Do the Pros of Brown Rice Outweigh the Cons of Arsenic?

Are there unique benefits to brown rice that would justify keeping it in our diet despite the arsenic content?

For years, warnings had been given about the arsenic levels in U.S. rice potentially increasing cancer risk, but it had never been put to the test until a study out of Harvard. The finding? “Long-term consumption of total rice, white rice or brown rice[,] was not associated with risk of developing cancer in US men and women.” This was heralded as good news. Indeed, no increased cancer risk found even among those eating five or more servings of rice per week. But, wait a second: Brown rice is a whole grain, a whole plant food. Shouldn’t brown rice be protective and not just neutral? I discuss this in my video Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

If you look at whole grains in general, there is “a significant inverse”—or protective—“association between total whole-grain intake and risk of mortality from total cancers,” that is, dying from cancer. My Daily Dozen recommendation of at least three servings of whole grains a day was associated with a 10 percent lower risk of dying from cancer, a 25 percent lower risk of dying from heart attacks or strokes, and a 17 percent lower risk of dying prematurely across the board, whereas rice consumption in general was not associated with mortality and was not found to be protective against heart disease or stroke. So, maybe this lack of protection means that the arsenic in rice is increasing disease risk, so much so that it’s cancelling out some of the benefits of whole-grain brown rice.

Consumer Reports suggested moderating one’s intake of even brown rice, but, given the arsenic problem, is there any reason we should go out of our way to retain any rice in our diet at all? With all of the other whole grain options out there, should we just skip the rice completely? Or, are there some unique benefits we can get from rice that would justify continuing to eat it, even though it has ten times more arsenic than other grains?

One study showed that “a brown rice based vegan diet” beat out the conventional Diabetes Association diet, even after adjusting for the extra belly fat lost by the subjects on the vegan diet, but that may have been due to the plant-based nature of their diet rather than just how brown rice-based it was.

Another study found a profound improvement in insulin levels after just five days eating brown rice compared to white rice, but was that just because the white rice made people worse? No, the brown rice improved things on its own, but the study was done with a South Indian population eating a lot of white rice to begin with, so this may have indeed been at least in part a substitution effect. And yet another study showed that instructing people to eat about a cup of brown rice a day “could significantly reduce weight, waist and hip circumference, BMI, Diastole blood pressure,” and inflammation—and not just because it was compared to white. However, a larger, longer study failed to see much more than a blood pressure benefit, which was almost as impressive in the white-rice group, so, overall, not too much to write home about.

Then, another study rolled around—probably the single most important study on the pro-rice sideshowing a significant improvement in artery function after eight weeks of eating about a daily cup of brown rice, but not white, as you can see at 3:18 in my video, and sometimes even acutely. If you give someone a meal with saturated fat and white rice, you can get a drop in artery function within an hour of consumption if you have some obesity-related metabolic derangements. But, if you give brown rice instead of white, artery function appears protected against the adverse effects of the meal. Okay, so brown rice does show benefits in interventional studies, but the question is whether it shows unique benefits. Instead, what about oatmeal or whole wheat?

Well, first, researchers needed to design an artery-crippling meal, high in saturated fat. They went with a Haagen Daaz, coconut cream, and egg milkshake given with a bowl of oatmeal or “a comparable bowl of whole rolled wheat.” What do you think happened? Do you think these whole grains blocked the artery-damaging effects like the brown rice did? The whole oats worked, but the whole wheat did not. So, one could argue that brown rice may have an edge over whole wheat. Do oats also have that beneficial long-term effect that brown rice did? The benefit was of a similar magnitude but did not reach statistical significance.

So, what’s the bottom line? Until we know more, my current thinking on the matter is that if you really like rice, you can moderate your risk by cutting down, choosing lower arsenic varieties, and cooking it in a way to lower exposure even further. But, if you like other whole grains just as much and don’t really care if you have rice versus quinoa or another grain, I’d choose the lower arsenic option.

Tada! Done with arsenic in the food supply—for now. Should the situation change, I’ll produce another video on the latest news. Make sure you’re subscribed so you don’t miss any updates.


Here are all 13 videos in the series, in case you missed any or want to go back and review:

And you may be interested in Benefits of Turmeric for Arsenic Exposure.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Is White Rice a Yellow-Light or Red-Light Food?

Arsenic is not just considered to be a carcinogen; it’s also designated as a “nonthreshold carcinogen, meaning that any dose, no matter how small, carries some cancer risk”—so there really isn’t a “safe” level of exposure. Given that, it may be reasonable to “use the conservative ALARA” approach, reducing exposure As Low As Reasonably Achievable.

I have a low bar for recommending people avoid foods that aren’t particularly health-promoting in the first place. Remember when that acrylamide story broke, about the chemical found concentrated in french fries and potato chips? (See my video Acrylamide in French Fries for more.) My take was pretty simple: Look, we’re not sure how bad this acrylamide stuff is, but we’re talking about french fries and potato chips, which are not healthy anyway. So, I had no problem provisionally bumping them from my list of yellow-light foods into my red-light list, from “minimize consumption” to “ideally avoid on a day-to-day basis.”

One could apply the same logic here. Junk foods made out of brown rice syrup, rice milk, and white rice are not just processed foods, but also arsenic-contaminated processed foods, so they may belong in the red zone as red-light foods we should avoid. What about something like whole brown rice? That is more difficult, because there are pros to help outweigh the cons. I discuss this in my video Is White Rice a Yellow-Light or Red-Light Food?, where you can see a graphical depiction of my traffic light food system at 0:49.

The rice industry argues that the “many health benefits of rice consumption outweigh any potential risk,” which is the same sentiment you hear coming out of Japan about the arsenic-contaminated seaweed hijiki: Yes, “the cancer risk posed by hijiki consumption exceeds this acceptable [cancer risk] level by a factor of 10,” an order of magnitude, but the Japanese Ministry of Health stresses the “possible health benefits,” such as lots of fiber and minerals, as if hijiki was the only weed in the sea. Why not choose any of the other seaweeds and get all the benefits without the arsenic? So, when the rice industry says the “many health benefits of rice consumption outweigh any potential risk,” it’s as if brown rice was the only whole grain on the planet. Can’t you get the whole grain benefits without the risks by eating oatmeal, barley, or quinoa instead? Or, is there some unique benefit to rice, such that we really should try to keep brown rice in our diet?

Consumer Reports recommended moving rice to the yellow-light zone—in other words, don’t necessarily avoid it completely, but moderate your intake. The rice industry, in a fact sheet entitled “The Consumer Reports Article is Flawed,” criticized Consumer Reports for warning people about the arsenic levels in rice, saying “[t]here is a body of scientific evidence that establishes…the nutritional benefits of rice consumption; any assessment of the arsenic levels in rice that fails to take this information into account is inherently flawed and very misleading.” The rice industry cites two pieces of evidence. First, it asserts that rice-consuming cultures tend to be healthier, but is that because of, or despite, their white rice consumption? And what about the fact that rice-eating Americans tend to be healthier? Perhaps, but they also tend to eat significantly less saturated fat. So, once again, how do we know whether it’s because of—or despite—the white rice?

The rice industry could have cited the study I discuss at 3:12 in my video that showed that brown rice intake of two or more servings a week was associated with a lower risk of diabetes, but presumably, the reason it didn’t is because intake of white rice is associated with an increased risk of diabetes, and white rice represents 95 percent of the U.S. rice industry. Switching out a third of a serving of white rice a day for brown rice might lower diabetes risk by 16 percent, but switching out that same white rice for whole grains in general, like oats or barley, might work even better! So, other grains have about ten times less arsenic and are associated with even lower disease risk. No wonder the rice industry doesn’t cite this study.

It does cite the Adventist studies, though, and some in vitro data. For example, in a petri dish, as you can see at 4:05 in my video, there are rice phytonutrients that, at greater and greater doses, can inhibit the growth of colon cancer cells while apparently leaving normal colon cells alone, which is exciting. And, indeed, those who happened to eat those phytonutrients in the form of brown rice once or more a week between colonoscopies had a 40 percent lower risk of developing polyps. (The consumption of green leafy vegetables, dried fruit, and beans were also associated with lower polyp incidence.) But, the only reason we care about the development of polyps is that polyps can turn into cancer. But, there had never been studies on brown rice consumption and cancer…until now, which I discuss in my video Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.


For those unfamiliar with my traffic light system, I talk about it in my book trailer. Check out How Not to Die: An Animated Summary.

Almost there! This is the corresponding article to the 12th in my 13-video series on arsenic in the food supply. If you missed any of the first 11 videos, see:

Ready for the finale? See Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

And you may be interested in Benefits of Turmeric for Arsenic Exposure.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How Much Arsenic in Rice Is Too Much?

What are some strategies to reduce arsenic exposure from rice?

Those who are exposed to the most arsenic in rice are those who are exposed to the most rice, like people who are eating plant-based, gluten-free, or dairy-free. So, at-risk populations are not just infants and pregnant women, but also those who may tend to eat more rice. What “a terrible irony for the health conscious” who are trying to avoid dairy and eat lots of whole foods and brown rice—so much so they may not only suffer some theoretical increased lifetime cancer risk, but they may actually suffer arsenic poisoning. For example, a 39-year-old woman had celiac disease, so she had to avoid wheat, barley, and rye, but she turned to so much rice that she ended up with sky-high arsenic levels and some typical symptoms, including “diarrhea, headache, insomnia, loss of appetite, abnormal taste, and impaired short-term memory and concentration.” As I discuss in my video How Much Arsenic in Rice Is Too Much, we, as doctors, should keep an eye out for signs of arsenic exposure in those who eat lots of rice day in and day out.

As you can see at 1:08 in my video, in its 2012 arsenic-in-rice exposé, Consumer Reports recommended adults eat no more than an average of two servings of rice a week or three servings a week of rice cereal or rice pasta. In its later analysis, however, it looked like “rice cereal and rice pasta can have much more inorganic arsenic—a carcinogen—than [its] 2012 data showed,” so Consumer Reports dropped its recommendation down to from three weekly servings to a maximum of only two, and that’s only if you’re not getting arsenic from other rice sources. As you can see from 1:29 in my video, Consumer Reports came up with a point system so people could add up all their rice products for the week to make sure they’re staying under seven points a week on average. So, if your only source of rice is just rice, for example, then it recommends no more than one or two servings for the whole week. I recommend 21 servings of whole grains a week in my Daily Dozen, though, so what to do? Get to know sorghum, quinoa, buckwheat, millet, oatmeal, barley, or any of the other dozen or so common non-rice whole grains out there. They tend to have negligible levels of toxic arsenic.

Rice accumulates ten times more arsenic than other grains, which helps explain why the arsenic levels in urine samples of those who eat rice tend to consistently be higher than those who do not eat rice, as you can see at 2:18 in my video. The FDA recently tested a few dozen quinoa samples, and most had arsenic levels below the level of detection, or just trace amounts, including the red quinoas that are my family’s favorite, which I was happy about. There were, however, still a few that were up around half that of rice. But, overall, quinoa averaged ten times less toxic arsenic than rice. So, instead of two servings a week, following the Consumer Reports recommendation, you could have 20. You can see the chart detailing the quinoa samples and their arsenic levels at 2:20 in my video.

So, diversifying the diet is the number-one strategy to reduce exposure of arsenic in rice. We can also consider alternatives to rice, especially for infants, and minimize our exposure by cooking rice like pasta with plenty of extra water. We found that a 10:1 water-to-rice ratio seemed best, though the data suggest the rinsing doesn’t seem to do much. We can also avoid processed foods sweetened with brown rice syrup. Is there anything else we can do at the dining room table while waiting for federal agencies to establish some regulatory limits?

What if you eat a lot of fiber-containing foods with your rice? Might that help bind some of the arsenic? Apparently not. In one study, the presence of fat did seem to have an effect, but in the wrong direction: Fat increased estimates of arsenic absorption, likely due to the extra bile we release when we eat fatty foods.

We know that the tannic acid in coffee and especially in tea can reduce iron absorption, which is why I recommend not drinking tea with meals, but might it also decrease arsenic absorption? Yes, by perhaps 40 percent or more, so the researchers suggested tannic acid might help, but they used mega doses—17 cups of tea worth or that found in 34 cups of coffee—so it isn’t really practical.

What do the experts suggest? Well, arsenic levels are lower in rice from certain regions, like California and parts of India, so why not blend that with some of the higher arsenic rice to even things out for everybody?

What?!

Another wonky, thinking-outside-the-rice-box idea involves an algae discovered in the hot springs of Yellowstone National Park with an enzyme that can volatize arsenic into a gas. Aha! Researchers genetically engineered that gene into a rice plant and were able to get a little arsenic gas off of it, but the rice industry is hesitant. “Posed with a choice between [genetically engineered] rice and rice with arsenic in it, consumers may decide they just aren’t going to eat any rice” at all.


This is the corresponding article to the 11th in a 13-video series on arsenic in the food supply. If you missed any of the first ten videos, watch them here:

You may also be interested in Benefits of Turmeric for Arsenic Exposure.

Only two major questions remain: Should we moderate our intake of white rice or should we minimize it? And, are there unique benefits to brown rice that would justify keeping it in our diet despite the arsenic content? I cover these issues in the final two videos: Is White Rice a Yellow-Light or Red-Light Food? and Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How Risky Is the Arsenic in Rice?

Getting rice down to the so-called safe water limit for arsenic would still allow for roughly 500 times greater cancer risk than is normally considered acceptable. Given the level of arsenic in rice, how could we figure out how much rice is too much? There are no U.S. standards for arsenic in rice, even though “food sources are the main source of exposure.” There are limits on arsenic in apple juice and tap water, though. To calculate those, experts must have sat down, determined out how much arsenic a day was too much—too risky—then figured people typically drink about four to eight cups of water a day, and set the limits that way, right? Okay, well, can’t we just use their how-much-arsenic-a-day-is-too-much-arsenic-a-day number, and, based on the average arsenic content in rice, figure out how-much-rice-a-day-is-too-much-rice? I discuss this in my video How Risky Is the Arsenic in Rice?.

“The allowable level established by the FDA for arsenic in bottled water is 10 ppb,” assuming people might drink a liter a day. So, based on that daily 10 ppb limit, how much rice is that?

“Each 1 g increase in rice intake was associated with a 1% increase in urinary total arsenic, such that eating 0.56 cups [a little over a half cup] of cooked rice was considered comparable with drinking 1 L/d,” one liter per day, of that maximally contaminated water. Well, if you can eat a half cup a day, why does Consumer Reports suggest eating just a few servings of rice a week? You could eat nearly a serving every day and still stay within the daily arsenic limits set for drinking water.

Well, Consumer Reports felt the 10 ppb water standard was too lax, so, it went with the “most protective standard in the country,” at 5 ppb. Guess where it came from? New Jersey. Good for New Jersey! So, by using 5 ppb instead of 10 ppb in the calculation, you can see how Consumer Reports got to its only-a-few-servings-of-rice-a-week recommendation. Presumably, that’s based on average arsenic levels in rice. If you choose a lower-arsenic rice, one with only half the level of arsenic, can you have four servings a week instead of two? And, if you boil rice like pasta and drain off the excess water, doesn’t that also cut levels in half? If so, then you are up to about eight servings a week. Based on the water standard, apparently, you could still safely eat a serving of rice a day if you choose the right rice and cook it right. I assumed the water limit is ultra-conservative since people are expected to drink water every day of their lives, whereas most people don’t eat rice every day, seven days a week. I made that assumption, but I was wrong. It turns out the opposite is true.

All this time, I had been assuming the current drinking guideline exposure would be safe, which in terms of carcinogens, is usually “1 in a million chances of getting cancer over a lifetime.” I’ve mentioned this before. It’s how cancer-causing substances are typically regulated. If a company wants to release some new chemical, it has to show that it doesn’t cause more than one in a million excess cancer cases. Of course, there are 300 million people in this country, so that one-in-a-million doesn’t make the 300 extra families who have to deal with cancer feel any better, but that’s just the kind of agreed upon “acceptable risk.”

The problem, according to the National Research Council, is that with the current federal drinking water standard for arsenic of 10 μg/L, we are not talking about an excess cancer risk of 1 in a million people, but as high as 1 case in 300 people. Those 300 extra cases of cancer just turned into a million more cases? A million more families dealing with a cancer diagnosis? “This is 3000 times higher than a commonly accepted cancer risk for an environmental carcinogen of 1 case in 1 000 000 people.” If we were to use the normally accepted 1 in a million odds of cancer risk, the water standard would have to be 500 times lower, .02 instead of 10. Even the New Jersey standard is 250 times too high. “While this is a rather drastic difference… it underlines just how little precaution is instilled in the current guidelines.”

Hold on. So why isn’t the water standard .02 instead of 10? Because that “would be nearly impossible to implement” as we just don’t have the technology to get arsenic levels in water that low. The technologically feasible level has been estimated at 3. Okay, so why is the limit 10 and not 3? The decision to use a threshold of 10 instead of 3 was “mainly a budgetary decision.” A threshold of three would cost a lot of money.

So, the current water “safety” limit “is more motivated by politics than by technology.” Nobody wants to be told they have toxic tap water. If they did, they might demand better water treatment and that would be expensive. “As a result, many people drink water at levels very close to the current guideline… and may not be aware that they are exposed to an increased risk of cancer.” Even worse, millions of Americans drink water exceeding the legal limit, as you can see at 5:10 in my video. But, even the people living in areas that meet the legal limit “must understand that current arsenic guidelines are only marginally protective.”

Perhaps we should tell people who drink water—i.e., everyone—“that current arsenic regulations are a cost-benefit compromise and that, based on usual health risk paradigms, the standards should be much lower… People must be made aware that regulatory targets for arsenic should be as close to zero as possible,” and, when it comes to water, we should aim for the reachable limit of 3. What does this mean for rice, though?

Well, first of all, so much for just trying to get rice down to the so-called safe water limit, since that “already exceeds standard [carcinogen] risks and is based on feasibility and cost-benefit compromises,” which “allows for a roughly 500 times higher risk of cancer” than is normally considered acceptable. So, “while authorities ponder when and how they will regulate arsenic concentration in rice,” perhaps we should “curtail or strongly limit our consumption of rice.”

This is the corresponding blog post to the pivotal video in my 13-part series on arsenic in the food supply. The final three videos focus on how to deal practically with the repercussions:


If you missed any of the first nine videos, see:

You may also be interested in Benefits of Turmeric for Arsenic Exposure.

My arsenic series reminds me of the extensive video series I did on lead:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Arsenic in Rice Milk, Rice Krispies, and Brown Rice Syrup

I recommend people switch away from using rice milk

For kids and teens, the amount of arsenic flowing through their bodies was found to be about 15 percent higher for each quarter cup of rice consumed per day, and a similar link was found in adults. A study of pregnant women found that consuming about a half cup of cooked rice per day could raise urine arsenic levels as much as drinking a liter of arsenic-contaminated water at the current upper federal safety limit. These findings “suggest that many people in the United States may be exposed to potentially harmful levels of arsenic through rice consumption.” which I explore in my video Arsenic in Rice Milk, Rice Krispies, and Brown Rice Syrup.

Do you know where Americans get most of their rice arsenic? From Rice Krispies, though brown rice crisps cereal may have twice as much, as I discuss in my video Arsenic in Rice Milk, Rice Krispies, and Brown Rice Syrup.

“Organic brown rice syrup (OBRS) is used as a sweetener in organic food products as an alternative to high-fructose corn syrup.” Big mistake, as organic brown rice syrup products “may introduce significant concentrations” of toxic arsenic into people’s diets. For example, two energy chews sweetened with brown rice syrup might hit the provisional upper daily arsenic intake based on the water standards.

“Toddler formulas with added organic brown rice syrup have 20 times higher levels of inorganic [toxic] arsenic than regular formulas,” and in older children, thanks to brown rice syrup, a few cereal bars a day “could pose a very high cancer risk.”

What about rice milk? A consensus statement of both the European and North American societies for pediatric nutrition recommends the “avoidance of rice drinks for infants and young children,” and, generally, toxic “inorganic arsenic intake in infancy and childhood should be as low as possible.”

To this end, the United Kingdom has banned the consumption of rice milk for young children, a notion with which Consumer Reports concurred, recommending no servings a week of rice milk for children and no more than half a cup a day for adults, as you can see at 1:56 in my video.

The arsenic in various brands of rice milk ranges wildly—in fact, there’s a 15-fold difference between the highest and lowest contamination, suggesting manufacturers could make low arsenic rice milk if they wanted. As you can see at 2:16 in my video, Consumer Reports found rice drinks from Pacific and Rice Dream brands were right about average, though, for Rice Dream, it appears the vanilla or chocolate flavors may be lower. It doesn’t seem we have anything to worry about with rice vinegar, but rice pasta and rice cakes end up similar to pure rice in terms of arsenic levels, which makes sense because that’s pretty much what they are—pure rice. However, pasta is boiled, so we’d expect the levels to be cut 40 to 60 percent, like when you boil and drain rice.

If you just couldn’t live without rice milk for some reason, you could make your own using lower arsenic rice, like brown basmati from India, Pakistan, or California, but then your homemade rice milk might have even less nutrition, as most of the commercial brands are at least fortified. Better options might be soy, oat, hemp, or almond milk, though you don’t want kids to be drinking too much almond milk. There have been a few case reports of little kids drinking four cups a day and running into kidney stone problems due to its relatively high oxalate content, which averages about five times more than soy milk. More on oxalates in my video series starting with Oxalates in Spinach and Kidney Stones: Should We Be Concerned?

I have about 40 videos that touch on soy milk, discussing such topics as how it may normalize development in girls and reduce breast cancer risk, as well reduce prostate cancer risk in men. Some of the latest science on soy milk includes an association with better knee x-rays, suggesting protection from osteoarthritis, and an interventional study suggesting improved gut health by boosting the growth of good bacteria. However, drinking 3 quarts a day, which is 10 to 12 daily cups, for a year may inflame your liver, but two cups a day can have an extraordinary effect on your cholesterol, causing a whopping 25 percent drop in bad cholesterol after just 21 days.

An ounce and a half of almonds, about a handful, each day, can drop LDL cholesterol 13 percent in six weeks and reduce abdominal fat, though a cup of almond milk only contains about ten almonds, which is less than a third of what was used in the study. So, it’s not clear if almond milk helps much, but there was a study on oat milk compared to rice milk. As you can see at 4:37 in my video, five weeks of oat milk lowered bad cholesterol, whereas rice milk didn’t, and even increased triglycerides and may bump blood pressure a bit. However, the oat milk only dropped LDL about 5 percent and that was with three cups a day. As plant-based alternatives go, it appears soy milk wins the day.

So, why drink rice milk at all when there are such better options? There really isn’t much nutrition in rice milk. In fact, there are case reports of severe malnutrition in toddlers whose diets were centered around rice milk due to multiple food allergies. Infants and toddlers have increased protein requirements compared to adults, so if the bulk of a child’s diet is rice milk, coconut milk, potato milk, or almond milk, they may not get enough, as you can see at 5:23 in my video. In fact, cases of kwashiorkor—that bloated-belly protein- and calorie-deficient state of malnutrition—due to rice milk have been reported in Ethiopia…and Atlanta, Georgia, because literally 99 percent of the child’s diet was rice milk. So, these malnutrition cases were not because they drank rice milk, but rather because they drank rice milk nearly exclusively. I just use these examples to illustrate the relative lack of nutrition in rice milk. If you’re going to choose a milk alternative, you might as well go for one that has less arsenic—and more nutrition.

I have released several videos on soy milk, but only one on almond milk video so far: Prostate Cancer and Organic Milk vs. Almond Milk. I plan on producing many more on choosing between various milk options, so stay tuned.


If you’ve missed any of the useful material on dietary arsenic I’ve also shared, please see:

The final four videos in this series take all of this information and try to distill it into practical recommendations:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Arsenic in Infant Rice Cereal

When it comes to rice and rice-based products, pediatric nutrition authorities have recommended that arsenic intake should be as low as possible.

“The US Food and Drug Administration (FDA) has been monitoring the arsenic content in foods” for decades, yet despite the “well-established science describing the health risks associated with arsenic exposure, no standards have been set limiting the amount of arsenic allowable in foods” in the United States. In 2001, the EPA “adopted a new stricter standard for arsenic in drinking water,” and in 2013, the FDA proposed a legal limit for apple juice. “There are still no standards for arsenic in food products despite the fact that food sources are our main source of exposure.”

Unlike the United States, China has standards. As of 2014, China set a maximum threshold of inorganic arsenic at 150 parts per billion, stricter than the World Health Organization’s limit of 200 ppb. In the United States, a 200 ppb limit wouldn’t change the cancer risk much. If we had China’s safety limits of 150 ppb, though, cancer risk would be reduced up to 23 percent and a maximum threshold of 100 ppb would lower cancer risk up to 47 percent—but that could seriously affect the rice industry. In other words, U.S. rice is so contaminated with arsenic that if a safety standard that really cut down on cancer risk were set, it “would wipe out the U.S. rice market.” However, with no limits, what’s the incentive for the rice industry to change its practices? Setting arsenic limits would not only directly protect consumers but also encourage the industry to stop planting rice paddies on arsenic-contaminated land.

Those cancer estimates are based on arsenic-contaminated water studies. Might the arsenic in rice somehow have a different effect? You don’t know…until you put it to the test. We know rice has a lot of toxic arsenic that urine studies have shown we absorb into our body, but there hadn’t been any studies demonstrating “deleterious health impacts” specific to rice arsenic—until now. Since arsenic causes bladder cancer, the researchers figured they would see what kind of DNA mutations the urine of rice eaters can have on human bladder cells growing in a petri dish. And, indeed, they clearly demonstrated that eating a lot of arsenic-contaminated rice every day can “give rise to significant amounts of genetic damage,” the kind that‘s associated with cancer. Yes, but the study used pretty contaminated rice. However, only about 10 percent of the rice in certain parts of Asia might ever reach those levels of contamination, though a quarter of rice in parts of Europe might and more half in the United States, making for considerable public health implications.

So, “there remains little mystery surrounding the health risks associated with arsenic levels in rice. The remaining mystery is why long-overdue standards for arsenic levels in rice have not been set by the FDA” in the United States, but that may be changing. In 2016, the FDA proposed setting a limit on toxic arsenic—at least in infant rice cereal, which I discuss in my video Arsenic in Infant Rice Cereal.

As you can see at 3:24 in my video, infants and children under four years of age average the highest rice intake, in part because they eat about three times the amount of food in relation to their body size, so there’s an especially “urgent need for regulatory limits” on toxic arsenic in baby food.

Pediatric nutrition authorities have recommended that when it comes to rice and rice-based products, “arsenic intake should be as low as possible,” but how about as early as possible? Approximately 90 percent of pregnant women eat rice, which may end up having “adverse health effects” on the baby.

You can estimate how much rice the mother ate while pregnant by analyzing arsenic levels in the infant’s toenail clippings. “Specifically, an increase of 1/4 cup of rice per day was associated with a 16.9% increase in infants toenail [arsenic] concentration,” which indicates that arsenic in rice can be passed along to the fetus. What might that arsenic do? A quarter cup of rice worth of arsenic has been associated with low birth weight, increased respiratory infections, and, above that, a 5- to 6-point reduction in IQ, among other issues. So, “based on the FDA’s findings, it would be prudent for pregnant women to consume a variety of foods, including varied grains (such as wheat, oats, and barley),” which is code for cut down on rice. Saying eat less of anything, after all, is bad for business.

Once the baby is weaning, “what’s a parent to do?” Asks Consumer Reports, “To reduce arsenic risks, we recommend that babies eat no more than 1 serving of infant rice cereal per day on average. And their diets should include cereals made of wheat, oatmeal, or corn grits, which contain significantly lower levels of arsenic”—that is, rely on other grains, which are much less contaminated than rice. As the American Academy of Pediatrics has emphasized, “there is no demonstrated benefit of rice cereal over those made with other grains such as oat, barley, and multigrain cereals, all of which have lower arsenic levels than rice cereal.” As you can see at 5:28 in my video, reducing consumption of infant rice cereal to just two servings per week could have an even more dramatic effect on reducing risk.

 The proposed limit on toxic arsenic in infant rice cereals would end up removing about half of the products off the shelves. The FDA analyzed more than 500 infant and toddler foods, and the highest levels of toxic arsenic were found in organic brown rice cereals and “Toddler Puffs.” Based on the wording in the report, these puffs appear to be from the Happy Baby brand. Not-so-happy baby if they suffer brain damage or grow up to get cancer. A single serving could expose infants to twice the tolerable arsenic intake set by the EPA for water. I contacted the Happy Baby company and was told they “are not able to provide any comments” on the FDA’s results.

“Eliminating all rice and rice products from the diets of infants and small children up to 6 years old could reduce the lifetime cancer risk from inorganic arsenic in rice and rice products by 6% and 23% respectively.” That is, there would be a 6 percent lower chance of developing lung or bladder cancer later in life if infants stopped, and a 23 percent lower chance if young kids stopped. However, switching to other grains is a move described as “drastic and dramatic,” creating “a huge crisis”—for the rice industry, presumably—and therefore “not feasible at all.”

I was hoping Happy Baby, upon learning of the concerning FDA arsenic toddler puffs data (regardless of whether the data were about its brand or not) would have kicked its own testing and potential remediation into high gear like Lundberg did (see Which Brands and Sources of Rice Have the Least Arsenic?). But, unfortunately, in my email correspondence with the company, I got no sense that it did.


For more videos on this topic, see:

And here are five more:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How to Cook Rice to Lower Arsenic Levels

Boiling rice like pasta reduces arsenic levels, but how much nutrition is lost?

Cooking rice in a high water-to-rice ratio reduces toxic arsenic content, which I discuss in my video How to Cook Rice to Lower Arsenic Levels. What exactly does that mean? Well, as you can see at 0:16 in my video, if you boil rice like pasta and then drain off the water at the end, you can drop arsenic levels in half—50 to 60 percent of the arsenic gets poured down the drain—whereas the typical way we make rice, boiling off the water in a rice cooker or pot, for example, doesn’t help. In fact, it may even make things worse if the water you’re using to cook the rice has arsenic in it, too, which is a problem that exists for about three million Americans, as about 8 percent of public water supplies exceed the current legal arsenic limits.

“Cooking rice in excess water”—and then discarding the excess water—“efficiently reduces the amount of inorganic As [that is, toxic arsenic] in the cooked rice,” but how much nutrition are you pouring down the drain when you do pour off the excess water?

“Unpolished brown rice naturally contains vitamins and minerals that are lost when the bran layer and germ are removed to make white rice. To compensate, since the 1940s polished white and parboiled rice sold in the United States is often enriched”—that is, white rice has had vitamins and minerals sprayed on it to so it’s “enriched” and “fortified.” That’s why cooking instructions for enriched white rice specifically say you shouldn’t rinse it and you should cook it in a minimal amount of water. In other words, you should do the opposite of what you’d do to get rid of some of the arsenic. But brown rice has the nutrients inside, not just sprayed on.

“Rinsing [white] rice,” by putting it in a colander under running water, for example, “removes much of the enriched vitamins sprayed onto the rice grain surface during manufacture,” removing most of the B-vitamins. But, “rinsing had almost no effect on vitamins in whole grain brown rice”—because brown rice has got the nutrition inside. It’s the same with iron: Rinsing white rice reduces iron levels by about three-fourths, but the iron in brown rice is actually in it, so rinsing only reduces the iron concentration in brown rice by about 10 percent. Rinsing didn’t seem to affect the arsenic levels, so why bother?

Well, if you really wash the rice, for example, agitating the uncooked rice in water, rinsing, and repeating for three minutes, you may be able to remove about 10 percent of the arsenic. So, one research team recommends washing rice as well as boiling it in excess water, but I don’t know if the 10 percent is worth the extra time it takes to wash the rice. However, as we discussed, boiling rice like pasta and then draining off the excess water does really cut way down on the arsenic, and, while that cooking method also takes a whack at the nutrition in white rice, the nutrient loss in brown rice is “significantly less,” as it is not so much enriched as it is rich in nutrition in the first place.

“Cooking brown rice in large amounts of excess water reduces the toxic arsenic by almost 60% and only reduces the iron content by 5%. It reduces the vitamin content of brown rice by about half,” however. You can see a graph of what I’m talking about at 3:18 in my video. A quick rinse of brown rice before you cook it doesn’t lower arsenic levels, but boiling it and draining off the excess water, instead of cooking to dry, drops arsenic levels by 40 percent. That was using about a ratio of 6 parts water to 1 part rice. What if you use even more water, boiling at 10-to-1 water-to-rice ratio? You get a 60 percent drop in arsenic levels.

With white rice, you can rinse off a little arsenic, but after cooking, you end up with similar final drops in arsenic content, but the iron gets wiped out in white rice by rinsing and cooking, whereas the iron in brown rice stays strong. There are similar decrements in the B vitamins with cooking for brown and unrinsed white rice, but once you rinse white rice, the B vitamins are mostly gone before they even make it into the pot.

What about percolating rice? Well, we know that regular rice cooking doesn’t help reduce arsenic levels, but boiling then draining rice like pasta does, while steaming doesn’t do much. What about percolating rice as a radical rethink to optimize arsenic removal? Researchers tried two types of percolating technology: One was a mad scientist-type lab set-up, and the other was just a regular off-the-shelf coffee percolator. Instead of putting in coffee, they put rice and percolated 20 minutes for white and 30 for brown. The result? As you can see at 4:39 in my video, they got about a 60 percent drop in arsenic levels using a 12-to-1 water-to-rice ratio. Raw brown rice started out at about double the arsenic levels of raw white rice, but, after cooking with enough excess water and draining, they end up much closer. Though, a 60 percent drop in arsenic levels by percolating at a 12-to-1 ratio was about what we got boiling at just 10-to-1. So, I don’t see a reason to buy a percolator.

But, what does that 60 percent drop really mean? By boiling and draining a daily serving of rice, we could cut excess cancer risk more than half from about 165 times the acceptable cancer risk to only about…66 times the acceptable risk.


At this point, I can imagine you thinking, Wait, so should we avoid rice or not? I’m getting there. First, I’m just laying out the issue. Here are videos on the latest on the topic, if you’re interested:

 And here are six more:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Which Rice Has the Least Amount of Arsenic: Black, Brown, Red, White, or Wild?

Brown rice contains more arsenic than white rice, but the arsenic in brown rice is less absorbable, so how does it wash out when you compare the urine arsenic levels of white-rice eaters to brown-rice eaters?

Arsenic in rice is a cause for concern, according to a consensus statement by the European and North American societies for pediatric nutrition. At the very least, “in areas of the world where rice consumption is high in all ages, authorities should be prompted to declare which of the rice [types] have the lowest arsenic content and are, therefore, the least harmful for use during infancy and childhood.” I look into the arsenic content of different rices in my video Which Rice Has Less Arsenic: Black, Brown, Red, White, or Wild?.

Extensive recent testing by the FDA found that long grain white rice, which is what most people eat, appears to have more arsenic than medium or short grain rice, but this may be because most of the shorter grains are produced in California, which has significantly less contaminated rice paddies than those in the South, such as in Texas or Arkansas, where most of the long grain rice is grown. So, it’s less long grain versus short grain than white rice versus brown rice, as the mean concentration of inorganic arsenic in parts per billion of long grain white rice is 102.0 and 156.5 in short, medium, and long grain brown rice, as you can see at 0:54 in my video.

What about some of the naturally pigmented varieties like red rice or black rice, which may be even healthier than brown? As you can see at 1:08 in my video, they may contain even less arsenic than white rice. One sample of black rice from China that was purchased in Kuwait had higher levels for total arsenic, so the toxic inorganic portion may only be half that, putting it on par with U.S. brown rice. The study’s red rice sample from Sri Lanka was even more extraordinary, with less than a fifth of the arsenic of the Chinese black rice. But, the Sri Lankan red rice sample had a ridiculous high amount of cadmium, evidently attributed to the cadmium content of widely used Sri Lankan fertilizers.

Colored rice samples purchased mostly in the United States were better than brown or white, and a dozen samples of red rice purchased in Europe were as bad, or even worse, as brown rice. I was hoping that wild rice would have little or no arsenic because it’s a totally different plant, but an average of eight samples showed it to be nearly comparable to white, though the wild rice samples contained only half as much toxic arsenic as brown rice.

As you can see at 2:06 in my video, the arsenic found in a daily serving of white rice carries 136 times the acceptable cancer risk, but brown rice is even riskier at 162. Brown rice averages two-thirds more toxic arsenic than white rice. But, is that just because brown rice tends to be a different strain or grown in different places? No. If you take the exact same batch of brown rice and measure the arsenic levels before and after polishing it to white, you do get a significant drop in arsenic content.

It’s not what you eat, though. It’s what you absorb. The arsenic in brown rice appears to be less bioavailable than the arsenic in white rice. The texture of brown rice may cut down on the release of arsenic from the grain, or perhaps the bran in brown rice helps bind it up. Regardless, taking bioavailability into account, the difference in arsenic levels in white versus brown rice may be a third more, rather than 70 percent more, as you can see at 2:57 in my video. This estimate, however, was based on an in vitro gastrointestinal fluid system in which researchers strung together beakers and tubes to mimic our gut, with one flask containing stomach acid and another intestinal juices. What happened when it was tested in humans? Yes, “evidence suggests that brown rice may contain more arsenic than white rice,” but the researchers aimed to determine how much is actually absorbed by measuring the urine levels of arsenic in white-rice eaters compared with brown-rice eaters. For the arsenic to get from the rice into your bladder, it has to be absorbed through your gut into your bloodstream.

As you can see at 3:45 in my video, the urine of thousands of American test subjects who don’t eat rice at all still contains about 8 micrograms of toxic, carcinogenic arsenic a day. It’s in the air, it’s in the water, and there’s a little bit in nearly all foods. But, eat just one food—a cup or more of white rice a day—and your arsenic exposure shoots up by 65 percent to about 13 micrograms a day.

What about those who eat a cup or more of brown rice every day, which technically contains even more arsenic? Their exposure shoots up the same 65 percent. There is no difference between the urine arsenic levels of white-rice eaters compared with brown-rice eaters. However, this was not an interventional study in which they fed people the same amount of rice to see what happened, which would have been ideal. Instead, it was a population study, so maybe the reason the levels are the same is that white-rice eaters eat more rice than do brown-rice eaters. Could that be why they ended up with the same levels? We don’t know, but it should help to put the minds of brown-rice eaters to rest. But would it be better to eat no rice at all? That’s what I’ll explore in my next few blogs.


 If you’re just joining in on this topic, check out these lead-up videos:

 

It seems like each of these videos just raises more questions, but don’t worry because I’ve got answers for you. See:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Which Brands and Sources of Rice Have the Least Arsenic?

Arsenic levels were tested in 5,800 rice samples from 25 countries.The arsenic found in five servings of rice a week poses a hundred times the acceptable cancer risk. What did the rice industry have to say about that? When the story first broke in the media that U.S. rice had some of the highest arsenic levels in the world, the USA Rice Federation said, “Enough nonsense about arsenic already!” in the August 9, 2005, issue of USA Rice Daily, its daily newsletter. The study, in its mind, was “not only inaccurate in the highest degree, but also maliciously untrue.” One of the researchers responded, “By not addressing this problem [of arsenic] that has been ignored for decades, the U.S. cotton-belt rice industry is doing itself an injustice. “Had the problem been addressed in the past, given that it is well known that arsenic in paddy soils was a problem in the U.S….safe soils would have been identified and low grain arsenic rice varieties developed.” Instead, arsenic-resistant varieties have been developed that build up excessive levels of arsenic without dying themselves. I discuss arsenic levels in rice in my video Which Brands and Sources of Rice Have the Least Arsenic?.

Not all rice producers have been so dismissive, though. After a subsequent Consumer Reports exposé, one rice company detailed “how it is taking matters into its own hands.” Lundberg Farms started testing hundreds of samples of its rice to share the results with the FDA. “We’re committed to providing safe food,” said the CEO, “to really listening to our consumers, and dealing with this problem very openly….” Lundberg Farms isn’t just sharing its results with the FDA, but with everyone.

If you visit its website or go to 1:37 in my video, you can see it apparently followed through on its testing promise for its brown rice. Lundberg Farms use parts per million (ppm) instead of parts per billion (ppb) to make it look better than it is, but compared with the average U.S. brown rice level of 154 ppb, Lundberg does do better. In fact, at 80 ppb, its aromatic brown rice, presumably its brown basmati and brown jasmine, averages less than national white rice levels, as do, apparently, Lundberg’s red and black rices, at 90 ppb. In fact, none of its samples even reached the average U.S. brown rice level.

Consumer Reports found most other brands to be pretty comparable to the U.S. average arsenic levels in brown rice, as you can see at 2:15 in my video, including Uncle Ben’s and Walmart’s Great Value brand. Whole Foods, however, scored the worst with its 365 Everyday Value long grain brown rice, about a third higher than these others and exceeding the national average.

In the largest review to date, based on 5,800 rice samples from 25 countries, the highest total arsenic average came from the United States. U.S. studies averaged overall about double that of rice out of Asia, with the high levels in the United States blamed on “the heavy [historical] use of arsenic-based pesticides.” But arsenic levels were not the same across the United States. Yes, U.S. rice averages twice the arsenic of Asian rice and nearly all rice samples tested in upstate New York that were imported from India or Pakistan had arsenic levels lower than 95 percent of domestically produced rice. But, “[r]ice grown in the U.S. showed the widest overall range…and the largest number of outliers,” due primarily to where it was grown, as you can see at 3:01 in my video. There is significantly more arsenic in Texas and Arkansas rice than rice from California. California rice is comparable to rice produced around the rest of the world. These are presumably some of the data that led Consumer Reports to suggest brown basmati from California, India, or Pakistan might be among the safer rice choices.If the arsenic is from pesticides, would organic rice have less than conventionally grown rice? No, because arsenic pesticides were banned about 30 years ago. It’s just that 30,000 tons of arsenic chemicals had already been dumped onto cotton fields in the southern United States, “so it is understandable that arsenic residues still remain in the environment” even if you don’t add an ounce of new pesticides. That’s why the industry specifically selects for arsenic-resistant varieties of rice plants in the South. If only there were arsenic-resistant humans.

What about other brands of rice? That was the subject of Which Rice Has Less Arsenic: Black, Brown, Red, White, or Wild?.


For even more background, see:

 You may also be interested in:

Kudos to Consumers Union, the wonderful organization that publishes Consumer Reports, for its pioneering work on this and so many other topics.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Cancer Risk from Arsenic in Rice and Seaweed

A daily half-cup of cooked rice may carry a hundred times the acceptable cancer risk of arsenic. What about seaweed from the coast of Maine?

“At one point during the reign of King Cotton, farmers in the south central United States controlled boll weevils with arsenic-based pesticides, and residual arsenic still contaminates the soil.” Different plants have different reactions to arsenic exposure. Tomatoes, for example, don’t seem to accumulate much arsenic, but rice plants are really good at sucking it out of the ground—so much so that rice can be used for “arsenic phytoremediation,” meaning you can plant rice on contaminated land as a way to clear arsenic from the soil. Of course, you’re then supposed to throw the rice—and the arsenic—away. But in the South, where 80 percent of U.S. rice is grown, we instead feed it to people.

As you can see at 0:52 in my video Cancer Risk from Arsenic in Rice and Seaweed, national surveys have shown that most arsenic exposure has been measured coming from the meat in our diet, rather than from grains, with most from fish and other seafood. Well, given that seafood is contributing 90 percent of our arsenic exposure from food, why are we even talking about the 4 percent from rice?

The arsenic compounds in seafood are mainly organic—used here as a chemistry term having nothing to do with pesticides. Because of the way our body can deal with organic arsenic compounds, “they have historically been viewed as harmless.” Recently, there have been some questions about that assumption, but there’s no question about the toxicity of inorganic arsenic, which you get more of from rice.

As you can see at 1:43 in my video, rice contains more of the toxic inorganic arsenic than does seafood, with one exception: Hijiki, an edible seaweed, is a hundred times more contaminated than rice, leading some researchers to refer to it as the “so-called edible hijiki seaweed.” Governments have started to agree. In 2001, the Canadian government advised the public not to eat hijiki, followed by the United Kingdom, the European Commission, Australia, and New Zealand. The Hong Kong Centre for Food Safety advised the public not to eat hijiki and banned imports and sales of it. Japan, where there is actually a hijiki industry, just advised moderation.

What about seaweed from the coast of Maine—domestic, commercially harvested seaweed from New England? Thankfully, only one type, a type of kelp, had significant levels of arsenic. But, it would take more than a teaspoon to exceed the provisional daily limit for arsenic, and, at that point, you’d be exceeding the upper daily limit for iodine by about 3,000 percent, which is ten times more than reported in a life-threatening case report attributed to a kelp supplement.

I recommend avoiding hijiki due to its excess arsenic content and avoiding kelp due to its excess iodine content, but all other seaweeds should be fine, as long as you don’t eat them with too much rice.

In the report mentioned earlier where we learned that rice has more of the toxic inorganic arsenic than fish, we can see that there are 88.7 micrograms of inorganic arsenic per kilogram of raw white rice. What does that mean? That’s only 88.7 parts per billion, which is like 88.7 drops of arsenic in an Olympic-size swimming pool of rice. How much cancer risk are we talking about? To put it into context, the “usual level of acceptable risk for carcinogens” is one extra cancer case per million. That’s how we typically regulate cancer-causing substances. If a chemical company wants to release a new chemical, we want them to show that it doesn’t cause more than one in a million excess cancer cases.

The problem with arsenic in rice is that the excess cancer risk associated with eating just about a half cup of cooked rice a day could be closer to one in ten thousand, not one in a million, as you can see at 4:07 in my video. That’s a hundred times the acceptable cancer risk. The FDA has calculated that one serving a day of the most common rice, long grain white, would cause not 1 in a million extra cancer cases, but 136 in a million.

And that’s just the cancer effects of arsenic. What about all the non-cancer effects? The FDA acknowledges that, in addition to cancer, the toxic arsenic found in rice “has been associated with many non-cancer effects, including ischemic heart disease, diabetes, skin lesions, renal [kidney] disease, hypertension, and stroke.” Why, then, did the FDA only calculate the cancer risks of arsenic? “Assessing all the risks associated with inorganic arsenic would take considerable time and resources and would delay taking any needed action to protect public health” from the risks of rice.

“Although physicians can help patients reduce their dietary arsenic exposure, regulatory agencies, food producers, and legislative bodies have the most important roles” in terms of public health-scale changes. “Arsenic content in U.S.-grown rice has been relatively constant throughout the last 30 years,” which is a bad thing.

“Where grain arsenic concentration is elevated due to ongoing contamination, the ideal scenario is to stop the contamination at the source.” Some toxic arsenic in foods is from natural contamination of the land, but soil contamination has also come from the dumping of arsenic-containing pesticides, as well as the use of arsenic-based drugs in poultry production and then the spreading of arsenic-laced chicken manure on the land. Regardless of why south central U.S. rice paddies are so contaminated, we shouldn’t be growing rice in arsenic-contaminated soil.

What does the rice industry have to say for itself? Well, it started a website called ArsenicFacts. Its main argument appears to be that arsenic is everywhere, we’re all exposed to it every day, and it’s in most foods. But shouldn’t we try to cut down on the most concentrated sources? Isn’t that like saying look, diesel exhaust is everywhere, so why not suck on a tailpipe? The industry website quotes a nutrition professor saying, “All foods contain arsenic. So, if you eliminate arsenic from your diet, you will decrease your risk…and you’ll die of starvation.” That’s like Philip Morris saying that the only way to completely avoid secondhand smoke is to never breathe—but then you’ll asphyxiate, so you might as well just start smoking yourself. If you can’t avoid it, you might as well consume the most toxic source you can find?!

That’s the same tack the poultry industry took. Arsenic and chicken? “No need to worry” because there’s a little arsenic everywhere. That’s why it’s okay the industry fed chickens arsenic-based drugs for 70 years. If you can’t beat ’em, join ’em.

How can the rice industry get away with selling a product containing a hundred times the acceptable cancer risk? I cover that and so much more in my other videos on arsenic and rice, which also include concrete recommendations on how to mediate your risk.


Check out:

Pesticides were not the only source of arsenic. Poultry poop, too, if you can believe it! I cover that story in Where Does the Arsenic in Chicken Come From? and Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?.

Chronic low-dose arsenic exposure is associated with more than just cancer. See The Effects of Too Much Arsenic in the Diet.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Effects of Too Much Arsenic in the Diet

Even at low-level exposure, arsenic is not just a class I carcinogen, but may also impair our immune function and increase our risk of cardiovascular disease and diabetes.

When people hear about arsenic, they think of it as an acute poison, and, indeed, a tiny amount—a hundred milligrams, about one-tenth the weight of a paperclip—could kill you in an hour. But, there is also chronic arsenic poisoning, where even a dose 10,000 times as small can be harmful if you’re exposed day-after-day for years at a time as I discuss in my video The Effects of Too Much Arsenic in the Diet. Chief among the concerns is cancer.

Arsenic is classified as a class I carcinogen, which is the highest level and includes things known to cause cancer in humans. Other class I carcinogens are asbestos, cigarette smoke, formaldehyde, plutonium, and processed meat (the consumption of bacon, ham, hot dogs, deli meat, and the like). So, arsenic is pretty bad, to say the least, implicated in tens of thousands—or even hundreds of thousands—of cancer cases worldwide every year.

Of course, cancer is our number-two killer. What about heart disease, our leading cause of death? “Long-term exposure to low to moderate arsenic levels was associated with cardiovascular disease incidence and mortality,” meaning heart attacks and strokes.

Arsenic is also considered an immunotoxicant, meaning it’s toxic to our immune system. How do we know that? There’s a virus called varicella, which is what causes chickenpox—the first time we get it. Our immune system is able to stamp it down but not stamp it out. The virus retreats into our nerve cells where it lies in wait for our immune function to dip. And, when it does, the virus re-emerges and causes a disease called shingles. We’ve all been exposed to the virus, but only about one in three of us will get shingles because our immune system is able to keep it at bay. However, the virus can slip its muzzle as we get older or immunosuppressed, for instance, if we’re given arsenic chemotherapy. Shingles is a common side effect, because the arsenic drugs not only kill the cancer but also some of our immune cells, too. That’s at high doses, though. Might even low doses of arsenic, like the kind we’re exposed to in our daily diet, impact our immune function? Researchers tested the levels of arsenic in the urine of thousands of Americans, along with their levels of anti-virus antibodies, and, indeed, they found that the more arsenic the subjects had flowing through their bodies, the lower their defenses.

And, if you’re pregnant, arsenic can pass to your baby, possibly increasing the risk of miscarriage or infant mortality, and “may affect an infant’s immune development and susceptibility to infections early in life.” Indeed, a study out of New Hampshire on infant infections in relation to prenatal arsenic exposure found that the more arsenic the mom was exposed to during pregnancy, the higher the baby’s risk of infection during infancy. However, “it’s unknown whether arsenic-induced epigenetic changes are transgenerational”—that is, whether changes in gene expression can impact the health of not only your own children but your grandchildren as well. Regardless, arsenic exposure isn’t good for mom’s own health, as it is associated with increasing blood pressure.

Hold on. If arsenic suppresses immune system function, then, as a silver lining, would we, for example, have fewer allergies, which is a kind of over-reaction of the immune system? Apparently not. Those with higher arsenic levels tend to have higher rates of food allergies, tend not to sleep as well, and tend not to feel as well. When people were asked how they would rate their health, those reporting “excellent” or “very good” tended to have lower levels of arsenic, compared to those who reported their general health condition as “good,” “fair,” or “poor,” who tended to have higher arsenic levels.

What about diabetes? You can see the results of two dozen population studies on arsenic exposure and confirmed diabetes at 4:07 in my video. Any result above one suggests increased risk for diabetes, and any result below one suggests lower risk. The findings? “Our results support an association between ingested arsenic and DM [diabetes] in humans.” Population studies can’t prove cause and effect, though. “While it would be nice to demonstrate a cause and effect relationship…is it necessary?”

We know arsenic is a carcinogen. We know it causes cancer. What more do we need to take steps to decrease our exposure?

Where is arsenic found in our diet? See my videos Where Does the Arsenic in Chicken Come From?  and Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?.


 Ready for a deep dive into the rice issue? Check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

 

 

Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?

What happens when our crops are grown in soil contaminated with arsenic-based pesticides and arsenic drug-laced chicken manure?

When arsenic-containing drugs are fed to chickens, not only does the arsenic grow out into their feathers, which are then fed back to them as a slaughterhouse byproduct, but the arsenic can also get into their tissues and then into our tissues when we eat eggs or meat, a cycle depicted at the start of my video Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?. This explains why national studies have found that those who eat more poultry have tended to have more arsenic flowing through their bodies. Why would the industry do that? In modern poultry farms, often called CAFOs for concentrated animal feeding operations, there can be 200,000 birds under one roof and the floors of these buildings become covered with feces. While this so-called factory farming decreases costs, it also increases the risk of disease. That’s where arsenic-containing drugs and other antibiotic feed additives can come in: to try to cut down the spread of disease in such an unnatural environment. If you’re feeling a little smug because you don’t eat chicken, what do you think happens to the poop?

As depicted at 1:17 in my video, from chicken manure, the arsenic from the drugs in the animal feed can get into our crops, into the air, and into the groundwater, and find its way into our bodies whether we eat meat or not. Yes, but how much arsenic are we really talking about? Well, we raise billions of chickens a year, and, if, historically, the vast majority were fed arsenic, then, if you do the math, we’re talking about dumping a half million pounds of arsenic into the environment every year—much of it onto our crops or shoveled directly into the mouths of other farm animals.

Most of the arsenic in chicken waste is water soluble, so, there are certainly concerns about it seeping into the groundwater. But, if it’s used as a fertilizer, what about our food? Studies on the levels of arsenic in the U.S. food supply dating back to the 1970s identified two foods, fish aside, with the highest levels—chicken and rice—both of which can accumulate arsenic in the same way. Deliver an arsenic-containing drug like roxarsone to chickens, and it ends up in their manure, which ends up in the soil, which ends up in our pilaf. “Rice is [now] the primary source of As [arsenic] exposure in a non seafood diet.”

I was surprised to learn that mushrooms are in the top-five food sources of arsenic, but then it made sense after I found out that poultry litter is commonly used as a starting material to grow mushrooms in the United States. As you can see at 2:58 in my video, over the years, the arsenic content in mushrooms has rivaled arsenic concentration in rice, though people tend to eat more rice than mushrooms on a daily basis. Arsenic levels in mushrooms seemed to be dipping starting about a decade ago, which was confirmed in a 2016 paper that looked at a dozen different types of mushrooms: plain white button mushrooms, cremini, portobello, shiitake, trumpet, oyster, nameko, maitake, alba clamshell, brown clamshell, and chanterelle. Now, mushrooms are only averaging about half the arsenic content as rice, as you can see at 3:37 in my video.

Just like some mushrooms have less arsenic than others, some rice has less. Rice grown in California has 40 percent less arsenic than rice grown in Arkansas, Louisiana, Mississippi, Missouri, and Texas. Why? Well, arsenic-based pesticides had been used for more than a century on millions of acres of cotton fields, a practice noted to be “dangerous” back in 1927. Arsenic pesticides are now effectively banned, so it’s not simply a matter of buying organic versus conventional rice because millions of pounds of arsenic had been laid down in the soil well before the rice was even planted.

The rice industry is well aware of this. There’s an arsenic-toxicity disorder in rice called “straighthead,” where rice planted in soil too heavily contaminated with arsenic doesn’t grow right. So, instead of choosing cleaner cropland, they just developed arsenic-resistant strains of rice. Now, lots of arsenic can build up in rice without the plant getting hurt. Can the same be said, however, for the rice consumer?

It’s the same story with wine. Arsenic pesticides were used, decade after decade, and even though they’ve since been banned, arsenic can still be sucked up from the soil, leading to “the pervasive presence of arsenic in [American] wine [that] can pose a potential health risk.” Curiously, the researchers sum up their article by saying that “chronic arsenic exposure is known to lower IQ in children,” but if kids are drinking that much wine, arsenic toxicity is probably the least of their worries.

Hold on. Chickens are being fed arsenic-based drugs? See Where Does the Arsenic in Chicken Come From? to find out more.


 I expect the arsenic-in-rice issue brought up a lot of questions, and giving you answers is exactly why I’m here! Check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Why Was Chicken the Primary Source of Arsenic Exposure in Children?

What was the National Chicken Council’s response to public health authorities calling for the industry to stop feeding arsenic-based drugs to poultry?

“Dietary practices influence our exposure to pesticides, toxic heavy metals, persistent organic pollutants, and industrial pollutants….A diet high in fish and other animal products, for example, results in greater exposure to persistent organic compounds and metals than does a plant-based diet because these compounds bioaccumulate up the food chain.” Researchers at UC Davis analyzed the diets of children and adults in California to see just how bad things have gotten.

Cancer benchmark levels were exceeded by all children—100 percent of children—for arsenic, the banned pesticides dieldrin and DDT, metabolite DDE, as well as dioxins, and not just by a little. As you can see at 0:51 in my video Where Does the Arsenic in Chicken Come From?, researchers found more than a hundred times the acceptable daily exposure for arsenic in preschoolers, school-aged children, parents, and older adults, about ten times the acceptable levels for various pesticides, and up to a thousand times the daily dose for dioxins. Where are all these toxins coming from?

The number-one source of dioxins in the diets of Californian preschoolers, kids, parents, and grandparents appears to be dairy for all age groups, followed by meat, and then white potatoes, refined grains, mushrooms, poultry, and fish.

These days, our DDT legacy is also mostly from dairy. Dieldrin was created as a safer alternative to DDT, but it was banned just two years later, in 1974, though it’s still found in our bodies, mostly thanks to dairy, meat, and, evidently, cucumbers.

Chlordane made it into the 1980s before being banned, though we’re still exposed through dairy (and cukes). Lead is — foodwise — also mostly from dairy, and mercury is not surprisingly mostly from tuna and other seafood. But the primary source of arsenic in children? Surprisingly, mostly from chicken. Why?

Let me tell you a tale of arsenic in chicken. Arsenic is “well known as a poison by anyone who reads mysteries or the history of the Borgias, and with its long and colourful history, arsenic is not something that people want in their food.” So, when a biostatistics student went to the USDA in 2000 in search of a project for his master’s degree, he decided to look into it. He found a startling difference: Arsenic levels in chicken were three times higher than in other meats. His veterinary colleagues weren’t at all surprised and explained that four different types of arsenic-containing antibiotic drugs are fed to poultry—and have been fed to them since 1944.

“While arsenic-based drugs had been fed to poultry since the 1940s, recognition of this source of exposure [for humans] only occurred after appropriate statistical analysis of the data”—that is, after this student churned through the data. It was published in 2004 and expanded upon in 2006. The National Chicken Council (NCC) was none too pleased, saying lots of foods are contaminated with arsenic. “By focusing specifically on chicken, IATP [the Institute for Agriculture and Trade Policy] makes it clear that it is producing a publicity-oriented document focused on the objective of forcing [chicken] producers to stop using these safe and effective products”—by which the NCC means these arsenic-containing drugs. In fact, the NCC admits to using them but says we don’t need to worry because chicken producers use organic arsenic, “not the inorganic form made infamous in ‘Arsenic and Old Lace.’” Okay, so we don’t need to worry—until, apparently, we cook it. When chicken is cooked, it appears that some of the arsenic drug in the meat turns into the ”Arsenic and Old Lace” variety. So, the Poison-Free Poultry Act of 2009 was introduced into Congress, flopped, and was followed by the subsequent introduction of the Poison-Free Poultry Act of 2011. Did the second attempt fare any better? No, legislators once again said pish posh to poison-poor poultry. So, in 2013, a coalition of nine organizations got together and sued the FDA, and by December 31, 2015, all arsenic-containing poultry drugs were withdrawn. As of 2016, arsenic is no longer to be fed to chickens. The bad news is that without giving birds the arsenic-containing drug roxarsone, chicken may lose some of its “appealing pink color.”

In the end, the poultry industry got away with exposing the American public to arsenic for 72 years. “It should be noted that the European Union has never approved drugs containing arsenic for animal consumption” in the first place, saying, Hmm, feed our animals arsenic? No thanks, nein danke, no grazie, non, merci.

Europe has also long since banned the “urgent threat to human health” posed by feeding farm animals millions of pounds of human antibiotics. As you can see at 5:30 in my video, feeding chickens en masse literally tons of drugs like tetracyclines and penicillins to fatten them faster is a problem that gets worse every year instead of better and dates back to 1951 when drug companies whipped out the ALL CAPS in advertisements,  promising “PROFITS…several times higher!”, a dangerous practice the poultry industry has gotten away with for 68 years…and counting.


If you don’t eat poultry and are feeling a little cocky, you may want to check out my 12-video series on arsenic in rice before you gloat too much:

Think feeding arsenic to chickens is weird? Check out Illegal Drugs in Chicken Feathers.

And for more on the critical public health threat posed by antibiotic overuse in animal agriculture, see:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

What About the Trans Fat in Animal Fat?

The years of healthy life lost due to our consumption of trans fats are comparable to the impact of conditions like meningitis, cervical cancer, and multiple sclerosis. But, if “food zealots” get their wish in banning added trans fats, what’s next? I explore this in my video Banning Trans Fat in Processed Foods but Not Animal Fat.

Vested corporate interests rally around these kinds of slippery slope arguments to distract from the fact that people are dying. New York Mayor Bloomberg was decried as a “meddling nanny” for his trans fat ban and attempt to cap soft drink sizes. How dare he try to manipulate consumer choice! But isn’t that what the food industry has done? “Soft drink portion sizes have grown dramatically, along with Americans’ waistlines.” In 1950, a 12-ounce soda was the king-sized option. Now, it’s the kiddie size. Similarly, with trans fats, it was the industry that limited our choice by putting trans fats into everything without even telling us. Who’s the nanny now?

New York City finally won its trans fat fight, preserving its status as a public health leader. “For example, it took decades to achieve a national prohibition of lead paint, despite unequivocal evidence of harm,” but New York City’s Board of Health led the way, banning it “18 years before federal action.”

There’s irony in the slippery slope argument: First, they’ll come for your fries; next, they’ll come for your burger. After the trans fat oil ban, one of the only remaining sources of trans fat is in the meat itself. “Trans fats naturally exist in small amounts in the fat in meat and milk,” as I’ve discussed before in my video Trans Fat in Meat and Dairy. Before the trans fat ban, animal products only provided about one fifth of America’s trans fat intake, but since the U.S. trans fat ban exempts animal products, they will soon take over as the leading source. As you can see at 2:09 in Banning Trans Fat in Processed Foods but Not Animal Fat, now that added trans fats are banned in Denmark, for example, the only real trans fat exposure left is from animal products found in the U.S. dairy, beef, chicken fat, turkey meat, lunch meat, and hot dogs, with trace amounts in vegetable oils due to the refining process.

The question is: Are animal trans fats as bad as processed food trans fats? As you can see at 2:38 in my video, a compilation of randomized interventional trials found that they both make bad cholesterol go up and they both make good cholesterol go down. So, both animal trans fats and processed food trans fats make the ratio of bad to good cholesterol go up—which is bad. Therefore, all trans fats cause negative effects “irrespective of their origin.” The researchers suspect that also removing natural trans fats from the diet could prevent tens of thousands of heart attacks, but unlike processed foods, you can’t remove trans fats from milk and meat because trans fats are there naturally.

The livestock industry suggests that a little bit of their trans fats might not be too bad, but you saw the same everything-in-moderation argument coming from the Institute of Shortening and Edible Oils after industrial trans fats were first exposed as a threat. The bottom line is “that intake of all sources of trans fat should be minimized.” The trans fat in processed foods can be banned, and just adhering to the current dietary guidelines to restrict saturated fat intake, which is primarily found in meat and dairy, would automatically cut trans fat intake from animal fats.

The reason no progress may have been made on animal trans fat reduction in Denmark is because The Danish Nutrition Council that pushed for the trans fat ban was a joint initiative of The Danish Medical Association and The Danish Dairy Board. They recognized that “the economic support from The Danish Dairy Council could be perceived as problematic” from a scientific integrity point of view, but, not to worry—“The Danish Medical Association expanded the Executive Board and the funding members to also include the Danish pork industry, the Danish meat industry, The Poultry and Egg Council and The Danish Margarine Industry Association.”

If people want to eat trans fat, isn’t that their right? Yes, but only if they’re informed about the risks—yet The Food Industry Wants the Public Confused About Nutrition.

For more on the industry pushback, see my video Controversy Over the Trans Fat Ban.

There does not appear to be a safe level of exposure to trans fat—or to saturated fat or dietary cholesterol, for that matter. See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.


If you find these videos about industry influence on public policy compelling, check out my many others, including:

Note that the concept of raising or lowering HDL (the so-called good cholesterol) playing a causal role in heart disease has come into question. See Coconut Oil and the Boost in HDL “Good” Cholesterol.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Vitamin C for Male Infertility and Lead Poisoning?

What is the clinical relevance of vitamin C among lead-exposed infertile men? Compared to controls, lead battery industry workers given 1,000 mg of vitamin C every workday for three months experienced “a significant increase in sperm motility and sperm count, as well as decrease in abnormal sperm,” and “a significant reduction in the incidence of sperm DNA fragmentation,” that is, damaged sperm DNA. Okay, but the ideal endpoint would be bouncing baby boys and girls. Enter this extraordinary little study from the University of Texas from more than 30 years ago.

Twenty-seven men with fertile wives had been trying to have kids for years to no avail. Twenty of them were given 1,000 mg of vitamin C a day for two months, and 7 acted as controls and didn’t get any vitamin C. The researchers followed up at the end of the 60 days. By then, every single one of the wives of each of the 20 men who had gotten the vitamin C had became pregnant—20 out of 20! After years of frustration, boom: 100-percent pregnant. What’s more, not a single one of the wives of men in the control group got pregnant. Rarely does one see these kinds of black-and-white results in the medical literature for any intervention.

Is the vitamin C lowering the oxidative stress from the lead, or is it actually lowering the level of lead? Sure, antioxidant supplementation can have antioxidant effects, but it may fail to actually lower lead levels in the blood. Now, this was in a group of workers who were breathing lead day in and day out, and the way vitamin C may work is by simply blocking the “intestinal absorption of lead.” An earlier study showed vitamin C supplementation apparently cut lead levels by a third within six months, but that was with a whopping dose of 2 g with added zinc. Another small study found the same 30 percent drop with just 500 mg a day, no zinc, and in only one month. But neither of those studies had a control group of subjects who didn’t take anything, so we don’t know if their levels would have fallen anyway.

Similarly, there is an almost too-good-to-be-true study on the role of vitamin C in scavenging lead toxicity from “biosystems,” by which they meant children. They got 250 to 500 mg a day of vitamin C for a few months, and shaved hair samples every month saw up to a 69 percent decline in lead levels. Researchers repeated it in two other small groups of kids and saw the same amazing kind of drops in every single child. But maybe lead levels were just dropping throughout the whole community during that time? Without measuring lead levels in a control group of kids not taking vitamin C, we can’t be sure.

As I illustrate from 3:17 in my video Yellow Bell Peppers for Male Infertility and Lead Poisoning?, with eight weeks of vitamin C, lead levels dropped in the blood and rose in the urine. One could conclude that the vitamin C was pulling lead out of the body, but the same thing happened in the placebo group: Blood levels dropped, and urine levels rose. So, it had nothing to do with the vitamin C at all. That’s why it’s always important to have a control group.

The same applies with studies that appeared to show no benefit. For example, 36 battery manufacturing workers were studied. Each was given vitamin C, yet there was no change in their lead levels. But, maybe their co-workers suffered a big increase in lead levels during that same time period, and the vitamin C was actually successful in keeping the subjects’ levels from rising. You don’t know without a control group.

That’s why studies like “The effects of vitamin C supplementation on blood and hair levels of cadmium, lead, and mercury” are so important. Vitamin C versus an identical-looking sugar pill placebo. The result? The vitamin C failed to help, which really put a damper on enthusiasm for using vitamin C for lead poisoning until a now-famous study was published in 1999 that showed that vitamin C supplementation could lead to a decrease in blood levels. As you can see at 4:32 in my video, after four weeks of taking a placebo, not much change occurred in blood lead levels in the control group, which is what we’d expect. In contrast, the vitamin C group started out at about the same blood lead level as the control group, but within one week of taking 1,000 mg of vitamin C a day, lead levels dropped 81 percent. So, supplementation of vitamin C “may provide an economical and convenient method of reducing blood-lead levels, possibly by reducing the intestinal absorption of lead.”

The urine lead levels didn’t change, so it’s not as if the subjects were excreting more lead in their urine to bring down their blood levels. However, most of the lead in our blood is in the red blood cells, which are recycled in the liver and discharged through the bile into the gut where the lead could just get reabsorbed—unless, perhaps, you’ve got a lot of vitamin C in there to block the re-absorption. But 1,000 mg is a lot of vitamin C. Would something like 200 mg, which is just about how much vitamin C you’d get in an orange and a cup of broccoli or strawberries, work? The researchers tested that, too. The 200 mg group started out the same as the control and the 1,000 mg group, but blood lead levels didn’t really budge. Bummer! So, 1,000 mg seemed to work, but 200 mg didn’t. Isn’t 1,000 mg of vitamin C a bit unnatural, though? The RDA is only 60 mg. Well, actually, we may have evolved for millions of years getting closer to 600 mg a day—ten times the current RDA—because we were eating so many fruits and greens. Okay, but could you reach 1,000 mg of vitamin C without having to take pills? Yes! That’s the amount of vitamin C, for example, that can be found in three yellow bell peppers.


Other videos in my series on lead include:

Note that there is nothing special about yellow bell peppers—other than their extraordinary vitamin C content, that is. I just used them as a practical way to get 1,000 mg of vitamin C in whole-food form. They’re certainly easier than eating ten oranges!

Though, remember my video Peppers and Parkinson’s: The Benefits of Smoking Without the Risks? So, one would expect to get all the benefits of the 1,000 mg of vitamin C with benefits. Why not just take vitamin C supplements? See Do Vitamin C Supplements Prevent Colds but Cause Kidney Stones?.

If hundreds of milligrams a day of vitamin C sounds like a lot, check out What Is the Optimal Vitamin C intake?.

You may be interested in my vitamin C and cancer series:

Finally, for more on male fertility, see:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Can Vitamin C Supplements Help with Lead Poisoning?

“Even if a nutritional manipulation is proven effective in reducing blood lead levels, reliance on such an intervention places most of the burden for prevention on those most affected and least responsible for the underlying environmental causes of lead toxicity. Nutritional interventions, therefore, must never substitute for efforts to reduce lead exposure to safe levels. On the other hand, when used as an adjunct to environmental measures, some nutritional changes may prove to have benefits beyond any impact on lead toxicity.” For example, consumption of vitamin C-rich foods may help with “blood pressure, blood lipid profiles, and respiratory symptoms,” in addition to perhaps influencing “lead toxicity through an influence on absorption of lead, elimination of lead, transport within the body, tissue binding, or secondary mechanisms of toxicity,” that is, even just helping ameliorate some of the damage. But what is this based on?

In 1939, a remarkable study was published, entitled “Vitamin C treatment in lead poisoning,” in which 17 lead industry workers were given 100 mg of vitamin C a day, the amount found in one or two oranges, and “with practically all of them there was a marked gain in vigor, color of skin, cheerfulness, blood picture, appetite and ability to sleep well.” The 17 workers were chosen because they seemed to be in pretty bad shape and possibly even had scurvy, so it’s no wonder a little vitamin C helped. But vitamin C is an antioxidant, and oxidation is “an important mechanism underlying lead toxicity,” so it’s conceivable that it may have mediated some of the harm. But, the vitamin C didn’t appear to just reduce the damage from the lead—it also reduced the lead itself. As you can see from 1:43 in my video Can Vitamin C Help with Lead Poisoning?, the amount of lead in a painter’s urine over a period of a month after starting 200 mg of vitamin C a day exhibited a five-fold drop, suggesting he was absorbing less of the lead into his body. He was one of three painters researchers tried this on, and evidently all three painters’ levels dropped. The researchers concluded that those “exposed to lead…should be advised to include in their diet plenty of such rich sources of vitamin C as tomatoes (fresh or canned), raw cabbage, oranges or grapefruit, raw spinach (or even cooked, in very little water), raw turnips, green bell peppers, cantaloupe, etc.”

Now, this drop in lead in the subjects’ urine was seen with only three painters, and the study didn’t have a control group of painters who didn’t take vitamin C, so perhaps everyone’s lead levels would have dropped for some other reason or perhaps it was just a coincidence. You don’t know…until you put it to the test.

Those original data were so compelling that others were inspired to try to replicate them. I mean, if it actually worked, if vitamin C could help with lead poisoning, grapefruits could be handed out at the factory door! The earlier study didn’t have a good control group, but the researchers weren’t going to make that same mistake this time. In this study, half of the group got 100 mg of vitamin C a day—not just for a month but for a year—and the other group got nothing. The result? “Careful study of a large group of lead workers failed to reveal any effect of ascorbic acid vitamin C…on the lead concentration in the blood…or urine” (emphasis added). There was no difference in their physical condition and no changes in their blood work, so “no reason has been found for recommending the use of ascorbic acid vitamin C to minimize effects of lead absorption.” What a disappointment. It looked so promising!

Whenever I study a topic, I try to read the research chronologically so I can experience the discoveries as they happened throughout history. At this point, though, I was so tempted to jump to a recent review to see what had happened in the intervening 74 years since that first study was published, but I didn’t want to spoiler alert! myself, so I kept reading the papers sequentially. There were in vitro studies where researchers dripped antioxidants on lead exposed cells and it seemed to help, so they jumped on the cantaloupe bandwagon, too, but these were test tube studies.

The first population study was published in 1999, and, as you can see at 4:02 in my video, researchers did find that those with high vitamin C levels in their blood tended to have lower lead levels. Youths with the highest vitamin C levels had a nearly 90 percent lower prevalence of elevated blood lead levels compared to those with the lowest vitamin C levels. Now, this was a cross-sectional study, just a snapshot in time, so we don’t know if the vitamin C caused a drop in lead or if perhaps the lead caused a drop in vitamin C. Lead is a pro-oxidant, so maybe it ate up the vitamin C. And who has higher vitamin C levels? Those who can afford to have higher vitamin C levels and eat lots of fruits and vegetables. “It is also possible that higher ascorbic acid levels may represent healthier lifestyles or greater socio-economic status.” Indeed, maybe lower vitamin C levels are just a proxy for being poor, and that’s the real reason for higher lead levels.

There are lots of good reasons to be eating more fruits and vegetables, and we should be eating more spinach regardless, but it would be nice to know if vitamin C actually helps with lead poisoning. And, to know that, we need to put it to the test.

Unfortunately, most of the published interventions are not very helpful, with such titles as “Effects of dietary vitamin C supplementation on lead-treated sea cucumbers,….”  And, there is a surprising number of articles on the effects of vitamin C supplementation on mouse testicles. Why? Because lead may impair male fertility. Indeed, lead workers appear to have a reduced likelihood of fathering children, but this may in part be due to oxidative stress. In that case, how about giving an antioxidant, like vitamin C, and putting it to the test(es)? No, I’m not talking about rat testes or suggesting frog testes. Neither am I proposing crab testes. (I didn’t even know crabs had testicles!) Finally, here’s one to discuss: “Clinical relevance of vitamin C among lead-exposed infertile men.” A study of human men, which I will cover in Yellow Bell Peppers for Male Infertility and Lead Poisoning?.

I’m always conflicted about writing these kinds of blogs and producing videos like Can Vitamin C Help with Lead Poisoning?. I can imagine some just want “the answer,” but those with vested and commercial interests often exploit that natural impulse. This is problem with science in general, but perhaps particularly in nutrition. When it comes to something as life-or-death important as what to feed ourselves and our families we shouldn’t just follow someone’s opinions or beliefs on the matter. We should demand to see the science. That’s what I try to do: Present the available data as fairly and even-handedly as possible, and let you make up your own mind. You can imagine how easily someone could cherry-pick just one or two studies and present a distorted but compelling case for or against, in this case, vitamin C supplements. That’s why I feel it’s important to present each study in their historical context. Stay tuned for the thrilling conclusion in Yellow Bell Peppers for Male Infertility & Lead Poisoning?.


 For those of you who are thinking, Why should I care about lead? I don’t eat paint chips or use leaded gasoline. Anyway, what’s the big deal?, check out my full series of lead videos for information on how we got into this mess and some of the ways we can dig ourselves out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Garlic Powder to Lower Lead Levels

There are so-called chelation drugs that can be taken for acute, life-threatening lead poisoning—for instance if your two-year-old swallowed one of the little lead weights her grandma was using while sewing curtains and the doctor happened to miss it on x-ray, so it stayed lodged inside her until she died with a blood lead level of 283 mcg/dcl, a case I discuss in my video Best Foods for Lead Poisoning: Chlorella, Cilantro, Tomatoes, Moringa?.

However, for lower grade, chronic lead poisoning, such as at levels under 45 μg/dL, there were no clear guidance as to whether these chelation drugs were effective. When they were put to the test, the drugs failed to bring down lead levels long term. Even when they worked initially, in dose after dose, the lead apparently continued to seep from the patients’ bones, and, by the end of the year, they ended up with the same lead levels as the sugar pill placebo group, as you can see at 0:50 in my video. It was no surprise, then, that even though blood lead levels dipped at the beginning, researchers found no improvements in cognitive function or development.

Since much of lead poisoning is preventable and the drugs don’t seem to work in most cases, that just underscores the need “to protect children from exposure to lead in the first place.” Despite the medical profession’s “best intentions to do something to help these kids…drug therapy is not the answer.” Yes, we need to redouble efforts to prevent lead poisoning in the first place, but what can we do for the kids who’ve already been exposed?

The currently approved method, these chelating drugs that bind and remove lead from our tissues, “lack[s]…safety and efficacy when conventional chelating agents are used.” So, what about dietary approaches? Plants produce phytochelatins. All higher plants possess the capacity to synthesize compounds that bind up heavy metals to protect themselves from the harmful effects, so what if we ate the plants? “Unlike other forms of treatment (e.g., pharmacotherapy with drugs), nutritional strategies carry the promise of a natural form of therapy that would presumably be cheap and with few to no side effects.” Yes, but would it work when the drugs didn’t?

We had learned that a meal could considerably cut down on lead absorption, but “the particular components of food intake that so dramatically reduce lead absorption” were uncertain at the time. Although the calcium content of the meal appeared to be part of it, milk didn’t seem to help and even made things worse. What about calcium supplements? Some assert that calcium supplements may help in reducing lead absorption in children, but “recommendations…must be based on evidence rather than conviction.” What’s more, those assertions are based in part on studies on rodents, and differences in calcium absorption and balance between rats and humans make extrapolation tricky. What you have to do is put it to the test. Researchers found that even an extra whopping 1,800 mg of calcium per day had no effect on blood lead levels. Therefore, the evidence doesn’t support conclusions that calcium supplements help.

What about whole foods? Reviews of dietary strategies to treat lead toxicity say to eat lots of tomatoes, berries, onions, garlic, and grapes, as they are natural antagonists to lead toxicity and therefore should be consumed on a regular basis. Remember those phytochelatins? Perhaps eating plants might help detoxify the lead in our own bodies or the bodies of those we eat.

These natural phytochelatin compounds work so well that we can use them to clean up pollution. For example, the green algae chlorella can suck up lead and hold onto it, so what if we ate it? If it can clean up polluted bodies of water, might it clean up our own polluted bodies? We don’t know, because we only have studies on mice, not men and women.

So, when you hear how chlorella detoxifies, they’re talking about the detoxification of rat testicles. Yes, a little sprinkle of chlorella might help your pet rat, or perhaps you could give them some black cumin seeds or give them a sprig of cilantro, but when you hear how cilantro detoxifies against heavy metals, I presume you don’t expect the researchers to be talking about studies in rodents. If we’re interested in science protecting our children, not just their pets, we’re out of luck.

The same is true with moringa, tomatoes, flaxseed oil, and sesame seed oil, as well as black grapes, and black, white, green, and red tea. There are simply no human studies to guide us.

Dietary strategies for the treatment of lead toxicity are often based on rodent studies, but, for tofu, at least, there was a population study of people that showed lower lead levels in men and women who ate more tofu. The researchers controlled for a whole bunch of factors, so it’s not as if tofu lovers were protected just because they smoked less or ate less meat, but you can’t control for everything.

Ideally, we’d have a randomized, placebo-controlled study. Researchers would take a group of people exposed to lead, split them into two groups, with half given food and the other half given some kind of identical placebo food, and see what happens. It’s easy to do this with drugs because you just use look-alike sugar pills as placebos so people don’t know which group they’re in, but how do you make placebo food? One way to do disguised food interventions is to use foods that are so potent they can be stuffed into a pill—like garlic. There had been various studies measuring the effects of garlic in rats and looking at garlic as a potential antidote for lead intoxication distributed among different mouse organs, but who eats mouse organs? One animal study did have some direct human relevance, though, looking at the effect of garlic on lead content in chicken tissues. The purpose was to “explore the possible use of garlic to clean up lead contents in chickens which”—like all of us on planet Earth—“had been exposed to lead pollution and consequently help to minimize the hazard” of lead-polluted chicken meat.

And…it worked! As you can see at 1:59 in my video Best Food for Lead Poisoning: Garlic, feeding garlic to chickens reduced lead levels in the “edible mass of chicken” by up to 75 percent or more. Because we live in a polluted world, even if you don’t give the chickens lead and raise them on distilled water, they still end up with some lead in their meat and giblets. But, if you actively feed them lead for a week, the levels get really high. When you give them the same amount of lead with a little garlic added, however, much less lead accumulates in their bodies.

What’s even more astonishing is that when researchers gave them the same amount of lead—but this time waited a week before giving them the garlic—it worked even better. “The value of garlic in reducing lead concentrations…was more pronounced when garlic was given as a post-treatment following the cessation of lead administration”—that is, after the lead was stopped and had already built up in their tissues. We used to think that “the beneficial effect of garlic against lead toxicity was primarily due to a reaction between lead and sulfur compounds in garlic” that would glom on to lead in the intestinal tract and flush it out of the body. But, what the study showed is that garlic appears to contain compounds that can actually pull lead not only out of the intestinal contents, but also out of the tissues of the body. So, the “results indicate that garlic contain chelating compounds capable of enhancing elimination of lead,” and “garlic feeding can be exploited to safeguard human consumers by minimizing lead concentrations in meat….”

If garlic is so effective at pulling lead out of chickens’ bodies, why not more directly exploit “garlic feeding” by eating it ourselves? Well, there had never been a study on the ability of garlic to help lead-exposed humans until…2012? (Actually, I’m embarrassed to say I missed it when the study was first published. That was back when I was just getting NutritionFacts.org up and running. Now that we have staff and a whole research team, hopefully important studies like this won’t slip through the cracks in the future.)

The study was a head-to-head comparison of the therapeutic effects of garlic versus a chelation therapy drug called D-penicillamine. One hundred and seventeen workers exposed to lead in the car battery industry were randomly assigned into one of two groups and, three times a day for one month, either got the drug or an eighth of a teaspoon of garlic powder compressed into a tablet, which is about the equivalent of two cloves of fresh garlic a day. As expected, the chelation drug reduced blood lead levels by about 20 percent—but so did the garlic. The garlic worked just as well as the drug and, of course, had fewer side effects. “Thus, garlic seems safer clinically and as effective,” but saying something is as effective as chelation therapy isn’t saying much. Remember how chelation drugs can lower blood levels in chronic lead poisoning, but they don’t actually improve neurological function?

Well, after treatment with garlic, significant clinical improvements were seen, including less irritability, fewer headaches, and improvements in reflexes and blood pressure, but these improvements were not seen in the drug group. They weren’t seen after treatment with the chelation therapy drug. So, garlic was safer and more effective. “Therefore, garlic can be recommended for the treatment of mild-to-moderate lead poisoning.


 There are also some human studieson vitamin C. Check out Can Vitamin C Help with Lead Poisoning?.

For even more lead videos, see:

To learn more about chlorella, see:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Eating to Block Lead Absorption

Intake of certain nutrients has been associated with lower lead levels in the body. For example, women with higher intake of thiamine, also called vitamin B1, tended to have lower blood lead levels, and the same was found for lead-exposed steel workers—and not just with thiamine, as “content of dietary fiber, iron, or thiamine intake each correlated inversely with blood lead concentrations in workers…” The thinking is that the fiber might glom onto the lead and flush it out of the body, the iron would inhibit the lead absorption, and the thiamine may accelerate lead removal through the bile. So, researchers suggest that eating lots of iron, fiber and especially thiamine-rich foods “may induce rapid removal and excretion of the lead from the tissues.” But thiamine’s never been put to the test by giving it to people to see if their lead levels drop. The closest I could find is a thiamine intervention for lead-intoxicated goats.
 

And much of the fiber data are just from test tube studies. In one, for example, researchers used simulated intestinal conditions, complete with “flasks” of feces, and both soluble and insoluble dietary fiber were able to bind up large amounts of mercury, cadmium, and lead to such an extent that they may have been able to block absorption in the small intestine. But, when our good gut flora then eat the fiber, some of the heavy metals may be re-released down in the colon, so it’s not completely fail safe. And, as with thiamine, there haven’t been controlled human studies.

But where is thiamine found? At 1:47 in my video How to Lower Lead Levels with Diet: Thiamine, Fiber, Iron, Fat, Fasting?, I feature a list of some of the healthiest sources of thiamine-rich foods that also contain fiber, which include highly concentrated, super healthy foods like beans and greens—foods we should all be eating anyway. So, even if thiamine- and fiber-rich foods don’t actually lower lead levels, we’ll still end up healthier.

What happened when iron was put to the test? It failed to improve the cognitive performance of lead-exposed children and failed to improve behavior or ADH symptoms, which is no surprise, because it also failed to bring down lead levels, as did zinc supplementation. It turns out that while iron may limit the absorption of lead, “it may also inhibit excretion of previously absorbed lead” that’s already in your body. What’s more, iron may not even inhibit lead absorption in the first place. That was based on rodent studies, and it turns out we’re not rodents.

We get the same story with zinc. It may have helped to protect rat testicles, but didn’t seem to help human children. “Nevertheless, iron is routinely prescribed in children with lead poisoning.” But, “given the lack of scientific evidence supporting the use of iron [supplementation] in…children with lead poisoning, its routine use should be re-examined.” Though, obviously, supplementation may help if you have an iron deficiency.

High fat intake has been identified as a nutritional condition that makes things worse for lead-exposed children. In fact, dietary fat has been associated with higher lead levels in cross-sectional, snapshot-in-time type studies, and there is a plausible biological mechanism: Dietary fat may boost lead absorption by stimulating extra bile, which in turn may contribute to lead absorption, but you really don’t know until you put it to the test.

In addition to testing iron, researchers also tested fat. They gave a group of intrepid volunteers a cocktail of radioactive lead and then, with a Geiger counter, measured how much radiation the subjects retained in their bodies. Drinking the lead with iron or zinc didn’t change anything, but adding about two teaspoons of vegetable oil boosted lead absorption into the body from about 60 percent up to around 75 percent, as you can see at 4:17 in my video.

The only thing that seemed to help, dropping lead absorption down to about 40 percent, was eating a light meal with the lead drink. What was the meal? Coffee and a donut. I think this is the first donut intervention I’ve ever seen with a positive outcome! Could it have been the coffee? Unlikely, because if anything, coffee drinking has been associated with a tiny increase in blood lead levels. If fat makes things worse, and the one sugar they tried didn’t help, the researchers figured that what made the difference was just eating food—any food—and not taking in lead on an empty stomach. And, indeed, if you repeat the study with a whole meal, lead absorption doesn’t just drop from 60 percent to 40 percent—it drops all the way down to just 4 percent! That’s extraordinary. That means it’s 15 times worse to ingest lead on an empty stomach.

Lead given 12 hours before a meal was absorbed at about 60 percent, so most of it was absorbed. When the same amount of lead was given three hours after a meal and also seven hours after a meal, most of it was absorbed at those times, too. But, if you get some food in your stomach within a few hours of lead exposure, you can suppress the absorption of some or nearly all of the lead you ingested, which you can see at 0:11 in my video How to Lower Lead Levels with Diet: Breakfast, Whole Grains, Milk, Tofu?.

This is why it’s critical to get the lead out of our tap water. Although it’s estimated that most of our lead exposure comes from food, rather than water, it’s not what we eat that matters, but what we absorb. If 90 percent of the lead in food is blocked from absorption by the very fact that it’s in food, 10 to 20 times more lead could be absorbed into your bloodstream simply by consuming the same amount of lead in water drank on an empty stomach.

And, since children empty their stomachs faster than adults because kids “have more rapid gastric emptying times,” the timing of meals may be even more important. With little tummies emptying in as few as two hours after a meal, offering midmorning and midafternoon snacks in addition to breakfast and regular meals may cut down on lead absorption in a contaminated environment. And, of course, we should ensure that children wash their hands prior to eating.

So, do preschoolers who eat breakfast have lower levels of lead in their blood? In the first study of its kind, researchers found that, indeed, children who ate breakfast regularly did appear to have lower lead levels, supporting recommendations to provide regular meals and snacks to young children at risk for lead exposure.

Is there anything in food that’s particularly protective? Researchers tested all sorts of foods to find out, and it turns out the “effect of a meal was probably largely due to its content of calcium and phosphate salts but lead uptake was probably further reduced by phytate which is plentiful in whole cereals,” but if calcium and phosphates are protective, you’d think dairy would work wonders. And, indeed, they started giving milk “to workers to prevent lead exposure” ever since calcium was shown to inhibit lead absorption in rats. But, in humans, there’s something in milk that appeared to increase lead uptake, and it wasn’t the fat because they found the same problem with skim milk.

“For over a century milk was recommended unreservedly to counteract lead poisoning in industry,” but this practice was abandoned in the middle of the last century once we learned that milk’s “overall effect is to promote the absorption of lead from the intestinal tract.” What’s the agent in milk that promotes the absorption of lead from the gut? It may be the milk sugar, lactose, though the “mechanism by which lactose enhances lead absorption is not clear.”

The bottom line? “In the past…milk was used as a prophylactic agent to protect workers in the lead industry. Recent studies, however, suggest that this practice is unjustified and may even be harmful.” So, giving people whole grains may offer greater protection against lead uptake.

However, the most potently calcium and phytate-rich food would be tofu. Isolated soy phytonutrients may have a neuroprotective effect, at least this was the case in petri dish-type studies. As you can see at 3:45 in my video, if you add a little lead to nerve cells, you can kill off about 40 percent of them, but if you then give more and more soy phytonutrients, you can ameliorate some of the damage. This is thought to be an antioxidant effect. If you add lead to nerve cells, you can get a big burst of free radicals, but less and less as you drip on more soy compounds.

Nevertheless, even if this worked outside of a lab, cutting down on the toxic effects of lead is nice, but cutting down on the levels of lead in your body is even better. “Because tofu has high content of both calcium and phytic acid phytate…it is biologically plausible that tofu may inhibit lead absorption and retention, thus reducing blood lead levels.” But you don’t know, until you put it to the test.

Tofu consumption and blood lead levels were determined for about a thousand men and women in China. For every nine or so ounces of tofu consumed a week, there appeared to be about four percent less lead in their bloodstream. Those who ate up to two and a half ounces a day had only half the odds of having elevated lead levels, compared to those eating less than about nine ounces a week. Those consuming nearly four ounces a day appeared to cut their odds by more than 80 percent. This was just a cross-sectional study, or snapshot in time, so it can’t prove cause and effect. What you need is an interventional study where you randomize people into two groups, giving half of them some food to see if it drives down lead levels. I cover this in my video Best Food for Lead Poisoning: Chlorella, Cilantro, Tomatoes, Moringa?.


Where does all this lead exposure come from anyway? Check out the first five videos on this series:

For more about blocking lead absorption, as well as what to eat to help rid yourself of the lead you’ve already built up, see:

Or, even better, don’t get exposed in the first place. Find out more in these videos:

Some of my other videos on lead include:

And what about lead levels in women? See:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Adult Exposure to Lead

“Children in approximately 4 million households in the United States are being exposed to high levels of lead.” As I discuss in my video The Effects of Low-Level Lead Exposure in Adults, “Despite the dramatic decline in children’s blood-lead concentrations over the decades, lead toxicity remains a major public health problem”—and not just for children. Yes, lead is “a devastating neurotoxin,” with learning disabilities and attention deficits in children beginning around blood lead levels of 10 mg/dL, which is when you start seeing high blood pressure and nerve damage in adults, as you can see at 0:41 in my video. But, the blood levels in American adults these days are down around 1 mg/dL, not 10 mg/dL, unless you work or play in an indoor firing range, where the lead levels in the air are so high that more than half of recreational target shooters have levels over 10 mg/dL or even 25 mg/dL.

In fact, even open-air outdoor ranges can be a problem. Spending just two days a month at such a range may quadruple blood lead levels and push them up into the danger zone. What if you don’t use firearms yourself but live in a house with someone who does? The lead levels can be so high that the Centers for Disease Control and Prevention advises those who go to shooting ranges to take “measures to prevent take-home exposure including showering and changing into clean clothes after shooting…, storing clean clothes in a separate bin from contaminated clothing, laundering of non disposable outer protective clothing…and leaving at the range shoes worn inside the firing range,” among other actions. Even if none of that applies and your blood levels are under 10 mg/dL, there is still some evidence of increased risk of hand tremors, high blood pressure, kidney damage, and other issues, as you can see at 1:44 in my video. But what if you’re down around a blood lead level of 1 mg/dL, like most people?

“Blood lead levels in the range currently considered acceptable are associated with increased prevalence of gout,” a painful arthritis. In fact, researchers found that blood levels as low as approximately 1.2 mg/dL, which is close to the current American average, can be associated with increased prevalence of gout. So, this means that “very low levels of lead may still be associated with health risks,” suggesting “there is no such thing as a ‘safe’ level of exposure to lead.”

Where is the lead even coming from? Lead only circulates in the body for about a month, so if you have lead in your bloodstream, it’s from some ongoing exposure. Most adults don’t eat peeling paint chips, though, and autos aren’t fueled by leaded gas anymore. There are specific foods, supplements, and cosmetics that are contaminated with lead (and I have videos on all those topics), but for most adults, the source of ongoing lead exposure is from our own skeleton. I just mentioned that lead only circulates in the body for about a month. Well, where does it go after that? It can get deposited in our bones. “More than 90% of the total body lead content resides in the bone, where the half-life is decades long,” not just a month. So, half or more of the lead in our blood represents lead from past exposures just now leaching out of our bones back into our bloodstream, and this “gradual release of lead from the bone serves as a persistent source of toxicity long after cessation of external exposure,” that is, long after leaded gasoline was removed from the pumps for those of us that who were around back before the 1980s.

So, the answer to where the lead comes from is like Pogo’s We’ve met the enemy and he is us or that classic horror movie scene where the call is coming from inside the house.

The amount of lead in our bones can actually be measured, and research shows higher levels are associated with some of our leading causes of death and disability, from tooth decay and miscarriages to cognitive decline and cataracts. “Much of the lead found in adults today was deposited decades ago. Thus, regulations enacted in the 1970s were too late” for many of us, but at least things are going in the right direction now. The “dramatic societal decreases” in blood lead in the United States since the 1970s have been associated with a four- to five-point increase in the average IQs of American adults. Given that, a “particularly provocative question is whether the whole country suffered brain damage prior to the 1980 decreases in blood lead. Was ‘the best generation’ really the brain damaged generation?”

I’m such a sucker for science documentaries, and my favorite episode of Cosmos: A Spacetime Odyssey was The Clean Room, which dealt with this very issue. Trivia: Carl Sagan was my next-door neighbor when I was at Cornell!

If you want to find out How the Leaded Gas Industry Got Away with It, check out that video. How the Lead Paint Industry Got Away with It is similarly scandalous. Lead in Drinking Water offers the modern-day tale of what happened in Flint, Michigan, and “Normal” Blood Lead Levels Can Be Toxic explores the impacts on childhood development.


I close out this extended video series on lead with information on what we can do about it:

Interested in learning more about lead being absorbed and released in our bones, and how calcium supplements may affect that process? See The Rise in Blood Lead Levels at Pregnancy and Menopause and Should Pregnant Women Take Calcium Supplements to Lower Lead Levels?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Why You Don’t Want “Normal” Blood Lead Levels

“By the 1950s, lead—a dangerous neurotoxin that was once buried deep in the ground, far away from humans—had polluted the entire planet.” We have leaded gasoline to thank for this. It’s hard to imagine “a better strategy for maximizing population exposure to a poison than to have it emitted by a ubiquitous mobile source and to line the surfaces of dwellings” and our neighborhoods with it.

“Overall, about 5 million metric tons of lead was deposited in the environment as a result of the combustion of leaded gasoline” by our automobiles before it was regulated. A single busy street could receive more than a metric ton a year, and the lead just built up, decade after decade. Finally, thanks to regulations starting in the 1970s, we stopped spewing so much into the air. As you can see at 0:57 in my video “Normal” Blood Lead Levels Can Be Toxic, as lead use dropped, so did the levels of lead in our blood, resulting in a 98 percent reduction in the percentage of young children with elevated blood lead levels. Of course, the term “elevated” is relative.

“Prior to 1970, lead poisoning was defined by a blood lead concentration of 60 mg/dL or higher” but “since then, the blood lead concentration for defining lead toxicity gradually has been reduced” to 40 mg/dL, then 30 mg/dL, then 25 mg/dL, and then further down to 10mg/dL, as lead levels “previously thought to be safe or inconsequential for children have consistently been shown to be risk factors” for cognitive and behavioral problems.

Currently, an elevated blood lead level is considered to be more than 5 mg/dL. So, under 5 mg/dL, your lead level is considered to be non-elevated or normal. But what does having a “normal” lead level mean?

“Virtually all residents of industrialized countries have bone lead stores that are several orders of magnitude greater than those of our preindustrial ancestors.” If you go to a museum and test the lead levels of ancient skeletons buried a millennium ago, they are a thousand times lower compared to people today, “which indicates the probable existence within most Americans of dysfunctions caused by poisoning from chronic, excessive overexposures to industrial Pb lead.”

You can see a graphical representation of “body burdens of lead” in a preindustrial ancestor, a typical American citizen, and a person with overtly symptomatic lead poisoning, where he might be doubled over in pain, at 2:30 in my video. What the medical and research communities had failed to understand is that they had only concerned themselves with people with actual lead poisoning and those at “typical” lead levels, but “the new value for natural lead levels in [preindustrial] humans shows that typical levels of lead in humans are quite definitely not properly described by the term ‘very low levels’ at all, but instead constitute grossly excessive, 1000-fold over-exposure levels.”

 The bottom line? “No level of lead exposure appears to be ‘safe’ and even the current ‘low’ levels of exposure in children are associated with neurodevelopmental deficits,” including reduced IQ. It could have been a lot worse if we hadn’t started restricting leaded gas. Thanks to falling blood lead levels starting in the 1970s, preschoolers born in the 1990s were two to five IQ points higher than kids like me born before 1976. So, when we see our kids and grandkids being such wizzes at technology that it’s hard to keep up with them, a small part of that may be them not suffering as much lead-induced brain damage as we did. And, what that means for the country is potentially hundreds of billions of dollars of improved productivity because our children are less brain-damaged.

If that seems like a lot for just a few IQ points, as you can see at 4:26 in my video, what you have to realize is that even a small shift in average IQ could result in a 50 percent increase in the number of the “mentally retarded,” millions more in need of special education and services.

So, “removal of lead from gasoline in the United States has been described as one of the great public health achievements of the 20th century, but it almost did not happen.” Indeed, “tremendous pressure by the lead industry itself was brought to bear to quiet, even intimidate, researchers and clinicians who reported on or identified lead as a hazard.” Decent “scientists and health officials faced enormous opposition but never lost sight of the mandate to protect public health.”

Two of the “young, idealistic employees” at the newly formed Environmental Protection Agency, who played key roles in the fight, recount how “naïve [they were] to the ways of Washington”:

“Our youth was also used against us. Our inexperience was cited as a reason for rejecting the lead regulatory proposals….Finally, in retrospect, our youth and inexperience also helped us to succeed in taking on a billion dollar industry. We were too young to know, that regulating lead in gasoline was impossible.”


What about lead exposure after childhood? That’s the topic of my video The Effects of Low-Level Lead Exposure in Adults.

What can we do about lead exposure? See:

If you missed the first three videos in this series, check out:

For the effects of mercury, another heavy metal, see:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Flint Lead Crisis May Be the Tip of the Iceberg

Back in the 1960s, a Pulitzer prize-winning scientist described the problem of childhood lead poisoning as “so well defined, so neatly packaged with both causes and cures known, that if we don’t eliminate this social crime, our society deserves all the disasters that have been forecast for it.”

As I discuss in my video Lead in Drinking Water, “We have the knowledge required to redress this social crime. We know where the lead is, how people are exposed, and how it damages health. What we lack is the political will to do what should be done.” Unfortunately, “many policy makers consider the costs of action primarily in economic and financial terms and ignore the costs of inaction on human health and communities’ livelihoods.”

“At this point, most Americans have heard of the avoidable and abject failure of government on the local, state and federal level; environmental authorities; and water company officials”—in fact, failure across the board—“to prevent the mass poisoning of hundreds of children and adults in Flint, Michigan.”

“A government plan to save some money had led public officials to switch the city’s water source from Lake Huron to the Flint River, once the sewer for the auto industry.” Flint citizens “complained that their tap water was foul and discolored. But city, state, and federal officials took no heed.”

Why? Could it have anything to do with the fact that those who complained are “among the poorest in America, mostly African American”?

Officials failed to act for eighteen months, “until a local pediatrician revealed dramatically elevated lead levels in children’s blood.” An investigation didn’t just find fault but highlighted seeming falsification of water-quality results to keep people in the dark.

Though “the specific breed of alleged government corruption” may be unique to Flint, “the end result might not be so rare in the USA—home to an ageing water system.” As the president of the Children’s Health Fund said, “The Pandora’s box is now wide open.” Flint may be only “the tip of an enormous iceberg”—potentially “just one of a great many icebergs.”

“In addition to lead-based paint and residual lead in soil”—found everywhere from leaded gasoline—“a significant source of childhood lead exposure occurs through drinking water as a result of leaching from lead pipes, lead solder, or brass fixtures.” This has been recognized to be a health issue in the United States as early as 1845, a year our flag only had 26 stars. Yet, the use of lead in water pipes and solder was not restricted until the Safe Drinking Water Act Amendment, 141 years later. Was the city you’re living in built before 1986 when the amendment was passed? Today, the “exact number of lead water pipes currently in use is not clear” as about one in three cities surveyed shrugged their shoulders, “not being able to state how much lead piping exists.”

There are anti-corrosion chemicals you can add to tap water to try to keep the lead in the pipes. Flint could have done that, but it could have cost about $100 a day. Today, “the cost of repairing the Flint water system is estimated at $1.5 billion…”

Let me close with a quote from the heroic pediatrician who blew the whistle, Dr. Hanna-Attisha. She was asked, “What advice would you have for other physicians taking on a whistle-blower role?” She replied, “This is our job. This is why we went to medical school—to help people.”

Wasn’t there lead in paint, too, for the longest time? Yes, and that’s the subject of my video How the Lead Paint Industry Got Away with It. And what about leaded gasoline? How many of you remember going to the pumps and seeing the choice between leaded and unleaded? That’s the subject of How the Leaded Gas Industry Got Away with It.


I also get into what the effects are and what we can do about it. Check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How the Lead Paint and Gas Industries Got Away with It

We have known for thousands of years that lead can be toxic and for more than a century that children could be poisoned by lead paint. Since those first cases, the “lead industry has mobilized against the advances of science,” as I discuss in my video How the Lead Paint Industry Got Away with It.

By 1926, lead poisoning was already “of relatively frequent occurrence in children,” yet “the United States continued to allow the use of lead-based paint until 1978.” In contrast, in Europe, many countries said, Hmm, poisoning children? No, thanks. and “banned the use of lead-based paint as early as 1909.” 

“The delay in banning lead-based paint in the United States was due largely to the marketing and lobbying efforts of the lead industry,” profiting from the poison. It knew it couldn’t hold off forever, but the industry boasted that its “victories have been in the deferral of implementation of…regulations.”

And now, “peeling paint turns into poisonous dust,” and guess where it ends up? As a Mount Sinai dean and a Harvard neurology professor put it: “Lead is a devastating poison. It damages children’s brains, erodes intelligence, diminishes creativity…” and judgment and language. Yet, despite the accumulating evidence, the lead industry didn’t just fail to warn people—“it engaged in an energetic promotion of lead paint.” After all, a can of pure white lead paint had huge amounts of lead, which meant huge profits for the industry.

But, as you can see in an old advertisement featured at 1:55 in my video, “[t]here is no cause for worry” if your toddler rubs up against lead paint, because those “fingerprint smudges or dirt spots” can be removed “easily without harming the paint.” Wouldn’t want to harm the paint. After all, “painted walls are sanitary…”

The director of the Lead Industry Association blamed the victims: “Childhood lead poisoning is essentially a problem of slum dwellings and relatively ignorant parents.”

“It seems that no amount of evidence, no health statistics, no public outrage could get industry to care that their lead paint was killing and poisoning children,” but how much public outrage was there really?

“It goes without saying that lead is a devastating, debilitating poison” and that “literally millions of children have been diagnosed with varying degrees of elevated blood lead levels…” Compare that to polio, for example. “In the 1950s, for example, fewer than sixty thousand new cases of polio per year created a near-panic among American parents and a national mobilization that led to vaccination campaigns that virtually wiped out the disease within a decade.” In contrast, despite “many millions of children [who have] had their lives altered for the worse by exposure to lead…[a]t no point in the past hundred years has there been a similar national mobilization over lead.” Today, after literally a century, the Centers for Disease Control and Prevention estimates over five hundred thousand children still suffer from “elevated blood-lead levels.”

The good news is that blood lead levels are in decline, which is celebrated as one of our great public health achievements. But, given what we knew, and for how long we knew, “it is presumptuous to declare the decline in childhood lead poisoning a public health victory.” Indeed, “even if we were victorious…it would be a victory diminished by our failure to learn from the epidemic and take steps to dramatically reduce exposures to other confirmed and suspected environmental toxicants as well as chemicals of uncertain toxicity.”

That’s one of the reasons I wanted to do this series on lead. We need to learn from our history so the next time some industry wants to sell something to our kids, we’ll stick to the science. And, of course, lead levels aren’t declining for everyone.

As the whistle-blowing pediatrician who helped expose the Flint drinking water crisis explained, “The people in Flint have a 20-year lower life expectancy than people in a neighboring suburb. We were already struggling with every barrier to our children’s success. Then we gave them lead.”

Her research showed that the switch in water supplies from the Great Lakes to the polluted Flint River “created a perfect storm” for lead contamination, doubling the percentage of kids with elevated lead levels in their blood, as you can see at 0:42 in my video How the Leaded Gas Industry Got Away with It, whereas out in the suburbs, where the water supply remained unchanged, children’s lead levels stayed about the same. That’s how she knew it was the switch in water supplies. That’s what broke the story of the Flint crisis: a doubling of elevated lead levels.

But wait a moment: Even before the switch from Lake Huron to the polluted Flint River, when everyone was getting the same water, lead levels in children in Flint were twice that of the suburbs. There was already a doubling in elevated lead levels in Flint and other poor communities around the country, but where have all the crisis headlines been? Indeed, even with all the bottled water in the world, the children in Flint will continue to live in a lead-polluted environment.

Many have pointed out the irony that the new water from the Flint River was “so corrosive” that the nearby General Motors plant switched back to a clean water source when it started noticing rust spots on its new parts, all while water quality complaints from Flint residents were being ignored. But, there is an additional irony: General Motors is a major reason why the world is so contaminated with lead in the first place, as GM invented leaded gasoline. “Shortly after manufacture began, workers…began to become floridly psychotic and die.”

“In the wake of blaring headlines” about the lead-poisoned workers, public health leaders “warned of the potential for damage to broad swaths of the population” posed by putting this “well established toxin” into gasoline, “into the daily lives of millions of people. Yet, despite these warnings, millions…were harmed…and this entirely preventable poisoning still occurs today.”

“Virtually all the lead in the environment is there as a result of human activity.” Because we put it there. It used to be locked away, deep underground or under the ocean, but that was before we drove it around the Earth. “In the early 1970s, 200,000 tons of lead was emitted from automobiles in the United States each year, mostly in urban areas.” Had lead not been added to gasoline, the industry would have had to use higher-octane gas, which is less profitable. So, the “oil and lead industries…successfully thwarted government efforts to limit lead in gasoline for 50 years.” But, how were they able to do that? “Early public health warnings were not heeded because the industry assured the scientific community and the public that there was no danger.” I could see how a gullible public might be swayed by slick PR, but how do you manipulate the scientific community? By manipulating the science.

“The lead industry was able to achieve its influence in large part by being the primary supporter of research on health effects of lead,” and it got the best science money could buy. “Long before Big Tobacco, the lead industry understood the inestimable value of purchasing ‘good science.’”

“Consequently, the vast majority of relevant studies of lead in gasoline published [for decades]…were favorable to the lead industries.” What’s more, they “even sent a delegation to try to convince the U.S. EPA administrator that the lead regulation was not necessary because they alleged lead was an essential mineral required for optimum growth and development.”

Of course, the exact opposite is true. Lead is toxic to development. There are, however, nutritional interventions that can help alleviate lead toxicity. For example, there are food components that can help decrease the absorption of lead and help flush it out of your body. I’ve produced a series of three videos on specific dietary interventions, such as particular foods to eat, but—spoiler alert—in general, “food patterns that reduce susceptibility to lead toxicity are consistent with the recommendations for a healthy diet.”

As soon as I learned about the unfolding crisis in Flint, Michigan, I knew I had to take a deep dive into the medical literature to see if there is anything these kids might be able to do diet-wise to reduce their body burden.

Most of the time when I cover a subject on NutritionFacts.org, I’ve addressed it previously, so I just have to research the new studies published in the interim. But I had never really looked deeply into lead poisoning before, so I was faced with more than a century of science to dig through. Yes, I did discover there were foods that could help, but I also learned about cautionary tales like this one about our shameful history with leaded paint. By learning this lesson, hopefully, we can put more critical thought into preventing future disasters that can arise when our society allows profits to be placed over people.


This is part of a series on lead. You can view the rest of the series here:

 You may also be interested in How to Lower Heavy Metal Levels with Diet.

If you enjoyed this article, you may also like:

What relevance does this have for us today? See, for example, my video How Smoking in 1959 Is Like Eating in 2019.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Armpit Shaving and Breast Cancer

Shaving before applying underarm antiperspirants can increase aluminum absorption. Could this explain the greater number of tumors and the disproportionate incidence of breast cancer in the upper outer quadrant of the breast near the armpit?

A famous case report called “The Mortician’s Mystery,” published in the New England Journal of Medicine back in the 1980s, described a man whose testicles started shrinking and breasts started growing. It turns out the mortician failed to wear gloves as he massaged embalming cream onto corpses. It was concluded there must have been an estrogenic compound in the cream that was absorbed through his skin into his body, one of the first such cases described.

This case was cited as inspiration by a group of researchers who came up with a new theory to explain a breast cancer mystery: Why do most breast cancers occur in the upper outer corner of the breast? The standard explanation was simply because that’s where most of the breast tissue is located, as the so-called tail of the breast extends up to the armpit, but that doesn’t explain the fact that it wasn’t always this way. Indeed, there has been a shift toward the appearance of breast cancer in the upper corner of the breast. And, it also doesn’t explain why “greater genomic instability”––chromosome abnormalities––has been “observed…in outer quadrants of the breast,” which may signal precancerous changes. There definitely seems to be something happening to that outer side of the breast, and it’s something relatively new, occurring in the last 50 years or so.

Is it possible that the increasing use of [underarm] antiperspirant which parallels breast cancer incidence could also be an explanation for the greater number of ductal tumours…and disproportionate incidence of breast cancer in the upper outer quadrant” of the breast near the site where stick, spray, or roll-on is applied? I discuss this possibility in my video Antiperspirants and Breast Cancer, where you can see a graph of U.S. breast cancer incidence and antiperspirant/deodorant sales at 1:38.

There is a free flow of lymph fluid back and forth between the breast and the armpit. If you measure aluminum levels in breasts removed during mastectomies, the “aluminum content of breast tissue in the outer regions [near the armpits]…was significantly higher,” presumably due to the “closer proximity to the underarm” area.

This is a concern because, in a petri dish at least, it has been demonstrated that aluminum is a so-called metalloestrogen, having pro-estrogenic effects on breast cancer cells. Long-term exposure of normal breast tissue cells in a test tube to aluminum concentrations in the range of those found in breasts results in precancerous-type changes. Then, as you can see at 2:41 in my video, once the cells have turned, those same concentrations “can increase the migratory and invasive activity of…human breast cancer cells” in a petri dish. This is important because women don’t die from the tumor in the breast itself, “but from the ability of the cancer cells to spread and grow at distant sites,” like the bones, lungs, liver, or brain. But, we don’t care about petri dishes. We care about people.

In 2002, a paper was published in the Journal of the National Cancer Institute in which the underarm antiperspirant habits of 800 breast cancer survivors were compared with those of women who had never gotten breast cancer, the first study of its kind. The finding? No indication of a link between the two.

Based on this study, Harvard Women’s Health Watch assured women that antiperspirants do not cause breast cancer and “women who are worried that antiperspirants might cause breast cancer can finally rest easy.” But two months later, another study was published that found that “frequency and earlier onset of antiperspirant/deodorant usage with underarm shaving was associated with an earlier age of breast cancer diagnosis.” As you can see at 3:56 in my video, it’s as much as 20 years earlier in women using antiperspirant and shaving their armpits more than three times a week. And, the earlier they started before versus after age 16 appeared to move up their breast cancer diagnosis by 10 or 20 years. The researchers concluded that “underarm shaving with antiperspirant/deodorant use may play a role in breast cancer” after all.

But what does shaving have to do with it? Shaving removes more than just armpit hair. It also removes armpit skin; you end up shaving off the top skin layer. And, while there is very little aluminum absorption through intact skin, when you strip off the outer layer with a razor and then rub on an antiperspirant, you get a six-fold increase in aluminum absorption through the skin. Though this is good news for women who don’t shave, the high transdermal, or through-the-skin, aluminum uptake on shaved skin “should compel antiperspirant manufacturers to proceed with the utmost caution.”

Both European safety authorities and the U.S. Food and Drug Administration (FDA) specifically advise against using aluminum antiperspirants on damaged or broken skin. However, shaving before antiperspirant application “can create abrasions in the skin…thereby negating the specific warning by the FDA and EU.” (I’m sure everyone knows about the FDA’s cautionary advice, having read Title 21 Part 350 Subpart C50-5c1 of the Code of Federal Regulations.)

We get so much aluminum in our diet from processed foods—such as anticaking agents in pancake mix, melting agents in American cheese, meat binders, gravy thickeners, baking powder, and candy—that the contribution from underarm antiperspirants would presumably be minimal in comparison. “But everything was turned topsy-turvy in 2004,” when a case was reported of a woman with bone pain and fatigue suffering from aluminum toxicity. Within months of stopping the antiperspirant, which she had been applying daily to her regularly shaved armpits, her aluminum levels came down and her symptoms resolved. Although not everyone absorbs that much aluminum, the case “suggests that caution should be exercised when using aluminum-containing antiperspirants frequently.”

Recently, as you can see at 6:29 in my video, it was shown that women with breast cancer have twice the level of aluminum in their breasts compared with women without breast cancer, though this doesn’t prove cause and effect. Maybe the aluminum contributed to the cancer, or maybe the cancer contributed to the aluminum. Maybe tumors just absorb more aluminum. Subsequent research has suggested this alternative explanation is unlikely. So, where do we stand now?

The latest review on the subject concluded that as a consequence of the new data, given that aluminum can be toxic and we have no need for it, “reducing the concentration of this metal in antiperspirants is a matter of urgency.” Or, at the very least, the label should warn: “Do not use after shaving.” Of course, we could cease usage of aluminum-containing antiperspirants altogether, but then wouldn’t we smell? Ironically, antiperspirants can make us stink worse. They increase the types of bacteria that cause body odor. It’s like the story with antidepressant drugs, which can actually make one more depressed in the long run (as I discuss in my video Do Antidepressant Drugs Really Work?). The more we use antiperspirants, the more we may need them, which is awfully convenient for a billion-dollar industry.

Is there any way to decrease body odor through changes in diet? An early video of mine discusses Body Odor and Diet, and I have some new updated ones coming down the pike!


What else can we do to decrease breast cancer risk? See, for example:

In health,

Michael Greger, M.D.

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Contaminants Found in 90% of Herbal Supplements Tested

 

The majority of dietary supplement facilities tested were found noncompliant with good manufacturing practices guidelines.

“The U.S. public is not well protected” by current dietary supplement recommendations, an issue I explore in my video Dangers of Dietary Supplement Deregulation. Sometimes, there is too little of whatever’s supposed to be in the bottle, and other times, there’s too much, as I discussed in my video Black Raspberry Supplements Put to the Test. In one case, as you can see at 0:20 in my video, hundreds of people suffered from acute selenium toxicity, thanks to an “employee error at one of the ingredient suppliers.” Months later, many continued to suffer. Had the company been following good manufacturing practices, such as testing their ingredients, this may not have happened. In 2007, the FDA urged companies to adhere to such guidelines, but seven years later, the majority of dietary supplement facilities remained noncompliant with current good manufacturing practices guidelines.

What are the consequences of this ineffective regulation of dietary supplements? Fifty-thousand Americans are harmed every year. Of course, prescription drugs don’t just harm; they actually kill 100,000 Americans every year—and that’s just in hospitals. Drugs prescribed by doctors outside of hospital settings may kill another 200,000 people every year, but that doesn’t make it any less tragic for the thousands sickened by supplements.

Sometimes the supplements may contain drugs. Not only does a substantial proportion of dietary supplements have quality problems, the “FDA has identified hundreds of dietary supplements…that have been adulterated with prescription medications” or, even worse, designer drugs that haven’t been tested—like tweaked Viagra compounds. About half of the most serious drug recalls in the U.S. aren’t for drugs but for supplements, yet two-thirds or recalled supplements were still found on store shelves six months later.

There is also inadvertent contamination with potentially hazardous contaminants, such as heavy metals and pesticides in 90 percent of herbal supplements tested, as you can see at 2:09 in my video. Mycotoxins, potentially carcinogenic fungal toxins like aflatoxin, were found in 96 percent of herbal supplements. Milk thistle supplements were the worst, with most having more than a dozen different mycotoxins. It’s thought that since the plant is harvested specifically when it’s wet, it can get moldy easily. Many people take milk thistle to support their livers yet may end up getting exposed to immunotoxic, genotoxic, and hepatotoxic—meaning liver toxic—contaminants. How is this even legal? In fact, it wasn’t legal until 1994 with the passage of the Dietary Supplement Health and Education Act. Prior to that, supplements were regulated like food additives so you had to show they were safe before they were brought to market—but not anymore. Most people are unaware that supplements no longer have to be approved by the government or that supplement ads don’t have to be vetted. “This misunderstanding may provide some patients with a false sense of security regarding the safety and efficacy of these products.”

This deregulation led to an explosion in dietary supplements from around 4,000 when the law went into effect to more than 90,000 different supplements now on the market, each of which is all presumed innocent until proven guilty, presumed safe until a supplement hurts enough people. “In other words, consumers must suffer harm…before the FDA begins the slow process toward restricting [a] product from the market.” Take ephedra, for example. Hundreds of poison control center complaints started back in 1999, increasing to thousands and including reports of strokes, seizures, and deaths. Yet the FDA didn’t pull it off store shelves for seven years, thanks to millions of dollars from the industry spent on lobbying.

What did the companies have to say for themselves? Metabolife swore that it had never received a single report of a single adverse effect from any customer. “According to the company, Metabolife had a ‘claims-free history’” when in fact it had gotten 14,000 complaints from customers, but covered them up. Basically, “dietary supplement manufacturers have no realistic accountability for the safety of their products,” and the industry trade organizations have been accused of responding to legitimate concerns with “bluster and denial.” Yes, but are these criticisms of dietary supplements just a Big Pharma conspiracy to maintain its monopoly? No. Big Pharma loves dietary supplements because Big Pharma owns dietary supplement companies to dip into the tens of billions in annual sales.


Isn’t the supplement issue insane? For more, check out:

More than a hundred thousand people are killed every year by pharmaceuticals? Learn more: