Sunlight for Children May Help Prevent Multiple Sclerosis

A new study of identical twins suggests that children who spend more time in the sun have a lower risk for developing multiple sclerosis, or MS, as adults.

Reported in the medical journal Neurology, the study shows that evidence is growing that sunlight and/or vitamin D exposure during childhood may help protect health.

According to the National Multiple Sclerosis Society, MS is an autoimmune disease of the central nervous system that currently affects more than 400,000 Americans. More than 2.5 million men and women worldwide suffer from the disorder.

While it is unclear what causes MS, the often-crippling disease is thought to develop when the body's own immune system begins attacking a fat and protein-laden substance called myelin that insulates nerve fibers.

Numbness, tingling, loss of coordination and balance, blindness, fatigue, and even paralysis can ensue, as normal communications between brain and body progressively collapse.

The majority of MS patients are first diagnosed between the ages of 20 and 50, and female patients outnumber males two-to-one.

Linked More to Females than Males

The new study findings echo those of a recent Harvard School of Public Health study, published in the Journal of the American Medical Association (JAMA).

Among 140 Caucasian men and women, those with the highest levels of sunlight-derived vitamin D were 62 percent less likely to have developed MS than those with the lowest levels.

However, the finding was not replicated in a smaller patient pool of either African Americans or Hispanics.

In the latest study, Dr. Thomas Mack’s team assessed the sun exposure of 79 pairs of identical twins in the US and Canada, in which at least one twin in each pair had been diagnosed with MS.

Most of the twins were girls, and among those with MS, most had been diagnosed between the ages of 20 and 40.

Each subject was asked about his or her childhood history of outdoor activity, as well as that of the twin.

Time spent tanning, going to the beach, and playing team sports during childhood was also noted. No absolute sun exposure measurements were recorded.

The authors assessed relative degrees of sun exposure between twins, based on personal recall.

All participants were also asked to reveal any history of childhood infections as well as smoking habits.

The result: The twin with MS usually had been exposed to less sun overall as a child than the twin without the disease, the researchers find.

They observed, however, that this protective effect was only apparent among female twins. The lack of evidence among male twins could simply be a function of the relatively small number of male twins included in the study, the researchers say.

The degree to which the risk for developing MS was reduced as a result of increased sun exposure ranged from 25 percent to 57 percent, depending on the disease-free twin's activities.

For example, the researchers determined that non-MS twins who had spent more childhood time sun-tanning than their sibling had a nearly 50 percent reduced risk of developing MS as an adult.

It is not clear how sun exposure might protect against the illness. Ultraviolet rays might trigger a beneficial cellular immune response directly, or perhaps sunlight helps stave off the disease indirectly, by boosting vitamin D production.

To better understand the mystery behind sun exposure and its link to MS risk, the researchers said future sun-MS studies should be given "high priority."

"If it's true that sunlight is protective and/or vitamin D is protective, then there's one group of people who ought to think seriously about it, and that is young parents who have MS," notes Dr. Mack.

High Risk Families Should Take Note

He says the likelihood that a child of a parent with MS will go on to get MS is 3 percent or 4 percent, and this is many, many times the likelihood that the average person could get MS.

"So, I think if I was a young parent, and I or my wife had MS, and I had a child, I would want to take every step I could take to prevent my child from getting the disease," adds Dr. Mack.

"But," he cautions, "the problem is, of course, that we know that too much sunlight is the cause of melanoma. So, that's a dilemma. We want to give the child some exposure but not too much."

Dr. John Richert, executive vice president for research and clinical programs at the National Multiple Sclerosis Society, which co-sponsored the study, says that "we all have to take note of" the new findings.

"This is one of a series of reports over the last couple of years that have at least indirectly implicated the role of sun exposure and vitamin D production with susceptibility to MS," he notes.

"And this builds a stronger and stronger case that sun is one of the factors that can contribute to the development of MS," says Dr. Richert.

Dr. Richert observed that MS in general is more common the farther away from the equator one lives, particularly during childhood, further supporting the sunlight-MS link.

However, he also agreed that too much sunlight brings its own risks.

"Certainly, in terms of relative risk - skin cancer that can develop from sun exposure versus the potentially diminished risk for MS - we don't have equations to really balance these," stresses Dr. Richert.

"And there's a lot more work that still needs to be done before any kind of recommendations can be made about sun exposure or vitamin D intake," he says.

Always consult your physician for more information.

Facts About Sunburn

Sunburn is a visible reaction of the skin's exposure to ultraviolet (UV) radiation, the invisible rays that are part of sunlight. Ultraviolet rays can also cause invisible damage to the skin.

Excessive and/or multiple sunburns cause premature aging of the skin and lead to skin cancer. Skin cancer is the most common type of cancer in the US and exposure to the sun is the leading cause of skin cancer.

Children often spend a good part of their day playing outdoors in the sun, especially during the summer. Children who have fair skin, moles, or freckles, or who have a family history of skin cancer, are more likely to develop skin cancer in later years.

Exposure to the sun during daily activities and play causes the most sun damage. Overexposure to sunlight before age 18 is most damaging to the skin.

UV rays are strongest during summer months when the sun is directly overhead (normally between 10:00 a.m. and 3:00 p.m.).

First aid for sunburn includes the following:

• Have your child take a cool bath or use cool compresses on the sunburned area.

• Give your child acetaminophen or ibuprofen for discomfort. Be sure to follow the directions on the container.

• Apply a topical moisturizer, aloe gel, hydrocortisone cream, or a topical pain reliever to sunburned skin. Avoid commercial products that contain Benadryl or benzocaine, because of the possibility of skin irritation or allergy.

• If blisters are present, do not break them open, as infection can occur.

• Keep your child out of the sun until the burn is healed.

Specific treatment for sunburn will be determined by your child's physician and may depend on the severity of the sunburn. In general, call your child's physician if the sunburn is severe or forms blisters, or if your child has symptoms of heat stress such as fever, chills, nausea, vomiting, or feeling faint.

Protection from the sun should start at birth and continue throughout your child's life. It is estimated that 60 to 80 percent of total lifetime sun exposure occurs in the first 18 years of life.

The best way to prevent sunburn in children over 6 months of age is to follow the A, B, Cs recommended by the American Academy of Dermatology:

• Away: Stay away from the sun in the middle of the day. This is when the sun's rays are the most damaging.

• Block: Block the sun's rays using a SPF 15 or higher sunscreen. Apply the lotion 30 minutes before going outside and reapply it often during the day. Sunscreens should not be used on infants under 6 months of age.

• Cover-up: Cover up using protective clothing, such as a long sleeve shirt and hat when in the sun. Use clothing with a tight weave to keep out as much sunlight as possible. Keep babies less than 6 months old out of direct sunlight at all times. Hats with brims are important.

What are sunscreens?

Sunscreens protect the skin against sunburns and play an important role in blocking the penetration of ultraviolet (UV) radiation. However, no sunscreen blocks UV radiation 100 percent.

Terms used on sunscreen labels can be confusing. The protection provided by a sunscreen is indicated by the sun protection factor (SPF) listed on the product label. A product with an SPF higher than 15 is called a sunblock.

Always consult your child's physician for more information.