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Image result for pills wikipedia All of us at some point or another have wondered if we can hold on to medicines past their expiration date, or do we need to throw them out? And if they're still good past the expiration date, how much past the expiration date? Well... the investigative journalism site ProPublica has been examining this issue, and they published an article saying researchers and the government find that many medicines may be good for YEARS past the expiration date. Yes - years!

According to people interviewed for the article, there are no documented cases of negative effects from taking expired drugs. However, while most medicines are fairly stable and last past the expiration date (they mention the exception of liquid medicines, the asthma inhalant albuterol, the topical rash spray diphenhydramine, and a local anesthetic made from lidocaine and epinephrine). Not mentioned, but there is also another one that degrades and can cause health problems such as Fanconi Syndrome: tetracycline. But other than those, it looks like many medicines are incredibly stable past the expiration date - especially when stored properly and in the original sealed containers. Do go read the whole article - it's eye-opening. Including the government's "Shelf Life Extension Program". Excerpts from ProPublica:

The Myth of Drug Expiration Dates

The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless. But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term “expiration date” was a misnomer. The dates on drug labels are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee their effectiveness, typically at two or three years. But the dates don’t necessarily mean they’re ineffective immediately after they “expire” — just that there’s no incentive for drugmakers to study whether they could still be usable.

What if the system is destroying drugs that are technically “expired” but could still be safely used? In his lab, Gerona ran tests on the decades-old drugs, including some now defunct brands such as the diet pills Obocell (once pitched to doctors with a portly figurine called “Mr. Obocell”) and Bamadex. Overall, the bottles contained 14 different compounds, including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers. The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations. “Lo and behold,” Cantrell says, “The active ingredients are pretty darn stable.”

....That raises an even bigger question: If some drugs remain effective well beyond the date on their labels, why hasn’t there been a push to extend their expiration dates? It turns out that the FDA, the agency that helps set the dates, has long known the shelf life of some drugs can be extended, sometimes by years. For decades, the federal government has stockpiled massive stashes of medication, antidotes and vaccines in secure locations throughout the country. The drugs are worth tens of billions of dollars and would provide a first line of defense in case of a large-scale emergency.

Maintaining these stockpiles is expensive. The drugs have to be kept secure and at the proper humidity and temperature so they don’t degrade. Luckily, the country has rarely needed to tap into many of the drugs, but this means they often reach their expiration dates. Though the government requires pharmacies to throw away expired drugs, it doesn’t always follow these instructions itself. Instead, for more than 30 years, it has pulled some medicines and tested their quality.

Once a drug is launched, the makers run tests to ensure it continues to be effective up to its labeled expiration date. Since they are not required to check beyond it, most don’t, largely because regulations make it expensive and time-consuming for manufacturers to extend expiration dates, says Yan Wu, an analytical chemist who is part of a focus group at the American Association of Pharmaceutical Scientists that looks at the long-term stability of drugs. Most companies, she says, would rather sell new drugs and develop additional products. Pharmacists and researchers say there is no economic “win” for drug companies to investigate further. They ring up more sales when medications are tossed as “expired” by hospitals, retail pharmacies and consumers despite retaining their safety and effectiveness.

That being said, it’s an open secret among medical professionals that many drugs maintain their ability to combat ailments well after their labels say they don’t.....In 1986, the Air Force, hoping to save on replacement costs, asked the FDA if certain drugs’ expiration dates could be extended. In response, the FDA and Defense Department created the Shelf Life Extension Program. Each year, drugs from the stockpiles are selected based on their value and pending expiration and analyzed in batches to determine whether their end dates could be safely extended. For several decades, the program has found that the actual shelf life of many drugs is well beyond the original expiration dates.

2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. Each of them had their expiration dates extended, on average, by more than four years, according to research published in the Journal of Pharmaceutical Sciences. Some that failed to hold their potency include the common asthma inhalant albuterol, the topical rash spray diphenhydramine, and a local anesthetic made from lidocaine and epinephrine, the study said. But neither Cantrell nor Dr. Cathleen Clancy, associate medical director of National Capital Poison Center, a nonprofit organization affiliated with the George Washington University Medical Center, had heard of anyone being harmed by any expired drugs. Cantrell says there has been no recorded instance of such harm in medical literature.

 The use of nanoparticles in foods is increasing every year, but we still know very little about whether they have health risks to humans, especially if one is eating foods with them daily (thus having chronic exposure). The nanoparticles in foods are ingredients so small that they are measured in nanometers or billionths of one meter. The most common nanoingredients are: titanium dioxidesilicon dioxide, and zinc oxide. Titanium dioxide is typically used as a "food coloring" to make foods whiter or brighter, but it may or may not be listed on the label. In Europe, this food additive is known as E171. Currently there are no restrictions on using titanium diaoxide nanoparticles in food.

Recent search suggests that there may be health effects from the nanoparticles in our food (here and here), thus we should be cautious. Evidence is accumulating that titanium dioxide nanoparticles can have a negative inflammatory effect on the intestinal lining. Similarly, a new study  looking at both mice and humans suggests that individuals with inflammatory intestinal conditions such as intestinal bowel disease (colitis and Crohn's disease) might have negative health effects from titanium dioxide nanoparticles - that they could worsen intestinal inflammation. Interestingly, the nanoparticles accumulated in spleens of mice used in the study. The researchers also found that levels of titanium were increased in the blood of patients with active colitis. From Science Daily:

Titanium dioxide nanoparticles can exacerbate colitis

Titanium dioxide, one of the most-produced nanoparticles worldwide, is being used increasingly in foodstuffs. When intestinal cells absorb titanium dioxide particles, this leads to increased inflammation and damage to the intestinal mucosa in mice with colitis. Researchers at the University of Zurich recommend that patients with colitis should avoid food containing titanium dioxide particles. The frequency of inflammatory bowel disease like Crohn's disease and ulcerative colitis has been on the rise in many Western countries for decades.... In addition to genetic factors, environmental factors like the Western lifestyle, especially nutrition, play an essential role in the development of these chronic intestinal diseases.

The research of Gerhard Rogler, professor of gastroenterology and hepatology at the University of Zurich, now shows that titanium dioxide nanoparticles can intensify the inflammatory reaction in the bodies of patients with inflammatory intestinal diseases. Titanium dioxide is a white pigment used in medicines, cosmetics and toothpaste and increasingly as food additive E171, for example, in icing, chewing gum or marshmallows. Until now, there have been no restrictions on its use in the food industry.

The scientists led by Gerhard Rogler concentrated their research on a protein complex inside cells: the NLRP3 inflammasome. This protein complex is part of the non-specific immune system, which detects danger signals and then triggers inflammation. If the inflammasome is activated by bacterial components, for example, and the inflammatory reaction plays a vital role in the defense against infective agents. In the same way, NLRP3 can be activated by small inorganic particles -- sometimes with negative consequences: If uric acid crystals form in the cells, for example the inflammation leads to gout.

The research team first studied the effect of inorganic titanium dioxide particles in cell cultures. They were able to show that titanium dioxide can penetrate human intestinal epithelial cells and macrophages and accumulate there. The nanoparticles were detected as danger signals by inflammasomes, which triggered the production of inflammatory messengers. In addition, patients with ulcerative colitis, whose intestinal barrier is disrupted, have an increased concentration of titanium dioxide in their blood. "This shows that these particles can be absorbed from food under certain disease conditions," Rogler says.

In a further step, the scientists orally administered titanium dioxide nanoparticles to mice, which serve as a disease model for inflammatory bowel disease. Here, as well, the particles activated the NLRP3 complex, which led to strong intestinal inflammation and greater damage to the intestinal mucosa in the mice. In addition, titanium dioxide crystals accumulated in the animals' spleens. Whether these findings will be confirmed in humans must now be determined in further studies. "Based on our results," Rogler concludes, "patients with an intestinal barrier dysfunction as found in colitis should abstain from foods containing titanium dioxide."  [Original study.]

 Image result for red meat, wikipedia Red meat allergies from a lone star tick bite? I first read about this a few years ago in Science Daily and it seemed pretty incredible - eat some red meat (beef, pork, or venison) and a few hours later have severe allergy symptoms such as itching, hives, swelling, shortness of breath, vomiting, and diarrhea. And the allergy starts after a person is bitten by a lone star tick.

A few years ago the red meat allergy seemed to occur only in the southeastern United States. But recently the severe red meat allergies are occurring in new places (such as Minnesota and Long island, NY) - so it appears that either the area where this tick lives is spreading or other species of ticks are also now causing this allergy. By the way, once a person has this allergy there is no cure, vaccine, or treatment other than avoiding red meat, treating the allergy symptoms, and carrying an EpiPen (just in case). It is also referred to as Alpha-Gal allergy syndrome because the allergy is to the sugar molecule commonly called alpha-gal which is found in red meat and some medications (such as the cancer drug cetuximab). From Wired:

OH, LOVELY: THE TICK THAT GIVES PEOPLE MEAT ALLERGIES IS SPREADING

First comes the unscratchable itching, and the angry blossoming of hives. Then stomach cramping, and—for the unluckiest few—difficulty breathing, passing out, and even death. In the last decade and a half, thousands of previously protein-loving Americans have developed a dangerous allergy to meat. And they all have one thing in common: the lone star tick.

Red meat, you might be surprised to know, isn’t totally sugar-free. It contains a few protein-linked saccharides, including one called galactose-alpha-1,3-galactose, or alpha-gal, for short. More and more people are learning this the hard way, when they suddenly develop a life-threatening allergy to that pesky sugar molecule after a tick bite.

Yep, one bite from the lone star tick—which gets its name from the Texas-shaped splash of white on its back—is enough to reprogram your immune system to forever reject even the smallest nibble of perfectly crisped bacon. For years, physicians and researchers only reported the allergy in places the lone star tick calls home, namely the southeastern United States. But recently it’s started to spread. The newest hot spots? Duluth, Minnesota, Hanover, New Hampshire, and the eastern tip of Long Island, where at least 100 cases have been reported in the last year. Scientists are racing to trace its spread, to understand if the lone star tick is expanding into new territories, or if other species of ticks are now causing the allergy.

Over the next few years Platts-Mills and his colleague Scott Commins screened more meat allergy patients and discovered that 80 percent reported being bitten by a tick.What’s more, they showed that tick bites led to a 20-fold increase in alpha-gal antibodies. Since ethics standards prevented them from attaching ticks to randomized groups of patients, this data was the best they could do to guess how meat allergy arises. Something in the tick’s saliva hijacks humans’ immune systems, red-flagging alpha-gal, and triggering the massive release of histamines whenever red meat is consumed.Researchers are still trying to find what that something is. 

Whatever it is, allergy researchers will be paying attention. Because, as far as anyone can tell, alpha-gal syndrome seems to be the only allergy that affects all people, regardless of genetic makeup. “There’s something really special about this tick,” says Jeff Wilson, an asthma, allergy, and immunology fellow in Platts-Mills’ group. Usually a mix of genes and environmental factors combine to create allergies. But when it comes to the lone star tick it doesn’t matter if you’re predisposed or not. “Just a few bites and you can render anyone really, really allergic,” he says.

 Lone star tick Credit: CDC Public Image Library

 The following is a study with weird results, really weird results. And it makes me think of all the times I've heard people joke: "just smelling food makes me gain weight", because we all knew it wasn't true. But what if it was true? .... The results of this study done in mice are that actually smelling the food one eats results in weight gain, and not being able to smell the food results in weight loss - even if both groups eat the same amount of food. And the "supersmellers" (those with a "boosted" sense of smell) gained the most weight of all.

What? How could that be? Yes, the study was done in mice, but perhaps it also applies to humans (the researchers think so). The researchers think  that the odor of what we eat may play an important role in how the body deals with calories - if you can't smell your food, you may burn it rather than store it. In other words, a link between smell and metabolism. Excerpts from Science Daily:

Smelling your food makes you fat

Our sense of smell is key to the enjoyment of food, so it may be no surprise that in experiments at the University of California, Berkeley, obese mice who lost their sense of smell also lost weight. What's weird, however, is that these slimmed-down but smell-deficient mice ate the same amount of fatty food as mice that retained their sense of smell and ballooned to twice their normal weight. In addition, mice with a boosted sense of smell—super-smellers—got even fatter on a high-fat diet than did mice with normal smell.

The findings suggest that the odor of what we eat may play an important role in how the body deals with calories. If you can't smell your food, you may burn it rather than store it. These results point to a key connection between the olfactory or smell system and regions of the brain that regulate metabolism, in particular the hypothalamus, though the neural circuits are still unknown. The new study, published this week in the journal Cell Metabolism, implies that the loss of smell itself plays a role, and suggests possible interventions for those who have lost their smell as well as those having trouble losing weight. "Sensory systems play a role in metabolism. Weight gain isn't purely a measure of the calories taken in; it's also related to how those calories are perceived," said senior author Andrew Dillin,...

The smell-deficient mice rapidly burned calories by up-regulating their sympathetic nervous system, which is known to increase fat burning. The mice turned their beige fat cells—the subcutaneous fat storage cells that accumulate around our thighs and midriffs - into brown fat cells, which burn fatty acids to produce heat. Some turned almost all of their beige fat into brown fat, becoming lean, mean burning machines. In these mice, white fat cells—the storage cells that cluster around our internal organs and are associated with poor health outcomes—also shrank in size. The obese mice, which had also developed glucose intolerance - a condition that leads to diabetes—not only lost weight on a high-fat diet, but regained normal glucose tolerance.

On the negative side, the loss of smell was accompanied by a large increase in levels of the hormone noradrenaline, which is a stress response tied to the sympathetic nervous system. In humans, such a sustained rise in this hormone could lead to a heart attack.

Dillin and Riera developed two different techniques to temporarily block the sense of smell in adult mice. .... In both cases, the smell-deficient mice ate as much of the high-fat food as did the mice that could still smell. But while the smell-deficient mice gained at most 10 percent more weight, going from 25-30 grams to 33 grams, the normal mice gained about 100 percent of their normal weight, ballooning up to 60 grams. For the former, insulin sensitivity and response to glucose - both of which are disrupted in metabolic disorders like obesity - remained normal.

Mice that were already obese lost weight after their smell was knocked out, slimming down to the size of normal mice while still eating a high-fat diet. These mice lost only fat weight, with no effect on muscle, organ or bone mass. The UC Berkeley researchers then teamed up with colleagues in Germany who have a strain of mice that are supersmellers, with more acute olfactory nerves, and discovered that they gained more weight on a standard diet than did normal mice[Original study.]

 Could probiotics be used to treat depression? The medical site Medscape reported on a very small preliminary study (only 10 people) that tested that idea, with findings that suggested that taking certain probiotics does help treat the symptoms of mild to moderate depression. The bacteria taken were Lactobacillus helveticus and Bifidobacterium longum (in the product Probio'Stick). Specifically, the symptoms of mood, anhedonia (inability to feel pleasure), and sleep disturbance were significantly reduced after probiotoc therapy.

Sounds great, yes? But ....just a few months ago a much larger study was published where people were randomly assigned to either a placebo group or the treatment group (the same 2 probiotics: Lactobacillus helveticus and Bifidobacterium longum). It was also "double-blind" - so no one knew who got the placebo or the treatment. And here the results were: the probiotics did NOT help the depression symptoms. This study found "no evidence that the probiotic formulation is effective in treating low mood, or in moderating the levels of inflammatory and other biomarkers".

Why the different results? Maybe the "placebo effect" was why the 10 person study had a positive effect. Wanting and thinking something works can definitely influence results. (This is why ideally studies are double-blind, randomized, and with a placebo.) Or was it because the study was done "in association" with the manufacturers of Probio'Stick? Yup, it's not surprising the manufacturer of a product finds a "positive effect" from its product. Bottom line: Be careful and critical when reading "study results".

However, after saying all that - there is a "gut-brain axis" in humans, and some researchers are examining whether probiotics can treat various symptoms such as anxiety (here and here). So perhaps some other probiotic bacteria might work to treat depression.

The problematic study from Medscape: Probiotics Promising for Mild to Moderate Depression

Probiotics may be effective in reducing core depressive symptoms in treatment-naive patients with a mild to moderate form of the disorder, results of a new pilot study suggest. Investigators led by Caroline Wallace, PhD candidate, Queen's University, Kingston, Ontario, Canada, found that symptoms of mood, anhedonia, and sleep disturbance were significantly reduced with probiotic therapy after just 4 weeks, with results maintained at 8 weeks..... The hypothesis is that the effects are mediated via the gut-brain axis by reducing inflammation and increasing serotonin levels.

To assess the efficacy of probiotics in treatment-naive patients with depression, the researchers carried out a pilot study using Probio'Stick, a probiotic supplement that combines two different strains known to act on the gut-brain axis ― Lactobacillus helveticus R0052 and Bifidobacterium longum R0175. The 8-week, single-arm, open-label intervention pilot study involved 10 treatment-naive patients with major depressive disorder who were experiencing a current episode of depression..... Next steps will be to confirm these findings in a double-blind, randomized, placebo-controlled trial of Probio'Stick. 

Same probiotic bacteria, but no effect from the treatment. From The Australian and New Zealand Journal of Psychiatry: A double-blind, randomized, placebo-controlled trial of Lactobacillus helveticus and Bifidobacterium longum for the symptoms of depression.

No significant difference was found between the probiotic and placebo groups on any psychological outcome measure or any blood-based biomarker.

This study found no evidence that the probiotic formulation is effective in treating low mood, or in moderating the levels of inflammatory and other biomarkers. The lack of observed effect on mood symptoms may be due to the severity, chronicity or treatment resistance of the sample; recruiting an antidepressant-naive sample experiencing mild, acute symptoms of low mood, may well yield a different result. Future studies taking a preventative approach or using probiotics as an adjuvant treatment may also be more effective. Vitamin D levels should be monitored in future studies in the area. The results of this trial are preliminary; future studies in the area should not be discouraged.

 A study of 60 million Americans 65 years old and older (the entire Medicare population) found that long-term exposure to airborne fine particulate matter (PM2.5) and ozone at concentrations below current national standards increases the risk of premature death ("all cause mortality") even when the levels are below current national standards. This effect was most pronounced among racial minorities and people with low income. The national standards are called National Ambient Air Quality Standards (NAAQS), and they are established by the U.S. Environmental Protection Agency (EPA).

Note that PM2.5 refers to fine particles in the air smaller than 2.5 micrometers - these are truly small particles. It is thought that these tiny particles contribute to the development of potentially fatal diseases various ways - by causing chronic inflammation, and also because they slip past the body's defenses and can be absorbed deep into the lungs and bloodstream. They are not sneezed or coughed out the way larger natural particles (like airborne soil and sand) are removed from the body's airways.

These study results are a strong argument in support of the view that our air needs to be protected and standards need to be strengthened - not loosened. Earlier posts on this topic have found links between air pollution (especially fine particulate matter smaller than 2.5 micrometers) and cognitive decline and dementia in older women, strokes, high blood pressure, an increase in death (especially cardiovascular disease), etc. From Medical Xpress:

Study of US seniors strengthens link between air pollution and premature death

A new study of 60 million Americans—about 97% of people age 65 and older in the United States—shows that long-term exposure to airborne fine particulate matter (PM2.5) and ozone increases the risk of premature death, even when that exposure is at levels below the National Ambient Air Quality Standards (NAAQS) currently established by the U.S. Environmental Protection Agency.

The Harvard T.H. Chan School of Public Health researchers found that men, blacks, and low-income populations had higher risk estimates from PM2.5 exposure compared with the national average, with blacks having mortality risks three times higher than the national average. The results showed that if the level of PM2.5 could be lowered by just 1 microgram per cubic meter (ug/m3) nationwide, about 12,000 lives could be saved every year. Similarly, if the level of ozone could be lowered by just 1 part per billion (ppb) nationwide, about 1,900 lives would be saved each year.

"This is a study of unprecedented statistical power because of the massive size of the study population. These findings suggest that lowering the NAAQS for fine particulate matter will produce important public health benefits, especially among self-identified racial minorities and people with low incomes," said Francesca Dominici, principal investigator of this study and professor of biostatistics at Harvard Chan School and co-director of the Harvard Data Science Initiative.

The researchers examined Medicare claims records of 60 million Americans 65+ over a seven-year period, representing 460 million person-years of follow-up. They also estimated air pollution levels at each 1 kilometer grid for the entire U.S. upon which the claims data could be overlaid and interpreted. .... By relying on this well-validated prediction model, the team was able to include subjects who live in unmonitored and less-populated areas so that the effects of air pollution on all 60 million people could be analyzed regardless of whether they lived in urban, suburban, or rural areas. "This study shows that although we think air quality in the United States is good enough to protect our citizens, in fact we need to lower pollution levels even further," said Schwartz. [Original study in New England Journal of Medicine.]

 Image result for white supplement pills wikipedia Depression treated by ordinary over-the-counter magnesium? A recent small study (112 people) found that 6 weeks of taking magnesium chloride (four 500 mg tablets daily) improved mild to moderate depression - and it improved it similarly in both those who were not taking any antidepressant medications and those taking antidepressants. Positive effects were seen within 2 weeks. There was also a reduction in anxiety symptoms. And interestingly, after 2 weeks of stopping magnesium supplementation, some of the positive effects were diminished (meaning it was cleared from the body). Age, and gender also didn't seem to make a difference, or whether the depression was mild or moderate.

The dosage taken of four 500 mg tablets of magnesium chloride daily is equivalent  to 248 mg of elemental magnesium. The researchers pointed out that it was tolerated well by everyone and that oral (taking it by mouth) magnesium supplementation is safe in adults with normal kidney function, who are not taking medications that interact with the supplement, and when the doses taken are below the "upper tolerable limit set by the Institute of Medicine of 350 mg elemental magnesium per day". Persons taking magnesium supplements also reported some positive physical effects - such as decreases in headaches and muscle cramps.

Now the study needs to be done in a larger group of people. Note that large doses of magnesium supplements can cause diarrhea (wasn't a problem in this study). A good safe way to boost magnesium intake is through foods. What foods are good sources of magnesium?  The National Institutes of Health (NIH) page on magnesium state that green leafy vegetables, such as spinach, legumes, nuts (especially almonds, cashews, peanuts), seeds, and whole grains are good sources. From Medical Xpress:

With health care cuts looming, low-cost magnesium a welcome option for treating depression

Depression presents an enormous disease burden, with a reported 350 million people worldwide suffering from the disease, but traditional SSRI treatments carry a burden of their own - in dollars and side effects. New clinical research published today in PLoS One shows that over-the-counter magnesium appears safe and effective to treat mild to moderate depression. Critical to such body functions as heart rhythm, blood pressure and bone strength, the mineral magnesium plays a role in combating inflammation in the body and has been proven to have an association with depression. However, few clinical trials have studied the supplement's effects.

Emily Tarleton, MS, RD, CD, a graduate student in Clinical and Translational Science and the bionutrition research manager in the University of Vermont's Clinical Research Center, and colleagues conducted a clinical trial of over-the-counter oral magnesium tablets for mild-to-moderate depression. Their results showed that magnesium is safe and effective and comparable to prescription SSRI treatments in effectiveness.

The researchers at the University of Vermont's Larner College of Medicine conducted an open-label, blocked, randomized cross-over trial involving 126 adults in outpatient primary care clinics. The study participants, who were currently experiencing mild-to-moderate depression, had a mean age of 52, with 38 percent of them male. Participants in the active arm of the study received 248 milligrams of elemental magnesium per day over six weeks, while those in the control arm received no treatment. Depression symptom assessments were conducted on all participants on a bi-weekly basis.

The study team found that in 112 participants with analyzable data, consumption of magnesium chloride for six weeks resulted in a clinically significant improvement in measures of depression and anxiety symptoms. In addition, these positive effects were shown quickly, at two weeks, and the supplements were well tolerated and similarly effective regardless of age, sex, or use of antidepressants, among other factors....Tarleton and colleagues say the next step is to see if their promising results can be replicated in a larger, more diverse population. [The original study.]

 I'm starting to see studies questioning whether some of the beneficial health effects that many attribute to vitamin D may actually be due to sunlight. In the first study, researchers said that sunlight also has low levels of "blue light" which energizes T cells. T cells are a type of white blood cell, are part of the immune system, and help protect the body from infection and cellular abnormalities (cancer). So the blue light in sunlight had a positive effect on the T cells.

The second study examined whether it was low levels of vitamin D that is linked to multiple sclerosis (which is the widely accepted medical view) or was it low exposure to sunlight? They found that vitamin D is not associated with multiple sclerosis risk in blacks or Hispanics (but is in whites). But sun exposure is protective in all three racial/ethnic groups (blacks, Hispanics, whites). Thus it was the sunlight that was important in protecting against multiple sclerosis rather than vitamin D. Bottom line: for various beneficial health reasons, go out in sunshine frequently (20 minutes a day is fine). Remember, sunlight is the "natural source" for vitamin D (the ultraviolet light hitting our bare skin allows us to make vitamin D).

From Dec. 2016 in Science Daily: Sunlight offers surprise benefit: It energizes infection fighting T cells

Sunlight allows us to make vitamin D, credited with healthier living, but a surprise research finding could reveal another powerful benefit of getting some sun. Georgetown University Medical Center researchers have found that sunlight, through a mechanism separate than vitamin D production, energizes T cells that play a central role in human immunity.

Their findings, published today in Scientific Reports, suggest how the skin, the body's largest organ, stays alert to the many microbes that can nest there. They specifically found that low levels of blue light, found in sun rays, makes T cells move faster -- marking the first reported human cell responding to sunlight by speeding its pace.

"T cells, whether they are helper or killer, need to move to do their work, which is to get to the site of an infection and orchestrate a response," Ahern says. "This study shows that sunlight directly activates key immune cells by increasing their movement."

"We know that blue light can reach the dermis, the second layer of the skin, and that those T cells can move throughout the body," he says. ...."We found that sunlight makes hydrogen peroxide in T cells, which makes the cells move. And we know that an immune response also uses hydrogen peroxide to make T cells move to the damage," Ahern says. "This all fits together." Ahern says there is much work to do to understand the impact of these findings, but he suggests that if blue light T cell activation has only beneficial responses, it might make sense to offer patients blue light therapy to boost their immunity.

From Medscape: Is It Time to Rethink Low Vitamin D as a Contributor to MS?

The idea that vitamin D deficiency may contribute to multiple sclerosis (MS) has been well established in the literature and has, for the most part, been etched into recent neurology dogma. Yet, research by Annette Langer-Gould, MD, PhD—a clinical assistant professor at the University of Southern California's Keck School of Medicine in Los Angeles—suggests that the association might not be that simple. ....As background, the vitamin D–multiple sclerosis hypothesis originated from the observation that the prevalence of MS increases with increasing distance from the Equator, as ultraviolet radiation (UVR) from the sun becomes less intense. But this is also where more white people live.

The main result of our study is that vitamin D is not associated with MS risk in blacks or Hispanics, regardless of genotype. In contrast, sun exposure is protective in all three racial/ethnic groups.

 This week a forceful statement paper was issued by more than 200 hundred scientists and health professionals expressing serious concerns about triclosan and triclocarban. This statement, called The Florence Statement on Triclosan and Triclocarban, asked that the use of these widely used antimicrobials be restricted due to their risks to human health, to wildlife, and its accumulation in water, land, wildlife, and humans. They stated that the negatives outweigh any benefits, and they also questioned the use of other antimicrobials (because they also have similar health and environmental concerns).

Not only do triclosan and triclocarban persist in the environment, they are also a source of toxic and carcinogenic compounds including dioxins, chloroform, and chlorinated anilines. They are endocrine disruptors that bioaccumulate (build-up) in humans and wildlife. They are toxic to aquatic and other organisms, yet they are found in the majority of people and freshwater streams. In other words, the chemicals are all around us and in us!

More than 2000 personal and consumer products, as well as building materials, contain triclosan and triclocarban. For example, they are found in soaps, toothpastes, detergents, clothing, toys, carpets, plastics, kitchen items, and paints. But the U.S. Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee have concluded, “No evidence is available to suggest that use of [antimicrobial-impregnated articles and consumer items bearing antimicrobial labeling] will make consumers and patients healthier or prevent disease”. According to the FDA, which is responsible for regulation of foods, drugs, cosmetics, medical devices, and similar products, there is no evidence that antibacterial soaps are more effective than nonantibacterial soap and water. So why is it in so many products? It's a marketing gimmick!

What should one do? Read labels and avoid products containing triclosan, triclocarban, or anti-microbials, and products labeled anti-odor, antibacterial, or anti-germ. No, you don't need antibacterial or anti-odor socks or cutting boards! See earlier posts on this topic (here, here, and here). From Environmental Health News:

Hundreds of scientists call for caution on anti-microbial chemical use

Two ingredients used in thousands of products to kill bacteria, fungi and viruses linger in the environment and pose a risk to human health, according to a statement released today by more than 200 scientists and health professionals. The scientists say the possible benefits in most uses of triclosan and triclocarban—used in some soaps, toothpastes, detergents, paints, carpets—are not worth the risk.

The statement, published today in the Environmental Health Perspectives journal, urges “the international community to limit the production and use of triclosan and triclocarban and to question the use of other antimicrobials.” They also call for warning labels on any product containing triclosan and triclocarban and for bolstered research of the chemicals' environmental toll.

The statement says evidence that the compounds are accumulating in water, land, wildlife and humans is sufficient to merit action. The chemicals are used to kills microbes such as bacteria and viruses that make people ill. However, both chemicals affect animals’ hormone systems, causing reproductive and development problems.  And there is nascent evidence that the impacts may extend to humans as well—having been linked to reduced growth of fetuses, earlier births, and lower head circumference in boys at birth.

U.S. manufacturers are phasing out triclosan from hand soaps after the Food and Drug Administration banned it last year amid concerns that the compound disrupted the body's hormone systems. The FDA noted in the restriction that antibacterial hand soaps were no more effective than non-antibacterial soap and water at preventing illness. .... More worrisome, Lindeman said some manufactures of personal care products are simply substituting other antimicrobials for triclosan—some of which may pose the same risks to people and the environment. Because of the widespread use, most people have some levels of triclosan in them. A 2008 study of U.S. residents found it in the urine of about 75 percent of people tested.

Once the compounds get into the environment, they don’t readily go away.  Researchers have detected triclosan and triclocarban in water and sediment all over the world—including drinking water, oceans and streams. The U.S. Geological Survey found triclosan in 60 percent of U.S. streams. Studies have shown triclosan toxic to some algae, fish and other crustaceans.

The compounds impact hormones in animal studies. And there’s evidence that they may do the same to developing babies. Properly functioning hormones are critical for babies’ proper development. Last month Brown University researchers reported that mothers’ triclosan exposure during pregnancy was linked to lower birth weights, smaller heads and earlier births. ...In addition to endocrine disruption concerns, Lindeman and other signers outline two other potential human health impacts from exposure to triclosan: heightened sensitivity to allergens, and antibiotic resistance. Large studies of children in the United States and Norway have linked triclosan to allergies and worsening asthma. And there is evidence bacteria that develop resistance to triclosan also become resistant to other antibacterial compounds.

 Should the results of this study determine what kind of coffee one drinks? Does it really make a difference? Eh...Not for me (because all coffee seems to be beneficial), but it might for you.

Studies show that daily drinking of coffee appears to have health benefits. Studies have linked coffee consumption with lower rates of cancer (here and here), cardiovascular disease, and diabetes. Coffee contains beneficial chemicals (such as caffeine and chlorogenic acid) that are antioxidant and anti-inflammatory, and could help fight chronic inflammatory diseases. It turns out that how much coffee beans are roasted changes how much chlorogenic acid they contain, but the amount of caffeine basically stays the same among the different roasting levels.

Researchers in Korea compared the caffeine and chlorogenic acid components of Arabica coffee beans at different roasting levels: Light, Medium, City, and French roast. They then tested various protective antioxidant and anti-inflammatory properties of the different coffee extracts in various "cell models" (meaning in the lab, not on real people). They found that chlorogenic acid levels were higher in light roasted coffee extract than the other roasted groups, and also light roasted coffee extract had the highest antioxidant activity. The results found that increasing degrees of roasting reduced antioxidant and anti-inflammatory activities.

From the Journal of Medicinal Food: Cellular Antioxidant and Anti-Inflammatory Effects of Coffee Extracts with Different Roasting Levels

During roasting, major changes occur in the composition and physiological effects of coffee beans. In this study, in vitro antioxidant effects and anti-inflammatory effects of Coffea arabica green coffee extracts were investigated at different roasting levels corresponding to Light, Medium, City, and French roast. Total caffeine did not show huge difference according to roasting level, but total chlorogenic acid contents were higher in light roasted coffee extract than other roasted groups. In addition, light roasted coffee extract had the highest antioxidant activity.... The expression of mRNA for tumor necrosis factor-alpha and interleukin-6 was decreased in cells treated with the coffee extracts and the expression decreased with increasing roasting levels. These data suggest that coffee has physiological antioxidant and anti-inflammatory activities and these effects are negatively correlated with roasting levels in the cell models.

Coffee is one of the most popular beverages worldwide. Increasing consumption of coffee is related to the pleasing taste and aroma, as well as its physiological effects. Coffee is proposed to exert beneficial effects against cancer, cardiovascular disease, obesity, and diabetes. Coffee contains phenolic compounds such as caffeic acid, chlorogenic acid, ferulic acid, vanillic acid, and other phytochemicals. The quality of coffee is significantly related to the roasting process.... During roasting, there are numerous changes in coffee bean compound profiles and the aroma is increased. Major changes in coffee bean composition occur during roasting as a result of the Maillard reaction..... Roasting markedly affects chlorogenic acid, leading to hydrolysis of chlorogenic acid. New compounds are formed during the roasting process; one of these is melanoidin. Its formation might alter the overall antioxidant capacity of coffee beans after roasting.

Coffee is a rich source of antioxidants that may contribute to prevention of oxidative stress-related diseases. The antioxidant properties of coffee may reflect the presence of both phenolic and nonphenolic bioactive compounds, such as caffeine and chlorogenic acids. Previous studies have shown that coffee has protective effects against oxidation and DNA damage in human cell models and has been shown to possess an in vitro antioxidant activity that lessens lipid peroxidation and neoplastic activity. 

Caffeine is the major component in coffee extract and has antioxidant property. Chlorogenic acid is another well-known efficient antioxidant in coffee extract; it was highest in Light roast coffee extract and highest with low roasting temperature and lowest in Dark roasted extract. Carbohydrates, protein, and chlorogenic acid are all decreased in coffee during the roasting process.... Caffeine contents showed no differences among roasting levels, but chlorogenic acid content decreased as roasting degree increased..... The effect of coffee roasting on the antioxidant properties of coffee extracts was investigated in several earlier studies; antioxidant capacity decreased in Dark roast coffee. The antioxidant property of coffee extracts prepared with different roasting levels was also determined in this study. The best antioxidant activity was evident in Light roast coffee extract and the lowest in French roast coffee.