Throughout evolution, exposure to sunlight and the photosynthesis of
vitamin D(3) in the skin has been critically important for the evolution of land vertebrates. During exposure to sunlight, the solar UVB photons with energies 290-315 nm are absorbed by
7-dehydrocholesterol in the skin and converted to
previtamin D(3).
Previtamin D(3) undergoes a rapid transformation within the plasma membrane to
vitamin D(3). Excessive exposure to sunlight will not result in
vitamin D intoxication because both
previtamin D(3) and
vitamin D(3) are photolyzed to several noncalcemic photoproducts. During the winter at latitudes above approximately 35 degrees , there is minimal, if any,
previtamin D(3) production in the skin. Altitude also has a significant effect on
vitamin D(3) production. At 27 degrees N in November, very little ( approximately 0.5%)
previtamin D(3) synthesis was detected in Agra (169 m) and Katmandu (1400 m). There was an approximately 2- and 4-fold increase in
previtamin D(3) production at approximately 3400 m and at Everest base camp (5300 m), respectively. Increased skin pigmentation, application of a
sunscreen, aging, and clothing have a dramatic effect on
previtamin D(3) production in the skin. It is estimated that exposure in a bathing suit to 1 minimal erythemal dose (MED) is equivalent to ingesting between 10,000 and 25,000 IU of
vitamin D(2). The importance of sunlight for providing most humans with their
vitamin D requirement is well documented by the seasonal variation in circulating levels of
25-hydroxyvitamin D [25(
OH)D].
Vitamin D deficiency [i.
e., 25(
OH)D < 20 ng/ml] is common in both children and adults worldwide. Exposure to lamps that produce UVB radiation is an excellent source for producing
vitamin D(3) in the skin and is especially efficacious in patients with fat
malabsorption syndromes. The major cause of
vitamin D deficiency globally is an underappreciation of sunlight's role in providing humans with their
vitamin D(3) requirement. Very few foods naturally contain
vitamin D, and those that do have a very variable
vitamin D content. Recently it was observed that wild caught salmon had between 75% and 90% more
vitamin D(3) compared with farmed salmon. The associations regarding increased risk of common deadly
cancers,
autoimmune diseases,
infectious diseases, and
cardiovascular disease with living at higher latitudes and being prone to
vitamin D deficiency should alert all health care professionals about the importance of
vitamin D for overall health and well being.