Sunshine! Its not too late to top up!

I am lucky enough to be writing this from my holiday in France, where the September sun has already worked its magic on me and my family. Doing yoga in the sunshine has been a real tonic for me and my little one! Experiencing the effects of the sun, as well as the peaceful countryside and good food of course, has made me reflect on and research the effects of sunlight on vitamin D levels and the link with mood and health.

Everyone knows that after a walk in the country on a bright day, or on holiday when you spend more time outdoors, you feel calmer, happier and sleep better. Most of us also know that we need a certain amount of sunlight to make Vitamin D; lack of which has been linked to low mood and tiredness, as well as the more well known ricketts (surprisingly prevalent today).  The publicity about SAD (seasonal affective disorder) a few years back made people more aware of the importance of daylight and its link to mood. On the other hand, increasing awareness of the ageing effects of too much sun and the increasing incidence of skin cancer has caused those of us who grew up in the era of Hawaiian Tropic, to rethink our attitude to sunbathing and commonly to wear facial products with sunscreen on a daily basis to protect against premature aging. Our kids are slathered in sunscreen at nursery and school the minute the sun peeps out (my daughter’s nursery wont let them play out without it in the sunny months). So where do we find the right balance between getting enough sun to boost Vit-D but not so much it is dangerous for our skin? Should pregnant and breastfeeding women take Vit-D supplements? And what about babies and children?

There is conflicting information out there on sunlight exposure and Vitamin D; obviously the climate you live in as well as dietary and lifestyle factors are crucial. In the UK,  the prevailing advice shifted in late 2010 when a consortium of 7 British health organisations (including the British Association of Dermatologists and Cancer Research UK), issued a joint statement taking into account the latest research in this area. This made it clear that exposing your skin to sun for a short amount of time, in the middle of the day, without suncreen, on a regular basis, is important for maintaining sufficient Vitamin D levels in the body. The exact amount of time needed, and how this varies according to weather factors, skin tone and other individual factors, is not specified, as this has not yet been sufficiently  researched. However, the interpretation in many of the newspapers seems to be around 5-15 mins per day, several days per week, in the mid- day daylight ( i hesitate to say sunshine as we don’t tend to associate the British weather with sunshine! And it does not need to be blue skies and blazing sun to get our Vit-D top up). I have previously read that people with dark brown/ black skin need more than twice as much, and those with ‘olive’ or lighter brown skin somewhere imbetween. I could not find any reliable guideance on this however.

Some summary points which i thought to be of particular interest for my client group are:

  • People with darker skin, pregnant women, and babies born to vit- D deficient mothers, are included in the list of people at higher risk of Vit- D deficiency. There are two ways to reduce this risk;- supplements, and increasing sunlight exposure.
  • Regular exposure to sunlight should be sufficient for most people to maintain adequate Vit-D levels. Vit-D made in the body in Summer can be stored for several months, meaning the fewer opportunities for sun exposure in Winter should not mean you automatically need a Vit-D supplement.
  • The best dietary sources of Vit-D which are also pregnancy / breastfeeding friendly, are oily fish, meat, and eggs. Fortified breakfast cereals and marg also contain Vit-D. These foods are not however sufficient to get our full requirements of Vit-D; we need sunshine above all!
  • Some US info and older UK info, suggests that breastfed babies may need Vitamin D supplements; in my opinion, not only is this wrong in suggesting that breastmilk is somehow inherantly ‘deficient’; the 2010 UK advice does not reflect this view. Advice on the Cancer Research UK website suggests that breastfed babies whose mothers are Vit-D deficient are at high risk of Vit-D deficiency. This sounds much more sensible!
  • Babies and children need some sun exposure too, to ensure they are making enough Vit-D. Just as for adults, this should be for short periods only, and never enough to cause reddening of the skin. Extra caution should be exercised with babies and young children as their skin is more sensitive, and prone to sun damage. However, advice to avoid direct sunlight altogether for babies, in my opinion, is misleading. We are not talking sunbathing on a hot day here- playing outside on a bright day , with face and arms exposed, seems likely to be acceptable and achievable for most little ones.
  • Of course, skin type is an important factor for all ages, babies and children in particular. Type 1s ( v pale skinned)  should limit exposure to less harsh sunshine, short periods later in the day on a hot day, or mid dayish on a cloudier day. The best guideline seems to me to be, never anywhere near enough to cause reddening of the skin.
  • My own view is that even though i am a ‘higher risk’ person as i am pregnant and having to share my Vit-D supplied with my growing baby, as long as i spend plenty of time outside , i do not need a supplement. I try to uncover some skin while walking for work visits, working on my allotment, or just sit out in the back yard after work for 10 minutes. I do have a pretty healthy diet but as i dont eat meat, or fortified marg or breakfast cereals, and I replace cows’ with soya milk, this research has reminded me to ensure i eat plenty of eggs and dairy products to keep up my dietary Vit-D. ( i see this as a top-up to the sun-induced Vit-D.)
  • The effects of Vit-D supplementation are still not sufficiently well researched for widespread supplementation to be recommended by health organisations.
  • Cautions apply to any general multivit or combined vit supplement such as fish oils, for babies, children, pregnant or breastfeeding Mums; check it out with a pharmacist.

So, while on holiday or in the sunnier months at home, good advice seems to me for the whole family to be to spend the first 5-15 mins or so with as much skin exposed as possible, without any sunscreen, and then to put on high-factor sunscreen (the days of Factor 8 are long gone….!!) or to get out of the sun. The rest of the year, extra walks or trips to the park, or daring to bare the odd arm or leg, will probably be sufficient for most. Mums afraid of facial sun damage must judge for themselves whether to continue to wear their sunscreen- boosted lotions and potions, and weigh this up against their chances of needing that sun exposure to top up their Vit-D levels.