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Another study finding a benefit of coffee consumption - this time linked to a lower rate of MS. Keep in mind that numerous studies have shown a strong association of higher sunlight exposure (especially in childhood), and living at lower latitudes (more sunlight exposure) with lower rates of multiple sclerosis. From Science Daily:

Can coffee reduce your risk of MS?

Drinking coffee may be associated with a lower risk of developing multiple sclerosis (MS), according to a study released today that will be presented at the American Academy of Neurology's 67th Annual Meeting in Washington, DC, April 18 to 25, 2015."Caffeine intake has been associated with a reduced risk of Parkinson's and Alzheimer's diseases, and our study shows that coffee intake may also protect against MS, supporting the idea that the drug may have protective effects for the brain," said study author Ellen Mowry, MD, MCR, with Johns Hopkins University School of Medicine in Baltimore and a member of the American Academy of Neurology.

For the study, researchers looked at a Swedish study of 1,629 people with MS and 2,807 healthy people, and a U.S. study of 1,159 people with MS and 1,172 healthy people. The studies characterized coffee consumption among persons with MS one and five years before MS symptoms began (as well as 10 years before MS symptoms began in the Swedish study) and compared it to coffee consumption of people who did not have MS at similar time periods. The study also accounted for other factors such as age, sex, smoking, body mass index, and sun exposure habits.

The Swedish study found that compared to people who drank at least six cups of coffee per day during the year before symptoms appeared, those who did not drink coffee had about a one and a half times increased risk of developing MS. Drinking large amounts of coffee five or 10 years before symptoms started was similarly protective.

In the US study, people who didn't drink coffee were also about one and a half times more likely to develop the disease than those who drank four or more cups of coffee per day in the year before symptoms started to develop the disease.

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Very exciting research. And it's the exact opposite advice that doctors used to tell parents - which was if there was a high risk for a specific allergy that ran in the family (peanuts, dogs, etc.) to have the young child try to avoid exposure to that item (or in the case of peanuts - until the age of 3). From NPR:

Feeding Babies Foods With Peanuts Appears To Prevent Allergies

Babies at high risk for becoming allergic to peanuts are much less likely to develop the allergy if they are regularly fed foods containing the legumes starting in their first year of life. That's according to a big new study released Monday involving hundreds of British babies. The researchers found that those who consumed the equivalent of about 4 heaping teaspoons of peanut butter each week, starting when they were between 4 and 11 months old, were about 80 percent less likely to develop a peanut allergy by their fifth birthday.

"This is certainly good news," says Gideon Lack of King's College London, who led the study. He presented the research at the annual meeting of the American Academy of Allergy, Asthma and Immunology. It was also published in The New England Journal of Medicine.

As many as 2 million U.S. children are estimated to be allergic to peanuts — an allergy that has been increasing rapidly in the United States, Britain and other countries in recent years. While most children who are allergic to peanuts only experience relatively mild symptoms, such as hives, some have life-threatening reactions that can include trouble breathing and heart problems.

Lack's study was launched after he noticed that Israeli kids are much less likely to have peanut allergies than are Jewish kids in Britain and the United States."My Israeli colleagues and friends and young parents were telling me, 'Look, we give peanuts to these children very early. Not whole peanuts, but peanut snacks,' " Lack says. Peanut snacks called Bamba, which are made of peanut butter and corn, are wildly popular in Israel, where parents give them to their kids when they're very young. That's very different from what parents do in Britain and the United States, where fears about food allergies have prompted many parents to keep their children away from peanuts, even though the American Academy of Pediatrics revised a recommendation to do so in 2008.

"That raised the question whether early exposure would prevent these allergies" by training babies' immune systems not to overreact to peanuts, Lack says. "It's really a very fundamental change in the way we're approaching these children." To try to find out, Lack and his colleagues got funding from the U.S. National Institutes of Health to launch a study. They found 640 babies who were at high risk for developing peanut allergies because they already had eczema or egg allergy. They asked half of the infants' parents to start feeding them Bamba, peanut butter, peanut soup or peanut in some other form before their first birthday and followed them for about five years.

"What we found was a very great reduction in the rate of peanut allergy," Lack says. About 17 percent of the kids who avoided peanuts developed peanut allergies, compared with only 3.2 percent of the kids who ate peanuts, the researchers reported.

Based on the findings, Lack thinks most parents should start feeding their babies peanut products as early as possible — not whole peanuts or globs of peanut butter, but peanut mixed in some other food to avoid any possible choking hazard."We've moved, really, 180 degrees from complete avoidance to we should give peanuts to young children actively," Lack says. Other allergy experts hailed the results as an important advance. "This is a major study — really what we would call a landmark study," says Scott Sicherer, who advises the American Academy of Pediatrics on allergies. 

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Since people have abandoned using iodized salt and started using kosher salt or sea  salts, iodine deficiency has increased (especially during pregnancy when iodine needs are greater). The medical journal The Lancet noted in 2008: "According to World Health Organization, in 2007, nearly 2 billion individuals had insufficient iodine intake, a third being of school age. ... Thus iodine deficiency, as the single greatest preventable cause of mental retardation, is an important public-health problem." From Wikipedia : Iodine deficiency is the leading cause of preventable mental retardation, a result which occurs primarily when babies or small children are rendered hypothyroidic by a lack of the element. The addition of iodine to table salt has largely eliminated this problem in the wealthier nations. The article states that iodine deficiency typically lowers IQ by 10 to 15 points. So it's a big deal, a really big deal.  But don't overdo the iodine! Excess iodine also has serious problems.From Medscape:

New Recommendations Call for Iodine in All Prenatal Vitamins

Endocrinology groups are applauding a new recommendation from a dietary-supplement trade association that calls for iodine supplementation in all prenatal vitamins prescribed for pregnant and breastfeeding women.

In addition, the public health committee of the American Thyroid Association (ATA) recently published a statement reiterating the ATA recommendation that women take a daily multivitamin containing 150 μg of iodine during prepregnancy, pregnancy, and lactation. The statement also warns of the potential risks of excess iodine consumption and exposure, particularly through the use of unregulated kelp supplements.

The US Council for Responsible Medicine's new guidelines call for all dietary-supplement manufacturers and marketers to begin including at least 150 μg of iodine in all daily multivitamin/mineral supplements intended for pregnant and lactating women in the United States within the next 12 months.

In the past several years, removal of iodized salt from commercial products such as bread and milk, along with increased use of kosher salt and sea salt, which don't contain iodine, and the adoption of vegetarian and vegan diets have led to a reduction in dietary iodine consumption. "There never was a coherent US policy about iodization," Dr Stagnaro-Green noted.

Worldwide, about two billion people are iodine-deficient. While most of the US population has adequate iodine levels, data from the National Health and Nutrition Examination Survey suggest that more than half of pregnant women have urinary iodine concentrations below 150 mg/dL (Thyroid. 2011;21:419-427). 

Pregnant women actually need more iodine than other people because of increased thyroid-hormone production, renal losses, and fetal iodine requirements. Iodine deficiency during pregnancy can result in maternal and fetal goiter, cretinism, intellectual impairment, neonatal hypothyroidism, and increased pregnancy loss and mortality, Dr Stagnaro-Green and colleagues explained in a 2012 editorial (JAMA2012;308:2463-2464).

"So, women of childbearing age are the subpopulation of Americans with the lowest iodine levels yet have the greatest need during pregnancy and breastfeeding, for the neurodevelopment of the fetal and neonatal brain," he told Medscape Medical News. 

In 2009, a study found that only 51% of US prenatal multivitamin brands contained any iodine and, in a number of randomly selected brands, the actual dose of iodine contained in the supplements did not match values on the labeling.

However, the American College of Obstetricians and Gynecologists (ACOG) has not joined in these efforts. While the group does recommend the 150-μg dose for pregnant and lactating women, it does not currently endorse the prenatal-supplement recommendation, advising instead that women get their iodine through dietary sources.

In the ATA's public health committee statement, Angela M Leung, MD, from the University of California Los Angeles David Geffen School of Medicine, and colleagues, including Dr Stagnaro-Green, note that iodine is a micronutrient required for normal thyroid function. The US recommended daily allowances (RDA) for iodine intake are 150 μg in adults, 220 to 250 μg in pregnant women, and 250 to 290 μg in breastfeeding women. Dietary sources such as iodized salt, dairy products, some breads, and seafood usually contain enough to meet the RDA for most people who aren't pregnant or lactating.

However, there is an upper safety limit, with ingestion of more than 1100 μg/day not recommended due to the risk for thyroid dysfunction. In particular, infants, the elderly, pregnant and lactating women, and people with preexisting thyroid disease are at risk for adverse effects of excess iodine on the thyroid.

Many iodine, potassium iodide, and kelp supplements contain hundredfold greater amounts of iodine than the recommended upper limit, Leung and colleagues caution."Given the increasing popularity of iodine and kelp supplements, recommendations cautioning against excess iodine were indicated. The potential result of iodine-induced thyroid dysfunction, which may be particularly harmful during pregnancy and breastfeeding and in the elderly, may not be well-known," she told Medscape Medical News.

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Chronic inflammation can have a variety of negative health effects. From Time:

13 Ways Inflammation Can Affect Your Health

You can't live without inflammation, but it can also be hazardous to your health. You’ve heard of anti-inflammatory medications and anti-inflammatory diets, but do you really know what inflamation is? In short, it’s the body’s response to outside threats like stress, infection, or toxic chemicals. When the immune system senses one of these dangers, it responds by activating proteins meant to protect cells and tissues. “In a healthy situation, inflammation serves as a good friend to our body,” says Mansour Mohamadzadeh, PhD, director of the Center for Inflammation and Mucosal Immunology at the University of Florida.” “But if immune cells start to overreact, that inflammation can be totally directed against us.” This type of harmful, chronic inflammation can have a number of causes, including a virus or bacteria, an autoimmune disorder, sugary and fatty foods, or the way you handle stress. Here are a few ways it can affect your health, both short-term and long.

It fights infection.Inflammation is most visible (and most beneficial) when it’s helping to repair a wound or fight off an illness...It prepares you for battles Another type of inflammation occurs in response to emotional stress. Instead of blood cells rushing to one part of the body, however, inflammatory markers called C-reactive proteins are released into the blood stream and travel throughout the body.

It can harm your gut Many of the body’s immune cells cluster around the intestines, says Denning. Most of the time, those immune cells ignore the trillions of healthy bacteria that live in the gut. “But for some people, that tolerance seems to be broken,” says Denning, “and their immune cells begin to react to the bacteria, creating chronic inflammation.” The immune cells can attack the digestive tract itself, an autoimmune condition known as inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease. 

It can harm your joints When inflammation occurs in the joints, it’s can cause serious damage. One joint-damaging condition is rheumatoid arthritis(RA)—another example of an autoimmune disorder that appears to have a genetic component, but is also linked to smoking, a lack of vitamin D, and other risk factors.

It’s linked to heart disease Any part of your body that’s been injured or damaged can trigger inflammation, even the insides of blood vessels. The formation of fatty plaque in the arteries can trigger chronic inflammation. The fatty plaques attract white blood cells, grow larger, and can form blood clots, which can cause a heart attack.Obesity and unhealthy eating increases inflammation in the body.

It’s linked to a higher risk of cancer Chronic inflammation has been linked to cancers of the lung, esophagus, cervix, and digestive tract, among others..The inflammation may be due to obesity, a chronic infection, a chemical irritant, or chronic condition; all have been linked to a higher cancer risk....It may sabotage your sleep In a 2009 study from Case Western Reserve University, people who reported sleeping more or less than average had higher levels of inflammation-related proteins in their blood than those who said they slept about 7.6 hours a night.

It’s bad for your lungs When inflammation occurs in the lungs, it can cause fluid accumulation and narrowing of the airways, making it difficult to breathe...Smoking, exposure to air pollution or household chemicals, being overweight, and even consumption of cured meats have been linked to lung inflammation... It damages gums Inflammation can also wreak havoc on your mouth in the form of periodontitis, a chronic inflammation of the gums caused by bacteria accumulation. 

It makes weight loss more difficult Obesity is a major cause of inflammation in the body, and losing weight is one of the most effective ways to fight it. But that’s sometimes easier said than done, because elevated levels of inflammation-related proteins can also make weight loss more difficult than it should be.... Inflammation can also increase insulin resistance (which raises your risk for diabetes) and has been linked with future weight gain.

It damages bones Inflammation throughout the body can interfere with bone growth and even promote increased bone loss, according to a 2009 review study published in the Journal of Endocrinology.  It affects your skin The effects of inflammation aren’t just internal: They can also be reflected on your skin. Psoriasis, for example, is an inflammatory condition that occurs when the immune system causes skin cells to grow too quickly. .... It’s linked with depression 

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It seems that currently it is a case of buyer beware - because supplements may NOT even contain the desired ingredients! Excerpts from two articles from the NY Times that discuss this issue:

Knowing What’s in Your Supplements

Last week, the New York State attorney general’s office uncovered another example of what appeared to be widespread fraud in the dietary supplement industry. The office accused four of the country’s biggest retail stores of selling herbal products that in many cases were contaminated or did not contain any of the herb listed on the label.

For many readers, the news raised an urgent question: Which supplements can I trust? Experts say that there is no guarantee that supplements will do what they say they do, or that they are safe or won’t interact with any medications you may be taking. But there are several steps people can take to give themselves some reassurance that at least some of the supplements they buy actually contain what they advertise on the label – and nothing else.

For one, you can look for products that receive a seal of approval from the United States Pharmacopeial Convention, an independent, nonprofit organization of scientists that sets high standards for medicine, food ingredients and dietary supplements. The United States Pharmacopeia has a voluntary program through which supplement companies can have their products and facilities tested and reviewed. Companies whose supplements meet the group’s standards – which ensure purity, identity and potency, among other things – are allowed to carry an official “USP Verified” seal on their labels. The group maintains an evolving list of the brands that have received its seal and the places where they can be purchased. That list can be found on the group’s website.

But keep in mind that there are some companies that print the letters “USP” on their labels without the official USP Verified seal... But it is not the same as the distinctive black and yellow “USP Verified” seal, which means that the product has actually been vetted by the United States Pharmacopeia. Only a handful of brands carry the seal. A few of them are Nature Made, Kirkland Signature and TruNature, for example.

Another nonprofit group that independently certifies some supplements and their ingredients is NSF International. The group certifies such supplements as fish oil and multivitamins. It also has an “NSF Certified for Sport” program that is especially useful for athletes and other people who use sports supplements such as protein powders, amino acids and creatine. These products have been found in some cases to be deliberately spiked with steroids and prescription drugs. The blue and white NSF seal means that a product has been independently vetted to ensure that it is not adulterated and that it contains the ingredients listed on its label.

Lastly, there are at least two independent laboratories that routinely test a range of dietary supplements and then publish full reports with their findings. One is ConsumerLab.com, which frequently tests products and maintains an archive of reports on its website. Another testing company is LabDoor. On its website, you can find reports and rankings of protein powders, fish oil, probiotics, vitamin D and multivitamins. Both websites charge a fee for access to their reports.

Consumer testing groups such as these are necessary, many experts say, because the 1994 federal law that applies to supplements does more to protect companies than consumers. That law – the Dietary Supplement Health and Education Actor DSHEA – was spearheaded by legislators with strong financial ties to the industry. It allows companies to attach general health claims to their products without providing evidence of their effectiveness, and it protects supplements from the strict premarket approval rules that apply to prescription drugs. 

Although companies are required to follow an established set of manufacturing practices, policing the industry has been a special challenge for the federal government because DSHEA essentially created an environment in which companies operate on the honor code.

From the NY Times: What’s in Those Supplements?

The New York State attorney general’s office accused four national retailers on Monday of selling dietary supplements that were fraudulent and in many cases contaminated with unlisted ingredients.

The authorities said they had run tests on popular store brands of herbal supplements at the retailers — Walmart, Walgreens, Target and GNC — which showed that roughly four out of five of the products contained none of the herbs listed on their labels. In many cases, the authorities said, the supplements contained little more than cheap fillers like rice and house plants, or substances that could be hazardous to people with food allergies.

At GNC, for example, the agency found that five out of six samples from the company’s signature “Herbal Plus” brand of supplements “were either unrecognizable or a substance other than what they claimed to be.” In pills labeled ginkgo biloba, the agency found only rice, asparagus and spruce, an ornamental plant commonly used for Christmas decorations.

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The researcher who led the study pointed out that millions of people live with and die from cardiovascular disease and that : "Many of these deaths may be prevented by the right lifestyle, including diet." Eating oily fish appears to be part of a healthy lifestyle. From Medical Xpress:

Consuming oily fish could repair damaged blood vessels

Eating oily fish may not only keep your heart healthy but it could actually help to fix damaged blood vessels faster, reducing your risk of cardiovascular disease, University of Reading scientists have found. It is well known that these high in omega-3 fatty acid foods can improve the elasticity of blood vessels and potentially protect against heart disease.

However the reasons for these positive effects are less clear. This study tested two new emerging markers of cardiovascular disease that are of particular interest to researchers in the quest for answers.

The first was endothelial progenitor cells (EPCs), stem cells made in the bone marrow that repair the linings of blood vessels when they become damaged. Previous studies associate a higher number of EPCs with a lower risk of heart disease. Over a period of eight weeks the researchers introduced small amounts (3 g per day) of fish oils to a volunteer group of people with mild risk of cardiovascular risk of a mixed age range. At the end of the eight weeks this study group increased their EPCs numbers by up to 15% compared to a control group.

The second marker, endothelial microparticles (EMPs), are tiny circular vesicles which are shed when the lining of blood vessels is damaged. High numbers of these indicates a high degree of blood vessel damage and are associated with higher risk of heart disease. At the end of the trial, the group consuming the oily fish decreased EMPs by 20% compared to the control group.

"Fish oil is known to increase the release of nitric oxide from the lining of the blood vessel wall which causes relaxation of the vessel and increases blood flow. Our study shows that fish oils could be better for our heart in more ways than previously thought, decreasing damage to the lining of blood vessels and by increasing the numbers of cells which repair those linings.

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Another study that links following the Mediterranean diet with a beneficial health effect - this time a lower risk of ischemic stroke. Unfortunately, it did not seem to lower the risk of hemorrhagic stroke.

The findings were presented at the American Stroke Association's annual meeting. From Medical Xpress:

Mediterranean diet may lower stroke risk, study finds

A Mediterranean diet may reduce your risk of one type of stroke, new research suggests. People who most closely followed the Mediterranean diet were less likely to suffer an ischemic stroke—caused by a blood clot—compared to people with the lowest adherence to the diet, the study found.

A Mediterranean diet includes plenty of fruits and vegetables, whole grains, legumes, nuts, fish, poultry and olive oil. There is limited consumption of red meat, sweets and saturated fats such as those in meat, butter and full-fat dairy products, according to the researchers.

Sherzai's team analyzed data from more than 104,000 teachers in California, averaging 52 years of age, who are taking part in a long-term study. The participants, 90 percent of who were white, were divided into five groups based on how well they followed a Mediterranean diet.

While closely following a Mediterranean diet was associated with a reduced risk of a stroke caused by a blood clot, the healthy eating plan had no effect on a person's odds for a bleeding (hemorrhagic) stroke, according to the study.

According to the researchers, prior research has shown that people who follow a Mediterranean diet have a lower risk of heart disease, mental decline and death, but there is little information about how the diet affects stroke risk.Wright noted that the study was especially rigorous, since the authors accounted for "other factors that would reduce stroke risks, such as exercise, total caloric intake,body mass index, smoking and menopausal/hormonal status."

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Image result for dark chocolate Now this is shocking news for chocolate lovers - that it may be contaminated with lead and cadmium! Maybe it's not so bad for those who rarely eat chocolate, but it's not good for those who really love their chocolate and eat a lot. The group As You Sow did independent laboratory testing of 42 chocolate products for lead and cadmium and found that 26 of the chocolate products (~62%) contained lead and/or cadmium at levels in which one serving exceeds theCalifornia safe harbor level for reproductive harm.From The Washington Post:

How much lead is in your chocolate?

If you (like me) have been happily snarfing down chocolate in recent years, secure in the knowledge that those flavonols were at least doing good things for your heart, today is not your day. Just in time for Valentine's Day, a California consumer health watchdog group filed legal notices Wednesday demanding that many of the big chocolate companies post warnings on their packages that show their products contain high levels of lead and cadmium.

As You Sow, an Oakland nonprofit, says single servings of  26 products it tested (three times) contain more of the two harmful heavy metals than allowed under the Golden State's Proposition 65 toxic chemical warning law. Here is the list, which includes many of the big name producers of my favorite food. Try not to weep openly at work.

"We are getting [lead and cadmium] from multiple sources," Eleanne Van Vliet, director of toxic chemicals research for As You Sow, said in an interview. "The problem with those toxic heavy metals is they accumulate in the body. It’s terrible for adults, but especially for children." Overexposure to lead, of course, can cause all kinds of health problems,including lowering children's IQ. Cadmium is a carcinogen and can cause kidney and bone damage.

Now before you ask the boss to remove all the vending machines, let's be clear that the chocolate companies, and the association that represents them, are having none of this. They say there are, at worst, trace amounts of lead and cadmium in chocolate from natural sources and that regulators have rejected this argument before....Van Vliet insists that As You Sow is not talking about tiny amounts; rather, she says, if you think about the amount of chocolate the average person consumes each year, these concentrations are worrisome.If we could get them all in a room, both sides would probably agree on one thing: We do eat a lot of chocolate. 

.However, that prompted researchers at the University of California Santa Cruz to look into the amount of lead (but not cadmium) in chocolate, and the results were somewhat sobering. Their study, published in 2005 in the journal Environmental Health Perspectives, concluded that the lead in chocolate was not from naturally occurring sources, a stance that one of the researchers, Russ Flegal, reiterated when I called him.

"The average lead concentration of cocoa beans was ≤ 0.5 ng/g, which is one of the lowest reported values for a natural food," they wrote. "In contrast, lead concentrations of manufactured cocoa and chocolate products were as high as 230 and 70 ng/g, respectively, which are consistent with market-basket surveys that have repeatedly listed lead concentrations in chocolate products among the highest reported for all foods. One source of contamination of the finished products is tentatively attributed to atmospheric emissions of leaded gasoline, which is still being used in Nigeria."

Van Vliet says she doesn't know where the metals come from, only that they may enter the chocolate somewhere in the manufacturing process -- which Flegal said is also possible -- and are at unsafe levels in the chocolate we eat.

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Well DUH, of course eating organic foods lowers pesticide exposures. And yes, it can be measured in your body. So, as previous studies have shown, replacing regular fruits and vegetables (conventionally grown) with organic fruits and vegetables will lower your exposure to pesticides and the levels in your body.

And why is this important? Research shows health effects from pesticides, so it is healthier for you to lower your pesticide exposures - whether from eating food, or from your house and your yard (breathing it in, getting it on skin).

From Science Daily: Organic food reduces pesticide exposure

While health-conscious individuals understand the benefits of eating fresh fruits and veggies, they may not be aware of the amount of pesticides they could be ingesting along with their vitamin C and fiber. A new study to be published in the Feb. 5 edition of Environmental Health Perspectives is among the first to predict a person's pesticide exposure based on information about their usual diet.

Curl and her colleagues analyzed the dietary exposure of nearly 4,500 people from six U.S. cities to organophosphates (OPs), the most common insecticides used on conventionally grown produce in the United States. OP pesticides are linked to a number of detrimental health effects, particularly among agricultural workers who are regularly exposed to the chemicals.

Results showed that among individuals eating similar amounts of fruits and vegetables, those who reported eating organic produce had significantly lower OP pesticide exposures than those consuming conventionally grown produce. In addition, consuming those conventionally grown foods typically treated with more of these pesticides during production, including apples, nectarines and peaches, was associated with significantly higher levels of exposure. "For most Americans, diet is the primary source of OP pesticide exposure," said Curl "The study suggests that by eating organically grown versions of those foods highest in pesticide residues, we can make a measurable difference in the levels of pesticides in our bodies."

The researchers were able to predict each participant's exposure to OP pesticides based on the amount and type of produce each participant typically ate and the U.S. Department of Agriculture's measurements of pesticide residue levels on those foods. The researchers then compared these predictions to pesticide metabolite levels measured in urine samples from a subset of 720 of these people.

"The next step is to use these exposure predictions to examine the relationship between dietary exposure to pesticides and health outcomes, including neurological and cognitive endpoints. We'll be able to do that in this same population of nearly 4,500 people," she said.

One way people can reduce their pesticide exposure, said Curl, is to eat organic versions of those foods that are listed on the Environmental Working Group's "Dirty Dozen" list, which ranks fruits and vegetables according to pesticide residue level.

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This is very interesting, and raises all sorts of possibilities for microbial transplants. While it's looking at only one person, this seems to be evidence that microbes are involved with our weight and manipulating them may result in weight gain or loss. From Science Daily:

Rapid and unexpected weight gain after fecal transplant

A woman successfully treated for a recurrent Clostridium difficile infection with stool from an overweight donor rapidly gained weight herself afterwards, becoming obese, according to a case report published in the new journal Open Forum Infectious Diseases.

Fecal microbiota transplant (FMT) is a promising treatment for relapsing C. difficile infections, a common cause of antibiotic-related diarrhea that in severe cases may be life-threatening. The case suggests that clinicians should avoid selecting stool donors who are overweight. The report also raises questions about the role of gut bacteria in metabolism and health.

At the time of the woman's fecal transplant in 2011, her weight was stable at 136 pounds, and her Body Mass Index (BMI) was 26. Then 32 years old, she had always been of normal weight. The transplant used donor stool from the woman's overweight but otherwise healthy teenage daughter, administered via colonoscopy, to restore a healthy balance of bacteria in the woman's gut, curing her C. difficile infection.

Sixteen months later, the woman weighed 170 pounds, and her BMI was 33, meeting medical criteria for obesity. The weight gain persisted despite a medically supervised liquid protein diet and exercise program. Continuing efforts to diet and exercise did not lower her weight: Three years after the transplant, she weighed 177 pounds with a BMI of 34.5, and she remains obese today.

"We're questioning whether there was something in the fecal transplant, whether some of those 'good' bacteria we transferred may have had an impact on her metabolism in a negative way," said Colleen R. Kelly, MD, of the Warren Alpert Medical School of Brown University, who wrote the case report with Neha Alang, MD, of Newport Hospital in Rhode Island. Such a link between bacteria in the gastrointestinal tract and weight is supported by previously published animal studies, where transfer of gut bacteria from obese to normal-weight mice can lead to a marked increase in fat. In light of the case and the animal data, the authors recommend selecting stool donors who are not overweight for fecal transplants.

Importantly, the FMT was not the only possible cause of the woman's weight gain. In addition to treatment for C. difficile, she had also been treated with several antibiotics for Helicobacter pylori infection. Other possible contributing factors in the woman's weight gain include the resolution of her C. difficile infection, genetic factors, aging, and stress related to illness. However, as noted above, she had never been overweight before.