Research Article| Volume 90, ISSUE 1, P109-114, October 2010

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Are active sun exposure habits related to lowering risk of type 2 diabetes mellitus in women, a prospective cohort study?



      An inverse relationship exists between vitamin D levels and diabetes mellitus. However, little is known about the correlation of sun exposure habits and type 2 diabetes mellitus (DM).


      A South Swedish cohort study comprising 1000 women from each age group between 25 and 64 (n = 40,000) drawn from the Southern Swedish population registry 1990–1992. At the inception of the study 74% answered the inquiry (n = 29,518) and provided detailed information on their sun exposure habits and other variables. A follow-up inquiry was sent 2000–2002 which 24,098 women answered. The mean follow-up time was 11 years. Logistic regression analysis was used and the main outcome was the relationship between type 2 DM and sun exposure habits.


      Our findings indicated that women with active sun exposure habits were at a 30% lower risk of having DM, as compared to those with non-active habits. There was an inverse relation between this risk reduction and BMI.


      Our investigation gives possible epidemiological explanation to ethnic and seasonal differences in type 2 DM and metabolic control. The study supports that sunlight is involved in the glucose metabolism.


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        • Scragg R.
        • Sowers M.
        • Bell C.
        Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third national health and nutrition examination survey.
        Diabetes Care. 2004; 27: 2813-2818
        • Pittas A.G.
        • Lau J.
        • Hu F.B.
        • Dawson-Hughes B.
        The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.
        J Clin Endocrinol Metab. 2007; 92: 2017-2029
        • Knekt P.
        • Laaksonen M.
        • Mattila C.
        • Harkanen T.
        • Marniemi J.
        • Heliovaara M.
        • et al.
        Serum vitamin D and subsequent occurrence of type 2 diabetes.
        Epidemiology. 2008; 19: 666-671
        • McGill A.T.
        • Stewart J.M.
        • Lithander F.E.
        • Strik C.M.
        • Poppitt S.D.
        Relationships of low serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity.
        Nutr J. 2008; 7: 4
        • Sohmiya M.
        • Kanazawa I.
        • Kato Y.
        Seasonal changes in body composition and blood HbA1c levels without weight change in male patients with type 2 diabetes treated with insulin.
        Diabetes Care. 2004; 27: 1238-1239
        • Doro P.
        • Benko R.
        • Matuz M.
        • Soos G.
        Seasonality in the incidence of type 2 diabetes: a population-based study.
        Diabetes Care. 2006; 29: 173
        • Pittas A.G.
        • Dawson-Hughes B.
        • Li T.
        • Van Dam R.M.
        • Willett W.C.
        • Manson J.E.
        • et al.
        Vitamin D and calcium intake in relation to type 2 diabetes in women.
        Diabetes Care. 2006; 29: 650-656
        • Holick M.F.
        Vitamin D deficiency.
        N Engl J Med. 2007; 357: 266-281
        • Brot C.
        • Vestergaard P.
        • Kolthoff N.
        • Gram J.
        • Hermann A.P.
        • Sorensen O.H.
        Vitamin D status and its adequacy in healthy Danish perimenopausal women: relationships to dietary intake, sun exposure and serum parathyroid hormone.
        Br J Nutr. 2001; 86: S97-S103
        • Lagunova Z.
        • Porojnicu A.C.
        • Lindberg F.
        • Hexeberg S.
        • Moan J.
        The dependency of vitamin D status on body mass index, gender, age and season.
        Anticancer Res. 2009; 29: 3713-3720
        • Shai I.
        • Jiang R.
        • Manson J.E.
        • Stampfer M.J.
        • Willett W.C.
        • Colditz G.A.
        • et al.
        Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study.
        Diabetes Care. 2006; 29: 1585-1590
        • McWilliams J.M.
        • Meara E.
        • Zaslavsky A.M.
        • Ayanian J.Z.
        Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of medicare coverage.
        Ann Intern Med. 2009; 150: 505-515
        • Chiu K.C.
        • Chu A.
        • Go V.L.
        • Saad M.F.
        Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction.
        Am J Clin Nutr. 2004; 79: 820-825
        • Sugden J.A.
        • Davies J.I.
        • Witham M.D.
        • Morris A.D.
        • Struthers A.D.
        Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels.
        Diabet Med. 2008; 25: 320-325
        • Holick M.F.
        • Chen T.C.
        Vitamin D deficiency: a worldwide problem with health consequences.
        Am J Clin Nutr. 2008; 87: 1080S-1086S
        • Schleithoff S.S.
        • Zittermann A.
        • Tenderich G.
        • Berthold H.K.
        • Stehle P.
        • Koerfer R.
        Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial.
        Am J Clin Nutr. 2006; 83: 754-759
        • Lyssenko V.
        • Nagorny C.L.
        • Erdos M.R.
        • Wierup N.
        • Jonsson A.
        • Spegel P.
        • et al.
        Common variant in MTNR1B associated with increased risk of type 2 diabetes and impaired early insulin secretion.
        Nat Genet. 2009; 41: 82-88
        • Clemens T.L.
        • Adams J.S.
        • Henderson S.L.
        • Holick M.F.
        Increased skin pigment reduces the capacity of skin to synthesise vitamin D3.
        Lancet. 1982; 1: 74-76
        • Thieden E.
        • Jorgensen H.L.
        • Jorgensen N.R.
        • Philipsen P.A.
        • Wulf H.C.
        Sunbed radiation provokes cutaneous vitamin D synthesis in humans—a randomized controlled trial.
        Photochem Photobiol. 2008; 84: 1487-1492
        • Porojnicu A.C.
        • Bruland O.S.
        • Aksnes L.
        • Grant W.B.
        • Moan J.
        Sun beds and cod liver oil as vitamin D sources.
        J Photochem Photobiol B. 2008; 91: 125-131
        • Harris S.S.
        • Dawson-Hughes B.
        Reduced sun exposure does not explain the inverse association of 25-hydroxyvitamin D with percent body fat in older adults.
        J Clin Endocrinol Metab. 2007; 92: 3155-3157
        • Kirii K.
        • Mizoue T.
        • Iso H.
        • Takahashi Y.
        • Kato M.
        • Inoue M.
        • et al.
        Calcium, vitamin D and dairy intake in relation to type 2 diabetes risk in a Japanese cohort.
        Diabetologia. 2009; 52: 2542-2550
        • Nakamura K.
        • Nashimoto M.
        • Hori Y.
        • Yamamoto M.
        Serum 25-hydroxyvitamin D concentrations and related dietary factors in peri- and postmenopausal Japanese women.
        Am J Clin Nutr. 2000; 71: 1161-1165
        • Stewart J.W.
        • Alekel D.L.
        • Ritland L.M.
        • Van Loan M.
        • Gertz E.
        • Genschel U.
        Serum 25-hydroxyvitamin D is related to indicators of overall physical fitness in healthy postmenopausal women.
        Menopause. 2009; 16: 1093-1101
        • Ponsonby A.L.
        • McMichael A.
        • van der Mei I.
        Ultraviolet radiation and autoimmune disease: insights from epidemiological research.
        Toxicology. 2002; 181–182: 71-78
        • Lindqvist P.G.
        • Epstein E.
        • Olsson H.
        Does an active sun exposure habit lower the risk of venous thrombotic events? A D-lightful hypothesis.
        J Thromb Haemost. 2009; 7: 605-610
        • Epstein E.
        • Lindqvist P.G.
        • Geppert B.
        • Olsson H.
        A population-based cohort study on sun habits and endometrial cancer.
        Br J Cancer. 2009; 101: 537-540