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More bad news about BPA (bisphenol A) - an endocrine disrupter linked to a number of health problems, including reproductive disorders (here, here, and here). A new study has lent support for a  link between bisphenol A (BPA) exposure during pregnancy and later breast cancer. BPA can cross the placenta in the womb, and so expose the fetus, it has been found in placental tissue, and newborns can be exposed through breastfeeding. BPA is found in the urine of about 95% of the U.S. population.

It's hard to avoid BPA because it's found in so many products, but a person can lower exposure to it by avoiding canned products (it's in the can linings), as well as plastic bottles and containers, microwaving or heating food in plastic containers, and fast food (it's in the packaging and leaches into the food) . Glass and stainless steel is OK for storing food. By the way, BPA substitutes such as BPS  and BPSIP have the same negative health effects (because they're chemically similar) - so also avoid "BPA-free" products. From Endocrine News;

A Pervasive Threat: The Danger of in utero BPA Exposure

A new study presented at ENDO [Endocrine Society] 2016 revealed a possible link between bisphenol A exposure in utero to breast cancer later in life. In the process, the researchers created a new bioassay that can test chemicals much faster than typical animal studies. Almost every single person alive today has detectable amounts of endocrine-disrupting chemicals (EDCs) in his or her body, according to the 2015 joint Endocrine Society/IPEN publication Introduction to Endocrine Disrupting Chemicals (EDCs): A Guide for Public Interest Organizations and Policy-Makers.

These EDCs — phthalates (plasticizers), bisphenol A (BPA), polychlorinated biphenyls (PCBs), and others, in their bodies — are hormone-like industrial chemicals that did not even exist 100 or so years ago. Studies on human populations consistently demonstrate associations between the presence of certain chemicals and higher risks of endocrine disorders such as impaired fertility, diabetes, obesity, cardiovascular disorders, and cancer.

The xenoestrogen BPA is especially prevalent as a component used in rigid plastic products such as compact discs, food and beverage containers, food and formula can linings, and glossy paper receipts. In the case of food containers, when they are heated or scratched, the BPA can seep out into the food and then be ingested. BPA also escapes from water pipes, dental materials, cosmetics, and household products among others and is released into the environment or directly consumed. According to research, such exposures help account for why BPA has been found in the urine of a representative sample of 95% of the U.S. population.

Notably, BPA can cross the placenta in the womb, indirectly exposing the fetus — it has been found in both maternal and fetal serum as well as neonatal placental tissue. Newborns can also be directly exposed through breastfeeding.

The results of a study presented at ENDO 2016 provide compelling support for the idea that fetal exposure to BPA might increase risk for development of breast cancer in adulthood; in fact, it may explain why overall incidence increased in the 20th century. Lucia Speroni, PhD, a research associate and member of the Soto-Sonnenschein lab at Tufts University School of Medicine in Boston and the study’s lead investigator, reports, “We found that BPA acts directly on the mammary gland and that this effect is dose dependent: A low dose significantly increased ductal growth, whereas a high dose decreased it.”

“Because these effects are similar to those found when exposing the fetus through its mother, our experiment suggests that BPA acts directly on the fetal mammary gland, causing changes to the tissue that have been associated with a higher predisposition to breast cancer later in life,” Speroni explains. In replicating the process of mammary gland development in vitro, this method additionally allows for live observation throughout the whole process.....The lab team had previously shown that the most harmful time for exposure to BPA is during fetal development by causing alterations in the developing mammary gland.

Image result for calcium rich foods, wikipedia Once again, research shows that a supplement is not beneficial and may have some health harms, while eating foods rich in the mineral or vitamin being measured has health benefits. A ten year study found that calcium supplements are not beneficial and linked to health harm - they raised the risk of atherosclerosis, as measured by "coronary artery calcification" or plaque buildup in arteries, while a diet high in calcium rich foods was linked with health benefits (a protective effect). Other studies have found a higher risk for other health problems with calcium supplements (heart attacks, kidney stones, death),

Currently an estimated 43 percent of American adults take a supplement that includes calcium. Instead, for health benefits, focus on eating calcium rich foods. Some calcium rich foods are: dairy products (milk, cheese, yogurt, kefir), sardines, salmon, broccoli, collard greens, kale, edamame, figs, oranges, white beans, okra, tofu, and almonds. From Science Daily:

Calcium supplements may damage the heart

After analyzing 10 years of medical tests on more than 2,700 people in a federally funded heart disease study, researchers at Johns Hopkins Medicine and elsewhere conclude that taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appears be protective.

In a report on the research....the researchers caution that their work only documents an association between calcium supplements and atherosclerosis, and does not prove cause and effect. But they say the results add to growing scientific concerns about the potential harms of supplements....But our study adds to the body of evidence that excess calcium in the form of supplements may harm the heart and vascular system.

"The researchers were motivated to look at the effects of calcium on the heart and vascular system because studies already showed that "ingested calcium supplements -- particularly in older people -- don't make it to the skeleton or get completely excreted in the urine, so they must be accumulating in the body's soft tissues," says nutritionist John Anderson, Ph.D., professor emeritus of nutrition at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health and a co-author of the report. Scientists also knew that as a person ages, calcium-based plaque builds up in the body's main blood vessel, the aorta and other arteries, impeding blood flow and increasing the risk of heart attack.

Their study focused on 2,742 of these participants who completed dietary questionnaires and two CT scans spanning 10 years apart. The participants chosen for this study ranged in age from 45 to 84, and 51 percent were female. Forty-one percent were white, 26 percent were African-American, 22 percent were Hispanic and 12 percent were Chinese. At the study's onset in 2000, all participants answered a 120-part questionnaire about their dietary habits to determine how much calcium they took in by eating dairy products; leafy greens; calcium-enriched foods, like cereals; and other calcium-rich foods....The coronary artery calcium tests were repeated 10 years later to assess newly developing or worsening coronary heart disease.

Next, the investigators focused on the differences among those taking in only dietary calcium and those using calcium supplements. Forty-six percent of their study population used calcium supplements. The researchers.....found that supplement users showed a 22 percent increased likelihood of having their coronary artery calcium scores rise higher than zero over the decade, indicating development of heart disease....Among participants with highest dietary intake of calcium -- over 1,022 milligrams per day -- there was no increase in relative risk of developing heart disease over the 10-year study period.

Excerpts from the original study (Please note:  CVD = cardiovascular disease, CAC = coronary artery calcification) in the  Journal of the American Heart Association:  Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10‐Year Follow‐up of the Multi‐Ethnic Study of Atherosclerosis (MESA)

Recent evidence derived from randomized, controlled trials, including the Women's Health Initiative, have raised a concern for an association between calcium supplement use and increased risk for CVD events.12, 13, 14 Among calcium supplement users, a high intake of calcium greater than 1400 mg/day has been reported to be associated with higher death rates from all causes, including from CVD.15

The purported CVD risk associated with total calcium intake may depend on the source of calcium intake.3 Intake of calcium from food sources has not been shown to increase CVD risk, whereas a signal for increased risk of myocardial infarction (MI) among calcium supplement users has been reported.7 In a similar fashion, dietary calcium intake may decrease risk of kidney stones, whereas calcium supplementation may increase risk.16 One explanation for this apparent paradox may be that large boluses of calcium intake through supplements may transiently elevate serum calcium concentrations,17, 18 which, in turn, may lead to vascular calcification and other adverse health effects.

In summary, results from this long‐term study of 10 years showed a protective relationship between total calcium intake and incident coronary atherosclerosis, particularly among nonsupplement users. Even though mean total calcium intake in quintile 5 was greater than the upper limits of current recommendations, no increased risk of CAC progression was found, and the highest quintile of calcium intake actually had decreased risk of incident CAC among those without prevalent CAC at baseline. However, we found evidence that calcium supplement use was independently associated with incident CAC, whether or not we adjusted for total calcium intake.

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Image result My last post discussed Lactobacillus crispatus as an important bacteria for womens' vaginal health and as a possible treatment for bacterial vaginosis (BV) - a condition where the vaginal microbes are out of whack (dysbiosis). It appears that Lactobacillus crispatus may also be a possible treatment for women with urinary tract infactions (UTIs), a condition where again microbes are out of whack.

The bacteria Lactobacillus crispatus is part of the vaginal microbiome of many healthy women and thought to be protective. It is unknown whether L. crispatus would also work for men with UTIs.

In the US, the vaginal suppository product Lactin-V (containing the freeze dried human vaginal strain of L. crispatus CTV-050) is currently being tested for both bacterial vaginosis and recurring urinary tract infections (UTIs). So far there are positive results for this product (manufactured by Osel, Inc.) in phase 2 clinical trials, but it may be years away from FDA approval.

The following article excerpts are from April 2011, but these are still the most recent published research results for this probiotic (beneficial bacteria). The results are pretty convincing that beneficial bacteria might some day replace standard medical treatment (antibiotics) for UTIs.  The Lactin-V treatment in women with recurrent UTIs resulted in "robust and prolonged colonization with Lcrispatus" in the vagina, which resulted in reducing the incidence of UTIs by about 50%.

But...the results also showed that which strain of L. crispatus the women had was important - some women had lots of one strain of "endogenous" L. crispatus - naturally occurring in them - that was not protective. Or...it could be that other microbes that are not being looked at are also important.

Of course researchers are also looking at other beneficial bacteria and there has been more recent research. D-Mannose and cranberry supplements have also been found to be effective in treating UTIs of many women (see herehere, and here), as well as changing the urine's acidity through diet.

While studies typically focus on women, these other products also work for UTIs in men (D-Mannose and cranberry supplements seem to be especially effective). Looks like probiotics and alternative treatments (D-mannose, cranberry supplements, etc.) are the future in treating UTIs!

From Medscape: Pro biotic May Help Prevent Recurrent Urinary Tract Infection ...continue reading "Urinary Tract Infections and Lactobacillus Crispatus"

Image result Today I read an interesting article about bacterial vaginosis and research on bacteria that could finally treat it effectively. Bacterial vaginosis (BV) appears to be a problem with the microbial community of a woman's vagina being out of whack (dysbiosis). Common symptoms include increased white or gray vaginal discharge that often smells like fish, there may be burning with urination and sometimes itching, and the discharge has higher than normal vaginal pH (alkaline).

One bacteria that seems to be very important and beneficial for vaginal health is Lactobacillus crispatus. Research suggests that L. crispatus may be a treatment for both bacterial vaginosis and urinary tract infections. Currently the treatment for BV is a course of antibiotics, but the problem recurs frequently.

In the US, the vaginal product Lactin-V (containing the freeze dried human vaginal strain of L. crispatus CTV-05, and used as an vaginal suppository) is currently being tested (with so far positive results in phase 2 clinical trials) for both bacterial vaginosis and recurrent urinary tract infections (UTIs). But it may be years away from FDA approval. The biopharmaceutical company Osel Inc. is currently conducting research on this product, and as of May 2016 is recruiting women for a phase 2b clinical study of this product in the US.

Other sources that I know of for the bacteria L. crispatus are: the probiotic Ordesa DonnaPlus+Intimate Flora (manufactured in Spain) and NaturaMedicatrix LactoGyn Crispatus Bio (made in Luxembourg). However, these are different strains of L. crispatus than what has been successfully tested using Lactin-V. (It is unknown whether this makes a difference.) Both are meant to be taken orally (swallowed daily) - which may or may not be an effective way to get L. crispatus in the vagina (it is unknown which way works best).

Other probiotics, especially Lactobacillus species, may also benefit vaginal health. One way to get an idea of products women find helpful is to look at user comments after products listed on Amazon. (By the way - douches, sprays, wipes, deodorizers, and special soaps will not help bacterial vaginosis.... Not at all.).

The following article was written by science journalist Kendall Powell. Do click on the link and read the entire article to get an idea of the complexity of the problem, the role of various bacteria in vaginal health, other health problems that occur with BV, ethnic differences, and how certain bacteria can alter vaginal mucus (leaving women vulnerable to infection). It is clear that much is unknown, but it looks like vaginal health depends on a "healthy microbial community". Excerpts from Mosaic:

The superhero in your vagina

The aisle is marked with a little red sign that says “Feminine Treatments”. Squeezed between the urinary incontinence pads and treatments for yeast infections, there is a wall of bottles and packages in every pastel shade imaginable. Feminine deodorant sprays, freshening wipes, washes for your “intimate area”.

Vaginal odor might be the last taboo for the modern woman.....The companies behind these products know that many women are looking for ways to counter embarrassing and debilitating symptoms such as vaginal odor and discharge. The culprit is often bacterial vaginosis, the most common vaginal infection you’ve probably never heard of. Nearly one-third of US women of reproductive age have it at any given time. The sad truth is that these sprays, soaps and wipes will not fix the problem. They will – in many cases – actually make it worse.

But while women try to mask embarrassing smells, a more sinister truth also remains under cover: the bacteria responsible are putting millions of women, and their unborn babies, at risk from serious health problems. All of which is making researchers look anew at the most private part of a woman’s body, to understand what it means to have a healthy – some prefer “optimal” – vagina and why that is so important for wider health.

Compared with those of other mammals, the human vagina is unique. As warm, moist canals exposed to all sorts of things including penises, babies and dirt, most mammalian vaginas harbour a diverse mix of bacteria. However, for many women, one or another species of Lactobacillus has become the dominant bacterial resident. Lactobacillus bacteria pump out lactic acid, which keeps the vaginal environment at a low, acidic pH that kills or discourages other bacteria, yeast and viruses from thriving. There are even hints that certain Lactobacillus species reinforce the mucus in the vagina that acts as a natural barrier to invaders.

For the most part, we’ve been happily cohabitating ever since, but it’s a delicate balancing act. Normal intrusions to the vaginal environment, such as semen (which causes vaginal pH to rise) or menstruation, can reduce numbers of Lactobacillus and allow other microbes, including those associated with bacterial vaginosis (BV), to flourish.

Her doctor explained that BV is a disturbance of the natural balance of bacteria that live inside the vagina. Sex with someone new, having multiple partners, and douching – rinsing out the vagina with a bag or bottle of liquid – can all contribute to getting BV, but it is not classified as a sexually transmitted disease. Mostly, how a woman develops BV is still a big mystery.

And if the embarrassment and discomfort weren’t enough, BV has a far more menacing side. Women affected have a higher risk of contracting sexually transmitted infections (STIs) like gonorrhoea and chlamydia, acquiring and transmitting HIV, and having pelvic inflammatory disease (which can lead to infertility) and other vaginal and uterine infections. During pregnancy, BV gives a woman a greater chance of having a preterm birth or passing infections to her baby, both of which can lead to lifelong problems for the baby.

Holmes felt the syndrome should be renamed bacterial vaginosis, which loosely translates to “too much bacteria”. And fulfilling three of the four Amsel criteria – thin vaginal discharge, vaginal pH greater than 4.5, positive whiff test and clue cells – is still used by many doctors today to diagnose BV.

They are realising that all Lactobacillus bacteria – long thought to keep vaginas healthy – are not created equal. For some researchers, L. crispatus is emerging as the vagina’s superhero. It not only pumps out the best mix of two different types of lactic acid to keep the vagina inhospitable to other bugs, but it also fortifies a woman’s vaginal mucus to trap and keep at bay HIV and other pathogens.

In 2011, Larry Forney, an evolutionary ecologist at University of Idaho in Moscow, and Jacques Ravel, a microbial genomicist from the University of Maryland School of Medicine in Baltimore, sequenced the bacterial species found in the vaginas of nearly 400 North American women who didn’t have the symptoms of BV. They found five different types of bacterial community. Four of these were dominated by different Lactobacillus species, but the fifth contained a diverse mix of microbes (including Gardnerella, Sneathia, Eggerthella and Mobiluncus species), many of which have been associated with BV. 

The African studies leave researchers clamouring for better solutions for these women. Like others, van de Wijgert believes that the solution lies in getting the right bacteria to set up house in women’s vaginas. In 2014, she found that Rwandan sex workers with L. crispatus dominant in their vaginas were less likely to have HIV and other STIs. This bacterium may have even protected the clients of HIV-positive sex workers somewhat, because these women were also less likely to shed HIV in the vagina.

Image result Lactobacillus crispatus Credit: MicrobeWiki

Image result for yoga wikipedia A recent study found that yoga is as good as physical therapy in reducing chronic back pain in a diverse group of low-income patients. In those sticking with the program and attending the most yoga classes, yoga was better in the long-term than physical therapy and much better than just receiving educational advice about back pain. Both physical therapy and yoga reduced pain medication use by 20% at 12 weeks. These findings are supported by other research finding that yoga improves pain, function, reduces medication use, and practicing yoga long-term results in positive brain changes (such as more gray matter in the brain). From Medscape:

Yoga as Good as Physical Therapy for Back Pain

Yoga is as good as physical therapy (PT) in reducing chronic low back pain, the most common pain problem in the United States, new research shows. "Our study showed that yoga was noninferior to physical therapy for a diverse group of low-income patients," said Robert B. Saper, MD, director of integrative medicine, Boston Medical Center, Massachusetts. "Its effectiveness was most obvious in the most adherent patients." Dr Saper presented his study at the American Academy of Pain Management (AAPM) 2016 Annual Meeting. 

Previous research has shown that yoga improves pain and function and reduces medication use. For example, a 2013 meta-analysis demonstrated small to medium effect sizes for yoga in short-term and long-term back pain–related disability. Research also shows that PT is effective in treating patients with back pain. PT is considered a conventional therapy and is the most common nonpharmacologic referral by physicians for chronic low back pain, Dr Saper said. 

For this new study, researchers enrolled 320 adult patients from Boston-area community health centers who had chronic back pain with no obvious anatomic cause, such as spinal stenosis. The patients were predominantly nonwhite and low income, with a relatively low education level. The patients had "quite high" pain scores (average of 7 out of 10 on a pain scale) and were "quite disabled" in terms of their back pain, said Dr Saper. Almost three quarters were using pain medication, with about 20% taking opioids....Patients were randomly assigned to one of three groups: yoga, PT, or education.

To develop the structured yoga protocol, Dr Saper and his colleagues organized an expert panel, which reviewed the literature on the topic. The final product was a 75-minute weekly class with a very low student-to-teacher ratio. The classes began with short segment on yoga philosophy (nonviolence, moderation, self-acceptance). Participants were then given mats on which to do the simple yoga poses. They received a DVD to practice these at home. The PT group had 15 one-on-one 60-minute sessions that included aerobic exercise. PT personnel were trained to help coach patients on fear avoidance. The education group got a comprehensive book on back pain.

Both the PT and yoga sessions continued for 12 weeks, after which patients were followed to 52 weeks. During this postintervention period, patients in both the yoga and PT groups were randomly assigned to maintenance (drop in yoga classes or more PT sessions) or just at-home practice. Overall adherence was not great. The mean number of yoga classes and PT sessions attended during the initial phase was 7.

The primary question being addressed was whether yoga is not inferior to PT at 12 weeks. The study showed that for function (score on the Roland-Morris Disability Questionnaire), yoga and PT "are exactly the same, ie noninferior," said Dr Saper, adding that, "they are not terribly different from education at 12 weeks...."What that means is that for every two patients who go to yoga, about 50% of them are going to have a clinical response."....comparing the various interventions, "yoga is actually superior" to PT and is "quite a bit" superior to education, said Dr Saper. At baseline, about 70% of participants were using medication. At 12 weeks, such use was down by about 20% in both the yoga and PT groups, and hadn't changed in the education group. A similar number of yoga and PT subjects reported being "very improved" and "very satisfied," said Dr Saper.

Yoga proved to be safe, with only mild, usually transient exacerbations of back pain.....Larger studies are needed to develop better strategies to enhance adherence, he said. The new study "adds to our knowledge in suggesting that a) yoga is as good as the standard of care, non pharmacologic therapy, and b) it can be done in a diverse population, including a low income, non-English speaking population in Boston. So it takes away some of those barriers to recommending it."

There's also evidence that yoga has a positive impact on the brain. According to M. Catherine Bushnell, PhD, National Center for Complementary and Integrative Health, National Institutes of Health, long-time yoga practitioners have more gray matter than matched physically active controls. "Gray matter goes down with age, but yoga practitioners have a flat line; you don't see this age-related decrease in gray matter that you see in other healthy people,".... And there seems to be "quite a robust" relationship between how long a person has done yoga and positive brain changes, she said. "The number of years a person has practiced yoga, the more gray matter at multiple sites in the brain." Yoga influences areas of the brain that are important for pain modulation, said Dr Bushnell. It is a "complex activity" that involves not only exercise but also breath control and meditation.

More great news about drinking coffee daily - for women. Older women (between ages of 65 to 80 at the start of the study) reporting drinking higher amounts of caffeinated beverages (about 261 mg which is about 2 to 3 cups of coffee per day) had a lower incidence of dementia and cognitive impairment over a 10 year period (as compared to the low caffeine group). The low caffeine group averaged 64 mg of caffeine per day.  Other studies also found a reduction in "cognitive decline" in older people with coffee consumption. This study, among others, is more evidence of caffeine being "neuroprotective". NOTE: an 8-ounce cup of brewed coffee contains about 95 mg of caffeine, 8-ounces of brewed black tea contains about 47 mg, a 12-ounce can of carbonated cola contains 33 mg, and 8-ounces of decaffeinated coffee has about 5 mg of caffeine. Science Daily:

For women, caffeine could be ally in warding off dementia

Among a group of older women, self-reported caffeine consumption of more than 261 mg per day was associated with a 36 percent reduction in the risk of incident dementia over 10 years of follow-up. This level is equivalent to two to three 8-oz cups of coffee per day, five to six 8-oz cups of black tea, or seven to eight 12-ounce cans of cola.

"The mounting evidence of caffeine consumption as a potentially protective factor against cognitive impairment is exciting given that caffeine is also an easily modifiable dietary factor with very few contraindications," said Ira Driscoll, PhD, the study's lead author and a professor of psychology at the University of Wisconsin-Milwaukee. "What is unique about this study is that we had an unprecedented opportunity to examine the relationships between caffeine intake and dementia incidence in a large and well-defined, prospectively-studied cohort of women."

The findings come from participants in the Women's Health Initiative Memory Study, which is funded by the National Heart, Lung, and Blood Institute. Driscoll and her research colleagues used data from 6,467 community-dwelling, postmenopausal women aged 65 and older who reported some level of caffeine consumption. Intake was estimated from questions about coffee, tea, and cola beverage intake, including frequency and serving size.

In 10 years or less of follow-up with annual assessments of cognitive function, 388 of these women received a diagnosis of probable dementia or some form of global cognitive impairment. Those who consumed above the median amount of caffeine for this group (with an average intake of 261 mg per day) were diagnosed at a lower rate than those who fell below the median (with an average intake of 64 mg per day). The researchers adjusted for risk factors such as hormone therapy, age, race, education, body mass index, sleep quality, depression, hypertension, prior cardiovascular disease, diabetes, smoking, and alcohol consumption. (The original study in the Journal of Gerontology.)

Recent research examined levels of endocrine disruptors called phthalates in people eating fast food. Researchers found evidence of a dose–response relationship between fast food intake and exposure to phthalates - the more one eats fast food, the more phthalates (actually metabolites of the phthalates) can be measured in the person's urine. Fast food consumers had higher urinary levels of the phthalates DEHP, DiNP, and BPA than those not consuming fast food (even though the differences in levels of BPA among groups were "non-significant"). This is of concern because these endocrine disruptors are linked to a number of health problems. (Earlier discussion of this research.)

DEHP, DiNP, and BPA are detected in over 90% of the population in the US, but since there are many health concerns - it is better to have lower levels than higher levels. (Zero levels would be best). Note that phthalates and BPA are quickly metabolized and excreted in urine, with elimination half-lives of less than 24 hr - which is why the study looked at what had been eaten in the last 24 hours. But this also shows that one can quickly reduce their levels in the body.

Some possible sources of phthalate contamination in fast food are: PVC tubing, vinyl gloves used for food handling, and food packaging, including beverage cans - the chemicals leach or migrate out into the food and then are ingested. (More on chemicals migrating from containers to food), Fast food was defined as food obtained from restaurants without waiter service and from pizza restaurants, as well as all carry-out and delivery food. Another excellent reason to cut back on fast food (like we don't have enough reasons already!). The following news report discusses the research. From Environmental Health Perspectives:

Phthalates in Fast Food: A Potential Dietary Source of Exposure

Many research studies have surveyed nutritional habits, but fewer have studied how food processing and packaging might introduce unwanted chemicals into foods. In this issue of EHP, researchers report that fast food consumption appears to be one source of exposure to the chemicals di(2-ethylhexyl) phthalate (DEHP) and diisononyl phthalate (DiNP).1

The authors used data from the National Health and Nutrition Examination Survey (NHANES) to estimate the percentage of individuals’ calories that came from fast food, fat intake attributable to fast food consumption, and fast food intake by food group. During NHANES interviews, respondents had reported their diet from the preceding 24 hours. Fast food was defined as food obtained from restaurants without waiter service and from pizza restaurants, as well as all carryout and delivery food.2 ....The final study population included nearly 9,000 people aged 6 years or older. Approximately one-third of people surveyed had eaten fast food in the preceding 24 hours. Study participants who ate fast food were more likely to be male, under age 40, and non-Hispanic black, and to have higher total calorie and total fat intake from fast food, compared with the general population.1

Fast food consumers had higher urinary levels of DEHP, DiNP, and BPA than non-consumers, although the differences in average urinary levels were small and for BPA were non-significant. When fast food intake was categorized by food group, DEHP metabolites were associated with intake of grains and “other” (a category that included vegetables, condiments, potato items, beverages, and more). DiNP metabolites were associated with intake of meat and grains.1

The authors also found that the associations between phthalates and fast food were not uniform across the population.1They speculate that the pronounced association they saw between fast food consumption and DEHP in black consumers could reflect higher overall consumption of fast food and/or different food choices among this population. Prior research suggests that predominately black neighborhoods in urban areas have a greater density of fast food restaurants than white neighborhoods.3

The authors point to PVC tubing, vinyl gloves used for food handling, and food packaging as possible sources of phthalate contamination in fast food. DEHP is a ubiquitous high-molecular-weight phthalate that has been removed from some products due to concerns about potential adverse health effects.5 In some cases it is being replaced with DiNP.2

The related Environmental Health Perspectives research article:  Recent Fast Food Consumption and Bisphenol A and Phthalates Exposures among the U.S. Population in NHANES, 2003–2010

Experimental animal studies demonstrate that DEHP and DiNP have endocrine-disrupting properties because of their anti-androgenic effects on the male reproductive system (National Research Council 2008). Human exposure to DEHP has been associated with adverse reproductive, neurobehavioral, and respiratory outcomes in children (Braun et al. 2013; Ejaredar et al. 2015) and metabolic disease risk factors such as insulin resistance in adolescents and adults (James-Todd et al. 2012; Attina and Trasande 2015). Though epidemiologic evidence of DiNP is less complete, recent studies report associations between exposure and similar health outcomes including adverse respiratory and metabolic outcomes in children (Bertelsen et al. 2013; Attina and Trasande 2015). BPA is also a suspected endocrine disrupter, and experimental and human evidence suggest that BPA is a reproductive toxicant (Peretz et al. 2014). In addition, prenatal BPA exposure has also been associated with adverse neurobehavioral outcomes in children (Mustieles et al. 2015).

Given the concern over chemical toxicity, it is important to identify modifiable sources of exposure that may be targeted for exposure reduction strategies. Simulated exposure modeling, observational epidemiologic studies, and intervention studies all suggest that diet is an important exposure pathway for both high-molecular-weight phthalates and BPA.....Phthalates have been shown to leach into food from PVC in materials like tubing used in the milking process, lid gaskets, food preparation gloves, conveyor belts and food packaging materials (Cao 2010;Serrano et al. 2014). In fact, an intervention study reported that urinary BPA and DEHP were reduced by 66% and 53–56%, respectively, when participants’ diets were restricted to food with limited packaging (Rudel et al. 2011). Foods high in fat, such as dairy and meat, may be more contaminated by high-molecular-weight phthalates that are more lipophilic such as DEHP (Serrano et al. 2014). Fast food may be an important source of exposure to phthalates and BPA because it is highly processed, packaged, and handled.

Many of us grew up having silver colored dental fillings (called dental amalgam) in our teeth. Dental amalgam has been used for over 150 years for the treatment of dental cavities (caries) because it is durable, easy to use, and affordable. But it is composed of about 50% elemental mercury (Hg) and so it may release a certain amount of mercury both during the time the cavity is filled and afterward with normal wear. Mercury can cause adverse health effects, such as effects on the central nervous system, kidneys, and immune system. Human mercury exposure also occurs through the consumption of mercury (MeHg) contaminated seafood.

Recently many dentists switched to the use of the composite resins, which are mercury-free alternative materials. However, these can release can release small quantities of bisphenol A (BPA) when applied and as they degrade in the mouth. BPA is an endocrine disruptor, has been found to cause various adverse health effects, including reproductive effects, and can be measured in urine. Which raised the question, do persons with composite resin fillings have elevated BPA in their bodies?

This study examined 14,703 subjects who were divided into three groups based on the number of dental surface restorations (DSR): 0, 1–8, or greater than 8. Dental surface restorations applies to fillings, and not crowns. Note that a tooth's surface can have 5 surfaces (in molars and pre-molars), so 8 filled surfaces can be fewer than 8 teeth with fillings. (It's not the number of fillings, but the surface area they occupy - so the Science Daily article title is misleading.)

They found that the more dental surface restorations a person has, the higher the levels of mercury in the blood. But they found no association between dental surface restorations and urinary BPA. These results are reassuring for those with fillings made of composite resins, but not for people with fillings of dental amalgam. Note: DSR are Dental Surface Restorations, THg is blood total mercury, IHG is inorganic mercury, and MeHg is methyl mercury (typically from seafood). From Science Daily:

Have more than eight dental fillings? It could increase the mercury levels in your blood

Dental surface restorations composed of dental amalgam, a mixture of mercury, silver, tin and other metals, significantly contribute to prolonged mercury levels in the body, according to new research from the University of Georgia's department of environmental health science in the College of Public Health.This research, which analyzed data from nearly 15,000 individuals, is the first to demonstrate a relationship between dental fillings and mercury exposure in a nationally representative population.  ...continue reading "Dental Fillings and Mercury Levels"

Monosodium glutamate is an additive used as a "flavor enhancer" that has long been used in foods (processed and packaged foods, as well as fast food and restaurant meals) - and it has also been controversial for decades. Even four decades ago some people complained of headaches after having foods with added monosodium glutamate, and since then health complaints have just increased. Since so much is still unknown about the health effects of additives commonly added to foods, then many people just want to avoid them. But it's tricky because manufacturers sneak monosodium glutamate into foods using various other name such as hydrolyzed vegetable protein, autolyzed yeast, glutamic acid, and yeast extract.

The FDA points out on its web-site that monosodium glutamate (MSG) is the "sodium salt of the common amino acid glutamic acid" - in other words, it is a form of glutamic acid. Glutamic acid is an amino acid naturally present in our bodies, and found naturally in many foods, such as tomatoes, cheeses, meat, seaweed, and mushrooms. The FDA views MSG as "generally recognized as safe". But even if a form of something may occur naturally in foods, that does NOT mean that we want to eat foods with added forms of it, or that we should be eating food with added additives, including MSG.

Sometimes the term "natural flavor" is used by the food industry for glutamic acid (which is chemically similar to MSG). So read ingredient lists carefully. And note that "natural flavor" can mean many things, that they are produced in a lab, and that the Food and Drug Administration (FDA) does not require disclosure of components and amounts of "natural flavor". From Tech Insider:

Here’s how food companies sneak MSG into foods

That savory, meaty, salty taste you get after taking a bite of Chinese beef and broccoli or after a crunch into a Doritos nacho cheese chip is unmistakable. It hits your tongue, makes it water, and leaves you craving more. MSG, which stands for monosodium glutamate — a naturally-occurring food additive — is largely responsible for that irresistible taste. Chemists have been infusing it into everything from broths, frozen pizzas, flavored potato chips, salad dressings, deli meats, and hot dogs, for more than a century to make them taste addictively delicious.

MSG is a naturally occurring amino acid that makes up proteins in our bodies. But the compound's safety has been debated for years. While it is generally recognized as safe by the Food and Drug Administration, some claim that it can cause adverse reactions in sensitive people, including chest pain, flushing, and sweating. It's also reportedly caused numbness or burning near the mouth and facial pressure or swelling. While there haven't been any studies to back up this claim, it would be helpful for sensitive or MSG-wary people to know which processed foods contain the ingredient. But because the additive can go by many different names, it can be difficult to tell which foods contain it.

Take this Doritos label, for instance. You can easily tell that there's MSG in it, because it's listed simply by its full name, "Monosodium Glutamate."....But check out this nutrition label for Nissin Chicken Garden Vegetable Flavor Soup. While it does reveal that it indeed contains monosodium glutamate, it also contains many other forms of glutamates that are often considered slight variations on MSG. Hydrolyzed protein, for example, is just proteins that are broken down into their animo acid components – one of which is glutamic acid, another name for MSG. Autolyzed yeast is a similar example, yeast cells are allowed to die and pop open, which releases their innards, which then break down into individual amino acids — including glutamic acid.

MSG can go by these and many other synonymous names as well, including monosodium salt, monohydrate, monosodium glutamate, monosodium glutamate monohydrate, monosodium L-glutamate monohydrate, MSG monohydrate, sodium glutamate monohydrate, UNII-W81N5U6R6U, L-Glutamic acid, monosodium salt, and monohydrate. Foods that contain these ingredients, of course, aren't necessarily bad for you. Glutamate is a naturally occuring chemical in cheeses, tomatoes, mushrooms, broccoli, peas, and walnuts. Japanese biochemist Kikunae Ikeda first isolated MSG from seaweed in 1908.