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Vitamin D Can Protect Against Colds, Flu, Study Suggests

Taking extra vitamin D can protect against colds, flu and other respiratory infections, said a study Thursday which reopened a debate on the usefulness of over-the-counter supplements.

A review of 25 clinical trials in 14 countries, some with conflicting results, yielded “the first definitive evidence” of a link between vitamin D and flu prevention, researchers claimed in The BMJ medical journal.

The effects were strongest for people with very low levels of the nutrient which is found in some foods and can be synthesised by the body when the skin is exposed to ultraviolet light.

Many people, especially in grey, cloudy climes, do not have enough vitamin D.

Scientific studies over the years have delivered contradictory conclusions on the topic.

Some have shown that low levels of the vitamin increase the risk of bone fractures, heart disease, colorectal cancer, diabetes, depression, Alzheimer’s disease and death.

Others said there is no evidence of a link to disease risk.

For the new study, researchers from the Queen Mary University of London conducted the biggest-ever survey of trials involving nearly 11,000 people.

Sunshine
Vitamin D is found in some foods and can be synthesized
by the body when the skin is exposed to ultraviolet light.

And they found clues as to why supplements seem to work in some trials but not in others.

“The bottom line is that the protective effects of vitamin D supplementation are strongest in those who have the lowest vitamin D levels, and when supplementation is given daily or weekly rather than in more widely-spaced doses,” lead researcher Adrian Martineau said in a statement.

‘Undeniable’

Vitamin D is thought to protect against respiratory infections, including bronchitis and pneumonia, by boosting levels of antibiotic-like peptides in the lungs, said the team.

This fits with an observation that colds and flu are more common in winter and spring, when vitamin D levels are lowest.

It may also explain why vitamin D seems to protect against asthma attacks, they said.

In an editorial published with the study, experts Mark Bolland and Alison Avenell said it should be viewed as a hypothesis in need of scientific confirmation.

Louis Levy, head of nutrition science at Public Health England, shared their caution.

“This study does not provide sufficient evidence to support recommending vitamin D for reducing the risk of respiratory tract infections,” he said via the Science Media Centre in London.

Other observers were more optimistic.

The case for universal vitamin D supplements, or food fortification, “is now undeniable,” concluded Benjamin Jacobs of the Royal National Orthopaedic Hospital.

AFP     Thursday, February 16, 2017
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This Vitamin Deficiency is a Global Health Problem

By: Jordyn Cormier   May 4, 2016

We all hear about vitamin D’s importance on a regular basis, but do you really know how to make sure you’re getting enough of it? It’s not as simple as just going outside on a sunny day.

For the prevention of the majority of diseases, it’s recommended that blood serum levels of vitamin D 25(OH)D fall between 40 and 60. However, many of us who spend the bulk of our days indoors are incredibly vitamin D deficient. In fact, it is estimated that 40 to 75 percent of the world’s population is vitamin D deficient.

Vitamin D is an unsung hero in the body. It is indispensable in a variety of functions, such as enhancing calcium absorption for bone health, supporting several immune system functions, preventing depression and helping to prevent some forms of cancer and autoimmune disorders. Inadequate levels in the body contribute to overall poor health and can be at the root cause of certain diseases.

Vitamin D can be found in some foods, such as beef liver, egg yolks and cold water fish. However, food-based sources of D are generally a less dense source. They are also an inactive form of the vitamin which must undergo various processes to become activated in the body. On the other hand, vitamin D produced by the sun is highly bioavailable.

Vitamin D is actually a hormone rather than a vitamin. It is for this reason that spending a little time outside with exposed skin is incredibly important, as the sun is one of the most efficient ways to stock up on vitamin D.

sun

Here’s the catch: you can’t make vitamin D anytime you go outside. The sun has to be at the proper angle in the sky, so those of us living further from the equator have limited opportunities to allow our bodies to synthesize vitamin D.

“I have established that in order to produce adequate levels of vitamin D the solar azimuth angle/the angle of incidence of solar radiation should be 45 O < α < 90 O . UVB rays will only penetrate the atmosphere when the sun is above an angle of  around 45 degrees from the horizon. A useful observation when you are outdoors is to evaluate the length of your own shadow. If it is longer then you are, you are not producing any vitamin D.” (Dr. Karolina M. Zielinska-Dabkowska, source)

To calculate for yourself, use this azimuth chart. Simply enter data into the table indicating your location and the date, and compute. You’ll get a long and impressive looking list of numbers. Simply glance down the altitude column and find where the number falls between 45 and 90 degrees. Then, take note of the times in the column on the left. These are the only times when your body can produce vitamin D during the day on that particular date (if it is sunny). Otherwise, the rays gets filtered out through the atmosphere and you’ll simply be subjecting yourself to harmful UV rays without the benefit of D synthesis.

Additionally, using sunscreen can block the rays that initiate vitamin D synthesis, so spending 10 minutes in the sun without sunscreen is important. Of course, if you’re going to be outside longer than that, slather up.

Vitamin D is essential for a myriad of functions. While it’s great to get outside whenever you can, supplementing with a quality D3 supplement is important for those of us who don’t live along the sunny equator.


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How to Avoid Summer’s Health Woes

Experts explain strategies for preventing 6 common maladies from ruining your summer fun

By Heather Hatfield     WebMD Feature     Reviewed by Louise Chang, MD

It’s summer, which means the mercury is on the rise, the beach is where it’s at, and a cold glass of lemonade is exactly what the doctor ordered.

WebMD looks at how to survive the summer season – from heat waves to poison ivy to bad burgers.

Dehydration and Heatstroke

“Dehydration and heatstroke go hand in hand,” says Peter Galier, MD, associate professor of medicine at the David Geffen School of Medicine at UCLA. “It happens most commonly in people who are out in the sun.”

What happens, explains Galier, is that people sweat and replace their lost electrolyte-packed body fluids with only water. Dehydration can soon follow, and heatstroke can set in if a person becomes so dehydrated they can’t sweat enough to cool down, and their body temperature rises.

How to avoid it. “If you are outside and sweating, you should be drinking at least a 50-50 mix of Gatorade and water, which has potassium and sodium,” Galier tells WebMD. “You need to be drinking at least one small liter bottle of this mix every hour if you’re working or exercising in the sun.”

Warning signs. “Symptoms of dehydration can run the gamut from thirst and general fatigue, to headaches, nausea, and confusion,” says Galier. “Heatstroke symptoms are also headache and confusion, but include delirium and even hallucinations.”

What to do. While mild dehydration can be treated by rehydrating with fluids, heatstroke is more serious. “If you have heatstroke, you need to go to the emergency room so you can have intravenous fluids,” says Galier. “With really bad heatstroke, your kidneys can shut down.”

Poison Ivy

The old adage still rings true, explains Galier. “Leaves of three — let them be,” he says. So when the summer months begin, plan ahead when you know you’re going to be trekking through the woods.

How to avoid it. “Poison ivy is a tri-leafed plant, usually with a little yellow and purple, and it tends to be anywhere with shrubbery, hiding out with other vegetation,” says Galier. “So stay out of shrub areas or wear high boots or high socks, stay on the path, and don’t touch anything you don’t recognize.”

Warning signs. Poison ivy can creep up on you, even if you wear head-to-toe clothing. “It’s the oil of the leaf that’s the problem,” says Galier. “If you take your clothes off and you touch your clothes, you’re going to get it.” The “it” he’s referring to is the itching and swelling.

What to do. It’s time to get out the topical anti-itching cream again, like calamine lotion. “If you can suffer through it and it doesn’t get worse, you can ride it out,” says Galier. If it gets worse, you’ll need to see a doctor for topical steroids or oral steroids.”

Food-Borne Illnesses

“Food-borne illnesses are more common in summer for a number of reasons,” says Linda Harris, PhD, professor in the food science and technology department at University of California Davis. “If the temperature is higher, there is more opportunity for temperature abuse of foods – that is leaving them in the danger zone, which is anything above 40 and below 140 degrees. In this range, microorganisms that cause food-borne disease can multiply.”

From the pasta salad left out all afternoon on the Fourth of July, to a turkey and mayo sandwich in your backpack on a 3-mile hike up a mountain on a warm day, to simply driving from the grocery store to your home in the sweltering heat, summertime foods are a breeding ground for trouble — and bacteria.

How to avoid it. “There are four basic rules for preventing food-borne illness: cook, clean, chill, and separate – and these become important during summer,” says Harris, who is a scientific communicator with the Institute of Food Technologists.

First, she recommends, use a thermometer when cooking so you know your food is adequately heated.

Second, “when you are outside, it’s always best to wash with soap and water. But if you can’t, bring sanitizing handy wipes so you can clean your hands after you handle food,” Harris tells WebMD.

Third, “if you are going to a picnic, use a cooler where you can maintain food in a cool temperature,” says Harris. “Don’t use it to make things cold, but to keep things cold. Remember to bring enough ice, as well. If you can’t use a cooler, like on a hike, bring foods that don’t need refrigeration. Or freeze your foods, so when you are ready to eat them, they’re thawed out.”

Finally, Harris says, “Keep your utensils and dishes that you use for raw meat separate from those you use to eat.”


Warning signs. The warning signs of food-borne illness are the usual suspects, explains Harris: vomiting, stomach cramps, diarrhea, flu-like symptoms, or any combination of these not-so-pleasant symptoms.

“One of the mistakes people make is to assume that the last thing they ate is the cause of their symptoms,” says Harris. “While some types of food-borne illnesses take two to six hours until symptoms appear, others take one or three days. So the culprit is not always the last thing you had, even though that’s probably what came up.”

What to do. Despite best efforts, if you fetch up with something you might suspect is food-borne, keep in mind, “Some food-borne illnesses, such as E. coli O157:H7, can be life-threatening, particularly for young children, the elderly, and those with weakened immune systems,” according to the FDA’s Center for Food Safety and Applied Nutrition. “Symptoms that are severe or prolonged may need to be treated. People who believe they may have contracted a food-borne illness should call their physician.”

Mosquito Bites

While mosquito bites used to be little more than annoying and itchy bumps on your arm or behind your ear, now we have even more reason to avoid them with things like West Nile virus and Triple E (Eastern equine encephalitis) making headlines.

How to avoid it. Your attack against a mosquito bite is three-pronged, according to the CDC’s web site: “Use insect repellent, particularly those with DEET, picaridin, or oil of lemon eucalyptus; wear as much clothing as the warm weather will allow; and avoid the outdoors during dusk and dawn — peak biting times.”

Warning signs. Mosquito bites will appear as red, raised bumps on your skin. Worse, they’ll itch.

What to do. Mosquito bites usually go away in less than a week, according to the web site of the University of Maryland Medical Center. In the meantime, you can wash the area and keep it clean, use an ice pack or a cool compress to alleviate itching, take an antihistamine, or use an anti-itching cream, such as calamine lotion.

Nearly 80% of people infected with West Nile virus will not have any symptoms. If you start to experience symptoms like fever, headache, body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach, and back, according to the CDC’s web site, see your doctor. There’s a chance these could be symptoms of West Nile virus.

Swimmer’s Ear

Swimmer’s ear is a kid’s nightmare when summer finally arrives.

“Just like when your fingers get pruney when you’re in the water too long, the same thing happens to your ears,” says Galier.

When you swim, or even shower or bathe, water can get trapped in your ear canal, causing the canal to get inflamed and infected.

How to avoid it. Gone are the days of Silly Putty in your ears. Now it’s simply wax ear plugs, or custom-fit ear plugs, explains Galier, to prevent swimmer’s ear.

Warning signs. “The symptoms of swimmer’s ear are ear pain and decreased hearing,” says Galier.

You might also experience, according to the web site of the American Academy of Otolaryngology, a sensation that the ear is full, fever, or swollen lymph nodes.

What to do. “Treating swimmer’s ear requires a prescription,” says Galier. “You need to see your doctor.”

Sunburns

There’s nothing worse than a sunburn in the summer. It hurts, it looks funny, and it means you have to stay inside until it gets better – or go outside in the hot summer sun fully clothed to protect your burnt-to-a-crisp skin. Why does the sun cook us like a strip of bacon? According to the CDC’s web site, “Sunlight consists of infrared, visible, and ultraviolet light, and ultraviolet light consists of UVA, UVB, and UVC rays. The UVA rays cause tanning and wrinkling, while UVB rays cause sunburn, aging, wrinkling, and skin cancer.”

How to avoid it. It’s simple – either stay inside or wear sunscreen. According to the CDC’s web site, “Dermatologists recommend using a full-spectrum sunscreen that blocks or absorbs all UV rays.” And of course, don’t think just because it’s cloudy you can skip the sunscreen. Most UV rays pass right through clouds.

Warning signs. While the sun might feel nice while you’re baking underneath it, a few hours later, you’ll pay the price if you didn’t protect yourself with sunscreen. According to the CDC’s web site, “Symptoms usually start about four hours after sun exposure, worsen in 24-36 hours, and resolve in three to five days. In mild sunburn, the skin becomes red, warm, and tender. More serious burns are painful, and the skin becomes swollen and may blister.”

What to do. The bad news is, there’s really no way to treat a sunburn — you just need to ride it out. The CDC recommends aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) to relieve pain and headache and reduce fever; drinking water to help rehydrate; and cool baths.

If the sunburn is more severe and blisters develop, the CDC’s web site recommends, “Lightly bandage or cover the area with gauze to prevent infection. The blisters should not be broken, as this will slow the healing process and increase the risk of infection.”

source: webmd.com


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Are higher SPF sunscreens better? How to pick the right protection

Angela Mulholland, CTVNews.ca      Published Sunday, June 2, 2013

You’d think that with all that Canadians hear about the risks of sunburns and tanning, we’d be doing whatever we can to protect our skin.

But a recent survey – commissioned by the Aveeno and Neutrogena sunscreen brands – found that one in four Canadians do not regularly use sunscreen, while one in three don’t see tanning as risky.

That might help explain why more than 81,000 Canadians will be diagnosed with skin cancer this year, including about 6,000 who will be diagnosed with the most deadly form, melanoma.

While most Canadians use sunscreen, it can be easy to be confused by the array of choices on store shelves. One of the biggest sources of confusion is Sun Protection Factor, or SPF.

A common assumption is sunscreens with an SPF 60 will allow you to stay out in the sun twice as long as an SPF 30.In fact, a sunscreen’s ability to block ultraviolet radiation begins to top out after a certain level. SPF 15 sunscreens block about 93 per cent of UVB rays, the Canadian Cancer Society notes. SPF 30 sunscreens meanwhile block out only slightly more: about 97 per cent of UVB rays. So not twice as effective at all.

Some dermatologists think sunscreens really shouldn’t be allowed to promise an SPF higher than 50.

“The high SPF numbers are just a gimmick,” Marianne Berwick, a professor of epidemiology at the University of New Mexico, recently told The Associated Press.

The U.S. FDA is working on setting a limit to SPF promises on sunscreen labels, but for now, the Canadian Dermatology Association advises Canadians to aim for an SPF of at least 30.

Even a sunscreen with high SPF may not do much if Canadians don’t put enough on, says Toronto-based dermatologist Dr. Paul Cohen.

“The issue is when people apply sunscreen, they don’t apply enough,” Cohen told CTV News Channel this week. “When (manufacturers) measure a sunscreen’s SPF value, they use quite a lot. You need to use about a shot glass full to cover yourself.”

Cohen also says the average bottle of sunscreen shouldn’t last you all summer; it should last about a week.

“So you need to apply it often and you need to apply it repeatedly, especially after swimming or sweating,” he says.

“Even waterproof sunscreen – now we can call it water-resistant – loses its efficacy after 80 minutes and needs to be reapplied.”


Concerns about spray sunscreen

In recent years, spray sunscreens have become hugely popular because they are quick and easy to apply. But some doctors worry about sprays.

Respirologist Dr. Matthew Stanbrook, of Toronto Western Hospital, has concerns about spray sunscreen, especially for children.

He notes many contain oxybenzone, a chemical that absorbs ultraviolet light. While Health Canada and the American Academy of Dermatology says the chemical is safe for the skin, there are concerns that breathing it into the lungs might not be safe for children, because the chemical can act as a synthetic estrogen.

“So there are concerns about breathing those in regularly, especially in developing children, where you can imagine that repeated exposure to synthetic estrogen and testosterone might have some worrisome effects,” he recently told CTV Toronto.

Spray sunscreens also contain particulate matter such as zinc oxide and titanium oxide in their aerosolized spray, he says.

“We know that exposure to fumes or dusts from these types of substances in industrial settings can be associated with some lung diseases,” he says. And he says an aerosol is more likely to release particles that are the right size to be breathed into the lungs.

Stanbrook says the potential problems of breathing in sunscreen have not been studied enough to understand if there is a harmful effect. But he says it’s best to avoid using them with small children.

As well, never spray them directly onto the face; instead, spray the product into your hands and wipe onto the face, he advises.

Finally, there’s one further warning about spray sunscreens: they could be a fire hazard

Last year, a Massachusetts man suffered second-degree burns on his chest, and back after he applied a spray sunscreen before walking over to his barbecue.

The sunscreen hadn’t fully absorbed into his skin, and the propellants in the spray’s vapour trail ignited, causing flames to shoot up his arm and spread over his chest and neck. So be sure to stay away from open flames while using spray sunscreen and rub it in well.

source: CTV


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Sunshine Might Help Love Bloom, Study Suggests

February 1, 2013  

THURSDAY, Jan. 31 (HealthDay News) — People looking for a date might want to wait for better weather. Flirting is most effective when the sun is shining, according to new research conducted in France.
The study involved an “attractive” 20-year-old man who approached women aged 18 to 25 walking alone in the street and asked them for their phone number. These advances were made on both sunny and cloudy days when the temperature was about the same.
Women were more receptive to being approached and flirted with — and more likely to give their phone number — on sunny days (about 22 percent) than on cloudy days (about 14 percent), according to the results of the study, which were published online recently in the journal Social Influence.

The findings suggest that flirting is more likely to have a positive result on bright days, said study author Nicolas Gueguen, of the University of South Brittany in France.
It’s the first study to examine how weather may influence courtship or dating behavior, he noted in a journal news release. But the association between weather and flirting success noted in the study does not prove a cause-and-effect relationship.
Previous research has found that other environmental factors — such as romantic music, pleasant smells and certain colors — make people more likely to flirt or exchange phone numbers, according to background information in the news release.
Other studies have also found that the weather can affect certain social behaviors. For example, sunshine makes people more likely to help strangers, answer a survey or leave bigger tips in restaurants, the researchers noted.


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15 Natural Options for Depression

Michelle Schoffro Cook     May 10, 2012


Everyone feels down at some point, usually as a reaction to difficult circumstances, but clinical depression goes far beyond that. In such cases a person experiences a prolonged sadness that is out of proportion with the apparent cause. The physical and psychological symptoms affect a person’s capacity to function normally in the world.
Depression is often accompanied by sleep disruption, fatigue, anxiety, mood swings, prolonged lapses of concentration, pain, apathy, decreased sex drive and suicidal thoughts.  Because these symptoms can be attributed to other diseases or conditions and are serious, it is always important to consult a medical doctor for a diagnosis.
Diet: Poor nutrition, in my opinion, is one of the greatest causes of depression, and one of the easiest and most overlooked solutions. My two decades of clinical experience tell me that depression cannot be managed for the long-term without addressing the diet.
Poor diet is frequently linked to depression because food additives, chemicals, alcohol, sugar, and sugar substitutes can have severely negative effects on our mental and physical health.
Eating a healthful diet (not a low carb diet, in this case) helps the body balance hormone levels, including important brain hormones that help us feel good.  For example, complex carbohydrates from vegetables, legumes and whole grains help the brain manufacture serotonin, a “feel good” neurotransmitter that is needed to prevent and treat depression.

Food Sensitivities: It’s also important to address possible food allergens or sensitivities, which can sometimes be tough to pinpoint. The most common ones include: dairy, wheat, gluten, MSG, sugars, artificial sweeteners, and food colors. Removing these foods from the diet in favor of wholesome, nutrient-dense food choices frequently improves mood. Assistance from a qualified natural health practitioner can be helpful.
Blood Sugar Fluctuations: Many of my depressive clients confirm that they are in the habit of skipping meals (like breakfast) or waiting long periods of time between eating. This confirms a suspicion that blood sugar imbalances are a factor in depression. Keep blood sugar levels balanced by eating a healthy snack or meal every two to three hours.
Essential Fats: Essential fatty acids are necessary to treat depression, as they are required to create healthy brain cells and are involved in regulating neurotransmitters—the brain hormones that balance mood including serotonin and oxytocin. Take 3000 mg daily of either fish or flax oils, or 500 mg of DHA or EPA, or a blend of both. Flaxseed oil is also a good source of essential fatty acids. Two tablespoons daily of flax oil can be helpful. You can pour flax oil over baked sweet potatoes or vegetables, or blend some into smoothies.

Digestion: Improving the body’s ability to extract nutrients from food can be helpful in treating depression naturally. Supplementing your diet with a high-quality full-spectrum digestive enzyme formula that includes the amylase, invertase, lactase, maltose, lipase, and protease, enzymes can be beneficial. One to three enzyme capsules or tablets with every meal help your body break down the carbohydrates, fats, and proteins in your food into natural sugars, essential fatty acids, and amino acids needed for optimal healing.

Nutrient Deficiencies: Because so many vitamins and minerals are involved with mood balancing, it is important that you address any possible deficiencies by taking a high-quality multivitamin and mineral supplement with meals.
Mood-Boosting B Vitamins: Additionally, because the B-complex vitamins are so vital for restoring balanced moods, an extra 100 mg B-complex supplement daily is often necessary in people suffering from depression.

Balancing Serotonin: As a precursor to serotonin, 5-HTP helps to restore healthy levels of this much needed brain chemical.  I usually use 50 to 100 mg of 5-HTP at bedtime for two months for people with depression.
Herbal Support: Despite one well-publicized study that demonstrated the ineffectiveness of St. John’s wort against severe depression, many research studies show that it is effective against mild and moderate depression, and it also helps raise serotonin levels in the brain. I recommend 900 to 1200 mg daily.  However, avoid taking St. John’s wort if you are taking pharmaceutical antidepressants, and do not take it within two to three hours of sunlight exposure.
Boosting Oxygen in the Brain: The herb gingko biloba helps bring more oxygen to the brain via the blood stream. Your brain needs oxygen to work properly. A beneficial dose for depression is 60 mg three times daily.
Regulating Brain Biochemistry:  S-Adenosylmethionine (SAMe) occurs naturally in the body and helps regulate certain biochemical reactions, including those linked to mood regulation; however it can be low in people suffering from depression. Four hundred to 1600 mg daily of SAMe to ensure your brain can make important mood elevating hormones.

Balancing Hormones: Supplementing with 2 to 4 grams of vitamin D daily can help with depression, because it helps the body make serotonin.
Sunlight: We all know that getting moderate amounts of sunshine helps boost mood. It’s no different with depression.
Exercise: People suffering from depression should also supplement their daily routines through more fresh air and physical activity. Exercise is a natural anti-depressant, and engaging in regular cardiovascular exercise like brisk walking or jogging is good for your body and mind.
Dehydration: And as always, drink lots of pure water to avoid dehydration, which is frequently a factor in depression.

source: Care2.com


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4 Tips for Safer Sunscreen

  • June 24, 2012


By Experience Life

While recent research shows that a little sun exposure each day may benefit your health, most experts suggest that you protect yourself if you plan to spend long stretches in the sun.
The problem is, many sunscreen products contain harmful chemicals, and some are not as effective as they seem, says Sonya Lunder, MPH, a senior analyst at the Washington, D.C.–based Environmental Working Group. To help you find a good sunscreen, Lunder offers this advice:

  • Beware a “50+” SPF. According to the FDA, no reliable research has shown that sun protection factors above 50 offer significantly better protection than those with a 50 SPF value. Such super-high-SPF products can lull you into a false sense of security.
  • Look for UVA protection on the label. Almost all sunscreens are great at blocking sunburn-causing UVB rays. But for protection against the far more damaging UVA rays, which can cause malignant melanoma (the most deadly form of skin cancer), choose mineral-based sunscreens rather than their chemical counterparts.
  • Avoid spray or powder sunscreens with titanium dioxide. Mineral-based sunscreens often contain titanium dioxide, which is considered potentially carcinogenic if it reaches the bloodstream. Because spray and powder sunscreens are more easily inhaled (and, hence, more directly accessible to the bloodstream), opt for lotions, which are considered safer, when choosing a mineral-based option.
  • Avoid oxybenzone. Stay away from sunscreens that contain this active ingredient, which has been linked to allergic reactions and potential hormone disruption. It is particularly harmful for children and has been linked to low infant birth weight.

If you want to see how the prod­ucts you already have in your cabinet stack up, visit the EWG Sunscreen Guide.

source: care2.com