Chemicals in Fast Food Wrappers Show Up in Human Blood

TORONTO, Ontario, Canada - Chemicals used to keep grease from leaking through fast food wrappers and microwave popcorn bags are migrating into food, being ingested by people and showing up as contaminants in blood, according to new research at the University of Toronto.

The contaminants are perfluoroalkyls, stable, synthetic chemicals that repel oil, grease, and water. They are used in surface protection products such as carpet and clothing treatments and coating for paper and cardboard packaging.

Earlier research by University of Toronto environmental chemists Scott Mabury and Jessica D'eon, established in 2007 that the wrappers are a source of these chemicals in human blood. Their new study shows that perfluorinated chemicals can migrate from wrappers into food.

The specific chemicals studied are polyfluoroalkyl phosphate esters, or PAPs, breakdown products of the perfluorinated carboxylic acids, or PFCAs, which are used in coating the food wrappers.

"We suspected that a major source of human PFCA exposure may be the consumption and metabolism of polyfluoroalkyl phosphate esters, or PAPs," said D'eon, a graduate student in the University of Toronto's Department of Chemistry.

"PAPs are applied as greaseproofing agents to paper food contact packaging such as fast food wrappers and microwave popcorn bags," she explained.

In their latest study, D'eon and Mabury exposed rats to PAPs either orally or by injection and monitored for a three-week period to track the concentrations of the PAPs and PFCA metabolites in their blood.

The researchers used the PAP concentrations previously observed in human blood together with the PAP and PFCA concentrations observed in the rats to calculate human exposure to the chemical perflurooctanoic acid, PFOA.

"In this study we clearly demonstrate that the current use of PAPs in food contact applications does result in human exposure to PFCAs, including PFOA," said Mabury, the lead researcher and a professor in the university's Department of Chemistry.

Elevated levels of PFOA in blood have been associated with changes in sex hormones and cholesterol, according to the U.S. Agency for Toxic Substances. Exposure to PFOA also has resulted in early death and delayed development in mice and rat pups, the agency says.

Rats that ingested PFOA for a long time developed tumors. However, based on differences between rats and humans, scientists have not determined for certain whether this could also occur in humans, the agency says.

"We found the concentrations of PFOA from PAP metabolism to be significant and concluded that the metabolism of PAPs could be a major source of human exposure to PFOA, as well as other PFCAs," said Mabury.

"This discovery is important because we would like to control human chemical exposure, but this is only possible if we understand the source of this exposure," Mabury said.

"In addition," he said, "some try to locate the blame for human exposure on environmental contamination that resulted from past chemical use rather than the chemicals that are currently in production."

The study is published today in the journal "Environmental Health Perspectives," published by the U.S. National Institute of Environmental Health Sciences. Research was funded by the Natural Sciences and Engineering Research Council of Canada.

"We cannot tell whether PAPs are the sole source of human PFOA exposure or even the most important, but we can say unequivocally that PAPs are a source and the evidence from this study suggests this could be significant," Mabury said.

The researchers concluded that due to the long time that PFOA remains in human blood, even low-level PAP exposure could, over time, result in significant exposure to PFOA.

Although humans are exposed directly to PFCAs in food and dust, the University of Toronto researchers said that because of the way the human body processes these chemicals, "PAP exposure should be considered as a significant indirect source of human PFCA contamination."

Regulatory interest in human exposure to PAPs has been growing. Governments in Canada, the United States and Europe have signaled their intentions to begin extensive and longer-term monitoring programs for these chemicals.

Regulators have made three assumptions, said Mabury, releasing the results of his 2007 study. "That the chemicals wouldn't move off paper into food, they wouldn't become available to the body and the body wouldn't process them. They were wrong on all three counts."

Green tea extracts plus vitamin D may boost bone health

Combining green tea polyphenols and a form of vitamin D called alfacalcidol may boost bone structure and strength, according to a new study in mice.

The new research in mice suggests that supplementation with either green tea polyphenols or alfacalcidol (1-alpha-OH-vitamin D3) may reverse damage to bones caused by lipopolysaccharide induced chronic inflammation, while combining the ingredients may sustain bone micro-architecture and strength, according to new findings published in The Journal of Nutritional Biochemistry.

According to the authors, led by Dr Chwan-Li Shen from Texas Tech University Health Sciences Center, the study also shows that the improvement in bone micro-architecture and quality along with the down-regulation bone TNF-alpha expression mechanism further corroborate the anti-inflammatory role of green tea polyphenols and 1-alpha-OH-vitamin D3 (alfacalcidol) in skeletal health – which may reduce the risk of osteoporosis.

Bone loss

Chronic inflammation has been associated with progression of bone loss and micro- architecture deterioration through oxidative stress and excessive production of pro-inflammatory molecules such as tumor necrosis factor-alpha (TNF-alpha).

Various anti-oxidant and anti-inflammatory compounds, such as green tea, alfacalcidol, and soy isoflavones have been suggested suppress TNF-alpha expression.

The researchers noted that certain compounds suggested to inhibit inflammation via suppressing TNF-alpha expression, may have therapeutic value in the prevention and treatment of chronic inflammation-induced bone loss.

In particular green tea (Camellia sinensis), has been suggested to have a wide range of effects on animal and human health due to its anti-oxidant and anti-inflammatory properties.

It has been reported in previous studies to have beneficial effects in various inflammatory conditions, such as inflammatory bowel disease, collagen-induced arthritis and lipopolysaccharide (LPS)-induced gingival inflammation.

The new study investigated the effects of green tea polyphenols and alfacalcidol on bone microstructure and strength along with possible mechanisms in rats with chronic inflammation.

Damage reversal

Scan Ban

That’s a pretty disturbing statistic published in the Archives of Internal Medicine. It just adds to the controversy stirring around CT (computed tomography) scan use. A tipping point that led to more investigation of CT scan use was this: General Electric applying for approval of CT scans as tests for colon cancer. It’s a request made because, even though the practice of screening healthy patients with CT scans has become commonplace, many insurers are hesitant to pay for the scans.
The FDA moved to approve GE’s request—until agency scientists had objections. They said that the increased cancer risk from CT scans’ radiation would outweigh any potential benefits. Gastroenterologist and former FDA consultant Julian Nicholas—who trained at Oxford University and the Mayo Clinic—was one of those objecting. He wrote in an e-mail that approval would “expose a number of Americans to a risk of radiation that is unwarranted and may lead to instances of solid organ abdominal cancer.”
That didn’t set too well. Nicholas says, “I was first ignored, then pressured to change my scientific opinion, and when I refused to do that, I was intimidated and ultimately terminated.”

Nicholas wasn’t alone in questioning the safety of CT scans. FDA medical officer Dr. Robert Smith of Yale and Cornell Universities said, “The increased radiation exposure to the population could be substantial and would raise a serious public health/public policy issue.” Smith’s input was dismissed, too.
At present, approval for G.E.’s request is still pending.

Even 1 Soda a Day Can Hike Your Diabetes Risk

A soda a day? That's not so bad—a 150-calorie blip, burned off with a brisk half-hour walk. But it's not only your waistline that's at stake. A study released today in the journal Diabetes Care found that people with a daily habit of just one or two sugar-sweetened beverages—anything from sodas and energy drinks to sweetened teas and vitamin water—were more than 25 percent likelier to develop type 2 diabetes than were similar individuals who had no more than one sugary drink per month. Since the overall rate of diabetes is roughly 1 in 10, an increase of 25 percent raises the risk to about 1 in 8. One-a-day guzzlers in the study also had a 20 percent higher rate of metabolic syndrome, a collection of indicators such as high triglyceride levels suggesting that diabetes is not far off.

"Previous studies have shown that sugar-sweetened beverages are strongly associated with weight gain," says lead author Vasanti Malik, a research fellow in the Harvard School of Public Health Department of Nutrition, who says the decision to examine the relationship between sugar-sweetened beverages and risk of diabetes was "the logical next step."

[To Cut Diabetes-Related Heart Risks, Diet and Exercise May Beat Drugs]

The researchers conducted a study of studies—a meta-analysis—to reach their conclusions. They identified eight studies with enough data to let them check for a link between sugary drinks and type 2 diabetes and three similar studies of metabolic syndrome. The largest diabetes study, which followed more than 91,000 American women ages 24 to 44 for eight years, made the strongest case for a relationship, and it wasn't just because higher consumption of sweetened drinks added excess calories that turned into pounds. While weight gain is a known diabetes risk factor, the diabetes-beverage link persisted even after adjusting for that. "Other factors independently put you at risk for developing diabetes," says Malik.

The main one is spikes in blood glucose and insulin because sweetened drinks are often consumed quickly and in large quantities and their sugar content is rapidly absorbed. Frequent spiking can lead to insulin resistance, inflammation, and hypertension—often precursors to diabetes. High-fructose corn syrup, the sugar in many sweetened drinks, is emerging as possibly riskier than other sugars because it seems to produce more belly fat. Fat that accumulates around the middle is closely tied to high blood pressure and other cardiovascular problems.

Americans love sweetened drinks. Consumption climbed to an average of 142 calories a day, or nearly one 12-ounce can of soda, in 2006, from 65 in the late 1970s. And many people down far more than that, notes Frank Hu, a senior author of the study and a professor of nutrition and epidemiology at Harvard, which puts them at a much greater risk of diabetes. A report from the Centers for Disease Control and Prevention released earlier this week projects that by 2050, 1 in 3 Americans will develop the disease. "Soft drink consumption has significant public health implications in terms of the diabetes epidemic," says Hu.

[Why Diabetes May Triple by 2050]

Earlier this year the American Heart Association issued a recommendation advising consumers to set a limit on sweetened drinks of 450 calories a week, or three 12-ounce sodas, in a 2,000-calorie diet. Calorie-counting is a convenient way to keep track, but it can be misleading. "Consumers are overly focused on calories," says Constance Brown-Riggs, a spokesperson for the American Dietetic Association, who would like people also to understand that a 12-ounce can of soda contains the equivalent of 15 teaspoons of sugar. "They think it's not that bad, without taking into consideration the other components that are putting them at risk."

Type 2 diabetes and metabolic syndrome aren't the only risks of a one-a-day habit. In a 2004 study published in the Journal of the American Medical Association of 88,000 women followed for 24 years, those who guzzled two or more sugary drinks a day had a risk of coronary artery disease 35 percent higher than non-guzzlers, even after adjusting for other unhealthy lifestyle factors. "You receive no benefits out of drinking these beverages," says Malik, who lists additional hazards from dental cavities to gout. "It's a wake-up call for the American public."

Blood Pressure Treatment on Rise in Younger Adults, Says CDC Report

Kristen Pessalano just turned 23, but has been on blood pressure medication for more than two years. Pessalano, a New Yorker who works in public relations, found out she had high blood pressure while getting a physical before heading abroad for an internship.

"[I] got upset when I first found out because I automatically associated it with people who are overweight or old," said Pessalano. "I would have never associated high blood pressure with someone my age, especially when I appeared to be totally healthy."

Pessalano has a lot of company, according to a new report by the Centers for Disease Control and Prevention. The report finds that while the percentage of Americans who have high blood pressure has remained steady over the past decade at 30 percent, the number of younger adults -- ages 18 to 39 -- who have high blood pressure and take medication to treat it has significantly increased from 27.6 percent in 1999 to 2000 to 49.1 percent in 2007 to 2008.
Doctors say they're not surprised because of other health problems that plague younger adults.

"I'm not surprised that more and more young people are being treated for high blood pressure since the incidence of obesity, a contributing cause for high blood pressure, is increasing in this age group," said Dr. Randal Thomas, a cardiologist at the Mayo Clinic in Rochester, Minn.

"With increasing obesity and diabetes in younger populations, clinicians may be more aggressive about recognizing risk factors for cardiovascular disease, like hypertension, and treating it," said Dr. Carol Horowitz, associate professor of medicine at Mount Sinai School of Medicine.

Although the news that she had high blood pressure was unexpected to Pessalano, the CDC report found most people with high blood pressure have become more aware of the condition, which is something physicians say they've noticed in their own practices.

"[I]ndividuals are taking their own health issues more seriously and noticing the increased blood pressure readings," said Dr. R. Scott Wright, also a cardiologist at the Mayo Clinic.

Exercise Your Depression Away

Good news all you exercise fanatics.

Researchers have found that the more people engage in physical activity, even very light exercise, during their spare time, the less likely they are to be depressed.

Surprisingly, the study showed that people who exert themselves at work by doing lots of walking or lifting are no less likely to be depressed than people with sedentary jobs.

People who were inactive during their leisure time were almost twice as likely to have symptoms of depression, compared with the most active individuals.

lead author of the study, said the findings underlined the importance of the context in which exercise was taken.

“Our study shows that people who engage in regular leisure time activity of any intensity are less likely to have symptoms of depression,” he said.

“We also found that the context in which activity takes place is vital and that the social benefits associated with exercise, like increased numbers of friends, are more important in understanding how exercise may be linked to improved mental health than any biological markers of fitness.

“This may explain why leisure activity appears to have benefits not seen with physical activity undertaken as part of a working day.”

Exercise 'can prevent a cold', a study shows

People who exercise regularly are less likely to get a cold, researchers say.


A study of 1,000 people found that staying active nearly halved the odds of catching cold viruses and, failing that, made the infection less severe.

Experts told the British Journal of Sports Medicine that this could be because exercise helps bolster the immune system to fight off bugs.

But you may not have to actually do much exercise - those who merely think they are fit enjoy the same lower risk.

Adults can expect to suffer two to five colds per year. This latest research suggests there are lifestyle choices you can make to improve your odds of either avoiding them, or suffering too badly from them.

For their study, US researchers asked the healthy volunteers to keep a record of any coughs and sniffles they experienced over a three-month period during the autumn and winter.

The volunteers were also asked to say how frequently in any given week they would do exercise lasting at least 20 minutes and intensive enough to break a sweat.

How should value be defined in spine surgery?

Introduction
In a health care economy with limited resources, providers and consumers of health care services need to be accountable for the end result and the cost of care. The value proposition in health care is an analysis of the benefits of care relative to the direct cost and risk of providing the care. Measurement of benefits and costs is challenging, and a consensus on the measures that encompass the relevant components of the value equation has not been reached. Traditional outcome measures in orthopedics including survival, radiographic outcomes, and disease-specific outcome tools do not adequately reflect the patient’s health care experience, or the impact of an intervention on health-related quality of life. Similarly, measuring cost of care is complex, and may encompass both direct costs of treatment and alternative treatments, and indirect costs including time from work or family role, loss of productivity, and cost of caretakers.

The value equation may vary depending on the perspective of the stakeholder in the health care economy. Hospitals and facilities providing care may measure outcome and costs by factors that affect their short-term, single admission interaction, including length of stay, implant utilization, and complications. Third-party payors may focus on a timeframe that is longer that a single admission, and may include factors in the value equation such as readmission within 90 days, or cost of outpatient care. Hospital- and payor-based quality measures may be misinterpreted as measures of outcome or value. Length of stay, surgical times, compliance with antibiotic or thromboembolic prophylaxis, and perioperative complications are process measures that may be useful to compare hospital and provider performance when appropriately matched and stratified. However, they are not useful in measuring a patient’s health care experience, or the impact of an intervention on long-term health-related quality of life. In fact, a focus on quality and process measures alone may be misleading in the pursuit of value in health care, and may provide incentive for counterproductive care strategies that serve the measurement system rather than the patient.

The health care provider and the patient measure outcome by the impact of an orthopedic intervention on health-related quality of life (HRQoL). The timeframe for the patient and provider is a lifetime, rather than a single admission. As Porter and Teisberg wrote in 2006, the right goal for health care delivery is superior patient value, which is measured at the level of specific medical conditions. Measurement of outcomes of care needs to reflect the patient’s long-term health care experience, and the impact of one intervention compared with alternatives on the patients self-assessment of HRQoL.

Study: Growing Rods for Childhood Scoliosis Treatment Likely to Cause Autofusion

While the use of growing rods has produced efficacy in the control of deformity within the growing spine, the surgery also has high rates of unintended autofusion, which can lead to a difficult and moderate correction, according to an article published in Spine.

Researchers conducted a retrospective review of the medical records and radiographs of young patients who received treatment for scoliosis using growing rods. The researchers collected data on complications, pre- and postoperative Cobb angles, total spine length, correction since initiation of treatment, total number of surgeries and the number of patients found to have autofusion at the time of device removal.

The rate of autofusion in the patients treated with growing rods was 89 percent. The average percent of the Cobb angle was 44 percent, and an average of seven osteotomies per patient were required at the time of definitive fusion due to autofusion.

Health In Your Hands – Scoliosis Exercises for Prevention and Correction DVD

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