The study researchers followed 30,000 women 25 to 64 over a period of 20 years, collecting information about personal sun exposure, activities like sunbathing (winter and summer), and asking whether they consciously chose “sun vacations” and if they used tanning beds. Except for tanning-bed users, just about everyone used sunblock, helpful to prevent sunburn and premature skin aging, but as we’ll soon see completely ineffective for skin cancer prevention.

Based on their own reporting, the 30,000 women were divided into five groups, ranging from Group 0 (deliberate avoidance of sun) to Group 4 (greatest sun exposure).

After 20 years, to everyone’s surprise, Group 4 was statistically the healthiest. They had developed the fewest chronic illnesses, especially heart disease, and had the lowest death rate. In Group 4, there was also a slightly higher rate of cancers of all types, but this was attributed to the fact that they were living longer than those in the other groups rather than to sun exposure itself.

As sun exposure declined, health stats worsened Group 0 (with the least sun exposure) had the highest amount of chronic illness and a death rate virtually equal to that of cigarette smokers. The authors’ startling conclusion: when it comes to serious health risks, sun avoidance joins obesity, smoking, and a sedentary life as a harbinger of ill health.

“But,” you’re tempted to splutter, “What about skin cancer? Aren’t these Group-4 bronzed goddesses dying of skin cancer?” It turned out that the five groups of women developed skin cancer about equally, but among those who got the potentially fatal skin cancer melanoma, those with the most sun exposure were the least likely to die from the disease. That curious fact is attributed to the higher vitamin D levels in Group 4. Melanoma patients with high levels of D have a lower rate of the cancer spreading throughout the body. Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort

And, when you just can’t get the amount of sun you require, there’s always the ability to add-in photobiomodulation.