Why supplements including anti-oxidants should be taken seriously.

Why supplements including anti-oxidants should be taken seriously.  Originally published in WODMASTERS.    Click for complete article.

• Products that are classified as drugs/medicine are required to meet standards of quality and consistency in manufacturing and of safety.    Studies are done in vitro, on animals, and finally on humans.  Drug interactions are checked.  Information is gathered on how the drug is metabolized. Drugs are sometimes metabolized into something deadly before being rapidly metabolized into something safe.  Tylenol is an example.  Not a problem unless something, like alcohol, blocks a metabolic step and traps Tylenol in its deadly form.  This is why people sometimes die when they drink alcohol and then take Tylenol.  This should be common knowledge, but it isn’t, yet.
• Another important thing to know about a drug or supplement is its “Effective Dose.”  How much is needed to give a desired effect?  How much selenium is needed for health?  How much is too much?   How much is “optimal”?  These are unanswered questions for many nutritional supplements.  What happens if you take too much?  Frequently the answer to that question is unknown as well.
• Anti-Oxidants should not be assumed to be safe.   Recent research has indicated that anti-oxidants, like oxidants, can harm DNA.  DNA damage can lead to cancer, the very thing anti-oxidants in nutritional supplements are supposed to prevent.
• The last point to raise for this article is a manufacturing issue.  Like most people, I used to assume that vitamins and supplements contained what was written on the package.   But this is not always the case.  An example is the recent report of human growth factors added to deer antler velvet supplements.  It is hard to believe human growth factors were accidentally added to deer antler velvet supplements.   You’d have to hear the manufacturer out on that one.  However, problems like poor mixing and poor calculations can and do happen.  Our research group found that out the hard way when we tried to use a well-known brand of vitamins for a human health study.

So, how much of what is in a multi-vitamin?   How much of what is in Deer Antler Velvet, DHEA supplements, or “high performance packets?”  Deer antler velvet, especially if it is secretly spiked with human growth hormone may quite unsafe.  Secret additions to supplements may or may not be added carefully or consistently.  There is no way to know unless you are the one doing the spiking . . . or if you have the technical expertise and expensive equipment needed to test it yourself.

New Video on The Economic Costs of Obesity

The producers (?) of this video asked if we would post it on our blog.  The organization is called Academic Earth.  The video discusses obesity and brings up some interesting statistics on agricultural subsidies.  Apparently, fresh fruit and vegetables don't get much in the way of subsidies.  This may make them more expensive for consumers.  The final result is that calories from junk food are cheaper than calories from healthy food.    They also bring up some disturbing numbers about changes in caloric intake since the 1970s.

If this is true (and it probably is) why has it happened?  Changes in family structure and habits?  Environmental chemicals that interfere with metabolism or satiety?  Lack of exercise?  The development of eating as a recreational activity?  Eating out more?  Being too busy to cook or not knowing how to cook?  Its an interesting and sometimes frightening topic.  Here is the video.  What do you think?

Created by AcademicEarth.org

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New Book: The Rise of the U.S. Environmental Health Movement by Dr. Kate Davies

Author Dr. Kate Davies

A new book on the history of the US Environmental Health Movement has just been published.  The Title is: The Rise of the US Environmental Health Movement.  The book is described as the first of its kind and will offer a thorough examination of the environmental health movement.  Environmental health in this context refers to the impact of the environment on human health.  Many people are concerned about synthetic chemicals in air, food and water. A good understanding of how chemicals impact (or do not impact) health is important.  It is also important to understand history.  Unfortunately, there is a lot if misleading or inaccurate information out there. Disinformation fuels conspiracy theories and a generally poor approach to problem solving.  Dr. Davies' writing is clear, rational and refreshing.  The book is highly recommended. 

Dr. Davies' book describes how people first became aware of environmental health problems.  And how they organized to effect change.  There are some very interesting stories there and some very interesting struggles.

In some ways things are vastly different today than they were just a few decades ago.  Companies are much more cautious about introducing new chemicals into the environment.  Testing for potential problems is much easier today.  This helps companies avoid producing or using chemicals that come back to bite them in the ass.  Advances in chemistry have also made it much easier for companies to develop less toxic alternatives.  The history of the US environmental health movement also examines how chemical companies and other responsible parties attempted to undermine what were usually poorly funded and poorly organized grass-roots activists.   The fights go on.  Both sides have become more sophisticated in their political and public relations battles.  A better understanding of history and science among all parties should help take us away from battles and towards rational approaches to the resolution of problems that effect us all.

Protecting Children from Celiac Disease and a Child's View the problem.

Protecting children from Celiac Disease:

I've written several articles about gluten, microbes and auto-immunity.   All those interactions are interesting to think about.  To me this has been like tinkering with puzzles.  Celiac disease is a problem of auto-immunity and exposure to the plant protein gluten.  It can be a rough road to follow, especially for children.  They can't eat the same things other kids eat, and other kids and even adults may not understand that something that seems so normal to them, like a cupcake or sandwich, can cause serious pain and discomfort for a celiac child.  This website, "Growing Up Gluten Free" is written and maintained by a child with celiac disease.  It helped me understand what life is like for kids like her. 

Two children enjoy a Box lunch at CrossFit Seven in Fort Worth, TX.

Celiac disease is more common in people of European descent and probably has a strong genetic component.  However, there are other factors involved as well.  An individual may be predisposed to developing Celiac disease but not get it unless a combination of other factors line up as well.  One thing I had written about in an earlier post was the possibility that gut flora (microbial species and ratios of species) might influence the development of Celiac disease.  Intestinal flora in infants will be dependent on whether the infant was born by C-section and on whether he or she was breast fed or bottle fed.  The infant digestive system is not completely developed at birth.  It is suited for breast milk.  New research published this month (October 2012) supports a role for bacterial ecology in Celiac Disease.  Delaying introduction of wheat until the infant reaches 12 months of age appears to reduce risk that a genetically at-risk child will develop the disease.  Children with a genetic predisposition to Celiacs may take longer to develop an intestinal ecology favorable for wheat (and possibly other foods) than other children.  The study was a joint project of the University of Maryland School of Medicine and the Universita` Politecnica delle Marche, in Ancona, Italy.

A Systematic Review of infant feeding practices and incidence of Celiac (Coelicac) disease has also been published very recently (Szajewska et al. 2012).  The authors suggest that the best time to introduce wheat into an infant's diet is between 4 and 7 months, and that it should be done while the child is still breastfeeding.   Introducing wheat before a child is under 4 months increases the likelihood that he or she will develop Celiac Disease.  Likewise, delaying introduction until a child is older than seven months may also increase risk of Celiac's.

There are lots of unknowns still.  The Szajewska paper does a great job of defining what they are.  

Sellitto M, Bai G, Serena G, Fricke WF, Sturgeon C, Gajer P, White JR, Koenig SS, Sakamoto J, Boothe D, Gicquelais R, Kryszak D, Puppa E, Catassi C, Ravel J, & Fasano A (2012). Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants. PloS one, 7 (3) PMID: 22432018  

Szajewska H, Chmielewska A, Pieścik-Lech M, Ivarsson A, Kolacek S, Koletzko S, Mearin ML, Shamir R, Auricchio R, Troncone R, & PREVENTCD Study Group (2012). Systematic review: early infant feeding and the prevention of coeliac disease. Alimentary pharmacology & therapeutics, 36 (7), 607-18 PMID: 22905651

Correlation and Causality: Alcohol and Diabetes to BPA and Estrogen Disruption

Alcohol and Diabetes:

From a purely health-oriented perspective, alcohol is one of those things where a little seems to be good and more than a little puts you at risk for a bad health outcome. One of the positive things small regular intake can do for you is protect you from diabetes. There is good epidemiological evidence that this is the case. Light drinkers are less likely to develop diabetes than those who abstain.

Samples prepared for analysis. 

As most people know, just because two things occur together does not mean that one caused the other. Correlation and causality are two different things. It is important to keep this in mind when reading about human health studies in the news. Epidemiology is a wonderful tool however, and provides clues to problems that might have gone unnoticed. In addition to identifying potential problems correlational (and epidemiological) studies are important in evaluating how a problem identified in the lab may be harming people in the real world. Are light drinkers more likely to eat better, exercise better, be healthier than those who drink more alcohol or even none at all?

An important next step is figuring out why the correlation exists.  Here is a case where epidemiology observed something (low alcohol = less diabetes, high alcohol = more diabetes) and experimental study identified a physiological reason that explains those observations.    He et al. (2007) discovered that light alcohol intake activates a biochemical pathway that has a positive influence on removal of blood sugar from the blood stream. Higher alcohol intake disrupts glucose management by activating an additional protein that blocks the positive effects seen with light alcohol intake.  This discovery helps explain why you can see two different outcomes with alcohol.  At first light it may have seemed that scientific studies conflicted each other.  The appearance of contradiction may lead some people to throw up their hands and decide to disregard health news or science in general.

Sometimes we need to keep working at the puzzle.

There may be a similar issue with environmental contaminants.  Sometimes a relationship is observed and someone publishes on it, and there there are a flurry of other studies that confirm or don't confirm the relationship, expand it or limit it.  Identifying the mechanism and understanding how it works under varied circumstances becomes essential.  There are now many correlational studies that show that Bisphenol A (BPA) intake is associated with health problems.  There are also mechanistic studies that show how BPA interacts with estrogen receptors and causes things to go arwy.  One could stop here and take steps to remove BPA from use.  Environmentalists and children's health advocates could claim victory.  This might result in fewer birth defects, less obesity, less diabetes, fewer behavioral problems in children etc.  But it might not.

Plastics are more complex than they seem.  Even without BPA many of the chemicals that go into or are released from different plastics may be may activate estrogen receptors.  Would people be exposed to less estrogenic chemicals if BPA is banned?  We still don't know.  While many studies have used data on concentrations of BPA or BPA-metabolites, to the best of my knowledge no one has looked at total exposures to estrogenic chemicals originating from plastics.  (There are also estrogenic chemicals from sources other than plastics too).   Does removing BPA from a plastic actually make it less estrogenic?  Is BPA, rather than other chemicals coming off of plastics, the main source of dietary exposures to estrogenic compounds?

Plastics are amazing, really, and have made many positive and important contributions to our economy and quality of life.  For information on how plastics benefit the environment and contribute to quality of life take a look at this pdf from the British Plastics Federation.  Its taken tremendous effort and ingenuity to develop polymers.  We can figure out where they might cause problems in the environment or in human health by continuing polymer research and including within, cell and molecular studies.  We should not have to leave epidemiology to discover problems that could have been avoided after the fact. 

He L, Marecki JC, Serrero G, Simmen FA, Ronis MJ, & Badger TM (2007). Dose-dependent effects of alcohol on insulin signaling: partial explanation for biphasic alcohol impact on human health. Molecular endocrinology (Baltimore, Md.), 21 (10), 2541-50 PMID: 17622585

Nguyen KH, Lee JH, & Nyomba BL (2012). Ethanol causes endoplasmic reticulum stress and impairment of insulin secretion in pancreatic β-cells. Alcohol (Fayetteville, N.Y.), 46 (1), 89-99 PMID: 21840159

What are obesogens?

Living things are delicate, resilient and tenacious.  Their chemistry is fascinating.  We are molecular machines, in a sense, and fine tuned to interact with the external world.  The chemical systems that make us who and what we are took many millions of years to develop.  It is incredible that we are now able to synthesize molecules by ingenuity.  Chemical engineering, pharmaceutical companies and even the much maligned agrochemical industry have, and are, incredibly important to where we stand now.  The drugs, and even pesticides, that have been produced have saved countless lives. It is just now that we have calmed down a little from the excitement of synthesizing new molecules, and started looking at the unintended effects these new molecules have on biochemistry.  Things that alter our biochemistry can alter our health.   Sometimes they can alter the developmental paths we follow in utero. It would be wonderful if inadvertent exposures to new molecules had beneficial effects.  Its possible.  As with most things, the good things that happen by accident usually go unnoticed. However, as in most situations, it is far easier to be destructive than constructive. 

So, back to the post title: what are obesogens?

Obesity can make your life harder than it needs to be

Obesogens are chemicals that change the way fats (lipids) are handled.  Exposure, especially early in life, may influence patterns of fat distribution, the way the body uses fat, and/or the way fat is synthesized.  It is possible that some chemicals might make us develop as lean, fat burning machines.  This would be a huge problem if we ever have a famine, but that is not our current issue.  Obesity, and its associated health problems, is on the rise.  Some of the chemicals that may be acting as obesogens in people are:

Organotins (used in marine paints, production of plastics, pesticides. Exposure may come through seafood, produce, drinking water and plastics.

Bisphenol A (BPA): from plastics.

Phthalates: from plastics

 Perfluoroalkyll compounds (PFCs): water repellant fabrics, stain preventing treatments.

How to avoid obesogens.

Avoid plastics when possible.  Avoid fabrics treated with water repellants or stain blockers.  Avoid carpet treatments.  

Grün F, & Blumberg B (2006). Environmental obesogens: organotins and endocrine disruption via nuclear receptor signaling. Endocrinology, 147 (6 Suppl) PMID: 16690801
 

Thayer KA, Heindel JJ, Bucher JR, & Gallo MA (2012). Role of environmental chemicals in diabetes and obesity: a National Toxicology Program workshop review. Environmental health perspectives, 120 (6), 779-89 PMID: 22296744

Plastics, Diabetes and Obesity

Things start to get interesting when the results human epidemiology and animal exposure studies meet.  Epidemiology studies of human exposures to a xenoestrogen like BPA show relationships between exposure and diabetes, or exposure and obesity.  But it is very difficult to say that exposure to a plastics component causes obesity, diabetes or heart disease.  People who are exposed to a lot of xenoestrogens may eat more canned food and have more BPA (or similar) circulating in their systems, but people who eat a lot of canned and packaged food may also eat poorly, exercise less, and/or be less educated compared to someone who has very little plastics exposure.  

This is why animal studies are so important.  When the results of controlled animal studies are similar to trends we are observing in people the case for concern about a particular chemical jumps.  Many people oppose animal studies for ethical reasons, but sometimes leaving questions unanswered is unethical as well.  

There is increasing evidence that chemicals in the environment may be contributing to diabetes and obesity. This is not to say that there is no such thing as good habits, but biochemical variables, set during early life, may make it harder to regulate things like blood sugar and weight.  For current reviews and discussion take a look at:

• Toxic environment and obesity pandemia: Is there a relationship?
• Impact of environmental endocrine disrupting chemicals on the development of obesity.

Here is animal evidence for a relationship between exposure to bisphenol A, (and possibly other chemicals that are structurally similar)  and diabetes: Bisphenol A Exposure during Pregnancy Disrupts Glucose Homeostasis 
in Mothers and Adult Male Offspring. As discussed in previous posts, nearly everyone is exposed to Bisphenol A (BPA) and probably to other xenoestrogens through consumption of food and beverages packaged in plastic.  It is an interesting study.  It shows that exposures during pregnancy will affect offspring into adulthood.  Whether or not this is happening in people is unknown, and not testable. 

Katzenellenbogen JA (1995). The structural pervasiveness of estrogenic activity. Environmental health perspectives, 103 Suppl 7, 99-101 PMID: 8593885
 

Newbold RR (2010). Impact of environmental endocrine disrupting chemicals on the development of obesity. Hormones (Athens, Greece), 9 (3), 206-17 PMID: 20688618
 

Alonso-Magdalena P, Vieira E, Soriano S, Menes L, Burks D, Quesada I, & Nadal A (2010). Bisphenol A exposure during pregnancy disrupts glucose homeostasis in mothers and adult male offspring. Environmental health perspectives, 118 (9), 1243-50 PMID: 20488778