Richard Weller: Could the sun be good for your heart?

Translator: Morton Bast Reviewer: Thu-Huong Ha

Translator: Intan Andini Reviewer: Made Pramana

Sebelum saya menjadi dokter kulit,

saya memulai dari kedokteran umum,

seperti kebanyakan dokter kulit di Inggris.

Waktu itu, saya pergi ke Australia,

sekitar 20 tahun lalu.

So, before I became a dermatologist,

Saat ke Australia, saya sadar

bahwa orang Australia sangat kompetitif.

I started in general medicine,

Dan mereka tak murah hati soal kemenangan.

as most dermatologists do in Britain.

At the end of that time, I went off to Australia,

Dan itu banyak terjadi:

“Orang Inggris, kalian tak bisa bermain kriket, rugbi.”

about 20 years ago.

What you learn when you go to Australia

Saya bisa menerima itu.

is the Australians are very competitive.

Tapi beralih ke pekerjaan --

dan tiap minggu kami adakan yang namanya klub jurnal,

And they are not magnanimous in victory.

And that happened a lot:

saat Anda duduk bersama dokter lain

"You pommies, you can't play cricket, rugby."

dan Anda akan mempelajari makalah ilmiah

yang berkaitan dengan kedokteran.

I could accept that.

Di minggu pertama, kami membahas kematian kardiovaskular,

But moving into work --

and we have each week what's called a journal club,

topik biasa -- berapa banyak yang meninggal karena penyakit jantung,

when you'd sit down with the other doctors

berapa tingkatnya.

and you'd study a scientific paper

Dan mereka berkata:

in relation to medicine.

“Orang Inggris, tingkat penyakit jantung kalian mengejutkan.”

And after week one, it was about cardiovascular mortality,

Dan tentu saja, mereka benar.

a dry subject -- how many people die of heart disease,

Orang Australia mempunyai penyakit jantung 1/3 lebih sedikit daripada kami --

what the rates are.

lebih sedikit kematian atas serangan jantung, gagal jantung,

And they were competitive about this:

"You pommies, your rates of heart disease are shocking."

lebih sedikit stroke --

umumnya mereka lebih sehat.

And of course, they were right.

Tentu mereka mengatakan ini karena

Australians have about a third less heart disease than we do --

kedudukan moral mereka baik, latihan mereka,

karena mereka orang Australia, kami orang Inggris lemah, dan sebagainya.

less deaths from heart attacks, heart failure, less strokes --

Namun bukan hanya Australia yang kesehatannya lebih baik dari Inggris.

they're generally a healthier bunch.

And of course they said this was because of

their fine moral standing, their exercise,

Di Inggris, ada gradien kesehatan --

because they're Australians and we're weedy pommies, and so on.

dan inilah yang disebut kematian standar,

pada dasarnya peluang Anda untuk mati.

But it's not just Australia that has better health than Britain.

Data ini diambil dari artikel sekitar 20 tahun lalu,

tapi datanya benar hari ini.

Within Britain, there is a gradient of health --

Membandingkan tingkat kematian Anda di 50 derajat utara --

and this is what's called standardized mortality,

itu daerah Selatan, itu London dan tempat-tempat --

basically your chances of dying.

menurut garis lintang, dan 55 derajat --

This is looking at data from the paper about 20 years ago,

berita buruknya ada di sini, Glasgow.

but it's true today.

Saya dari Edinburgh. Kabar buruknya, Edinburgh termasuk.

Comparing your rates of dying 50 degrees north --

that's the South, that's London and places --

(Tawa)

by latitude, and 55 degrees --

Jadi apa yang menyebabkan ruang mengerikan ini

the bad news is that's here, Glasgow.

di antara kita di sini di Skotlandia selatan

I'm from Edinburgh. Worse news, that's even Edinburgh.

dan daerah Selatan?

Sekarang, kita tahu soal rokok,

(Laughter)

Coklat Mars goreng, keripik -- diet Glasgow.

Semua hal ini.

So what accounts for this horrible space here

Tapi grafik ini setelah memperhitungkan

between us up here in southern Scotland

semua faktor risiko yang diketahui ini.

and the South?

Grafik ini setelah memperhitungkan merokok, kelas sosial, diet,

Now, we know about smoking,

deep-fried Mars bars, chips -- the Glasgow diet.

semua faktor risiko lain.

All of these things.

Kita disisakan dengan ruang yang hilang

But this graph is after taking into account

dari peningkatan kematian ini semakin jauh ke utara.

all of these known risk factors.

This is after accounting for smoking, social class, diet,

Sinar matahari, tentunya, berperan.

Dan vitamin D mendapat banyak tekanan,

all those other known risk factors.

We are left with this missing space

dan banyak orang mencemaskannya.

Kita butuh vitamin D. Kini anak-anak diwajibkan memilikinya di jumlah tertentu.

of increased deaths the further north you go.

Now, sunlight, of course, comes into this.

Nenek saya dibesarkan di Glasgow,

di tahun 1920-an dan 30-an ketika rakitis jadi masalah nyata

And vitamin D has had a great deal of press,

and a lot of people get concerned about it.

dan minyak ikan cod dibawa masuk.

And we need vitamin D. It's now a requirement that children have a certain amount.

Minyak ikan cod amat mencegah rakitis yang dulu umum di kota ini.

My grandmother grew up in Glasgow,

Saat masih kecil, saya diberi makan minyak ikan cod oleh nenek saya.

back in the 1920s and '30s when rickets was a real problem

Saya jelas -- tak ada yang melupakan minyak ikan cod.

and cod liver oil was brought in.

And that really prevented the rickets that used to be common in this city.

Namun ada asosiasi: makin tinggi kadar vitamin D dalam darah seseorang,

And I as a child was fed cod liver oil by my grandmother.

makin sedikit penyakit jantung yang dimiliki, makin sedikit kanker.

I distinctly -- nobody forgets cod liver oil.

Tampaknya ada banyak data menunjukkan vitamin D sangat baik bagi Anda.

But an association: The higher people's blood levels of vitamin D are,

Dan ia mencegah rakitis dan sebagainya.

Tapi jika Anda memberi orang suplemen vitamin D,

the less heart disease they have, the less cancer.

Anda tak mengubah tingkat penyakit jantung yang tinggi itu.

There seems to be a lot of data suggesting that vitamin D is very good for you.

Dan bukti suplemen mencegah kanker belum mendukung.

And it is, to prevent rickets and so on.

Saya usulkan bahwa vitamin D bukanlah satu-satunya yang penting.

But if you give people vitamin D supplements,

you don't change that high rate of heart disease.

Ia bukan satu-satunya alasan pencegahan penyakit jantung.

And the evidence for it preventing cancers is not yet great.

Kadar vitamin D yang tinggi, menurut saya, adalah penanda paparan sinar matahari,

So what I'm going to suggest is that vitamin D is not the only story in town.

dan paparan sinar matahari, dalam metode yang akan saya tunjukkan,

It's not the only reason preventing heart disease.

baik untuk penyakit jantung.

Lagi pula, saya kembali dari Australia,

High vitamin D levels, I think, are a marker for sunlight exposure,

meski risiko kesehatan saya jelas, saya pindah ke Aberdeen.

and sunlight exposure, in methods I'm going to show,

(Tawa)

Sekarang, di Aberdeen, saya memulai pelatihan dermatologi saya.

is good for heart disease.

Saya pun tertarik pada penelitian,

Anyway, I came back from Australia,

dan khususnya pada zat ini, nitrit oksida (NO).

and despite the obvious risks to my health, I moved to Aberdeen.

Ketiga pria di sini,

(Laughter)

Furchgott, Ignarro dan Murad,

memenangkan Hadiah Nobel untuk kedokteran pada 1998.

Now, in Aberdeen, I started my dermatology training.

But I also became interested in research,

Mereka orang pertama yang mendeskripsikan

and in particular I became interested in this substance, nitric oxide.

pemancar kimia baru ini, nitrit oksida.

Now these three guys up here,

Yang dilakukan nitrit oksida adalah melebarkan pembuluh darah,

Furchgott, Ignarro and Murad,

won the Nobel Prize for medicine back in 1998.

jadi ia menurunkan tekanan darah Anda.

Ia melebarkan arteri koroner, sehingga menghentikan angina.

And they were the first people to describe

this new chemical transmitter, nitric oxide.

Yang luar biasa tentangnya

yaitu dulu saat kita memikirkan pembawa pesan kimiawi di dalam tubuh,

What nitric oxide does is it dilates blood vessels,

so it lowers your blood pressure.

kita memikirkan hal-hal rumit seperti estrogen dan insulin,

It also dilates the coronary arteries, so it stops angina.

atau transmisi saraf.

Proses yang sangat kompleks dengan bahan kimia kompleks

And what was remarkable about it

was in the past when we think of chemical messengers within the body,

berkaitan dengan reseptor yang sangat kompleks.

Dan inilah molekul yang sangat sederhana ini,

we thought of complicated things like estrogen and insulin,

nitrogen dan oksigen yang saling menempel,

or nerve transmission.

Very complex processes with very complex chemicals

namun ini sangat penting untuk [tidak jelas] tekanan darah rendah kita,

that fit into very complex receptors.

untuk transmisi saraf, untuk banyak hal,

And here's this incredibly simple molecule,

tetapi terutama kesehatan jantung.

a nitrogen and an oxygen that are stuck together,

Saya memulai penelitian, dan kami menemukan, menariknya,

and yet these are hugely important for [unclear] our low blood pressure,

bahwa kulit menghasilkan nitrit oksida.

for neurotransmission, for many, many things,

Jadi itu tak hanya muncul di sistem kardiovaskular saja.

but particularly cardiovascular health.

Nitrit oksida muncul di kulit.

Nah, setelah menemukan dan menerbitkannya,

And I started doing research, and we found, very excitingly,

saya pikir, apa fungsinya?

that the skin produces nitric oxide.

Tekanan darah rendah di kulit?

Itu bukan hati. Apa yang dilakukannya?

So it's not just in the cardiovascular system it arises.

Saya pun ke Amerika, seperti orang lain saat akan penelitian,

It arises in the skin.

Well, having found that and published that,

dan saya habiskan beberapa tahun di Pittsburgh. Ini Pittsburgh.

I thought, well, what's it doing?

How do you have low blood pressure in your skin?

Dan saya tertarik dengan sistem yang sangat rumit ini.

It's not the heart. What do you do?

Kami pikir mungkin nitrit oksida memengaruhi kematian sel,

So I went off to the States, as many people do if they're going to do research,

cara sel bertahan hidup, dan ketahanannya pada hal lain.

and I spent a few years in Pittsburgh. This is Pittsburgh.

Dan awalnya saya mulai bekerja dalam kultur sel, menumbuhkan sel,

And I was interested in these really complex systems.

lalu saya memakai model tikus tak berdaya --

We thought that maybe nitric oxide affected cell death,

tikus yang tak bisa membuat gen.

Kami menemukan mekanisme, yang -- NO membantu sel bertahan hidup.

and how cells survive, and their resistance to other things.

And I first off started work in cell culture, growing cells,

Lalu saya pindah kembali ke Edinburgh.

and then I was using knockout mouse models --

Di Edinburgh, hewan percobaan kami mahasiswa kedokteran.

mice that couldn't make the gene.

We worked out a mechanism, which -- NO was helping cells survive.

Ia spesies yang dekat dengan manusia,

dengan keunggulan dibanding tikus:

Mereka gratis, tak harus dicukur, mereka memberi makan diri sendiri,

And I then moved back to Edinburgh.

dan tak ada yang jaga kantor sambil berkata,

And in Edinburgh, the experimental animal we use is the medical student.

"Selamatkan mahasiswa lab kedokteran."

It's a species close to human,

Mereka memang model ideal.

with several advantages over mice:

They're free, you don't shave them, they feed themselves,

Tapi kami menemukan

kami tak bisa mereproduksi pada manusia, data yang ditunjukkan pada tikus.

and nobody pickets your office saying,

"Save the lab medical student."

Sepertinya kami tak bisa mematikan produksi

So they're really an ideal model.

nitrit oksida di kulit manusia.

But what we found

was that we couldn't reproduce in man the data we had shown in mice.

Kami oleskan krim yang memblokir enzim yang membuatnya,

kami menyuntikkan sesuatu. Kami tak bisa mematikan nitrit oksida.

It seemed we couldn't turn off the production

Dan alasannya, ternyata, setelah dua atau tiga tahun bekerja,

of nitric oxide in the skin of humans.

adalah karena di kulit kita terdapat simpanan yang sangat besar

We put on creams that blocked the enzyme that made it,

we injected things. We couldn't turn off the nitric oxide.

bukan dari nitrit oksida, karena nitrit oksida adalah gas,

dan ia dilepaskan -- dan dalam beberapa detik ia menghilang,

And the reason for this, it turned out, after two or three years' work,

tapi ia bisa diubah menjadi bentuk nitrit oksida ini --

was that in the skin we have huge stores

nitrat, NO3; nitrit, NO2; nitrosothiol.

not of nitric oxide, because nitric oxide is a gas,

Dan ini lebih stabil,

and it's released -- (Poof!) -- and in a few seconds it's away,

dan kulit Anda memiliki simpanan NO yang sangat besar.

but it can be turned into these forms of nitric oxide --

Kami lalu berpikir, dengan simpanan besar itu,

nitrate, NO3; nitrite, NO2; nitrosothiols.

saya ingin tahu apakah sinar matahari bisa mengaktifkan simpanan itu

And these are more stable,

dan melepaskannya dari kulit,

and your skin has got really large stores of NO.

di mana simpanan sekitar 10 kali lebih besar dari yang beredar.

And we then thought to ourselves, with those big stores,

Bisakah matahari mengaktifkan simpanan itu ke dalam sirkulasi,

I wonder if sunlight might activate those stores

dan di sana sirkulasi melakukan hal baik bagi sistem kardiovaskular Anda?

and release them from the skin,

where the stores are about 10 times as big as what's in the circulation.

Saya ahli dermatologi eksperimental,

kami lakukan yang kiranya

Could the sun activate those stores into the circulation,

kami harus memaparkan hewan percobaan kami ke sinar matahari.

and there in the circulation do its good things for your cardiovascular system?

Jadi yang kami lakukan ialah kami ambil sekelompok sukarelawan

Well, I'm an experimental dermatologist,

dan kami paparkan mereka pada sinar ultraviolet.

so what we did was we thought

Jadi ini semacam lampu matahari.

we'd have to expose our experimental animals to sunlight.

Yang kami lakukan hati-hati adalah,

vitamin D dibuat oleh sinar ultraviolet B

And so what we did was we took a bunch of volunteers

dan kami ingin memisahkan kisah kami dari kisah vitamin D.

and we exposed them to ultraviolet light.

Jadi kami gunakan ultraviolet A, yang tak menghasilkan vitamin D.

So these are kind of sunlamps.

Now, what we were careful to do was,

vitamin D is made by ultraviolet B rays

Saat kami menempatkan orang di bawah lampu

yang setara sekitar 30 menit sinar matahari musim panas di Edinburgh,

and we wanted to separate our story from the vitamin D story.

So we used ultraviolet A, which doesn't make vitamin D.

yang dihasilkan ialah, kami menghasilkan peningkatan

nitrit oksida yang bersirkulasi.

When we put people under a lamp

Jadi kami tempatkan pasien dengan subjek ini di bawah UV,

for the equivalent of about 30 minutes of sunshine in summer in Edinburgh,

dan tingkat NO mereka naik,

dan tekanan darah mereka turun.

what we produced was, we produced a rise

Tidak banyak, sebagai tingkat individu,

in circulating nitric oxide.

tapi cukup pada tingkat populasi

So we put patients with these subjects under the UV,

untuk menggeser tingkat penyakit jantung di seluruh populasi.

and their NO levels do go up,

and their blood pressure goes down.

Saat kami menyinari mereka sinar UV,

Not by much, as an individual level,

atau saat kami hangatkan mereka ke tingkat yang sama dengan lampu,

but enough at a population level

tapi tak biarkan sinarnya mengenai kulit, hal ini tak terjadi.

to shift the rates of heart disease in a whole population.

Jadi sepertinya ini ciri sinar ultraviolet yang mengenai kulit.

And when we shone UV at them,

or when we warmed them up to the same level as the lamps,

Kami masih mengumpulkan data.

Beberapa hal bagus di sini:

Tampaknya ini lebih ditandai pada orang tua.

but didn't actually let the rays hit the skin, this didn't happen.

Saya tak yakin berapa banyak.

So this seems to be a feature of ultraviolet rays hitting the skin.

Salah satu subjek di sini ibu mertua saya,

dan jelas saya tak tahu usia beliau.

Now, we're still collecting data.

Tapi yang pasti pada orang yang lebih tua dari istri saya,

A few good things here:

This appeared to be more marked in older people.

ini tampaknya menjadi efek yang lebih nyata.

I'm not sure exactly how much.

Yang juga harus disebutkan

One of the subjects here was my mother-in-law,

adalah tidak ada perubahan pada vitamin D.

and clearly I do not know her age.

Ini terpisah dari vitamin D.

But certainly in people older than my wife,

Vitamin D baik, menghentikan rakitis,

mencegah metabolisme kalsium, hal-hal penting.

this appears to be a more marked effect.

Tapi ini mekanisme yang terpisah dari vitamin D.

And the other thing I should mention

was there was no change in vitamin D.

Satu masalah saat meneliti tekanan darah ialah

tubuh Anda melakukan segalanya

This is separate from vitamin D.

untuk menjaga tekanan darah Anda.

So vitamin D is good for you -- it stops rickets,

Jika kaki dipotong, Anda kehilangan darah,

it prevents calcium metabolism, important stuff.

But this is a separate mechanism from vitamin D.

tubuh Anda akan tertekan, detak jantung meningkat,

lakukan segalanya menjaga tekanan darah tetap tinggi.

Now, one of the problems with looking at blood pressure

Itulah prinsip fisiologis yang sangat mendasar.

is your body does everything it can

to keep your blood pressure at the same place.

Jadi yang kami lakukan selanjutnya

If your leg is chopped off and you lose blood,

adalah beralih meneliti dilatasi pembuluh darah.

your body will clamp down, increase the heart rate,

Kami mengukur -- sekali lagi,

do everything it can to keep your blood pressure up.

perhatikan tak ada ekor dan bulu, dia mahasiswa kedokteran.

That is an absolutely fundamental physiological principle.

So what we've next done

Di lengan, Anda bisa mengukur aliran darah di lengan

is we've moved on to looking at blood vessel dilatation.

dengan berapa banyak darah yang membengkak saat darah mengalir ke dalamnya.

So we've measured -- this is again,

notice no tail and hairless, this is a medical student.

Dan yang kami tunjukkan adalah melakukan penyinaran palsu --

ini garis tebal di sini --

ini UV yang bersinar di lengan hingga menghangatkan

In the arm, you can measure blood flow in the arm

tapi tetap menutupinya agar sinarnya tak mengenai kulit.

by how much it swells up as some blood flows into it.

Tak ada perubahan aliran darah, pada pelebaran pembuluh darah.

And what we've shown is that doing a sham irradiation --

Tapi penyinaran aktif,

this is the thick line here --

selama UV dan satu jam setelahnya,

this is shining UV on the arm so it warms up

but keeping it covered so the rays don't hit the skin.

terjadi pelebaran pembuluh darah.

There is no change in blood flow, in dilatation of the blood vessels.

Inilah mekanisme di mana Anda menurunkan tekanan darah,

di mana Anda juga melebarkan arteri koroner,

But the active irradiation,

agar darah mensuplai jantung.

during the UV and for an hour after it,

Jadi di sini, data lebih lanjut tentang ultraviolet -- yaitu sinar matahari --

there is dilation of the blood vessels.

This is the mechanism by which you lower blood pressure,

memiliki manfaat pada aliran darah dan sistem kardiovaskular.

by which you dilate the coronary arteries also,

to let the blood be supplied with the heart.

Jadi rasanya kami hanya akan membuat model --

So here, further data that ultraviolet -- that's sunlight --

Jumlah UV berbeda menghantam bagian bumi berbeda di waktu berbeda sepanjang tahun,

has benefits on the blood flow and the cardiovascular system.

jadi Anda sungguh bisa menghitung simpanan nitrit oksida itu --

So we thought we'd just kind of model --

nitrat, nitrit, nitrosothiol di kulit --

Different amounts of UV hit different parts of the Earth at different times of year,

membelah demi melepaskan NO.

Panjang gelombang cahaya berbeda memiliki aktivitas berbeda dalam melakukannya.

so you can actually work out those stores of nitric oxide --

Lihat panjang gelombang cahaya yang melakukannya.

the nitrates, nitrites, nitrosothiols in the skin --

Lihatlah -- jika Anda tinggal di ekuator, matahari tepat di atas kepala,

cleave to release NO.

ia melalui sedikit atmosfer yang tipis.

Different wavelengths of light have different activities of doing that.

Di musim dingin atau musim panas, jumlah cahayanya sama.

Jika Anda tinggal di sini, di musim panas

So you can look at the wavelengths of light that do that.

And you can look -- So, if you live on the equator, the sun comes straight overhead,

matahari akan langsung turun,

tetapi di musim dingin ia datang melalui sejumlah besar atmosfer,

it comes through a very thin bit of atmosphere.

In winter or summer, it's the same amount of light.

dan sebagian besar ultraviolet disingkirkan,

If you live up here, in summer

dan rentang panjang gelombang yang menghantam bumi

the sun is coming fairly directly down,

berbeda dari musim panas ke musim dingin.

but in winter it's coming through a huge amount of atmosphere,

Anda bisa mengalikan data itu

dengan NO yang dirilis

and much of the ultraviolet is weeded out,

dan Anda bisa menghitung berapa banyak nitrit oksida

and the range of wavelengths that hit the Earth

yang akan dilepaskan dari kulit ke dalam sirkulasi.

are different from summer to winter.

Jika Anda berada di ekuator di sini --

So what you can do is you can multiply those data

yaitu dua garis ini, garis merah dan garis ungu --

by the NO that's released

and you can calculate how much nitric oxide

jumlah nitrit oksida yang dilepaskan adalah area di bawah kurva,

would be released from the skin into the circulation.

area di ruang ini.

Now, if you're on the equator here --

Jika Anda berada di khatulistiwa, Desember atau Juni,

that's these two lines here, the red line and the purple line --

Anda mendapat NO besar-besaran dilepaskan dari kulit.

the amount of nitric oxide that's released is the area under the curve,

Jadi Ventura berada di California selatan.

Di musim panas, Anda mungkin berada di ekuator.

it's the area in this space here.

Sangat bagus. Banyak NO dilepaskan.

So if you're on the equator, December or June,

Ventura pertengahan musim dingin, yah, masih ada jumlah yang lumayan.

you've got masses of NO being released from the skin.

Edinburgh di musim panas, area di bawah kurva cukup bagus,

So Ventura is in southern California.

In summer, you might as well be at the equator.

tapi Edinburgh di musim dingin, jumlah NO yang bisa dilepaskan

It's great. Lots of NO is released.

Ventura mid-winter, well, there's still a decent amount.

hampir tak ada, jumlahnya kecil.

Edinburgh in summer, the area beneath the curve is pretty good,

Jadi apa yang kami pikirkan?

Kami masih mengerjakan ini,

but Edinburgh in winter, the amount of NO that can be released

kami masih mengembangkan dan memperluasnya.

Kami pikir ini sangat penting.

Ini mungkin menjelaskan alasan kesenjangan kesehatan utara-selatan di Inggris.

is next to nothing, tiny amounts.

Ini relevan bagi kita.

So what do we think?

Kami berpikir bahwa kulit --

We're still working at this story,

kita tahu bahwa kulit punya simpanan nitrit oksida

we're still developing it, we're still expanding it.

yang sangat besar dalam berbagai bentuk lainnya.

We think it's very important.

We think it probably accounts for a lot of the north-south health divide within Britain,

Kami duga banyak yang berasal dari makanan,

sayuran berdaun hijau, gula bit, selada

It's of relevance to us.

memiliki banyak nitrit oksida yang kami pikir masuk ke kulit.

We think that the skin --

well, we know that the skin has got very large stores

Kami pikir mereka lalu disimpan di kulit,

of nitric oxide as these various other forms.

dan kami pikir sinar matahari melepaskannya

We suspect a lot of these come from diet,

di mana ia memiliki efek yang umumnya menguntungkan.

green leafy vegetables, beetroot, lettuce

Ini yang masih dikerjakan, tapi dokter kulit --

has a lot of these nitric oxides that we think go to the skin.

maksud saya, saya dokter kulit.

We think they're then stored in the skin,

Tugas saya memberitahu, “Anda punya kanker kulit,

and we think the sunlight releases this

penyebabnya sinar matahari, jangan berjemur."

where it has generally beneficial effects.

Saya kira pesan yang jauh lebih penting

And this is ongoing work, but dermatologists --

ialah ada manfaat serta risiko dari sinar matahari.

I mean, I'm a dermatologist.

Ya, sinar matahari faktor risiko utama yang bisa diubah untuk kanker kulit,

My day job is saying to people, "You've got skin cancer,

it's caused by sunlight, don't go in the sun."

I actually think a far more important message

tapi kematian akibat penyakit jantung 100 kali lebih tinggi

is that there are benefits as well as risks to sunlight.

dibanding kematian akibat kanker kulit.

Dan saya pikir kita perlu lebih waspada,

Yes, sunlight is the major alterable risk factor for skin cancer,

dan juga menemukan rasio risiko-manfaat.

Berapa banyak sinar matahari yang aman,

but deaths from heart disease are a hundred times higher

dan bagaimana kita bisa mengatur yang terbaik bagi kesehatan secara umum?

than deaths from skin cancer.

And I think that we need to be more aware of,

Jadi, terima kasih banyak.

(Tepuk tangan)

and we need to find the risk-benefit ratio.

How much sunlight is safe,

and how can we finesse this best for our general health?

So, thank you very much indeed.

(Applause)