Richard Kift

Concurrent beneficial (vitamin D production) and hazardous (cutaneous DNA damage) impact of repeated low-level summer sunlight exposures†

The concurrent impact of repeated low‐level summer sunlight exposures on vitamin D production and cutaneous DNA damage, potentially leading to mutagenesis and skin cancer, is unknown.

Sun Exposure Behavior, Seasonal Vitamin D Deficiency, and Relationship to Bone Health in Adolescents

CONTEXTnVitamin D is essential for bone health in adolescence, when there is rapid bone mineral content accrual. Because cutaneous sun exposure provides vitamin D, there is no recommended oral intake for UK adolescents.nnnOBJECTIVEnOur objective was to assess seasonal vitamin D status and its contributors in white Caucasian adolescents and examine bone health in those found deficient.nnnDESIGNnProspective cohort study was undertaken.nnnSETTINGnSix schools in Greater Manchester, UK, were included.nnnPARTICIPANTSnParticipants were 131 adolescents between 12 and 15 years of age.nnnINTERVENTION(S)nSeasonal assessment of circulating 25-hydroxyvitamin D (25OHD), personal sun exposure, and dietary vitamin D. Adolescents deficient (25OHD <10 ng/ml/25 nmol/liter) in at least one season underwent dual-energy X-ray absorptiometry (lumbar spine, femoral neck), with bone mineral apparent density correction for size, and peripheral quantitative computed tomography (distal radius) for volumetric bone mineral density (BMD).nnnMAIN OUTCOME MEASUREnSerum 25OHD and BMD measurements.nnnRESULTSnMean 25OHD was highest in September: 24.1 (SD, 6.9) ng/ml and lowest in January: 15.5 (5.9) ng/ml. Over the year, 16% were deficient in ≥ one season and 79% insufficient (25OHD <20 ng/ml/50 nmol/liter) including 28% in September. Dietary vitamin D was low year-round, whereas personal sun exposure was seasonal and predominantly across the school week. Holidays accounted for 17% variation in peak 25OHD (P < .001). Nineteen adolescents underwent bone assessment, which showed low femoral neck bone mineral apparent density vs matched reference data (P = .0002), three with Z less than or equal to -2.0 distal radius trabecular volumetric BMD.nnnCONCLUSIONSnSun exposure levels failed to provide adequate vitamin D, with approximately one-quarter of adolescents insufficient even at summer peak. Seasonal vitamin D deficiency was prevalent and those affected had low BMD. Recommendations on vitamin D acquisition are indicated in this age-group.

Target the message: A qualitative study exploring knowledge and cultural attitudes to sunlight and vitamin D in Greater Manchester, UK.

Vitamin D is vital for musculoskeletal health and has been associated with protection against several internal cancers and auto-immune diseases. Skin synthesis following exposure to ultraviolet radiation (UVR) in sunlight is the major source of the vitamin, with diet providing only small amounts. Skin synthesis requires sunlight exposure containing sufficient UVB to initiate vitamin D synthesis, which precludes the winter months at mid-high latitudes, including the UK. n nThis article is protected by copyright. All rights reserved.

A predictive model of serum 25-hydroxyvitamin D in UK white as well as black and Asian minority ethnic population groups for application in food fortification strategy development towards vitamin D deficiency prevention.

Within Europe, dark-skinned ethnic groups have been shown to be at much increased risk of vitamin D deficiency compared to their white counterparts. Increasing the dietary supply of vitamin D is potentially the only modifiable environmental component that can be used to prevent vitamin D deficiency among dark-skinned ethnic groups living at high latitude. Empirical data to support development of such strategies is largely lacking. This paper presents the development and validation of an integrated model that may be adapted within the UK population to design fortification strategies for vitamin D, for application in both white and black and Asian minority ethnic (BAME) population groups. Using a step-wise approach, models based on available ultraviolet B (UVB) data, hours of sunlight and two key components (the dose-response of serum 25-hydroxyvitamin D [25(OH)D] to UVB in white and BAME persons and the dose-response of 25(OH)D to vitamin D) were used to predict changes population serum 25(OH)D concentrations throughout the year, stratified by ethnicity, via increases in dietary intake arising from food fortification simulations. The integrated model successfully predicted measured average wintertime 25(OH)D concentrations in addition to the prevalence of serum 25(OH)D <30nmol/L in adult white and BAME individuals (18-70y) in the UK-based National Diet and Nutrition Survey both separately (21.7% and 49.3% predicted versus 20.2% and 50.5% measured, for white and BAME, respectively) and when combined at UK population-relevant proportions of 97% white and 7% BAME (23.2% predicted versus 23.1% measured). Thus this integrated model presents a viable approach to estimating changes in the population concentrations of 25(OH)D that may arise from various dietary fortification approaches.

Sunlight exposure and photoprotection behaviour of white Caucasian adolescents in the UK

Sun exposure has positive and negative effects on health, yet little is known about the sun exposure behaviour of UK adolescents, including those more prone or less prone to sunburn.

Colour Counts: Sunlight and Skin Type as Drivers of Vitamin D Deficiency at UK Latitudes

Sunlight exposure, with resulting cutaneous synthesis, is a major source of vitamin D for many, while dietary intake is low in modern diets. The constitutive pigment in skin determines skin type, observed as white, brown, or black skin. The melanin pigment absorbs ultraviolet radiation (UVR) and protects underlying skin from damage caused by UVR. It also reduces the UVR available for vitamin D synthesis in the skin. It has been shown that the white-skinned population of the UK are able to meet their vitamin D needs with short, daily lunchtime exposures to sunlight. We have followed the same methodology, based on a 10-year UK all-weather UVR climatology, observation (sun exposure, diet, vitamin D status), and UVR intervention studies with Fitzpatrick skin type V (brown) adults, to determine whether sunlight at UK latitudes could provide an adequate source of vitamin D for this section of the population. Results show that to meet vitamin D requirements, skin type V individuals in the UK need ~25 min daily sunlight at lunchtime, from March to September. This makes several assumptions, including that forearms and lower legs are exposed June–August; only exposing hands and face at this time is inadequate. For practical and cultural reasons, enhanced oral intake of vitamin D should be considered for this population.

Assessment of a Dual-Channel Array Spectrometer for Ground-Based Ozone Retrievals

AbstractThis study describes a dual-channel array spectrometer system designed to make high-frequency simultaneous spectral global irradiance and direct solar irradiance measurements covering the visible and ultraviolet wavelength ranges. The dual-channel nature of the instrument allows spectrally integrated quantities (e.g., erythema or vitamin D) to be calculated at a rate similar to broadband instruments while retrieving total column ozone (TCO) from the direct solar channel. The characterization and calibration of the instrument is discussed, with emphasis on temperature stabilization (<±0.01°C) and stray light removal. Focusing on the TCO retrieval from direct spectra, results are compared to a collocated Brewer spectrophotometer during the study period of May 2013–January 2014. Agreement for individual measurements made within 20 min of a reference Brewer direct sun observation on relatively clear example days is <1.5%. For all valid individual measurements, the study found an overall bias of 1.1 Do...

Fractional sunburn threshold UVR doses generate equivalent vitamin D and DNA damage in skin types I-VI, but with epidermal DNA damage gradient correlated to skin darkness

Public health guidance recommends limiting sun exposure to sub-sunburn levels, but it is unknown whether these can gain vitamin D (for musculoskeletal health) while avoiding epidermal DNA damage (initiates skin cancer). Well-characterized healthy humans of all skin types (I–VI, lightest to darkest skin) were exposed to a low-dose series of solar simulated UVR of 20%–80% their individual sunburn threshold dose (minimal erythema dose). Significant UVR dose responses were seen for serum 25-hydroxyvitamin D and whole epidermal cyclobutane pyrimidine dimers (CPDs), with as little as 0.2 minimal erythema dose concurrently producing 25-hydroxyvitamin D and CPD. Fractional MEDs generated equivalent levels of whole epidermal CPD and 25-hydroxyvitamin D across all skin types. Crucially, we showed an epidermal gradient of CPD formation strongly correlated with skin darkness (r = 0.74, P < 0.0001), which reflected melanin content and showed increasing protection across the skin types, ranging from darkest skin, where high CPD levels occurred superficially, with none in the germinative basal layer, to lightest skin, where CPD levels were induced evenly across the epidermal depth. People with darker skin can be encouraged to use sub-sunburn UVR-exposure to enhance their vitamin D. In people with lighter skin, basal cell damage occurs concurrent with vitamin D synthesis at exquisitely low UVR levels, providing an explanation for their high skin cancer incidence; greater caution is required.

Is Sunlight Exposure Enough to Avoid Wintertime Vitamin D Deficiency in United Kingdom Population Groups

Solar ultraviolet radiation (UVR) is required for cutaneous vitamin D synthesis, and experimental studies have indicated the levels of sun exposure required to avoid a vitamin D deficient status. Our objectives are to examine the sun exposure behaviours of different United Kingdom sectors and to identify if their exposure is enough to maintain winter circulating 25-hydroxyvitamin D above deficiency (>25 nmol/L). Data are from a series of human studies involving >500 volunteers and performed using the same protocols in Greater Manchester, UK (53.5° N) in healthy white Caucasian adolescents and working-age adults (skin type I–IV), healthy South Asian working-age adults (skin type V), and adults with photodermatoses (skin conditions caused or aggravated by cutaneous sun exposure). Long-term monitoring of the spectral ambient UVR of the Manchester metropolitan area facilitates data interpretation. The healthy white populations are exposed to 3% ambient UVR, contrasting with ~1% in South Asians. South Asians and those with photodermatoses wear clothing exposing smaller skin surface area, and South Asians have the lowest oral vitamin D intake of all groups. Sun exposure levels prevent winter vitamin D deficiency in 95% of healthy white adults and 83% of adolescents, while 32% of the photodermatoses group and >90% of the healthy South Asians were deficient. The latter require increased oral vitamin D, whilst their sun exposure provides a tangible contribution and might convey other health benefits.

Duration of casual sunlight exposure necessary for adequate Vitamin D status in Indian Men

Objectives: To investigate the duration of casual sunlight ultraviolet-B (UVB) exposure required to maintain optimal Vitamin D status (25-hydroxyvitamin-D [25(OH)D]) >50 nmol/L in urban Indian men, using polysulfone (PSU) dosimeters and a sunlight exposure questionnaire. Methods: In healthy men (aged 40–60 years) from Pune (18.52° N, 73.86° E), India, serum 25(OH)D was measured using enzyme-linked immunosorbent assay. Sunlight exposure was assessed using PSU dosimeter and by questionnaire. Results: Of 160 men (48.3 ± 5.6 years), 26.8% were deficient and 40.6% had insufficient Vitamin D concentrations. A hyperbolic function for the relationship between PSU measured sunlight exposure in standard erythema dose (SED) and serum 25(OH)D concentrations (r = 0.87, P < 0.01) revealed that daily exposure of 1 SED was sufficient to maintain serum 25(OH)D concentrations over 50 nmol/L. The curve plateaued around 5 SED (80 nmol/L) and extrapolation of the curve (>5 SED) did not increase 25(OH)D concentrations above 90 nmol/L. Receiver operating curve analysis confirmed that 1 SED-UV exposure was sufficient to maintain 25(OH)D concentrations over 50 nmol/L. Based on the questionnaire data, >1 h of midday casual sunlight exposure was required to maintain serum 25(OH)D concentrations above 50 nmol/L. Duration of sunlight exposure assessed by questionnaire and PSU dosimeter showed a significant correlation (r = 0.517, P < 0.01). Conclusion: In urban Indian men, >1 h of casual midday sunlight exposure daily was required to maintain serum 25(OH)D concentrations above 50 nmol/L, and >2 h of casual sunlight exposure was needed to maintain 25(OH)D concentrations above 75 nmol/L. Excess sunlight did not increase 25(OH)D linearly. The sunlight exposure questionnaire was validated for use in clinical studies and surveys.