---January 9, 1997---
HEADLINES:
INFECTIOUS DISEASE AND POLLUTION
Between 1980 and 1992 in the U.S., the death rate due to infectious diseases as the underlying cause of death increased 58%, from 41 to 65 deaths per 100,000 population, according to the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.[1] The increase was larger among males (69%) than among females (44%). The greatest increase occurred among people between the ages of 25 and 44; in this age group, the death rate from infectious diseases rose from six to 38 deaths per 100,000 people, more than a six-fold increase. Among people over the age of 65, the death rate from infections increased from 271 per 100,000 to 338 per 100,000, a 25% increase during the period. Among children younger than 5, the death rate from infectious diseases declined during the 12-year period. Overall, during the period, age-adjusted mortality from infectious diseases increased 39% in the U.S.
The bulk of the increase can be accounted for by the AIDS virus. During the period 1980-1992, deaths attributed to AIDS appeared and then increased to 13 per 100,000. However, if the AIDS virus is omitted entirely from the statistics, the death rate due to infectious diseases as the underlying cause still increased 22% during the period.
Deaths from infectious diseases not related to AIDS increased substantially during the period. For example, the death rate for respiratory infections increased 20%, from 25 to 30 deaths per 100,000, and the rate of death from septicemia (a blood infection) increased 83%, from 4.2 to 7.7 per 100,000.
Among the leading causes of death in 1980, infectious diseases ranked fifth in the U.S., based on underlying-cause-of-death data. (The big four causes of death in 1980 were heart disease, cancers, strokes, and accidents.) By 1992, infectious diseases ranked third, after cardiovascular disease and cancers.
This analysis has underestimated the contribution of infectious agents to the U.S. death rate because it counted only deaths in which infection was clearly the "underlying cause." Infections contributed to --but were not the "underlying cause" of --many more deaths than those counted in this analysis, the authors of the study say.
The authors of the study cannot explain all of the increases that they observed. They think some of the increases may have been caused by improper food handling, and by the appearance of microbes that are resistant to antibiotics.
The development of microbes resistant to antibiotics is now recognized as a large and growing public health problem. (See REHW #402.)
Medical researchers concerned about increasing rates of infectious disease are recommending wider use of the vaccine that is now available for pneumonia caused by the bacterium, STREPTOCOCCUS PNEUMONIA.[2]
They are also recommending that physicians prescribe antibiotics prudently. (Unnecessary use of antibiotics is a major cause of the development of antibiotic-resistant strains of bacteria.) Furthermore, they urge people with a case of the sniffles to stop demanding antibiotics from their doctor. The common cold is caused by viruses, not bacteria, and antibiotics are not effective against viruses. Use of antibiotics to treat the common cold merely increases the number of antibiotic-resistant bacteria in the world. Many physicians report that they prescribe antibiotics for colds, even though they know such a remedy will not be effective, because patients demand it.
In addition to antibiotic-resistant microbes, another possible contributor to the rising death rate from infectious diseases is damage to the human immune system. Immune system damage is known to occur as a result of our constant exposure to combinations of exotic chemicals. For example, the National Academy of Sciences acknowledged in a 1992 study, "In the general population, increasing numbers of people suffer from disorders of the immune system, such as allergies, asthma, and AIDS. The incidence of asthma has increased 58% since 1970, and it is well known that nitrogen dioxide and ozone, common air pollutants, interact with allergens to increase the frequency and severity of asthma attacks."[3]
The immune system is a complex set of specialized cells and organs that defends the body against attack by invaders. When it functions properly, the immune system fights off diseases caused by bacteria, viruses, fungi, parasites, and cancer cells. "When it malfunctions, however, it can unleash a torrent of diseases, from allergy to arthritis to cancer to AIDS," according to the federal National Institutes of Health (NIH).[4] When it malfunctions, the immune system can fail to protect against infectious diseases.
In 1996, a study of pesticides and the immune system, published by the World Resources Institute (WRI), examined a growing body of literature from around the world, showing that many common pesticides degrade the immune systems of laboratory animals, wildlife, and humans.[5]
WRI examined studies of all major classes of pesticides --organochlorines such as DDT, organophosphates such as malathion, and carbamates such as aldicarb.
Though most of the studies were of laboratory animals, WRI reviewed studies of wildlife as well.
In a controlled experiment, Dutch virologist Albert D.M.E. Osterhaus of Erasmus University in Rotterdam fed two groups of harbor seals fish from different sources.[6] One group of seals received relatively clean fish from the North Atlantic and the other group received fish from the industrially-polluted Baltic sea. The Baltic fish contained 10 times as much organochlorine pollution (for example, DDT and PCBs) as the Atlantic fish. Osterhaus emphasized that both kinds of fish were taken from catches destined for (and considered legally fit for) human consumption.
For 2 years, Osterhaus sampled blood from the seals every six to nine weeks and made various measurements of immune system function. Almost immediately after the experiment began, vitamin A levels dropped 20 to 40 percent in the blood of seals fed fish from the Baltic and remained low throughout the 2-year experiment. Vitamin A is associated with disease resistance; lower vitamin A levels in the blood correspond to greater vulnerability to disease.
Seals fed Baltic fish showed another important change: the level of NK cells in the blood remained 20 to 50 percent below normal throughout the study. NK cells are "natural killer" cells that attack foreign bodies in the blood, thus providing important immune protection.
Other key components of the immune system were compromised in the Baltic-fed seals. In a healthy immune system, B cells produce antibodies and T cells orchestrate the immune response to foreign invaders. In the Baltic-fed seals, the T-cell response to a standard set of antigens dropped 25 to 60 percent, compared to the Atlantic-fed seals.
"I was surprised to see significant immune changes in animals that were fed on a normal diet using fish fit for human consumption," Osterhaus says.[7]
WRI commissioned scientists in Eastern Europe to translate technical studies of chemical effects on the human immune system. Lyudmila Kovtyukh of the Academy of Sciences of Kishinev, Moldova (a republic between Romania and the Ukraine) reported heavy use of pesticides around Kishinev. She also reported that children living in the pesticide-contaminated areas had unusually high incidence of acute respiratory infections, including pneumonia, ear infections, tuberculosis, and dental caries. Adults in the area also had unusually high rates of infections. Scientists there measured diminished T cell populations, and they were able to show a dose-response relationship with pesticide exposure: the greater the pesticide exposure, the greater the loss of T cells.[8]
An ongoing series of studies of Inuit natives in northern Quebec, Canada, has shown that organochlorine contamination of the food chain (including many pesticides) leads to a buildup of these toxic substances in breast-fed Inuit babies.[9] Inuit infants and children suffer from high incidence of infectious diseases, specifically ear infections (chronic otitis),[10] and meningitis.[11] In some cases, these children's immune systems are so damaged that they cannot be vaccinated against disease because their immune systems cannot produce the needed antibodies.
After the discovery of sulfa drugs in the 1930s, and other antibiotics in the 1940s and '50s, many public health specialists assumed that infectious diseases were readily controllable, and were perhaps even a thing of the past. This gave rise to an emphasis on heart disease and cancer. Now, however, we know that this perspective was mistaken. Infectious diseases are making a comeback world-wide. Recent evidence indicates that the dramatic failure of our regulatory system for controlling toxic chemicals is contributing to the re-emergence of this class of diseases, even in parts of the globe, such as the Arctic, where use of toxic chemicals has been minimal.
In 1996 the American Medical Association acknowledged that worldwide pollution, leading to global warming, is likely to increase the incidence of infectious diseases in many human communities.[12] The links between pollution and human disease have become impossible to deny.
--Peter Montague (National Writers Union, UAW Local 1981/AFL-CIO)
RACHEL'S ENVIRONMENT & HEALTH WEEKLY #527
---January 2, 1997, ---
There was good news and bad about the American diet in 1996. The bad news is that people in the 1990s are eating far more pizza, tacos and pasta dishes loaded with hidden fats, compared to 30 years ago. "The most sweeping changes in the American diet can be traced to fast foods --increases in mozzarella cheese for pizza, tomato products for ketchup and pizza, pickles for relish, potatoes for fries, chicken for Kentucky fried, ice milk for soft serve, beef for burgers, and soft drinks. These are foods that are high in fat, saturated fat, salt and calories, and low in fiber," says Bonnie Liebman of the Center for Science in the Public Interest in Washington, D.C.[1] McDonalds spends $800 million each year advertising its wares while the National Cancer Institute spends only $1 million each year promoting fruits and vegetables.
During the period 1965-1991, consumption of grains, fruits and vegetables actually declined among part of the population --African-Americans living below the poverty line. (Among wealthy whites, the trend ran strongly in the opposite direction.) Many of the free foods distributed to women and children as part of the nation's welfare programs are high in fats and cholesterol; furthermore, pizza, burgers, and tacos have become popular school lunch items as McDonalds and Burger King have invaded the schools, participating in the national frenzy to "privatize" everything possible.
However, some good news about heart disease, cancer and diet also came along in 1996. Holiday party-goers needn't feel too guilty about eating chocolate or drinking alcohol (in moderation), according to new studies. Chocolate and alcohol both appear to reduce considerably the chances of having a heart attack. A daily cup of tea offers the same protection.
Grapefruit, orange, and tangerine juices were found in 1996 to protect somewhat against breast cancer. In addition, a common household remedy, aspirin, was also reported this year to protect some women against breast cancer.[2] Aspirin had previously been shown to protect against colon cancer, heart disease, and stroke.
Wine, Beer, Liquor
Studies over the past decade have shown that atherosclerosis (plaque deposited on the inner walls of the arteries, reducing blood flow) occurs when "bad" cholesterol (low-density lipoprotein [LDL] cholesterol) combines with oxygen.
This insight has caused scientists to search for items in the diet that might prevent LDLs from combining with oxygen. These studies have identified several anti-oxidants that seem to do the trick: vitamin E, vitamin C, and beta-carotene (a class of naturally-occurring red and yellow dyes, one of which gives carrots their orange color).[3]
The value of vitamin E was confirmed again at the conference Experimental Biology '96 in Washington, D.C. in late April. Lisa Nicholson of the University of Southern California School of Medicine (Los Angeles) reported a 5-year study showing that a vitamin E supplement was very effective at reducing the accumulation of artery-clogging plaque in a small study group of 56 individuals (32 men and 24 women). Participants in the study, aged 38 to 60, were given 100 international units of vitamin E per day (or 10 times the recommended daily allowance). At the end of 5 years, the vitamin E supplements had reduced average plaque buildup by an amount "equivalent to 14 years of aging," Nicholson told Janet Raloff of SCIENCE NEWS.[4] In March, 1996, a study of 2002 individuals with serious heart disease showed that vitamin E supplements (of 800 and 400 international units per day to two different groups) reduced heart attacks in both groups substantially.[5]
In the past two years, new studies have identified other chemicals --called flavonoids --that also prevent the oxidation of "bad" cholesterol. These flavonoids are present in alcohol, chocolate, tea, and certain fruit juices.[6]
In 1995, John D. Folts of University of Wisconsin (Madison, Wisc.) showed that wine and red grape juice helped prevent atherosclerosis in dogs, while white grape juice did not.[7] At the conference Experimental Biology '96 in April, Folts reported more experiments with atherosclerotic dogs, showing that dark beer was effective at preventing plaque deposits from building up in dogs' arteries.[8] Guiness Extra Stout, a dark, malty brew, was twice as effective as a lighter-colored beer (Heineken lager).
Tea was as effective as the dark beer, Folts reported. Furthermore, tea seemed to have a lasting effect. After taking tea for a week, dogs needed only half as much tea (one cup per day) to achieve the beneficial effect, Folts said. Coffee, on the other hand, made the dogs' atherosclerosis worse.
At the same conference, Kenneth K. Carroll of the University of Western Ontario in London, Ontario reported that the flavonoids in grapefruit, orange and tangerine juices were powerful cancer inhibitors in laboratory animals.[9] The best of these was tangerine juice.
Danish researcher Hans Ole Hein in March published a study in the BRITISH MEDICAL JOURNAL solving the "French paradox." French people generally have high cholesterol levels in their blood yet don't experience high rates of heart disease. Hein and his colleagues say the French seem to be protected by flavonoids in the wine they drink.[10,11]
Eric Brimm of the Harvard University School of Public Health examined 25 separate studies showing that moderate alcohol use reduces the chances of serious heart disease.[12] He concluded that there is "strong evidence" that all alcoholic drinks, used in moderation, reduce the dangers of heart disease. He says, therefore, it seems to be the alcohol that provides the benefit and "it doesn't matter what beverage you get the alcohol in."
Hein and Brimm both think doctors should begin recommending a drink with dinner for most patients at high risk of heart disease. However, not everyone agrees. Marion Nestle of New York University told Janet Raloff of SCIENCE NEWS that "under no circumstances should persons who don't drink [alcohol] be encouraged to do so" because of "the enormous social impacts" of alcohol on society: drunk driving, violence against women and children, and accidents (involving guns, boats, etc.).[9] You should ask your doctor what he or she recommends for you.
Chocolate
Chocolate isn't entirely good for people either, because of the fat and sugar that usually accompany it. However Andrew L. Waterhouse of the University of California at Davis reported in September that the flavonoids in chocolate are more powerful than red wine in protecting against heart disease.[13] A 5-ounce glass of red wine contains about 210 milligrams (mg) of antioxidants; a cup of hot chocolate made with 2 tablespoons of cocoa would deliver 146 mg of antioxidants, and a 1.5 ounce chunk of milk chocolate, 205 mg. Waterhouse suggests a beneficial synergistic effect from combining red wine with dark chocolate.
A danger of chocolate in addition to the sugar and fat is possible addiction. Americans consume 2.86 billion pounds of chocolate each year --about 11 pounds per person per year, but certain 'chocoholics' consume far more than the average.[14] Daniele Piomelli of the Neurosciences Institute in San Diego, California in August reported finding a chemical in chocolate, called anandamide, which is closely related to the cannabinoids in marijuana.[15] Anandamide is a pleasure-inducing opiate which hits all areas of the brain, creating a "global high," says Piomelli.[16] Some people just can't seem to get enough of it.
Aspirin
A case-control study of 511 women with breast cancer, and 1534 women who did not have the disease, showed that women who took aspirin or ibuprofin at least three times a week for 5 years cut their chances of getting breast cancer by one third. If these findings are confirmed in other studies, these nonsteroidal anti-inflammatory drugs (NAIDs) will become the first chemicals found to protect against this malignancy.[2] In the study, women who took one aspirin or ibuprofin every day had the best chances of avoiding breast cancer. About 180,000 new cases of breast cancer occur each year, causing approximately 46,000 deaths annually.
Americans take 20 to 30 billion aspirin every year with few side effects, though some people experience irritation of the stomach lining and bleeding.[17] Several studies in the 1980s showed that aspirin can protect against colon cancer.[18] Many physicians now recommend an aspirin a day for their patients. Ask your doctor.
Because so much remains unknown about the effects of diet on health, probably the best advice still comes from Terence, the Roman playwright who said in 166 B.C., "Moderation in all things."
--Peter Montague
===============
[1] Jane E. Brody, "Study Finds a Three-Decade Gain in American Eating Habits, but a Long Way to Go," NEW YORK TIMES September 5, 1996, pg. A14, describing Barry M. Popkin and others, "A Comparison of Dietary Trends Among Racial and Socioeconomic Groups in the United States," NEW ENGLAND JOURNAL OF MEDICINE Vol. 335, No. 10 (September 5, 1996), pgs. 716-720.
[2] Randall E. Harris and others, "Nonsteroidal Antiinflammatory Drugs and Breast Cancer," EPIDEMIOLOGY Vol. 7, No. 2 (March 1996), pgs. 203-205.
[3] A good overview of antioxidants can be found in Barry Haliwell, "Free radicals, antioxidants, and human disease: curiosity, cause, or consequence," THE LANCET Vol. 344, No. 8924 (September 10, 1994), pgs. 721-724.
[4] Janet Raloff, "Vitamin E slows artery 'aging,'" SCIENCE NEWS Vol. 149 (May 4, 1996), pg. 287.
[5] Nigel G. Stephens and others, "Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS)," THE LANCET Vol. 347 (March 23, 1996), pgs. 781-786. For a discussion of the limitations of this study, see Rudolph A. Riemersma, "Coronary heart disease and vitamin E," THE LANCET Vol. 347 (March 23, 1996), pg. 776.
[6] Michael Hertog and others, "Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study," THE LANCET Vol. 344, No. 8878 (October 23, 1993), pgs. 1007-1011. And see J. Raloff, "Add tea to that old 'apple a day' adage," SCIENCE NEWS Vol. 149 (October 30, 1993), pg. 278
[7] Heather S. Demrow, Peter R. Slane, and John D. Folts, "Administration of Wine and Grape Juice Inhibits In Vivo Platelet Activity and Thrombosis in Stenosed Canine Coronary Arteries," CIRCULATION Vol. 91, No. 4 (February 15, 1995), pg. 1182. And see John Folts, "An In Vivo Model of Experimental Arterial Stenosis, Intimal Damage, and Periodic Thrombosis," CIRCULATION [Supplement IV] Vol. 83, No. 6 (June 1991), pgs. IV-3 to IV-14.
[8] Janet Raloff, "A couple of heart-friendly dark brews," SCIENCE NEWS May 4, 1996, pg. 287.
[9] Janet Raloff, "Juicy anticancer prospects," SCIENCE NEWS Vol. 149 (May 4, 1996), pg. 287.
[10] Hans Ole Hein and others, "Alcohol consumption, serum low density lipoprotein cholesterol concentration, and risk of ischaemic heart disease: six year follow up in the Copenhagen male study," BRITISH MEDICAL JOURNAL Vol. 312 (March 23, 1996), pgs. 736-741.
[11] J. Raloff, "Have Danes solved the French paradox?" SCIENCE NEWS Vol. 149 (March 30, 1996), pg. 197.
[12] Eric B. Rimm and others, "Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits?" BRITISH MEDICAL JOURNAL Vol. 312 (March 23, 1996), pgs. 731-736.
[13] Andrew L. Waterhouse and others, "Antioxidants in chocolate," THE LANCET Vol. 348 (September 21, 1996), pg. 834. And see "Chocolate: As hearty as red wine..." SCIENCE NEWS Vol. 150 (October 12, 1996), pg. 235.
[14] J. Raloff, "Coming: Drug therapy for chocoholics?" SCIENCE NEWS Vol. 147 (June 17, 1995), pg. 374.
[15] Emanuelle di Tomaso, Massimiliano Beltramo, and Daniele Piomelli, "Brain cannabinoids in chocolate," NATURE Vol. 382 (August 22, 1996), pgs. 677-678.
[16] "...but we eat it for pleasure," SCIENCE NEWS Vol. 150 (October 12, 1996), pg. 235.
[17] S. Sternberg, "Aspirin Users May Trim Breast Cancer Risk," SCIENCE NEWS Vol. 149 (February 24, 1996), pg. 116.
[18] L. Rosenberg and others, "A Hypothesis: Nonsteroidal Anti-Inflammatory Drugs Reduce the Incidence of Large-Bowel Cancer," JOURNAL OF THE NATIONAL CANCER INSTITUTE Vol. 83, No. 5 (March 6, 1991), pg. 355.
CORRECTION
In RACHEL'S #525 we described David Brower as the "founder" of the Sierra Club. The Club was actually founded in the early 1890s by John Muir. Mr. Brower became the Club's first executive director in 1952 and changed the Club from a regional conservation club to a modern national environmental organization.
Descriptor terms: food safety; breast cancer; colon cancer; diet and health; cholesterol; fat; mcdonalds; center for science in the public interest; heart disease; chocolate; wine; beer; alcohol; liquor; tea; coffee; grapefruit juice; orange juice; tangerine juice; aspirin; ibuprofin; nonsteroidal anti-inflammatory drugs; atherosclerosis; anti-oxidants; vitamin e; vitamin c; beta-carotene; flavonoids; anandamide; cannabinoids; cspi; sierra club; david brower; john muir;
################################################################
NOTICE Environmental Research Foundation provides this electronic version of RACHEL'S ENVIRONMENT & HEALTH WEEKLY free of charge even though it costs our organization considerable time and money to produce it. We would like to continue to provide this service free. You could help by making a tax-deductible contribution (anything you can afford, whether $5.00 or $500.00). Please send your contribution to: Environmental Research Foundation, P.O. Box 5036, Annapolis, MD 21403-7036. --Peter Montague, Editor ################################################################
