BPA: New Perspectives on Longevity
Bisphenol A, called BPA for short, and phthalates are known in the environmental community as "everywhere chemicals" since they are found in so many products -- from containers to flooring. According to a new study, high levels of BPA in the body are associated with a 49% increased risk of death within 10 years.
First, let’s review how we are exposed to BPA. While the FDA says it is still investigating the safety of BPA and monitoring our exposure to phthalates to determine whether there is a risk, I can tell you for a fact BPA and PHTHALATES ARE NOT GOOD FOR HUMAN HEALTH; the research agrees. Scientists are voicing concerns about these chemicals because they disrupt our bodies' hormones and most specifically, cause infertility problems in women and men (Huo et al., 2015).
Sources of BPA
Paper plates, paper towels, and toilet paper: If you use any of these products, you have circulating levels of BPA in your body. And to make matters worse, when you rip and tear paper plates, paper towels, and toilet paper apart, tiny BPA particles circulate in the air, further increasing your exposure. The dust that collects on all surfaces of the house is then littered with BPA.
Receipts: If you handle thermal paper receipts, then you have increased urinary BPA (Hehn, 2016). In fact, another study found that if you handle these thermal paper receipts and use hand sanitizer, you absorb almost tenfold more bisphenols into your body (Hormann et al., 2014). So next time you go shopping, say YES to an electronic receipt and NO to paper.
Plastic food containers: According to the CDC, the most common way people are exposed to BPA is when food and water is stored in plastic food containers. One study found drinking water from plastic polycarbonate bottles increased BPA levels and other gasoline derivatives by two-thirds in just one week. Even if the bottle says it is BPA-free, the toxins will still easily leach into our food and water from these containers (Carwile et al., 2009). What’s worse is heating up foods and beverages in the microwave; it’s as if you are melting BPA and other toxins directly into the food and water.
Nail polish, synthetic shampoos and lotions: Since phthalates are used to make plastics more flexible, they are often found in cosmetics (i.e., nail polish), synthetic shampoos and lotions. Do you ever wonder why some nail polishes crack so quickly? It’s because they don’t contain phthalates that keep your nail polish from cracking.
Dental materials used to treat and prevent cavities: Make sure to ask your dentist if he/she is using products that contain BPA or phthalates.
Kids toys and sippy cups: This is a big area of concern since many parents don’t realize the amount of harm that comes from chemical-laden toys, rattles and teethers. “If a plastic product is flexible, it probably contains phthalates unless the label specifically says it does not,” National Institute of Environmental Health Sciences says. The biggest risk comes when children place these items into their mouth (i.e., teethers). Congress has permanently banned three types of phthalates (DEHP, DBP and BBP1) in any amount over 0.1% in many children’s products. Turns out wooden blocks might be safer after all.
Canned food and Infant formula container: This should be another huge red flag, as referenced in “Is BPA-free really Free of BPA? BPA in can linings leach into your food from the lining of metal food cans, even more so when they are at room temperature or warmer. In one CDC report on their website (found here), researchers found traces of BPA in the urine of nearly all 2,517 participants, likely due to canned food exposure, but with BPA so ubiquitous it’s hard to pinpoint the exact source.
Plastic wrap: Plastic wrap is probably the leachiest of all BPA products. Avoid it! BPA is frequently found in plastic wrap (although many companies have started to remove BPA from their products; this begs the question, “Are they just replacing it with a BPA-like substance?”). Instead, consider using reusable wax or cloth coverings made of natural material.
Hair spray: Phthalates are also used in hair spray to help avoid stiffness; phthalates allow the spray to form a flexible film on the hair, according to the FDA. Consequently, this increases the amount of plastics in the air and the amount you inhale in your lungs.
Vinyl flooring: The floors and walls of offices and homes may also contain phthalates. A 2010 test of four representative vinyl flooring samples sold in the U.S. found that 4 of the 6 phthalates severely restricted in children's products had levels as high as 84,000 parts per million. This is 84 times what is allowed in toys.
Shower curtains: BPA and DEHP are also found in a variety of consumer products like shower curtains, which can release gases when hot enough.
Again, the most common method of exposure of BPA and phthalates is through food and water contaminated by the linings of plastic and aluminum containers. The next highest level of exposure is via thermal paper used to create receipts (at virtually every store).
The chemical compound BPA is an endocrine disruptor, affecting the hormones in the body. Fetuses and babies are especially vulnerable with phthalates linked to causing fetal abnormalities (Machtinger et al., 2013), low birth weight, brain and behavior disorders (Wolstenholme et al., 2011). Endocrine-disrupting chemicals like BPA are important factors in our global obesity and diabetes epidemic (Longnecker & Daniels, 2001) as well as heart disease (Gao & Wang, 2014), cancer (Gao et al., 2015), and erectile dysfunction (Li et al., 2010). Death from any cause may now be added to this list (Bao et al., 2020). This comes as the most recent scientific study found that people who had higher levels of BPA in their urine were about 49% more likely to die during a 10-year period.
In a systematic review of a large body of cross-sectional studies showed people with higher urinary BPA concentrations are more likely to gain excess weight, have diabetes, and high blood pressure vs. those with lower BPA concentrations (Rancière et al., 2015).
Another cross-sectional study by Adesman & Rosen (2017) showed 9.5 million formula-fed children exposed to BPA in formula cans or baby bottles had a 5-fold increased odds of developing attention-deficit/hyperactivity disorder (ADHD) compared to breastfed infants. Five years later, this same study showed that when BPA linings were used less often, there was no association between being fed formula cans and developing ADHD.
Increasing evidence is mounting that BPA is a harmful polymer. Because of the public pressure to remove BPA from food-containing products, Kroger’s grocery chain, for example, has made a commitment to eliminate BPA from their products, claiming, “by 2017, we had converted 92% of applicable Our Brands canned goods to Non-BPA liners,” which includes their organic brand.
This compellingly speaks to the seriousness of the threat posed by these chemicals used in can linings, thermal papers, and so many other products. While this is the first study in history to find the all-cause mortality result, it is not necessarily a huge stretch from the perspective of what you might expect to happen. BPA after all is a hormone disruptor and triggers the four most common diseases which plague most Americans: obesity, diabetes, heart disease, and cancer.
What BPA Exposure Means in a Pandemic
It's especially critical you know the risk of exposure during COVID-19, since studies are now showing that using hand sanitizer is a key gateway for these chemicals to be absorbed into your body. After all, hand sanitizer is stored in BPA bottles. You get DOUBLE the dose.
Cashiers in stores who use a lot of hand sanitizer are having a very tough time in the context of the pandemic, and their exposure to BPA is undoubtedly going up. Think about it. They're wearing gloves these days (which increases plastic exposures), and if they’re not, they are touching receipts all day. In an ideal world, we would go all electronic.
And with quarantine, people have shifted to buying more canned goods and plastic products to save up for the months down the road. This undoubtedly means more BPA exposure to an already BPA-full world.
Unfortunately, the official stance from the US Food and Drug Administration (FDA) is bleak. They believe that, based on “current” research, the levels of BPA in foods are "generally recognized as safe" or what is known in regulatory jargon as "GRAS." You can read more about that here.
The FDA says the National Toxicology Program continues to stay “on top” of research into potential harms. But they are not doing anything about any of the warnings already out. A lot of the safety information the FDA reports to the public is incomplete. For example, in 2010, the FDA found "some concern' about the impact on fetuses, infants and children's brain and behavior, as well as on the prostate gland; "minimal concern" when it comes to mammary glands or early puberty; and "negligible concern" about fetal abnormalities, low birth weight or future reproductive problems. But it’s 2020;
The evidence about BPA and phthalates has doubled in the last five years alone regarding the dire health implications caused by endocrine-disrupting chemicals in plastics, pesticides, flame retardants and other merchandise (Kahn et al., 2020). For instance, a 2017 report by the CDC found high levels of BPA in the urine of nearly every American adult (CDC, 2017).
Even with all this evidence, the FDA continues to state, “There is minimal concern”. Some can definitely now claim that the FDA IS NOT KEEPING UP WITH THE MOST RECENT SCIENTIFIC LITERATURE at least when it comes to environmental toxins and the direct harm they cause on human health. This is certainly suspicious but not surprising since federal money which goes to directly fund the FDA is heavily influenced by industry. For instance, when Jennifer Garfinkel, ACC, the director of product communications at the American Chemistry Council (ACC), which represents U.S. chemical, plastics and chlorine industries, put out the public statement:
"BPA is one of the most thoroughly tested chemicals used today and has a safety track record of 50 years, and regulatory bodies around the world have reviewed the science and have found BPA to be safe. Total exposure to BPA, from all sources, is extremely low — about 1,000 times below the safe intake levels set by government bodies in the US.”
What the ACC neglects to mention is that even extremely low levels of BPA exposure is extremely harmful.
Even though the 2018 large scale BPA CLARITY study (funded by FDA and the National Toxicology Program) found multiple dire health effects at low levels of BPA exposure, the FDA has continued to stand by organizations the ACC, one of its biggest financial supporters. Talk about a conflict of interest.
Check back here next week to see how YOU can easily and safely avoid exposure to so many of the chemicals a majority of us are bathening in.
What You Can Do To Decrease Your Exposure to BPA
Food packaging is the biggest source of exposure to the hormone disrupting chemicals BPA and bis(2-ethylhexyl) phthalate (DEHP) in children and adults. If you avoid canned food consumption, you avoid the major source of bisphenol exposure. The alternative to canned fruits and vegetables is seasonal and fresh produce that you can then freeze and consume at a later date. Note, I appreciate there are some accessibility issues caused by the pandemic, so if you must buy frozen fruits/veggies, that is fine.
And, of course, the existence of food deserts for certain economically disadvantaged groups presents the same challenge. (While out of the scope of this conversation, it is something I believe needs to be addressed at the local, state, and federal levels.)
Other ways to protect you and your family from being exposed to BPA and its sisters includes:
Avoiding microwaving foods in plastic containers
Choose glass or stainless steel, NOT PLASTIC when buy and store foods
Buy fresh food always
Use frozen foods only if you are in a pinch (the plastic bags on frozen foods are still a minor concern, but not anywhere as much as canned goods). Freezing stops the spread of plastics into food. The caveat here is that if you buy frozen foods in plastic, do NOT microwave them.
Don't use harsh detergents
Try put plastic containers in the dishwasher
Opt for email or text receipts and skip out on thermal paper receipts
By trying your best to eliminate BPA-like products from your lifestyle, you can lower the amount of BPA in your bloodstream within even a few days.
Don’t Underestimate the Power of Whole Foods
According to new research published in Environmental Health Perspectives, conducted by Silent Spring Institute and Breast Cancer Fund, it shows that a fresh food plant-based diet significantly reduces levels of BPA and phthalates after just three days.
The research team assessed BPA and DEHP levels in adults and children from five families by testing their urine before, during, and after a three-day fresh whole foods plant-based diet. (Please note, urinary excretion is the most common way our bodies get rid of these chemicals). After the three day diet, participants continued to eat organic meals with no canned food and minimal plastic packaging of foods and beverages. They also shifted from storing food in plastic containers as historically done and switched to glass and stainless steel containers.
While families were consuming the fresh food plant based meal plan, average levels of BPA in urine decreased by over 60% and DEHP metabolites (i.e. the breakdown products of phthalates) dropped by over 50%. Reductions were even more pronounced for those with the highest exposures of these toxins historically with BPA levels decreasing by over 70% and over 90% for DEHP. When individuals went back to their conventional standard American diets, these levels quickly returned back to pre-intervention levels.
Takeaway: The research team provides compelling evidence that removing canned food, plastic food and beverage packaging, animal protein and refined foods wrapped in plastic along with microwaving in plastic containers dramatically reduces exposure to BPA, DEHP, and other phthalates in adults and children.
The reason why: because any level of exposure to these phthalates causes significant damage to the brain, nervous system and reproductive organs along with causing detrimental hormonal imbalances. In fact, 3 of the 5 phthalates measured, including DEHP, are now banned under Europe’s REACH regulation because they cause reproductive toxicity.
Silent Spring Institute measured BPA and DEHP in household air and dust in 170 homes in its ongoing Household Exposure Study, and DEHP was detected in 100% of homes tested. This finding should be the wake-up call to families to begin the process of removing the aforementioned items from their homes. Furthermore, industry and government must enact big-picture solutions that eliminate harmful chemicals from food packaging and protect public health. Until then, it’s up to us.
While the research unfolds and the case against BPA and phthalates grows stronger, there are several precautionary steps individuals can take to reduce their exposures to BPA and DEHP, including avoiding canned food and plastic packaging, cooking more plant-based fresh whole food meals at home, and using glass and stainless steel containers to store food.
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References
Bao W, Liu B, Rong S, Dai SY, Trasande L, Lehmler H. Association Between Bisphenol A Exposure and Risk of All-Cause and Cause-Specific Mortality in US Adults. JAMA Netw Open. 2020;3(8):e2011620. doi:10.1001/jamanetworkopen.2020.11620
Carwile, J. L., Luu, H. T., Bassett, L. S., Driscoll, D. A., Yuan, C., Chang, J. Y., ... & Michels, K. B. (2009). Polycarbonate bottle use and urinary bisphenol A concentrations. Environmental health perspectives, 117(9), 1368-1372.
Centers for Disease Control and Prevention (CDC, 2017). "Bisphenol A (BPA) Factsheet". Retrieved from: https://www.cdc.gov/biomonitoring/BisphenolA_FactSheet.html
Gao, H., Yang, B. J., Li, N., Feng, L. M., Shi, X. Y., Zhao, W. H., & Liu, S. J. (2015). Bisphenol A and hormone-associated cancers: current progress and perspectives. Medicine, 94(1).
Gao, X., & Wang, H. S. (2014). Impact of bisphenol A on the cardiovascular system—Epidemiological and experimental evidence and molecular mechanisms. International journal of environmental research and public health, 11(8), 8399-8413.
Hehn, R. S. (2016). NHANES data support link between handling of thermal paper receipts and increased urinary bisphenol A excretion. Environmental science & technology, 50(1), 397-404.
Hormann, A. M., Vom Saal, F. S., Nagel, S. C., Stahlhut, R. W., Moyer, C. L., Ellersieck, M. R., ... & Taylor, J. A. (2014). Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA). PloS one, 9(10), e110509.
Huo, X., Chen, D., He, Y., Zhu, W., Zhou, W., & Zhang, J. (2015). Bisphenol-A and female infertility: a possible role of gene-environment interactions. International journal of environmental research and public health, 12(9), 11101-11116.
Kahn, L. G., Philippat, C., Nakayama, S. F., Slama, R., & Trasande, L. (2020). Endocrine-disrupting chemicals: implications for human health. The Lancet Diabetes & Endocrinology, 8(8), 703-718.
Li, D., Zhou, Z., Qing, D., He, Y., Wu, T., Miao, M., ... & Zhu, Q. (2010). Occupational exposure to bisphenol-A (BPA) and the risk of self-reported male sexual dysfunction. Human reproduction, 25(2), 519-527.
Machtinger R, Combelles CM, Missmer SA, et al. Bisphenol-A and human oocyte maturation in vitro. Hum Reprod. 2013;28(10):2735-2745. doi:10.1093/humrep/det312
National Toxicology Program. (2018). NTP research report on the CLARITY-BPA core study: a perinatal and chronic extended-dose-range study of bisphenol A in rats.
Vandenberg, L. N., Chahoud, I., Heindel, J. J., Padmanabhan, V., Paumgartten, F. J., & Schoenfelder, G. (2010). Urinary, circulating, and tissue biomonitoring studies indicate widespread exposure to bisphenol A. Environmental health perspectives, 118(8), 1055-1070.
Wolstenholme, J. T., Rissman, E. F., & Connelly, J. J. (2011). The role of Bisphenol A in shaping the brain, epigenome and behavior. Hormones and behavior, 59(3), 296-305.
AUTHOR
Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of SF Advanced Health. She combines the best in Eastern and Western Medicine to understand the root causes of diseases and provide patients with personalized treatment plans that quickly deliver effective results. Dr. Bhandari specializes in cell function to understand how the whole body works. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.