Sharif Mohr - Academia.edu (original) (raw)
Papers by Sharif Mohr
PLOS Neglected Tropical Diseases, 2008
PLOS Neglected Tropical Diseases, 2008
Annals of Epidemiology, 2007
Higher levels of the principal circulating form of vitamin D, 25-hydroxyvitamin D [25(OH)D], are ... more Higher levels of the principal circulating form of vitamin D, 25-hydroxyvitamin D [25(OH)D], are associated with substantially lower incidence and death rates from colon, breast, and ovarian cancer, with a linear dose–response gradient. The accumulated evidence from observational studies and a randomized trial reveal that population serum levels of 25(OH)D in the range of 40–60 ng/ml will markedly reduce incidence and mortality rates of several cancers including those of the breast, colon, and ovary. There is an immediate clinical need for cancer care providers worldwide to assure that a serum 25(OH)D level > 40 ng/ml is achieved as soon as feasible after diagnosis of patients with breast and colon cancer, unless specifically contraindicated by preexisting hypercalcemia. This serum target could be revisited after further rigorous studies are performed, but the evidence that has accumulated during the past 30 years is sufficiently strong now to adopt the above dosages and serum targets for professional and public health action. Such prompt action is likely to cut mortality from these cancers by half within approximately 5 years. Research on a wider range of cancer types with higher serum 25(OH)D levels (≥50 ng/ml or 125 nmol/l) is needed. In the meantime, vitamin D3 intake by everyone in the continental United States and Canada aged 1 year and older should be no less than 2,000 IU/day of vitamin D3 and 1,000 IU/day for infants.
Annals of Epidemiology, 2009
Higher serum levels of the main circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are... more Higher serum levels of the main circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are associated with substantially lower incidence rates of colon, breast, ovarian, renal, pancreatic, aggressive prostate and other cancers. Epidemiological findings combined with newly discovered mechanisms suggest a new model of cancer etiology that accounts for these actions of 25(OH)D and calcium. Its seven phases are disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition (abbreviated DINOMIT). Vitamin D metabolites prevent disjunction of cells and are beneficial in other phases. It is projected that raising the minimum year-around serum 25(OH)D level to 40 to 60 ng/mL (100-150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year, and three fourths of deaths from these diseases in the United States and Canada, based on observational studies combined with a randomized trial. Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half. There are no unreasonable risks from intake of 2000 IU per day of vitamin D(3), or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increase intake of vitamin D and calcium.
Breast Journal, 2008
Abstract: Epidemiological data show an inverse relationship between vitamin D levels and breast ... more Abstract: Epidemiological data show an inverse relationship between vitamin D levels and breast cancer incidence. This study investigates the relationship of modeled and measured serum 25-hydroxyvitamin D [25(OH)D] levels with age-standardized incidence rates of breast cancer in 107 countries. The hypothesis being tested is that breast cancer incidence is inversely related to geographically-dependent cutaneous sunlight exposure. A multiple regression approach was used to examine the contributions of ultraviolet B (UVB) irradiance to age-standardized incidence rates of breast cancer in the 107 countries with data on these covariates—total column ozone thickness, per capita intake of alcohol and energy from animal and vegetable sources, cigarettes, proportion of female population overweight, and total fertility. Age-standardized incidence rates were substantially higher at latitudes distant from the equator (R2 = 0.43, p < 0.0001). The dose–response gradient between modeled serum 25(OH)D levels and incidence rates of breast cancer followed a standard inverse dose–response curve. Increasing increments in serum 25(OH)D in the range above 22 ng/mL were associated with incrementally lower incidence rates of breast cancer. According to multiple regression, UVB irradiance adjusted for cloud cover was inversely associated with incidence rates (p = 0.04) after controlling for covariates. Intake of energy from animal sources was also positively associated with incidence rates (p < 0.01). The overall coefficient of determination, R2, was 0.81 (p < 0.0001). There was a protective effect of UVB irradiance on risk of breast cancer that was independent of fertility rate, proportion of the population overweight, alcohol intake, animal energy intake, and other covariates.
International Journal of Cancer, 2006
Incidence rates of kidney cancer are thought to be highest in places situated at high latitudes a... more Incidence rates of kidney cancer are thought to be highest in places situated at high latitudes and in populations with high intake of energy from animal sources. This suggests that low 25-hydroxyvitamin D status, due to lower levels of UVB irradiance, and energy from animal sources might be involved in etiology. The association of latitude with age-adjusted incidence rates was determined for all 175 countries in a UN cancer database, GLOBOCAN. The independent association of UVB irradiance, cloud cover and intake of calories from animal sources with age-adjusted incidence rates was assessed using multiple regression in 139 countries that provided dietary data. Renal cancer incidence rates were highest in countries situated at the highest latitudes, in men (R2 = 0.64, p < 0.01) and women (R2 = 0.63, p < 0.01). According to multivariate analysis in men, UVB irradiance was inversely associated with renal cancer incidence rates (p = 0.0003), while cloud cover (p = 0.003) and intake of calories from animal sources (p < 0.0001) were independently positively associated (R2 for model = 0.73, p < 0.0001). In women, UVB irradiance was inversely associated with incidence rates (p = 0.04), while total cloud cover (p = 0.0008) and calories from animal sources (p < 0.0001) were positively associated (R2 = 0.68, p < 0.0001). Lower levels of UVB irradiance and higher intakes of calories from animal sources were independently associated with higher incidence rates of kidney cancer. © 2006 Wiley-Liss, Inc.
Journal of Steroid Biochemistry and Molecular Biology, 2007
Cancer Epidemiology Biomarkers & Prevention, 2008
Journal of Epidemiology and Community Health, 2008
ABSTRACT
American Journal of Preventive Medicine, 2011
American Journal of Preventive Medicine, 2010
Moderate exposure to sunlight is a key factor in maintaining adequate levels of vitamin D. Vitami... more Moderate exposure to sunlight is a key factor in maintaining adequate levels of vitamin D. Vitamin D sufficiency is associated with reduced incidence of many forms of cancer, osteoporotic fractures, multiple sclerosis, and other diseases. However, excessive ultraviolet radiation (UVR) exposure may be associated with melanoma and nonmelanoma skin cancer. An estimated 50,000-60,000 individuals die prematurely from cancer annually due to insufficient vitamin D in the US. The annual economic burden due to vitamin D insufficiency from inadequate exposure to solar ultraviolet B (UVB) or deficient oral intake is estimated at 46−65billion,whilethatforexcessiveUVRexposureis46-65 billion, while that for excessive UVR exposure is 46−65billion,whilethatforexcessiveUVRexposureis5-7 billion (1). Since excessive UVR exposure is not required for adequate vitamin D photosynthesis, increasing national guidelines for vitamin D intake and de-stigmatizing appropriate solar UVB exposure would substantially reduce medical care costs. This report describes an algorithm for estimating the annual number of dollars that could be saved and deaths from colorectal cancer that could be prevented by moderate daily exposure to sunlight or increased oral intake of vitamin D3. If the assumptions of this analysis are valid, moderate exposure to sunlight or adequate oral intake of vitamin D3 would prevent 10 deaths from colorectal cancer for every death from skin cancer that it might induce, and would save $11 billion per year. Reference: (1) Grant WB, Garland CF, Holick MF. Comparisons of estimated economic burdens due to insufficient solar ultraviolet (UV) irradiation or vitamin D and excess solar UV irradiation. Photochem Photobiol. In press.
Diabetologia, 2008
Aims/hypothesis This study is an analysis of the relationship between ultraviolet B (UVB) irradia... more Aims/hypothesis This study is an analysis of the relationship between ultraviolet B (UVB) irradiance, the primary source of circulating vitamin D in humans, and age-standardised incidence rates of type 1 diabetes mellitus in children, according to region of the world. Methods The association of UVB irradiance adjusted for cloud cover to incidence rates of type 1 diabetes in children aged <14 years during 1990–1994 in 51 regions worldwide was assessed using multiple regression. Incidence data were obtained from the Diabetes Mondial Project Group. Results Incidence rates were generally higher at higher latitudes (R 2 = 0.25, p < 0.001). According to multiple regression, UVB irradiance adjusted for cloud cover was inversely associated with incidence rates (p < 0.05), while per capita health expenditure (p < 0.004) was positively associated (overall R 2 = 0.42, p < 0.0001). Conclusions/interpretation An association was found between low UVB irradiance and high incidence rates of type 1 childhood diabetes after controlling for per capita health expenditure. Incidence rates of type 1 diabetes approached zero in regions worldwide with high UVB irradiance, adding new support to the concept of a role of vitamin D in reducing the risk of the disease.
Annals of Epidemiology, 2009
The purpose of this review is to summarize ecological studies of solar ultraviolet B (UVB), vitam... more The purpose of this review is to summarize ecological studies of solar ultraviolet B (UVB), vitamin D and cancer since 2000. The journal literature is surveyed and summarized. The ecological approach has been the primary tool used during the past two decades to extend the applicability of the UVB-vitamin D-cancer theory to include at least 18 types of cancer. Many of these studies were conducted in the United States, which has the advantages of availability of reliable age-standardized cancer incidence and mortality rate data for geographic areas at various spatial resolutions, and an asymmetric solar UVB dose pattern, with higher UVB irradiance in the west and lower in the east, at any particular latitude. In addition, indices for other cancer risk-modifying factors are readily available including those for smoking, alcohol consumption, ethnic background, urban/rural residence, socioeconomic status, air pollution, and in limited fashion, diet. The ecological approach has also been used to identify latitudinal variations in cancer mortality rates in Australia, China, Japan, and Spain, and in multicountry studies. It has been used to investigate the relative roles of solar UVB and dietary factors on a global scale. The ecological approach has also been applied to cancer survival. Studies in Norway and England found that individuals diagnosed with cancer in summer or fall, when serum 25-hydroxyvitamin D levels are highest, had a milder clinical course and longer survival than those diagnosed in winter or spring. These findings provide strong evidence that vitamin D status plays an important role in controlling the outcome of cancer. Support for the UVB-vitamin D-cancer theory is now scientifically strong enough to warrant use of vitamin D in cancer prevention, and as a component of treatment. More research studies would help to explore whether there are benefits beyond the substantial effects that have been observed.
Pancreas, 2010
To determine if an inverse association exits between latitude, ultraviolet B (UVB) irradiance and... more To determine if an inverse association exits between latitude, ultraviolet B (UVB) irradiance and incidence rates of pancreatic cancer worldwide. Multiple linear regression was used to investigate the relationship and between UVB irradiance incidence rates of pancreatic cancer and while controlling for cigarette, alcohol and sugar consumption, and proportion overweight. Serum 25-hydroxyvitamin D [25(OH)D] levels were estimated, and their association with incidence rates also was analyzed. Incidence rates were higher at higher latitudes (R2 for latitude for men, 0.51; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; R2 for latitude for women, 0.32; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Ultraviolet B irradiance also was independently inversely associated with incidence in men (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and women (P = 0.02). Alcohol (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and cigarette (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.01) consumption were positively associated with incidence in men (R2 for overall model for men, 0.76; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Alcohol (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and sugar (P = 0.001) consumption were positively associated with incidence rates in women (R2 for overall model for women, 0.64; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Incidence rates were half as high in countries with estimated serum 25(OH)D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30 ng/mL (75 nmol/L) than in those with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =30 ng/mL. Countries with lower UVB irradiance had higher incidence rates of pancreatic cancer in both hemispheres, with occasional exceptions.
PLOS Neglected Tropical Diseases, 2008
PLOS Neglected Tropical Diseases, 2008
Annals of Epidemiology, 2007
Higher levels of the principal circulating form of vitamin D, 25-hydroxyvitamin D [25(OH)D], are ... more Higher levels of the principal circulating form of vitamin D, 25-hydroxyvitamin D [25(OH)D], are associated with substantially lower incidence and death rates from colon, breast, and ovarian cancer, with a linear dose–response gradient. The accumulated evidence from observational studies and a randomized trial reveal that population serum levels of 25(OH)D in the range of 40–60 ng/ml will markedly reduce incidence and mortality rates of several cancers including those of the breast, colon, and ovary. There is an immediate clinical need for cancer care providers worldwide to assure that a serum 25(OH)D level > 40 ng/ml is achieved as soon as feasible after diagnosis of patients with breast and colon cancer, unless specifically contraindicated by preexisting hypercalcemia. This serum target could be revisited after further rigorous studies are performed, but the evidence that has accumulated during the past 30 years is sufficiently strong now to adopt the above dosages and serum targets for professional and public health action. Such prompt action is likely to cut mortality from these cancers by half within approximately 5 years. Research on a wider range of cancer types with higher serum 25(OH)D levels (≥50 ng/ml or 125 nmol/l) is needed. In the meantime, vitamin D3 intake by everyone in the continental United States and Canada aged 1 year and older should be no less than 2,000 IU/day of vitamin D3 and 1,000 IU/day for infants.
Annals of Epidemiology, 2009
Higher serum levels of the main circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are... more Higher serum levels of the main circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are associated with substantially lower incidence rates of colon, breast, ovarian, renal, pancreatic, aggressive prostate and other cancers. Epidemiological findings combined with newly discovered mechanisms suggest a new model of cancer etiology that accounts for these actions of 25(OH)D and calcium. Its seven phases are disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition (abbreviated DINOMIT). Vitamin D metabolites prevent disjunction of cells and are beneficial in other phases. It is projected that raising the minimum year-around serum 25(OH)D level to 40 to 60 ng/mL (100-150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year, and three fourths of deaths from these diseases in the United States and Canada, based on observational studies combined with a randomized trial. Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half. There are no unreasonable risks from intake of 2000 IU per day of vitamin D(3), or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increase intake of vitamin D and calcium.
Breast Journal, 2008
Abstract: Epidemiological data show an inverse relationship between vitamin D levels and breast ... more Abstract: Epidemiological data show an inverse relationship between vitamin D levels and breast cancer incidence. This study investigates the relationship of modeled and measured serum 25-hydroxyvitamin D [25(OH)D] levels with age-standardized incidence rates of breast cancer in 107 countries. The hypothesis being tested is that breast cancer incidence is inversely related to geographically-dependent cutaneous sunlight exposure. A multiple regression approach was used to examine the contributions of ultraviolet B (UVB) irradiance to age-standardized incidence rates of breast cancer in the 107 countries with data on these covariates—total column ozone thickness, per capita intake of alcohol and energy from animal and vegetable sources, cigarettes, proportion of female population overweight, and total fertility. Age-standardized incidence rates were substantially higher at latitudes distant from the equator (R2 = 0.43, p < 0.0001). The dose–response gradient between modeled serum 25(OH)D levels and incidence rates of breast cancer followed a standard inverse dose–response curve. Increasing increments in serum 25(OH)D in the range above 22 ng/mL were associated with incrementally lower incidence rates of breast cancer. According to multiple regression, UVB irradiance adjusted for cloud cover was inversely associated with incidence rates (p = 0.04) after controlling for covariates. Intake of energy from animal sources was also positively associated with incidence rates (p < 0.01). The overall coefficient of determination, R2, was 0.81 (p < 0.0001). There was a protective effect of UVB irradiance on risk of breast cancer that was independent of fertility rate, proportion of the population overweight, alcohol intake, animal energy intake, and other covariates.
International Journal of Cancer, 2006
Incidence rates of kidney cancer are thought to be highest in places situated at high latitudes a... more Incidence rates of kidney cancer are thought to be highest in places situated at high latitudes and in populations with high intake of energy from animal sources. This suggests that low 25-hydroxyvitamin D status, due to lower levels of UVB irradiance, and energy from animal sources might be involved in etiology. The association of latitude with age-adjusted incidence rates was determined for all 175 countries in a UN cancer database, GLOBOCAN. The independent association of UVB irradiance, cloud cover and intake of calories from animal sources with age-adjusted incidence rates was assessed using multiple regression in 139 countries that provided dietary data. Renal cancer incidence rates were highest in countries situated at the highest latitudes, in men (R2 = 0.64, p < 0.01) and women (R2 = 0.63, p < 0.01). According to multivariate analysis in men, UVB irradiance was inversely associated with renal cancer incidence rates (p = 0.0003), while cloud cover (p = 0.003) and intake of calories from animal sources (p < 0.0001) were independently positively associated (R2 for model = 0.73, p < 0.0001). In women, UVB irradiance was inversely associated with incidence rates (p = 0.04), while total cloud cover (p = 0.0008) and calories from animal sources (p < 0.0001) were positively associated (R2 = 0.68, p < 0.0001). Lower levels of UVB irradiance and higher intakes of calories from animal sources were independently associated with higher incidence rates of kidney cancer. © 2006 Wiley-Liss, Inc.
Journal of Steroid Biochemistry and Molecular Biology, 2007
Cancer Epidemiology Biomarkers & Prevention, 2008
Journal of Epidemiology and Community Health, 2008
ABSTRACT
American Journal of Preventive Medicine, 2011
American Journal of Preventive Medicine, 2010
Moderate exposure to sunlight is a key factor in maintaining adequate levels of vitamin D. Vitami... more Moderate exposure to sunlight is a key factor in maintaining adequate levels of vitamin D. Vitamin D sufficiency is associated with reduced incidence of many forms of cancer, osteoporotic fractures, multiple sclerosis, and other diseases. However, excessive ultraviolet radiation (UVR) exposure may be associated with melanoma and nonmelanoma skin cancer. An estimated 50,000-60,000 individuals die prematurely from cancer annually due to insufficient vitamin D in the US. The annual economic burden due to vitamin D insufficiency from inadequate exposure to solar ultraviolet B (UVB) or deficient oral intake is estimated at 46−65billion,whilethatforexcessiveUVRexposureis46-65 billion, while that for excessive UVR exposure is 46−65billion,whilethatforexcessiveUVRexposureis5-7 billion (1). Since excessive UVR exposure is not required for adequate vitamin D photosynthesis, increasing national guidelines for vitamin D intake and de-stigmatizing appropriate solar UVB exposure would substantially reduce medical care costs. This report describes an algorithm for estimating the annual number of dollars that could be saved and deaths from colorectal cancer that could be prevented by moderate daily exposure to sunlight or increased oral intake of vitamin D3. If the assumptions of this analysis are valid, moderate exposure to sunlight or adequate oral intake of vitamin D3 would prevent 10 deaths from colorectal cancer for every death from skin cancer that it might induce, and would save $11 billion per year. Reference: (1) Grant WB, Garland CF, Holick MF. Comparisons of estimated economic burdens due to insufficient solar ultraviolet (UV) irradiation or vitamin D and excess solar UV irradiation. Photochem Photobiol. In press.
Diabetologia, 2008
Aims/hypothesis This study is an analysis of the relationship between ultraviolet B (UVB) irradia... more Aims/hypothesis This study is an analysis of the relationship between ultraviolet B (UVB) irradiance, the primary source of circulating vitamin D in humans, and age-standardised incidence rates of type 1 diabetes mellitus in children, according to region of the world. Methods The association of UVB irradiance adjusted for cloud cover to incidence rates of type 1 diabetes in children aged <14 years during 1990–1994 in 51 regions worldwide was assessed using multiple regression. Incidence data were obtained from the Diabetes Mondial Project Group. Results Incidence rates were generally higher at higher latitudes (R 2 = 0.25, p < 0.001). According to multiple regression, UVB irradiance adjusted for cloud cover was inversely associated with incidence rates (p < 0.05), while per capita health expenditure (p < 0.004) was positively associated (overall R 2 = 0.42, p < 0.0001). Conclusions/interpretation An association was found between low UVB irradiance and high incidence rates of type 1 childhood diabetes after controlling for per capita health expenditure. Incidence rates of type 1 diabetes approached zero in regions worldwide with high UVB irradiance, adding new support to the concept of a role of vitamin D in reducing the risk of the disease.
Annals of Epidemiology, 2009
The purpose of this review is to summarize ecological studies of solar ultraviolet B (UVB), vitam... more The purpose of this review is to summarize ecological studies of solar ultraviolet B (UVB), vitamin D and cancer since 2000. The journal literature is surveyed and summarized. The ecological approach has been the primary tool used during the past two decades to extend the applicability of the UVB-vitamin D-cancer theory to include at least 18 types of cancer. Many of these studies were conducted in the United States, which has the advantages of availability of reliable age-standardized cancer incidence and mortality rate data for geographic areas at various spatial resolutions, and an asymmetric solar UVB dose pattern, with higher UVB irradiance in the west and lower in the east, at any particular latitude. In addition, indices for other cancer risk-modifying factors are readily available including those for smoking, alcohol consumption, ethnic background, urban/rural residence, socioeconomic status, air pollution, and in limited fashion, diet. The ecological approach has also been used to identify latitudinal variations in cancer mortality rates in Australia, China, Japan, and Spain, and in multicountry studies. It has been used to investigate the relative roles of solar UVB and dietary factors on a global scale. The ecological approach has also been applied to cancer survival. Studies in Norway and England found that individuals diagnosed with cancer in summer or fall, when serum 25-hydroxyvitamin D levels are highest, had a milder clinical course and longer survival than those diagnosed in winter or spring. These findings provide strong evidence that vitamin D status plays an important role in controlling the outcome of cancer. Support for the UVB-vitamin D-cancer theory is now scientifically strong enough to warrant use of vitamin D in cancer prevention, and as a component of treatment. More research studies would help to explore whether there are benefits beyond the substantial effects that have been observed.
Pancreas, 2010
To determine if an inverse association exits between latitude, ultraviolet B (UVB) irradiance and... more To determine if an inverse association exits between latitude, ultraviolet B (UVB) irradiance and incidence rates of pancreatic cancer worldwide. Multiple linear regression was used to investigate the relationship and between UVB irradiance incidence rates of pancreatic cancer and while controlling for cigarette, alcohol and sugar consumption, and proportion overweight. Serum 25-hydroxyvitamin D [25(OH)D] levels were estimated, and their association with incidence rates also was analyzed. Incidence rates were higher at higher latitudes (R2 for latitude for men, 0.51; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; R2 for latitude for women, 0.32; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Ultraviolet B irradiance also was independently inversely associated with incidence in men (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and women (P = 0.02). Alcohol (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and cigarette (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.01) consumption were positively associated with incidence in men (R2 for overall model for men, 0.76; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Alcohol (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and sugar (P = 0.001) consumption were positively associated with incidence rates in women (R2 for overall model for women, 0.64; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Incidence rates were half as high in countries with estimated serum 25(OH)D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;30 ng/mL (75 nmol/L) than in those with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =30 ng/mL. Countries with lower UVB irradiance had higher incidence rates of pancreatic cancer in both hemispheres, with occasional exceptions.