Women’s Health: Pregnant Women and BPA

A Washington State University (WSU) researcher has found new evidence that the plastic additive BPA (Bisphenol-A) might disrupt women’s reproductive systems, potentially causing chromosome damage, miscarriages and birth defects. The new non-human primate study adds more evidence that BPA may be harming human reproduction.

Writing in the journal Proceedings of the National Academy of Sciences, WSU geneticist Patricia Hunt and colleagues at WSU and the University of California, Davis, report seeing reproductive abnormalities in rhesus monkeys with BPA levels similar to those found in humans. The study featured an animal with the most human-like reproductive system and builds upon earlier work by Hunt and others documenting BPA’s widespread reproductive effects in rodents. The research also adds to the number of organs affected by BPA.

“The concern is exposure to this chemical that we’re all exposed to could increase the risk of miscarriages and the risk of babies born with birth defects like Down Syndrome,” says Hunt. “The really stunning thing about the effect is we’re dosing grandma, it’s crossing the placenta and hitting her developing fetus, and if that fetus is a female, it’s changing the likelihood that that female is going to ovulate normal eggs. It’s a three-for-one hit.”

BPA can be found in many of the common plastic (polycarbonate plastic) food and beverage containers – including plastic water bottles, plastic baby bottles and plastic cups. BPA is also be found in toys and other consumer goods and in the epoxy resins used to coat the inside of metal products, such as food cans, baby formula cans, bottle tops and water supply lines. Another common source of BPA is thermal paper products, which include some cash register and credit card receipts.

The Study
Hunt’s colleagues at UC, Davis exposed different groups of gestating monkeys to single daily doses of BPA and low-level continuous doses and looked at how they affected the reproductive systems of female fetuses. The study showed that in the earliest stage of the adult’s egg development, the egg cell failed to divide properly. Earlier mouse studies showed that similar disturbances translated into genetic defects in the mature egg. A fertilized egg with the wrong number of chromosomes will almost always fail to come to term, leading to a spontaneous abortion. Alternatively, these damaged eggs can result in progeny with severe birth defects.

In monkeys continuously exposed to BPA, Hunt saw further complications in the third trimester, as fetal eggs had not been packaged appropriately in follicles, structures in which they develop. Eggs need to be packaged properly to grow, develop, and mature.

“That’s not good,” says Hunt, “because it looks to us like you’re just throwing away a huge number of the eggs that a female would have. It raises concerns about whether or not she’s going to have a really short reproductive lifespan.”
Via: EurkAlert.org

Minimizing BPA Exposure
If a product label doesn’t mention BPA, remember that most aluminum cans or bottles have linings that contain BPA (they will usually say “BPA-Free Lining” if they don’t), while steel bottles or cans don’t. Polycarbonate plastic (containing BPA) is generally hard, clear, lightweight plastic. It often has the No. 7 recycling symbol on the bottom. Glass bottles are also BPA-free. Other tips:

  • Use glass baby bottles, or those made from safer plastics including polyamine, polypropylene and polyethylene. Soft, or cloudy-colored plastic does not contain BPA.
  • When searching out products that don’t contain BPA look for the words “BPA-Free” on the product label of packaging.
  • Avoid eating canned foods.
  • Avoid microwaving food in plastic containers. The National Toxicology Program advises against microwaving polycarbonate plastics. It is believed the repeated microwaving and heating of plastic containers may break down the plastic allowing BPA to leach into foods.
  • Avoid storing hot foods in plastic containers. Use glass, porcelain, ceramic or steel containers.
  • Avoid washing polycarbonate plastic containers in the dishwasher.
  • Store leftovers and foods in glass, steel and BPA-free containers.

Additional source: The Mayo Clinic

*Note: The American Chemistry Council, an association that represents plastics manufacturers, contends that BPA poses no risk to human health.

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The Cardiovascular Disease Taskforce Calls for Urgent Action

The CVD Taskforce, a group of eminent experts who represent five leading heart-health organizations, has published a paper calling for urgent action to reduce premature mortality by 25 percent by 2025. The Taskforce paper is released ahead of World Heart Day on September 29th, when supporters worldwide will rally in support of healthful homes and countries, with a particular focus on the lesser-known CVD risks for women and children.

The Paper recommends a set of ambitious global targets to curb the growing incidence of non-communicable diseases (NCDs), which includes cardiovascular disease (CVD – heart disease and stroke). The new targets and recommendations are critical components in the effort to prevent millions of premature deaths worldwide.

The Taskforce is calling on governments and the CVD community to accelerate progress on the commitments made at last year’s United Nations High-Level Meeting on NCDs, announcing support for 10 evidence-based targets. The first step in this program, agreed to at the 65th World Health Assembly in Geneva this past May, was to set a global target to reduce premature deaths from NCDs to 25 per cent by 2025.

Additional targets to achieve by 2025:

  • A 10% relative reduction in the prevalence of physical inactivity in adults aged 18+ years
  • A 30% relative reduction in prevalence of tobacco abuse
  • A 30% relative reduction in mean adult (aged 18+) salt intake, with the ultimate aim of achieving a recommended consumption level of less than 5 grams (5,000 mg) per day
  • A 25% relative reduction in the prevalence of high blood pressure

Other CDV-related issues and behaviors targeted include fat intake (saturated and trans-fatty acids), cholesterol, obesity, excessive alcohol intake, and the wider use of drug therapies and essential medicines to prevent and treat CVD.

“The number of people with CVD is growing and its impact is disproportionately felt by those in the developing world, where people die younger; we now have the opportunity of a lifetime to stem its rise with concerted international action that will help countries tackle the preventable causes of CVD,” said Dr Sidney C. Smith, Jr (World Heart Federation President and Chair of the writing group).

With cardiovascular disease currently costing governments nearly $863 billion globally, the Taskforce recommends a set of interventions designed by the World Health Organization and designated as “best buys” – cost-effective treatments that can be delivered regardless of the income level of a country. These include the widespread adoption of multi-drug therapies that could save nearly 18 million lives over a 10-year period, at a cost of just over a dollar a day.

“Cardiovascular disease risk can be lowered by public policies that help people to make healthier choices. This set of robust targets can focus governments’ efforts on this vital task and make progress measurable,” said Dr Ralph Sacco, Past President of the American Heart Association.

Sources: EurekAlert and the World Heart Federation

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A Deeper Look at the Omega-3 Fish Oil Question

man jogging on beach
How many times have we borne witness to the medical recommendations and subsequent reversals and re-reversals of prominent medical societies? In the ‘70s the American Heart Association (AHA) advocated the use of margarine’s hydrogenated oils (trans fats) in place of butter. That, we all now know, was a critical error. The AHA also banned eggs – since reversed – and advocates the use of oils high in omega-6 fatty acids (a recommendation that is currently under significant scrutiny by the scientific community). The AHA has also advised people to eat fish and fish oils. That opinion, still widely held by world leaders in this scientific arena, is now in jeopardy. Last week, Rizos et al published a meta-analysis in the famed Journal of the American Medical Association (JAMA). Rizos findings in a nutshell, omega-3s and fish oil do not help stave off heart disease. There are a number of problems with their trial, but I will limit myself to the two that I consider to be most significant.

First, the statistics. There is a convention in medical science that outcomes are considered to be significant when the p value is < 0.05. In English this means that when the probability that a particular outcome is due to chance is less than 5%, we consider it to be true. A p value of 0.01 (which is less than 0.05) means there’s only a 1% likelihood that a finding is due to chance. This, we consider to be true. On the other hand, a p value of 0.5 means that there’s a 50% possibility that a particular finding is due to chance. We would not consider this finding to be true. You see though, it’s all about possibilities. In reality, we never know that something is true or false, just that it’s likely or not to be true or false. It’s important for you to recognize that our p value designation of 0.05 is considered gospel. Any first year medical student can tell you that. Now consider Rizos’ paper. He performed extraordinarily complex statistical maneuvers and ultimately decided to utilize a p value of 0.0063. That’s correct; he changed convention. By so doing he made the possibility of finding fish oil to be beneficial about 10 times as difficult as it would have been had he stuck to the rules. In fact, had he used a p value of 0.05, the trial would have shown that fish oil indeed does lower cardiovascular death. Instead of the media reporting that fish oil has no value, the headlines would have read, “Take your fish oil. It just might save your life!” That’s because the p value found for cardiovascular death reduction was 0.01, meaning that there is only a 1% possibility that this finding is due to chance, and there is a 99% likelihood it is a real finding! So please don’t stop eating fish or taking fish oil because of this trial’s findings.

Another point of contention is that Rizos described the three cardiovascular benefits of fish oil and omega-3s as: triglyceride-lowering, anti-hypertensive, and anti-arrhythmic. He omitted the two most salient cardiovascular benefits, anti-inflammation and anti-thrombosis (blocking blood clots). He ignored fundamental pathophysiology, an error that I feel can have dire and far-reaching consequences.

In sum, we must not abandon fish oil because of this meta-analysis. So many trials have shown the benefits of omega-3s in myriad medical conditions, such as rheumatologic disorders, cardiovascular disease, macular degeneration, and not least of all, the dementias like Alzheimer’s. Our scientific understanding of the advantages of increasing fish consumption is irrefutable. We cannot afford to repeat the 1970’s misguided AHA initiative for margarine to replace butter. Although doctors on the Today Show and many other popular stations took Rizos’ study at face value and unjustly condemned fish and fish oil, we cannot fall prey to this misinformation.

My advice is to continue your fish and fish oil unless your physician offers a solid reason for you to stop.

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September 20th is FH Awareness Day!

September 20th is FH Awareness Day. So you ask yourself; what does this mean to you and your loved ones? FH, or Familial Hypercholesterolemia, is a genetic cholesterol disorder that leads to premature vascular disease. In the most severe circumstances, very young children can experience life-threatening heart attacks and strokes. Typically however, the disease does not wreak havoc until people reach their 40s and 50s. FH is not as rare as you might imagine. It occurs in one out of every 500 people, but in some populations – like French Canadians and South African Ashkenazi Jews – the number can be as high as one in 67! To make matters worse, the disorder often goes undetected.

In an attempt to thwart the dire consequences of FH, organizations like the FH Foundation, the National Lipid Association and the American Society for Preventive Cardiology are working hard to raise awareness. September 20th was therefore established as National FH Awareness Day by the FH Foundation. These organizations – and I personally – encourage you to speak to your doctor to see whether you harbor this silent threat. If you do, don’t be afraid; treatment is available for you and your family. Remember, as a genetic disease FH can impact all members of your immediate and even extended family. Consequently all relatives of a single FH patient should be screened with simple cholesterol tests. Please don’t procrastinate. See your doctor soon to be sure you do not have FH.

For more information on FH treatment alternatives, including LDL-Apheresis, visit Preventive Cardiology Inc.

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Health Issues and Older Americans: The Stats Show Mixed Reviews

man jogging on beach
The National Institute on Aging recently published an important report tracking trends in older Americans. The report, “Older Americans 2012: Key Indicators of Well-Being,” tracks trends in those older than 65 in categories ranging from health to housing to economics.

Medical advances, improved diet, and the pursuit of a more healthful lifestyle has allowed today’s older Americans to enjoy longer lives and better physical function than did those of prior generations. The report states that in 2010, 40 million people age 65 and over accounted for 13 percent of the total population in the United States. In 2030, the number and proportion of older Americans is expected to grow substantially — to 72 million and nearly 20 percent of the population respectively. The report revealed major negative factors affecting certain segments of this population including the increased burden of housing costs and rising obesity.

Some highlights of the report:

Older Americans, like their younger counterparts, are gaining weight. Obesity is undeniably a major cause of preventable disease and premature death. Sadly, the percentage of obese individuals 65 and over continues to escalate. In 1988–1994, 22 percent of people age 65 and over were obese. Fast forward to 2009-2010 when 38 percent of the elderly were found to be obese, 44 percent of people age 65-74, and 29 percent of those age 75 and older. Please note that the number of obese people falls in the latter years of life as a consequence of the excessive mortality among the overweight. You will see this recurrent theme in the following statistics.

  • In 2009–2010, 45 percent of women age 65–74 and 30 percent of women age 75 and over were obese. This is an increase from 1988–1994, when 27 percent of women age 65–74 and 19 percent of women age 75 and over were obese.
  • Older men followed similar trends: 24 percent of men age 65–74 and 13 percent of men age 75 and over were obese in 1988–1994, compared with 43 percent of men age 65–74 and 27 percent of men age 75 and over in 2009–2010.

Working later in life
As the overall population ages, a growing percentage of older people are working later into their golden years. In 1963, 17 percent of women aged 65-69 were in the labor force; in 2011, that number had increased to 27 percent. For women 70 and older, 6 percent worked in 1963, increasing to 8 percent in 2011.

Older people are becoming more active

  • The percentage of older people meeting the Federal physical activity guidelines has increased over time. In 1998, about 6 percent of people age 65 and over met the guidelines, compared with 11 percent in 2010.
  • In 2010, about 11 percent of people age 65 and over reported participating in leisure-time aerobic and muscle-strengthening activities. Unfortunately the percentage of older people meeting the physical activity guidelines decreases with age, ranging from 14 percent among people age 65–74 to 4 percent among people age 85 and over.
  • Men age 65 and over were more likely than women in the same age group to meet the physical activity guidelines (14 percent and 8 percent, respectively, in 2010).

Smoking numbers on the decline
A key negative factor impacting cardiovascular health, smoking, has been on the decline for decades. The percentage of older Americans who are “current cigarette smokers” fell significantly between 1965 and 2010.

  • Most of the decrease in the number of smokers has been among men (from 29 percent in 1965 to 10 percent in 2010). Through the same period, the percentage of women who smoked cigarettes has remained relatively constant (10 percent in 1965 and 9 percent in 2010).
  • In 2010, the percentage of older Americans who were “current smokers” was similar for white and black Americans.
  • A large percentage of both men and women age 65 and over were former smokers. In 2010, about 53 percent of older men previously smoked cigarettes, while 29 percent of women age 65 and over were former smokers.


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