3 ms·

So TLDR; - a bunch of studies have shown Vitamin D strongly correlates with health - however more studies show supplementation of Vitamin D does not give the

So TLDR; - a bunch of studies have shown Vitamin D strongly correlates with health - however more studies show supplementation of Vitamin D does not give the same outcomes - Thus probably Vitamin D is not the cause, rather just an indicator for sun exposure, and sun exposure is what’s good for you - lots of research showing sun exposure has many befits and avoiding it has high risks - as for melanoma, it’s less common than you think and the risk is mostly sunburn not sun exposure in general - this is more serious for people with darker skin whose bodies are better adapted to more sunlight and have much lower risk of skin cancer but need more sunlight to get the health benefits Conclusion: go outside a lot and get sun, just do it gradually and don’t shock your system with sunburn. If you’re not getting sunburn then your melanoma risk is very low while the other benefits are very high. That is interesting to read, and it also feels really common-sense to me. I definitely feel better when I’m getting good sun exposure, and I can feel it in the winter when I’m not. Most interesting to me is the studies showing Vitamin D supplementation is not effective for health benefits. That’s too bad because my D levels tend to be low and I have supplemented in the past, but not shocking because it’s never really felt different to me when supplementing.

PKop 8y ago
One other point to highlight: Many of the doctors quoted in the article couldn't dispute the data (reminiscent of nutrition conventional wisdom) but inexplicably advocated not to get benefits mentioned from sun, but instead take statins/blood pressure drugs. This is ridiculous, and if one looks into the criticisms of these drugs, mirrors the terrible advice peddled by same doctors as nutrition advice, to the detriment of millions. Why does this mentality persist, always and everywhere take blood pressure drugs? Madness.
- burlesona 8y ago
  Well, I’ve come to see it that western primary care doctors main job is to try and match your symptoms to a pill that can help. I’m not trying to disparage all the doctors or say they do nothing else. But if you look at it like that, then a lot of the behavior makes sense. “I don’t know about sun exposure, but I’m confident this pill will help you, so avoid the sun and take the pill.”
  - classichasclass 8y ago
    A more charitable view would be, "Currently I have better evidence in the literature that this medication would be more helpful than sun exposure, which in large quantities has more evidence of harm than benefit." That's not an indictment of physicians, that's a recognition that our evidence base is skewed (for a variety of reasons). But there is good evidence that at least for some people, sun exposure above some level does more harm than benefit. You're saying the average primary care doctor should just toss that out. Who says this isn't the latest whim to be disproven in 20 years? The evidence base for lifestyle interventions sucks because it's much harder to measure and pharma has certainly been able to tip the scales, no question. That should change and I hope it does. But when I have a patient come in and ask, we go with what we've got.
    - pakitan 8y ago
      > A more charitable view would be, "Currently I have better evidence in the literature that this medication would be more helpful than sun exposure, which in large quantities has more evidence of harm than benefit." That's indeed a very charitable view. The more realistic view, in my experience is "I just go with the mainstream as nobody got fired or sued for going with the mainstream and I don't really have the time, nor the inclination to keep up with the latest studies". > Who says this isn't the latest whim to be disproven in 20 years? A million years of evolution, spent in extreme sun exposure, without sunblock? I've long suspected that the "Always put on sunblock" advice is bollocks and have never used the substance. Partly because of common sense (evolution of human species) and partly because of simple observation. All my grandparents and their relatives were raised in villages (and quite a few still live or lived there till they passed away), with serious sun exposure, working on the field, long before the age of sunblock. Yet, none of them had skin cancer. Other cancers, diabetes, heart attacks, strokes, yes. Skin cancer - not a single one of them. Why is that, if the sun is so dangerous? And while you may dismiss my anecdata, note that the article says "outdoor workers have half the melanoma rate of indoor workers"!! So, for me this isn't the "latest whim", we're just going back to common sense.
  - arkades 8y ago
    Well, for starters, the Centers for Medicare & Medicaid Services uses “what percentage of people with qualifying conditions get the right pill” as a quality measure, which reduces your income as it goes down. Docs can’t fight CMS. That’s not “western medicine,” that’s the US government.
- alexandercrohde 8y ago
  I think it's some sort cognitive dissonance. I think it's emotionally hard for doctors to recognize the cases when the product they peddle (medicine) is actually worse than the solution they have no control over (a more natural lifestyle). I think this leads to systematic bias towards intervention.
gilbetron 8y ago
Maybe it is just going outside and being active that's the benefit, and the "sun" part is just a correlation. People that spend a lot of time in the sun aren't just sitting in front of a computer while doing so, they are moving more. How about research that shows people with the same amount of outside time doing the same types of things, but one group wears sun block, the other doesn't?
- classichasclass 8y ago
  I think this is worth looking into. There may be some direct benefit from sun exposure, but it's very difficult to extricate it from other benefits of good regular outdoor activity. In public health there's been an interest in looking at park access for kids to improve activity and overall wellbeing, and I wonder if a similar effect is being observed here.
- njarboe 8y ago
  I think that these hard to prove health factors vary a lot depending on a persons genetics, diet, and lifestyle. Big studies with small statistical results using an average of outcomes is not going to be very useful for you, a single individual. 100% of people who don't eat Vitamin C get scurvy. This is useful information for an individual person. A study of 20,000 people over 20 years that finds that people with a vitamin D level below a certain number died on average 100 day earlier than the ones with vitamin D above that level is useless to an individual. Maybe with individual genetic testing some more useful things can be learned about health for individual people, but for now the low hanging fruit of health studies has been picked. Instead more focus on how individual people can figure out what works for them should be done.

PKop 8y ago

One other point to highlight: Many of the doctors quoted in the article couldn't dispute the data (reminiscent of nutrition conventional wisdom) but inexplicably advocated not to get benefits mentioned from sun, but instead take statins/blood pressure drugs. This is ridiculous, and if one looks into the criticisms of these drugs, mirrors the terrible advice peddled by same doctors as nutrition advice, to the detriment of millions. Why does this mentality persist, always and everywhere take blood pressure drugs? Madness.

burlesona 8y ago
Well, I’ve come to see it that western primary care doctors main job is to try and match your symptoms to a pill that can help. I’m not trying to disparage all the doctors or say they do nothing else. But if you look at it like that, then a lot of the behavior makes sense. “I don’t know about sun exposure, but I’m confident this pill will help you, so avoid the sun and take the pill.”
- classichasclass 8y ago
  A more charitable view would be, "Currently I have better evidence in the literature that this medication would be more helpful than sun exposure, which in large quantities has more evidence of harm than benefit." That's not an indictment of physicians, that's a recognition that our evidence base is skewed (for a variety of reasons). But there is good evidence that at least for some people, sun exposure above some level does more harm than benefit. You're saying the average primary care doctor should just toss that out. Who says this isn't the latest whim to be disproven in 20 years? The evidence base for lifestyle interventions sucks because it's much harder to measure and pharma has certainly been able to tip the scales, no question. That should change and I hope it does. But when I have a patient come in and ask, we go with what we've got.
  - pakitan 8y ago
    > A more charitable view would be, "Currently I have better evidence in the literature that this medication would be more helpful than sun exposure, which in large quantities has more evidence of harm than benefit." That's indeed a very charitable view. The more realistic view, in my experience is "I just go with the mainstream as nobody got fired or sued for going with the mainstream and I don't really have the time, nor the inclination to keep up with the latest studies". > Who says this isn't the latest whim to be disproven in 20 years? A million years of evolution, spent in extreme sun exposure, without sunblock? I've long suspected that the "Always put on sunblock" advice is bollocks and have never used the substance. Partly because of common sense (evolution of human species) and partly because of simple observation. All my grandparents and their relatives were raised in villages (and quite a few still live or lived there till they passed away), with serious sun exposure, working on the field, long before the age of sunblock. Yet, none of them had skin cancer. Other cancers, diabetes, heart attacks, strokes, yes. Skin cancer - not a single one of them. Why is that, if the sun is so dangerous? And while you may dismiss my anecdata, note that the article says "outdoor workers have half the melanoma rate of indoor workers"!! So, for me this isn't the "latest whim", we're just going back to common sense.
- arkades 8y ago
  Well, for starters, the Centers for Medicare & Medicaid Services uses “what percentage of people with qualifying conditions get the right pill” as a quality measure, which reduces your income as it goes down. Docs can’t fight CMS. That’s not “western medicine,” that’s the US government.
alexandercrohde 8y ago
I think it's some sort cognitive dissonance. I think it's emotionally hard for doctors to recognize the cases when the product they peddle (medicine) is actually worse than the solution they have no control over (a more natural lifestyle). I think this leads to systematic bias towards intervention.

gilbetron 8y ago

Maybe it is just going outside and being active that's the benefit, and the "sun" part is just a correlation. People that spend a lot of time in the sun aren't just sitting in front of a computer while doing so, they are moving more. How about research that shows people with the same amount of outside time doing the same types of things, but one group wears sun block, the other doesn't?

classichasclass 8y ago
I think this is worth looking into. There may be some direct benefit from sun exposure, but it's very difficult to extricate it from other benefits of good regular outdoor activity. In public health there's been an interest in looking at park access for kids to improve activity and overall wellbeing, and I wonder if a similar effect is being observed here.
njarboe 8y ago
I think that these hard to prove health factors vary a lot depending on a persons genetics, diet, and lifestyle. Big studies with small statistical results using an average of outcomes is not going to be very useful for you, a single individual. 100% of people who don't eat Vitamin C get scurvy. This is useful information for an individual person. A study of 20,000 people over 20 years that finds that people with a vitamin D level below a certain number died on average 100 day earlier than the ones with vitamin D above that level is useless to an individual. Maybe with individual genetic testing some more useful things can be learned about health for individual people, but for now the low hanging fruit of health studies has been picked. Instead more focus on how individual people can figure out what works for them should be done.