amount of light to pass into the skin imply there must be a health benefit to it doing so?

  58. There was a study reported on in Scientific American a few years ago that argued that, from an evolutionary perspective, skin cancer is a non-starter for influencing skin color since its effects tend to show up after one’s prime reproductive years are over. On the other hand, excessive exposure to sun light destroys folate in the body and leads to neural tube defects in developing fetuses, which does have a direct evolutionary impact since those babies tend to not reproduce. On the other hand not enough sun and you get rickets from Vitamin D deficiency and similar problems that keep you out of the gene pool. So the evolutionary trick was to balance those two. The study actually came out and suggested that women of child-bearing age who might get pregnant avoid tanning parlors and eat folate-rich vegetables.

  59. ?On the other hand, excessive exposure to sun light on the mother’s part destroys folate in the body?

  60. If I get all my rolls of fat to lay out smooth, will I get the necessary vitamin D in less time due to increased surface area? Does a thong help increase vitamin uptake?

  61. All things in moderation.

  62. I spent EVERY summer of my childhood through young adult years (70’s and 80’s) at the beach (and even worked as a Lifeguard and Swim Instructor into the 90’s). I am of Irish and Scottish descent–blond hair, green eyes, and fair skin, that burns then tans.

    Our parents sent us off to the beach at around 8AM every morning (unless it rained) and we didn’t come home until around 7PM.

    Did any of us wear sunscreen? NOPE! Maybe this red-headed kid named Danny slathered on Coppertone #4, but that’s it!

    I’ve been waiting all this time since the big “sun scare” for my freckles to connect and develop into a giant malignant melanoma, but at the age of 39…I got nothing–except REALLY strong bones! Sure, a few premature wrinkles, but I blame my children for that!!! :o)

  63. My dad, who is a born-again genetic fanatic, has now adopted the stance that every fargin’ thing from cancer to longevity is purely genetic. He won’t even spot you smoking, although he will make an exception for getting porky.

    If he’s right Lorikeet will be waiting a long time for lesions and Lily better stay out of the sun. Or grab her a contractors pack of 600 grit sandpaper at Home Depot.

    Have to say though Ms Keet–(there’s a punny little play on that right there but I’m not going there) the skin damage to the tops of my feet hadn’t shown up yet at 39. It looks like they’re dirty and smudged but you can’t wash it off. No, haven’t had them looked at.

  64. This is surely a conspiracy by auto makers to get everyone to trade in their roofed vehicles for expensive, new convertibles.

  65. Is there an increase in cancers for people who are lactose intolerant, and so avoid drinking milk?

  66. Post #69! (Low-hanging fruit.)

  67. There has been extensive work on this “vitamin” published in the last year.

    “Vitamin D3 is one of the most useful nutritional tools we have at our disposal for improving overall health. This vitamin is unique because cholecalciferol (Vitamin D3) is a vitamin derived from 7-dehyrocholesterol; however, Vitamin D3 acquires hormone-like actions when cholecalciferol (Vitamin D3) is converted to 1,25-dihydroxy Vitamin D3 (Calcitriol) by the liver and kidneys. As a hormone, Calcitriol controls phosphorus, calcium, and bone metabolism and neuromuscular function. Vitamin D3 is the only vitamin the body can manufacture from sunlight (UVB). Yet, with today’s indoor living and the extensive use of sunscreens due to concern about skin cancer, we are now a society with millions of individuals deficient in life-sustaining bone building and immune modulating 1,25-dihydroxy Vitamin D3.”

    D3 has been described in recent literature as a “proto-hormone”, rather than as a vitamin, most likely because it does not function as an enzyme in the digestive process.

    The research implies that higher doses of D3 (which can be manufactured by the skin under sunlight) may have beneficial effects on the body’s immune response, which accounts for the efficacy of D3 in regards to certain cancers.

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