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Avoidance of sun exposure as a risk factor for major causes of death (2016)
- rajnathani 2y agoAvoidance of sun exposure is mostly connected to more time spent indoors, where the ventilation is lower with higher CO2 buildup, viral exposure, and indoor pollution (mostly VOCs, but also Ozone, and also particulate and NO2 pollution (for gas stoves) from kitchens, etc.). However, outdoor time would have slightly more exposure to vehicular pollution, but likely less to nanoparticles in the case of gas stove usage (https://www.earth.com/news/gas-stoves-release-more-harmful-nanoparticles-than-vehicle-exhaust/ https://www.earth.com/news/gas-stoves-release-more-harmful-n...).
- mgh2 2y agoIs there a correlation vs causation error here? Diet and exercise were not controlled. Asian culture avoids sun exposure and sometimes exercise yet are healthier than their Western counterparts who have an unhealthy diet high in fats and sugar in addition to a sedentary lifestyle.
- Aloisius 2y agoExercise is mentioned: > similar sHR values were obtained when including exercise for those women who answered the second questionnaire in 2000 A bigger caveat tough is this is for Southern Sweden which is rather further north than where the average person in Asian lives. Even if one tries to avoid the sun, the considerably higher UV level and brighter sunlight likely someone is getting more sun than someone who avoids it in Sweden. While the article seems focused on Vitamin D production, exposure to bright light has a wide range of positive effects on people from mood and sleep regulation to wound healing.
- bpodgursky 2y ago"Asian culture". Have you seen how the superelderly cohorts on Okinawa etc actually live? It's all outdoors. Yes pasty sedentary 40 year old office workers in Beijing avoid the sun. That's not a longitudinal analysis, lifestyles have changed rapidly in the past generation.
- mgh2 2y agoOkinawans are a specific subset of centenarians with distinct lifestyle and diet, not quite representative. What I mean is that Eastern Asian culture in general avoid the sun because pale skin is considered "more beautiful" vs. tanned for Western culture - ex: using umbrellas to cover sun. Also, myopia epidemic in Asian countries is due to upbringing with strong emphasis in studying indoors but lacking encouragement for sports or outdoors activities: https://news.ycombinator.com/item?id=38782482#38783161 https://news.ycombinator.com/item?id=38782482#38783161
- bpodgursky 2y agoI hear that but what I am saying is that the cohorts whose longevity is being measured (ie, people dying now who were born in ~1950) grew up in an utterly different world and did not spend their adolescence indoors avoiding the sun, they were mostly rural, agricultural, poor, and outdoors. We have no idea what the longevity of the current ~30yo urban east asian will be, but the lifestyle is so radically different than their grandparents that I don't think there's any value in connecting the two.
- jjtheblunt 2y agoAre you saying that pretty much everyone trends healthier than anyone with a comparably more unhealthy diet, high in fats and sugar, with a more sedentary lifestyle? I ask because, looking around at Americans, so genetically from all over the planet, with a large fraction from Europe, there's a huge dynamic range in diet and exercise levels and it really seems to correlate with the huge dynamic range in external presentation of fitness.
- hombre_fatal 2y agoFwiw the sun exposure data was a questionnaire that asked women if they sunbathe never, a little, or a lot.
- hn_user82179 2y agoIs sunbathing even much of a thing anymore? I feel like I heard of people sunbathing in their yards or at the beach when I was younger (~20 years ago) but not so much now
- deleted 2y ago[deleted]
- riffic 2y agogo check out the beach or pool sometime.
- yxhuvud 2y agoIn Sweden? Oh yes.
- JohnBooty 2y agoI'm a middle-aged white-skinned American and I do it sometimes. Probably about 20 minutes per week in the summer? I'm not trying to get a deep dark tan or anything. I just want to make my back and my chest match my arms and face a little bit more closely. Otherwise people laugh at you at pool parties!
- anatnom 2y agoFrom the paper[0]: > Four predetermined questions were posed regarding sun exposure: (i) How often do you sunbathe during the summertime? (never, 1−14 times, 15−30 times, >30 times); (ii) Do you sunbathe during the winter, such as on vacation to the mountains? (no, 1−3 days, 4−10 days, >10 days); (iii) Do you use tanning beds? (never, 1−3 times per year, 4−10 times per year, >10 times per year); and (iv) Do you go abroad on vacation to swim and sunbathe? (never, once every 1–2 years, once a year, two or more times per year). The four questions were dichotomized into yes/no in the analysis (i.e. sometimes versus no or never). We created a four-score variable as a measure of sun exposure depending on the number of ‘yes’ responses to the above questions on a scale from 0 (avoid sun exposure: reference) to 4 (greatest sun exposure). Sun exposure habits were categorized into three groups: zero ‘yes’ responses (avoidance of sun exposure; the main study group); ‘yes’ responses to one or two questions (moderate exposure); and ‘yes’ responses to three or four questions (greatest exposure). Of note, the surveys are of Swedish women and were conducted in Swedish. There could be some translation nuance for the word "sunbathe" which doesn't map well to English, or other cultural differences to explain the "but no one I know actually sunbathes..." thought that I immediately jump to. [0] https://onlinelibrary.wiley.com/doi/10.1111/joim.12496 https://onlinelibrary.wiley.com/doi/10.1111/joim.12496
- GolDDranks 2y agoSo, outdoorsy people live longer because of the other health benefits of outdoorsy lifestyle, but are risking more skin cancer? But the risk of skin cancer isn't enough to outweigh the benefits?
- Spooky23 2y agoMelanoma risk is driven by a number of factors. A white 40-something female who doesn’t tan and has heavy freckling has a risk close to 1% of developing a cancerous lesion in 5 years. If that person tans dark and has no freckles, that risk is 90% less. My wife list a battle with melanoma - in her case a single severe childhood burn likely increased her risk by another 25-30%.
- kmeisthax 2y agoI'm assuming this is a correlation with other healthy habits, and not specifically a thing that UV exposure does?
- TibbityFlanders 2y ago[dead]
- jmward01 2y agoI haven't delved deeply into the papers here. I'm not a doctor. But have seen in a few places that there is a correlation between latitude and all source mortality. Maybe it isn't just 'people that go outside tend to have a healthy lifestyle and that is why their mortality is lower'. A great Ted Talk on this (now a few years old) can be found here: https://www.ted.com/talks/richard_weller_could_the_sun_be_good_for_your_heart https://www.ted.com/talks/richard_weller_could_the_sun_be_go...
- deadbabe 2y agoWellp, if this is accurate I’m truly a dead woman, but at least my skin will look great!
- lelanthran 2y ago> Wellp, if this is accurate I’m truly a dead woman, but at least my skin will look great! Have to admit, your username choice at sign-up was awfully prescient. Don't suppose you want to give me your guesses for any upcoming lottery? :-)
- deadbabe 2y agoWell my username is also a hexadecimal number :D
- chalcolithic 2y agoSouthern Sweden! If sun poses a risk there...
- strogonoff 2y agoIf you follow current WHO guidelines for sun exposure, you will avoid UV almost anywhere on planet. Apple’s Weather app (based on those guidelines) recommends all day sunscreen in Stockholm this entire week; same in Singapore, where it is overcast and rainy. This Swedish paper’s summary does not differentiate between UV and sun, but assuming it concerns UV—the guidelines will seriously have to change, and ASAP: > Nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking.
- tracerbulletx 2y agoIt's completely pointless for the general public, the media, or anyone else to take any particular advice or truth from any single medical study. Even if it's a good study, and you know how to evaluate if its good, even if it's highly plausible and has a mechanism of action it's almost never the case that a single study will be likely to make a strong enough case to jump to a conclusion or even consider a conclusion highly likely.
- deely3 2y agoThats very unorthodox claim, no?
- naasking 2y agoUnorthodox but probably not wrong. Replication is key. They might have overlooked something obvious or unexpected, or they might have faked data, and we would never know without an attempted replication.
- dahart 2y agoI’d say not at all, this is pretty common advice, but maybe depends on what you mean by unorthodox, exactly. The advice is fairly good (and routine) for studies and papers from any discipline. All kinds of things can cause a single paper, single set of authors, single methodology, single dataset, etc., to come to misleading conclusions. The study can even be accurate in their measurements but not representative in subtle ways that are important. Before using someone’s results or making decisions based on it, it’s good to wait for confirmation from someone else, and even more so for a meta analysis of multiple publications.
- eternauta3k 2y agoNo, the orthodox advice is to get your information from your doctor or, if he's a doofus, directly from the local professional association (e.g. American Heart Association), who do the work of reviewing and weighing the literature for you.
- drekipus 2y agoI got into the same arguments during the height of COVID
- assmanreturns 2y agoIt's possible that sick weak people are just too tired to want to go outside. In which case it's ill health that causes less sun exposure not the reverse.
- _moof 2y agoBefore anyone gets too excited about another opportunity to say the line about correlation: > We acknowledge several major limitations of this study. First, it is not possible to differentiate between active sun exposure habits and a healthy lifestyle, and secondly, the results are of an observational nature; therefore, a causal link cannot be proven.
- hn_throwaway_99 2y agoI mean, perhaps we don't need to say it because they say it explicitly. Which makes me think that the title about "avoidance of sun exposure" is misleading, even if not deliberately so. "Avoidance" in the general lexicon usually means conscious choices to deliberately not expose yourself to something. Is someone who is, say, obese and bedridden "avoiding" sun exposure?
- assmanreturns 2y agoSure. This is in every single study using surveys or statistics and yet everyone thinks the paper is making a casual argument. The paper itself actually does do that. So the whole limitations part is just ass covering for the fact that the authors are lying. Why call it anything else. I mean it's like me writing a long paper proving that thermodynamics is flawed and then ending the paper with some acknowledgement that one of the key arguments has a logical flaw which renders the whole proof incorrect. So then the whole paper is worthless.
- cpncrunch 2y agoThey do adjust the results for certain lifestyle factors, in particular exercise and smoking. They are just pointing out that they can't correct for all lifestyle factors.
- SaintSeiya 2y agoFound a sun avoidance advocate.
- jhguibcdtt 2y ago
- RamiAwar 2y agoReading this paper made me cringe so hard... You can't just frame it like it's sun exposure that leads to low mortality. Or that sentence: "Lack of sun exposure is just as bad as smoking." Do you even hear yourself? Have you taken a statistics course before? How did this even get published? There are 99999999 other reasons that contributed to mortality. Sun exposure is definitely not one of them. Exercise and nutrition are the leading factors, period. Who funded this shit
- osigurdson 2y agoDoesn't it seem logical, given we have spent millions or years evolving in the sun?
- _cenw 2y agoevolutionary pressures don't usually optimize for longevity beyond a certain point.
- osigurdson 2y agoIt is a strange hypothesis. Living under a rock and avoiding sun exposure might kill you before you are able to reproduce. But, if you get past that point you will live long life under said rock.
- samus 2y agoNot really, since evolution doesn't optimize organisms for longevity, but for reproductive success.
- meisenhus 2y agoLongevity is a component in reproductive success since until quite recently in humans evolutionary past, the family played a crucial role in upbringing of the young generation. The more grandparents were missing, the harder it was for the young to survive since they tended to be less cared for.
- forgotusername6 2y agoHaving older family members around to pass on skills and look after the young is an advantage that happens after reproductive age.
- samus 2y agoFor that to work, they don't have to be ancient. Just fit enough long enough to be too much of a net burden to the younger generations. The menopause seems to coincide with the age where people used to become grandparents. Furthermore, people getting too old might make it harder for collective cultural knowledge to evolve. Which is fine in good times, but disadvantageous in volatile circumstances.
- woolion 2y agoI've read in "Lies My Doctor Told Me" by the MD Ken Berry that there isn't a single paper that shows that sun exposure is bad. In particular the current consensus is that Vitamin D is essential to health and so this is considering that sun is avoided but replaced by pills, as the protective role of vitamin D is well-proven. But there are many other health benefits that are triggered by sun exposure (the skin metabolism activates and it goes down to influence gene expression). So I've looked a few articles (at least 7, including some reviewing existing research), and sure enough there wasn't a single paper that actually showing that sun exposure is bad. They all relied on showing on something related to sunlight, most of the time that suntanning with artificial UV beds is really bad. But there it lacks a convincing argument that this transfers to 'the real product', as this is the equivalent of saying that carrots are good/bad for people based on some people ingesting large quantities of carotene in pills. And we know from diet that these kinds of arguments do break down when extrapolating only part of one molecule to a whole, natural product (eggs are a famous example). If somebody has done more research on this please elaborate, I haven't spent too much time because the research seemed in all cases fairly low quality (questionnaires?) and a lot contained confusing arguments (it's not always clear how dark-skinned the individuals are, or how removed from their natural habitat they are, like some Swedish in Australia or Kenyan in the UK, although some do make an effort in that regard).
- ardaoweo 2y agoToo much sun exposure is definitely bad, because it increases likelihood of skin cancer. Moderation is the key.
- lurking15 2y agoexcept the reality for the vast number of people isn't about needing to moderate, it's about getting outside period, instead of glued to their devices inside you can look at the epidemic of myopia as a related indicator that kids especially are not outside enough so this whole safetyism nagging about melanoma is ridiculous when they can just go to regular dermatologist screenings and avoid sunburns
- bigfryo 2y ago
- choeger 2y agoIt should be obvious that the linear no-threshold model of radiation danger is so weak that other findings are possible. After all, the human body has some repair mechanisms. Vitamin D is just the most well-known positive effect of sunlight.
- at_a_remove 2y agoI have one of the classic severe photodermatoses and, well, tough luck for me, I guess. I must take some fairly annoying measures if I wish to avoid pain and disfigurement. As to the Vitamin D angle, the more I look into it, the more I see that it is a balancing act, and you need other supplements in a particular ratio for it to be more effective.
- robxorb 2y agoSurprised no one is mentioning vitamin D. As I understood it, sun exposure is one of the few ways the body is supplied with this vitamin in a usable form. Vitamin D is essential for the immune system so a correlation between a lack of sun exposure and ill-health seems almost so obvious it's a wonder it needs studying. What would be useful is the exact parameters around sun exposure/vit D metabolism.
- casenmgreen 2y agoI may be wrong, but I understand vitamin D2 is a vitamin, but "vitamin D3" is in fact a hormone. A vitamin is a building block, which by itself does nothing; a hormone is a directive, which instructs the body to do something - adrenaline, for example. Vitamin D2 is a precursor / building block for the hormone D3.
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- kkfx 2y agoThe famous study to discover that "a bit is better the zero or too much", sorry to be rude but...
- tim333 2y agoGiven human instincts are so strong for getting a bit of sun you'd think there must be evolutionary advantage for doing so. Sunbathing, flying to different countries to get sun, the preference for sun tanned skin to pasty, and the whole difference in appearance between black people and whites seems to be an evolutionary response to letting more light in. Presumably because we need the sun to make vitamin D.
- yjftsjthsd-h 2y ago> Sunbathing, flying to different countries to get sun, the preference for sun tanned skin to pasty, and the whole difference in appearance between black people and whites seems to be an evolutionary response to letting more light in. Aren't all of those purely cultural things that have actively changed over the last ~century?
- JohnBooty 2y agothe preference for sun tanned skin to pasty, In some cultures, tanned/dark skin is seen as less desirable. https://en.wikipedia.org/wiki/Light_skin_in_Japanese_culture https://en.wikipedia.org/wiki/Light_skin_in_Japanese_culture My loose (and quite possibly wrong) understanding is that this is based on the notion of tanned skin being associated with lower-class women who spent time laboring outside and getting smelly/dirty versus rich and noble women who could sit inside all day. In America, there is sometimes (often?) discrimination even within an ethnic group based on skin tone, e.g. lighter-skinned vs. darker-skinned African-Americans.