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Hazard and risk

Our OSS Blog - Thu, 11/26/2015 - 19:19

If you watched the news, read newspapers or surfed the web recently you will have been inundated with pictures of bacon and headlines describing it as carcinogenic. That’s because the International Agency for Research on Cancer (IARC) classified processed meats as being carcinogenic, placing them in the same category as tobacco smoke, asbestos, oral contraceptives, alcohol, sunshine, X-rays, polluted air, and inhaled sand. However, it is critical to understand that the classification is based on hazard as opposed to risk. Hazard can be defined as a potential source of harm or adverse health effect. Risk is the likelihood that exposure to a hazard causes harm or some adverse effect. If a substance is placed in IARC’s Group 1, it means that there is strong evidence that the substance can cause cancer, but it says nothing about how likely it is to do so. That likelihood depends on several factors including innate carcinogenicity, extent of exposure and personal liability. Ultraviolet light, a component of sunlight, is a good example to illustrate the difference between hazard and risk

Light can be thought of as being composed of packets of energy called photons. When a photon impacts a molecule of DNA it can damage it, triggering an irregular multiplication of cells, in other words, cancer. X-rays are also made up of photons, but these are more energetic than the photons of ultraviolet light so they are more likely to damage DNA. Although both sunlight and X-rays are in Group 1, X-rays are clearly more capable of triggering cancer than sunlight. But exposure matters. A single chest X-ray is not a problem but repeated baking in the sun is. More photons of lower energy can have a greater effect than fewer photons of greater energy. Then there is individual liability. A person with dark skin is less at risk for developing cancer than someone with pale skin even at the same ultraviolet light exposure. Inhaled sand is also listed in Group 1. That’s because studies have shown that workers engaged in occupations that can result in inhaling sand show a significantly increased risk of cancer. But this doesn’t mean that going to the beach and frolicking in the sand is a risky business. Tobacco smoke is also in Group 1because there is no doubt that it causes lung cancer. In fact about ninety percent of all lung cancer cases can be attributed to smoking. Alcohol is also in this category because it is known to increase the risk of oral cancers as well as breast cancer, yet nobody worries about drinking a glass of wine. Listing processed meat in IARC’s Group 1 just says that like alcohol, like tobacco, like sunshine, and some 180 other chemicals, mixtures and exposure circumstances, it is capable of causing cancer. It does not mean that if you have a bacon lettuce and tomato sandwich you are putting yourself at risk. Let’s clarify what is meant by processed meat. Grinding meat into hamburger does not result in processed meat. But smoking, fermenting or adding chemicals such as salt or nitrites to either extend the product’s shelf life or change its taste does. We’re talking about bacon, sausages, hot dogs, salami, corned beef, beef jerky and ham as well as canned meat and often meat-based sauces. The evidence that these tasty morsels are linked to cancer comes from observational studies, which of course do not prove cause and effect. But they are quite consistent in demonstrating that populations that consume lots of processed meats have higher cancer rates, particularly colorectal cancer, even when corrections are made for smoking, other foods eaten and activity levels. Furthermore, there are theoretical and experimental foundations for declaring some components found in processed meat, like polycyclic aromatics, heterocyclic amines, nitrites, insulin-like growth factor and heme-iron, carcinogenic. The evidence is certainly not ironclad, but science rarely is. It comes down to making educated guesses and evaluating the downside of such guesses. There is no significant downside to limiting processed meat, especially if it is replaced by plant products.But the significant question to ask is how much can we reduce our risk of colorectal cancer by robbing our taste buds of the taste of bacon and such? The risk of this cancer in the general population is roughly six in a hundred. After poring through some 800 peer-reviewed publications, IARC estimates that eating 50 grams of processed meat every day over a lifetime increases risk by about 18%. In other words, if a hundred people follow such a regimen over a lifetime, there will be seven cases of colorectal cancer instead of six. So for an individual, the chance of getting colon cancer because of eating processed meats is about 1 in 100. That is a very small risk, but because there may well be millions of people following such a diet, the impact on the population can be significant, in IARC’s estimate, about 34,000 cases a year.

What do we do with this information? A one in a hundred chance is not insignificant and it makes sense to try to reduce it. That means consuming less than 50 grams of processed meat a day on average. To do that we need to keep some numbers in mind. Two to three strips of bacon add up to 50 grams, as do two slices of ham, 4 slices of salami or one hot dog. Remember though that we are talking averages here. Certainly a couple of hot dogs, a salami sandwich and a couple of bacon and egg breakfasts a week is not a great risk. But if you have a smoked meat sandwich, well, you have used up your weekly allotment. But remember that all these numbers are estimates, basically educated guesses, and are not based on hard evidence.

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“No day shall erase you from the memory of time”

Our OSS Blog - Tue, 11/24/2015 - 14:35

The city that never sleeps; where dreams are made and realized, (and probably more often than not, discarded); the possibilities endless. I was strolling through the streets and making my way down to the Financial District where I was set to have a tour of the 9/11 Museum.

The day, I was soon told by our guide, was similar to that horrific September 11th morning – where, according to air traffic control, skies were an “extreme clear” – where in a matter of minutes, the world, as we knew it, would change forever. The Museum is relatively new, only opening its doors to the public in 2014. And although I Iived in NYC last year, I never ended up making my way to the museum. I knew there were two pools, where each of the towers stood, but that was about it. Of course I also knew there was much consultation with the families of the victims as to what the museum should include and how its artifacts presented. With whatever unknown I went in with, I did know that I would feel much of the same emotions I felt on that Tuesday September morning where, in Mr. Moore’s English class, we were told that a plane had crashed into the World Trade Center. Read more

Chemistry Lesson for Food Babe #5

Our OSS Blog - Tue, 11/17/2015 - 19:18

Just about everyone now knows something about DNA ( with some obvious notable exceptions). The term “template of life” has been repeatedly used in the press to describe this molecule. That is quite accurate because DNA is like a library of information which tells our cells which proteins to synthesize. Proteins are the key to life because they make up important structures of the body as well as hormones and the enzymes that govern the body’s numerous chemical reactions. DNA is a nucleic acid, a "polymer" composed of pieces called nucleotides strung together like beads on a necklace.

Each of these nucleotides is made up of a sugar called deoxyribose, a phosphate group and a molecule commonly referred to as a “base.” It is the sequence of the bases along the nucleic acid chain that holds genetic information. There are four such bases: adenine, thymine, cytosine and guanine. They are named after the source from which they were isolated. Adenine from the Greek word for gland because it was first isolated from the pancreas, thymine from the thymus, cytosine from cells and guanine from bird guano, the technical name for bird poop.

Yes Ms. Hari, every one of your cells contains the same chemical that is found in bird excrement. This is as relevant as finding azodicarbonamide, the chemical that was used in Subway rolls in yoga mats. (I'm including the molecular structures of the four nucleotides although I'm quite confident they will be meaningless to our intended pupil. I have no idea what she thinks of molecular structures, but given that she thinks that multisyllabic names make a chemical dangerous, she probably doesn't look on them favourably.)

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Food Babe Lesson #4

Our OSS Blog - Tue, 11/17/2015 - 19:15

Rotting apples release ethylene gas, which is a natural hormone produced by fruits to stimulate ripening. A rotten apple is just an overly ripe apple, producing enough ethylene to "ripen" the rest of the apples in the barrel. The process is usually initiated by physical damage to an apple. The skin becomes bruised, releasing nutritious juice which is very inviting to air-borne molds. When molds set up shop on the apple, ethylene production increases, ripening other apples, inviting more mold! The answer of course is to remove the rotten apple!

Although in this instance the reaction is not desirable, the use of ethylene gas often allows fruit to be picked "green" and to be subsequently ripened during transport in tank cars under an atmosphere of ethylene. This is especially useful in the case of bananas, the most widely consumed fresh fruit in North America. Bananas bruise very easily and could not survive shipping if they were picked when ripe. Green bananas are much more hearty and stand up well during transport. If they are still green when purchased you can ripen the bananas by putting them in a plastic bag with an over-ripe apple!

Our such bases: adenine, thymine, cytosine and guanine. They are named after the source from which they were isolated. Adenine from the Greek word for gland because it was first isolated from the pancreas, thymine from the thymus, cytosine from cells and guanine from bird guano, the technical name for bird poop.

Yes Ms. Hari, every one of your cells contains the same chemical that is found in bird excrement. This is as relevant as finding azodicarbonamide, the chemical that was used in Subway rolls in yoga mats. (I'm including the molecular structures of the four nucleotides although I'm quite confident they will be meaningless to our intended pupil. I have no idea what she thinks of molecular structures, but given that she thinks that multisyllabic names make a chemical dangerous, she probably doesn't look on them favourably.)

P.S. Vani's take on this would likely be: Do you want a chemical that is used to make pig balls in your bananas?

(Ethylene is used to make polyethylene which is used to make "pig balls" that are thrown into pig pens to give the animals something to play with instead of nibbling on each others' ears and tails.)

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Cleaning the air with jeans

Our OSS Blog - Tue, 11/17/2015 - 19:02
You may want them in your jeans, but you probably want to keep them away from your genes. They’re “nano” particles of titanium dioxide, about ten billionths of a meter in diameter that can exhibit beneficial properties not possessed by their larger cousins, but they may also have a darker side.   There are more jeans in the world than people. That stat sparked an idea in the mind of University of Sheffield chemist Tony Ryan. Why not use people’s penchant for wearing denim to help purify the air? After all, the International Agency for Research on Cancer (IARC) classifies outdoor air pollution in Group 1, reserved for substances that are known to cause cancer in humans. It estimates that there are up to seven million premature deaths in the world every year as a result of air pollution.   With thoughts of reducing pollutants such as the nitrogen oxides and volatile organic compounds emitted by vehicles, power plants, residential heating, cooking and various consumer products, Ryan, in partnership with former fashion designer Helen Storey, came up with the concept of “Catalytic Clothing.”   “Catalytic” apparel uses fabric impregnated with nano-sized particles of titanium dioxide to degrade air pollutants. “Nano” means small. So small that the combined surface area of the nanoparticles that are distributed through any fabric is immense. And that matters because the action takes place on the surface of the particles.   Titanium dioxide is a “photocatalyst,” meaning that it can make chemical reactions happen when exposed to the right wavelength of light, in this case ultraviolet. The light energy causes it to release electrons that then target water molecules in the air, breaking them apart to form extremely reactive hydroxyl radicals that then chop up organic compounds into simple molecules such as carbon dioxide and convert nitrogen oxides into water soluble nitric acid. This is not just theory, it is well established technology that already has commercial application, for example in “self-cleaning glass.” A thin layer of titanium dioxide ends window cleaning worries, as long as the climate provides for sufficient sunshine and rain. The chemical can even be mixed into concrete, resulting in self-cleaning buildings such as the Jubilee Church in Rome.   Thanks to titanium dioxide we may never have to confront yellow urinals again. Coating the ceramic with a layer of titanium dioxide, about a fiftieth the thickness of human hair, prevents stains from forming. The technology also has potential in operating rooms where bacteria on floor and wall tiles can be destroyed with fluorescent light, common in hospitals, furnishing enough of the right wavelengths. And how about self-cleaning tiles for the kitchen and bathroom?   Clearly, titanium dioxide photocatalysis is sound technology. But can wearing jeans treated with this chemical actually have an impact on air pollution? According to Professor Ryan, yes. He calculates that that if a third of a million people in Sheffield wore such jeans, nitrogen oxide levels could be significantly reduced. And there is no need to buy special jeans. Titanium dioxide particles stick readily to the fabric so the idea is to add a formulation of the chemical to the water when the jeans are being laundered. The nano particles will stick until the fabric degrades.   As is often the case in science, there is a “but.” What happens if nanoparticles enter the bloodstream? What tissues might they affect? Titanium dioxide has the potential to damage DNA, but to do that it has to enter cells. That is a possibility since nanoparticles are smaller than cells. In the lab, nano titanium dioxide has been shown to damage DNA in human intestinal cells, but only at doses far higher than what could ever be ingested.   In any case, people will not be dining on their treated jeans. But they may be gulping donuts, or a vast array of other foods such as Gobstoppers, M&Ms, pastries or soy milk that have titanium dioxide added to them to provide a more pleasing whitened appearance. Only about 5% of the titanium dioxide is made of nano sized particles, but that has raised concern because IARC has classified titanium dioxide as possibly carcinogenic to humans (Group 2B). This classification is based on inhalation of titanium dioxide dust in an occupational setting, quite a different exposure than eating a donut with a titanium dioxide enhanced white sugar coating. Nevertheless consumer activism has resulted in Dunkin Donuts removing titanium dioxide from the powdered sugar coating on its products. Maybe it can be redirected into catalyst jeans. We really don’t need to make junk food look more appealing, do we? Read more


From Our Contributors - Wed, 10/28/2015 - 10:20

“ When life gives you lemons, make lemonade,” or so a goes a proverbial phrase. But when the lemons come at the most inopportune times, I say forget about the lemonade; I need to make tequila. And when excrements really hit the fan, I make that tequila extra añejo. Let’s just say that there has been a lot of tequila.

The past couple of months have definitely been very trying. Those who have read my previous blog entry know that I faced some pretty impossible scenario regarding my visa to stay in the U.S. to continue my medical training. But after obstinately knocking on every door I could think of, both literally and figuratively, including that of the Prime Minister of Health of Quebec, I was granted an extension on my visa, a lucky exception, allowing me to stay in the U.S. and start my fellowship in Pulmonary and Critical Care Medicine.  It was a much hoped-for and prayed-for triumph, followed by a summer not without its challenges.

It is hard to believe that I started writing this blog as I entered medical school, and this summer marked the end of my training as an internal medicine resident. At the end of residency, one can choose to practice independently as an attending physician, or continue further training in a sub-specialty in a fellowship. I signed up for another three years of training to be a lung and critical care specialists.  Call me nuts. But this means that in three years, I will work with patients afflicted with various pulmonary issues, as well as manage some of the sickest people in the Intensive Care Unit.

July is always a chaotic month for doctors. An old batch of trainees leave, and a new batch of wide-eyed incomers flood in. Add into the equation apartment hunting, car hunting, money scrambling, and oh, how can I forget, studying for one of the biggest exams of my life, the American Board of Internal Medicine, or the ABIM. Everything was on a tight and carefully thought-out schedule, all the while living out of cardboard boxes.

Unfortunately, or perhaps fortunately, depending on how you look at it, doctors are humans, too.  We have lives outside the hospital, we get sick, we get hungry and sleepy, we laugh, we cry, we make mistakes, we try to make lemonades when life gets sour, but sometimes we get overwhelmed by all the bitter lemons thrown at us.

Well, I found an apartment and even managed to move by myself, hopping over fences while carrying heavy boxes.  I moved some money around (euphemism for ‘I borrowed’) and got a car so I can drive between the three different hospitals where I will be working.

Then I found that I that I failed the ABIM on my first try. Never having failed an exam in my life, it was to my surprise that I did not die from failing one exam.  I learned that a bad test score does not equate a failed career and that there are always second chances. So here I am, ready for the challenge and fun that the next three years will offer. Let me dust off that nasty feces that was thrown at me, and cheers!

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Food Babe Lesson #3

Our OSS Blog - Tue, 10/20/2015 - 06:58
In our continuing, but extremely challenging effort to educate the Food Babe on science, let us pick on a grapefruit.

“A chance finding of our study on ethanol-drug interactions was that citrus fruit juices may greatly augment the bioavailability of some drugs.” So began a paper published in 1991 in The Lancet, one of the most respected medical journals in the world. Dr. David Bailey and colleagues at the University of Western Ontario had been studying felodipine, a blood pressure–lowering drug, and wondered if it interacted with alcohol. They decided on a double-blind trial in which some subjects were to take the drug with alcohol and some without. This meant that the taste of alcohol had to be masked, and after some experimentation Dr. Bailey concluded that grapefruit juice was up to the task. To the researchers’ surprise, the alcohol had no effect, but in both groups the blood levels of felodipine were three times higher than expected. Bailey knew he was on to something.

It turned out that some compound specific to grapefruit inhibited the action of CYP3A4, an enzyme found in the wall of the intestine. This enzyme is part of the body’s detoxicating system and tackles intruders, such as medications. If its action is impaired, blood levels of these foreign substances can be expected to rise. Since CYP3A4 is known to be involved in the metabolism of numerous drugs, researchers suspected that felodipine would not be the sole medication to show a “grapefruit effect.” Indeed it was not. Various oral medications, ranging from heart-rhythm regulators and immunosuppressants to estrogen supplements and AIDS treatments, all interact with grapefruit juice. And the effect can last as long as 24 hours, meaning that drinking grapefruit juice at any time is contraindicated when taking drugs metabolized by CYP3A4. Since it isn’t completely clear which drugs fall into this category and which do not, and because of the known variation in CYP3A4 levels in different individuals, some experts suggest that grapefruit juice be avoided when taking any medication. Accordingly, many hospitals have taken grapefruit juice off the menu.

Grapefruit is not the only food to be involved in a drug-food interaction. Dairy foods can interfere with some antibiotics, broccoli can reduce the effect of anticoagulants, foods high in tyramine (aged cheese, red wine, soy sauce, sauerkraut, salami) can cause dramatic rises in blood pressure when coupled with antidepressants of the monoamine oxidase (MAO) inhibitor variety, and the absorption of digoxin (taken for congestive heart disease) is impaired by cereals such as oatmeal. And oh, all these interactions involve “natural” foods.

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Citrus greening

Our OSS Blog - Tue, 10/20/2015 - 06:52

You have probably never heard of the Asian citrus psyllid. But this insect, no bigger than the head of a pin, could be the reason that within a couple of years you will not be drinking orange juice or eating oranges from the U.S. The insect spreads a bacterium, which is harmless to humans and animals, but is devastating to citrus trees. Infected trees suffer from what has been called “citrus greening” because they produce green, misshapen fruit that is bitter and inedible. Once infected, the trees die within a few years. Since the insect clings to various parts of the tree, citrus greening can be spread by moving infected plant materials including bud wood, fruit and even leaves from one place to another. The disease has already killed millions of citrus plants in the southeastern United States and is threatening to spread across the country. There are no pesticides that are effective against the Asian citrus psyllid.

Since the infection is bacterial, one possibility is the use of antibiotics to try to curtail the problem. Interestingly, periwinkle plants are readily infected by the disease when exposed to lemon trees infected by citrus greening and respond well when treated with penicillin and some other antibacterial agents. Test are underway to see if these substances also work on infected citrus plants. The Madagascar periwinkle has already made a contribution to health in another arena. Vinblistine and vincristine isolated from the plant are used in chemotherapy.

Another approach involves genetic modification which could be helpful but comes with the baggage of public fear of the technology. Dr. Erik Mirkov, a Texas AgriLife Research plant pathologist, was actually interested in another disease known as citrus canker. He knew that some spinach proteins had antibacterial and anti-fungal properties and managed to insert the genes that code for these proteins into the DNA of citrus trees. The trees developed resistance to canker. As the problem of citrus greening became more and more important, he tested the spinach genes in citrus trees infected with the citrus psyllid. Early greenhouse tests looked good so field trials were begun and these also look hopeful.

But even if the technology pans out, the approval process is long and difficult. It’s expensive because it involves contracts with firms that do the actual testing with rats, bees, fish and maybe even songbirds It could take three to four years to complete, but it’s important of course to determine that the fruit produced from transgenic trees are safe to eat, especially by what are considered at-risk groups, which include infants, the elderly and those with compromised immune systems. The work is made easier by the fact that only proteins that are commonly eaten anyway are introduced into the crop. Saving citrus trees is not a minor issue and we need to explore all technologies that may play a role. Not only will the loss of the U.S. citrus industry have an effect on the availability and cost of citrus products, it will have a catastrophic fallout on the lives of citrus farmers and juice producers and thereby on the economy, especially of Florida.

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Charcoal is one of the most important substances ever discovered

Our OSS Blog - Mon, 10/12/2015 - 04:52

It’s a killer. It’s a saviour. It’s also a trickster. It’s one of the most important substances ever discovered. It’s charcoal!

Burn any animal or vegetable matter with a limited supply of air, as is the case inside a wood pile, and you are left with charcoal, essentially carbon mixed with some mineral ash. The fact that charcoal burns better than wood was probably noted soon after man learned to control fire over a million years ago. The first use of charcoal for purposes other than providing heat was around 30,000 BC when cavemen used it as a pigment for drawing on the walls of caves.

Then around 4000 BC came a monumental discovery, probably by accident, when a piece of ore fell into a charcoal fire and began to ooze metal. When naturally occurring ores of copper, zinc and tin oxides are heated with charcoal, the carbon strips away the oxygen, leaving the pure metal behind. Alloying copper with tin forms bronze. The Bronze Age was followed by the Iron Age, characterized by the smelting of iron from iron oxide with charcoal. That same technology is still used today. But it wasn’t only through the smelting of metals that charcoal had an impact on history.

Sometime in the 9th century a Chinese alchemist discovered that blending charcoal with saltpeter (potassium nitrate) and sulphur resulted in a mixture that would combust readily. “Gunpowder” would eventually be used to create explosives that gave access to coal and minerals, making huge engineering achievements possible. Of course gunpowder also made possible the easier destruction of life, casting a dark shadow on charcoal.

Around 1500 BC, Egyptian papyri recorded the use of charcoal to eliminate bad smells from wounds, the first mention of a medical application of charcoal. By 400 BC, the Phoenicians were storing water in charred barrels on trading ships to improve its taste. It seems they had hit upon one of charcoal’s most important properties, the ability to bind substances to its surface, a phenomenon known as “adsorption.” That application lay more or less dormant until the late 18th century, when Europeans developed a taste for sugar. Raw sugar from sugar cane or sugar beets is tainted by coloured impurities that can be removed by passing sugar extract through beds of charcoal.

The rapid growth of the sugar refining industry led to a search for charcoal with improved adsorption properties and resulted in the development of “activated” charcoal, also referred to as “activated carbon.” In this process, carbonaceous matter such as wood, coal or nutshells is first heated in the absence of air, followed by exposure to carbon dioxide, oxygen or steam. This has the effect of increasing the surface area and establishing a network of submicroscopic pores where adsorption takes place. Later, it was determined that impregnation with chemicals like zinc chloride or phosphoric acid prior to heating improved the adsorption properties. Today, a variety of activated carbon products are available for use in various applications.

Activated charcoal is used in water filters, air purification systems, gas masks and even underwear. Yes, flatulence filtering undergarment for people suffering from various gastric problems really works. But in order to avoid flatulence escaping around the filter, the patient is recommended to stand with legs together and let the wind out slowly.

Because of its amazing adsorptive properties, activated carbon is a staple in emergency rooms. In cases of suspected drug overdose or poisoning, it is administered orally to bind the toxins before they have a chance to be absorbed into the bloodstream. It isn’t surprising that inventive marketers have absorbed this information and have started to roll out various foods and beverages containing activated carbon with promises of “detoxing.” “Black Magic Activated Charcoal” a “zesty lemon detox and purification elixir,” invites you to “come over to the dark side.” A very apropos invitation. Just what sorts of toxins are this beverage supposed to remove? And since activated carbon isn’t very specific in what it adsorbs, it is as likely to remove vitamins, polyphenols and medications as those unnamed toxins. Of course it is made with “alkaline water,” catering to the nonsense that cancer is caused by an acidic pH. Any alkaline water is of course immediately neutralized by stomach acid. Believe it or not, you can also get “activated carbon ramen noodles.” The only thing these will eliminate is your appetite.

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Food Babe Lesson #2

Our OSS Blog - Fri, 10/09/2015 - 05:51

I’m not sure my chemistry lesson for the Food Babe got through to her but many of you said that I should keep up the effort to teach her some science. Others said that it was like trying to teach an ant to crawl up a Teflon wall. Let’s give it another shot.

Vani, you posted a recipe for a smoothie, which is fine, but it was accompanied by this introduction:

“I include smoothie recipes like this as a regular part of this program because it’s one of the best ways to get greens in your diet, provide your body a rich source of chlorophyll on a daily basis, and ultimately is one of the key actions you can take to keep your body in an alkaline state to avoid disease!”

Chlorophyll is one of the most important compounds in the world because without it plants cannot photosynthesize and without plants there is no life. But humans are not plants; we do not photosynthesize and have no need for chlorophyll. Yes, there are some claims that chlorophyll in the diet can prevent some carcinogens, such as produced by high cooking temperatures, but there is no proper scientific evidence that this is so. But that is a minor point in comparison to your call for keeping the body in an alkaline state.

Alkalizing” the body is a nonsensical concept. The human body carefully maintains the pH of blood at about 7.35, which is slightly alkaline, or basic. This is also the pH of the cells in all our organs that depend on the blood supply for their nourishment. Should the pH drop below 7 or exceed 7.7 we are looking at a potentially catastrophic situation. Luckily, our blood constitutes a buffered system, meaning that any variation of pH is immediately compensated for. Should there be an increase in acids entering the bloodstream, we immediately start exhaling more carbon dioxide, which then reduces acidity. Should the blood start to alkalize, the lungs retain more carbon dioxide, which dissolves to form carbonic acid while the kidneys eliminate basic bicarbonate.

What all this means is that the pH of the blood cannot be altered by changing the diet. A change in diet can certainly alter the acidity of the urine but that is unrelated to the pH of the blood. Breads, cereals, eggs, fish, meat, poultry can acidify the urine while most fruits and vegetables tend to make it more alkaline. The idea of monitoring the pH of the urine to achieve optimal health by “balancing” the body’s acidity is senseless. Is it possible that some people feel better by making their urine more alkaline? That’s possible. If they switch from a heavy meat and cereal diet to one that features more fruits and vegetables they may feel better. But this has nothing to do with balancing the body’s pH.

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Food Babe Lesson #1

Our OSS Blog - Sun, 10/04/2015 - 10:16

I think instead of criticizing the Food Babe on a regular basis, which could easily become a second career, it is time to take a different approach. Maybe we can be pro-active here and attempt to teach her some of the chemistry she so sorely lacks.

Vani, in your attack on polydimethylsiloxane, a chemical used to prevent foaming in frying oils, you make the following claim: "The FDA allows dimethylpolysiloxane to be preserved by several different chemicals that don’t have to be listed on the label either, including formaldehyde!"

First of all polydimethylsiloxane is a polymer (that's a giant molecule made of repeating units) that does not require a preservative. There is no formaldehyde added to this polymer! Your confusion probably comes from having seen polydimethylsiloxane and formaldehyde appear in the same sentence somewhere. That's because at temperatures above 200 degrees C, the methyl groups (those are groupings made of three hydrogen atoms attached to a carbon atom) on the silicone polymer react with oxygen from the air, and through a complex series of reactions can produce trace amounts of formaldehyde.

Now for some numbers..the crux of science. Polydimethylsiloxane is used at a concentration of 0.2-0.3 parts per million in commercial cooking oil. If this released the maximum amount of formaldehyde, it would be way less than the formaldehyde that occurs naturally in a glass of apple juice. But frying is done at 185-190 degrees C, and at that temperature essentially no formaldehyde is produced. Furthermore, the addition of polydimethylsiloxane to oil reduces the formation of oxidation products. I realize that there are words here you don't understand, but maybe you get the gist of the argument. Maybe.

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“Oh… Those nasty chemicals!”

Our OSS Blog - Sun, 10/04/2015 - 10:14
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Catching some rays could help your heart

Our OSS Blog - Sat, 09/26/2015 - 06:23

Life comes down to a struggle between risk and benefit. Although not always consciously, we evaluate our diet, our cosmetics, our medications, household chemicals and activity levels on the basis of whether they are good or bad for us. Mention sun exposure, and the conflict comes down to the “bad,” namely skin cancer, and the “good,” usually ascribed to the enhanced production of vitamin D. Skin cancer is bad, but why is vitamin D good? For one, it is required for the proper absorption of calcium and a lack can lead to soft bones, in extreme cases to the characteristic bow legs of rickets. But there may be more to vitamin D.

Epidemiological investigations have shown that people with high blood levels are generally healthier, particularly when it comes to cardiovascular disease. It is interesting to note that the heart disease rate in Australia is lower than in northern climates, and that in Britain the risk increases as one travels north even when lifestyle factors are taken in to account. But here is a curiosity. Numerous studies have been carried out with vitamin D supplements without noting an effect on cardiovascular disease. Could it be that high blood levels of vitamin D are just a marker for sun exposure and that the cardiovascular benefits are actually due to some other feature of sunlight? British dermatologist Richard Weller makes a case for nitric oxide, a chemical that can be released by the action of ultraviolet light on substances such as nitrates that are stored in the skin.

Nitric oxide is a gas, and lasts only a few seconds after it is produced in the inner lining of blood vessels by the action of enzymes on the amino acid arginine. During its brief existence, though, it acts as an important signalling molecule causing smooth muscles around blood vessels to relax. This results in an increased blood flow and a lowering of blood pressure. Indeed, the classic drug to treat angina, nitroglycerine, works by releasing nitric oxide, and Viagra’s performance is due to its ability to increase signalling and improve blood flow through the nitric oxide pathway.

It was back in 1996 that Weller discovered that sunlight had the ability to convert nitrates in the skin to nitric oxide, a discovery that took on greater meaning with the awarding of the 1998 Nobel Prize in Physiology or Medicine to Robert F. Furchgott, Louis J. Ignarro and Ferid Murad “for their discoveries concerning nitric oxide as a signalling molecule in the cardiovascular system.” Weller began to wonder whether nitric oxide produced by sun exposure might explain the lower blood pressure in populations living closer to the equator and why the average blood pressure in the U.K. is lower in summer than in winter.

To investigate, Weller exposed volunteers to ultraviolet light and measured blood pressure and nitric oxide levels. To eliminate the possibility of vitamin D playing a role, he used long wavelength UVA that does not produce vitamin D. Nitric oxide levels increased and blood pressure decreased with an exposure equivalent to about thirty minutes of sunshine in Edinburgh in the summer. The effect wasn’t dramatic, but could be significant in a large population. Just heating the skin had no effect, so UVA is needed to produce nitric oxide.

In another experiment, the performance of cyclists was enhanced in response to irradiation with UVA but only if they took nitrate supplements. The theory is that increased nitric oxide release dilates blood vessels and allows more oxygen to reach the muscles. Nitrates occur naturally, and are particularly high in celery, red beet root, lettuce and spinach, vegetables that have been associated with lower blood pressure. In light of Weller’s studies, this may be a consequence of the combination of nitrates and exposure to sunlight. He also identifies studies that showed Scandinavian women who spent more time sunbathing lived longer. Of course that may also have been due to less stress, different diets or activity levels. And then there is a Danish study that showed that people with non-melanoma skin cancer were much less likely to have a heart attack. Could skin cancer be a marker for a longer life?

As I said, life is a struggle between the good and the bad, but it isn’t easy to identify what is good and what is bad. Maybe someone should investigate if nudists live longer.

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You Asked: Why does a barber’s pole has a red stripe?

Our OSS Blog - Sat, 09/26/2015 - 06:18

It represents the colour of blood. During the Middle Ages monks were required to shave the crown of their head, a function commonly performed by itinerant barbers. Also, under ecclesiastic law, monks had to be periodically bled. This was supposedly a symbol of piousness, of devotion to God. Barbers began to attend to this duty as well. They would travel with a "flag" of a white cloth dipped in blood to indicate that they would attend to anyone who needed to be bled. This early mode of advertisement eventually was transformed into the barber's pole. And the pole began to symbolize more than haircuts and bleeding. Barbers began to expand their role and became quasi surgeons, specializing in sewing up wounds and extracting teeth. They also dabbled in the whitening of teeth by dabbing them with nitric acid. This did produce an immediate whitening, but destroyed the teeth in the long run by wearing away the protective enamel. But at least one 16th-century barber surgeon, Ambroise Pare, made an important contribution to medicine. Barbers in those days worked under the guidance of physicians, who thought themselves above menial jobs like cutting and scalding. Why scalding? Because physicians thought that gunpowder was poisonous and therefore gunshot wounds had to be treated with boiling oil to destroy the poison. Unfortunately, if the bullet didn’t kill the victim, the scalding often did. During the siege of Turin in 1537 Pare ran out of oil and for some reason substituted a cold mixture of egg yolks, oil of roses, and turpentine. To his surprise, the soldiers treated with this mixture fared better than those who had been scalded. And thus ended the brutal practice of pouring hot oil into bullet wounds. The French-trained Pare was a religious sort, and thought he had had help in making his observation. That’s why he introduced the oft-repeated phrase, "I dressed the wound, but God healed him."

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A Question of Evidence

Our OSS Blog - Sat, 09/26/2015 - 06:15

When we take a medication, we trust there is evidence that it will work. When we apply a cosmetic, we trust there is evidence that it is safe. When we put on a sunscreen, we trust there is evidence that it filters ultraviolet light. But evidence is not white or black; it runs the gamut from anecdotal to incontrovertible.

Some people claim that placing a bar of soap under the sheet when they sleep solves the problem of restless leg syndrome. That’s what we call anecdotal evidence, and it remains so until it is confirmed or dismissed by proper randomized double-blind controlled trials. On the other hand, evidence that gold conducts electricity is ironclad. There are no ifs or buts about it. Often, though, the use of the term “evidence” is open to interpretation. An interesting example is a recent paper published in Nature, one of the world’s foremost scientific journals, intriguingly titled: “Evidence for human transmission of amyloid-beta pathology and cerebral amyloid angiopathy.”

Let’s dissect this title. Amyloid-beta proteins are one of the hallmarks of Alzheimer’s disease, so the title implies that evidence has been found that the disease can be transmitted from person to person. Little wonder that the paper generated headlines in the lay press ranging from “Alzheimer’s may be a transmissible infection” and “You can catch Alzheimer’s” to “Alzheimer’s bombshell.” All of these are highly misleading because the paper, in spite of its provocative title, does not provide evidence for the transmission of Alzheimer’s disease between humans.

So what did the researchers, led by Dr. John Collinge of University College London, actually find? They investigated the brains of eight people who had been injected with human growth hormone as children due to stunted growth back when this hormone was extracted from the pituitary glands of dead donors. Unfortunately, the donors from whom the hormone was extracted for these children had been harbouring proteins known as “prions” that cause Creutzfeldt-Jakob disease, a terminal neurological affliction. The recipients ended up dying from the disease they had contracted via the hormone.

Collinge found that six of the eight people also had amyloid plaques typical of Alzheimer’s disease. But none of 116 people who had died of Creutzfeldt-Jakob disease who had not received contaminated growth hormone showed any sign of amyloid protein deposits. Dr. Collinge therefore suggests that molecules that lead to amyloid plaque formation were passed to the recipients along with the growth hormone.

A very interesting hypothesis to be sure. But the study did not show that the patients would actually have developed Alzheimer’s had they lived longer. A more appropriate title for the paper would have been “Possibility for human transmission of amyloid-beta pathology via contaminated growth hormone.” The word “evidence” should not have appeared in the title. The authors point out clearly that “there is no suggestion that Alzheimer’s disease is a contagious disease and no supportive evidence from epidemiological studies that Alzheimer’s disease is transmissible.” Nevertheless it was the term “evidence” that caught journalists’ eye and created undue public alarm with the suggestion that Alzheimer’s disease can be “caught.”

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Phthalates and microwave ovens

Our OSS Blog - Sun, 09/20/2015 - 07:48
It always pays to read the study! It really does, because popular accounts often misinterpret what researchers actually found and end up raising undue alarm. Of course it is raising the red flag of alarm that gets attention, and these days, with all sorts of bloggers scooting around to popularize their websites hoping to recruit advertisers, getting attention is what it is all about. Let's get down to a study that generated the headline: “Don’t Microwave Those Vegetables; It Could Lead to Diabetes.” As one would expect, that headline ricocheted around the Internet spawning all sorts of comments about the evils of microwave ovens and plastic dishes. First of all, the study referred to was not about microwaving leftovers, and second, the word diabetes was never mentioned. What researches did was to take some data about phthalate metabolites found in urine as measured on a single occasion to see if there was any association with blood pressure. They did find an association, albeit a weak one. There was a difference of 1-2 mm Hg in systolic blood pressure between low and high levels of phthalate metabolites, which is essentially insignificant for an individual but could have significance across a population. Where do the phthalates come from? These chemicals are used extensively as "plasticizers" to soften hard plastics such as polyvinyl chloride (PVC) which is commonly used in food production equipment, floor tiles, blinds, furniture and packaging. So given the ubiquitous nature of PVC, it isn't surprising that trace amounts of phthalates end up in the urine. But microwave containers are not made of PVC; they are made of polyethylene or polypropylene which contain no phthalates. While some commercial plastic wraps are made of PVC, home plastic wraps and sandwich bags are usually made of polyethylene with no phthalates in sight. There are other issues here too. Associations cannot prove cause and effect. Indeed, there may actually be reverse causation. People may have higher blood pressure because they eat a lot of processed foods which may harbour phthalates, but the increase in blood pressure may be due to other components such as salt or fat. Phthalates may be just a marker for processed food consumption. Furthermore, there are many kinds of phthalates and they have very different properties. Also, single measurements of substances in urine are always a problem because they may not be reflective of average values. The bottom line here is that this study has nothing to do with microwave dishes or with diabetes. The only way any connection can be made to diabetes is through suggesting that high blood pressure can increase the risk of diabetes. But most assuredly, in spite of the headlines it generated, this study does not show that using plastics in a microwave oven could lead to diabetes. Read more

A rather remarkable coincidence!

Our OSS Blog - Sun, 09/13/2015 - 10:17

My column this week is about Alexander Shulgin, the chemist who synthesized a number of mind-altering drugs which unfortunately sometimes became subjects of abuse. My column was submitted last Sunday and a couple days later we had that bizarre story emerge from Germany with a bunch of homeopaths suffering an overdose of one of Shulgin's compounds. It still isn't clear what happened there. Were they involved in some ridiculous homeopathic "proving" or did someone spike their food or drink? It will be interesting to find out. In any case, the last sentence of my column turned out to be somewhat prophetic.

Chemist's curiosity led him to synthesize mind-altering substances

“I’m curious!” That was Alexander Shulgin’s simple answer to the question of why he had dedicated much of his life to the exploration of psychedelic drugs. The American chemist who died in 2014 at the age of 88 was famous not only for synthesizing a large number of mind-altering substances but also for experimenting with them on himself, his wife and friends. He worked within the context of existing laws because the compounds he synthesized had not existed before and therefore were legal at the time he made them. Dr. Shulgin never intended his creations to be used as “street drugs;” his interest was in researching the effects of chemicals on the mind. Nevertheless, many of the drugs he created became the subject of abuse and were eventually made illegal. Perhaps the best known of these is Ecstasy, which had actually been patented by Merck back in 1914, but was abandoned because the company could not find a use for it. Shulgin developed a novel synthesis for the drug, and after experimenting on himself, suggested it could be used as a treatment for anxiety. He never intended it to be used as a recreational substance.

Shulgin was interested in chemistry from a young age, but it was surgery for an infection of his thumb that launched his enthusiasm for pharmacology. Prior to the surgery he was been given a glass of orange juice that had some undissolved crystals at the bottom. Convinced he had been given a sedative, he promptly fell asleep. As he was to learn later, the crystals were just sugar and it was his mind that had actually lulled him into sleep. What sort of chemistry was going on in his brain, he wondered? He began to explore the literature of mind altering substances and became interested in the chemistry of mescaline, the active ingredient in the peyote cactus, a plant long used by Native North Americans for spiritual purposes. Eventually he tried mescaline himself and was amazed by the hallucinations it produced.

After obtaining a PhD in biochemistry from the University of California at Berkley, Shulgin was hired by the Dow Chemical company to work on insecticides and came up with Zectran, one of the first biodegradable such products. It turned out to be so profitable that as a reward Dow allowed Shulgin to work on any project of his choosing. He didn’t have to think much about what that would be. Before long he had prepared a number of compounds that were candidates for mind altering effects with therapeutic potential. By this time he had come to learn that many compounds that affected the mind, such as mescaline and amphetamine, shared a common feature in terms of molecular structure. They all had a “phenethylamine” grouping of atoms. When Dow decided against pursuing this line of research, Shulgin left, set up a lab in his home, and began to churn out compounds. Because of the expertise he had acquired on drugs that had a potential for abuse, he developed an interesting relationship with the Drug Enforcement Agency, often giving talks to agents about the identification of such substances. For a while he even had a researcher’s license to produce Schedule 1 drugs, those that have no accepted medical use and have great potential for abuse.

Shulgin did not work in secret; he published numerous scientific papers about the drugs he had made. But as drug abuse became more and more of a problem, he had increasing difficulty in getting his research into the scientific literature. He then decided to release it all in a self-published book written with his wife under the curious title of “PiHKAL.” Readers would learn that it stood for “Phenethylamines I Have Known and Loved.” The book was divided into two sections, with the first being a long-winded story about the couples romance and numerous drug experiences, while the second section was a compilation of the 179 compounds Shulgin had made, including dosages he had used, effects experienced, and details of synthesis. Inevitably this led to abuse, with the book essentially becoming a manual for making drugs that had a potential for doing harm through improper dosage or through impurities introduced by inexperienced chemists. Many of the listed compounds would eventually be made illegal.

There is no question that Alexander Shulgin’s unconventional research methods and his descriptions of the effects of the compounds he synthesized stimulated pharmacological research into drugs, Ecstasy being an example, that may actually have therapeutic potential. But we are still left with the disturbing idea that curiosity sometimes kills the cat.

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Chewing on “Chewpods”

Our OSS Blog - Mon, 09/07/2015 - 07:10

The dietary supplement market is huge, so it is little surprise that many companies try to get in on the game by torturing data until it succumbs to their desires. An estimated 40 billion dollars are spent each year in North America on vitamins, minerals, herbal products and various esoteric fruit and animal extracts that purport to keep our bodies running smoothly in face of an avalanche of “toxic chemicals” unleashed by Big Pharma, Big Food, Big Agro and Big Beauty. Of course the dietary supplements never contain “chemicals,” they only contain “natural” substances that are portrayed as the secret to health. Advertisements feature trim, attractive bodies brimming with vigour thanks to nature’s gifts. Never mind that those gifts may not contain what the label indicates, that they may be adulterated with real pharmaceuticals, or that the “evidence” provided is on such a shaky platform that a little scientific jiggle leads to its collapse.

Since thousands and thousands of products vie for customers’ attention, producers are keen to find ways to make their supplement stand out. “Chewpods” claim to “provide beneficial effects on energy, concentration and ability to recuperate” with the discriminating feature that the tablets are meant to be chewed. The rationale is that delivery of the active ingredients through the oral mucous membrane bypasses the digestive tract and enables a smaller quantity of active ingredients to be absorbed more quickly for greater effect.

The theory of oral absorption is sound, and many medications, with nitroglycerin for angina being a prime example, are designed to enter the bloodstream by this route. Whether transport through the mucous membranes of the mouth is viable depends on a number of factors including the relative solubilities of the substance in oil and water, with a greater oil solubility being a requirement. The potential of the chemical to bind to mucous membranes and the pH of the saliva are also important. Exactly what technology Chewpod employs to enhance absorption through the mucus membrane of the mouth isn’t clear, although there is a claim about “personalized action that balances saliva pH.” Since the normal pH of the saliva is in the 6-7 range, and that is also the range where mucosal absorption is the most effective, there doesn’t seem to be any need for “balancing.” In any case, the evidence provided for faster absorption by means of the technology being used is based on experiments with aspirin and acetaminophen, not the ingredients in Chewpods.

Of course what interests consumers is not the technology involved in active ingredient delivery, but whether the ingredients deliver the goods. One would think that the issuing of a “Natural Products Number (NPN)” by Health Canada would guarantee that efficacy has been demonstrated, but one would be wrong! The evidence required is minimal, and in the case of products that have several ingredients, there is no requirement for any proof that the product as a whole is beneficial. For example, the “Sleep and Restore” version of Chewpods contains the sleep-inducing hormone melatonin as well as 5-hydroxytryptamine (5-HTP), a precursor to serotonin, the neurotransmitter associated with mood. But the dosages are way less than those that have shown any efficacy in clinical trials. Nevertheless, just their presence is enough to get an NPN. There is no requirement to show that the supplement itself lives up to the advertising.

The “Focus and Action” version of Chewpods claims “that product helps to temporary relieve symptoms of stress such as mental fatigue and sensation of weakness, that it helps support cognitive function such as mental focus and mental stamina, that it provides antioxidants and that it helps the body to metabolize carbohydrates, proteins and fats.” Justification seems to be based on the supplement containing the stimulant caffeine as well as an extract of rhodiola which, at least according to some studies, reduces fatigue. The thin support for metabolizing carbohydrates, proteins and fat comes from the inclusion of vitamins A and B6, which play a role in numerous biochemical reactions.

But now for some numbers. The amount of caffeine (30 mg) is less than that in a cup of coffee, the vitamin A content at 80 mcg is about one tenth the recommended daily allowance, and the 72 mg of rhodiola extract, also the source of the over-hyped antioxidants, is way less than what has been shown to have any benefit in placebo-controlled trials. There is no harm in trying Chewpods, but remember that Health Canada’s NPN on the label does not mean it has been shown to be effective. And that is something to chew on.

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You Asked: Should we be concerned about parabens in cosmetics?

Our OSS Blog - Fri, 08/28/2015 - 10:30

Not if you look at the numbers. Many cosmetics now advertise "no parabens," as they cater to chemical paranoia. Parabens are very effective preservatives and prevent bacterial growth in creams and lotions. The reason that they have made news is that they have estrogenic activity. But the fact is that this activity by comparison to the body's natural estrogen is essentially insignificant, some 10,000 times less. Based on studies carried out with animals, the no observed adverse effect level (NOAEL) has been determined to be about 800 mgs per kg of body mass. The NOAEL is the maximum amount that can be given on a regular basis without causing any effect. This means that a 70 kg person would have to apply 55 grams of parabens regularly to have an adverse effect, assuming that it is all absorbed when applied to the skin, which of course is not the case. And how much cream does this translate to? Given that the most parabens used as a preservative makes up about 0.8% of the weight of a lotion, a quick calculation shows that about 70 bottles each containing 100 mL each would have to be applied to the skin every day to approach the NOAEL. Basically, parabens "toxicity" is a non-issue. And not that this is of any relevance, but parabens occur in nature. They are found in blueberries as well as in the secretions female dogs use to attract males.

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You Asked: Is it True That People Who Drink Tea Live Longer Longer ?

Our OSS Blog - Tue, 08/25/2015 - 08:17

Drink tea to live longer? Newspaper headlines may have said that, but, that is not exactly what the study they were referring to said. Nevertheless it is an interesting study, published in the American Journal of Clinical Nutrition, a highly respected peer-reviewed publication. The study evaluated intake of flavonoids in an elderly Australian female population through food frequency questionnaires. Flavonoids constitute a huge class of compounds found in plants, members of which are linked through a basic molecular structure they share. The reason for interest in these compounds is that laboratory experiments have shown possible anti-allergenic, anti-inflammatory, anti-cancer,-anti-heart disease and antioxidant effects. Although, there is a dearth of studies in people using isolated flavonoids, it is generally assumed that the benefits ascribed to eating fruits and vegetables may be due to their flavonoid content.

One way to get a handle on possible flavonoid benefits is to see if there is any connection between estimated flavonoid intake and health status. The best measure of health status is longevity. Two data bases of flavonoid content of foods were used to estimate intake of these compounds in the diets of over a thousand women with an average age of 80 who were followed for five years. Indeed, subjects who consumed the most flavonoids, 800 mgs or so a day, lived longer than women whose intake was less than 500 mgs whether the eventual cause of death was cancer or heart disease. In this population the major source of flavonoids was tea, about 350 mg for two cups, but there is no reason to believe that flavonoids in tea are in any way different from those found in berries, onions, bananas, cocoa, wine, citrus fruits, parsley or peanut skins. What all these have in common is that they are plant products, so this study reinforces the notion that our diet should be mostly plant based.

There are the usual caveats with such a study, the classic one being that an association cannot prove cause and effect. Although attempts were made to correct for confounders such as body weight and physical activity level, it is still possible that other components of the diet that parallel flavonoid intake are responsible for the noted difference in longevity. Then there is the usual problem that food frequency questionnaires may not accurately reflect food intake because of memory and honesty issues. But if flavonoids are really players in the good health game, which is likely, it is interesting to note that the average North American intake is only about 300 mgs which is considerably less than that of the longest lived subjects in this study. For a ballpark idea, an apple, a cup of blueberries or a cup of tea are all in the 150 mg flavonoid content range. So while tea may not be the elixir of life, a couple of cups a day are an easy way to increase flavonoid intake. There is no downside. Unless you load it up with sugar as is the case with many canned and bottled teas. Make your tea at home, add a dose of lemon juice if you like, but leave out the sugar. It may not make you live longer but it will make life a little more pleasant.

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