 By the turn of the 20th century, the vitamin D deficiency disease rickets was rampant thanks to city life, with the shade of the buildings and coal soot in the air. The dairy industry jumped at the opportunity to fortify milk with vitamin D, and so did the beer industry. Beer is good for you, read the ad, but beer with sunshine vitamin D is extra good. So drink it every day. Now there are healthier fortified options like vitamin D, fortified orange juice, but to reach recommended intake levels, it could take 15 to 20 cups of fortified milk, beer, and or juice every day. So to get those kind of doses, it really comes down to sun or supplements. Sunlight supplies 90 to 95% of vitamin D for most people. The threat of skin cancer is real. However, it's mostly from chronic excessive sun exposure and sun burns. There's little evidence that minimal sensible exposure to sunlight will considerably increase the risk of skin cancer, though why accept any risk at all when you can just get your vitamin D from supplements. But for the sake of argument, what if there were no supplements available? What if you were just trying to balance the positive and negative effects of sun exposure? On one side, you have entities like the American Academy of Dermatology that recommends that no one should be exposed to direct sunlight without sun protection. After all, the UV rays in the sun are proven carcinogens, responsible for about half of all Caucasian malignancies, blaming the tanning industry for downplaying the risk. Even those who accept research dollars from the tanning industry acknowledge that excessive sun exposure can increase skin cancer risk. But argue for moderation, advocating quote-unquote sensible sun exposure, and blame the sunscreen industry for over-inflating the risk. Though it's harder to impugn the motives of the dermatologists who are essentially arguing against their financial interests since skin cancer is their bread and butter. The concern raised by UV advocates is that sunphobic propaganda may do more harm than good pointing to studies like this. A Swedish study found that those diagnosed with skin cancer tended to live longer and have less heart attacks and hip fractures. The media, of course, loved this with headlines like Sunbathers Live Longer, though only natural UV exposure was associated with reduced mortality, artificial UV exposure like tanning beds was associated with increased mortality. Well, then this probably has nothing to do with vitamin D, then. Why would those that run around outside enough to get skin cancer live longer? Maybe it's because they're running around outside. More exercise may explain why they live longer. And here in the US, more UV exposure was associated with a shorter, not longer lifespan. Now there are modeling studies that suggest that at least 50,000 American cancer deaths may be attributable to low vitamin D levels that could be avoidable with more sunlight exposure that would only kill at most 12,000 Americans from skin cancer. So on balance, the benefits would outweigh the risks. But again, why accept any risk at all? We can get all the vitamin D you need from supplements. In fact, where did they get those estimates about vitamin D preventing internal cancers from intervention studies involving giving people vitamin D supplements, not exposing people to UV rays? So it's not much of a controversy at all. After all, the issue is framed as needing to choose between the lesser of two evils, skin cancer versus internal cancers from vitamin D deficiency, but ignores the fact that there's a third way. When we were evolving, we didn't live long enough to have to worry about skin cancer. And vitamin D was not available at the corner store. And if you just want to look more attractive, how about eating more fruits and vegetables when high-Kale models were pitted against high-UV models? The golden glow from carotenoid phytonutrients went out. The same has been found in Asian and African American faces. So may I suggest a produce aisle to get a good, healthy tan? Dream.