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Lighting the way to better health: vitamin D

Thursday, July 22nd, 2010 | Tags: British Journal of Nutrition, cancer research uk, dermatology, public health, Shine on Scotland, sun advice, sunsmart campaign, the lancet, vitamin d campaign
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Lighting the way to better health: vitamin D

17th July 2010

The Lancet

The public health message is compellingly simple: avoid the sun to prevent melanoma and other forms of skin cancer. Unfortunately, exposure to sunlight is the mainstay of vitamin D synthesis, and vitamin D deficiency causes rickets and osteomalacia, contributes to osteoporosis, and has been associated with many other disorders, including diabetes, cancer, and cardiovascular disease.

Ultraviolet B radiation produces 90% of vitamin D in human beings; only a very small proportion can be obtained through diet. However, at high latitudes, levels of sunlight in winter are often so low that vitamin D insufficiency is common. Avoidance of the sun’s rays by covering up or use of sunscreen can compound this problem, and is thought to have contributed to a recent increase in metabolic bone disease. Cancer Research UK recognises the need to balance skin cancer prevention with generation of adequate vitamin D, but specified that “the skin efficiently produces vitamin D at levels of sun exposure below those that cause sunburn…when it comes to sun exposure, little and often is best”. Australia’s SunSmart guidelines underwent a revision to reflect this balance in 2006—07.

A major concern is that people might seek prolonged sun exposure without protection to boost vitamin D synthesis. Indeed, the American Academy of Dermatology argues that the risks of sun exposure outweigh the benefits, advocating instead for dietary supplementation as a safe source of vitamin D. A report published in the British Journal of Nutrition emphasises that in the UK, a unified approach to vitamin D supplementation is needed to address deficiency in pregnant women and avoid life-threatening complications for their babies.

Despite the simmering debate about sun exposure surrounding vitamin D, the SUNLIGHT consortium’s genome-wide association study, published in The Lancet today, should add to our understanding of the genetic basis of interindividual variability in the synthesis of vitamin D. These findings could eventually help to identify who is most at risk of vitamin D insufficiency and related diseases. Until such potential applications come to the fore, the message about sun exposure has to be sensibly moderate. Enjoy the summer sun, with caution.

Source : The lancet

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61094-X/fulltext?elsca1=TL-160710&elsca2=email&elsca3=segment

Oliver Gillie: Time to abandon this outdated view on staying out of the sun

Monday, July 5th, 2010 | Tags: cancer, cancer research uk, health news, melanoma, ms news, Oliver Gillie, rickets, Ryan McLaughlin, Shine on Scotland, Sunscreen Advice, the independant, uk news, undercover research, Vitamin D, vitamin d campaign
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Monday, 5 July 2010

Lack of sunshine and the vitamin that it makes in our skin is probably the most serious single cause of disease in the UK today.

Vitamin D deficiency is well known as the classic cause of rickets and serious bone diseases, but in the last 10 years it has also been identified as a major risk factor for diabetes, heart disease, arthritis, infections, some cancers and other ills.

The cost of all this disease to the UK has been put at an astounding £27bn annually, which compares with only £5bn for the cost of disease caused by smoking.

Small amounts of vitamin D can be obtained from food but you can’t obtain more than about 10 per cent of the optimal amount this way unless you eat oily fish – skin and all – three times a day.

We depend on the sun for our vitamin D. Since our weather is so unreliable, British people suffer more than almost any other from vitamin D deficiency.

Many years of bad advice has also been a factor.

The British Isles are located far north so the winter sun is not strong enough to make any vitamin D. The prevailing westerly wind bringing cloud in from the Atlantic is also against us. The Scots are worst off because there is nothing to the west to protect them. Their vitamin D levels are lower and they have the highest incidence of multiple sclerosis in the world.

Scientists studying MS now believe that it may be prevented if women take vitamin D in pregnancy and children take regular supplements. Another devastating disease, diabetes type 1 – affecting mostly children who must inject themselves with insulin – could be prevented by the same vitamin D supplements.

Indeed it is possible that these two diseases could now be eradicated if Government had the will.

However a recommendation that pregnant women take vitamin D has been ignored over many years by obstetricians.

Standard advice is that babies are not given vitamin D until they are six months old. Nobody any longer remembers the reason for this, which is implemented nowhere else.

Everybody thinks that breast milk is a complete food – and so it might be if mothers sunbathed as often as they can. As it is, breast milk in the UK is deficient in vitamin D while artificial milk is supplemented.

This need not be a problem if mothers give vitamin D drops to their babies. Melanoma, the worst form of skin cancer, has dramatically increased during some 20 years of advice to avoid the sun and use suncream. This is quite possibly because the advice has been wrong. Suncream blocks the action of UVB (shortwave ultraviolet radiation from the sun) – so blocking synthesis of vitamin D with loss of protection against cancer – while UVA (longwave radiation), which seems to carry the main risk of melanoma, is not blocked by many creams.

We could do much, much more. The Irish Republic has already fortified semi-skimmed milk with vitamin D, Finland has fortified milk and Israel is making milk fortification mandatory. Jordan is bringing in fortification of bread.

The UK the Food Standards Agency has hummed and hawed. The United States has had fortification for 80 years. What are the English and Scots waiting for?

The one simple action open to us all is to sunbathe, carefully without burning. The sun is natural, free, and safe if you are sensible. It’s also good to take a vitamin D supplement of at least 1000 to 2000 IUs [international units of measurement] per day.

The author is a health writer and vitamin D campaigner.

http://www.independent.co.uk/opinion/commentators/oliver-gillie-time-to-abandon-this-outdated-view-on-staying-out-of-the-sun-2018389.html

Public advice on suntanning may mean vitamin deficiency risk

Monday, July 5th, 2010 | Tags: british heart foundation, cancer research uk, diabetes UK, health disgrace, health news, MS Society Scotland, Multiple Sclerosis Society, National Osteoporosis Society, Oliver Gillie, osteoporosis, public health advice, sun advice, the independant, vitamin d deficency
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Concerns over the link between rising skin cancer rates and exposure to sunshine may have led to overly precautionary advice being given to the public about staying out of the sun at midday, according to a confidential “position statement” by leading health organisations.

The current advice to the public from the leading research charity on skin cancer, Cancer Research UK, states to spend between 11am and 3pm in the shade and to cover the skin with clothing, hats and sunscreen if out.

But a confidential position statement being prepared by the charity in collaboration with other health organisations – and seen by The Independent – acknowledges the changing evidence and emphasises the importance of exposing the skin to the midday sun without any protection in order to maximise production of vitamin D.

Many experts are concerned that past advice designed to protect against skin cancer may have resulted in an increased risk of other illnesses linked to a lack of vitamin D, which the body can only produce when skin in exposed to bright sunlight. New concerns about Britain’s policy on sun exposure led to this review of the evidence about the risks and benefits of staying in the shade and covering up during the sunniest part of the day.

The confidential document, seen by The Independent, says: “The time required to make sufficient vitamin D is typically short and less than the amount of time needed for skin to redden and burn. Regularly going outside for a matter of minutes around the middle of the day without sunscreen should be enough. When it comes to sun exposure, little and often is best. However, people should get to know their own skin to understand how long they can spend outside before risking sunburn under different conditions.”

The wording of the draft document is being seen by come commentators as a tacit admission by Cancer Research UK that it had got it wrong in the past about telling people to avoid the midday sun, to apply sunscreen and to stay in the shade in order to avoid exposure to the cancer-causing rays of the sun.

“Cancer Research UK is working on a new position statement on vitamin D and sunshine which it expects to agree with other health organisations,” said Oliver Gillie, a health writer who has championed the case for vitamin D. “Their new position is expected to break with 20 years of advice to seek the shade and is expected to suggest that people go out in the sun in the middle of the day for at least a few minutes. Several health bodies have agreed to the wording but others are still discussing the details.”

Organisations such as the British Heart Foundation, the Multiple Sclerosis Society, Diabetes UK and the National Osteoporosis Society are discussing what their public position should be on sunshine and vitamin D in the light of several new studies suggesting a link between various illnesses and a chronic lack of the vitamin.

The draft position statement says: “Cancer Research UK’s SunSmart campaign encourages people to enjoy the sun safely and avoid exposures that lead to sunburn. However, for most people, sunlight is also the most important source of vitamin D, which is essential for good bone health.

“It is important to ensure that skin cancer prevention messages are balanced with the need to make enough vitamin D, and reflect the latest scientific evidence.” Sara Hiom, director of health information at the charity, said that the draft consensus statement has not yet been finalised, agreed or released. “It is not our advice to the public and should not be interpreted in that way,” Ms Hiom said.

“Even once we reach a consensus we will not be advising the public to go in the sun in the middle of the day without sunscreen. This is because, for some people – those most likely to be at risk of skin cancer – a few minutes in the middle of the day is enough for them to burn and cause serious and lasting skin damage.

“The very fact that messages around safe sun exposure times cannot be generalised to the population means that our advice needs to be general and is, and will remain, to enjoy the sun safely, spend time in the shade around midday and know your own skin type.”

The Sunshine Vitamin

Saturday, March 20th, 2010 | Tags: bupa, canada, cancer, cancer research uk, chronic illness, europe, food standards agency, fortified milk, fortified school milk, healthier scotland, MS Society Scotland, Multiple Sclerosis, prof george ebers, Ryan McLaughlin, SACN, scotland, Scottish government, scottish news, Shine on Scotland, sustainable scotland, uk, united states, university of oxford, Vitamin D, wellcome trust
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Sustainable Scotland

Vitamin D , sometimes known as the sunshine vitamin because the body manufactures it in response to sunlight on the skin, is increasingly being thought of as important in preventing a variety of chronic illnesses. Vitamin D deficiency is now a strong suspect in Scotland’s poor health record, which gives it some of the highest rates of heart disease and cancer in Europe and, overall, chronic disease in the world. Another obvious characteristic of Scotland is its weather. Its geography and the Gulf Stream combine to give it a particularly damp, overcast climate where sunlight levels can be as low as parts of the Arctic Circle.

George Ebers, Professor of Clinical Neurology at the University of Oxford, can claim there is hard evidence of a causal link between genes and the environment to multiple sclerosis. In a genetic study for the Wellcome Trust he reports “We have known a long time that genes and environment determine MS risk . . . Here we show that the main environment risk candidate – vitamin D – and the main gene region are directly linked and interact.” Scotland has one of the highest incidences of MS in the world.

Shine on Scotland, supported by BUPA, are campaigning to have all school milk fortified with vitamin D. Campaigners would like legislators to allow GPs to recommend higher doses of vitamin D supplementation and to correct the current scare over sunlight (it is burning which is bad for the skin and heightens the risk of skin cancer. Regular, sensible exposure is healthy and has even been associated with improved moods).

Dietary sources of the vitamin are liver (which is very rich in vitamin A, which is essential for good health but is toxic in high doses, so stick to once a week); oily fish such as herring, catfish, salmon, mackerel, sardines, tuna and eel; eggs; dairy produce; and fortified margarines and cereals. The perennial supplement cod liver oil is an excellent source as well as having been confirmed as the best provider of omega 3 oils. Choose good quality capsules or bottled oil.

If making an effort to consume meaningful quantities of vitamin D is a way of slashing Scotland’s shocking health stats (and the evidence just keeps stacking up) then let’s get on with it.

“Our study implies that taking vitamin D supplements during pregnancy and the early years may reduce the risk of a child developing MS in later life,” says Dr Sreeram Ramagopalan, lead author of the Ebers study. “Vitamin D is a safe and relatively cheap supplement with substantial potential health benefits. There is accumulating evidence that it can reduce the risk of developing cancer and offer protection from other autoimmune diseases.”

In addition, campaigners suggest, all milk, bread and orange juice should be fortified, negating the necessity for individuals to remember to take a ‘pill’.

One wonders how much distress and waste of money could be avoided by adding tiny amounts of this inexpensive substance to more of our diet.

DID YOU KNOW?

Figures for the UK published by Cass Business School , City University London, state that the cost of treating coronary heart disease is £3.5 billion, with costs of £3.1 billion attributable to lost working days; cost of stroke £2.3 billion; hypertension, which is under-reported, £0.8 billion; diabetes, £1.3 billion; and COPD, £1 billion.

The UK RDA (recommended daily amount) is five micograms, equivalent to 200 IUs (International Units). This is half that of the EU and the US RDAs. Campaigners and experts want this to be revised upwards and for clarity (the Food Standards Agency and BUPA, for instance, are giving contradictory advice).

Should we all be taking vitamin D?

Monday, February 1st, 2010 | Tags: Alzheimer's, cancer research uk, colon cancer, Deputy First Minister, diabets, fortified bread, fortified milk, JK Rowling, kirsten mclaughlin, lung disease, MS Society Scotland, Multiple Sclerosis, Multiple Sclerosis Campaign, Nicola Sturgeon, Oliver Gillie, petitions committee, rheumatoid arthritis, rickets, Ryan McLaughlin, scotland, Scottish Parliament, Shine on Scotland, The Times Online, Vitamin D, vitamin d campaign, vitamins
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Dr Mark Porter: Should we all be taking vitamin D?

From The Times

February 1, 2010

New research showing that vitamin D may protect against cancer of the colon is the latest in a long line of studies suggesting that there is far more to this vitamin than its traditional role in helping to maintain healthy bones. And although this new study involved more than 500,000 people from ten different European countries, it is pertinent to the UK because so many of us have low levels of vitamin D — especially at this time of year.

So should more of us be considering supplements?

Vitamin D is required to help the body make proper use of calcium — the basic building block of bones — which is why interest in it has traditionally centred on rickets, a condition that results from severe deficiency. But we now understand that it does far more than maintain the skeleton, and that milder degrees of deficiency may predispose to a range of other illnesses including diabetes, lung disease, osteoporosis, multiple sclerosis (MS), rheumatoid arthritis, various cancers, and even Alzheimer’s disease.

The vitamin is manufactured in the skin when we’re exposed to sunlight but our northern latitude and short summers mean that for six months of the year UV levels are so low that most of us don’t make enough of the vitamin to meet basic requirements.

The problem is compounded by the use of sunscreens, which further reduce natural UV exposure during the summer months when vitamin D stores are replenished, and the popularity of supplements containing vitamin A (it is thought that as many as 1 in 5 of the population take one), which antagonise some of the D’s actions.

As well as manufacturing the vitamin in our skin, we also take it in from our diet. It occurs naturally in oily fish, such as tuna and herring, and liver, milk and eggs. In most industrialised countries it is added to margarine, some powdered milks, bread and breakfast cereals.

The scale of the potential problem is nicely outlined by researchers from the University of Sheffield, who looked at vitamin D levels in the cord blood of babies born at the hospital at the end of spring — the time when their mothers’ vitamin D stores were likely to be at their lowest. Seven out of ten of the babies had lower than ideal levels of vitamin D, 90 per cent of whom were white, dispelling the myth that deficiency is principally a problem in ethnic minorities with darker skin (the extra pigment reduces UV penetration even further).

Meanwhile in Finland researchers tracking a group of people born in the Sixties turned up evidence suggesting a link between low levels of vitamin D and Type 1 diabetes later in life. Children brought up in the gloomy winters of Finland are more than a hundred times more likely to develop the condition than their peers in sunny Venezuela. Since then UK research has shown that children given vitamin D supplements are around a third less likely to develop diabetes.

Vitamin D is a steroid and there are receptors on almost every cell in the body. Its link with diabetes could be explained by an action on receptors in the pancreas and on the various cells in the immune system, but there are similar vitamin D specific targets in almost every other organ, including the brain, heart, muscles, kidneys and, of course, the skeleton. Little wonder then that there is growing interest in the role of the vitamin in diseases, ranging from MS to Alzheimer’s.

Should we all be taking a supplement? It’s too early to tell whether mass supplementation is the way forward, but it is now widely agreed that the following key groups are those most likely to benefit:

Women who are pregnant or breastfeeding
Children under 5 (particularly breastfed infants)
The over-fifties
Vegetarians who don’t eat oily fish
Anyone who is housebound or who covers up when outside
Those who are dark-skinned — particularly Asians.

The standard dose for an adult is 10mcg day and trials looking at the safety of long-term supplementation have reported no adverse effects at intakes of more than double that. Much higher doses (50mcg a day or more) can weaken bones and increase the risk of calcium deposits (such as kidney stones) forming elsewhere.

During the summer most people will manufacture enough vitamin D by exposing their face and arms to the sun for an hour across the week. You don’t have to sunbathe, just accumulate around ten minutes of exposure while going about your normal business — assuming you are not wearing a sunscreen, or a moisturiser that contains one.

http://www.timesonline.co.uk/tol/life_and_style/health/expert_advice/article7008426.ece

Higher vitamin D levels may be linked to lower risk of bowel cancer

Monday, January 25th, 2010 | Tags: cancer research uk, MS, MS Society Scotland, Multiple Sclerosis, Multiple Sclerosis Campaign, petitions committee, Ryan McLaughlin, scotland, Scottish Parliament, Shine on Scotland, Vitamin D, vitamin d campaign, vitamin d linked to cancer prevention
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25/01/2010

People with higher levels of vitamin D appear to be significantly less likely to develop bowel cancer, a new European study has found.

Researchers from a number of institutes in Europe, including Imperial College London, analysed data contained in the European Prospective Investigation into Cancer (EPIC) study, which involved over 520,000 people in ten countries.

Participants provided blood samples and information on their diet and lifestyle between 1992 and 1998, before being followed for several years.

At the time of the analysis, information from 1,248 people who had been diagnosed with bowel cancer was compared with information on 1,248 healthy controls also involved in the study.

The researchers discovered that people with the highest concentrations of vitamin D in their blood had a 40 per cent reduced risk of bowel cancer compared with those recording the lowest levels of the vitamin.

Writing in the British Medical Journal, the researchers concluded that vitamin D may be associated with a protective effect against bowel cancer.

However, they noted that insufficient research has been carried out into the long-term health impact of having high levels of vitamin D in the blood and that further research is needed both to confirm any beneficial effect on bowel cancer risk and to rule out any potential adverse effects.

Ed Yong, head of health evidence and information at Cancer Research UK, said: “This large study confirms that low levels of vitamin D are linked to an increased risk of bowel cancer. More research is needed to clarify whether vitamin D alone directly prevents this disease or if having higher levels of vitamin D means people are generally healthier.

“Either way, we know that vitamin D is important for good health,” he continued.

“Enjoying the sun safely while taking care not to burn should help people strike a balance between making enough vitamin D and avoiding a higher risk of skin cancer. People can also top up their vitamin D levels by eating foods like oily fish (such as salmon, trout or mackerel), or by taking supplements after talking to their GP.”

Reference

Jenab, M. et al (2010). Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study BMJ, 340 (jan21 3) DOI: 10.1136/bmj.b5500

Vitamin D ‘can boost survival from cancer’

Tuesday, September 22nd, 2009 | Tags: asthma, British Journal of Cancer, cancer, cancer research uk, Dana-Farber Cancer Institute, depression, diabetes, high blood pressure, Journal of Clinical Oncology, Leeds Institute of Molecular Medicine, MS, MS Society Scotland, Multiple Sclerosis, Multiple Sclerosis Campaign, new study, osteoporosis, Prof Julia Newton Bishop, Prof Kimmie Ng, Ryan McLaughlin, Sara Hiom, Scottish Parliament, Shine on Scotland, survivng cancer, telegraph, Vitamin D, vitamin d campaign
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People who spend more time outside have a better chance of surviving certain cancers, new studies suggest.

Those who had higher levels of vitamin D – produced by the body in the presence of sunlight -when diagnosed with colon cancer were 50 per cent more likely to survive than those with low levels, researchers found.

A separate study also found that patients who had high levels of the vitamin when they were diagnosed with skin cancer were more likely to have thinner tumours.

Vitamin D, which is also present in a small number of foods, such as fatty fish, is thought to be important in protecting against a number of other conditions, including osteoporosis, diabetes, asthma, high blood pressure, depression and Multiple Sclerosis.

Earlier this year scientists cautioned that health warnings about the damaging effect of the sun could be causing vitamin D levels to drop.

Prof Kimmie Ng, from the Dana-Farber Cancer Institute, in Boston, who followed 1,017 patients with colon cancer, also called colorectal cancer, for around nine years, said: “Our study shows that levels of vitamin D after colorectal cancer diagnosis may be important for survival.

“We are now planning further research in patients with bowel cancer to see if vitamin D has the same effect, and to investigate how vitamin D works.”

The findings were published in the British Journal of Cancer and Journal of Clinical Oncology.

A second study found that skin cancer patients who had the lowest levels of vitamin D in their blood when they were diagnosed were almost a third more likely to relapse than those with high levels.

Prof Julia Newton Bishop, from Leeds Institute of Molecular Medicine, who led the study, said: “It’s common for the general public to have low levels of vitamin D in many countries.”

She added that skin cancer patients tended to avoid the sun as sunburn is known to increase the risk of the disease.

The findings suggested that they should increase their vitamin D levels by eating more fatty fish or taking supplements, she said.

Sara Hiom, from Cancer Research UK, said: “Both these studies support the theory that higher levels of vitamin D can improve the chance of surviving cancer.

The key is to get the right balance between the amount of time spent in the sun and the levels of vitamin D needed for good health.

“But protection from burning in the sun is still vital.”

Story by the Telegraph.co.uk

Sun exposure cancer warnings ‘lead to Vitamin D deficiencies’

Sunday, August 9th, 2009 | Tags: cancer research uk, Deputy First Minister, Dr Veronique Bataille, guidance, Health Protection Agency, Hemel Hempstead General Hospital, Kings College London, melanin, moles, MS, MS Society Scotland, Multiple Sclerosis, Multiple Sclerosis Campaign, National Osteoporosis Society, Nicola Sturgeon, Nina Goad, petitions committee, public health messages, public health warning, Ryan McLaughlin, scotland, Scottish Parliament, Shine on Scotland, skin, skin cancer, sunlight, The British Association of Dermatologists, ultraviolet exposure, united kingdon, University College London, vit, vita, Vitamin D, vitamin d campaign, Vitamin D deficiency, vitamins
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Public health warnings about skin cancer have led to a rise in Vitamin D deficiency through lack of sunlight, according to a controversial study into the effects of ultraviolet exposure.

But now, a controversial new study has blamed the same public health messages for causing growing numbers of people to suffer from vitamin D deficiency, because they are failing to get enough sunlight on their skin.

Vitamin D is produced by the body in response to exposure from ultraviolet radiation from natural sunlight. It helps protect against cancer and is also thought to be important in helping to prevent bone disease such as osteoporosis, as well as autoimmune diseases, asthma, diabetes, high blood pressure, depression, Parkinson’s disease and Multiple Sclerosis.

The researchers are now calling for guidelines on sunlight exposure to be reviewed to ensure people receive enough vitamin D.

Dr Veronique Bataille, who led the study, said: “There has been so much effort put into telling people about the damaging effects of ultraviolet light from sunshine, many now take extreme measures to ensure they don’t get exposure by wearing moisturisers with factor 15 all year round.

“We don’t want to say that sunbathing is healthy as there is clearly a risk, but people do need a bit of sunshine to stay healthy.”

Dr Bataille and her colleagues measured vitamin D levels in the blood of 1,414 white women in the UK and compared this to their skin type and details about the number of foreign holidays, sunbed use and the number of times they had been sunburnt.

They found that those with the fairest skin, who usually have red or blonde hair, had the lowest levels of vitamin D.

Conventional scientific thinking suggests this should not be the case.

People with greater levels of melanin – which is the pigment which causes darker colour in skin – make less vitamin D and there is evidence to show that those with Asian and Afro-Caribbean backgrounds have trouble producing the vitamin.

Dr Bataille, a consultant dermatologist at Hemel Hempstead General Hospital and a researcher at Kings College London, also found that those with fair skin also had the lowest levels of sun exposure through the number of holidays they had abroad and sunbed use.

The researchers concluded that people with fair skin actively avoided sun exposure more, due to their increased sensitivity and so produced less vitamin D. They added, however, there may also be a genetic element that means people with fair skin metabolise vitamin D differently.

The findings come after another study by Dr Bataille’s group that showed sunlight may not be the main cause of melanoma, the most dangerous form of skin cancer. Instead they concluded that the number of moles on the skin was a better indicator of risk.

“The advice on sun exposure needs to be reviewed,” said Dr Bataille. “It is potentially harmful if people are getting the message that they should completely avoid the sun. The advice needs to be better tailored to the differences in skin type and sun levels around the country.”

Experts claim that excessive avoidance of the sun has stemmed from confusing official guidance on sun exposure which has unduly raised fears about the risk of being outside in the sunshine.

Advice on the Health Protection Agency’s website states that people should limit unprotected personal exposure to solar radiation, particularly during the four hours around midday, even in the UK. It even warns that sunburn can occur when in the shade or when cloudy.

Cancer Research UK used to advice that people stayed in the shade between 11am and 3pm, the time when the sun is at its hottest and the best time for making vitamin D according to experts. They recently changed their advice to “spend time in the shade between 11am and 3pm” and “aim to cover up”.

Vitamin D can be obtained from food, including oily fish and eggs, but it is harder for the body to obtain enough from these sources and consumption of these products in the UK has dramatically declined.

Dr Bataille believes people can make enough vitamin D from just 15 minutes exposure to sunlight while wearing a T-shirt, but added that this would need to be increased for those with dark skin or during the winter months when sunlight is lower.

According to a separate recent study at University College London, 20 per cent of women and 12 per cent of men are now classed as being clinically vitamin D deficient, while levels of the vitamin in nearly two thirds of women and 57 per cent of men are “insufficient”.

Dr Vasant Hirani, who led the study, added: “The advice on sun exposure does need to be clarified.”

The British Association of Dermatologists has recently issued guidance with the National Osteoporosis Society that recommends people get 15 to 20 minutes of sun exposure a day.

Nina Goad, from the Association, said she doubted public health messages were responsible for causing vitamin D deficiency.

“Vitamin D deficiency is likely to be due to our lifestyles meaning we spend a lot of time indoors, to a lack of vitamin D in our diets, and to our climate meaning we have limited sun exposure for much of the year,” she added.

A spokesman for the Health Protection Agency said: “We are not saying that people should avoid all sunlight. Indeed a small amount can help to maintain vitamin D levels.

“Sunbathing incurs the potential hazard without adding to vitamin D levels.

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