Is It Tan O’Clock Yet?

How to avoid Vitamin D deficiency and skin cancer

When I was growing up in New York, I craved the hot weather and longed for tanning time in the sun. John Travolta and Olivia Newton-John’s song of Grease’s “Summer Nights” was my prelude for the season. Well, that was until I moved to the South and realized what summer was really like – LOL!

With summer naturally comes a lot of bright, sunny days and rays. Each year, we’re reminded to stock up on sunscreen, and many of us might opt for the higher SPFs to protect ourselves and family from harmful rays.

Protection from harmful sun exposure isn’t as simple as a higher number on the bottle, however. Even more so, we need some sun exposure to ensure we’re getting all the vitamins and nutrients we need to stay healthy and well. Today, we’re getting into the nitty-gritty of sun exposure do’s and don’ts, with practical tips for how you can stay safe in the sun this summer.

What are the benefits of sun exposure?

Spending adequate time in the sun each day is key to getting enough vitamin D. One of vitamin D’s core functions is assisting with cell division and proliferation, allowing our skin to stay healthy and repair itself when damaged or aging. A vitamin D deficiency has been connected to lower endurance, muscle weakness, and stress fractures, which can be expected from the decreased ability for cells to repair and reproduce.

There are more negative effects of little time in the sun, however; low levels of vitamin D have also been connected to increased depression in women, chronic pain, mood issues, fatigue, decreased immune function, and more. Getting sun exposure each day is important to unlocking your overall wellness; the trick is finding the balance of just enough sun exposure to get what you need in vitamin D.

It is generally recommended that folks with darker skin need more time in the sun – anywhere ranging from 30-45 minutes a day – as their skin is more protective against the sun’s rays. This is great for avoiding melanoma and skin cancers, but requires more time in the sun to get adequate vitamin D. If you are very pale or light skinned, less time in the sun is recommended per day (about 15-20 minutes), as lighter complexions are more susceptible to sunburn and skin cancers but require less time to absorb vitamin D.

How can the sun be harmful?

As we’ve been commonly taught, there are a number of risks with excessive sun exposure, namely painful sunburns and various forms of skin cancer. The National Cancer Institute has reported that the rates of skin cancer have nearly tripled since the 1970s, and the CDC reports about 8,000 people will pass away from some form of melanoma each year. Though skin cancer’s exact causes are hazy, it is clear that sun exposure contributes to its development.

There are two main rays from the sun that contribute to sunburns and skin cancer: UVA and UVB rays. UVB rays move into the more superficial layers of skin, and these are also the rays that provide vitamin D to our bodies. UVB rays are actually the main cause of sunburn, and consequently, most sunscreens are designed to protect mostly against these rays.

UVA rays, on the other hand, go into deeper layers of the skin. Research suggests that UVA rays are predominantly responsible for skin cancer, even though they don’t give you the uncomfortable sunburned splotches like UVB rays do. We run into trouble here because most sunscreens, especially in the United States, are not formulated to protect against UVA rays nearly as much as UVB rays.

When we don’t adequately protect ourselves from UVA rays, we put ourselves at risk of taking in too much of the harmful stuff from the sun, and potentially develop skin cancer down the line. Below, we’ve listed four tips to help you strike the tricky balance of avoiding vitamin D deficiency and skin cancer.

How can I enjoy the sun and protect myself?

Avoid high SPF sunscreens & sprays

SPF stands for sun protection factor, and if you’re shopping at Walmart on your way to the beach, chances are you’ll be inclined to buy a higher SPF sunscreen to feel more protected.

The number on your bottle of sunblock is not as reliable as it seems, however. A recent report from the Environmental Working Group (EWG) has found that, on average, most sunscreens provide around half (42 – 59%) of the UVB ray protection that their SPF suggests. In other words, they’re only about half as effective as they market themselves to be.

Even worse, the UVA ray protection was typically only 25% of the SPF on the bottle. As a recap, to prevent skin cancer, UVA protection is especially important, as those rays go deeper into the skin and have the potential to cause cancer over time.

With the lack of effective sunscreens, it’s important to avoid the ones which tout themselves as most effective, which is typically high SPF sunscreens. As the EWG outlines in their recent report on sunscreen, high SPF products, specifically 50+, give users a “false sense of security” for a variety of reasons. With higher SPF, there’s typically a lower level of UVA protection, a minimal reported increase in protection from sunburn (as little as 1% increase from SPF 50 to SPF 100), and overall increased health risks, as higher SPF sunscreens typically have much higher concentrations of chemicals. Sunscreens with SPF between 30-50 provide the protection you need.

In addition, the EWG recommends avoiding any spray sunscreens. They’re incredibly convenient, I know – I’m sad to let them go myself! But these aerosol sprays often include benzene, which is a recognized carcinogen by the FDA, CDC, and International Agency for Research on Cancer. Take your time and spread the screen rather than spray it!

Use different forms of sun protection

Another simple tip is to use a variety of forms of sun protection. If you’ve already been out for a few hours, go ahead and take some time in the shade. Opt to wear hats, beach cover-ups, or get shady under a beach umbrella. Getting out of the sun after substantial time in it is generally more effective than sunscreen, and exposes you to less side effects and chemicals!

Use EWG researched and recommended products

Before we dive into some product recommendations, if you want the full story on SPF, sunscreen, and skin cancer, check out the EWG’s 2022 Guide to Sunscreen, linked here.

We’ve gone through and picked out a few of their research-based recommendations, and have shared their link on Amazon (though they should be available through a wide variety of retailers). Opt for one of these more effective and less chemically concentrated products this summer!

Sport Sunscreen:

365 Everyday Value Sport Mineral Sunscreen Lotion, SPF 30
EWG Rating: 1/10 (1 Best, 10 Worst)

Buy on Amazon Here

Baby / Kids Sunscreen:

Pipette Mineral Sunscreen, SPF 50
EWG Rating: 1/10 (1 Best, 10 Worst)

Buy on Amazon Here

Babyganics Sunscreen Stick, SPF 50+
EWG Rating: 2/10 (1 Best, 10 Worst)

Buy on Amazon Here

Non-Mineral Sport Sunscreen:

Alba Botanica Hawaiian Sunscreen Lotion, Aloe Vera, SPF 30
EWG Rating: 2/10 (1 Best, 10 Worst)

Buy on Amazon Here

Facial Moisturizers with SPF:

Cocokind Daily Facial Sunscreen Lotion, SPF 32
EWG Rating: 2/10 (1 Best, 10 Worst)

Buy on Amazon Here

Is virtual care the key to better, more equitable health outcomes?


It wasn’t so long ago that the idea of taking a doctor’s appointment over Zoom was unfathomable — and even unappealing — to the bulk of consumers.

Times, of course, have changed.

In early 2020, just 7% of people in the U.S. had met with a healthcare provider virtually; by mid-2021, that number had jumped to 32%, according to a survey by Accenture. A quarter of respondents said their access to healthcare had improved since the onset of the pandemic, and more than 20% expressed interest in digital services.

“Through the past two years, people really got accustomed to remote services, really because they had to,” says Ellen Kelsay, CEO of Business Group on Health, a nonprofit that works with large employers to advocate for better solutions and innovation in healthcare. “But now we have to look at these solutions long-term, and make sure they are actually improving outcomes and reducing costs.”

The surge of tech-based solutions in healthcare has moved far beyond virtual visits. From advancements in remote patient monitoring to actual treatment delivered through new modalities, innovation continues to disrupt the healthcare space, bringing welcome change.

For folks battling chronic musculoskeletal (MSK) conditions, for example, Kaia Health is using technology in an effort to improve both access and care. The digital therapeutics company’s primary offering is an app that delivers virtual, artificial intelligence-based physical therapy. For a world that’s become accustomed to screen time, the offering is simple to adopt: log in on a smart device, prop it against a wall, and get to work. The day’s exercises will be demonstrated first, and once a user starts moving through the program, the app — with the help of the smart device’s camera — tracks 23 key points on the body, and will alert the user if they need to make any physical adjustments in real time.

“As it relates to MSK, in my mind, we’re achieving the holy grail of healthcare: delivering high quality care at reduced costs,” says Nigel Ohrenstein, president at Kaia Health, noting that the employer-provided program currently has 1.2 million active users. “You can’t do that by scaling people. You can only do that by scaling the tech piece with the human wrapper.”

That “human wrapper” is Kaia’s ability to connect patients with in-person treatment if necessary, even coordinating a session with a local provider in the user’s home. That can certainly appeal to anyone who favors human interaction. Still, Ohrenstein says, the benefits of digital therapies stretch well beyond convenience, and are positioned to create even greater change in healthcare.

“I happen to live in the Bronx, and the life expectancy there is five years less than it is a mile and a half south in Manhattan, and one of the reasons is access to cash and access to quality care,” Ohrenstein says. “But the thing about digital therapeutics is, the camera doesn’t distinguish between ethnicity, and it doesn’t distinguish between wealth. It doesn’t get tired, it doesn’t get irritated, it doesn’t go to check on the patient next door and leave you doing exercises alone.”

Kelsay agrees that technology has certainly boosted access to care for most populations, pushing the industry in the direction of more equitable treatment. But technology, she stresses, is not a quick or singular fix.

“Technology is one of many ways to deliver care, and it shouldn’t be a complete replacement for other delivery models,” she says. “Think of pockets of communities or rural locations where broadband is not widely accessible, or of individuals who may live in shelters, where a video visit won’t be comfortable for them. We have to keep a watchful eye on the embrace of technology and make sure we’re not overlooking any groups or communities.”

That’s where employers have plenty of power, she says. The pandemic forced consumers to get comfortable with digital care, but as we emerge from the COVID-19 crisis, there must be an impetus to keep improving.

“Employers are now asking a lot of hard questions of their vendor partners on outcomes and data before they implement solutions,” Kelsay says. “They’re being intentional about what their expectations are — and there’s a need and a hunger for serving unique populations.”

For Kaia’s part, they are looking to expand by finding new ways to serve and treat additional conditions and patient communities. In addition to its MSK solution, Kaia has also created a digital therapy to support people suffering from chronic obstructive pulmonary disease (COPD). The program is currently available in Germany and a U.S. rollout is expected in 2022. Unlike the MSK offering, which relies on visual tech capabilities, the COPD solution utilizes a smart device’s microphone to help a user strengthen lung health through breathing exercises.

That ease of use, as Ohrenstein sees it, is vital to get folks to embrace new technologies, and to stick with them. He’s seen firsthand the impact that can have on a patient’s progress, and is hopeful that Kaia — and the industry at large Kaia’s app will provide physical therapy instructions and offer corrections in real-time. — will continue on this trending path.

“I spoke to a patient and a Kaia user earlier, and she said it used to take her three hours to go back and forth to physical therapy, so she would go to two or three sessions and then stop,” Ohrenstein says. “But now, she’s a year into remaining highly compliant with our therapy because she can do it anytime that suits her. That’s putting her on a path to a better life with less pain and more mobility.”

Is That a Lion Coming My Way? Managing our Stress Responses

Imagine that you’re in the grassy plains a few thousand years back. You’re out alone, gathering plants, when you notice a looming figure in the distance – it’s a hungry lion! As you see it, it sees you. With no weapons on hand, in an instant, your body charges up and you’re sprinting to get back to your village. Your heart pumps faster to send more blood out to your arms and legs, allowing you to run more quickly and with more energy. Your respiration rate increases, bringing more oxygen into your body and powering you up further. You make it back to your village and find sanctuary with loved ones.  

This story is an example from a few thousand years ago and although we no longer have to run from lions, it illustrates how our nervous system evolved and the way our brain conceptualizes stress today.

What is the nervous system?

For starters, the nervous system is responsible for sending communications between the body and brain. It’s made up of miles and miles of nerve cells in our brain, spinal cord, and nerves extending throughout our body.

The brain sends signals through the nervous system to keep your heart beating, take a sip from your coffee cup, pet your dog’s head, and release different hormones throughout your body. The nervous system is how I am thinking of words to type and tapping my fingers on the keyboard right now!

With so many miles of nerves and a wide variety of functions, scientists organize the nervous system into many different subsystems. Only two of these are important for our discussion about stress today: the sympathetic and the parasympathetic nervous system.

The sympathetic and parasympathetic nervous system (NS) are a yin and yang of sorts. The sympathetic is responsible for activating the fight or flight response, while the parasympathetic sends cues to our body when it is safe to rest again.

What is the Fight or Flight response?

The sympathetic NS is often called the “fight or flight” system because it flips on the fight or flight response when a stressor arises. Whether you see a lion off in the distance or you receive a stressful text from your boss, your body responds with fight or flight.

In these moments, your brain signals to your body to either fight or flee. Your heart will start beating faster, your breathing rate will increase, and different hormones will start rushing throughout your body. All of this is a coordinated effort to send energy out to your muscles to fight or flee more effectively.

The fight or flight response was necessary to preserve the human race; we all need the help if we’re being chased by hungry predators.

The issue with fight or flight, however, is that it is still triggered in response to modern day stressors: receiving a hefty unexpected bill in the mail, having a difficult conversation with your partner, living in a 3-year pandemic, and more. 

In these situations, physically fighting or fleeing is rarely necessary or appropriate. When you have an intense text conversation with your boss, running away isn’t going to solve the issue, neither is challenging them to a duel.

Our bodies are constantly entering fight or flight mode, but we aren’t using the energy it supplies us. This “traps” many of us in fight or flight – our heart rates are increased, hormonal secretions are abnormal, and more. We are living with chronic stress and the myriad of poor health effects due to constant activation of the fight or flight response.

The situation isn’t hopeless, however. The good news is you can move yourself out of fight or flight without sprinting away from your stressors or entering into a fist fight.

How do I get out of Fight or Flight?

As I mentioned above, the parasympathetic nervous system (PNS) is responsible for moving you out of the fight or flight response. The PNS is often called the “rest and digest” system because it sends the energy from your muscles back into your daily activities like digestion and normal hormonal secretions.

In our lion example, the fight or flight response was turned off by a few different factors (these factors also turned on the parasympathetic nervous system):

  1. Movement. The fight or flight response evolved to do exactly what it says – fight or flee.

Physical activity – whether that’s walking, yoga, or working out – is a powerful way to replace fighting or fleeing. Because we are not literally fighting or fleeing in modern day, we need to release the energy pent up by the fight or flight response and signal to our body that it is safe to enter into a state of calm.

  1. Positive social connection. In the example, you made it back to the village and celebrated with loved ones.

Connecting with others – through physical affection, laughter, and gatherings – literally soothes the nervous system. It’s a signal to the PNS that you are safe and the fight or flight response is no longer needed.

One specific nerve acts as the on switch for the PNS: the vagus nerve. When you can activate the vagus nerve through physical activity or social connection, you can signal to your body that it is safe to rest and exit fight or flight.

In my next blog, we’re going deeper into the vagus nerve, and the many different ways you can activate it. Check back for more!

PS: If you want to learn more about this topic, check out the first chapter of the book Burnout: The Secret to Unlocking the Stress Cycle by Emily and Amelia Nagoski!

The 5-Minute Morning Routine for a Fantastic Day

“How you wake up each day dramatically affects your level of success in every single area of your life.” – Hal Elrod, Author

I listened to an interesting podcast on a 5-minute morning routine that anyone can implement and follow. The routine framework is based on Dr. Rangan Chatterjee’s book: Happy Mind, Happy Life: The New Science of Mental Well-Being.

Do you have a morning routine that is consistent and positive to kick off your day? Even if you do, read on for tips on how to make the most out of your morning coffee (or walk)…

Here are the highlights:

  • If you struggle with being consistent in the mornings, the goal isn’t about the routine but taking time for yourself to start the day GROUNDED. And believe it or not, 5 minutes is all you need to transition into the day.
  • We all know that changing behavior is hard so an easy way to implement a habit that will stick is via habit-stacking. According to Dr. BJ Fogg, author of Tiny Habits, stacking a new behavior on top of old ones will provide the impetus to do them. For example – use the time for brewing your morning cup-a-joe or taking the dog for a walk to do your 5-minute self-care ritual.

Here are the 3 Ms of the morning routine to include:  

M1: Mindfulness – 1-2 minutes:

  • Practice being in the present moment. The past or future are only ideas in your head. Enjoy the power of NOW.
  • Mindful breathing for 1-2 minutes is sufficient. Close your eyes. Notice your breath coming in and going out. Let thoughts and sounds come and go. Come back to the breath. Try some deep breaths – hold it and then exhale out. If you need guidance, try this video to follow along.
  • Even a minute of ‘falling still’ makes a difference in our lives.  Another falling still practice to try is to get sunshine on your face for 1-2 minutes to center the circadian rhythm for the rest of the day. 

M2: Movement – 1-2 minutes:

  • Do some squats while coffee is brewing. Or push ups if you are motivated.
  • The key is to wake up the body and get not only your blood flowing but also your lymphatic system. Unlike blood, our body does not have a pump for the lymphatic system so the primary way to move it is through exercise. Try squats, jumping jacks, push-ups or even dancing.
  • Here’s an exercise you can try. Grab a chair and practice getting up and sitting down without using your hands. Then try getting up with no hand movement and balancing on one foot.
  • Once you’ve mastered that, then try sitting down on the floor and getting up without using your hands to assist. This type of balance is key to longevity. This video shows how:

M3: Mindset – 1-2 minute:

  • For a positive mindset, try practicing gratitude. You can do this with journaling.
  • Or if you are not a fan of writing in journals, you can send a text or a short note and give gratitude to others. How about a nice memory of your time with a loved one and reminding them how much fun that was? Or thanking someone for a job well done – no matter how small.  
  • You can also read scripture, books, or whatever gets you into the positive mindset.

If you are worried that doing squats while walking the dog is going to look weird, remember what Dave Ramsey of The Ramsey Shows says: “If being broke is normal, I want to be weird for the rest of my life”. Weird is how you get to health – most of us are sedentary and overweight.  Our  population is sick and unhealthy – so we need to be weird. Gosh – how many times have I heard that? People think I’m nuts and beyond weird for all the things I’m doing to stay healthy and young. But my goal is to live well so that I can focus on the priorities in my life – family, leadership in business, friends and community.  

Try these techniques – you will notice how much impact 5 minutes can make to your day.  Remember that you have to come first so you can help others. Don’t jump into social media or into the priorities of others UNTIL you’ve taken time for your 5 minutes to ground yourself.

Here’s the podcast on the 5-minute morning routine.