 Blood pressure, vitamin D, and the sun. Hi, this is Dr. Ruscio, and if you're like most people, you've probably heard something about the beneficial effects of vitamin D. And you've also probably heard that overexposure to the sun may put you at risk for skin cancer. So you may be supplementing with vitamin D, so as to get your vitamin D and not put yourself at risk for skin cancer. And if you're doing this, you may not be deriving nearly the health benefit that you've been led to believe. Now, allow me to explain a few things. We know through population-wide studies that generally speaking, people who live closer to the equator have a lower incidence of certain diseases, cancer and heart disease being two. And so this North-South discrepancy in disease prompted investigators to start looking into why this might be. One of the theories was that because when you're closer to the equator, you have longer days with stronger sun, people got more sun exposure and that sun exposure caused higher vitamin D and vitamin D had this beneficial effect. Well, we certainly have seen a lot of research published showing that vitamin D does in fact have a good benefit. But as we continue to study vitamin D, we're starting to learn that vitamin D is not the whole story. And numerous pieces of information are coming out that are showing that if you rely on vitamin D supplementation alone, you may not derive full health benefits because there are other positive effects from sun exposure than just a vitamin D. So it's safe to say that vitamin D is a marker of sun exposure, but vitamin D is not the only beneficial thing that happens in the body when one is exposed to vitamin D. Now, if you click on the bubble here, you'll see a recent report that I did that showed that prostate cancer and non-Hodgkin's lymphoma did not benefit from vitamin D and only benefited from sun exposure. And another study or investigation by a British dermatologist named Richard Weller is depicted by this graph here. Now, what he has found is that independent of vitamin D levels, people who get sun exposure will actually have lower blood pressure. And the way this works and what this diagram is showing is that sunlight will actually help convert nitric oxide into an active form. And when the body releases nitric oxide, it actually helps with dilation of the blood vessels which causes a lowering of blood pressure. So sunlight and diet are two of the big factors that will help the body produce this nitric oxide which has a vasodilatory effect which helps lower blood pressure. Now, in this next slide, you'll see the actual study results where Dr. Weller exposed subjects to UVA radiation and UVA radiation will not cause any vitamin D production but with this UVA exposure, people actually did increase their production of nitric oxide and this decreased their blood pressure. So what he derived from this study was that independent of vitamin D, there are other benefits associated with sun exposure. Now, if we look into this a little bit more closely, we see, or we're brought to the question of, well, what about cancer? And it's a great question and it's one we should talk about. Now, in this slide, you'll see the top 10 cancer sites in women. Now, you see that there are a number of cancers above skin cancer. So skin cancer is, as far as cancers go, not the most prevalent form of cancer. In fact, non-Hodgkin's lymphoma is more prevalent than skin cancer. And remember that study I reviewed earlier showed that only sun exposure had a beneficial impact on non-Hodgkin's lymphoma and vitamin D did not. And if we look at another distribution slide here, you see that the third common distribution site of cancer is the male genitalia and the ninth is lymphomas. Both of those I know from, or we know from the recently published study, do not respond solely to vitamin D but do respond to sun exposure and they are both more prevalent than skin cancer. So we may want to rethink the recommendation that you should really avoid the sun at all costs and we may want to start swaying more closely to the side of reasonable sun exposure. At least 30 minutes a day during peak sun exposure, so between the hours of 11 and two are good times and 30 minutes and you want to steer that recommendation to be slightly more or slightly less depending on your skin tolerance. People who are lighter skinned burn easily. So they'll want to spend less time in the sun. People who are darker skinned will want to spend slightly more time in the sun. The most important thing is that you never burn but you do want to get what's called a minimal erythema response where you get a slight pigmentation change in the skin. So hopefully looking at this information has helped you take a second look at vitamin D, the sun, and how the sun interfaces the health. So what this really means is that while vitamin D supplementation is certainly a good idea and a practice that one should incorporate, you cannot use vitamin D as a crutch for not having solid or good lifestyle practices, one of which is getting outside and enjoying the sun. So this is Dr. Ruscio and I hope you find this information helpful. Thanks.