ADA Issues Updated Position Statement On Vitamin D
The American Academy of Dermatology (Academy) recently issued an updated position statement on vitamin D after an updated review of the increasing body of scientific literature on this vitamin and its importance for optimal health.
The Academy continues to recommend that the public obtain vitamin D from nutritional sources and dietary supplements, and not from unprotected exposure to ultraviolet (UV) radiation from the sun or indoor tanning devices, as UV radiation is a known risk factor for the development of skin cancer.
The Academy’s position statement on vitamin D now also states that individuals who regularly and properly practice sun protection, such as the daily use of sunscreen on exposed skin or the wearing of sun protective clothing, may be at risk for vitamin D insufficiency. A higher dose of vitamin D may be necessary for these individuals and others with known risk factors for vitamin D insufficiency, such as those with dark skin, the elderly, photosensitive individuals, people with limited sun exposure, obese individuals or those with fat malabsorption. Therefore, the Academy encourages those with concerns about their levels of vitamin D to discuss options for obtaining sufficient dietary or supplementary sources of vitamin D with their physician.
“The vitamin D position statement supports the Academy’s long-held conviction on safe ways to get this important vitamin – through a healthy diet which incorporates foods naturally rich in vitamin D, vitamin D-fortified foods and beverages, and vitamin D supplements,” stated dermatologist David M. Pariser, MD, FAAD, president of the American Academy of Dermatology. “The updated recommendation for individuals who practice daily sun protection acknowledges that while protecting the skin from the damaging rays of the sun is important, so is maintaining adequate vitamin D levels. Concern about vitamin D should not lead people to forego sun protection, but rather prompt a conversation with their physician about how to ensure adequate and safe vitamin D intake while guarding against skin cancer .”
The Academy’s new position statement notes that the National Academy of Sciences Institute of Medicine guidelines for vitamin D are the standard reference for advising patients on proper minimum intake levels. The currently recommended adequate intake levels established by the Institute of Medicine may be revised upward due to evolving research on the increasing clinical benefit of vitamin D. The statement also notes that the U.S. Department of Agriculture (USDA) Dietary Guidelines discuss a daily total dose of 1,000 IU (International Units) of vitamin D for supplementation of those at-risk for vitamin D insufficiency.
The Academy’s new position statement also asserts that there is no scientifically proven, safe threshold of sun or indoor tanning device exposure that allows for maximum vitamin D synthesis in the skin without increasing the risk of skin cancer. Also, while numerous studies suggest an association between low levels of vitamin D and an increased risk of certain types of cancers and diseases, the Academy emphasizes that the causal relationship of vitamin D to these disease outcomes has yet to be demonstrated with clinical trials.
“It is well documented in the medical literature that unprotected exposure to UV radiation from natural sunlight or indoor tanning devices causes skin damage. There is no current research available that provides a safe limit for sun exposure to maximize vitamin D production that does not put the individuals health at risk for developing skin cancer,” stated Dr. Pariser. “In addition, contrary to some reported information about vitamin D and the prevention of certain cancers and diseases--other than for bone health, we simply need more clinical data to determine what role, if any, vitamin D plays in these conditions.”
The Academy continues to recommend that individuals protect themselves from UV exposure when outdoors, such as seeking shade whenever possible, wearing sunscreen and covering up with a wide-brimmed hat, long sleeves, pants and sunglasses. Also, the Academy urges the public to avoid tanning beds.