Health and economic burdens from insufficient solar UVB irradiance and vitamin D
greatly outweigh all known adverse health outcomes. These are the
findings from a rigorous study published this week by the journal
Photochemisty and Photobiology. Scientists investigated the annual
number of cases and deaths due to cancer, multiple sclerosis, and osteoporotic hip fracture that likely could have been prevented with sufficient vitamin D as well as the number of cases and deaths from skin cancer and melanoma as well as cases of cataracts
that likely have been prevented by avoiding excess UV irradiance.
Economic burden values were then determined for these results.
It was estimated that about 50,000-63,000 annual cancer deaths in the U.S. (10% of all cancer deaths) could be prevented if all Americans had sufficient vitamin D. These findings are based on data in the Atlas of Cancer Mortality Rates for the United States, 1950-94, (cancer.gov/atlasplus/type.html), but are also supported by a number of recent reports that vitamin D plays a very important role in increasing survival once cancer is discovered. These deaths greatly outnumber the annual number of deaths from melanoma (8000) and skin cancer (2000).
In the UK, the preventable cancer deaths with sufficient vitamin D may be as high as 20% since oral intake is low and vitamin D produced from solar UVB is much lower than in the U.S.
In addition, UVB irradiance and vitamin D also provide important health benefits in preventing or ameliorating such conditions or diseases as bone diseases and muscle pain, multiple sclerosis, type 1 and type 2 diabetes mellitus, high blood pressure, etc. For more on these benefits, see Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005;10:94-111. thorne.com/altmedrev/.fulltext/10/2/94.pdf
While more research is needed to check these results, there is already enough known about the health benefits of vitamin D to change public health policies now. In fact, conferences were held in the U.S. in the past couple of years to review the evidence relating to the health benefits of vitamin D and set new recommended levels. Final recommendations, however, have not been issued.
It is hoped that these results will provide further emphasis on the health benefits of UVB and vitamin D for maintaining optimal health and treating diseases and conditions. It is hoped that there will be a diminution of efforts to demonize UVB irradiance, as is being done in Australia, that additional foods such as bread be fortified with vitamin D, that guidelines for vitamin D increased, and that there be increased testing of serum vitamin D levels.
According to Cedric Garland, a coauthor of this study, and the first to link vitamin D to cancer risk reduction (in 1980), "This analysis estimates the number of cases and lives that could be saved, and the major economic savings that could result, from attempts to reduce incidence rates of several important cancers by improving vitamin D status. More specifically, it estimates the reduction in incidence of these cancers that is likely to result from oral intake of vitamin D3, or no more than 10-15 minutes spent daily in activity outdoors in sunlight (not exceeding 0.75 MED), by persons whose skin type and personal history will allow. It also estimates a possible, although unlikely, increase in risk of skin cancer that might theoretically result, and places the potentially competing risks in context. This comparison revealed that the vitamin D-based strategy for cancer risk reduction would have considerably greater benefits than risks."
The title and abstract:
William B. Grant, Cedric F. Garland, and Michael F. Holick
Comparisons of estimated economic burdens due to insufficient solar ultraviolet irradiance and vitamin D and excess solar UV irradiance for the United States
Photochemistry and Photobiology, [Epub ahead of print]
Abstract
Vitamin D sufficiency is required for optimal health, and solar ultraviolet B (UVB) irradiance is an important source of vitamin D. UVB and/or vitamin D have been found in observational studies to be associated with reduced risk for over a dozen forms of cancer, multiple sclerosis, osteoporotic fractures, and several other diseases.
On the other hand, excess UV irradiance is associated with adverse health outcomes such as cataracts, melanoma, and nonmelanoma skin cancer. Ecologic analyses are used to estimate the fraction of cancer mortality, multiple sclerosis prevalence, and cataract formation that can be prevented or delayed.
Estimates from the literature are used for other diseases attributed to excess UV irradiation, additional cancer estimates, and osteoporotic fractures. These results are used to estimate the economic burdens of insufficient UVB irradiation and vitamin D insufficiency as well as excess UV irradiation in the United States for these diseases and conditions. We estimate that 50,00063,000 Americans die prematurely from cancer annually due to insufficient vitamin D, and 19,00025,000 in the United Kingdom.
The U.S. economic burden due to vitamin D insufficiency from inadequate exposure to solar UVB irradiance, diet, and supplements is estimated at $4056 billion in 2004, whereas that for excess UV irradiance is estimated at $67 billion. These results suggest that increased vitamin D through UVB irradiance, fortification of food and supplementation could reduce the health care burden in the U.S., U.K., and elsewhere. Further research is required to confirm these estimates.
It was estimated that about 50,000-63,000 annual cancer deaths in the U.S. (10% of all cancer deaths) could be prevented if all Americans had sufficient vitamin D. These findings are based on data in the Atlas of Cancer Mortality Rates for the United States, 1950-94, (cancer.gov/atlasplus/type.html), but are also supported by a number of recent reports that vitamin D plays a very important role in increasing survival once cancer is discovered. These deaths greatly outnumber the annual number of deaths from melanoma (8000) and skin cancer (2000).
In the UK, the preventable cancer deaths with sufficient vitamin D may be as high as 20% since oral intake is low and vitamin D produced from solar UVB is much lower than in the U.S.
In addition, UVB irradiance and vitamin D also provide important health benefits in preventing or ameliorating such conditions or diseases as bone diseases and muscle pain, multiple sclerosis, type 1 and type 2 diabetes mellitus, high blood pressure, etc. For more on these benefits, see Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005;10:94-111. thorne.com/altmedrev/.fulltext/10/2/94.pdf
While more research is needed to check these results, there is already enough known about the health benefits of vitamin D to change public health policies now. In fact, conferences were held in the U.S. in the past couple of years to review the evidence relating to the health benefits of vitamin D and set new recommended levels. Final recommendations, however, have not been issued.
It is hoped that these results will provide further emphasis on the health benefits of UVB and vitamin D for maintaining optimal health and treating diseases and conditions. It is hoped that there will be a diminution of efforts to demonize UVB irradiance, as is being done in Australia, that additional foods such as bread be fortified with vitamin D, that guidelines for vitamin D increased, and that there be increased testing of serum vitamin D levels.
According to Cedric Garland, a coauthor of this study, and the first to link vitamin D to cancer risk reduction (in 1980), "This analysis estimates the number of cases and lives that could be saved, and the major economic savings that could result, from attempts to reduce incidence rates of several important cancers by improving vitamin D status. More specifically, it estimates the reduction in incidence of these cancers that is likely to result from oral intake of vitamin D3, or no more than 10-15 minutes spent daily in activity outdoors in sunlight (not exceeding 0.75 MED), by persons whose skin type and personal history will allow. It also estimates a possible, although unlikely, increase in risk of skin cancer that might theoretically result, and places the potentially competing risks in context. This comparison revealed that the vitamin D-based strategy for cancer risk reduction would have considerably greater benefits than risks."
The title and abstract:
William B. Grant, Cedric F. Garland, and Michael F. Holick
Comparisons of estimated economic burdens due to insufficient solar ultraviolet irradiance and vitamin D and excess solar UV irradiance for the United States
Photochemistry and Photobiology, [Epub ahead of print]
Abstract
Vitamin D sufficiency is required for optimal health, and solar ultraviolet B (UVB) irradiance is an important source of vitamin D. UVB and/or vitamin D have been found in observational studies to be associated with reduced risk for over a dozen forms of cancer, multiple sclerosis, osteoporotic fractures, and several other diseases.
On the other hand, excess UV irradiance is associated with adverse health outcomes such as cataracts, melanoma, and nonmelanoma skin cancer. Ecologic analyses are used to estimate the fraction of cancer mortality, multiple sclerosis prevalence, and cataract formation that can be prevented or delayed.
Estimates from the literature are used for other diseases attributed to excess UV irradiation, additional cancer estimates, and osteoporotic fractures. These results are used to estimate the economic burdens of insufficient UVB irradiation and vitamin D insufficiency as well as excess UV irradiation in the United States for these diseases and conditions. We estimate that 50,00063,000 Americans die prematurely from cancer annually due to insufficient vitamin D, and 19,00025,000 in the United Kingdom.
The U.S. economic burden due to vitamin D insufficiency from inadequate exposure to solar UVB irradiance, diet, and supplements is estimated at $4056 billion in 2004, whereas that for excess UV irradiance is estimated at $67 billion. These results suggest that increased vitamin D through UVB irradiance, fortification of food and supplementation could reduce the health care burden in the U.S., U.K., and elsewhere. Further research is required to confirm these estimates.
No comments:
Post a Comment