Most dermatologists caution that any unprotected exposure to the sun – or other sources of UV light, like tanning beds – can cause cancer. Based on that, states and counties across the country are banning teens from using indoor tanning beds. Some say it’s the latest example of “nanny state” rules. Others point out that tanning can address vitamin D deficiencies or seasonal depression. We take a look at the arguments for and against indoor tanning.

Guests

  • Peter Beilenson Health Officer, Howard County, Md.
  • Michael Holick Professor of Medicine, Physiology and Biophysics, Boston University School of Medicine

Transcript

  • 13:06:45

    MR. KOJO NNAMDIFrom WAMU 88.5 at American University in Washington, welcome to "The Kojo Nnamdi Show," connecting your neighborhood with the world. Later in the broadcast, a tribute to Earl Scruggs who defined bluegrass and redefined the banjo. He died yesterday at the age of 88. But first, whether you think bronze is beautiful or pale is the new tan, it's likely you're well aware that too much sun is bad for you. Some research has shown that too much fake sun can even be worse, increasing your risk for melanoma, the deadliest form of skin cancer.

  • 13:07:32

    MR. KOJO NNAMDISince indoor tanning methods that rely on UV rays were classified as carcinogenic a few years ago, a number of states and counties have made moves to ban teens from using tanning booths and beds. At the same time, vitamin D is being hailed as a potential treatment for everything from Alzheimer's to allergies. And the number one way to get some vitamin D? Catching a few rays.

  • 13:07:58

    MR. KOJO NNAMDIJoining us to have a conversation about banning the tan is Dr. Michael Holick. He's a professor of medicine, physiology and biophysics at Boston University School of Medicine. He's also author of "The Vitamin D Solution and the UV Advantage. He joins us by phone from Boston, Massachusetts. Michael Holick, thank you for joining us.

  • 13:08:20

    DR. MICHAEL HOLICKMy pleasure.

  • 13:08:21

    NNAMDIAnd joining us by phone from Howard County, MD is Dr. Peter Beilenson. He is the health officer for Howard County, MD. Peter Beilenson, thank you for joining us.

  • 13:08:32

    DR. PETER BEILENSONThank you for having me.

  • 13:08:34

    NNAMDIPeter, I'll start with you. Most people know they should wear sunscreen or protective clothing when spending a lot of time outside. Is there a safe level of exposure to UV rays, whether from the sun or from indoor tanning?

  • 13:08:47

    BEILENSONWell, we don't think there's a safe level from indoor tanning. There probably is not a safe level from outdoor sun as well, though Dr. Holick would probably know better as a biophysicist. The simple answer, though, if I can just sort of cut through the chase because what you didn't mention in the intro is that we were the first jurisdiction in the United States to ban tanning.

  • 13:09:08

    NNAMDIHoward County indeed, yes.

  • 13:09:09

    BEILENSONRight. And California has now followed as a state and others are looking at it. And so I think there are three or four arguments, which we can go over. But if you don't mind, I'll just lay them out real quickly, because they'll come out.

  • 13:09:19

    NNAMDIPlease do.

  • 13:09:21

    BEILENSONFirst of all, you know, parent's consent, why isn't it okay for kids to use? And with very simple analogy, parents can't consent for all sorts of carcinogenic things, including their kids to be able to use the bathroom. Second, small businesses may well go out of business if -- tanning salons are often small businesses and why do we go after them? And I can tell you from our experience of three years now in Howard County, none of them went out of them because the chain smoking ban.

  • 13:09:48

    BEILENSONThirdly, is enforcement difficult? In fact, we actually use stings, sending in teenagers into tanning salons trying to get them tanned. And only two of the 10 tanning salons in Howard County over three years have ever offered tanning to teens. And the fourth argument, which I would stipulate is a good argument actually is that vitamin D is extremely important. I think I would stipulate, as with most physicians that vitamin D deficiency is a significant problem in most Americans.

  • 13:10:16

    BEILENSONBut I would argue that there is plenty of very safe ways to get vitamin D, including by pill, as I take vitamin in the cancer bed.

  • 13:10:25

    NNAMDIPeter Beilenson, what are some of the main concerns you have about the use of tanning beds and booths?

  • 13:10:31

    BEILENSONWell, there are a variety of things. I mean, teenagers -- first of all, the earlier you're exposed and the more often you're exposed to burning tans or to sunburns, the more likely you are to get melanoma. And so, the best statistic that I've seen actually that sort of supports this ban is that 58 percent of teens who used tanning beds actually get a burn in their tanning efforts at least once.

  • 13:10:56

    BEILENSONAnd a burn particularly under the age of 18 is a significant risk for developing melanoma later. One of the reasons that I actually was supporting this besides the fact that my teenage daughter would continue to get tans despite our trying to keep her from doing so was an 18-year-old that I saw when I was in medical school that had golf-ball sized melanoma lesions, tumors from excessive exposure by the time he was 18 to outdoor and indoor tanning.

  • 13:11:24

    BEILENSONAnd so, there's just really no reason to have indoor tanning beds. It's -- as I said, the one potential benefit of UV rays is vitamin D and you can get vitamin D in much safer ways than by exposing yourself in indoor tanning.

  • 13:11:39

    NNAMDILet's talk about vitamin D, Michael Holick. As awareness of the risks of too much sun exposure grew, research on the benefits of vitamin D began to mount. What are some of the main causes and consequences of not having enough vitamin D?

  • 13:11:54

    HOLICKWell, we are now realizing that during pregnancy that pregnant women who are vitamin D deficient are at increased risk for the most serious complication which is preeclampsia and also requiring a Cesarean section. We also know that young children, during the first year of life, if they were getting 2,000 units of vitamin D a day and follow-up with 31 years reduce their risk of getting type 1 diabetes by 88 percent.

  • 13:12:21

    HOLICKFor adults, there's good data to suggest that there's an association with vitamin D deficiency and increased risk for heart disease, deadly cancers like breast, colon and prostate, as well as increasing risk for infectious diseases. So, vitamin D is very important for overall health and well being.

  • 13:12:44

    NNAMDIIs there any group that's especially at risk for a vitamin D deficiency?

  • 13:12:49

    HOLICKI mean, originally it was thought that, you know, it's the very young and the very old. But a study that was done from NHANES, from the National Health Survey, showed that 50 percent of children one to five years of age are vitamin D deficient or insufficient. And 70 percent of children in the United States ages six to eleven years of age vitamin D deficient. So, it's a common problem throughout both the children as well as adult population in the United States no matter whether you live down South or, you know, here in Boston.

  • 13:13:26

    NNAMDI800-433-8850 is the number that you can call if you'd like to join this conversation on banning indoor tanning for teenagers or anything else pertaining to tanning that you'd like to discuss, 800-433-8850. Do you or have you visited a tanning salon? What made you decide to go? You can also send us email to kojo@wamu.org, a tweet @kojoshow or simply go to our website, kojoshow.org and join the conversation there.

  • 13:13:55

    NNAMDIWe're talking with Dr. Peter Beilenson. He is the health officer for Howard County, MD and Dr. Michael Holick who is a professor of medicine, physiology and biophysics at Boston University School of Medicine and the author of "The Vitamin D Solution and the UV Advantage." 800-433-8850. What potential benefits or risks play into your decision to tan or not to tan? Peter, you mentioned that Howard County, MD was the first place in the country to ban indoor tanning for teens.

  • 13:14:24

    NNAMDISince then, California has passed a statewide ban and a host of other states, including Maryland, have legislation that would do the same pending. What effects have you seen so far since the passage of this legislation in Howard County?

  • 13:14:38

    BEILENSONIt's been basically no confusion or controversy at all. The initial concern by small business folks who are claiming that it would be damaging to the salons actually are proving to be not true. As I said, as far as we know, no tanning salons have closed up shop in Howard County. And the complaint that it might be difficult to enforce against the teenagers using the tanning beds, again, actually we do stings where we send teenagers with an adult supervisor out in the parking lot to the teenager tries to go in and get a tanning session.

  • 13:15:14

    BEILENSONAnd if they are offered a tanning session, then we come in and cite the place. But, again, in three years of experience with the 10 tanning salons, only two times at all have they been offered a tan. And we go in and immediately inform the supervisor or the manager that's inappropriate. And I should mention, if I could, Mr. Nnamdi.

  • 13:15:34

    NNAMDISure.

  • 13:15:35

    BEILENSONYou know, there are other options -- I mean, let's be real. The reason people go to tan is to get the tan, to look a certain way, whether that's appropriate or not is up to the individual. But there are other ways to get tan, to get a coloring that you want to have than just having the baking tan. There are now much better spray tans than there used to be when I was a kid a while ago.

  • 13:16:01

    BEILENSONIt was basically orange, you know, orange dye that looked like -- we'd look ridiculous. Having been through this now, this process, not getting tan myself, but having gone through many tanning salons and talking to the owners, they've shown me the new spray tans and they are much, much better. So, if you want to get a, quote/unquote, "tan," before the winter dance or before you go to the spring break or whatever, there are ways of doing so in a much safer manner than getting baked.

  • 13:16:27

    BEILENSONAnd, again, everybody agrees, I think, that vitamin D deficiency is a real problem, but there are better ways of getting it than through a cancer bed.

  • 13:16:35

    NNAMDIHere is Jessie in Leesburg, VA. Jessie, you're on the air, go ahead please. Oh, Jessie dropped off. But speaking of adults, Peter, some jurisdictions that don't allow teens to tan do allow them to do so with parental consent, not so in Howard County. Why not?

  • 13:16:56

    BEILENSONRight. Well, again, that was the analogy. There are certain things that are dangerous enough that parents are not allowed to consent for their kids. And a perfect example is tobacco. You're not allowed to sign a consent form for your 16-year-old to be able to go buy cigarette packs at the giant pharmacy. So, you know, there are certain things and this we think is dangerous enough and the evidence is quite strong that this is dangerous enough, particularly the younger you are that you're exposed to it that it makes sense.

  • 13:17:29

    BEILENSONNow, if adults want to do this, just like if adults want to smoke, it's a legal, you know, we haven't banned tanning as an activity. If the adults want to make that decision, they can. We think it's a foolish decision, but they could do it.

  • 13:17:42

    NNAMDIDo you think states and counties should be restricting tanning? Tell us why or why not by calling 800-433-8850. Have any doctors in this area as far as you know, Peter Beilenson, prescribe use of a tanning bed for a teen since the ban went into effect?

  • 13:17:59

    BEILENSONThat was the one thing that we do allow, like, for psoriasis or certain other conditions. As far as I know, not a single prescription has been written for a tanning bed that we know of. That's not to say there haven't been any, but we don't know of any. And it certainly an out wire if there are any.

  • 13:18:16

    NNAMDIMichael Holick, our bodies make vitamin D, but there are ways to get it through food or through supplements. What's the ideal way to make sure one is getting enough?

  • 13:18:25

    HOLICKSure. I think that, you know, in the vitamin D solution, as I point out, is a three-part process. I mean, humans have always depended on the sun for their vitamin D requirement. So some sensible sun exposure on arms and legs, you know, abdomen and back for a short period of time that doesn't cause a sunburn, you know, is not an unreasonable way of getting some of your vitamin D.

  • 13:18:47

    HOLICKAnd I agree with Dr. Beilenson that, yes, taking a supplement is important but it's unrealistic to think that every child and adult in the world is going to be taking a supplement when they wake up every morning. And then finally, you can get some from your food. And then concept that has been out there is that if you have a healthy diet, you can get all the nutrients that you need including vitamin D and that's the problem.

  • 13:19:11

    HOLICKThere's essentially no vitamin D available in your diet. It's mainly in fortified milk, in orange juice. You can get about 100 units in a glass. The Institute of Medicine recommends 600 units a day for most children and adults. You'd have to drink six glasses of milk or orange juice a day to be able to get it. And wild caught salmon and cod liver oil and now mushrooms that are exposed to ultraviolet light as a major dietary sources of vitamin D.

  • 13:19:37

    HOLICKSo, if you got a little bit of vitamin D from your diet and you'd take a supplement and maybe some sensible sun exposure, all of those in combination will guarantee you to be vitamin D sufficient. And I just want to make, for the record, you know, I don't advocate tanning and I do agree with Dr. Bielenson that, yes, sunburning experiences will increase your risk for melanoma. And we should avoid that at all costs.

  • 13:20:01

    HOLICKMy worry about these spray-on tans is that it gives sometimes a false sense of security. And I'm sure that Dr. Beilenson will agree that, you know, they look great but they do not protect you from getting a sunburn. And so if teens wear these without wearing a sun protection, you know, such as a sunscreen, they can wind up getting a sunburn and potentially increasing their risk for melanoma.

  • 13:20:28

    NNAMDIMichael Holick, what is sensible for exposure to the rays of the sun?

  • 13:20:32

    HOLICKWell, it depends upon time of day, season of the year latitude and your degree of skin pigmentation. And I'd give you an example. I mean, here in Boston, from about November through February, can't make any vitamin D in your skin. In fact, if you live above Atlanta, Ga., exposure to sunlight will not make any vitamin D. Early morning and late afternoon have been suggested as a way of getting some vitamin D in minimum damage to your skin. Turns out that'd probably be the worst time to go out. You make no vitamin D in the early morning sunlight. But you're definitely getting blasted by UVA radiation.

  • 13:21:04

    HOLICKWhich definitely damages your skin and potentially increases your risk for melanoma. So for me, for example, being very light skinned, if I know I'm going to get a sunburn after about 30 minutes in June, I'll go out for maybe five, 10 minutes, play my tennis or go gardening or cycling. And then wear a sun protection. And this way, take advantage of the beneficial effect, prevented damaging effects from excessive exposure. I always recommend sun protection on your face.

  • 13:21:33

    NNAMDIGot to take a short break. When we come back, if you have called, stay on the line, we will get to your call. We're talking about banning tanning beds for teenagers in jurisdictions and states around the country and how that impacts the necessity that we have for vitamin D, 800-433-8850. Is a tan appealing to you or do you think that pale is in fact the new tan, 800-433-8850? I'm Kojo Nnamdi.

  • 13:23:47

    NNAMDIWelcome back, we're talking about tanning and teenagers and tanning beds and the bans on that in several jurisdictions and states with Dr. Peter Beilenson. He is the health officer for Howard County, Md. And Dr. Michael Holick is a professor of medicine, physiology and biophysics at Boston University School of Medicine. He's also the author of "The Vitamin D Solution" and "The UV Advantage."

  • 13:24:11

    NNAMDIPeter Beilenson, it's estimated that 70 percent of indoor tanning patrons are white women between the ages of 16 and 29 with middle class incomes or by the looks of the ads in Smart Tan Magazine, it's the cast of the "Jersey Shore." But that's Taylor Bernie's (sp?) line, not mine. Spray tanning and tanning lotions have improved dramatically since the '90s yet people still use indoor tanning beds over presumably less risky options, why do you think that is?

  • 13:24:38

    BEILENSONI'm not exactly sure. I think it's leftover from previous perceptions of how bad looking the spray tans are. As I was saying before, there are significantly improved -- I do want to agree completely with Dr. Holick, that they do not protect you from the sun. They just can give you the look that some people are going for or whether it's Snooki or the situation. So I think that's really part of it, I think we don't have enough of a public health message either that these can be dangerous.

  • 13:25:07

    BEILENSONI don't think the average person using the tanning beds really has quite gotten the message. And I would also want to agree with Dr. Holick, that a sensible amount of sun exposure particularly on less melanoma sensitive areas of the skin like the arms and potentially lower legs is a good way of getting Vitamin D, particularly when you're not exposed for a long period of time at the most extreme part of the day.

  • 13:25:33

    NNAMDIWell, Michael Holick, if you're going to use an indoor tanning bed because you or your doctor think you may benefit from this vitamin D boost, is there a safe way to do so?

  • 13:25:43

    HOLICKActually, I do recommend some of my patients that have inflammatory bowel disease and they're unable to absorb any vitamin D whatsoever, that they could go to a tanning salon. And what I typically recommend is to go in for about 50 percent of the time recommended for tanning and always wear sun protection on their face. And by doing so, they often can improve their vitamin D status and improve their overall health and well being. Because one of the consequences of vitamin D deficiency can be throbbing, aching bone pain that can be so overwhelming that the patients can -- need narcotics to be able to deal with the problem.

  • 13:26:28

    HOLICKAnd so we have found that to be a very effective method for being able to do that. And believe it or not, there's about 10 million people in the United States that have inflammatory bowel disease and other mal-absorption syndromes that really almost prevent them from absorbing vitamin D from either diet or from supplements.

  • 13:26:50

    NNAMDIHave a lot of calls and questions for you. We will start with Yvonne in Prince Georges County, Md. Yvonne, you're on the air. Go ahead, please.

  • 13:26:59

    YVONNEYes, thank you for lots of good information about vitamin D and its deficiency and how much is needed and differences in the amounts of vitamin D we get in different geographic areas. Would the doctor clarify the difference between the amount of vitamin D which is required related to (word?) pigmentation and the (word?) because I understand that the more pigmentation you have...

  • 13:27:27

    NNAMDIUh-oh...

  • 13:27:29

    YVONNE(unintelligible) amount, thank you.

  • 13:27:29

    NNAMDIYvonne, we missed the last part of your statement. The more pigmentation you have, could you finish that sentence again, please?

  • 13:27:34

    YVONNEYeah, yeah. The more time you need in the sun because it's related to skin cancer also. And people who don't have enough vitamin D to the...

  • 13:27:45

    NNAMDIMichael...

  • 13:27:45

    YVONNE...pigmentation blocks -- the pigmentation blocks the sun rays absorption.

  • 13:27:49

    NNAMDIMichael Holick.

  • 13:27:50

    HOLICKYeah and that's true. So African-Americans are at much higher risk for severe vitamin D deficiency. They're also at higher risk for common cancers, type two diabetes and even infectious diseases. And we think that that's in part due to their vitamin D deficiency. And, yes, melanin is a wonderful natural sunscreen.

  • 13:28:11

    HOLICKAnd so we actually did a study and compared the ability of African-American adult compared to a White adult, putting our tanning bed under very careful conditions and could show that whereas the White adult would raise their blood level 60 fold by being exposed to a suberythemal dose of simulated sunlight in a tanning bed, that the African-American didn't budge their blood levels, that they needed to be in for five to 10 times longer. So, yes, you're correct that skin pigmentation will reduce the synthetic capacity of the skin to make vitamin D. But...

  • 13:28:49

    NNAMDIWell...

  • 13:28:50

    HOLICK...African-Americans need exactly the same amount of vitamin D as Caucasians to maintain their blood levels. And so we typically recommend for children 600-1,000 units a day and for adults 1,5000-2,000 units a day.

  • 13:29:05

    NNAMDIHere we got an email from Cindy in Annapolis, Md. "How much does skin type have to do with tanning? My husband and son have what can be described as a Mediterranean completion. And my husband says that he doesn't need to worry about sun exposure and sunscreens because he never burns and gets a natural deep tan. Is this true?" Asks Cindy. Michael Holick.

  • 13:29:28

    HOLICKThese individuals typically have what we call skin type three and that is always tan, never burn. But believe it or not, you definitely can still burn. And that you still need to be cautious about sun exposure. But the tan certainly does help protect them from damaging rays from sunlight.

  • 13:29:51

    NNAMDIOnto...

  • 13:29:52

    BEILENSONOh, I...

  • 13:29:52

    NNAMDIGo ahead, please, Peter Beilenson.

  • 13:29:54

    BEILENSONYeah, as I'm sure Dr. Holick has seen, I've seen patients, African-American patients with melanoma. So it's not -- certainly not 100 percent protective. But the darker the skin, the less of a damage -- the less that you are affected by the rays.

  • 13:30:08

    NNAMDIHere is Christy in Alexandria, Va. Christy, your turn.

  • 13:30:13

    CHRISTYYes, hi. I've heard people mention that there are certain bulbs that you can still get a tan but the main objective in these bulbs in these tanning beds is to help produce the vitamin D. I believe they give you more UVB instead of UVA. Would that be a healthier alternative or would you not get the tan that the teenagers are going for or is that all just sort of over hype about these bulbs?

  • 13:30:35

    NNAMDIKeep...

  • 13:30:36

    CHRISTYAnd I'll take my answer off the air.

  • 13:30:37

    NNAMDI...keep in mind, the tan that the teenagers are going for, Michael Holick.

  • 13:30:42

    HOLICKRight. So it turns out that you're right, that there are two types of lamps that you can tan with. One is pure UVA and I never recommend that you use those types of lamps because you make no vitamin D to you, it would've give any benefit at all. And the UVA definitely can increase risk for skin wrinkling and potentially skin damage. And the UVB lamps are much better because you will make vitamin D. So tanning beds that have a component of UVB radiation would be the choice if you're using the tanning bed for vitamin D.

  • 13:31:23

    NNAMDIThank you very much for your call. Peter, tanning salon owners were upset in 2010 when a 10 percent federal tax on tanning went into effect. Would you like to see a broader federal crackdown on tanning yourself?

  • 13:31:36

    BEILENSONI mean, I think so. I think there's pretty clear evidence, Dr. Holick's point being well taken in its, you know, 10 million people with inflammatory bowel disease, but that's out of 308 million Americans. So it's, you know, one in 30-something. And for some folks like that and many of them are older than teenagers obviously, a doctor's prescription would be allowed in Howard County. But I think except for those exceptions, it makes good sense and it's scientifically supported that banning indoor tanning for teenagers makes sense and I'd like to see that actually taken up around the country.

  • 13:32:13

    NNAMDIAnd how do you feel, Michael Holick, about the movement around the country to keep teens out of tanning beds?

  • 13:32:20

    HOLICKI mean, as we had discussed, I mean I would much prefer for a teen to go to a tanning salon to get a tan, as long as they didn't burn and then to go out on spring break and not get a sunburn. I mean, I think probably we'd both agree that you never, never want the teen to get a sunburn because that definitely increases risk for melanoma. You know, wearing sun protection, you know, is certainly encouraged but, you know, a lot of teens don't always heed parents advice and, you know, would go out and get a burn because they have this concept that if you burn, that you'll be able to get a tan quicker. And it's just not true. So from my perspective, if they were using the tanning salon for that purpose, I would prefer they do that then get a sunburn.

  • 13:33:11

    HOLICKWe also did a study by the way in tanners in Boston. And we found that in the winter time, that tanners had a robust level of vitamin D and non-tanners did not. And also the tanners had a higher bone density. So like I said, even though I don't advocate tanning, it is interesting that tanners do have much higher blood levels of vitamin D. And until, you know, we can encourage broad vitamin D supplementation and increase foods that contain more vitamin D so we can improve the vitamin D health of both children and adults in the United States. It turns out that tanners have been benefiting from those tanning salons that have the UVB radiation that does make vitamin D.

  • 13:33:58

    NNAMDIOnto Carolyn in Fort Myers, Fla. Carolyn, you're on the air. Go ahead, please.

  • 13:34:04

    CAROLYNHi, Kojo. I just wanted to sort of give a testimony.

  • 13:34:08

    NNAMDIYes.

  • 13:34:08

    CAROLYNWhen I was a teenager, I was defiant and I was determined to get a tan and I didn't know the difference between a sunburn and a tan. So I sat in front of the sunlamps that were first introduced that you could buy at the drug store in 1950 and I sat 15 inches in front of them. And every time I could get to the beach, I went out and I kept sun burning myself. And I'm now in my 70s and I've had eight surgeries, basal cell and squamous cell cancer all on my face. So while melanoma is certainly the greater concern, I just think there's some other things that would be good for teenagers and parents to think about. And I can tell you, it's not fun to have your face operated on over and over and over. Just...

  • 13:35:09

    NNAMDIAnd...

  • 13:35:09

    CAROLYN...wanted to make this comment.

  • 13:35:11

    NNAMDIAnd Peter Beilenson, a part of what Carolyn is talking about is that teenagers never ever think about when they're 70.

  • 13:35:18

    BEILENSONWell, that's very true. My daughter is a good example, the kind of concrete thinkers and they think about now and they don't think about the long term consequences or even the medium term consequences which is why, again, when we're talking about advocating for a ban on tanning for teenagers, it's not for everyone. It's not for adults, adults can have the right to make that decision but we think teenagers particularly deserve that protection, that we should do as a society.

  • 13:35:44

    BEILENSONAnd I would also argue that although there are certainly are ways -- are safer ways, not safe but safer ways of tanning in a tanning bed as Dr. Holick was talking about with his chronic inflammatory disease, bowel disease patients, where you just keep sunscreen on your face and you stay in for a short period of time. Let's be honest, the typical teenager, I know for a fact, does not do that. They, again, are very likely to tan well over a half -- I mean, very likely burn.

  • 13:36:12

    BEILENSONWell, over half of teenage tanners actually get a burn in the tanning salon. And that puts them at significantly increased risk for melanoma. And so, again, I think that a sensible combination of foods with vitamin D, potentially vitamin D supplements and mild non-peak hour sun exposure on the arms is a way, I think, Dr. Holick would agree to get a safe level of vitamin D in a safe way.

  • 13:36:37

    NNAMDIThank you very much for your call, Carolyn. We move on to Colleen in Silver Spring, Md. Colleen, you're on the air. Go ahead, please.

  • 13:36:45

    COLLEENHello. What an interesting timing on this. I had just come from the pharmacy to pick up my supplemental for...

  • 13:36:56

    NNAMDIWe couldn't hear that at all, Colleen, are you still there? I think we lost Colleen. But, Colleen, I'm going to put you on hold to give you the opportunity to come back. Even as we talk with Christine in Silver Spring, Md. Christine, you're on the air. Go ahead, please.

  • 13:37:12

    CHRISTINEYes. My question has to do with the fact that I have not had any sun for 27 years. I heard the warnings when I was 14 about staying out and I heeded them. But the recent research about the vitamin D deficiency now has me a little concerned that there could be some problems with having done that. And is there anything accumulatively with this that can be a problem because I really never get sun. I haven't had a tan since I was 14. I never do now. And I just was kind of curious in terms of supplementation, things along those lines, if I've set myself up, maybe, for some problems by not being out in the sun. So, that was kind of my question.

  • 13:37:52

    NNAMDIMichael Holick?

  • 13:37:53

    HOLICKYeah, as I said, the three part process for improving your vitamin D status. But if you take 2,000 to 3,000 units of vitamin D a day as a supplement, you should be able to satisfy your body's vitamin D requirement. And so if you, you know, decide not to want to go out and get some sensible sun exposure, that supplemental vitamin D should be more than adequate to satisfy that requirement.

  • 13:38:18

    NNAMDIAnd Christine, thank you very much for your call. We're running out of time. But Michael Holick, you have a background in dermatology, but your advice runs counter to what we usually hear from dermatologists. And it's my understanding that it in fact cost you a job a few years ago. Tell us about that. Do you think we're being overly cautious?

  • 13:38:37

    HOLICKI realize, probably about 30 years ago, that as the sunscreen industry was being heavily promoted and that everybody was wearing a sunscreen, that the same sun rays that cause a tan and a sunburn are the same sun rays that make vitamin D. And true enough, when we did a study and looked very carefully at, if you put a sunscreen on with a sun protection factor of 30, properly, that you reduce your ability to make vitamin D in your skin by as much as 98 percent.

  • 13:39:08

    HOLICKAnd so I then try to alert basically the medical community and the dermatology community that we just need to have more moderation in our recommendations. That abstinence is really not the best course of action because you do need, maybe, a little bit of sensible sun exposure to satisfy that vitamin D requirement. Australia, right, the skin capital of the world, they now recognize 40 percent of Australians are vitamin D deficient.

  • 13:39:35

    HOLICKThey did a study in Australia dermatologist in the summertime, found 87 percent were vitamin D deficient. So I think, from my perspective, that you know, I wrote the book back in 2004, "The UV Advantage" was to make the public aware of this problem and to explain to them that sensible sun exposure with vitamin D supplementation and some foods that contain vitamin D in combination is the best way to satisfy your Vitamin D requirement.

  • 13:40:06

    NNAMDIAnd the operative word of course is sensible. Dr. Michael Holick is a professor of medicine, physiology, and biophysics at Boston University School of Medicine and the author of "The Vitamin D Solution" and "The UV Advantage." Michael Holick, thank you for joining us.

  • 13:40:19

    HOLICKOh, it was my pleasure. Thank you for the opportunity to be with you, and I enjoyed being on with Dr. Beilenson.

  • 13:40:24

    NNAMDIDr. Peter Beilenson is the health officer for Howard County, Md. Peter Beilenson, thank you for joining us.

  • 13:40:30

    BEILENSONThanks for having me, sir.

  • 13:40:32

    NNAMDIWe're gonna take a short break when we come back. A small tribute to Earl Scruggs who defined bluegrass and redefined the banjo. He died yesterday at the age of 88. I'm Kojo Nnamdi.

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