Vitamin D supply: from sun or pill? - Attitudes and recommendation on vitamin D and impact on sun protection practices among German general practitioners evaluated by the network of dermato-oncologists, Onkoderm e.V.

Abstract

Abstract.Recommendations concerning the intake of vitamin D and/or sunlight exposure in the handling of patients with vitamin D deficiency remain a matter of debate. The present study of the German network of dermato-oncologists (Onkoderm e.V.) refers to an inquiry conducted among general practitioners on this and related issues. Based on 448 answers provided to 10 distinct questions, the consulted physicians recommended vitamin D intake (94% replies) and/or exposure to sunlight (63% replies) in their patients with vitamin D deficiency. An average of approximately 26 min daily unprotected exposure to sunlight at midday in spring and summer was recommended. Nevertheless, 91% of the physicians considered the use of creams protecting against sunlight to be judicious. However, only 54% of physicians considered it worthwhile practice to protect oneself intensively against UV radiation. This study indicates evidence of a reduction in sun protection practices. Yet, approximately 25% of the patients were considered to present vitamin D deficiency and, hence, recommendations to prevent or correct the latter situation should not be ignored. Nevertheless, we consider that there is a need to focus messages regarding sun exposure and for continued sun protection practices. These messages should specifically focus on the vitamin D issue to ensure that the incidence of skin cancer does not increase. IntroductionCurrent recommendations concerning the respective roles of sun exposure and dietary intake in the supply of vitamin D presently remain a subject of endless debate. No less than 20 studies were recently published on this issue. These deal with items such as: the calculated UV exposure levels for a healthy vitamin D status (1); the high prevalence of vitamin D insufficiency (2); the vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention (3); the knowledge and attitudes concerning vitamin D and impact of sun protection practices among urban office workers (4); the need for future sun protection campaigns to address the issue of vitamin D and present strategies to achieve sufficient vitamin D levels in countries with high UV radiation throughout the year (5); the attitudes, practices and knowledge of general practitioners with regard to vitamin D in relation to prescribing sunshine (6); the impact of public health messages in terms of vitamin D and sun protection, as well as protection against skin cancer (7); the hazard of UV radiation for children and adolescents (8); the evaluation, treatment and prevention of vitamin D deficiency considered in a clinical practice guideline (9); the effects of ambient sunlight and photoprotection on vitamin D status (10); the common genetic determinants of vitamin D insufficiency (11); an overview analysis of the time individuals spend outdoors (12); the effectiveness of casual exposure to summer sunlight for maintaining adequate vitamin D status (13); the possible reduction of vitamin D production to insufficient levels resulting from the...