Sun on skin. In my childhood, it was an unadulterated sensual pleasure: warm radiance and the clean salt scent of sweat brought by the sun's rays. Now I think mainly of their burning power and, if I'm not properly protected with clothing or slathered with sunscreen, of the looming possibility of skin cancer.
The dangers of overexposure to the sun have been drilled into us—and rightly so. There's little question that excessive solar radiation damages skin, causing the changes we often associate with aging (thick leathery texture, wrinkles, brown spots) and the far more serious risk of skin cancer, including deadly melanoma.
The specter of burgeoning rates of skin cancer has given birth in Australia to the popular Slip, Slop, Slap campaign. In the U.S., it's Safe-Sun or SunWise, which advises avoiding those yellow rays altogether from 10 a.m. to 4 p.m. and applying sunscreen year-round. We are warned that ultraviolet rays pass through clouds, so we can fry even on overcast days.
But a clear view of the sun may be eclipsed by such messages about its risks. Sunshine doesn't just cause skin cancer. It is by far the biggest source of vitamin D, produced naturally in the skin by the same ultraviolet B rays that lead you to tan and burn. More than just a builder of strong bones, the sunshine vitamin has, over our eons on earth, insinuated itself into myriad cellular functions. A rising tide of basic research shows that it has regulatory effects on almost every system of the human body.
At the same time, what scientists call an impressive body of epidemiologic evidence suggests that a little unprotected sun exposure could be vitally important in preventing ailments from autoimmune disorders to cardiovascular disease and cancer. And in reducing mortality from them.
To do that, however, requires a shift in attitude toward sun exposure. Like so many issues in science and medicine, this one is complex, and passions run high on both sides. It may come down to this: Are you up to grasping the subtleties of sunlight?
That the human body might benefit from the sun's rays should come as no surprise. Our ancestors evolved in a world bathed in bright sunlight. The rays that shaped the biology of our oldest mammalian ancestors still glimmer deep in our genes.
These days, however, many of us spend our daylight hours indoors, in a kingdom of low-lux gloom. "Modern habits and work routines have curbed our exposure to sunlight," says Daniel Kripke, professor of psychiatry at the University of California at San Diego. "People don't walk as much as they used to, they don't work outside as much, they exercise indoors at gyms." Children spend more hours indoors playing on computers and fewer at recess.
When Kripke and his colleagues measured how much time people spend in the open in sunny San Diego, they were shocked by the results. On average, San Diegans enjoy less than an hour a day outside; many are in daylight for only 10 or 20 minutes.
Our low-light lifestyle may be undermining our health.
Patterns of Protection
A half-century ago, epidemiologists noticed a peculiar geographical pattern of death rates from cancer in the U.S.—higher in the north, lower in the south. Indeed, people living in the Northeast had as much as a twofold higher risk of dying from cancer than those in southern regions. Thus arose the hypothesis of a "sunlight effect," suggesting that direct sunshine might protect against cancer. But there was little clue of how this might work, and the link remained largely unplumbed.
At around the same time, evidence of the negative aspects of sun exposure was growing. In the 1960s, science learned that ultraviolet rays cause mutations in DNA. "This effectively pushed aside the emerging evidence about sunlight's possible benefits," says Edward Giovannucci, professor of nutrition and epidemiology at the Harvard School of Public Health.
Then, in 1980, brothers Frank and Cedric Garland, both epidemiologists at UCSD, revisited the topic and made a revolutionary suggestion. They studied the geographic distribution of colon-cancer deaths in the U.S. and found that cancer mortality rates were highest in places where populations were exposed to the least amount of natural light—in big cities and in rural areas at high latitudes. They proposed that the beneficial sunlight effect might be linked with vitamin D.
The sunshine vitamin had long been known for building strong bones. But how could it possibly prevent cancer?
More Vita in Vitamin D
We get a little vitamin D from diet—from fatty fish and egg yolks, for instance—and from fortified foods and supplements. However, our greatest source by far is exposure to sunlight. "The skin is incredibly efficient at making vitamin D," says Michael Holick, professor of medicine at Boston University and arguably the world's foremost expert on the vitamin. "Wearing a bathing suit at Cape Cod and exposing yourself to sunlight for 15 to 30 minutes until you have a slight pinkness is equivalent to 20,000 IU of vitamin D." (That's like drinking 200 glasses of milk.)
Perhaps it was by raising levels of vitamin D that abundant sunlight lowered the risk of cancer, the Garlands' thinking went. And conversely, perhaps sunlight deprivation and low levels of vitamin D in the blood jacked up risk of the disease.
Over the next two decades, scientists learned that most tissues and cells in the body have a receptor for vitamin D, including cells in the colon, breast, immune system, brain—even melanoma cells. This would help to explain why cells and tissues might respond to the presence of the vitamin.
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