Miscellaneous Health Concerns

by Ben Best




Fatty acids (fats) in the body usually exist unattached to any other molecule (free fatty acids), attached to glycerol in groups of three (triglycerides), or attached to phosphatidic acid molecules (phospholipids). (For details, see my essay Fats You Need — Essential Fatty Acids.) Fats can be saturated (no double bonds between carbon atoms) or unsaturated (double bonds) and the number of carbon atoms in naturally-occurring fats can vary from between 4 and 28. Medium chain triglycerides contain 8 to 10 carbon atoms, fewer than the number of carbon atoms typically found in plant and animal fats.

Medium Chain Triglycerides (MCTs) reputedly have health benefits over the longer chain-length triglycerides typically found in plant and animal fats. In one study, persons having a Body Mass Index (BMI) greater than 23 kilograms/meter2 consuming medium chain triglycerides for 12 weeks there was a significant decrease in body weight and body fat (including visceral fat, which can be pro-inflammatory) compared to subjects consuming long-chain triglycerides [JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS; Nosaka,N; 10:290-298 (2003)]. The effect was attributed to increased thermogenesis and fat oxidation. A study with rats indicated that medium chain triglycerides can increase serum adiponectin, and hence increase insulin sensitivity [LIPIDS; Takeuchi,H; 41:207-212 (2006)].

Medium chain triglycerides can also increase exercise performance. Time to exhaustion in high intensity exercise (associated with a reduced increase in blood lactic acid concentration) was lower for subject consuming medium chain triglycerides than for subjects consuming long chain triglycerides [JOURNAL OF NUTRITIONAL SCIENCE AND VITAMINOLOGY; Nakosa,N; 55:120-125 (2009)].

Coconut oil (15% MCTs) is the dietary fat containing the highest levels of medium chain triglycerides — containing more than twice the percentage found in milk product fats.

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Urban air pollution can consist of both gaseous (carbon monoxide, nitrogen dioxide, ozone) and particulate matter (which can include organic and inorganic carbon as well as metals and other chemicals). A study of over 200 patients having implantable cardiac defibrillators showed a two-hour exposure to typical urban air pollution is associated with increased ventricular arrhythmias [EUROPEAN HEART JOURNAL; Ljungman,P; 29(23):2894-2901 (2008)]. A two-hour exposure of healthy and asthmatic subjects to Los Angeles suburban air pollution constituents resulted in deterioration of cardiopulmonary function in both groups [INHALATION TOXICOLOGY; Gong,H; 20(6):533-545 (2008)].

Exposure to particulate matter less than 2.5 micrometers in diameter (PM2.5) for hours to weeks can trigger cardiovascular mortality, with longer exposure increasing the amount of risk [CIRCULATION; Brook,RD; 121(21):2331-2378 (2010)]. A Boston study found that risk of ischemic stroke increased with quantity of PM2.5 from traffic (black carbon and NO2) in the 24 hours preceding the stroke [ARCHIVES OF INTERNAL MEDICINE; Wellenius,GA; 172(3):229-234 (2012)]. A Chinese study found that every additional microgram per meter cubed of PM2.5 increased coronary artery calcium deposits by 20% [LANCET; Guan,WJ; 388:1939 (2016)].

PM2.5 promotes cardiovascular disease by increasing inflammation, blood coagulation, arrythmia, atherosclerosis, and endothelial dysfunction [CIRCULATION; Brook,RD; 121(21):2331-2378 (2010)]. Particulate matter can compromise cardiovascular function by both direct contact with the vasculature as well as by indirect effects from the autonomic nervous system [TOXICOLOGY LETTERS; Nelin,TD; 208(3):293-299 (2012)]. The World Health Organization has declared that mortality due to PM2.5 to be the 13th leading cause of death worldwide. The major source of PM2.5 is combustion of fossil fuels (traffic, industry, power generation).

A European study found an 18 percent increased risk of acute coronary events per 5 microgram/meter3 in PM2.5, where analysis was restricted to PM2.5 concentrations below the European limit value of 25 microgram/meter3 [BMJ; Cesaroni,G; 348:f7412 (2014)]. A nationwide survey in the United States found that cardiovascular and respiratory hospitalizations associated with PM2.5 were highest where particles had the highest concentration of nickel and vanadium [AMERICAN JOURNAL OF RESIRATORY CRITICAL CARE MEDICINE; Bell,ML; 179:1115-1120 (2009)].

Diabetics have been shown to be particularly vulnerable to endothelial dysfunction from exposure to urban pollution [CIRCULATION; O'Neill,MS; 111(22):2913-2920 (2005)]. Endothelial dysfunction is associated with insulin resistance [CIRCULATION; Kim,J; 113(15):1888-1904 (2006)] as well as with cardiovascular disease.

PM2.5 exposure has been estimated to increase cognitive decline by 81% and increase all-cause dementia by 92% [TRANSLATIONAL PSYCHIATRY; Cacciottolo,M; 7:e1022 (2017)]. The effects are greater for APOE4 carriers, accelerating the development of Alzheimer's Disease. People living within 50 meters of a major roadway have been shown to be 12% more likely to develop dementia than people living more than 200 meters away [SCIENCE; Underwood,E;355:342-345 (2017)].

The specific effects of nanoparticle (particles less than ten nanometers in diameter) pollution has not been studied because it cannot be easily measured. But the total surface area of many nanoparticles will be much greater than for a comparable volume of larger particles — and so is the expected toxicity [PARTICLE AND FIBRE TOXICOLOGY; Pedata,P;12:34 (2015)].

The US government website Air Now provides an assessment of air quality all over the United States.

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Heart Rate Variability (HRV) meansures how uniform is the distance between peaks of an electrocardiogram. If the peak distances are nearly equal, the HRV is low, whereas if the peak distances tend to be different, the HRV is high. High HRV values indicate good health, whereas low HRV indicates poor health and higher risk of death. Smoking lowers HRV [AMERICAN JOURNAL OF CARDIOLOGY; Hayano,J; 65(1):84-88 (1990)]. A study of both middle-aged and elderly non-smokers showed a substantial risk of death from all causes — including cancer — associated with low HRV [AMERICAN JOURNAL OF EPIDEMIOLOGY; Dekker,JM; 145(10):899-908 (1997)].

HRV measures the function of the automonic nervous system, which is composed of the parasympathetic and sympathic nervous systems. The parasympathetic nervous system slows the heart, whereas the sympthetic nervous system accelerates the heart [BIOLOGICAL PSYCHIATRY; Kemp,AH; 67(11):1067-1074 (2010)]. A more fine-grained analysis distinguishes between high frequency and low frequency HRV, with parasympathetic activity being the major contributor to the high frequency component [PROGRESS IN CARDIOVASCULAR DISEASE; Xhyheri,B; 55(3):321-332 (2012)] (the low frequency component is less well-defined). High HRV has been interpreted as adaptive, flexible control of the body by the brain [NEUROSCIENCE AND BEHAVIORAL REVIEWS; Thayer,JF; 36(2):747-756 (2012)].

Low HRV is predictive of cardiovascular disease independent of other cardiovascular disease risk factors [ CIRCULATION; Tsuji,H; 94(11):2850-2855 (2012)]. Low HRV is associated with coronary artery disease and depression [AUSTRALIAN & NEW ZEALAND JOURNAL OF PSYCHIATRY; Stapelberg,NJ; 46(10):946 (2012)], with atherosclerosis, high blood pressure, and metabolic syndrome [PROGRESS IN CARDIOVASCULAR DISEASE; Xhyheri,B; 55(3):321-332 (2012)], with air pollution and tobacco smoke [HEART; Pieters,N; 98(15):1127-1135 (2012))], and with sleep deprivation [SLEEP MEDICINE REVIEW; Stein,PK; 16(1):47-66 (2012)].

There are numerous ways of measuring HRV, most of which give different numbers. I have monitored my HRV using a Polar H7 Bluetooth Smart Heart Rate Sensor chest strap and software on my iPAD from Sweetwater Health [an organization that provides software (apps) for monitoring HRV]. High quality chest strap heart rate monitors give results that are comparable to multilead cardiography [PACING AND CLINICAL ELECTROPHYSIOLOGY; Porto,LG; 32:43-51 (2009)]. According to Sweetwater Health, the following table indicates average Sweetbeat HRV values, according to age and gender:

Average Sweetbeat HRV




10-29 72.3 67.7
30-49 62.5 60.5
50-69 52.9 55.7
70-99 52.9 52.9

Another study also showed declining HRV with age, but found a higher HRV for women rather than men [AMERICAN JOURNAL OF CARDIOLOGY; Antelmi,I; 93(3):381-385 (2004)].

A study of people who had been practicing strict calorie restriction for an average of seven years found that their HRV was equivalent to 20-years-younger than the HRV of people eating a typical Western diet [AGING CELL; Stein,PK; 11(4):644-650 (2012)]. Fish oil supplementation elevates HRV [AMERICAN JOURNAL OF CLINICAL NUTRITION; Xin,W; 97(5):926-935 (2013)]. Biofeedback has been shown to elevate HRV short-term, although long-term benefits have not been demonstrated [APPLIED PSYCHOPHYSIOLOGY AND BIOFEEDBACK; Wheat,AL; 35(3):229-242 (2010)].

Included in the Sweatwater Health app for measuring HRV is an app for measuring Heart Rate Recovery (HRR). HRR is the amount by which heart beats per minute (bpm) declines in the first minute after endurance exercise stops. People having HRR below 12 bpm have at least a four-fold risk of all-cause mortality compared to people with a HRR of 25 bpm [JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION; Nishime,EO; 1392-1398 (2000) & NEW ENGLAND JOURNAL OF MEDICINE; 341(18):1351-1357 (1999)]. Athletes have a high HRR [JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY; Imai,K; 24(6):1529-1535 (1994)].

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GMO (Genetically Modified Organism) food (genetically modified food) can be a subject of considerable health concern. Modifying food genetically refers to the modern practice of altering food plant genomes by the insertion of genes from other organisms. Natural mutation and sexual reproduction are genome-altering processes. Very few currently consumed crops resemble the plants from they were originally derived. Thousands of years of plant breeding has genetically modified and domesticated most plant foods.

The term GMO primarily refers to plants or animals that have been genetically modified by scientists who have extracted genes from one organism and consciously attempted to insert those genes into another organism. The vast majority of insulin in use worldwide is produced by GMO bacterial which have been given a gene for producing human insulin. Such insulin is more pure and less expensive than the insulin which was formerly obtained from pigs or cattle. Similary, chymosin, an enzyme used to produce cheese, is now mostly obtained from GMO bacteria rather than from the abdomen of ruminant animals.

A mystical, pantheistic view of life imagines that "natural foods" are safe, whereas genetically-modified foods are not. But there are few foods that could be called "natural". Humans have been genetically-modifying foods since the beginning of civilization. Many plant products are very poisonous and toxic substances that protect the plants from being eaten by animals. Humans have learned not to eat those plant products. Many foods contain toxic substances in low enough amounts that they can be safely consumed. Potatoes, for example, contain the toxic substance solanidine. It is possible to create GMO food that would be more toxic than existing food, but it is also possible to create GMO food that is less toxic, more nutritious, more flavorful, and less expensive. Because of the extensive testing required for GMO foods approval, no GMO food has been shown to cause health problems — but if that happened, that food could be removed. Anti-GMO activists claim that current testing is inadequate, but most of those activists fail to define what GMO testing would be adquate — and many have quasi-religious beliefs that GMO testing can never be adequate. Anti-GMO activists often say that many physicians are advocating non-GMO foods to remedy health problems, while ignoring the fact that the American Medical Association takes the position that GMO foods are safe.

Background radiation continously has a genetic modifying effect — causes mutations. Red ruby grapefruit was created by exposing grapefruit buds to thermal neutron radiation to intentionally induce mutations. Intentional mutation also produced a commonly used variety of durum wheat. Seedless oranges, grapes, and watermelons are not natural — and are propagated by human manipulation.

About 90% of cotton, corn, and soya crops planted in the United States are genetically modified to resist herbicides or insects. Bt cotton and Bt corn are genetically-modified cotton and corn plants that produce an insecticide because it contains a gene taken from the bacterium Bacillus thuriniensis which produces the insecticide. Bacillus thuriniensis has been sprayed onto crops since the 1920s — and is a preferred means of pest control by organic farmers, who regard the bacterium as "natural". But it is far more efficient to have the crops produce the insecticide themselves. The insecticide is toxic to the larva of a few harmful species of insects, but is not toxic to beetles, flies, bees, wasps, birds, fish, or mammals. Insecticide use in corn fields is less than a tenth what it was in 1996, largely due to Bt corn [SCIENCE; 341:730-731 (2013)]. Roundup Ready soybean plants have been genetically modified to resist Monsanto Corporation's Roundup herbicide. Less toxic herbicides can be used in association with GM crops. Although the development of crops genetically resistant to herbicide has led to increased volume of herbicide use in the US, there has been a reduction in environmental impact due to the reduced toxicity of those herbicides [GM CROPS & FOOD; Brookes,G; 4(2):109-119 (2013)] — though tolerance to those herbicides is increasing [NATURE; Gilbert,N; 497:24-26 (2013)]. Golden rice has been genetically modified to produce the pro-vitamin A beta-carotene that could save millions of lives or prevent blindness in children in countries where rice is a staple food. But expensive and time-consuming safety reviews, which many scientists believe are unnecessary, have prevented the adoption of Golden Rice since the 1990s [NEW BIOTECHNOLOGY; Chassy,BM; 27(5):534-544 (2010)]. In August 2013 during one such review in the Philippines, protesters trucked-in by Greenpeace and other NGOs trampled the rice field being tested [SCIENCE; Alberts,B; 341:1320 (2013)].

GMO opponents say that genetic modification involving the forceful insertion of foreign genes is not comparable to plant breeding — and has unpredictable effects. In the beginning of the month of May, 2013 the journal SCIENCE featured a debate between two East Indian scientists over whether GMOs are beneficial or hazardous. The false rumor of Indian farmers committing suicide because of GMOs was not mentioned. The suicides began nearly a decade before GMOs were introduced in India — and the suicide rate has not increased since the GMOs were introduced [NATURE; Gilbert,N; 497:24-26 (2013)]. NATURE had a special issue of the magazine devoted to the subject of GMOs, which discussed positives and negatives. Most scientists believe that GMO foods could be a technological boon for humanity, and that no health hazards can reasonably be attributed to GMO foods [PLANT PHYSIOLOGY; Ricroch,AE; 1752-1761 (2011), TRENDS IN BIOTECHNOLOGY; Batista,R; 27(5):277-286 (2009), NUTRITION REVIEWS; Magana-Gomez,JA; 67(1):1-16 (2009), and ANNUAL REVIEW OF PLANT BIOLOGY; Lemaux,PG;59:771-812 (2008)]. Social opposition based on ignorant fear is the main obstacle to GMO progress.

Supporters of GMOs complain that the full power of science to enhance the quality and quantity of food production is being hampered by groups that oppose all new technologies. And that the regulatory burden imposed by the FDA, USDA, and EPA has allowed only the largest corporations to be able to put new GMOs on the market (similar to the situation with drugs and large pharmaceutical corporations). The average approval period for a GMO food is about five years, due to the extensive testing requirements. GMO opponents say that GMOs are toxic, but that the toxicities go unrecognized due to the lack of labeling. GMO opponents claim that new allergenic proteins are being introduced into the food supply. No GMO food that has been introduced into the market has been proven to be allergenic — in contrast to conventional peanuts, mild, eggs, or tree nuts. Some people proved to be allergic to Kiwi fruit when it was introduced into the American market, even though it is not a GMO.

Consumers often say that they favor mandatory labeling of GMOs, but surveys have indicated that consumers rarely consider the costs of labeling and rarely even understand what GMOs are (imagining, for example, that chemicals have been added). In countries where GMO labeling is not mandatory, government officials have argued that mandatory labeling would send a frightening message that GMOs are unsafe. But foods labeled "organic" by the USDA cannot contain GMOs, and meat certified as "organic" cannot come from animals raised with antibiotics or which have been fed GMO plants. In June, 2013 Connecticut became the first State to mandate labeling of GMOs. But the law stipulated that mandated labeling could not take effect before four adjoining states with a population of more than 20 million passed similar legislation. Connecticut did not want to be the single state with a costly regulatory burden which would disadvantage Connecticut. Just over a week later Maine became the second state to pass a similar anti-GMO bill.

Genetically modified mosquitos have the potential to eliminate diseases such as malaria and dengue. Criticisms that genomic insertion is random and therefore unpredictable is technologically obsolete. But the objection that non-GM mosquitos will eventually regain predominance in the environment — and that no laboratory experiment can replicate the results of mosquitos in the wild — has more merit [AMERICAN JOURNAL OF TROPICAL DISEASE AND HYGENE; Knols,BGJ; 77(6 Suppl):232-242 (2007)]. But fear of unintended consequences based on speculation could prevent the adoption of all technologies. When unintended consequences result from new technologies, this creates a new problem which yet newer technologies will need to solve. There are no guarantees in life.

A notable anti-GMO book, is GENETIC ROULETTE by Jeffrey Smith and a notable pro-GMO book is MENDEL IN THE KITCHEN by Nina Fedoroff — both of which I purchased and studied in order to see both sides of the story. When I mentioned the title of Smith's book to a geneticist, he said that the phrase could be applied to sexual reproduction.

Adoption of GMO foods is not the result of Monsanto being a gigantic profit-hungry corportation. Instead, Monsanto products have been adopted by farmers wishing to increase their yeilds while reducing their pesticide use. An indication of American opposition to GMOs is the fact that Monsanto failed to get Bt wheat or Bt potatoes into the market. Activist groups and the wheat industry opposed Bt wheat, and McDonald's refused to sell French fries made with Bt potatoes.The Consumers Union (which publishes the magazine CONSUMER REPORTS) lobbied heavily in favor of the Connecticut GMO labeling law. The Consumers Union does not want to ban GMOs, but wants GMOs subjected to similar FDA regulation as is required for new drug approval.

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