Solar Ultraviolet Irradiance and Cancer Incidence and Mortality

  • William B. Grant
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 624)


Rates for many cancers are generally higher with increased distance from the equator. The first paper positing a link between sunlight and reduced risk of cancer was published in 1937.1 Persons in the US Navy with greater “skin irritation” (actinic keratosis and skin cancer) had lower risk of internal cancers. A second paper appeared then reported that residents of sunnier states had lower cancer risk.1 Although many studies have tried to explain these geographic variations, including differences in dietary factors and socioeconomic status, the most promising is that solar ultraviolet-B (UVB) (290–315 nm), through production of vitamin D, reduces the risk of cancer incidence and increases survival chances. Data at the World Health Organization3 indicated large latitudinal gradients in cancer mortality rates recorded as early as 1955 for breast, colon, intestinal, lung, prostate, rectal and renal cancer. However, rates were also low for countries where much fish was consumed, such as Iceland and Japan and in countries where animal products were a small fraction of the total energy supply, such as Egypt. Thus, it would have taken a clever researcher to suggest that solar UVB and fish were important sources of vitamin D and could explain much of the variance.


Skin Cancer Uterine Corpus Cancer Serum Calcidiol Solar Ultraviolet Irradiance European Light Dosimeter Network 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Peller S, Stephenson CS. Skin irritation and cancer in the United states Navy. Am J Med Sci 1937;194:326–333.Google Scholar
  2. 2.
    Apperly FL. The relation of solar radiation to cancer mortality in North America. Cancer Res 1941;1:191–5.Google Scholar
  3. 3.
    World Health Organization (WHO). WHO Mortality Database, (accessed 2007).Google Scholar
  4. 4.
    Mason TJ, McKay FW, Hoover R et al. Atlas of Cancer Mortality for US Counties: 1950–69. US Dept. of Health, Education and Welfare. DHEW Pub. No. 75-780, 1975.Google Scholar
  5. 5.
    Garland CF, Garland FC. Do sunlight and vitamin D reduce the likelihood of colon cancer? Int J Epidemiol 1980;9:227–31.PubMedGoogle Scholar
  6. 6.
    Lilienfeld AM, Levin ML, Kesler II. Cancer in the United States. Harvard Univ., Cambridge 1972:467–72.Google Scholar
  7. 7.
    Garland C, Shekelle RB, Barrett-Connor E et al. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet 1985;1:307–9.PubMedGoogle Scholar
  8. 8.
    Garland CF, Comstock GW, Garland FC et al. Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study. Lancet 1989;2:1176–8.PubMedGoogle Scholar
  9. 9.
    Gorham ED, Garland CF, Garland FC. Acid haze air pollution and breast and colon cancer mortality in 20 Canadian cities. Can J Public Health 1989;80:96–100.PubMedGoogle Scholar
  10. 10.
    Garland FC, Garland CF, Gorham ED et al. Geographic variation in breast cancer mortality in the United States: a hypothesis involving exposure to solar radiation. Prev Med 1990;19:614–22.PubMedGoogle Scholar
  11. 11.
    Lefkowitz ES, Garland CF. Sunlight, vitamin D and ovarian cancer mortality rates in US women. Int J Epidemiol 1994;23:1133–6.PubMedGoogle Scholar
  12. 12.
    Garland CF, Garland FC. Commentary: progress of a paradigm. Int J Epidemiol 2006;35:220–2.PubMedGoogle Scholar
  13. 13.
    Garland CF, Garland FC. Do sunlight and vitamin D reduce the likelihood of colon cancer? Int J Epidemiol 2006;35:217–20.PubMedGoogle Scholar
  14. 14.
    Cross HS. Commentary: from epidemiology to molecular biology-vitamin D and colorectal cancer prevention. Int J Epidemiol 2006;35:225–7.PubMedGoogle Scholar
  15. 15.
    Egan KM. Commentary: sunlight, vitamin D and the cancer connection revisited. Int J Epidemiol 2006;35:227–30.PubMedGoogle Scholar
  16. 16.
    Giovannucci E. Commentary: vitamin D and colorectal cancer—twenty-five years later. Int J Epidemiol 2006;35:222–4.PubMedGoogle Scholar
  17. 17.
    Grant WB, Gorham ED. Commentary: time for public health action on vitamin D for cancer risk reduction. Int J Epidemiol 2006;35:224–5.PubMedGoogle Scholar
  18. 18.
    Kricker A, Armstrong B. Does sunlight have a beneficial influence on certain cancers? Prog Biophys Mol Biol 2006;92:132–9.PubMedGoogle Scholar
  19. 19.
    Schwartz GG, Hulka BS. Is vitamin D deficiency a risk factor for prostate cancer? (Hypothesis). Anticancer Res 1990;10:1307–11.PubMedGoogle Scholar
  20. 20.
    Hanchette CL, Schwartz GG. Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation. Cancer 1992;70:2861–9.PubMedGoogle Scholar
  21. 21.
    Freedman DM, Zahm SH, Dosemeci M. Residential and occupational exposure to sunlight and mortality from nonHodgkin’s lymphoma: composite (threefold) case-control study. BMJ 1997;314:1451–5.PubMedGoogle Scholar
  22. 22.
    Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 1981;66:1191–308.PubMedGoogle Scholar
  23. 23.
    Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: current status and data needs. Am J Clin Nutr 2004;80:1710S–6S.PubMedGoogle Scholar
  24. 24.
    Grant WB, Garland CF. A critical review of studies on vitamin D in relation to colorectal cancer. Nutr Cancer 2004;48:115–23.PubMedGoogle Scholar
  25. 25.
    Gorham ED, Garland CF, Garland FC et al. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol 2005;97:179–94.PubMedGoogle Scholar
  26. 26.
    Gorham ED, Garland CF, Garland FC et al. Optimal vitamin D status for colorectal cancer prevention a quantitative meta analysis. Am J Prev Med 2007;32:210–6.PubMedGoogle Scholar
  27. 27.
    Houghton LA, Vieth R. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr 2006;84:694–7.PubMedGoogle Scholar
  28. 28.
    Grant WB. Dietary links to Alzheimer’s disease. Alz Dis Rev 1997; 2:42–55 ( Scholar
  29. 29.
    Grant WB. Milk and other dietary influences on coronary heart disease. Altern Med Rev 1998;3:281–94.PubMedGoogle Scholar
  30. 30.
    Grant WB. An ecologic study of dietary links to prostate cancer. Altern Med Rev 1999;4:162–169.PubMedGoogle Scholar
  31. 31.
    Grant WB. The role of meat in the expression of rheumatoid arthritis. Brit J Nutr 2000;85:589–95.Google Scholar
  32. 32.
    Devesa SS, Grauman DJ, Blot WJ et al. Atlas of Cancer Mortality in the United States, 1950–1994. NIH Publication 99-4564, 1999. (accessed 2007).Google Scholar
  33. 33.
    Leffell DJ, Brash DE. Sunlight and skin cancer. Sci Am 1996; 275:52–3, 56–9. (accessed 2007).PubMedGoogle Scholar
  34. 34.
    Grant WB. An estimate of premature cancer mortality in the US due to inadequate doses of solar ultraviolet-B radiation. Cancer 2002;94:1867–75.PubMedGoogle Scholar
  35. 35.
    Freedman DM, Dosemeci M, McGlynn K. Sunlight and mortality from breast, ovarian, colon, prostate and nonmelanoma skin cancer: a composite death certificate based case-control study. Occup Environ Med 2002;59:257–62.PubMedGoogle Scholar
  36. 36.
    Leistikow B. Lung cancer rates as an index of tobacco smoke exposures: validation against black male approximate nonlung cancer death rates, 1969–2000. Prev Med 2004;38:511–5.PubMedGoogle Scholar
  37. 37.
    Grant WB. Lower vitamin-D production from solar ultraviolet-B irradiance may explain some differences in cancer survival rates. J Natl Med Assoc 2006;98:357–64.PubMedGoogle Scholar
  38. 38.
    Grant WB, Garland CF. The association of solar ultraviolet B (UVB) with reducing risk of cancer: multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates. Anticancer Res 2006;26:2687–99.PubMedGoogle Scholar
  39. 39.
    Boscoe FP, Schymura MJ. Solar ultraviolet-B exposure and cancer incidence and mortality in the United States, 1993–2000. BMC Cancer 2006;6:264.PubMedGoogle Scholar
  40. 40.
    North American Association of Central Cancer Registries: SEER*Stat Database: NAACCR Incidence—CiNA Analytic File, 1995–2002, NHIA Origin, Boscoe—Solar Radiation (project-specific file). Springfield, IL: North American Association of Central Cancer Registries, 2005.Google Scholar
  41. 41.
    Surveillance Epidemiology and End Results (SEER) Program: SEER*Stat Database: Mortality—All COD, Public-Use With County, Total US (1969–2002). [] Bethesda, MD: National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, 2005.Google Scholar
  42. 42.
    National Center for Health Statistics. Plan and Operation of the Third National Health and Nutrition Survey, 1988–1994. National Center for Health Statistics, Hyattsville, MD. Vital Health Stat, 1994;32:1–407.Google Scholar
  43. 43.
    Hajjar I, Kotchen T. Regional variations of blood pressure in the United States are associated with regional variations in dietary intakes: the NHANES-III data. J Nutr 2003;133:211–4.PubMedGoogle Scholar
  44. 44.
    Hughes AM, Armstrong BK, Vajdic CM et al. Sun exposure may protect against nonHodgkin lymphoma: a case-control study. Int J Cancer 2004;112:865–71.PubMedGoogle Scholar
  45. 45.
    Smedby KE, Hjalgrim H, Melbye M et al. Ultraviolet radiation exposure and risk of malignant lymphomas. J Natl Cancer Inst 2005;97:199–209.PubMedGoogle Scholar
  46. 46.
    Zhang Y, Holford TR, Leaderer B et al. Ultraviolet Radiation Exposure and Risk of nonHodgkins Lymphoma. Am J Epidemiol 2007 [Epub ahead of print].Google Scholar
  47. 47.
    Garland CF, Garland FC, Gorham ED et al. The role of vitamin D in cancer prevention. Am J Public Health 2006;96:252–61.PubMedGoogle Scholar
  48. 48.
    Grant WB. Epidemiology of disease risks in relation to vitamin D insufficiency. Prog Biophys Mol Biol 2006;92:65–79.PubMedGoogle Scholar
  49. 49.
    Kricker A, Armstrong B. Does sunlight have a beneficial influence on certain cancers? Prog Biophys Mol Biol 2006;92:132–9.PubMedGoogle Scholar
  50. 50.
    van der Rhee HJ, de Vries E, Coebergh JW. Does sunlight prevent cancer? A systematic review. Eur J Cancer 2006;42:2222–32.PubMedGoogle Scholar
  51. 51.
    Krause R, Matulla-Nolte B, Essers M et al. UV radiation and cancer prevention: what is the evidence? Anticancer Res 2006;26:2723–7.PubMedGoogle Scholar
  52. 52.
    Kimlin MG, Olds WJ, Moore MR. Location and Vitamin D synthesis: Is the hypothesis validated by geophysical data? J Photochem Photobiol B 2007;86:234–9.PubMedGoogle Scholar
  53. 53.
    Samanek AJ, Croager EJ, Gies P et al. Estimates of beneficial and harmful sun exposure times during the year for major Australian population centres. Med J Aust 2006;184:338–41.PubMedGoogle Scholar
  54. 54.
    Lewis KG, Weinstock MA. Nonmelanoma skin cancer mortality (1988–2000): the Rhode Island follow-back study. Arch Dermatol 2004;140:837–42.PubMedGoogle Scholar
  55. 55.
    Kennedy C, Bajdik CD, Willemze R et al. Leiden Skin Cancer Study. The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi and skin cancer. J Invest Dermatol 2003;120:1087–93.PubMedGoogle Scholar
  56. 56.
    Grant WB. An ecologic study of cancer mortality rates in Spain with respect to indices of solar UV irradiance and smoking. Int J Cancer 2007;120:1123–7.PubMedGoogle Scholar
  57. 57.
    Jablonski NG, Chaplin G. The evolution of human skin coloration. J Hum Evol 2000;39:57–106.PubMedGoogle Scholar
  58. 58.
    Milan T, Verkasalo PK, Kaprio J et al. Lifestyle differences in twin pairs discordant for basal cell carcinoma of the skin. Br J Dermatol 2003;149:115–23.PubMedGoogle Scholar
  59. 59.
    De Hertog SA, Wensveen CA, Bastiaens MT et al. Relation between smoking and skin cancer. J Clin Oncol 2001;19:231–8.PubMedGoogle Scholar
  60. 60.
    Freedman DM, Sigurdson A, Doody MM et al. Risk of melanoma in relation to smoking, alcohol intake and other factors in a large occupational cohort. Cancer Causes Control 2003;14:847–57.PubMedGoogle Scholar
  61. 61.
    Odenbro A, Gillgren P, Bellocco R et al. The risk for cutaneous malignant melanoma, melanoma in situ and intraocular malignant melanoma in relation to tobacco use and body mass index. Br J Dermatol 2007;156:99–105.PubMedGoogle Scholar
  62. 62.
    Grant WB. A meta-analysis of second cancers after a diagnosis of nonmelanoma skin cancer: additional evidence that solar ultraviolet-B irradiance reduces the risk of internal cancers. J Steroid Biochem Mol 2007;103:668–74.Google Scholar
  63. 63.
    de Vries E, Soerjomataram I, Houterman S et al. Decreased Risk of Prostate Cancer after Skin Cancer Diagnosis: A Protective Role of Ultraviolet Radiation? Am J Epidemiol 2007;165:966–72.PubMedGoogle Scholar
  64. 64.
    Rukin NJ, Zeegers MP, Ramachandran S et al. A comparison of sunlight exposure in men with prostate cancer and basal cell carcinoma. Br J Cancer 2007;96:523–8.PubMedGoogle Scholar
  65. 65.
    Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 1975;15:617–31.PubMedGoogle Scholar
  66. 66.
    Grant WB. An ecologic study of the role of solar UV-B radiation in reducing the risk of cancer using cancer mortality data, dietary supply data and latitude for European countries, In; Holick MF, ed. Biologic Effects of Light 2001, Proceedings of the Biologic Effects of Light Symposium, Boston, USA, Massachusetts, 2001, 2002:267–76.Google Scholar
  67. 67.
    Grant WB. Ecologic studies of solar UV-B radiation and cancer mortality rates. Recent Results Cancer Res 2003;164:371–7.PubMedGoogle Scholar
  68. 68.
    Lebert M, Schuster M, Hader DP. The European Light Dosimeter Network: four years of measurements. J Photochem Photobiol B 2002;66:81–7.PubMedGoogle Scholar
  69. 69.
    Food and Agriculture Organization (FAO) of the United Nations. Food Balance Sheets, 1992–94 Average. FAO, Rome, 1996.Google Scholar
  70. 70.
    Harashima E, Nakagawa Y, Urata G et al. Time-lag estimate between dietary intake and breast cancer mortality in Japan. Asia Pac J Clin Nutr 2007;16:193–198.PubMedGoogle Scholar
  71. 71.
    Tylavsky FA, Cheng S, Lyytikainen A et al. Strategies to improve vitamin D status in northern European children: exploring the merits of vitamin D fortification and supplementation. J Nutr 2006;136:1130–4.PubMedGoogle Scholar
  72. 72.
    Grant WB. An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates. Cancer 2002;94:272–81.PubMedGoogle Scholar
  73. 73.
    Grant WB. A multicountry ecologic study of risk and risk reduction factors for prostate cancer mortality. Eur Urol 2004;45:371–9.Google Scholar
  74. 74.
    European Space Agency. Erythemal UV Index-Yearly average (2000). Tropospheric Emission Monitoring Internet Service. (accessed 2007).Google Scholar
  75. 75.
    Colli JL, Colli A. International comparisons of prostate cancer mortality rates with dietary practices and sunlight levels. Urol Oncol 2006;24:184–94.PubMedGoogle Scholar
  76. 76.
    Ferlay J, Bray F, Pisani P et al. GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide IARC CancerBase No. 5. version 2.0, IARCPress, Lyon, 2004. (accessed 2007).Google Scholar
  77. 77.
    Grant WB. The likely role of vitamin D from solar ultraviolet-B irradiance in increasing cancer survival. Anticancer Res 2006;26:2605–14.PubMedGoogle Scholar
  78. 78.
    Mohr SB, Gorham ED, Garland CF et al. Are low ultraviolet B and high animal protein intake associated with risk of renal cancer? Int J Cancer 2006;119:2705–9.PubMedGoogle Scholar
  79. 79.
    Garland CF, Mohr SB, Gorham ED et al. Role of ultraviolet-B irradiance and vitamin D in the prevention of ovarian cancer. Am J Prev Med 2006;31:512–4.PubMedGoogle Scholar
  80. 80.
    Garland CF, Garland FC, Gorham ED. Rising trends in melanoma. An hypothesis concerning sunscreen effectiveness. Ann Epidemiol 1993;3:103–10.PubMedGoogle Scholar
  81. 81.
    Diffey BL. Sunscreens and melanoma: the future looks bright. Br J Dermatol 2005;153:378–81.PubMedGoogle Scholar
  82. 82.
    Moan J, Dahlback A, Sedow RB. Epidemiological support for an hypothesis for melanoma induction indicating a role for UVA radiation. Photochem Photobiol 1999;70:243–7.PubMedGoogle Scholar
  83. 83.
    Osborne JE, Hutchinson PE. Vitamin D and systemic cancer: is this relevant to malignant melanoma? Br J Dermatol 2002;147:197–213.PubMedGoogle Scholar
  84. 84.
    Garland CF, Garland FC, Gorham ED. Epidemiologic evidence for different roles of ultraviolet A and B radiation in melanoma mortality rates. Ann Epidemiol 2003;13:395–404.PubMedGoogle Scholar
  85. 85.
    Millen AE, Tucker MA, Hartge P et al. Diet and melanoma in a case-control study. Cancer Epidemiol Biomarkers Prev 2004;13:1042–51.PubMedGoogle Scholar
  86. 86.
    Newsom SW. Pioneers in infection control: John Snow, Henry Whitehead, the Broad Street pump and the beginnings of geographical epidemiology. J Hosp Infect 2006;64:210–6.PubMedGoogle Scholar
  87. 87.
    Willett WC. Dietary fat intake and cancer risk: a controversial and instructive story. Semin Cancer Biol 1998;8:245–53.PubMedGoogle Scholar
  88. 88.
    Fung T, Hu FB, Fuchs C et al. Major dietary patterns and the risk of colorectal cancer in women. Arch Intern Med 2003;163:309–14.PubMedGoogle Scholar
  89. 89.
    Shannon J, Cook LS, Stanford JL. Dietary intake and risk of postmenopausal breast cancer (United States). Cancer Causes Control 2003;14:19–27.PubMedGoogle Scholar
  90. 90.
    Kapiszewska M. A vegetable to meat consumption ratio as a relevant factor determining cancer preventive diet. The Mediterranean versus other European countries. Forum Nutr 2006;59:130–53.PubMedGoogle Scholar
  91. 91.
    Beresford SA, Johnson KC, Ritenbaugh C et al. Low-fat dietary pattern and risk of colorectal cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 2006;295:643–54.PubMedGoogle Scholar
  92. 92.
    Mizoue T. Ecological study of solar radiation and cancer mortality in Japan. Health Phys 2004;87:532–8.PubMedGoogle Scholar
  93. 93.
    Hill AB. The environment and disease: association or causation? Proc R Soc Med 1965;58:295–300.PubMedGoogle Scholar
  94. 94.
    Koch R. Classics in infectious diseases. The etiology of tuberculosis: Robert Koch. Berlin, Germany 1882. Rev Infect Dis 1982;4:1270–4.PubMedGoogle Scholar
  95. 95.
    Garland CF, Gorham ED, Mohr SB et al. Vitamin D and prevention of breast cancer: Pooled analysis. J Steoid Biochem Mol Biol. 2007;103:708–11.Google Scholar
  96. 96.
    Skinner HG, Michaud DS, Giovannucci E et al. Vitamin D intake and the risk of pancreatic cancer in two cohort studies. Cancer Epidemiol Biomarkers Prevention 2006;15:1688–95.Google Scholar
  97. 97.
    Stolzenberg-Solomon RZ, Vieth R, Azad A et al. A prospective nested case-control study of vitamin d status and pancreatic cancer risk in male smokers. Cancer Res 2006;66:10213–9.PubMedGoogle Scholar
  98. 98.
    Giovannucci E, Liu Y, Rimm EB et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. JNCI 2006;98:451–9.PubMedGoogle Scholar
  99. 99.
    Tuohimaa P, Tenkanen L, Ahonen M et al. Both high and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic countries. Int J Cancer 2004;108:104–8.PubMedGoogle Scholar
  100. 100.
    van den Bemd GJ, Chang GT. Vitamin D and vitamin D analogs in cancer treatment. Curr Drug Targets 2002;3:85–94.PubMedGoogle Scholar
  101. 101.
    Krishnan AV, Peehl DM, Feldman D. Inhibition of prostate cancer growth by vitamin D: Regulation of target gene expression. J Cell Biochem 2003;88:363–71.PubMedGoogle Scholar
  102. 102.
    Lamprecht SA, Lipkin M. Chemoprevention of colon cancer by calcium, vitamin D and folate: molecular mechanisms. Nat Rev Cancer 2003;3:601–14.PubMedGoogle Scholar
  103. 103.
    Grau MV, Baron JA, Sandler RS et al. Vitamin D, calcium supplementation and colorectal adenomas: results of a randomized trial. J Natl Cancer Inst 2003;95:1765–71.PubMedGoogle Scholar
  104. 104.
    Wactawski-Wende J, Kotchen JM, Anderson GL et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006;354:684–96.PubMedGoogle Scholar
  105. 105.
    Holick ME. Calcium plus vitamin D and the risk of colorectal cancer. N Engl J Med 2006;354:2287–8; author reply 2287–8.PubMedGoogle Scholar
  106. 106.
    Holick MF. The role of vitamin D for bone health and fracture prevention. Curr 107. Osteoporos Rep 2006;4:96–102.Google Scholar
  107. 108.
    Heaney RP. Bone health. Am J Clin Nutr 2007;85:300S–3S.PubMedGoogle Scholar
  108. 109.
    Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 2003;78:1463–70.PubMedGoogle Scholar
  109. 110.
    Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 1997;30:150–6.PubMedGoogle Scholar
  110. 111.
    Dietrich T, Joshipura KJ, Dawson-Hughes B et al. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr 2004;80:108–13.PubMedGoogle Scholar
  111. 112.
    Newmark HL, Newmark J. Vitamin D and Parkinsons disease-A hypothesis. Mov Disord 2007 [Epub ahead of print].Google Scholar
  112. 113.
    Kurtzke JF, Beebe GW, Norman JE Jr. Epidemiology of multiple sclerosis in US veterans: 1. Race, sex and geographic distribution. Neurology 1979;29:1228–35.PubMedGoogle Scholar
  113. 114.
    van der Mei IA, Ponsonby AL, Blizzard L et al. Regional variation in multiple sclerosis prevalence in Australia and its association with ambient ultraviolet radiation. Neuroepidemiology 2001;20:168–74.PubMedGoogle Scholar
  114. 115.
    Cantorna MT, Mahon BD. Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Exp Biol Med (Maywood) 2004;229:1136–42.Google Scholar
  115. 116.
    Cantorna MT. Vitamin D and its role in immunology: multiple sclerosis and inflammatory bowel disease. Prog Biophys Mol Biol 2006;92:60–4.PubMedGoogle Scholar
  116. 117.
    Staples JA, Ponsonby AL, Lim LL et al. Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation and disease prevalence. Environ Health Perspect 2003;111:518–23.PubMedGoogle Scholar
  117. 118.
    Hypponen E, Laara E, Reunanen A et al. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 2001;358:1500–3.PubMedGoogle Scholar
  118. 119.
    Villamor E. A potential role for vitamin D on HIV infection? Nutr Rev 2006;64:226–33.PubMedGoogle Scholar
  119. 120.
    Cannell JJ, Vieth R, Umhau JC et al. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129–40.PubMedGoogle Scholar
  120. 121.
    Yu GP, Hu DN, McCormick SA. Latitude and Incidence of Ocular Melanoma. Photochem Photobiol 2006;82:1621–6.PubMedGoogle Scholar
  121. 122.
    Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr 2003;89:552–72.PubMedGoogle Scholar
  122. 123.
    Holick ME. Vitamin D:importance in the prevention of cancers, type 1 diabetes, heart disease and osteoporosis. Am J Clin Nutr 2004;79:362–71.PubMedGoogle Scholar
  123. 124.
    Peterlik M, Cross HS. Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur J Clin Invest 2005;35:290–304.PubMedGoogle Scholar
  124. 125.
    Grant WB, Holick MR Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 2005;10:94–111.PubMedGoogle Scholar
  125. 126.
    Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 2005;94:483–92.PubMedGoogle Scholar
  126. 127.
    Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353–73.PubMedGoogle Scholar
  127. 128.
    Zittermann A. Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol 2006;92:39–48.PubMedGoogle Scholar
  128. 129.
    Bouillon R, Eelen G, Verlinden L et al. Vitamin D and cancer. J Steroid Biochem Mol Biol 2006;102:156–62.PubMedGoogle Scholar
  129. 130.
    Grant WB, Garland CF, Holick ME Comparisons of estimated economic burdens due to insufficient solar ultraviolet irradiance and vitamin D and excess solar UV irradiance for the United States. Photochem Photobiol 2005;81:1276–86.PubMedGoogle Scholar

Copyright information

© Landes Bioscience and Springer Science+Business Media 2008

Authors and Affiliations

  • William B. Grant
    • 1
  1. 1.Sunlight, Nutrition and Health Research Center (SUNARC)San FranciscoUSA

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