The Best Source of Vitamin D

If one is going to make an evolutionary argument for what a “natural” vitamin D level may be, how about getting vitamin D in the way nature intended—that is, from the sun instead of supplements? I run through the pros and cons in my video The Best Way to Get Vitamin D: Sun, Supplements, or Salons?. Though supplements may only cost about 10 dollars a year, sunlight is free. We never have to worry about getting too much vitamin D from sunlight, since our body has a way to regulate production in the skin, so if we get our D from the sun, we don’t have to trust poorly regulated supplement companies not to mislabel their products. Indeed, only about half the supplement brands that researchers tested came within 10 percent of their labeled amount.

Sunlight may also have benefits beyond vitamin D, such as how our body may use the sun’s near-infra-red rays that penetrate our skin to activate chlorophyll by-products in our bloodstream to make Co-Q10. (See my video How to Regenerate Coenzyme Q10 (CoQ10) Naturally for more on this.) There’s another way our body appears to use the sun’s rays to maximize the effects of the greens we eat: Within 30 minutes of exposure to the ultraviolet (UV) rays in sunlight, we can get a significant drop in blood pressure and improvement in artery function, thanks to a burst of nitric oxide-releasing compounds that flow into our bloodstream. We can even measure the nitric oxide gas coming straight off our skin. Of course, we have to eat greens or beets in the first place, but that combo of greens and sunlight may help explain some of the protection that plant-based eaters experience.

Morning sun exposure may help those with seasonal affective disorder, as well as improve the mood of wheelchair-bound nursing home residents. Previously, I’ve talked about the benefits of avoiding light at night—see my video Melatonin and Breast Cancer if you’d like to know more—but underexposure to daytime sunlight may also affect our melatonin levels, which don’t only regulate our circadian rhythms but may also be helpful in the prevention of cancer and other diseases. Older men and women getting two hours of outside light during the day appear to secrete 13 percent more melatonin at night, though we’re not sure what, if any, clinical significance this has.

The downsides of sun exposure include increased risk of cataracts, a leading cause of vision loss, though this risk can be minimized by wearing a brimmed hat and sunglasses. Sunlight also ages our skin. In my The Best Way to Get Vitamin D: Sun, Supplements, or Salons? video, you can see a dramatic photo of a truck driver who spent decades getting more sun on the left side of his face—though his driver’s side window. “The effects of sunlight on the skin are profound, and are estimated to account for up to 90% of visible skin aging”—that is, wrinkles, thickening, and loss of elasticity. Things like sun exposure and smoking can make us look 11 years older. Cosmetic surgery can make us look up to eight years younger, but a healthy lifestyle may work even better. Doctors don’t preach about sun protection for youthful facial looks, though, but because of skin cancer. Medical authorities from the World Health Organization, the American Cancer Society, to the Surgeon General warn about excess sun exposure and for good reason, given the millions of skin cancers and thousands of deaths diagnosed every year in the United States alone.

The UV rays in sunlight are considered a complete carcinogen, meaning they can not only initiate cancer, but promote its progression and spread. Melanoma is the scariest, which “makes the rising incidence of melanoma in young women particularly alarming.” This increase has been blamed on the increased usage of tanning salons. Tanning beds and UV rays in general are considered class 1 carcinogens, like processed meat, accounting for as many as three quarters of melanoma cases among young people and six times the risk of melanoma for those who visited tanning salons ten or more times before the age of 30.

The tanning industry is big business, bringing in billions of dollars. There may be more tanning salons than there are Starbucks, and they use those dollars like the tobacco industry: to downplay the risks of their products. Laws are being passed to regulate tanning salons, from complete prohibitions, like in the country of Brazil, to age restrictions for minors. But, unlike tobacco, tanning isn’t addictive. Or is it?

Have you heard of “tanorexia”? Some people tan compulsively and report a so-called tanner’s high. Describing tanning behavior like a substance abuse disorder might seem a little silly—that is, until you stick people in a brain scanner and can show the same kind of reward pathways light up in the brain, thanks to endorphins that are released by our skin when we’re exposed to UV rays. In fact, we can even induce withdrawal-like symptoms by giving tanners opiate-blocking drugs. So, tanning is potentially addictive and dangerous. Harvard researchers suggest that we should “view recreational tanning and opioid drug abuse as engaging in the same biological pathway.” But there’s a reason sun exposure feels good. Sunlight is the primary natural source of vitamin D, and, evolutionarily, it’s more important, in terms of passing along our genes, not to die of rickets in childhood. Unlike natural sunlight, tanning bed lights emit mostly UVA, which is the worst of both worlds: cancer risk with no vitamin D production. The small amount of UVB many tanning beds do emit, however, may be enough to raise vitamin D levels. Is there a way to raise D levels without risking cancer? Yes: vitamin D supplements.


Indeed, we can get some of the benefits of sun exposure without the risks by taking vitamin D supplements. But, for the sake of argument, what if such supplements didn’t exist? Would the benefits of sun exposure outweigh the risks? That’s the subject of my video The Risks and Benefits of Sensible Sun Exposure.

For other videos in this vitamin D series, see:

I also explore Vitamin D as it relates to specific diseases:

Here’s the video about that amazing chlorophyll activation: How to Regenerate Coenzyme Q10 (CoQ10) Naturally.

What do greens and beets have to do with artery function? Check out some of my latest videos on the wonders of nitrate-rich vegetables:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Concerns About Bone Broth

There are toxicological issues associated with production and processing of meat, such as the presence of various toxic contaminants—from dioxins and PCBs to cooked meat carcinogens. Carcinogenesis, the development of cancer, may be the main concern, but there are a number of other toxic responses connected with the consumption of meat products. Lead, for example, can be toxic to the nerves, gastrointestinal tract, bone marrow, and kidneys.

Where is lead found in the food supply? In general terms, the highest levels of lead, as well as arsenic and mercury, are found in fish. Sardines have the most arsenic, but tuna may have sardines beat when it comes to mercury and lead.

The problem is that “fish-consumption advisories related to human health protection do not consider the fish by-products fed to farmed animals,” like farmed fish. If some tilapia are fed tuna by-products, they could bioaccumulate heavy metals and pass them onto us when we eat them. Researchers found the highest levels in frozen sole fillets, averaging above the legal limit for lead.

Lead exposure has been shown to have adverse effects on nearly every organ system in the body. Symptoms of chronic exposure range from memory loss and constipation to impotence and depression. These symptoms present after pretty hefty exposure, though. However, we now know that “[b]lood lead levels in the range currently considered acceptable are associated with increased prevalence of gout and hyperuricemia” (elevated levels of uric acid in the blood). According to the Centers for Disease Control and the World Health Organization, a blood lead level needs to be less than 25 micrograms per deciliter to be “non-elevated.” You’d assume that at values under 25, there’d be no relationship with health outcomes, but even throughout this “acceptable” range, lower lead means lower uric acid levels and lower gout risk. So, even blood lead levels 20 times below the acceptable level can be associated with increased prevalence of gout. “These data suggest that there is no such thing as a ‘safe’ level of exposure to lead.” 

Once lead gets into the body, it tends to stay in the body. It builds up in the bones such that it may take 30 years just to get rid of half. The best strategy? Don’t get exposed in the first place.

If lead builds up in bones, though, what about boiling bones for broth? As I discuss in my video Lead Contamination in Bone Broth, we know bones sequester lead, which can then leach from the bones. So, researchers suggested that “the bones of farmyard animals will sequester lead, some of which will then be released into broth during its preparation.” Who eats bone broth? Bone broth consumption is encouraged by many advocates of the paleo diet. Online, you can learn all about purported “benefits” of bone broth, but what they don’t tend to mention is the theoretical risk of lead contamination—or at least it was theoretical until now. Broth made from chicken bones was to have markedly high lead concentrations, up to a ten-fold increase in lead. Researchers concluded, “In view of the dangers of lead consumption to the human body, we recommend that doctors and nutritionists take the risk of lead contamination into consideration when advising patients about bone broth diets.”

But what if you only use bones from organic, free-range chickens? They did use only bones from organic, free-range chickens.


For more on the paleo diet, see:

Other products contaminated with lead include Ayurvedic supplements, protein powders, wild animals shot with lead ammunition, dairy products, and tea from China:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Do Flaxseeds Offer Sufficient Omega-3’s for Our Heart?

According to two of perhaps the most credible nutrition authorities, the World Health Organization and the European Food Safety Authority, we should get at least half of a percent of our calories from the essential omega-3 fat ALA. That’s easy: Just have about one tablespoon a day of chia seeds or ground flaxseeds and you’re all set.

Our body can then take the short-chain ALA from our diet and elongate it into the long-chain omega-3s, EPA and DHA. The question, however, has long been whether our bodies can make enough EPA and DHA for optimal health. How would one determine that? Take fiber, for example. “A convincing body of literature showed an increased [heart disease] risk when diets were low in fiber,” so the Institute of Medicine came up with a recommendation for about 30 grams a day, which is an intake observed to protect against coronary heart disease and to reduce constipation. “Thus, just as [cardiovascular disease] was used to help establish an [adequate intake] for dietary fiber,” it was also used as a way to develop a recommendation for EPA and DHA, as I discuss in my video Should We Take EPA and DHA Omega-3 for Our Heart?.

With reviews published as late as 2009 suggesting fish oil capsules may help with heart disease, nutrition authorities recommended an additional 250 mg per day of preformed EPA and DHA, since, evidently, we were not making enough on our own if taking more helped. So, in addition to the one or two grams of ALA, it was suggested we should take 250 mg of preformed DHA/EPA, which can be gotten from fish or algae.

Fish is a tough one. On one hand, fish has preformed DHA and EPA, but, on the other hand, our oceans have become so polluted that seafood may also contain various pollutants, including dioxins, PCBs, pesticides like DDT, flame-retardant chemicals, and heavy metals, including mercury, lead, and cadmium, all of which can negatively affect human health. Dietary exposure to PCBs, for example, is associated with increased risk of stroke in general and an almost three times higher risk of hemorrhagic stroke. Unless you live next to a toxic waste dump, the major  source of exposure to PCBs is fish consumption. Salmon may be the worst.

This may explain why studies in the United States have shown that just a single serving of fish a week may significantly increase one’s risk of diabetes, emphasizing that even levels of these pollutants once considered safe may “completely counteract the potential benefits of [the omega-3] fatty acids and other nutrients present in fish,” and lead to the type of metabolic disturbances that often precede type 2 diabetes. Now, one could get their daily 250 mg of preformed DHA/EPA from algae oil rather than fish oil. Algae oil is free of toxic contaminants because it is manufactured without pollutant exposure. 

Then, one could get the best of both worlds: the beneficial nutrients without the harmful contaminants. However, it was demonstrated recently that these long-chain omega-3s don’t seem to help with preventing or treating heart disease after all. Since that was the main reason we thought people should get that extra 250 mg of preformed EPA and DHA, why do I still recommend following the guidelines in my Optimum Nutrition Recommendations? Because the recommendations were not just based on heart health, but brain health, as well. See my video Should We Take DHA Supplements to Boost Brain Function?.


Other omega-3 videos include:

If the no-heart-benefit surprised you, check out Is Fish Oil Just Snake Oil?.

Surprised by the link with diabetes and want to learn more? See:

Food Sources of PCB Chemical Pollutants has more on PCBs, and here are additional videos on other pollutants:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: