title: [Vitamin D: evidence and controversies].
abstract: Vitamin D enhances musculoskeletal health and reduces mortality related to bone disease in some populations, particularly the elderly and other high-risk groups. Evidence suggests that vitamin D has an impact in cancer, cardiovascular disease, autoimmune processes, and infections. Epidemiologic studies have also detected vitamin D deficits or insufficiency in nearly all the world's populations. Such evidence has led to debate related, to a certain degree, to photoprotective measures that aim at protecting against skin cancer. The latest recommendations of the American Institute of Medicine consider that serum levels of 20 ng/mL (50 nmol/L) appear to be adequate in the general population and achievable even with minimal sun exposure. If these figures are reliable, the apparent pandemic of vitamin D deficiency reported in recent years may be exaggerated. This article reviews the evidence and issues under discussion, looking especially at the role ultraviolet radiation plays in synthesizing vitamin D in the skin. The conclusion is that sun exposure should not be used as the only source of vitamin D given that it is also clearly carcinogenic for the skin. A healthful approach combines moderate sun exposure, adequate food sources of the vitamin, and supplements whenever required.
authors.affiliation: Sección de Dermatología, Hospital San Jorge, Huesca, España. ygilaberte@salud.aragon.es
authors.forename: Y
authors.initials: Y
authors.lastname: Gilaberte
authors.forename: J
authors.initials: J
authors.lastname: Aguilera
authors.forename: J M
authors.initials: JM
authors.lastname: Carrascosa
authors.forename: F L
authors.initials: FL
authors.lastname: Figueroa
authors.forename: J
authors.initials: J
authors.lastname: Romaní de Gabriel
authors.forename: E
authors.initials: E
authors.lastname: Nagore
mesh_terms: D001327:Autoimmune Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D001842:Bone and Bones / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000517:prevention & control; D004032:Diet; D006184:Habits; D006801:Humans; D007113:Immunity, Innate; D007239:Infections / Q000276:immunology; D009369:Neoplasms / Q000188:drug therapy / Q000209:etiology; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control; D011565:Psoriasis / Q000188:drug therapy / Q000209:etiology; D012867:Skin / Q000276:immunology / Q000378:metabolism / Q000528:radiation effects; D012878:Skin Neoplasms / Q000209:etiology / Q000517:prevention & control; D013030:Spain; D013472:Sunlight / Q000009:adverse effects; D014466:Ultraviolet Rays / Q000009:adverse effects; D014807:Vitamin D / Q000096:biosynthesis / Q000097:blood / Q000502:physiology / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D014807:Vitamin D