A Bodacious Valentine’s Day

Be still my heart
 (Photo credit: EraPhernalia Vintage)

Yesterday, in honor of V-day, I had the pleasure of attending a ground-breaking panel on boobies. Because this is 2013, when the subject of breasts arises, so to speak, the topic of breast cancer isn’t far behind.

The purpose of the gathering was to announce publication of an important new report that — really for the first time — sets out an agenda for prevention of breast cancer and points to the significance of environmental factors like chemicals, instead of focusing almost exclusively on treatment. The 200+ page report was the result of two years of work by a group of academics, advocates and government scientists called the Interagency Breast Cancer and Environmental Research Coordinating Committee. (Oddly, the link to the report is not working on the government Website. The New York Times coverage is here. Update: Link fixed!)

In 2012, more than 200,000 women and 2,000 men will be diagnosed with breast cancer, and 40,00 women will die from it. A large majority of breast cancer cases — some 85 percent — occur in women with no family history of breast cancer. We know that some environmentally widespread chemicals — including PFOAs, dioxin, the pesticide Atrazine, DDT, flame retardants, and hormone disruptors like Bisphenol-A (BPA) — are linked to breast cancer.

We also know — most recently from shocking and sad reporting by the Center for Public Interest (CPI) of a published, peer reviewed study of plastics auto suppliers and other workers in Ontario that there is very strong evidence linking acute exposures to plastics and chemicals to cancer rates: women working in the auto supplier and canning jobs had cancer rates of 5 times the control group.

Here’s CPI’s summary of the report’s list of chemical exposures related to breasts:

At least 216 chemicals, including endocrine-disrupting substances like bisphenol A, have been associated with mammary gland tumors in animals. Endocrine-disrupting chemicals, or EDCs, are used to make plastics and pesticides and found in products such as furniture, metal food cans and cosmetics.

Ergo, it would nothing short of dunderheaded to talk about preventing cancer without looking at environmental factors in the mix, alongside genetic, diet and other risk factors. We badly need the kind of paradigm shift the report tees up, as well as the focused attention on environmental risks from regulators and researchers that it recommends.

The arrow on this mammogram points to a small ...

The arrow on this mammogram points to a small cancerous lesion. (Photo credit: Wikipedia)

In honor of the holiday, let’s get back to knockers for a sec. On the panel, author and reporter Florence Williams returned our attention to the physical facts by pointing out a number of novel features that uniquely describe the twin wonders on a woman’s chest.

She pointed out that breasts are among the fattiest organs in the body and that many chemicals are drawn (like men) to these fatty tissues, that breasts are filled with hormone receptors, and that they change over the course of women’s lives as biologically needed. Williams called them, rightly, a “sentinel organ,” noting that what happens to our breasts is an early signal for our overall environment and health. (I picked up a copy of Williams’ book, “Breasts: A Natural and Unnatural History,” and am excited to read it because she tests the level of flame retardants in her own breast milk, among other unpleasant but informative discoveries.)

Jeanne Rizzo, head of the Breast Cancer Fund, spoke next and highlighted the fact that we know that there are critical stages — called windows of susceptibility — that impact life-time risk for breast cancer, beginning in utero, and that due to the emerging science of epi-genetics, it’s now clear that genes and the environment interact throughout our lives in a complex dance of possibilities. Her wonderful op-ed is also well worth a read. (It’s for this reason that I do think a focus on reducing environmental risks for pregnant women and young children is important, and that consumers need help in this area.)

Linda Birnbaum, the Director of the National Institute of Environmental Health Sciences (NIEHS) of the National Institutes of Health (NIH), and National Toxicology Program (NTP) was also powerful. I was particularly struck by her description of an ongoing “sister study” pairing women who are diagnosed with breast cancer with their sisters who have not been.

As she pointed out, we may have been over-emphasizing genetic factors when we see diseases linked in families, because although it’s true that they share genes, siblings also tend to share environmental influences. This study will attempt to distinguish genetic factors from the other shared conditions, including chemical exposure levels, thus helpfully sorting out what we can fix, given sufficient political will, from what we really can’t.

This got me thinking about obesity as another confounding factor in the research. We all know — and it was reiterated by panelists — that obesity is major risk factor for breast cancer, heart disease, and basically every other major health problem. Yet we also know that mice exposed to a teensy amount of BPA get much fatter than other mice. As Nicholas Kristof noted:

Among chemicals identified as obesogens are materials in plastics, canned food, agricultural chemicals, foam cushions and jet fuel.

They’re everywhere, in other words. Yet the national report on obesity a big government panel issued last year barely mentioned the issue, instead focusing its major recommendations entirely on nutrition and exercise. Ditto with the President’s “Let’s Move” action plan.

Now, I’m not disputing that healthy foods and regular activity likely play an important role in obesity. But, as Jeanne Rizzo said the founder of the Breast Fund Center asked about breast cancer, I would still ask why we are so much fatter now than we used to be, and why Americans, who have far more chemicals in their diet and environment, are so much heavier than Europeans, when we eat basically the same types of foods.

The staggering rate of increase in obesity should be another indicator. A recent report found that adult obesity rates could exceed 60 percent in 13 states by 2030, and that:

If states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020—and double again by 2030.

Then there’s the stunning increase in childhood incidence of Type 2 diabetes. From a September 2012 article in the Times:

Before the 1990s, this form of diabetes was hardly ever seen in children….There were about 3,600 new cases a year from 2002 to 2005, the latest years for which data is available.

What has changed from before the 1990s until now? As a child of the 1970s and ’80s, I can tell you: our diets were no paragon of health. We ate junk food, nutrient-poor school lunches, and canned green beans, white rice and pork chops for dinner. We binged on Halloween candy while playing Atari for hours. But this disease was for the full decade of my adolescent decadence still virtually unknown in kids. In fact, we know a lot more about healthy eating and healthier foods are much more widely available today, yet we’re still in deep trouble.

Researchers are basically at a loss to explain the obesity increase, as in this comically uninformative paper where they more or less throw in the towel. Could it be, instead, that the ubiquitous chemicals, drugs and fillers in food and industrial agriculture, along with the plastics that package virtually all of our foods, are at least in part to blame? That cheap calories from a degraded and ever-more industrialized food supply — eaten by people across the socioeconomic spectrum — come at a very high cost? What are those fat mice trying to tell us?

As in the breast cancer sister study, when we treat obesity as an inert risk factor — “don’t get fat, you!” — we are missing an opportunity to shift the paradigm to environmental health factors and instead substituting a far less helpful blame-the-victim mentality.

We should not fail to acknowledge obesogens may be a confounding factor in the data — that the same people who are obese are more likely to get breast cancer because the cause of both conditions could be related to the same chemical exposures (or chemical-epigenetic interactions that reflect a sensitivity to environmental influences). If it turns out this is right, and chemicals are a major factor in all of these kinds of health conditions, then the solutions are also shared, and the public health costs of inaction virtually incalculable.

Please don’t misunderstand me. I care deeply about preventing breast cancer, having seen its terrible toll on close family friends. And I am so excited for the publication of this major report that talks clearly and for the first time about the impact of chemicals on cancer rates, though I wish there was a least a small section on consumer can-dos, to counteract the doom and gloom.

But we also must be uncompromising as we outline the possible damage from toxins, and push this powerful new paradigm to its logical conclusions. To meaningfully address a host of public health threats, we will need one day soon to take the full measure of what our ongoing, uncontrolled experimentation with biology-altering chemicals has actually accomplished, in both our bodies and our brave, sentinel breasts.

Breast cancer. Image made by Itayba

Breast cancer. Image made by Itayba (Photo credit: Wikipedia)

Three Days to a Brand-New BPA-Free You

happy faceWhen I was in junior high school, I distinctly and embarrassingly recall being a little obsessed with a certain cheesy teen novella called “8 Days to a Brand-New You” — a romantic and moving make-over tale in which our geeky, bespectacled heroine becomes a total babe in eight short days (or something like that). You can see the appeal.

My friends are accusing me of always being the bearer of bad news, and it’s certainly a fair charge. But I also still cling firmly to the belief that it’s possible to make small and easy changes that will transform your life. Or at least improve things a little bit.

In the bad hair-day backstage video I did for the ANDERSON show, I mention that you can quickly and immediately see results in efforts to decrease levels of Bisphenol-A (BPA), a potent endocrine disrupting chemical that behaves like a hormone in the body and has been linked to reproductive health damage and other serious concerns.

How do I know this? Last year, researchers set out to pilot new research methods by doing a small, short study of 20 people in five families in the Bay Area, co-sponsored by the Breast Cancer Fund, an organization focused on prevention of breast cancer by identifying and eliminating links to toxins. The results were astonishing, as summarized here and below:

Participants ate their usual diet, followed by three days of fresh foods that were not canned or packaged in plastic, and then returned to their usual diet.

The researchers collected evening urine samples over eight days in January 2010 and categorized them as pre-intervention, intervention, or post-intervention samples.

Test results showed an average drop of 60 percent in BPA levels when study participants ate a diet that avoided contact with food packaging containing BPA, which is used to make polycarbonate plastics and in the lining of food cans.

Tests showed a 50 percent average drop in DEHP, a phthalate commonly added to some food containers and plastic wraps to increase flexibility.

People with the highest levels of BPA prior to the intervention dropped their levels of BPA by 76 percent, and for DEHP that gap dropped by a stunning 93 to 96 percent. Study participants were shocked by the dramatic results.

The key was to prepare fresh foods, and to reduce incidental use of plastic. Three days was all it took, because the body flushes BPA and DEHP quickly, and it stays out so long as we don’t reintroduce it.

Here are some simple tips to reduce these types of exposures:

1) Don’t eat from plastic where it can be avoided. For example, avoid plastic water bottles of all kinds, including baby bottles and sippy cups, plastic drip coffee makers (we use a stainless steel electric kettle and glass french press), and most canned foods, particularly for sweet, acidic, or fatty items (which, let’s face it, is basically everything).

2) Try to frequent restaurants where the food is fresh and to order items that are unlikely to have been frozen (because they’re often stored in plastic) or canned. Just ask what’s fresh — a decent waiter at a good restaurant will tell you, and it’s a good guide to what the chef is excited about anyway.

3) Don’t heat plastic in the microwave or dishwasher or use plastic utensils for cooking or eating.

4) Store food in glass and food-grade stainless steel (some options are identified here in the Kitchen Gear section, and in the comments here), and keep food well below the level of the lid to minimize contact, as they did in the study. Avoid plastic wrap, especially the cheap kind like they use at the deli counter, which is usually PVC, or, at home, use a bowl to keep it away from the food and check to make sure what you’re using is labeled “PVC-free.”

5) Avoid jarred baby food and ready-to-use formula for infants, as they likely have BPA or a potentially suspect BPA-substitute in the lid. Preparing fresh baby food and using dried formula powder from cans are safer choices whenever possible.

6) As this article from the Natural Resources Defense Council says “[d]on’t allow your children to have dental sealants made from BPA (or BADGE) applied to their teeth, and don’t have these sealants applied to your teeth while you are pregnant. Ask your dentist to provide BPA-free treatments.”

7) Refuse receipts whenever you can, and don’t let children handle them or paper money, which has BPA from receipts all over it.

8) Sadly, recycled paper products, like toilet paper and napkins, are also high in BPA, likely due to receipts in the recycling chain. I’m still wrestling with my conscience over this one, but for pregnant women in particular, avoiding all kinds of recycled paper is likely a good idea.

A few other thoughts:

1) While many sites recommend Tetra-paks, for the reasons I explain here, these just store food in a polyethylene layer of plastic, which poses basically the same level of risk as a water bottle (or even more risk for acidic foods given their tendency to leach chemicals from plastic). Confirming my hunch, some links to German studies demonstrating that Tetra-paks leach more estrogens than water bottles, as well as some additional facts about how they make these types of packages sterile that may contribute to this leaching process, are here.

2) There are some BPA-free canned foods on the market, including Eden brand beans (not tomatoes), Muir Glen canned tomatoes (not glass jars; the lids have BPA), and Native Forest coconut milk (this was on several Websites; for example, here, but is not on their site and is not labeled on the can, so I will confirm with the company and update this post; as a side issue, I just noticed that they do use fillers like guar gum, which may be hard to digest for some; you can also evidently make your own coconut milk from dried coconut).

3) In addition, a number of fish companies are reportedly using BPA-free cans, including Oregon’s Choice, Wild Planet, Vital Choice and Eco-fish.

4) A depressingly large number of brands still use BPA, as this helpful local co-op page demonstrates. Another list is here, as well as comments pointing out that toothpaste tubes also have BPA! (I’ll look into this a bit and report what I find.)

5) Stonyfield Farm yogurts are probably in better packaging, as the company really put its plastic supplier through some paces. It’s just too bad that the sugar levels in their yogurt for babies, toddlers and kids are so darn high.

5) When you can’t use fresh, frozen organic foods are likely safer on this front, but do check the small print on the packaging, as many frozen brands are organic “made in China” or in other places in which organic certification is, IMHO, at least suspect (more on this in a future post). Also, salt is often added to frozen veggies, which may be undesirable if you’re cooking for a child.

6) The issue with all BPA-free canned foods is, of course, the question of what they are using instead. About this, companies are remarkably tight-lipped, as I explore here. One exception to this rule is Eden foods, which comes right out and says their substitute is oleoresin, a mixture of pine sap from trees.

For this reason, I’ll use the Eden canned beans in a pinch, though I still prefer the far more toothsome texture of soaked dried beans. (A tip: getting a decent pressure-cooker really helps to make cooking beans a bearable use of time. It’s a staple item in an Indian kitchen for dal and the like, so we have one and use it almost daily.)

See, don’t you feel more babe-like already? What BPA self-improvement tips do you have? Please let me know!