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Sunshine – the benefits and the harms The days are longer days and holidays will be approaching. Most of us are looking forward to some sunshine. However BBC News headlines this week, stated. "More than a quarter of a middle-aged person's skin may have already made the first steps towards cancer." We know however that the sun can be good for us. It is confusing. The general public get mixed messages about the sun so this blog will attempt to answer some questions. The benefits Mood We humans are programmed to be outdoors while the sun is shining and home in bed at night. A hormone melatonin is produced during the dark hours by the pineal gland in the brain. It also plays an important role in countering infection, inflammation, cancer, and auto-immunity. When people are exposed to sunlight melatonin production occurs sooner and they enter into sleep more easily at night. The melatonin precursor, serotonin, is also affected by exposure to daylight. Serotonin has an important ‘anti-depressant’. Ultraviolet light also increases the levels of endorphins, the body’s natural opiates which give us a ‘natural high’, make us cope with pain better and feel happier. The light we get from being outside on a summer’s day can be a thousand times brighter than we’re ever likely to experience indoors. For this reason, it’s important that people who work indoors get outside periodically. This can lead to improvements in mood, energy, and sleep quality. Going shades-free in the daylight, even for just 10–15 minutes, could confer significant health benefits. Vitamin D A large proportion of the UK population [as much as 40%] have lower than recommended vitamin D levels. We get most of our vitamin D from direct sunlight on our skin. We also get vitamin D from some foods – including eggs, meat and oily fish. Vitamin D is also added to all infant formula milk, as well as some breakfast cereals and fat spreads. This week Marks and Spencer’s announced it will be adding vitamin D to all their bread. Short daily periods of sun exposure without sunscreen during the summer months (April to October) are enough for most people to make enough vitamin D. A short period of time in the sun means just a few minutes – evidence suggests that about 10 to 15 minutes is enough for most lighter-skinned people – and is less than the time it takes you to start going red or burn. The larger the area of skin that is exposed to sunlight, the less time exposed you need. People with darker skin will need to spend longer in the sun to produce the same amount of vitamin D, especially if they cover up. In the UK, our skin isn't able to make vitamin D from winter sunlight (November to March) as the sunlight hasn't got enough UVB (ultraviolet B) radiation. During the winter, we get vitamin D from our body's stores and from food sources. Some groups of the population are at risk of vitamin D deficiency, and the Department of Health advises that they take daily vitamin D supplements. These groups are: all pregnant and breastfeeding women all babies and young children from six months to five years old (unless they are having more than 500ml a day of infant formula) older people, aged 65 and over people who are not exposed to much sun – for example, those who cover their skin, or who are housebound or confined indoors for long periods People who have darker skin – should take vitamin D supplements because it takes their skin more time to produce as much vitamin D as someone with lighter skin. Pregnant women and children aged five or under who qualify for the Healthy Start scheme can get free supplements containing vitamin D. Pregnant women and families with children aged under four years old who qualify for the Healthy Start scheme can also get free supplements containing vitamin D. The harms Skin cancer and skin ageing Skin cancer can affect anyone, but people most at risk have: fair skin that burns in strong sun red or fair hair a lot of moles or freckles a personal or family history of skin cancer Been sunburnt, especially when young. A bad case of sunburn which results in blistering can double the risk of melanoma. People with naturally brown or black skin are less likely to get skin cancer as darker skin has some protection against UV rays. What should you do? Spend time in the shade between 11am and 3pm. Make sure you never burn. Aim to cover up with a T-shirt, hat and sunglasses. Remember to take extra care with children. Then use factor 15+ sunscreen. There are different types of skin cancer. Malignant melanoma is by far the most aggressive type and results from a mole that has changed. Worrying features include: Any sudden change- If you are fair skinned or have been sunburned it is worth checking moles and taking photos of them next to a ruler so any change is easier to detect. Has it changed colour or developed areas of different colour [uneven pigmentation]? Grown over 4mm, or grown rapidly? Changed shape or become irregular around the border? Has risen above the skin surface? Does it itch or bleed or has it ulcerated? If it has any of these features –please see us!