Doctor Yourself Interviews Dr. Michael Holick

Lot's of very practical stuff here, particularly on sun exposure and supplement recommendations. Specific reference to colon cancer reduction is quite interesting.

"The population of the world has been brainwashed by the American
Academy of Dermatology and the sunscreen industry, for 30 years,
with the unrelenting message that you should never be exposed to
direct sunlight because it is going to cause serious skin cancer
and death." (Michael Holick, MD)

(Editor's Note: Born 60 years ago in Jersey City, New Jersey,
Michael Holick published his first scientific paper in 1970.
Hundreds would follow, and now, he is arguably the world's
leading authority on vitamin D. Yet Dr. Holick's advocacy of what
he calls "sensible sun exposure" is so controversial that he was
fired from Boston University Medical Center's dermatology
department. Controversy being no stranger to this Newsletter, we
were pleased when Dr. Holick agreed to an interview, which
follows in edited form below.)

DOCTOR YOURSELF NEWS: Dr. Holick, What are some of the
research-based benefits of more vitamin D?

DR. MICHAEL HOLICK: You can reduce cancer risk by 30 to 50% by
increasing vitamin D in the diet, or by sensible sun exposure. We
gave mice colon cancer, and followed them for 20 days. Tumor
growth was markedly reduced simply by having vitamin D in the
diet. There was a 40% reduction in tumor size. And, casual sun
exposure actually decreases your risk of melanoma. In Finland,
back in the 1960's, children that received 2,000 IU of vitamin D
each day reduced their risk of getting Type 1 diabetes by 80%.
Every tissue and every cell in your body has a receptor for
vitamin D. Every tissue and every cell of your body requires
vitamin D to function properly.

DY NEWS: Exactly how much vitamin D, and how much sun, do we
need?

HOLICK: Vitamin D deficiency is less than 400 IU per day along
with no sun exposure. If you take 400 IU daily, you would still
have an inadequate amount of vitamin D. Humans need 1,000 IU each
day, or to be exposed to sunlight. Five to ten minutes, arms and
legs, three times a week, is adequate.

DY NEWS: What is you opinion of the official US RDA/DRI
recommendations?

HOLICK: I was on the committee that set them (National Academy of
Sciences, Panel on Calcium and Related Nutrients, 1996-1997). We
have made some progress in increasing the recommendations. They
are now 200 IU/day for children and adults up to age 50; 400 IU
for adults over 50; and 600 IU/day for adults over 70.

DY NEWS: Would you have liked to have set the recommendations
higher?

HOLICK: Yes. At the time, we were obligated to base our
recommendations on the published literature before 1997. Based on
new evidence, I think infants, up to one year of age, need 400
IU/day. Canada recommends 400 IU already. Then, from age one, and
all through adulthood, I'd recommend 1,000 IU/day. Everyone needs
1,000 IU of vitamin D3 each day.

DY NEWS: And how are we doing?

HOLICK: In Boston, 50% of adolescent boys and girls are vitamin D
deficient. 70% of moms and 80% their babies are vitamin D
deficient at birth. These infants have no vitamin D stores, and
the moms have none to give them.

DY NEWS: And that means rickets?

HOLICK: Rickets is only the tip of the vitamin D deficiency
iceberg. If you are vitamin D deficient in childhood, you are 2.4
times more likely to develop Type 1 diabetes.

DY NEWS: And for people of color?

HOLICK: Skin pigment is a natural sunscreen. African American
children require two to three times as much sun exposure, without
sunscreen, to satisfy their requirement for vitamin D.

DY NEWS: What are the consequences of not getting enough
sunlight?

HOLICK: If you live above 35 degrees north latitude, you are
twice as likely to develop multiple sclerosis. Living in higher
latitudes also means higher risk for Crohn's disease, rheumatoid
arthritis, and high blood pressure.

DY NEWS: What are some examples of "high latitude" cities?

HOLICK: Anything above Atlanta, Georgia.

DY NEWS: I've been to Atlanta. To a Yankee like me, that's pretty
far south. Now you know I'm going to quote you on this. . .

HOLICK: That's fine. Anywhere above about 35 or 37 degrees
latitude, that is, anywhere north of Atlanta, Georgia, you
basically cannot make vitamin D in your skin during the
wintertime.

DY NEWS: And in the summer, should we tan?

HOLICK: I do not believe in tanning.

DY NEWS: That seems a rather moderate position.

HOLICK: I was fired from my position as Professor of Dermatology
at Boston University Medical Center because I have been promoting
sensible sun exposure, and had wrotten the book, "The UV
Advantage." I had held that position for nearly ten years.

DY NEWS: Who fired you, and when?

HOLICK: Dr. Barbara Gilchrest, BU Medical Center Chief of
Dermatology, in February 2004. She and I remain personal friends.
I'm still full Professor of Medicine, Physiology, and Biophysics,
and have been for 20 years. Dr. Gilchrest has been quoted as
saying that to suggest that vitamin D deficiency is a significant
health problem is "weak and absurd." She has also been quoted as
saying that linking vitamin D deficiency to medical illness is
"schlock science." I have never heard her rebut those statements.

DY NEWS: Were you fired entirely because of your stance on
vitamin D and for no other reason?

HOLICK: No question about it. The American Academy of Dermatology
is very uncomfortable about sensible sun exposure, and anyone who
recommends it.

DY NEWS: You're telling us that the American Academy of
Dermatology does not believe in sensible sun exposure?

HOLICK: That is correct. They are believers in abstinence from
all sun exposure. They have been pretty firm about this. In May
2004, three months after I was fired, I was asked to defend
myself in front of all the staff.

DY NEWS: How successful was it?

HOLICK: I got people's attention.

DY NEWS: Who is most opposed to you?

HOLICK: The "unenlightened" dermatologists of the American
Academy of Dermatology.

DY NEWS: Yet it seems to be particularly difficult to kill
yourself with vitamin D.

HOLICK: True. One man took 1,000,000 IU of vitamin D per day,
orally, for six months. Of course, he had the symptoms of severe
vitamin D intoxication.

DY NEWS: But he lived to tell the tale?

HOLICK: Yes. His treatment was hydration (lots of water), and no
more vitamin D or sunshine for a while. He's perfectly happy and
healthy. This was published in the New England Journal of
Medicine. (Koutkia P, Chen TC, Holick MF. Vitamin D intoxication
associated with an over-the-counter supplement. N Engl J Med.
2001 Jul 5;345(1):66-7.)

DY NEWS: How many people have died from vitamin D or other
vitamins?

HOLICK: I have no experience of anyone dying from vitamin
exposure. In thirty years, I've never seen it.

DY NEWS: And in the medical literature?

HOLICK: Not as far as I know.

DY NEWS: About how many people get too little vitamin D?

HOLICK: In the US and Canada, about 50%. About one billion
people, worldwide, are vitamin D deficient. This is true even in
sunny climates, because of lack of sun exposure.

DY NEWS: What advice do you wish to offer our readers?

HOLICK: The most important thing is to increase your vitamin D
intake.

DY NEWS: What's yours?

HOLICK: I take 1,100 IU of vitamin D every day.

DY NEWS: Do you use sunblock?

HOLICK: I do, but only after some sensible sun exposure.

DY NEWS: Do you wear a floppy hat?

HOLICK: Yes, after sensible sun exposure.

DY NEWS: You are one consistent person. So what's the bottom line?

HOLICK: The population of the world has been brainwashed by the
American Academy of Dermatology and the sunscreen industry, for
30 years, with the unrelenting message that you should never be
exposed to direct sunlight because it is going to cause serious
skin cancer and death. People are really quite surprised by the
new message that sensible sun exposure, in moderation, is very
important for good health. We should appreciate the sun for its
benefits, and not abuse it.

FOR FURTHER READING:

Holick, MF and Jenkins, M.  The UV Advantage, iBooks: New York,
2004.

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