Get the lead out!

Get the lead out!

"Hence gout and stone afflict the human race;Hence lazy jaundice with her saffron face;Palsy, with shaking head and tottering knees.And bloated dropsy, the staunch sot's disease;Consumption, pale, with keen but hollow eye,And sharpened feature, showed that death was nigh.The feeble offspring curse their crazy sires,And, tainted from his birth, the youth expires."

Description of lead poisoning by an anonymous Roman hermit, translated by Humelbergius Secundus, 1829

The Leaded History

Oh lead. What is it? Lead is a soft and malleable blue grey metal that has been mined for millennia for it's use in everything from paint and pottery to makeup and plumbing. In fact, the very word "plumbing" comes from the Latin word for lead, "plumbum." For a long time in the modern era it was added to gasoline to help minimize engines knocking. The ancients regarded lead as the father of all metals. The god associated with lead was Saturn (who was no angel and was known to devour his own young). In fact, the word "saturnine" applies to a person who has become gloomy, cynical, and socially withdrawn, all of which are associated with lead poisoning. The Romans lived in a lead heyday and used it extensively in food and industry despite being aware that it could cause serious health effects. They figured that small amounts could only cause small harm. What they didn't know was that lead is not processed through the body, but rather builds up in tissues, especially bones, and even a small amount on an ongoing basis can lead to toxicity.

Lead in America dates back to the earliest colonial times. The first lead mine and forge was set up in Virginia in 1621 and by the twentieth century the US was the leading producer of lead in the world. By 1980 the US was consuming 1.3 million tons of lead per year which was roughly 40% of worldwide supply and which amounted to 5,221 grams of lead per person in America at the time. For comparison, despite the Roman's love of lead they were only at 550 grams per person per year.  The primary form in which Americans were consuming lead had to do with our ongoing love of automotive travel. Starting in 1923 (with a brief interruption in 1925) Americans began their love affair with tetraethyl lead, informally known as "ethyl." GM, the developers of this anti-knock formula, soon began touting ethyl as the best thing since sliced bread. This quickly turned to controversy as one of the original engineers fell ill, followed soon after by the death of 15  workers in a tetraethyl lead manufacturing plant. Journalists at the time began calling it "looney gas" and the Surgeon General of the US put a temporary ban on leaded gasoline in 1925 for full investigation into the health effects. Despite 7 months of investigation, industry trumped and the final conclusion of the report was that there were "no good grounds for prohibiting the use of ethyl gasoline…as a motor fuelle, provided that its distribution and use are controlled by proper regulations." Oddly enough, even after this proclamation no mandatory regulations of any real significance were put in place for lead sales and manufacturing until 1975 when the EPA began it's slow phase out of the chemical additive. In only the first 7 years of this regulation, lead levels in the air dropped a whopping 64%. Although lead is still added in small amounts to some gasoline (the "leaded" vs "unleaded") the amount is miniscule compared to years past.

Where is it found?

Besides the automotive industry discussed in depth above, lead can be found in a variety of places. One of the lingering and most problematic routes of exposure is paint. Prior to 1978 lead was widely used in paint. While much of this paint has long since been painted over, anywhere where there's a hole in the wall or chipping paint can provide access. With kids being the little "put everything in my mouth" monsters that they are, the old question of "did you eat paint chips as a kid?" becomes more understandable and relevant. Additionally, when those sweet little munchkins are crawling around they are more vulnerable to airborne heavy metals in dust particles that tend to settle lower down. Some other potential sources of lead include: some cosmetics, miniblinds, artistic painting, stained glass, pottery glazing, soldering, bullets, fishing sinkers, lead in water from old pipes, brass faucets, computers, pewter, jewelry, auto batteries, imported or older pre-regulation products, and soil along roadways (from leaded gasoline). Work exposure is also an issue. Some high risk occupations include lead smelting and mining, construction/remodeling, auto repair, anyone who works with firearms, and plumbers.

Testing:

The best test for lead is a blood assessment. Many regions offer free or discounted blood lead level testing for kids and pregnant/lactating women. The CDC defines a "level of concern" in children as anything over 5 mcg/dl (a recent lowering from 10 mcg/dl). The CDC recommends testing children at age 1-2 years and then continuing with annual testing until age 6 for kids at higher risk of lead contamination.

Health Effects

Since this is a mama blog I will be focusing on the effects of lead on kiddos. Kids absorb lead 3x more than adults and as such, they show signs of lead more quickly. They also are rapidly developing and as lead can have a significant effect on development of tissues it is even more critical in this population. The CDC estimates that 4 million households in the US that have children in them have high levels of lead and that of those, 1.5 million children have blood lead levels above 5 mcg/dL, which is the level at which the CDC recommends action.

Lead can affect every system in the body, but it's actions often come on subtly and can easily go unrecognized. Lead's effect on the developing brain and nervous system is the largest concern as neurologic effects have been documented below 10mcg/dL. Low exposure effects that have been documented include lowered IQ, decreased verbal ability, attention deficit, constipation, abdominal pain, low energy, headache, and hearing and speech impairment. High level effects include irritability, severe abdominal pain, kidney damage, swelling in the brain, tremor, vomiting, seizures, coma, and death. These are not things we want any of our kids going through! eEspecially if it is a preventable issue!. How many of those low level symptoms do kids exhibit who get diagnosed with learning disorders or ADHD? What if there is a real and treatable reason why they are behaving that way?

Lead can also cross the placenta and can affect viability of the developing fetus. Lead also affects the endocrine (hormone) system and chronic exposure may affect thyroid function and vitamin D levels. Lead also increases the risk of developing high blood pressure and can lead to anemia. With significant exposure there is also the concept of a "lead line" which can sometimes be seen as a blue line along the gums in the mouth or as a bright white line at the ends of bones on an X-ray, demonstrating how the body stores away lead in the bones of developing children.

What can be done?

The number one way to avoid lead poisoning is education. Parents (or parents-to-be) living in older homes need to be educated about all the ways that lead exposure can happen and conduct testing to minimize it's effects. Washing kid's hands and toys regularly with soap and water can help to reduce dust containing lead from reaching their mouths. Assume that any old paint may have lead in it. Test your water to find out if lead is an issue and consider a filter which can remove heavy metals. Eating a diet high in iron and calcium (yay for leafy greens!) can help to displace lead. If a child does test positive for lead, there are treatment options available through qualified physicians to help remove the lead from the body, but prevention (as in most cases) is far better than the treatment. Here are a few specific ideas to help minimize exposure:

Water: The hard thing about exposure in water is that, converse to some other water contaminants, boiling the water can actually concentrate the lead more. What is typically recommended is running COLD water for a few minutes to flush out standing water in old pipes. Many regions offer free or low cost lead water testing. In Portland, Oregon there are multiple resources including free water testing and free blood testing for kids and pregnant/lactating women. Take advantage of resources! Knowledge is power to change your risks. There are also a multitude of water filters out there thatn can filter out heavy metals for drinking and cooking water.

Paint: If you, like me, live in an older house this is particularly concerning. Since lead was only an issue in paint made before 1978, newer homes are less risky. In my house, the old paint has been long painted over but… what happens when I hang a nail or when a misguided toy takes a chunk out of the wall? Painting over any holes is the easiest prevention, but should you remodel an older home it is well worth getting a professional to do the paint stripping or at least giving you a consult on how to minimize exposure. My home also has a rock border around the old flower garden with whitewashed rocks. Since they look ancient I can only assume that they were painted with leaded paint and we try to avoid allowing our munchkin to play in the soil near these rocks.

Workplace: Bless OSHA (Occupational Safety and Health Administration). These are the wonderful people (who often get written off for intrusive busybodies) who try to make work a safe environment for all. All businesses should have an health and safety officer who conducts regular OSHA trainings to help minimize risks, but if this isn't happening and toxic exposure is a concern, any worker can contact OSHA directly to request resources or to file an anonymous or urgent complaint. The contact form can be found here: https://www.osha.gov/html/Feed_Back.html  No one deserves to have their health put in jeopardy for a job, but reality dictates that many people are unknowingly exposed for the sake of a buck. OSHA can be the third party who steps in and steps up for the working men and women who deserve good health.

For additional resources, talk with your physician or local county health department as this is a nationwide movement to get the lead out! Lets protect our kids from this toxic metal and improve all our health.

References:

1.     Heavy Metal Notes from Environmental Medicine Class, Fall, 2014

2.     http://www2.epa.gov/aboutepa/lead-poisoning-historical-perspective

3.     http://www.cdc.gov/nceh/lead/

Plastics

Plastics. These ubiquitous, revolutionary, modern phenomena have changed our lives in countless ways. However, in a day and age where we are increasingly aware of the toxicity of the world around us, plastics are constantly coming under scrutiny, and for good cause. This blog is meant to be a starting point on the safety profile of the various types of plastics and will hopefully encourage you to do more research and at least be conscious of plastics in your life.

The Number

Many of us already are aware that there are different number plastics. This is the little number that you look at on the bottom of the container to determine if you can recycle it depending on your region of the world. However, this number also has a big impact on the toxicity of the plastic. Here is a run-down on the numbers and what they mean:

#1- PETE- polyethylene terephthalate. This is the main plastic used in bottled beverages such as soda and water.

#2- HDPE- high density polyethylene. This plastic is harder and is used in detergent bottles and playground equipment.

#3- PVC- polyvinyl chloride. PVC is everywhere. It is used in pipes, housing siding, shower curtains, and many more.

#4- LDPE- low density polyethylene. This is the soft and pliable plastic used in plastic bags and trash bags.

#5- PP- polypropylene. This plastic is found in clothing (esp. thermal underwear), older tupperware, lab equipment, and automotive components.

#6- PS- polystyrene. This is the basis for styrofoam, disposable utensils, CD/DVD cases, bottle lids, etc.

#7- Other. This group includes fiberglass, nylon, and other plastics that don't fall into the above categories. This includes polycarbonates which can include the toxin so much in the news, BPA.

The Toxic Effect

Now that you know what that little number means, lets talk about the toxicity associated. Here is a quick overview of what the research shows in regards to the various types of plastics. Lets start with overall safety profile.

Safest plastics: #2, #4. These plastics have no detectable leeching capacity and have not been found in detectable amounts in humans.

Safer plastics: #1, #5. These plastics DO have the capacity to leech (increased risk with heating food/beverages in them). However, there is no detected health effects at this time.

Un-safe: #3, #6, some #7. These plastics are known to leech and have known adverse health effects.

Now, onto some of the specifics regarding some of these safety issues.

Polyethylene: #1, #2, #4. These are the most common plastics in use. There are no proven adverse health effects at this time. They are considered potential carcinogens, but there is no definitive data. The biggest concern with these plastics are more on the environment. The Great Pacific Garbage Patch, which is a plastic debris accumulation twice the size of Texas found in the Pacific ocean, is a famous example of plastic waste trapped by water currents. The majority of the plastic in these messes are polyethylene based and are a danger to sea life and the ocean ecology. You need only google this to see the horrific effects these plastics can have on sea life. My hat is off to California for banning plastic bags (polyethylene #4), but there is still a lot of work to be done worldwide to reduce the amount of these plastics getting into the environment.

Polyvinyl Chloride (PVC): #3.These plastics are commonly used in industry (piping, housing siding). However, they are also used in medical industry such as IV bags and tubing, often with the added chemicals such as DEHP or phthalates to soften and make them more pliable. Additionally, plasticizers such as DEHP are often used in food packaging which may pose a significant route of exposure4. PVC has been associated with increased risk of cardiovascular and nervous system effects1, DEHP has been associated with increased inflammatory markers including those specific for the liver and kidney2, and phthalates have been associated with development and exacerbation of allergies and asthma3. Most of the studies regarding these toxicities have been in people who work in processing plants making these products, so the exposure is far higher than most of us would experience in every day life. Still, it's worth consideration if these products are a big part of your life.

Polypropylene: #5. This plastic is commonly used for food storage such as yogurt containers, plastic storage tubs, and baby bottles. It is also used in thermal long underwear, disposable diapers, and surgical mesh. While there is no definitive evidence of direct health effects, studies have shown potential for leeching of chemicals into food, especially if the food is heated in the plastic container5.

Plasticizers: These are substances such as phthalates (which include DEHP, DBP, BBP, DINP, DIDP, DnOP) which were mentioned above and are commonly added to plastics for their softening effects to make the item more flexible. These chemicals are not chemically bonded to the plastic and tend to leech very easily. The biggest age group where we are concerned with exposure is in toddlers who are putting anything and everything into their mouth. Fortunately, plasticizers are not like some other environmental toxins (such as heavy metals) in that they do not bio-accumulate, meaning they are able to pass through the body and don't stick around and build up in crazy high amounts. However, exposure can be significant due to their ability to easily leech and they have been associated with reproductive and development issues in animal studies and are suspected to disrupt endocrine function (all those fabulous hormones) in humans5.  A correlation has also been noted between phthalate exposure and obesity6… just in case we needed another thing to blame our obesity crisis on! There is some hope with phthalates as the FDA in 2008 banned phthalates in any "children's toy or child care article or item that can be placed in a child's mouth" that contains more than 0.1% phthalate. Hey, at least it's a start!

Polystyrene: #6. This plastic is most famous for it's development into styrofoam, but is also used in plastic jewelry, CD/DVD cases, lab equipment, razors, etc. It is inexpensive, partially explaining it's widespread use. Unfortunately, this is one of the plastics that is commonly not accepted for recycling due to it's more extensive processing. One of the health effects that is associated with this plastic is the styrene monomers which can be released when these products are burned (along with many other unhealthy chemicals). Some of the primary symptoms associated with styrene toxicity are developmental, ototoxicity (damaging hearing), and impairment of color discrimination (figuring out which color that block is…)7, along with dizziness, fatigue, nausea/vomiting, cognitive loss, neural toxicity, and possible kidney and liver toxicity. More acute high exposures first affect the mucous membranes with respiratory irritation. Oral exposure has also been shown to inhibit iron absorption8. Although the amount of styrene you would need to be exposed to  for severe effects is enormous (500-1000mg/kg), there is still understandable concern about this plastic as a source of toxins.

Bisphenol A (BPA): This is the last of our topics today. BPA is a common additive to plastics and other resins. It is a component in polycarbonate beverage bottles and has also been used in metal can coatings. It has a long history of use in food packaging since the 1960s, but has recently been in the media as many countries have banned its used in food products as research shows that it is an endocrine disruptor (messes with those hormones, particularly estrogen)9.  BPA has also shown association with childhood lung function and wheeze10. While many think the US is behind the curve in banning BPA, they did ban use in baby bottles, sippy cups, and packaging for infant formula. Many companies are also voluntarily removing BPA from their products in response to consumer demand.

Well, I personally think that's plenty to mull over. Next time you pick up a plastic container, I hope you will look at the number and consider it beyond it's recycling capacity.

References:

1. Med Tr Prom Ekol. 2014;(4):24-9. Risk assessment of health disorders and quality of life in employees of modern polyvinyl chloride production. Meshchakova NM, D'iakovich MP, Shaiakhmetov SF, D'iakovich OA, Telezhkin VV.
2. Chemosphere. 2014 Jun 26;120C:37-44. doi: 10.1016/j.chemosphere.2014.05.053. [Epub ahead of print] Health hazard assessment of occupationally di-(2-ethylhexyl)-phthalate-exposed workers in China. Wang W, Xu X, Fan CQ

3. Ann Allergy Asthma Immunol. 2014 Jun;112(6):496-502. doi: 10.1016/j.anai.2014.03.013. Epub 2014 Apr 13. Effects of phthalates on the development and expression of allergic disease and asthma. North ML, Takaro TK, Diamond ML, Ellis AK.

4. Food Chem Toxicol. 2013 Jan;51:434-8. doi: 10.1016/j.fct.2012.10.015. Epub 2012 Oct 26. Di(2-ethylhexyl)phthalate (DEHP) and di-n-butylphthalate (DBP) exposure through diet in hospital patients. Cirillo T1, Fasano E, Esposito F, Montuori P, Amodio Cocchieri R.

5. Int J Hyg Environ Health. 2007 Oct;210(5):623-34. Epub 2007 Sep 21. Phthalates: toxicology and exposure. Heudorf U1, Mersch-Sundermann V, Angerer J.

6. Ann Pediatr Endocrinol Metab. 2014 Jun;19(2):69-75. doi: 10.6065/apem.2014.19.2.69. Epub 2014 Jun 30. Phthalate exposure and childhood obesity. Kim SH, Park MJ.

7. Food Chem Toxicol. 2014 Feb;64:258-69. doi: 10.1016/j.fct.2013.11.039. Epub 2013 Dec 4. Derivation of safe health-based exposure limits for potential consumer exposure to styrene migrating into food from food containers. Gelbke HP, Banton M, Faes E, Leibold E, Pemberton M, Duhayon S.

8. Nat Nanotechnol. 2012 Feb 12;7(4):264-71. doi: 10.1038/nnano.2012.3. Oral exposure to polystyrene nanoparticles affects iron absorption. Mahler GJ, Esch MB, Tako E, Southard TL, Archer SD, Glahn RP, Shuler ML

9. Reprod Toxicol. 2014 Sep 29. pii: S0890-6238(14)00249-4. doi: 10.1016/j.reprotox.2014.09.012. [Epub ahead of print] Estrogens in the wrong place at the wrong time: fetal BPA exposure and mammary cancer. Paulose T, Speroni L, Sonnenschein C, Soto AM.

10. JAMA Pediatr. 2014 Oct 6. doi: 10.1001/jamapediatrics.2014.1397. [Epub ahead of print] Bisphenol A Exposure and the Development of Wheeze and Lung Function in Children Through Age 5 Years. Spanier AJ, Kahn RS, Kunselman AR, Schaefer EW, Hornung R, Xu Y, Calafat AM, Lanphear BP.

Tapioca what?

My new favorite healthy grain-free, low starch, to-die-for tapioca pudding impostor. Breakfast, after school snack, or dessert, this one's a kid and mom alike pleaser.

In the last few weeks there has been a major shift in the dietary habits of my household. This is due in large to my father's MS and the recommendation of a ketogenic diet trial from his physician. As I cook for everyone in the household, and am also trying to increase my brain health I have been adopting a largely similar diet high in healthy fats (even more than before!) and super low in carbs (even lower than before) and avoidance of grains. So there's the background to this ridiculously easy, absolutely delicious, and healthful recipe's invention.

On cold evenings I am one who thinks there is nothing better than a cup of tea or other such bowl of warmth to start the evening's wind-down. As a kid I loved tapioca (think snack-pack) although as an adult I learned how to make it the "real" way with tapioca and whole milk. Tonight I was craving such a treat so I invented this little beauty which absolutely hit the spot. Variations are highly encouraged as you could go a million different directions. I give the amounts for a single serving (about 6 oz) so just increase as needed for additional hungry mouths.

Ingredients:
- 1/2 cup Whole fat coconut milk, non sweetened, with no carageenan. (For me, this means cans at this point as my grocery store doesn't carry it otherwise to these specs)
- 1/2 Tbs Coconut sugar (or sweetener of your choice- maple syrup or honey would be yummy too)
- 2 Tbs chia seeds
- 1 Tbs ground flax seed
- 1 Tbs butter (grass fed organic is my fav)
- 1/2 tsp cinnamon
- 1 tsp vanilla
- 1 Tbs crushed/chopped nuts of your preference

Directions:
Stir the coconut milk, sugar, chia seeds, flax seeds, butter and cinnamon together in a microwave safe bowl/mug. Heat on high for 1 min. Remove from microwave and stir in nuts and vanilla. Allow to cool or serve warm. The longer it sits, the more liquid will be absorbed, and the softer the seeds will become. Expect a little crunch if you eat it hot.

This can also be made on the stove by heating the first 6 ingredients together on the stove top with a heavy bottom pan, stirring frequently, until it thickens and then allowing to cool before adding the nuts and vanilla.

Yum! Enjoy in good health :)

Here's the specs:

Recipe Nutrition Calculator

Recipe name

Number of servings

Serves  people

Ingredients	Calories	Carbs	Fat	Protein	Sodium	Sugar
Taste of Thai - Coconut Milk (Non-Lite), 0.5 cup	180	3	17	2	38	3
Madhava - Coconut Sugar, Organic, 0.5 tsp.	8	2	0	0	0	2
Seeds - Chia seeds, dried, 1 oz	139	12	9	4	5	0
Bob's Red Mill - Ground Flax Seed Meal (1 Tbsp, 6.5g), 1 Tbsp (13 g)	30	2	2	2	0	0
Organic Valley - Grass Fed Butter, 1 TBSP	110	0	12	0	40	0
Cinnamon - Cinnamon, 1/2 Tsp	4	1	0	0	0	0
Pecans - Chopped, 1 oz	199	4	21	3	0	1
Add Ingredient

Total:	670	24	61	11	83	6
Per Serving:	670	24	61	11	83	6