Insufficient Sun Exposure Has Become a Real Public Health Problem (2020) | Hacker News Reader

Insufficient Sun Exposure Has Become a Real Public Health Problem (2020)

ncbi.nlm.nih.gov

29 pointstvier15 comments

Well, as much as a I find this sort of thing annoying, I’m going to have to be the drive-by “is it just statistics?” guy.

> breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer’s disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure.

Quite a few, not all, but most, of the maladies they list seem to be well connected to a sedentary lifestyle. Is it possible that this, rather than insufficient sunlight, could be the cause?

I also wonder (wild stereotyping here, but) if there could be some correlations between some of the childhood stuff—Autism, asthma, autoimmune disorders and parents’ class. For example, if someone is an indoor worker, they are probably more likely to be white collar, right? Are we more likely to detect autism for white collar parents (who tend to be a bit more intrusive)?

I don’t have any real suggestions, just a worry that amount of time spent outdoors is a proxy for tons of stuff, including class basically, so it seems incredibly hard to study.

The biggest study I've found for this (which gets reference in the OP) seems to have done a pretty good job with this[1]. Like you I'd feel much more confident if we had a good understanding of the mechanism, but the effect size just seems too big.

[1] https://link.springer.com/article/10.1007/s43630-021-00017-x

Not to mention the pandemic of disease being caused by highly processed foods. The damage being done at a global scale is hard to quantify.

No perfect analogy for this. One of the many I have used over the years is to have someone imagine driving their car on the highway while pressing on the accelerator all the way down, as far as it will go. To control speed, use the brakes. And then, when the inevitable happens, we blame the brakes.

That's what's happening to billions of people. Except for corner cases, obesity is 100% caused by toxic nutrition. The same statement holds for type 2 diabetes.

In the US, the FDA (Food and Drug Administration) is complicit in that they do nothing to prevent what could be characterized as poisonous food from entering the market.

I think I can say that most food found at a supermarket is horrible stuff that will hurt you over the long run. Let's put it this way: Drugs require prescriptions because, among other things, they would be dangerous to consume freely, without a real medical reason to have them. If you read the ingredients in most food items sold, given what the consequences, it would be easy to wonder why this stuff doesn't require medical supervision to consume.

And then we blame vitamin D? C'mon. It's the brakes, not the engine going full throttle down the road. Right.

Get enough sun, but don't get sunburn. Can someone make a product that allows "just enough" sun through for people like me?

I live in the northern latitudes of the continental U.S. and take strongly after my Scandinavian ancestors. If I spend even 12 minutes outside in spring or fall (never mind summer!) in direct sunlight without a high SPF sunscreen, I burn. It doesn't fade to tan. It fades back to pale white, then burns again next time.

I've tried building up a "tolerance" and it hasn't worked at all. I'm pasty white if I stay at or below 11 minutes and bright red if I hit 12. I'm not kidding when I say I would pay for an actual solution to this. I would love to spend more time outside in the sun.

Limited exposure every couple of days, to allow UV to induce adaptation (melanin production) without too much damage, which makes it worse and sets you back (and is dangerous). 11 minutes between 10a and 2pm is even too much in the summer if you're out of hibernation.

Maybe also explore medium SPF sunscreen.

For me personally (not Scandinavian roots) after hibernation the first few exposures are key, and I try to be very conservative. Then I let myself recover for at least a day in between sun sessions. If I'm on vacation and I can't escape sun, then my recovery means high spf sunscreen. I treat it similar to exercise recovery - stress, rest, adaptation cycle.

I appreciate your and other commenters suggestions, but I've been down all these roads. I spent a whole summer slowly "working my way up," 5 mins a day the first week, 6 mins a day the 2nd week, 7 the 3rd, etc. It doesn't matter. As soon as I hit 12 minutes once, I turn bright red. I can do 11 for as many days as I care to and my skin looks like I've not been outside in months. I know it's not just subtly changing either, because I don't end up with tan lines even though I always wear the same basic swimwear.

I've also tried dminder, low SPF, all kinds of things. As far as I know, there isn't anything congenitally "wrong" with me or anything, but I wouldn't know what to look for to rule it out.

I even had someone tell me the GAPS diet would fix it, but I did that for two (very boring) years, and it didn't help either.

It could be that it's just hopeless, but it's bizarre to me that I should end up so evolutionarily unfit for my home planet.

I would look at a UV index chart for your area and act accordingly - e.g. deliberate sun exposure soon after sunrise and soon before sunset. But you might just be SOL, it sounds like you have skin type I on the Fitzpatrick scale which is no ability to tan or extremely difficult to tan. Something I considered is considered personally is moving somewhere further north and probably cloudier, just reality. Where I live now our max UV today is extreme - nearly 12.

There is also supplementation you can look into but the science for isn’t concrete. I know there’s a thread on the tanning subreddit near the top of all time with a list of them and how they might help.

I just checked and the nearest city I could find results for and we have zero extreme days, 25ish very high, and more than half the year very low. Unfortunately (for this purpose; I generally love it here), I'm about as far north as I can get without moving to Alaska or another country.

I think I just have to choose between the risks of skin cancer and the risks of whatever else might happen if I don't get enough sunshine. The latter is a bit more nebulous for the time being, so I guess I'll just keep making sure I don't go out without clothing coverage or high SPF.

I’ve always been a little suspicious of sunscreen, it just seems too good to be true, and I wonder if people might use it as an excuse to stay out in the sun indefinitely. It just provides an attenuation factor after all.

I wonder if you could select clothes so that you only get sun in locations that you can easily monitor and cover up when they start to burn. As a bonus, these should also be easy to keep an eye on for skin cancer, right?

IDK “get skin cancer somewhere you can see it easily” seems like a pretty stupid suggestion, now that I wrote it out. But I can’t think of anything better.

Long clothing and big hats are probably your best bet. If you want to learn more you can check out the Handbook Of Natural Fibres[1], but the short version is: white dye and looser weave mean less protection, colored dye and tighter weave mean more protection.

It's mostly pretty intuitive, but the dye makes a bigger difference than you'd expect. A white cotton t-shirt might have a UPF rating around 5 (1/5th the UV exposure), while a colored shirt is likely above 20.

[1] https://sci-hub.st/10.1533/9780857095510.1.141.

Fake tan DHA cream lotion. FDA approved.

Along with a list of unapproved methods: https://www.newsweek.com/self-tanning-fake-tan-dangers-skin-...

Use SPF 15, you'll develop a tan, but unless you are really fair-skinned or stay out a really long time you shouldn't get burnt.

Once you have a good base tan you can drop down to SPF 8 or maybe less.

My ancestry is scadinavian and german and I will burn if I go out in the sun with my winter skin, but if I take some care I can get to the point where I don't really need sunscreen at all.

The thing that sucks is that my other ancestry is Spanish and Italian. You would think it would help.

SPF 15 doesn't do a thing for me in terms of extending the time before I burn, but I'll be fine all day with 30 as long as friction from clothes doesn't rub it off or water doesn't wash it away.

(I offer the other details in case they make someone go, "Oh! I was the exact same way! Here's what ended up working for me," or some doctor goes, "Oh! With these fringe details, that tells me exactly why this is happening to you." I'm hoping someday LLMs will be able to take info like this and find the weird little niche answers that Google and other search engines' advertising focus have made impossible to find online.)

Check the dminder app.

> oral vitamin D supplementation has not been convincingly shown to prevent the above conditions

Many generalist will still prescribe vitamin D every winter as a standard procedure.

If it has a placebo effect, as long as producing vitamin D is not extremely polluting/costly I'd see it as win.

But otherwise, making an effort to get sun, and in particular managing one's life to not be locked in a building during the few sunny hours of a day should be valued more highly.

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