The vitamin D debate

• ITA’s claim: "A recent study in the prestigious Proceedings of the National Academy of Sciences determined that the risks of not getting enough UV light far outweighed the hypothetically minute risk of skin cancer. That’s because getting a healthy tan naturally produces vitamin D, which has been linked to significantly decreasing your risk of contracting internal cancers like lung, kidney, or liver cancer."

Why it’s questionable: While vitamin D is beneficial to the body, as of yet, there isn’t conclusive research that shows vitamin D actually prevents cancer. According to the National Institutes of Health: "Well-designed clinical trials need to be conducted to determine whether vitamin D deficiency increases cancer risk, or if an increased intake of vitamin D is protective against some cancers. Until such trials are conducted, it is premature to advise anyone to take vitamin D supplements to prevent cancer."

• Smart Tan’s claim: "New research has shown that vitamin D deficiency is epidemic in American adults today, suggesting that up to 90 percent of North Americans are vitamin D deficient and that vitamin D deficiency has significant implications on human health."

Why it’s questionable: Proponents of the above theory neglect to talk about the individuals most likely to suffer from vitamin D deficiency. According to Newsweek: "While the tanning industry expresses concern about widespread vitamin D deficiencies, critics point out that two of the groups with the lowest levels of vitamin D—people with dark skin and the elderly—are not the ones targeted by the salons."

In fact, before the tanning industry makes such claims, it should really evaluate its common customer. "The most frequent users of indoor tanning equipment are young — under age 30 — and generally, in the United States and Europe, are thus not the individuals who most need increased vitamin D intake," explains Skin and Aging.

For those who might have a deficiency, tanning beds aren’t necessarily the preferred modes of supplementation. Would doctors really recommend an older person visit a tanning salon for their vitamin D? Dermatologist and skin cancer specialist James Spencer, M.D., tells Skin and Aging, "Certainly there are a number of people in this country — those in nursing homes, for example — who are vitamin D-deficient. But I don’t see any nursing home patients with their walkers going to indoor tanning parlors."

• Smart Tan’s claim: "There is growing consensus that humans may not be able to get enough vitamin D through dietary supplements alone (especially if recommended vitamin D levels are raised, as is widely anticipated, from 200-600 IU daily to 1,000-2,000 IU) and growing acceptance of moderate sun exposure as the best, cheapest, most widely available and most natural source."

Why it’s questionable: Here, the debate becomes a question of numbers. For the average individual who isn't prone to vitamin D deficiency (meaning an individual under 50 who has reasonable access to sunlight and a healthy diet), two glasses of milk a day are sufficient enough to get the recommended dose of vitamin D, Newsweek reports.

In fact, the scientific community continues to debate whether sunlight is actually a better source of vitamin D at all: "Under no circumstances should anyone be misled into thinking that natural sunlight or tanning beds are better sources of vitamin D than foods or nutritional supplements," explains dermatologist Vincent A. DeLeo, M.D., associate professor of clinical dermatology at Columbia University and chairman of the dermatology department at St. Luke’s Roosevelt and Beth Israel Hospital Centers.

Not only is tanning a dangerous way of acquiring vitamin D, but it might actually hinder the body’s process of converting UV rays into vitamin D. According to Newsweek, pursuing a tan "actually slows the synthesis process, because the darker the skin, the longer it takes to get enough vitamin D from the sun."

• ITA’s claim: "(Dermatologists) are beginning to realize that we need a little sunshine every day. The problem remaining is that people living north of 37 degrees in cities like San Francisco, St. Louis, or Richmond can’t get enough sunlight during the winter to produce the minimum amount of vitamin D necessary to prevent deficiency. That’s why indoor tanning beds are a great way to get a healthy dose of vitamin D (and a tan, while you’re at it)."

Why it’s questionable: Is the ITA claiming that they manufacture their tanning beds exclusively to those who are vitamin D deficient? If this were true, why is summer the time that people seek out tanning beds, when UV rays are plentiful?

In reality, frequent users of tanning salons aren’t those who live in cooler climates, using these beds responsibly — they’re individuals concerned with the image of being tan. Dermatologist Diane Baker, M.D., tells Skin and Aging: "The people who usually want to go into the tanning booth are those with fair skin, those who can actually get more vitamin D from small amounts of sun exposure."

Dermatologist Jody A. Levine, M.D., tells WebMD that the amount of radiation produced by a tanning bed is far greater than the amount our body needs. "There is a certain point at which too much radiation causes the vitamin D production pathway to go backwards," says Dr. Levine. ?With extended exposure, vitamin D is converted back to its precursors. It is doubtful that the greater risks incurred by extensive tanning will be offset by the benefits of vitamin D from this radiation."

And a more important question: Do tanning beds even provide a good source of vitamin D? In Skin and Aging, dermatopathology expert Bernard Ackerman, M.D., explains: "The sun is obviously more beneficial to man than the UV radiation from the bulbs in a tanning bed. The sun is effective in the generation of vitamin D. That’s not the case...for the bulbs in a tanning bed."

The bottom line: Dermatologists aren’t arguing that vitamin D is insignificant; they’re simply advising the public to seek out a safer way to acquire it. "I don’t think there’s a dermatologist who would argue with the fact that people need more vitamin D, but the best way to get it is not to go to a tanning booth," Sherrif Ibrahim, M.D., Ph.D., explains to Skin and Aging. "You can get plenty of incidental sun exposure walking from the supermarket to your car, and advocating a known carcinogen when completely safe alternatives [foods and supplements] exist, is negligent," he adds.

The war on sunscreen

• Smart Tan’s claim: "While sunscreen is an excellent product that has an intelligent usage in the fight against sunburn, overuse of the product may have serious consequences as well. Because most women wear foundation products daily, their make-up may be preventing them from producing vitamin D much of the year. And because women are more likely than men to develop osteoporosis, making up 18 million of the 25 million Americans afflicted with the disease, they would stand to benefit even more from an increase in vitamin D production."

Why it’s questionable: Smart Tan is correct that women need sunlight, but its claims that sunscreen use leads to vitamin D deficiency is misleading. "For vitamin D purposes, people can get all the UV exposure they need from six to 15 minutes of incidental sun exposure daily," according to Modern Medicine.

In fact, some people need even less; Newsweek writes, "Someone with very fair skin needs only about five minutes in the sun without sunscreen, (three times a week between 10 a.m. and 4 p.m.), to achieve optimal levels of vitamin D."

• ITA’s claim: "Companies like Coppertone and Neutrogena, among others, quietly funnel millions of dollars into dermatological front groups like the Skin Cancer Foundation medical academies like the American Academy of Dermatology to spread half-truths and hype about getting a tan."

Why it’s questionable: The idea that the American Academy of Dermatology (AAD) is spreading lies to garner profits is absurd. First, consider AAD’s mission, reputation and research efforts. William Hanke, M.D., M.P.H., AAD’s president, tells Modern Medicine that the AAD "is a professional organization committed to excellence in dermatologic care and patient safety. We utilize the latest data and research to ensure that our recommendations for the public prevent any unnecessary health problems."

While certain sunscreen manufacturers do indeed support the AAD’s messages to the public regarding sun safety, "only a small fraction of this support comes from manufacturers of sunscreens," says Dr. Hanke. Although there’s a certain amount of cooperation between dermatologists and cosmetic manufacturers, the basic goal of the AAD remains the same: to ensure that the public is kept up-to-date about skin-related research and prevent problems before they occur.

Regarding any monetary motives, assistant professor of dermatology at the University of Iowa, Marta J. VanBeek, M.D., M.P.H., explains, "We’re essentially working to decrease the number of patients who see us for skin cancer. So, there’s no financial incentive."

The bottom line: Because most of those who suffer from vitamin D deficiency (those with darker complexions and the elderly) are highly unlikely to use tanning beds, it seems that the ITA offers little in the way of a solution to this alleged deficiency.

In addition, the amount of UV rays that the ITA suggests people seek out is far higher than the amount an individual actually needs to receive their daily, healthy dose of vitamin D. For the average individual, 15 minutes a day of sun exposure, a few times a week, provides the proper amount of vitamin D.

See also:

When Tanning Becomes the Drug of Choice

Pro-Tanning Campaign HYPE: Healthy Tanning

Indoor Tanning: It’s Really Safe, Right?

Is Your Sunscreen Safe?

Melanoma: Preventing the Most Serious Type of Skin Cancer