Sunshine Is Healthy

Tripling of Heart Failure Hospitalization Rate Coincides With Use of Sunscreen Lotion and Advice to Avoid the Sun

by Bill Sardi by Bill Sardi


A dramatic rise in the heart failure hospitalization rate now being reported over the past three decades has coincided with the use of ultraviolet-B blocking sunscreen lotions which inhibit the production of vitamin D in human skin.

The rate of hospitalization for heart failure nearly tripled since 1980. The public has been urged to avoid the sun and use sun-blocking agents beginning in 1971. A lag period of about a decade is explained by a delay in public adoption in the use of sunscreens. The use of sunscreen products peaked in 2004 at 72% of Americans using a sunscreen when going outdoors. [Skin & Allergy News July 1, 2005]

A recent Australian study shows a season pattern for heart failure peaking in winter months when vitamin D levels are typically low. [Australian New Zealand Journal Public Health 2008 Oct; 32(5):408—13]

Another study conducted by researchers in Austria reveals a 284% increased risk for heart failure and a 505% increased risk for sudden-death heart attack among adults with low circulating vitamin D levels (less than 25 nanomole/liter 25-OHD test compared to adults with optimal vitamin D levels greater than 75 nanomole/liter 25-OHD test). [Journal Clinical Endocrinology Metabolism 2008 Oct; 93(10):3927—35] This study suggests a massive public education program be implemented, aimed at senior adults, to promote vitamin D supplementation, particularly during winter months when vitamin D levels are low.

Longjian Liu, MD, PhD, MSc, associate professor of Epidemiology and Biostatistics of the Drexel University School of Public Health in Philadelphia, Pa., reports the number of patients 65 and older who were hospitalized for heart failure increased 131 percent to 807,082 in 2006, from 348,866 in 1980.

Nearly 5.3 million Americans live with heart failure and 660,000 new cases are diagnosed each year, generating over $34 billion in healthcare costs, according to estimates of the American Heart Association.

Heart failure is an age-related phenomenon. Patients ages 75—84 are twice as likely to be hospitalized for heart failure compared to US adults age 65—74 years, while those age 85 or older have four times more risk of hospitalization for heart failure than those ages 65—74. Due to skin thickening with advancing age, older adults produce less vitamin D from sun exposure compared to younger adults. [Hormone Research 1995; 43(1—3):76—9]

Dr. Liu urges “innovative strategies be implemented” to reduce the number of Americans with heart failure. Nothing is said of the growing body of evidence linking a shortage of vitamin D with heart failure.

The link between vitamin D deficiency and heart failure is compelling.

  • Among heart failure patients awaiting a heart transplant, those patients who have higher vitamin D levels are more likely to survive the waiting period prior to organ transplantation. [European Journal Heart Failure 2008 Mar; 10(3):321—7]
  • Heart failure among infants is observed in cases of rickets (bone weakening) caused by a lack of vitamin D. [Heart 2008 May; 94(5):581—4]
  • Heart failure is more prevalent among African Americans who dark skin pigmentation impairs vitamin D synthesis during sun exposure. [Translational Research 2006 Dec; 148(6):301—8]
  • Heart failure is more prevalent among Arabic women and their offspring due to the use of traditional clothing and headwear that blocks sun/skin exposure. [European Journal Heart Failure 2006 Nov; 8(7):694—6]
  • Bone loss (osteoporosis) among postmenopausal women is associated with low vitamin D levels and is more often accompanied by signs of heart failure, particularly among women who are genetically prone to vitamin D insufficiency. [Journal Internal Medicine 2003 Apr; 253(4):439—46; Journal American College Cardiology 2003 Jan 1;41(1):105—12; American Journal Medicine 1997 Sep;103(3):197—207]
  • The intravenous administration of the active form of vitamin D (calcitriol) reduces the thickening of the heart wall characteristically seen in heart failure patients. [American Journal Kidney Diseases 1999 Jan; 33(1):73—81]
  • As early as the 1970s doctors reported "hungry bone" syndrome and heart failure following surgical removal of the parathyroid glands. [American Journal Medical Sciences 1976 Jan—Feb; 271(1):85—9] A shortage of vitamin D causes parathyroid glands to shrink.
  • Adults with heart failure are less likely to be exposed to midday sun. [International Journal Vitamin Nutrition Research 2007 Jul; 77(4):280—8]

Public health authorities are remiss in recommending universal vitamin D testing for all older adults and testing all older adults for vitamin D levels upon hospital admission.

Mass vitamin D supplementation recommended

The widespread deficiency of vitamin D suggests all Americans begin supplementation with vitamin D3. Not known to show much interest in preventive medicine, modern medicine continues to drag its feet over the use of vitamin D supplements, a vitamin that was discovered in 1922. It is becoming more obvious every day that millions of Americans have died prematurely due to a lack of an inexpensive vitamin.

Concerns of over-dose of vitamin D are largely unfounded given that an hour of total-body midday summer sun exposure in a sunny climate can produce up to 10,000 units of vitamin D without side effect or liver toxicity. Vitamin D pills avoid concerns over aging and wrinkling of the skin by sunlight. The National Academy of Sciences inexplicably continues to assert 2000 units of vitamin D is the "safe upper limit" for vitamin D supplementation, an amount of vitamin D equivalent to just 12 minutes of sunning.

Vitamin D researchers now recommend the safe upper limit be established at 10,000 IU (international units) [American Journal Clinical Nutrition 2007 Jan;85:6—18], which represents a 4-times safety margin since side effects do not begin till 40,000 IU are consumed for many months. [American Journal Clinical Nutrition 2001 Feb; 73:288—94]

Sunscreen recommendations misdirected

Regarding skin cancer, the habitual use of sunscreen lotion has been counterproductive. Sunscreen lotions are designed to block the fast-tanning UV-B rays that produce vitamin D in the skin, while permitting more deeper-penetrating UV-A sun rays to reach the skin. Only recently has it been recognized that solar UV-A radiation produces mutations and skin cancer in humans. [Photochemistry Photobiology 2005 Jan—Feb; 81:3—8] Sunscreen lotions block production of vitamin D which prevents cancer, while allowing exposure to UV-A rays that promote cancer.

In 1971, when a campaign to urge Americans to use sunscreen lotions began, mortality due to malignant melanoma was uncommon. Today, with widespread sunscreen use, mortality due to malignant melanoma has risen to 7000 cases per year. Sunscreen use in northern climates actually increases the risk for melanoma. [Annals Epidemiology 2007 Dec; 17(12):956—63]

Misdirected modern medicine

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