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Plastic Packaging Linked to Diabetes and Other Health Problems

"Widespread and continuous exposure to BPA, primarily through food but also through drinking water and oher sources, is evident from the presence of detectable levels of BPA in more than 90 percent of the U.S. population," says a JAMA study.

18 September 2008

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This press release is an announcement submitted by the Journal of the American Medical Association, and was not written by Diabetes Health.

Mr. McGuire: I want to say one word to you. Just one word.
Benjamin: Yes, sir.
Mr. McGuire: Are you listening?
Benjamin: Yes, I am.
Mr. McGuire: Plastics.
Benjamin: Just how do you mean that, sir?

- The Graduate

Higher urinary levels of the commonly used chemical, BPA, are linked with cardiovascular disease and diabetes.

Higher levels of urinary bisphenol A (BPA), a chemical compound commonly used in plastic packaging for food and beverages, is associated with cardiovascular disease, type 2 diabetes, and liver-enzyme abnormalities, according to a study in the September 17 issue of JAMA. This study is being released early to coincide with a Food and Drug Administration (FDA) hearing on BPA.

BPA is one of the world's highest production-volume chemicals, with more than two million metric tons produced worldwide in 2003 and annual increase in demand of 6 percent to 10 percent annually, according to background information in the article. It is used in plastics in many consumer products. "Widespread and continuous exposureto BPA, primarily through food but also through drinking water, dental sealants, dermal exposure, and inhalation of household dusts, is evident from the presence of detectable levels of BPA in more than 90 percent of the U.S. population," the authors write.

Evidence of adverse effects in animals has created concern over low-level chronic exposures in humans, but there are few data of sufficient statistical power to detect low-dose effects. This is the first study of associations with BPA levels in a large population, and it explores "normal" levels of BPA exposure.

David Melzer, MB, PhD, of Peninsula Medical School, Exeter, U.K., and colleagues examined associations between urinary BPA concentrations and the health status of adults, using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The survey included 1,455 adults, ages 18 through 74 years, with measured urinary BPA concentrations.

The researchers found that average BPA concentrations, adjusted for age and sex, appeared higher in those who reported diagnoses of cardiovascular diseases and diabetes. A 1 standard deviation (SD) increase in BPA concentration was associated with a 39 percent increased odds of cardiovascular disease (angina, coronary heart disease, or heart attack combined) and diabetes.

When dividing BPA concentrations into quartiles, participants in the highest BPA concentration quartile had nearly three times the odds of cardiovascular disease compared with those in the lowest quartile. Similarly, those in the highest BPA concentration quartile had 2.4 times the odds of diabetes compared with those in the lowest quartile.

In addition, higher BPA concentrations were associated with clinically abnormal concentrations for three liver enzymes. No associations with other diagnoses were observed.

"Using data representative of the adult U.S. population, we found that higher urinary concentrations of BPA were associated with an increased prevalence of cardiovascular disease, diabetes, and liver-enzyme abnormalities. These findings add to the evidence suggesting adverse effects of low-dose BPA in animals. Independent replication and follow-up studies are needed to confirm these findings and to provide evidence on whether the associations are causal," the authors conclude. "Given the substantial negative effects on adult health that may be associated with increased BPA concentrations andalso given the potential for reducing human exposure, our findings deserve scientific follow-up."

Source: Journal of the American Medical Association (JAMA)

In an accompanying editorial, Frederick S. vom Saal, PhD, of the University of Missouri, Columbia, and John Peterson Myers, PhD, of Environmental Health Sciences, Charlottesville, Va., comment on the findings regarding BPA.

"Since worldwide BPA production has now reached approximately 7 billion pounds per year, eliminating direct exposures from its use in food and beverage containers will prove far easier than finding solutions for the massive worldwide contamination by this chemical due its to disposal in landfills and the dumping into aquatic ecosystems of myriad other products containing BPA, which Canada has already declared to be a major environmental contaminant."

"The good news is that government action to reduce exposures may offer an effective intervention for improving health and reducing the burden of some of the most consequential human health problems. Thus, even while awaiting confirmation of the findings of Lang et al., decreasing exposure to BPA and developing alternatives to its use are the logical next steps to minimize risk to public health."

Source: Journal of the American Medical Association

Officials Call Off Controversial Autism Study

WASHINGTON - Health officials have called off plans for a study examining a controversial type of treatment that some autism activists have touted as alternative medical therapy for children with the condition. .more...

Healthy Living Halves Premature Death Risk

Women who heed common sense health messages about smoking, diet and exercise can cut their risk of premature death in half, U.S. researchers said on Tuesday.

Many studies look at the impact of just one lifestyle change on overall health, but researchers at Harvard University wanted to see the total impact of a healthy diet, regular exercise, a healthy weight and a lifetime without smoking. ..more...

Virtual Colonoscopy Vs. Traditional Colonoscopy

A new study showed that virtual colonoscopy was able to detect 90% of precancerous polyps larger than 10 millimetres, giving the patients a less expensive alternative to standard colonoscopy, which had the same accuracy. These non-invasive tests are as effective as old-fashioned colonoscopies and ready to be widely used for cancer screening, said Dr. C. Daniel Johnson, lead author of the study published in the New England Journal of Medicine.

Colon cancer is the second leading cause of cancer deaths in the United States and the third most common type of cancer. More that 56,000 people lose the battle with cancer each year. The American Cancer Society estimates almost 150,000 new cases of colorectal cancer for 2008 in the U.S. Screening for polyps is recommended at age 50, but people avoid standard procedures because they are unpleasant. They involve inserting a long and flexible tube in a patient’s large intestine (rectum and colon). A small video camera is attached to the colonoscope so that your doctor can take pictures or video of the large colon. The test helps find ulcers, polyps, tumors and areas of inflammation or bleeding. In some cases during colonoscopy, if a polyp or abnormal tissue is found, your doctor may remove it at that time. During the procedure, a tissue sample (biopsy) of the polyp may be taken for lab analysis to determine whether subsequent surgical removal of the tissue is needed.

The report published in the New England Journal of Medicine, which was the largest of this kind, involved 2,600 men and women tested at 15 medical centers. All participants were over the age of 50 and had no known significant risk factors for colon cancer. All patients received both a virtual and a traditional colonoscopy. Researchers found that the virtual technique detected 90% of precancerous polyps 10 millimetres or larger. The virtual version of the test is done mainly outside the body and uses an X-ray computed tomography or CT scanner.

Virtual colonoscopy, also known as CT colonography or CTC, which costs $600 to $1,200 – the standard colonoscopy is much more expensive – is effective and is lessinvasive compared with traditional colonoscopy, the study authors said.

C. Daniel Johnson, MD, professor of radiology at the Mayo Clinic in Scottsdale, Ariz, who led the study, and colleagues also found that CT colonography could detect 78% of polyps as small as 6 millimeters in diameter. The procedure failed to detect about one in ten of the largest lesions. Previous studies showed that standard colonoscopies also failed to spot about 5 percent to 10 percent of the lesions.

Both techniques require preparations, which are the patients’ biggest complaint. For the procedures to be accurate, the colon must be well prepared. It must be clear of stool and fluids that obscure the view of the colon and rectal lining.

The National Cancer Institute and the American College of Radiology Imaging Network funded the research.

A second study published in the same journal involved nearly 2,500 people with an average risk of colon cancer. All participants had an initial colonoscopy and patients who had no signs of precancerous polyps on an initial test had an extremely low risk of developing colon cancer in the next five years. “We found no colon cancer after five years, and the risk of advanced precancerous polyps was very low,”said the study’s lead author, Dr. Thomas F. Imperiale, a professor of medicine at Indiana University School of Medicine and a research scientist at the Regenstrief Institute in Indianapolis.

Both studies move the field of colon cancer screening forward, wrote Robert Fletcher, professor emeritus at Harvard Medical School in Boston, in an editorial accompanying the studies.

Common Plastics Chemical Linked to Heart Problems

A major study links a chemical widely used in plastic products, including baby bottles, to health problems in humans like heart disease and diabetes, but U.S. regulators said on Tuesday they still believe it is safe.

The chemical bisphenol A, or BPA, is commonly used in plastic food and beverage containers and in the coating of food cans.

Until now, environmental and consumer activists who have questioned the safety of BPA have relied on animal studies. ..more...

Blood Pressure Drug Combo Reduces Heart Deaths

Thousands of patients with high blood pressure could benefit from changing their drug treatment regimen to reduce their risk of cardiac death.

The current U.S. hypertension treatment guidelines recommend using a thiazide diuretic – a drug that increases the volume of urine – alone as the initial drug therapy for high blood pressure. But a failure of diuretic drugs to decrease deaths from heart attacks, an important consequence of hypertension, prompted Vanderbilt University Medical Center researchers to analyze data from existing clinical trials of diuretic drugs.

They found that combining a thiazide diuretic with a “potassium-sparing” drug to treat hypertension reduced both sudden cardiac death and total coronary mortality by 40 percent. The findings call into question the current treatment guidelines.

“The recommendations can now be re-examined in light of these new findings,” said John Oates, M.D., senior author of the study published in the September/October issue of the Journal of the American Society of Hypertension. The Joint National Committee, under the direction of the National Heart, Lung, and Blood Institute, publishes clinical practice guidelines for hypertension – new guidelines are expected in 2009.

Thiazide diuretics successfully reduce blood pressure for many patients, but they are also known to deplete potassium, said Oates, a professor of Medicine and hypertension specialist. This potassium “wasting” has sparked concern over the years with studies suggesting a link between potassium loss and sudden cardiac death.

Oates and colleagues examined data from controlled clinical trials that compared a thiazide diuretic/potassium-sparing (ENaC inhibitor) drug combination to placebo. They generated new, previously unpublished data on sudden death in these trials, and then analyzed the results of the trials in a meta-analysis – a statistical evaluation of data combined from multiple trials. They found a 40 percent reduction in total cardiac mortality and in sudden cardiac death in elderly patients with hypertension taking the drug combination, compared with those receiving placebo.

“It was very striking,” Oates said.

The investigators also performed a new meta-analysis of the clinical trials of thiazides given without a potassium-sparing drug, adding new trials to the mix. They found no benefit in coronary mortality and a 26 percent increase in sudden death. Even though the increase was not statistically significant, it was “going in the direction in which you didn’t want to go,” Oates said.

Observational studies previously had found an increase in sudden cardiac death in patients taking a thiazide diuretic alone, and one showed that sudden death was greater at higher doses of thiazides, he said. Studies in animal models of heart attacks also have demonstrated that low potassium levels (caused by thiazide diuretics) can spark the abnormal heart rhythms that lead to sudden death.

Do thiazide diuretics given alone have an adverse effect of increasing the risk of sudden cardiac death in patients with high blood pressure? It’s possible.

“There’s biologic plausibility for an adverse effect of the thiazides,” Oates said. “If it’s true, it’s probably the largest adverse effect in the history of modern pharmacology. The number of individuals affected over the last 50 years would be staggering.”

And since the current U.S. clinical practice guidelines for hypertension recommend a thiazide diuretic without a potassium-sparing drug, millions of patients may be at increased risk of coronary death, Oates pointed out.

Oates acknowledges that potassium-sparing drugs may reduce coronary mortality through a mechanism unrelated to their prevention of potassium loss. As studies proceed to determine how these drugs reduce death risk, he said, it’s time to add them to thiazides as recommended first-line treatment for high blood pressure in the elderly.

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Your Car is a Germ-Mobile

By: Sylvia Booth Hubbard

“People would be horrified at the thought of eating off their toilet seat,” says British researcher Anthony Hilton. “But few realize eating off their car dashboard is just as likely to make them sick.”

Hilton was the leader of a new British study by Aston University in Birmingham which shows the typical vehicle harbors over 280 different bacteria per square centimeter. The study, conducted for a U.K. insurance company, showed some spots are nastier than others—the gearshift, for example, usually crawls with over 350 different varieties.

The worst place is the trunk, where about 850 bacteria typically hitch a ride. Scientists even found evidence of excrement in one Germ-Mobile’s trunk, which is where many people put their grocery bags. They also found that cars used to transport kids and pets are the germiest. “Whilst most of the bacteria we’ve found are unlikely to cause serious health problems, some cars, particularly those which regularly carry children and animals, play host to potentially harmful germs,” Hilton said.

And you may want to think twice before turning on the heater or air conditioner—when the fan comes on, it blows even more germs and fungi around the interior, probably because few people regularly replace the vehicle’s interior air filter. Most of the people whose vehicles were used for study owned up to being slobs with their cars, and half said they would never allow their homes to get in the condition their cars were in.

Healthy Lifestyle Increases Anti-Aging Enzyme

Sweeping lifestyle changes including a better diet and more exercise can raise the body's levels of an enzyme closely involved in controlling the aging process, U.S. researchers reported on Monday.

The small study involved 30 men with low-risk prostate cancer who underwent three months of lifestyle changes. They had blood levels of the enzyme telomerase 29 percent higher after these three months than when they began.

Telomerase fixes and lengthens parts of chromosomes known as telomeres that control longevity and are also important for maintenance of immune-system cells.

The research in the journal Lancet Oncology was led by Dr. Dean Ornish, head of the Preventive Medicine Research Institute in Sausalito, California, and a well-known author advocating lifestyle changes to improve health.

The lifestyle changes included a diet rich in fruits, vegetables, whole grains, legumes and soy products, moderate exercise such as walking for half an hour a day, and an hour of daily stress management methods such as meditation.

"This is the first study showing that anything can increase telomerase. If it were a new drug that had been shown to do this, it would be a billion-dollar drug. But this is something that people can do for free," Ornish said in a telephone interview.

Shortening of telomeres is seen as an indicator of disease risk and premature death in some types of cancer, including breast, prostate, colon and lung cancer.

Previously published findings from the same group of men showed they experienced dramatic changes at the genetic level.

As expected, they lost weight, lowered their blood pressure and saw other health improvements.

They also had changes in activity in about 500 genes. The activity of disease-preventing genes increasing while some disease-promoting genes, including those involved in prostate cancer and breast cancer, shut down, the researchers said.

Basil Fights Aging

In a “What’s old is new” medical moment, Indian researchers discovered that holy basil, a native Indian herb long believed to promote health, really does promote health—and it has anti-aging properties in the bargain.

Holy basil (Ocimum sanctum), also known as “Tulsi,” is a relative of the herb used in Western cooking. It differs from culinary basil in that it is more clove-like, and its leaves are commonly used in India to brew a tea valued for its healing powers.

Stress May Increase Breast Cancer Risk

The results of a new study support an interaction between severe life events, psychological distress, and breast cancer. The findings appear in the online BioMed Central journal BMC Cancer.

"Young women who are exposed to severe life events more than once should be considered as a risk group for breast cancer and treated accordingly," first author Dr. Ronit Peled said in a telephone interview with Reuters Health.