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:

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:

 

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:

What Happens if You Have Red Wine or Avocados with a Meal?

Whole plant sources of sugar and fat can ameliorate some of the postprandial (after meal) inflammation caused by the consumption of refined carbohydrates and meat.

Studies have shown how adding even steamed skinless chicken breast can exacerbate the insulin spike from white rice, but fish may be worse. At 0:18 in my video The Effects of Avocados and Red Wine on Meal-Induced Inflammation, you can see how the insulin scores of a low-carbohydrate plant food, peanuts, is lower compared to common low-carb animal foods—eggs, cheese, and beef. Fish was even worse, with an insulin score closer to doughnut territory.

At 0:36 in my video, you can see the insulin spike when people are fed mashed white potatoes. What do you think happens when they’re also given tuna fish? Twice the insulin spike. The same is seen with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein may make the pancreas work twice as hard.

You can do it with straight sugar water, too. If you perform a glucose challenge to test for diabetes, drinking a certain amount of sugar, at 1:10 in my video, you can see the kind of spike in insulin you get. But, if you take in the exact same amount of sugar but with some meat added, you get a higher spike. And, as you can see at 1:25 in my video, the more meat you add, the worse it gets. Just adding a little meat to carbs doesn’t seem to do much, but once you get up to around a third of a chicken’s breast worth, you can elicit a significantly increased surge of insulin.

So, a chicken sandwich may aggravate the metabolic harm of the refined carb white bread it’s on, but what about a PB&J? At 1:49 in my video, you can see that adding nuts to Wonder Bread actually calms the insulin and blood sugar response. What if, instead of nuts, you smeared on an all fruit strawberry jam? Berries, which have even more antioxidants than nuts, can squelch the oxidation of cholesterol in response to a typical American breakfast and even reduce the amount of fat in your blood after the meal. And, with less oxidation, there is less inflammation when berries are added to a meal.

So, a whole plant food source of sugar can decrease inflammation in response to an “inflammatory stressor” meal, but what about a whole plant food source of fat? As you can see at 2:38 in my video, within hours of eating a burger topped with half an avocado, the level of an inflammatory biomarker goes up in your blood, but not as high as eating the burger without the avocado. This may be because all whole plant foods contain antioxidants, which decrease inflammation, and also contain fiber, which is one reason even high fat whole plant foods like nuts can lower cholesterol. And, the same could be said for avocados. At 3:12 in my video, you can see avocado causing a significant drop in cholesterol levels, especially in those with high cholesterol, with even a drop in triglycerides.

If eating berries with a meal decreases inflammation, what about drinking berries? Sipping wine with your white bread significantly blunts the blood sugar spike from the bread, but the alcohol increases the fat in the blood by about the same amount. As you can see at 3:40 in my video, you’ll get a triglycerides bump when you eat some cheese and crackers, but if you sip some wine with the same snack, triglycerides shoot through the roof. How do we know it was the alcohol? Because if you use dealcoholized red wine, the same wine but with the alcohol removed, you don’t get the same reaction. This has been shown in about a half dozen other studies, along with an increase in inflammatory markers. So, the dealcoholized red wine helps in some ways but not others.

A similar paradoxical effect was found with exercise. If people cycle at high intensity for about an hour a half-day before drinking a milkshake, the triglycerides response is less than without the prior exercise, yet the inflammatory response to the meal appeared worse, as you can see at 4:18 in my video. The bottom line is not to avoid exercise but to avoid milkshakes.

The healthiest approach is a whole food, plant-based diet, but there are “promising pharmacologic approaches to the normalization” of high blood sugars and fat by taking medications. “However, resorting to drug therapy for an epidemic caused by a maladaptive diet is less rational than simply realigning our eating habits with our physiological needs.”

Protein from meat can cause more of an insulin spike than pure table sugar. See the comparisons in my video Paleo Diets May Negate Benefits of Exercise.

Interested in more information on the almond butter study I mentioned? I discuss it further in How to Prevent Blood Sugar and Triglyceride Spikes After Meals.

Berries have their own sugar, so how can eating berries lower the blood sugar spike after a meal? Find out in If Fructose Is Bad, What About Fruit?


For more on avocados, check out:

And here are more videos on red wine:

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:

Boosting Antiviral Immune Function with Green Tea

Unlike most antiviral drugs, green tea appears to work by boosting the immune system to combat diseases such as genital warts (caused by HPV) and the flu (caused by the influenza virus).

According to one study, “The belief in green tea as a ‘wonder weapon’ against diseases dates back thousands of years.” I’ve talked about it in relation to chronic disease, but what about infectious disease? I explore this in my video Benefits of Green Tea for Boosting Antiviral Immune Function. Interest in the antimicrobial activity of tea dates back to a military medical journal in 1906, which suggested that servicemen fill their canteens with tea to kill off the bugs that caused typhoid fever. “However, this effect of tea was not studied further until the late 1980s” when tea compounds were pitted against viruses and bacteria in test tubes and petri dishes, but what we care about is whether it works in people. I had dismissed this entire field of inquiry as clinically irrelevant until I learned about tea’s effect on genital warts. External genital warts, caused by human wart viruses, “are one of the most common and fastest-spreading venereal diseases worldwide.”

Patients with external genital warts “present with one or several cauliflower-like growths on the genitals and/or anal regions…associated with…considerable impairment of patients’ emotional and sexual well-being.” But rub on some green tea ointment, and you can achieve complete clearance of all warts in more than 50 percent of cases.

If it works so well for wart viruses, what about flu viruses? As you can see at 1:41 in my video, it works great in a petri dish, but what about in people? Well, tea-drinking school children seem to be protected, but you don’t know about the broader population until it’s put to the test. If you give healthcare workers green tea compounds, they come down with the flu about three times less often than those given placebo, as you can see at 2:02 in my video. In fact, just gargling with green tea may help. While a similar effect was not found in high school students, gargling with green tea may drop the risk of influenza infection seven or eight-fold compared to gargling with water in elderly residents of a nursing home, where flu can get really serious.

Unlike antiviral drugs, green tea appears to work by boosting the immune system, enhancing the proliferation and activity of gamma delta T cells, a type of immune cell that acts as “a first line defense against infection.” According to the researchers, “Subjects who drank six cups of tea per day had up to a 15-fold increase in [infection-fighting] interferon gamma production in as little as one week”—but why?

There is in fact a molecular pattern shared by cancer cells, pathogens, and “edible plant products such as tea, apples, mushrooms, and wine.” So, eating healthy foods may help maintain our immune cells on ready alert, effectively priming our gamma delta T cells so they “then can provide natural resistance to microbial infections and perhaps tumors.” I guess I shouldn’t have been so surprised; tea, after all, is a “vegetable infusion.” You’re basically drinking a hot water extraction of a dark green leafy vegetable.


For more on what green tea can (and cannot) do, check out videos such as:

How else can we improve our immune function? See, for example:

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: