In the summertime, many people shun the sun. Ladies apply thick sunscreen, wear shades and stay indoors to avoid as many rays from the sun as possible.
But such anti-sunlight attitudes that exist among many Thais must be changed, according to Dr Sant Chaiyodsilp, a cardiovascular thoracic surgery and family medicine specialist, as inadequate Sun exposure may bring about a vitamin D deficiency.
"Some medical statements make people afraid of sunlight. Such a belief has actually been heavily influenced by the West. But the truth is the incident of skin cancer is only one in 40 white Americans, one in 1,000 African Americans and only one in 30,000 Asians. So there is no need to avoid sunlight for fear of cancer. But if you do not want your skin to get dark, that's another story," said Sant during the "Have You Got Enough D?" seminar, organised last week by Roche Diagnostics (Thailand).
To discover if office workers in Thailand lack vitamin D, Sant conducted study entitled "A Cross Section Study Of Vitamin D Levels In Thai Office Workers", in which he examined the levels of vitamin D in all staff in a random office. His study revealed worrying results. One in three Thai office workers were found to have a vitamin D deficiency. His research was published in Bangkok Medical Journal this year.
"Long hours inside the office and concern regarding skin damage caused by cruel sunlight are significant reasons why people lack vitamin D — a result of inadequate sun exposure. And vitamin D deficiency can put people at risk of developing osteoporosis and experiencing fractures," Sant said.
Sunlight — or UVB — is the primary source of vitamin D. The rest comes from food such as cod, salmon, egg yolk and dried mushrooms. Vitamin D is also commonly added into fortified milk, certain types of cereals, juices and yoghurt. There are several factors responsible for people falling short of vitamin D. Barriers such as car and architectural glass can block UVB. Even sunscreen over SPF 15 can reduce UVB absorption by 99%.
"UVB's power of penetration is not as strong as UVA. Therefore it can easily be blocked by something," Sant said. "City smog and pollution in Bangkok, for example, can obstruct UVB by 60%."
Vitamin D has long been known to play a pivotal role in the promotion of bone health. Vitamin D assists in the absorption of calcium and phosphorus and subsequently an adequate amount of vitamin D leads to stronger bones — a shield against osteoporosis, a serious public health concern which affects over 200 million people globally, according to the International Osteoporosis Foundation (IOF).
And according to Dr Sant, vitamin D is found to be associated with five non-communicable diseases — cancer, coronary heart disease, diabetes, rheumatoid arthritis and Alzheimer's. Although scientists cannot be certain if a lack of vitamin D results in the development of these illnesses, it is evident that people who suffer these diseases have lower levels of vitamin D than those unaffected.
Having vitamin D levels tested, Sant said, is paramount, as deficiency can occur unknowingly, especially among high risk groups — people who usually avoid sunlight or apply excessive amount of sunscreen, pregnant and menopausal women, people aged over 50 years old, breastfeeding mothers, those with the aforementioned five diseases, those with a medical history of fractures and people who use steroids.
A blood test to measure the vitamin D level is currently available in several public and private hospitals. Prices range from 500-2,500 baht, and results are available within 48 hours. It is a non-fasting blood test.
"If your blood test shows vitamin D levels of lower than 20ng/ml, then you immediately need to change your lifestyle," Sant said. "You need to get more exposure to sunlight and try to engage in active, outdoor activities."
But in a tropical country like Thailand, people might find vitamin D dietary supplement an easier solution than going outside. But according to Dr Sant, dietary supplements are just a quick fix. A lifestyle change, however, is like killing two birds with one stone.
"You can fix the way you eat — take a vitamin D supplement and eat more vitamin-D-rich foods," he said. "In just seven days, there will be a change in vitamin D levels. But changing your lifestyle — cutting down on time spent in front of electronic screens, for instance, and spending more time outdoors, is definitely a more sustainable solution."