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Published on Leave a comment on Reduce Chronic Inflammation With Food

As we know, chronic inflammation is linked to cancer and other diseases. It is long-term persistent low-grade inflammation, and it has a "wear and tear" effect on the body. What causes chronic inflammation? Being overweight or obese, sedentary lifestyle, Western (low fiber, high processed foods and meat) diet, chronic illnesses, viruses or bacteria (e.g., gum disease), smoking, air pollution, stress, excessive alcohol intake. It often does not have symptoms, but doctors can test for C-reactive protein levels (CRP), which increase when the body is inflamed. So you absolutely want to lower chronic inflammation if you can.

High dietary intake of fruits and vegetables, which are rich in polyphenols, has been linked through many studies with reduced risk for diseases that are associated with chronic inflammation, such as cardiovascular disease, type II diabetes, cancers, Alzheimer’s disease, and Parkinson’s disease. Polyphenols are a class of chemicals or micronutrients found in many foods, especially fruits and vegetables.

New research looked at 31 polyphenols (alone and in some mixtures) to see which lowered inflammation the most. They found that some mixtures of polyphenols actually had more than an additive effect - that it's more than a sum of the individual polyphenols. They found that the polyphenols resveratrol, isorhamnetin, and curcumin were the most anti-inflammatory. Isorhamnetin is a flavonol that occurs in apples, onions and green tea; curcumin is from the Indian spice turmeric; and resveratrol is present in the skin of red, purple and black grapes, and in especially high concentrations in Itadori tea (from Japanese knotweed). Another important anti-inflammatory polyphenol is vanillic acid, which is found in vanilla, wine, whole wheat, and berries.

Just remember that it is better to eat a variety of fruits and vegetables rather than taking supplements. Foods are more than just one or 2 isolated ingredients, but consist of many micronutrients, microbes, etc , and when eating a varied diet, a person typically has mixtures of many polyphenols in their system at once. The research finds that these polyphenol mixtures interact with one another. Studies  typically find real foods to be superior to supplements in beneficial health effects. From Science Daily:

What foods can help fight the risk of chronic inflammation?

A new study by the University of Liverpool's Institute of Ageing and Chronic Disease has identified food stuffs that can help prevent chronic inflammation that contributes to many leading causes of death. Inflammation occurs naturally in the body but when it goes wrong or goes on too long, it can trigger disease processes. Uncontrolled inflammation plays a role in many major diseases, including cancer, heart disease, diabetes and Alzheimer's disease.

Diets rich in fruits and vegetables, which contain polyphenols, protect against age-related inflammation and chronic diseases. Polyphenols are abundant micronutrients in our diet, and evidence for their role in the prevention of degenerative diseases such as cancer and cardiovascular diseases is already emerging. The health effects of polyphenols depend on the amount consumed and on their bioavailability.

T-cells, or T-lymphocytes, are a type of white blood cell that circulate around our bodies, scanning for cellular abnormalities and infections. They contribute to cell signalling molecules (cytokines) that aid cell-to-cell communication in immune responses and stimulate the movement of cells towards sites of inflammation, infection and trauma. Cytokines are modulated by fruit and vegetable intake.

The study, conducted by Sian Richardson and Dr Chris Ford from the University's Institute of Ageing and Chronic Disease, examined the different potencies of the polyphenols. Sian Richardson, said: "The results of our study suggest that (poly)phenols derived from onions, turmeric, red grapes, green tea and açai berries may help reduce the release of pro-inflammatory mediators in people at risk of chronic inflammation. "Older people are more susceptible to chronic inflammation and as such they may benefit from supplementing their diets with isorhamnetin, resveratrol, curcumin and vanillic acid or with food sources that yield these bioactive molecules."

Published on Leave a comment on Medical Error Is the Third Leading Cause of Death In the US

The title of the article says it all.  The authors of this report calculate that 9.5% of deaths in the US or 251,454 deaths annually (which equates to nearly 700 deaths a day) are due to medical errors. Others have pointed out that the number of severe patient injuries resulting from medical errors are also overlooked, with some estimates saying that this number could be as high as 40 times the death rate.From Medscape:

Medical Error Is Third Leading Cause of Death in US

Medical error is the third leading cause of death in the United States, after heart disease and cancer, according to findings published today in BMJ. As such, medical errors should be a top priority for research and resources, say authors Martin Makary, MD, MPH, professor of surgery, and research fellow Michael Daniel, from Johns Hopkins University School of Medicine in Baltimore, Maryland.

But accurate, transparent information about errors is not captured on death certificates, which are the documents the Centers for Disease Control and Prevention (CDC) uses for ranking causes of death and setting health priorities. Death certificates depend on International Classification of Diseases (ICD) codes for cause of death, so causes such as human and system errors are not recorded on them. And it's not just the US. According to the World Health Organization, 117 countries code their mortality statistics using the ICD system as the primary health status indicator.

The authors call for better reporting to help capture the scale of the problem and create strategies for reducing it....."Top-ranked causes of death as reported by the CDC inform our country's research funding and public health priorities," Dr Makary said in an university press release. "Right now, cancer and heart disease get a ton of attention, but since medical errors don't appear on the list, the problem doesn't get the funding and attention it deserves."

The researchers examined four studies that analyzed medical death rate data from 2000 to 2008. Then, using hospital admission rates from 2013, they extrapolated that, based on 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error.That number of deaths translates to 9.5% of all deaths each year in the US — and puts medical error above the previous third-leading cause, respiratory disease. In 2013, 611,105 people died of heart disease, 584,881 died of cancer, and 149,205 died of chronic respiratory disease, according to the CDC

The authors suggest several changes, including making errors more visible so their effects can be understood.....Another is changing death certificates to include not just the cause of death, but an extra field asking whether a preventable complication stemming from the patient's care contributed to the death.The authors also suggest that hospitals carry out a rapid and efficient independent investigation into deaths to determine whether error played a role. A root cause analysis approach would help while offering the protection of anonymity, they say. Standardized data collection and reporting are also needed to build an accurate national picture of the problem.

 

Jim Rickert, MD, an orthopedist in Bedford, Indiana, and president of the Society for Patient Centered Orthopedics, toldMedscape Medical News he was not surprised the errors came in at number 3 and that even those calculations don't tell the whole story."That doesn't even include doctors' offices and ambulatory care centers," he notes. "That's only inpatient hospitalization resulting in errors." ...."It's public pressure that brings about change. Hospitals have no incentive to publicize errors; neither do doctors or any other provider," he said.

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Published on 1 Comment on Coal-tar Sealcoats Used on Driveways and Pavements Are More Toxic Than Suspected

The title says it all: coal-tar sealcoats used on drIveways and pavement are far more toxic than earlier suspected. The asphalt sealcoats are also toxic, but the coal-tar ones are far worse - so if you must use one, go with asphalt sealcoats. Or...better yet, skip either product and avoid breathing in toxic PAHs (polycyclic aromatic hydrocarbons). From Science Daily:

Coal-tar based sealcoats on driveways, parking lots far more toxic than suspected

The pavement sealcoat products used widely around the nation on thousands of asphalt driveways and parking lots are significantly more toxic and mutagenic than previously suspected, according to a new paper published this week by researchers from Oregon State University. Of particular concern are the sealcoat products based on use of coal tar emulsions, experts say. Studies done with zebrafish -- an animal model that closely resembles human reaction to toxic chemicals -- showed developmental toxicity to embryos.

Sealcoats are products often sprayed or brushed on asphalt pavements to improve their appearance and extend their lifespan. Products based on coal tar are most commonly used east of the U.S. continental divide, and those based on asphalt most common west of the divide. The primary concern in sealcoats are polycyclic aromatic hydrocarbons, or PAHs, which are common products of any type of combustion, and have been shown to be toxic to birds, fish, amphibians, plants and mammals, including humans.

The OSU program studying PAHs....can identify and analyze more than 150 types of PAH compounds. It found some PAHs in coal tar sealcoats that were 30 times more toxic than one of the most common PAH compounds that was studied previously in these products by the U.S. Geological Survey. The OSU study also showed that new PAH compounds found in coal tar sealcoats had a carcinogenic risk that was 4 percent to 40 percent higher than any study had previously showed. Among the worst offenders were a group of 11 "high molecular weight" PAH derivative compounds, of which no analysis had previously been reported.

By contrast, the study showed that sealcoats based on asphalt, more commonly used in the West, were still toxic, but far less than those based on coal tar. Use of coal tar sealcoats, which are a byproduct of the coal coking process, is most common in the Midwest and East..... "And if a decision is made to use sealcoats, we concluded that the products based on asphalt are significantly less toxic than those based on coal tar."

A 2011 report from the USGS outlined how PAH compounds from sealcoat products can find their way into soils, storm waters, ponds, streams, lakes, and even house dust, as the compounds are tracked by foot, abraded by car tires, washed by rain and volatilize into the air. They reported that the house dust in residences adjacent to pavement that had been treated with a coal tar-based sealcoat had PAH concentrations 25 times higher than those normally found in house dust. Some states and many municipalities around the nation have already banned the use of coal tar-based sealcoats, due to the human, wildlife and environmental health concerns. In the European Union, use of coal tar-based sealcoats is limited or banned.

Published on Leave a comment on One Season of High School Football Results In Brain Changes

Study after study finds negative effects on the brain from playing football - here it is one season of high school football resulting in measurable brain changes. None of these players had a concussion during the season, and so the negative effects were from subconcussive head impacts or hits. Interestingly, those special helmets they wore to measure impacts showed no relationship with what the brain scans showed - so the helmets were basically useless in measuring subconcussive impacts. From Science Daily:

Head impacts from single season of high school football produce measurable change in brain cells

Repeated impacts to the heads of high school football players cause measurable changes in their brains, even when no concussion occurs, according to new research. Researchers gathered data from high school varsity players who donned specially outfitted helmets that recorded data on each head impact during practice and regular games. They then used experimental techniques to measure changes in cellular microstructure in the brains of the players before, during, and after the season.

"Our findings add to a growing body of literature demonstrating that a single season of contact sports can result in brain changes regardless of clinical findings or concussion diagnosis," said senior author Dr. Joseph Maldjian, Chief of the Neuroradiology Division and Director of the Advanced Neuroscience Imaging Research Lab, part of the Peter O'Donnell Jr. Brain Institute at UT Southwestern.

In the study, appearing in the Journal of Neurotrauma, a team of investigators at UT Southwestern, Wake Forest University Medical Center, and Children's National Medical Center evaluated about two dozen players over the course of a single football season.....During the pre-season each player had an MRI scan and participated in cognitive testing, which included memory and reaction time tests. During the season they wore sensors in their helmets that detected each impact they received. Post-season, each player had another MRI scan and another round of cognitive tests. 

Researchers then used diffusional kurtosis imaging (DKI), which measures water diffusion in biological cells, to identify changes in neural tissues. ....DKI also allowed the researchers to measure white matter abnormalities. White matter consists of fibers that connect brain cells and can speed or slow signaling between nerve cells. In order for the brain to reorganize connections, white matter must be intact and the degree of white matter damage may be one factor that limits the ability of the brain to reorganize connections following TBI.

Football has the highest concussion rate of any competitive contact sport, and there is growing concern -- reflected in the recent decrease in participation in the Pop Warner youth football program -- among parents, coaches, and physicians of youth athletes about the effects of subconcussive head impacts, those not directly resulting in a concussion diagnosis, researchers noted. Previous research has focused primarily on college football players, but recent studies have shown impact distributions for youth and high school players to be similar to those seen at the college level, with differences primarily in the highest impact magnitudes and total number of impacts, the researchers noted.

Published on Leave a comment on Endocrine Disruptors Raise the Risk of Endometriosis and Fibroids

We're surrounded by hormone disrupting chemicals (endocrine disruptors) in daily life - in plastics, personal care products, pesticides, food containers, plastic toys, etc.

A recent study done in the European Union (EU) reports on a growing body of evidence suggesting that exposures to endocrine-disrupting chemicals (EDCs), particularly phthalates and diphenyldichloroethene (DDE), contribute to the development of common reproductive disorders in women: endometriosis and uterine fibroids. A group of global EDC experts estimated the economic costs of these female reproductive disorders attributable to endocrine disrupting chemical exposures at nearly €1.5 billion ($158 billion) annually.

EDCs (like DDT and phthalates) are believed to contribute to health problems by mimicking, blocking, or otherwise interfering with the function of hormones by disrupting the signaling system the body uses to determine how cells develop and grow.

A number of studies suggest a byproduct of the pesticide DDT, a chemical known as DDE, can raise the risk of developing uterine fibroids, and that another group of chemicals called phthalates, which are found in plastic products and cosmetics, have been linked to a risk of edometriosis. Keep in mind that several other chemicals, such as PCBs, or polychlorinated biphenyls, and BPA have also been linked with female reproductive health problems. From Science Daily:

Chemical exposure linked to 1.4 billion euros in women's health care costs, study suggests

Endocrine-disrupting chemicals may contribute to reproductive health problems experienced by hundreds of thousands of women, costing European Union an estimated 1.4 billion Euros ($1.5 billion) a year in health care expenditures and lost earning potential, according to a new study. The study examined rates of uterine fibroids -- benign tumors on the uterus that can contribute to infertility and other health problems -- and an often painful condition called endometriosis where the tissue that normally lines the uterus develops elsewhere in the body. The two conditions are common, with as many as 70 percent of women affected by at least one of the disorders.

Research has linked the development of uterine fibroids and endometriosis to chemicals found in pesticides, cosmetics, toys and food containers. Past studies suggest a byproduct of the pesticide DDT, a chemical known as DDE, can raise the risk of developing uterine fibroids. Another group of chemicals called phthalates, which are found in plastic products and cosmetics, have been tied to growing risk of endometriosis.....DDT and phthalates are known endocrine-disrupting chemicals (EDCs). 

"Although these two gynecological conditions affect millions of women worldwide, we recognize that this analysis only reflects the tip of the iceberg," Trasande said. "A growing body of evidence suggests EDC exposure is linked to a broader range of female reproductive problems, including polycystic ovary syndrome, infertility and pregnancy complications. These disorders also place a significant cost burden on women, their families and society as a whole.

A news story added some extra details and background to this story. From CNN:

Common chemicals linked to endometriosis, fibroids -- and healthcare costs

Hormone-disrupting chemicals are everywhere -- in plastics, pesticides and makeup -- and two of them, phthalates and DDE, have been particularly strongly linked with common female reproductive conditions, such as fibroids. In a new study, researchers estimate that the problems caused by these two chemicals alone could cost the European Union at least 1.41 billion euros a year, the U.S. equivalent of about $1.58 billion.

DDE is a breakdown product of the insecticide DDT that, although banned in the United States in 1972 and in Europe starting in the 1970s, still lingers in the environment and enters our body through food. The main exposure to phthalates is through eating food and drink stored in plastic containers that have phthalates.....In a similar way, they relied on a study that linked higher phthalate levels in women who had been diagnosed with endometriosis compared to healthy women.

The current study is important because it focused on chemicals that have not been restricted, and in the case of DDE -- which persists in the environment -- are not able to be restricted, Birnbaum said. However, she said she was surprised the researchers did not include an analysis of chemicals such as BPA, which has also been linked to endometriosis risk."This study is kind of a wake-up to say endocrine disruptors impact the female reproductive system, and we have some evidence they are associated with an increase in endometriosis and fibroids and it costs a lot of money," Birnbaum said.

Even with all the questions that remain, and few regulations in place, "there are safe and simple steps that families and women can take to reduce exposure to endocrine-disrupting chemicals," Trasande said. "They can eat organic, reduce canned food consumption, which reduces exposure to BPA, and avoid packaged or highly processed food, which is a major route for phthalates to enter food. They can also open windows to allow chemical dust, which accumulates on the carpet and electronics, to circulate out of homes."

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Published on 8 Comments on Health Reasons to Avoid Fragrances, Air Fresheners, Dryer Sheets

Did you ever wonder about all the consumer products that have fragrances in them and whether they are safe to use? Think of all the fragrances in personal care products and perfumes, in air fresheners, scented soaps, cleaning products, scented candles, even laundry detergents, and scented dryer sheets.

Fragrances are made up of many synthetic chemicals - with the "fragrance" in a product typically being a mixture of 50 to 300 chemicals. They are considered an important source of indoor air pollution and can have negative health effects on humans, especially developing fetuses and children. Fragrances are added to products to achieve a desired scent or mask other scents in the product. Air fresheners do not clean or freshen the air, but actually add chemicals to the air to mask other odors. Manufacturers are NOT required to disclose all the ingredients or chemicals in the products, and don't have to disclose any ingredients in any chemical mixture called "fragrance".

The few studies looking at health effects have found negative health effects, including on the lungs, respiratory effects, asthma, allergies, headaches, skin irritation, sensory irritation, hormonal effects, central nervous system effects, and inflammation. But more negative health effects are possible, especially because many of the chemicals are carcinogenic (cancer causing). We inhale the chemicals or absorb them through the skin, and from there they travel throughout the body - which is why they can be measured in the blood or urine.

Reading the studies that look at the chemicals emitted from scented products that people use every day can be overwhelming. Many of the studies specifically look at VOCs (volatile organic compounds) that the products emit, because these can affect air quality and human health. A big difficulty is that humans are exposed to mixtures of chemicals daily from many products, and the effects may take years to manifest themselves (such as cancer). 

Bottom line: avoid, avoid, avoid fragranced or scented products if possible. Do not use scented detergent or dryer sheets (not necessary), do not use air fresheners (either in the home, workplace, or car), do not use incense or scented candles (post on scented candles). Read labels. Opening windows is the best way to air out a house or apartment. Studies find that fragrances labeled "organic", "natural", "green", or "with essential oils" basically emit the same toxic chemicals into the air (view such labels as marketing or "greenwashing") - therefore avoid those also.

Air fresheners are consumer products used in homes or in restrooms that typically emit fragrances,  including incense, scented candles, aerosol liquid wick and electric diffusers, and gels. Depending on which air freshener is used (and including those labeled "all natural"), they emit varying levels of allergens and toxic air pollutants (and which can also combine to produce other pollutants - "secondary pollutants"): acetone, aldehydes, benzene, toluene, formaldehyde, terpenes, styrene, esters, phthalates (which are hormone disrupting chemicals), limonene, and also ultrafine particles. None of these toxic chemicals are listed on the product labels. Typically, a fragrance is listed simply as “fragrance,” even though each fragrance can contain hundreds of individual chemicals. Only this past year has one company (Glade) started posting online (but not on the packages) some of the many chemicals used in its scented products.  ...continue reading "Health Reasons to Avoid Fragrances, Air Fresheners, Dryer Sheets"

Published on Leave a comment on Chocolate, Cognitive Function, and Athletic Performance

Image result for dark chocolate Two new studies finding benefits from chocolate consumption: dark chocolate boosting athletic performance (in cycling), and long-term chocolate consumption (several times a week for many years) linked to better cognitive function. From Medical Xpress:

Eating chocolate improves cognitive function, study finds

People who ate chocolate at least once a week performed better on multiple cognitive tasks, compared to those who ate chocolate less frequently, according to a new study by researchers at the University of Maine, University of South Australia and Luxembourg Institute of Health that has garnered international attention. 

With age, education, gender, age and race controlled, cognitive tasks were related to following domains, each measured by multiple tests: Visual-Spatial Memory and Organization, Working Memory, Abstract Verbal Reasoning, Scanning and Tracking, and overall cognitive functioning. The 968 participants ages 23–98 in the study came from the Maine-Syracuse Longitudinal Study, directed by Elias, which has tracked more than 1,000 people over 35 years.

The researchers hypothesized that regular intake of cocoa flavanols may be one of several mechanism explaining the cognitive benefits of chocolate. In addition, compared to those who never or rarely ate chocolate, those who ate chocolate weekly had higher total and LDL cholesterol, but lower glucose levels. Hypertension and Type 2 diabetes also were lower in regular chocolate consumers than in nonconsumers. 

From Medical Xpress: Eating dark chocolate as a daily snack could help boost athletic performance, study suggests

Dark chocolate has already been hailed for its positive effects on cardiovascular health – and now a study undertaken at London's Kingston University has found the tasty treat could help give sports enthusiasts an extra edge in their fitness training. A team led by postgraduate research student Rishikesh Kankesh Patel discovered that dark chocolate provides similar benefits to beetroot juice, now taken regularly by elite athletes after studies showed it can improve performance. "Beetroot juice is rich in nitrates, which are converted to nitric oxide in the body. This dilates blood vessels and reduces oxygen consumption – allowing athletes to go further for longer," Mr Patel explained.

The Kingston University team wanted to find out whether dark chocolate could provide a similar boost, as it contains a substance called epicatechin – a type of flavanol found in the cacao bean, that also increases nitric oxide production in the body.

To test the theory, Mr Patel carried out a study with a group of nine amateur cyclists.....After undergoing initial fitness tests to establish a baseline for comparison, the participants were then split into two groups. The first group was asked to replace one of its normal daily snacks with 40 g of a dark chocolate known to be rich in flavanols for a fortnight, while the other participants substituted 40 g of white chocolate for one of their daily snacks as a control.

The effects of the athletes' daily chocolate consumption were then measured in a series of cycling exercise tests in the sports performance laboratory at the University's Penrhyn Road campus....The study, which has now been published in the Journal of the International Society of Sports Nutrition, found that after eating dark chocolate, the riders used less oxygen when cycling at a moderate pace and also covered more distance in a two-minute flat-out time trial.

Published on Leave a comment on Some Popular Medicines Have Negative Brain Effects

Another study showing big problems with anticholinergics, which are in many popular medicines - both non-prescription and prescription (e.g., Chlor-Trimeton, Benadryl, Tavist, Dimetapp). An earlier study with older adults found a dose-response link with dementia, but the current study explored this issue further. They followed 2 groups of  "cognitively normal older adults" in their early 70s for several years: those who took anticholinergic medicines and those who did not take anticholinergic medicines. They found that those who took anticholinergic medicines had reduced brain volume (brain shrinking) and cognitive decline (when compared to those who did not take anticholinergic medicines). The researchers summarized their findings as the "use of anticholinergic medication was associated with increased brain atrophy and dysfunction and clinical decline". This finding was greatest for those taking drugs with the most anticholinergic activity.

See a list of anticholinergic medicines  from the Aging Brain Program of the Indiana University Center for Aging Research. Definitely try to avoid medicines with a score of 2 (medium effect) or 3 (high effect), but I would even be cautious about score 1 (low effect) medicines - use all medicines only as long as absolutely needed. My one very important question is: If these effects are found in older adults, what do anticholinergics do to younger brains, especially the developing brains of children? From Medical Xpress:

Brain scans link physical changes to cognitive risks of widely used class of drugs

Older adults might want to avoid a using class of drugs commonly used in over-the-counter products such as nighttime cold medicines due to their links to cognitive impairment, a research team led by scientists at Indiana University School of Medicine has recommended. Using brain imaging techniques, the researchers found lower metabolism and reduced brain sizes among study participants taking the drugs known to have an anticholinergic effect, meaning they block acetylcholine, a nervous system neurotransmitter.

Previous research found a link between between the anticholinergic drugs and cognitive impairment and increased risk of dementia.....Drugs with anticholinergic effects are sold over the counter and by prescription as sleep aids and for many chronic diseases including hypertension, cardiovascular disease, and chronic obstructive pulmonary disease. A list of anticholinergic drugs and their potential impact is at http://www.agingbraincare.org/uploads/products/ACB_scale_-_legal_size.pdf.

Scientists have linked anticholinergic drugs and cognitive problems among older adults for at least 10 years. A 2013 study by scientists at the IU Center for Aging Research and the Regenstrief Institute found that drugs with a strong anticholinergic effect cause cognitive problems when taken continuously for as few as 60 days. Drugs with a weaker effect could cause impairment within 90 days.

The current research project involved 451 participants, 60 of whom were taking at least one medication with medium or high anticholinergic activity. The participants were drawn from a national Alzheimer's research project....and the Indiana Memory and Aging Study. To identify possible physical and physiological changes that could be associated with the reported effects, researchers assessed the results of memory and other cognitive tests, positron emission tests (PET) measuring brain metabolism, and magnetic resonance imaging (MRI) scans for brain structure.

The cognitive tests revealed that patients taking anticholinergic drugs performed worse than older adults not taking the drugs on short-term memory and some tests of executive function, which cover a range of activities such as verbal reasoning, planning, and problem solving. Anticholinergic drug users also showed lower levels of glucose metabolism—a biomarker for brain activity—in both the overall brain and in the hippocampus, a region of the brain associated with memory and which has been identified as affected early by Alzheimer's disease. The researchers also found significant links between brain structure revealed by the MRI scans and anticholinergic drug use, with the participants using anticholinergic drugs having reduced brain volume and larger ventricles, the cavities inside the brain.

Published on Leave a comment on Noninvasive Thyroid Cancer Is No Longer Cancer

For the first time ever, one type of cancer has been reclassified as a non-cancer. An international panel of pathologists and clinicians has reclassified a type of thyroid cancer to reflect that it is noninvasive and has a low risk for recurrence.The panel renamed encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). There has been concern for a while of the costs (financial, physical, and mental) of the overdiagnosis and overtreatment for something that won't spread (it's "indolent" and "low-risk").

There have been discussions for some time now in the medical community regarding the move away from the word "cancer" in the description of early stages of both breast and prostate cancer. In 2013, a medical team sanctioned by the National Cancer Institute proposed that a number of premalignant conditions, including ductal carcinoma in situ and high-grade prostatic intraepithelial neoplasia, should no longer be called "cancer." Instead, the conditions should be labeled something more appropriate, such as indolent lesions of epithelial origin (IDLE), the group suggested. " Use of the term 'cancer' should be reserved for describing lesions with a reasonable likelihood of lethal progression if left untreated," the group said at the time.

From Futurity: NONINVASIVE THYROID ‘CANCER’ ISN’T CANCER

The reclassification of a noninvasive type of thyroid cancer that has a low risk of recurrence is expected to reduce the fears and the unnecessary interventions that come with a cancer diagnosis, experts say. The incidence of thyroid cancer has been rising partly due to early detection of tumors that are indolent or non-progressing, despite the presence of certain cellular abnormalities that are traditionally considered cancerous, says senior investigator Yuri Nikiforov, professor of pathology at the University of Pittsburgh.

“This phenomenon is known as overdiagnosis,” Nikiforov says. “To my knowledge, this is the first time in the modern era a type of cancer is being reclassified as a non-cancer. I hope that it will set an example for other expert groups to address nomenclature of various cancer types that have indolent behavior to prevent inappropriate and costly treatment.”

In particular, a tumor type known as encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) has increased in incidence by an estimated two- to three-fold over the past 20 to 30 years and makes up 10 to 20 percent of all thyroid cancers diagnosed in Europe and North America. Although studies have shown EFVPTC is not dangerous, it is typically treated as aggressively as other types of thyroid cancer. At the recommendation of the National Cancer Institute, the panel sought to revise the terminology and to see if the word “cancer” could be dropped from its name.

As reported in JAMA Oncology, two dozen experienced pathologists from seven countries and four continents independently reviewed 268 tumor samples diagnosed as EFVPTC from 13 institutions....In a group of more than 100 noninvasive EFVPTCs, there were no recurrences or other manifestations of the disease at a median follow-up of 13 years. They decided to rename EFVPTC as “noninvasive follicular thyroid neoplasm with papillary-like nuclear features” or NIFTP. The new name cites key features to guide pathologists in diagnosis, but omits the word “cancer,” indicating that it need not be treated with radioiodine or other aggressive approaches.

“We determined that if NIFTP is carefully diagnosed, the tumor’s recurrence rate is extremely low, likely less than 1 percent within the first 15 years,” Nikiforov says. “The cost of treating thyroid cancer in 2013 was estimated to exceed $1.6 billion in the US. Not only does the reclassification eliminate the psychological impact of the diagnosis of ‘cancer,’ it reduces the likelihood of complications of total thyroid removal, and the overall cost of health care.”

Published on Leave a comment on Fast Food and Exposure to Phthalates and BPA

There is increasing concern over phthalates and BPA and their effects on human health. It turns out that a big source of phthalates (which are known endocrine disruptors) in humans may be fast food.

A new study looked at fast food consumption by  8877 people and found that those who reported eating more of it in the past 24 hours had urinary phthalate levels as much as 40 percent higher than those who had eaten no fast food in the 24 hours before testing. In fact, it was a dose-response relationship between fast food intake and exposure to phthalates - the more fast food, the higher the level of phthalates.

The researchers did not find an association between total fast food consumption and BPA. However, they did find an  association between fast food meat intake and BPA,  which corresponds to the small but growing evidence from other studies suggesting that hamburgers may be a source of BPA exposure.

These findings are of concern to all of us because phthalates and bisphenol A (BPA) are widely used industrial chemicals that may adversely impact human health. Studies detect phthalates in 98% of the US population. They are found in a wide variety of products (including plastics and personal care products), and can enter the human body via ingestion, inhalation, and absorption through the skin.

How are we exposed to them in fast food? Phthalates and BPA are typically found in food packaging and some leaches out into food. Some can also leach into food from dairy product tubing, in lid gaskets, food preparation gloves, conveyor belts, etc. Thus we ingest phthalates and BPA when we consume processed or packaged food. Fast food may be an especially important source of exposure to phthalates and BPA because it is highly processed, packaged, and handled.

Studies have demonstrated that the phthalates DEHP and DiNP are endocrine (hormone) disruptors, and that human exposure has been associated with adverse reproductive, neurobehavioral, and respiratory health effects. BPA is also an endocrine disruptor. We are all being exposed numerous ways, but the lower the levels, the better.

The good news is that once in the body, phthalates and BPA are quickly metabolized and excreted in urine, with elimination half-lives of less than 24 hours. Thus you can quickly reduce the levels in your body. And you should try.

From Science Daily: Fast food may expose consumers to harmful chemicals called phthalates

People who reported consuming more fast food in a national survey were exposed to higher levels of potentially harmful chemicals known as phthalates, according to a study published by researchers at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.

"People who ate the most fast food had phthalate levels that were as much as 40 percent higher," says lead author Ami Zota, ScD, MS, an assistant professor of environmental and occupational health at Milken Institute SPH. "Our findings raise concerns because phthalates have been linked to a number of serious health problems in children and adults."Phthalates belong to a class of industrial chemicals used to make food packaging materials, tubing for dairy products, and other items used in the production of fast food. Other research suggests these chemicals can leach out of plastic food packaging and can contaminate highly processed food.

Zota and her colleagues looked at data on 8,877 participants who had answered detailed questions about their diet in the past 24 hours, including consumption of fast food. These participants also had provided researchers with a urinary sample that could be tested for the breakdown products of two specific phthalates--DEHP and DiNP.

Zota and her colleagues found that the more fast food participants in the study ate the higher the exposure to phthalates. People in the study with the highest consumption of fast food had 23.8 percent higher levels of the breakdown product for DEHP in their urine sample. And those same fast food lovers had nearly 40 percent higher levels of DiNP metabolites in their urine compared to people who reported no fast food in the 24 hours prior to the testing. The researchers also discovered that grain and meat items were the most significant contributors to phthalate exposure. Zota says the grain category contained a wide variety of items including bread, cake, pizza, burritos, rice dishes and noodles.

In addition, the researchers also looked for exposure to another chemical found in plastic food packaging--Bisphenol A or BPA. Researchers also believe exposure to BPA can lead to health and behavior problems, especially for young children. This study found no association between total fast food intake and BPA. However, Zota and her colleagues found that people who ate fast food meat products had higher levels of BPA than people who reported no fast food consumption.