Vitamin D, UV, and skin cancer in the elderly: to expose or not to expose?

There is mounting concern about vitamin D insufficiency, especially in the ageing population. Increases in indoor lifestyle, obesity, car travel, clothing habits, the use of photo-protective makeup, and campaigns driven by dermatologists, governments, and the cosmetic industry to avoid or protect against the sun as much as possible are contributing to this trend. In a recent article in Gerontology, Barysch et al. [1] recommend that the ageing population avoid any 'intentional' UV radiation as well as 'minimize sun exposure' based on known dangers of developing skin cancer. They warn that 'studies with vitamin D supplements reported increased risks of prostate and esophagus cancer as well as atopy in childhood' and concluded that 'adequate levels of vitamin D are essential for the elderly', but do not suggest which level is optimal. I will argue that the ageing population should keep their serum 25-(OH)-vitamin D(3) (25-(OH)-D) levels in the 75-100 nmol/l range. An oral cholecalciferol intake of ∼2,000 IU/day is recommended as a supplement throughout the year for those who cannot enjoy the sun in summer or only during 'vitamin D winter' for the others.