Vitamin D and sun exposure statement

Media release: Vitamin D and sun exposure statement

A new statement on vitamin D and sun exposure has been developed highlighting the importance of balancing sun exposure with safety.

Research, which informed the joint statement by the Ministry of Health and Cancer Society with support from ACC, shows that some sun exposure is needed to produce vitamin D, says the Ministry of Health’s Public Health Medicine Specialist Dr Harriette Carr.

However Dr Jan Pearson National Health Promotion Manager for the Cancer Society says over-exposure to UV rays can increase the risk of skin cancer which must always be avoided.

The main groups identified as at risk of vitamin D deficiency in the Consensus Statement are:

- People with naturally very dark skin. This includes people from Africa, the Indian subcontinent and Middle East.

- Those who avoid the sun because of a higher skin cancer risk or are on photosensitising medications, for example some acne treatments.

- Those with limited mobility, who are frail or housebound either in residential care or the community, including anyone bedridden or wheelchair bound.

- Residents living in southern regions who get little time outdoors in the middle of the day between May and August, may be deficient by late winter.

Sun exposure is the main source of vitamin D for most people in New Zealand and this is generated by the body through exposing the skin to the sun’s UVB rays.

Vitamin D is important because it plays a key role in bone health. A deficiency in vitamin D can cause weak and softened bones, which can lead to rickets in children and osteoporosis and subsequent fractures in adults. Vitamin D deficiency also leads to more fall-related injuries, particularly in older people, ACC reports.

While the majority of New Zealand adults have good levels of vitamin D about five percent were deficient*, according to the Ministry of Health report on vitamin D deficiency. The report, based on 2008/09 NZ Adult Nutrition Survey data, also found that one in four New Zealand adults (27 percent) had less than the recommended level of Vitamin D - though they were not considered deficient.

It also found that people were more likely to have a vitamin D deficiency from August to October, particularly if they live south of Nelson-Marlborough in the South Island.

Dr Carr says it is worth reviewing your daily sun exposure if you live in the lower South Island, particularly between May and August.

“There are also some instances where taking a vitamin D tablet prescribed by a doctor may be more appropriate.” This could include people with very dark skin, especially those living in southern regions or people who either cannot or choose not to expose their skin to the sun and are at risk of deficiency.

Your doctor can also recommend whether taking a vitamin D tablet may be appropriate. PHARMAC-subsidised vitamin D tablets are available on prescription.

Background
During winter months the sun’s UV rays are weaker and therefore sunburn from exposure is less likely, except in the snow or at high altitude. In winter (May to August), a brisk walk or other form of physical activity outdoors around the middle of the day with your face, arms and hands exposed is a good way to increase your vitamin D.

However it is important to understand that any summer sun exposure (September to April), especially between the hours of 10am and 4pm, can increase the risk of skin cancer so remembering to slip, slop, slap and wrap is essential during these hours. It is best to schedule outdoor activity such as a brisk walk in the early morning or late afternoon during summer months.

Since 2008 ACC has delivered a targeted Vitamin D programme to older adults in residential care.

Around 30 percent of older adults will fall each year and the risk of falling increases with age. Vitamin D supplementation has helped reduce fall-related injuries.

ACC rates its programme uptake as strong. Currently 66 percent of the residential care population take vitamin D tablets - up from 17percent before the programme began.

* Vitamin D deficiency is when serum readings reach below a certain amount (serum 25-OHD levels less than 25 nmol/L).
Related links:
http://www.health.govt.nz/publication/consensus-statement-vitamin-d-and-sun-exposure-new-zealand
http://www.health.govt.nz/publication/vitamin-d-status-new-zealand-adults

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