[HN Gopher] Higher ultraviolet light exposure is associated with...
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       Higher ultraviolet light exposure is associated with lower
       mortality
        
       Author : janandonly
       Score  : 67 points
       Date   : 2024-08-20 17:36 UTC (5 hours ago)
        
 (HTM) web link (www.sciencedirect.com)
 (TXT) w3m dump (www.sciencedirect.com)
        
       | cpncrunch wrote:
       | So I think now we can now say that the Lindqvist 2016 paper
       | wasn't just a fluke. This is a real finding.
        
       | api wrote:
       | Is this more vitamin D evidence or is there something more going
       | on?
        
         | KennyBlanken wrote:
         | I was under the impression that recent consensus was that
         | Vitamin D supplementation has much less positive health impact
         | than sunlight exposure?
        
           | heroiccocoa wrote:
           | Of course, there exists the whole field of
           | photobiomodulation. Red light therapy
           | (630/670/810/830/850/1060 nm red and NIR light) helps the eye
           | in the morning (see Prof Glen Jeffery's work at UCL; the
           | mitochondria are only sensitive to RLT during a certain
           | window of the circadian rhythm, that coincides with early
           | morning sunlight that is shifted towards the red/NIR),
           | particularly when it comes to preventing and slowing age-
           | related macular degeneration, but also improving colour
           | perception, controlling blood glucose levels, improving
           | athletic performance and recovery, mood and cognitive
           | performance, and some other benefits. When I first got
           | interested I thought I'd just get a small handheld LED
           | device, but as I got deeper into it I decided to buy a large
           | mains powered full body panel with 5 wavelengths. In
           | particular the benefits to my sleep and skin have been
           | fantastic, with the caveat that I live in northern Europe at
           | a latitude of 53.3 degrees north. Perhaps those nearer the
           | equator will feel more muted responses. That being said,
           | improvements to vision are counterintuitively very difficult
           | to actually judge without measuring, because the brain is
           | constantly adjusting/hiding our defects.
        
         | OutOfHere wrote:
         | That is absolutely the right question to ask. If the results
         | are not adjusted for vitamin D levels, and it does not appear
         | that they are, then the results are largely useless because
         | vitamin D is very easy to supplement.
         | 
         | Note: Adjusting by vitamin D levels is _not_ the same as
         | adjusting by supplemental intake. Even adjusting for
         | supplemental intake must be a linear adjustment, not a binary
         | one.
        
           | jajag wrote:
           | That's an overly simplistic approach.
        
           | Mistletoe wrote:
           | Vitamin d supplementation studies are a lot more ambiguous
           | than this though. And this also matches my "feel". Getting
           | sun makes me feel good in a way that vitamin D
           | supplementation never does. I was once at a dinner and
           | sitting at the table with the head of the Office of Dietary
           | Supplements for the US government and asked him this
           | question- "How should I get vitamin D and how much should I
           | take?" He answered quite quickly "Get it from sunlight." Your
           | skin autoregulates how much vitamin D is made this way.
           | 
           | "The health effects of vitamin D supplementation: evidence
           | from human studies"
           | 
           | https://www.nature.com/articles/s41574-021-00593-z
           | 
           | I do think the question is complicated by the fact that
           | humans have wildly different skin tones. What is applicable
           | for skin types that are very pale is quite different than
           | darker skin tones. This question has been complicated even
           | more by recent migration of humans into zones their skin was
           | never meant to be exposed to. It feels like the
           | dermatologists all made their guidelines based on people with
           | porcelain skin that live at the equator. The truth is more
           | complicated than that, people with darker skin develop low
           | vitamin D status follwing those guidelines. Humans love to
           | have blanket rules they can follow without regard to
           | extenuating circumstances like different skin tones, but that
           | isn't reality.
        
             | OutOfHere wrote:
             | > "Get it from sunlight."
             | 
             | Listening to such people in power is a path to getting
             | yourself killed, in this case by diseases. Their interest
             | is in preserving their power, first by taking it away from
             | you.
             | 
             | They always have to say "don't supplement" because asking
             | everyday people to supplement will force the officials to
             | admit that the food and/or environment has recently been
             | made inadequate. This will put the officials in a corner
             | that they cannot get out of.
             | 
             | The study you linked is defective by design. It uses a
             | threshold of 50 nmol/l which is a pathetically low 20
             | ng/ml. Such studies are engineered to show a null result.
        
         | jajag wrote:
         | The paper addresses this briefly, and suggests additional
         | mechanisms to do with UV effects on different skin layers (e.g.
         | NO mediated vasodilatation) may be involved.
        
         | mcswell wrote:
         | Did you (and those who so far responded to you) actually read
         | the article? The Vitamin D question is addressed throughout,
         | e.g. "Linear regression models were fitted for the UV exposures
         | and vitamin D serum levels, adjusted for the same confounders
         | for each UV exposure described above, plus vitamin D
         | supplementation."
        
           | OutOfHere wrote:
           | > measured serum vitamin D levels, a biomarker for UV
           | exposure,
           | 
           | That's entirely the opposite of adjusting the results for
           | vitamin D levels. It's biasing the results by vitamin D
           | levels.
        
       | EstanislaoStan wrote:
       | So it's not just that people who go outside more are generally
       | healthier: "Solarium users were also at a lower risk of non-
       | CVD/non-cancer mortality."
        
         | sokoloff wrote:
         | I would wager that there's a positive covariance between
         | "solarium users" and "not poor" where "not poor" is surely
         | correlated with lower mortality.
        
       | ljf wrote:
       | Further discussion https://news.ycombinator.com/item?id=41301447
        
       | waihtis wrote:
       | I wonder how "moonbrah" Bryan Johnson will take this news
        
       | Horffupolde wrote:
       | So our body is best adapted to our natural environment where UV
       | exposure is frequent. Scientists had their null hypothesis
       | backwards.
        
       | swalling wrote:
       | Higher ultraviolet light exposure is associated with lower
       | mortality... _for white people residing in the United Kingdom._
       | 
       | The selected cohort of people is pretty specific from a global
       | perspective. In particular, if you live in a higher UV location
       | (i.e. closer to the equator), intentionally increasing sun
       | exposure like they measured in this study may not be necessary or
       | helpful. For instance, the entire lower 48 states in the USA are
       | below the same latitude as the UK.
        
         | mcguire wrote:
         | Higher ultraviolet light exposure from:
         | 
         | " _The UK Biobank has data from which behavioural and
         | geographic UV exposures can be estimated. Firstly, participants
         | were asked 'how many times a year would you use a solarium or
         | sunlamp?' We recoded the responses to create a solarium use
         | variable (solarium user or solarium non-user, defined as one or
         | more times per year versus never or less than one time per
         | year)._ "
         | 
         | and
         | 
         | " _Secondly, we estimated an annual average residential
         | shortwave radiation (SWR; kJ /m2) over the follow-up period
         | variable for each participant. Downward SWR is the total
         | incoming solar energy over the Earth's surface in the shortwave
         | spectrum and comprises both UVA and UVB radiation, (Yu et al.,
         | 2021) the components solar radiation that have effects on human
         | health. The Japan Aerospace Exploration Agency (JAXA)
         | calculates half-monthly average of daily downward SWR (250
         | nm-2500nm) measurements using daily data from the Moderate
         | Resolution Imaging Spectroradiometer (MODIS) instrument on
         | NASA's Aqua and Terra satellites, considering cloud and aerosol
         | thickness (Murakami, 2010). These measurements are available at
         | a 0.05degx.0.05deg spatial resolution._"
         | 
         | So, "Did you use a sunroom at least once?" and "How much solar
         | radiation does where you live according to our model?"
        
         | mint2 wrote:
         | Glad this was pointed out - this article is specifically about
         | regions in "low" UV latitudes, with the actual subject being
         | from the UK.
         | 
         | Accounting for UV intensity of your home country is crucial.
         | Don't just go out and frolic without precautions just because a
         | study from the UK found sun exposure was good. Their sun isn't
         | built the same.
         | 
         | Mid day UV index in SF is 9 as I type. Compare what the paper
         | says about the UK UV index:
         | 
         | " The UV index [in the uk], which measures the erythemal
         | intensity of sunlight, rarely exceeds 6 (where 3-5 is
         | classified as moderate and 6-7 high)"
         | 
         | Make good decisions people! I got some sun when the UV was 2
         | early in the early morning. Now it's 9 at midday. All sun is
         | not equal.
        
           | xattt wrote:
           | > Make good decisions people! I got some sun when the UV was
           | 2 early in the early morning. Now it's 9 at midday. All sun
           | is not equal.
           | 
           | I observed a group of people going into a theme park at 5 PM
           | and slopping on a thick layer of sunscreen. Sundown was ~8
           | PM. Local UV index is essentially 0 at that time of the day.
           | 
           | Mental models of UV exposure are not always intuitive.
        
         | noncoml wrote:
         | Higher calorific intake is associated with lower mortality*
         | 
         | *Study conducted during the Great Famine
        
           | hnlmorg wrote:
           | While I get your point, I think it's a rather uncharitable
           | way of putting it.
           | 
           | A lot of the world is in lower UV continents like the UK.
           | It's not like it's a statistical outlier like the great
           | famine. So this research can have benefits to a lot of other
           | people in other counties too.
        
             | noncoml wrote:
             | You are absolutely right about the research part.
             | 
             | I guess I was surprised that it made it to the news, as it
             | seems expected to me. If they would reach the opposite
             | conclusion however, now that's newsworthy.
        
         | arcticbull wrote:
         | I mean, they would be the ones I'd expect to be the most
         | sensitive to the negative impacts of UV radiation, right? The
         | acute effects of UV tend to be worse on people who are (a)
         | lighter skinned and (b) get less exposure in general.
         | 
         | I would actually expect the biggest positive impacts would be
         | to darker-skinned people who live in higher latitudes with more
         | time spent inside (as melanin protects you from the UV
         | radiation, so you see higher rates of, e.g. vitamin D
         | insufficiency).
         | 
         | There's three major pathways for health benefits from sun
         | exposure.
         | 
         | 1. UVB radiation stimulates the synthesis of vitamin D3.
         | 
         | 2. UVA radiation stimulates the release of nitric oxide. This
         | reduces your blood pressure and improves markers of
         | cardiovascular health.
         | 
         | 3. You're outside getting physical activity.
         | 
         | [edit] Also note that melanoma survival rates are much better
         | for people who get more time in the sun.
         | 
         | [1] https://academic.oup.com/jnci/article/97/3/195/2544082
        
         | jmward01 wrote:
         | In his TED talk Weller points out that latitude correlates with
         | heart disease well. This study gets to clear out a lot of
         | variables by sticking to the UK though so it is really valuable
         | in testing the potential of UV without having to deal with as
         | many social/environmental/etc etc factors. It would have been
         | nice if the paper mentioned the world data that shows
         | correlation between cardio vascular disease and latitude to
         | help put this study into better perspective. To sum it all up:
         | There is a world trend but the data is a bit messy. This study
         | took a smaller chunk of the world and the results support the
         | world trend and the data is much cleaner.
        
       | prbl2 wrote:
       | This is an interesting finding. But, a reminder that this is
       | epidemiological data. It is nearly impossible to "adjust" for all
       | confounding variables in epidemiological studies. For example,
       | you may expect a health user-bias among people who use solariums,
       | sunlamps, or have high vitamin-D levels, and health at baseline
       | might be effected by random fluctuations not accounting for all
       | variance. I would look for evidence of randomized trials before
       | taking this as the truth.
        
         | marcosdumay wrote:
         | How well fundamented is the opposite belief, that seems to be
         | held as true by nearly everybody? I know the link to skin
         | cancer is well established, but I don't know of any broad study
         | about all causes of mortality.
         | 
         | Yes, do not take this study as true. But also, look at your
         | priors.
        
           | arcticbull wrote:
           | UV causes skin cancer - but the majority of them (10:1) are
           | basal cell and squamous cell carcinomas. These have a 99-100%
           | 5-year survival. While UV exposure can increase the risk of
           | melanomas, it makes you less likely to die from them [1]. The
           | UVA-mediated release of nitric oxide from the skin improves
           | your cardiovascular health and you are far more likely to die
           | of CVD than skin cancers, especially if you screen for them.
           | Early stage melanomas have a 99.6% 5-year survival.
           | 
           | [1] https://academic.oup.com/jnci/article/97/3/195/2544082
           | 
           | Also note there is very limited evidence for the health
           | benefits of vitamin D supplementation, especially if you're
           | anywhere close to a normal level.
           | 
           | [2] https://www.nature.com/articles/s41574-021-00593-z
        
       | tannhaeuser wrote:
       | As usual, correlation != causation. In this case, higher exposure
       | to sunlight may just follow generally from more physical
       | activity, and correlate with a healthier lifestyle. Asking the
       | statistics champs here if such effects have been taken into
       | consideration?
        
       | ChrisArchitect wrote:
       | [dupe]
       | 
       | Discussion: https://news.ycombinator.com/item?id=41301447
        
       | Havoc wrote:
       | This smells like BS...or rather misdirection.
       | 
       | If I go on a hike...and the health benefits of doing so are real,
       | but I do incur a minor health negative from potential skin cancer
       | from higher UV exposure.
       | 
       | ...then I've still got a positive correlation between lower
       | mortality and UV...even thought that's linking the wrong
       | variables
        
         | sokoloff wrote:
         | Further, there's a selection bias in that those who choose to
         | go on a hike today are not among the least healthy to start
         | with, even if the hike itself didn't change anything.
        
         | cpncrunch wrote:
         | That doesn't explain the sunbed result. Also, Lundqvist did
         | control for exercise in their 2016 study which gave the same
         | result.
         | 
         | The evidence base has been building for a long time, and I
         | changed my own behavior over 10 years ago to get more UV. Not
         | sure why you seem to feel the need to call it bs before even
         | looking at the evidence.
        
       | fimdomeio wrote:
       | I have a very unscientific feeling that the scientific consensus
       | will probably one day end up being something like:
       | 
       | sun is good for you in moderation, the amount that is ok depends
       | on your skin color, how tanned you get, in which part of the
       | world you are and how often you are outside. Avoid too much sun
       | and avoid sun burns and also avoid crazy strong sunscreens that
       | block the benefits of getting sunlight. The lifestyle that some
       | people have of spending the whole year inside in an office and
       | that spending their all vacations roasting at the beach is very
       | unhealthy because body does not have time to adapt.
        
         | Unearned5161 wrote:
         | quick! go to publishing before they beat you there!
        
       | PaulKeeble wrote:
       | This is the same thing as Vitamin D is good for health. Exposure
       | to the sun is correlated with good health, the problem is the
       | direction is the other way around healthy people are outside and
       | in the sun more, hence they have higher Vitamin D levels.
        
       | schappim wrote:
       | I would have thought that exercise was the primary contributing
       | factor, but the study isolated the effects of UV exposure by
       | using independent UV measures, adjusting for confounders like
       | exercise, employing a negative control outcome, and using
       | directed acyclic graphs to identify and account for potential
       | confounders.
        
       | rich_sasha wrote:
       | They do adjust for area wealth / deprivation etc. Even then I
       | wonder if the "UV radiation" is just proxy for living up North
       | and in cities, both of which lead to less solar irradiation and
       | generally poorer health outcomes. E.g. healthcare coverage,
       | unemployment, access to education etc. all get worse along a
       | north-south axis.
        
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