Ask Joe DiMatteo

What is it good intentions pave the way to?

A U.S. government report that will likely incite serious debate has concluded that fluoride over double the recommended limit in drinking water is linked to lower IQ in children.

The report, based on an analysis of previously published research, has concluded with “moderate confidence” that higher levels of fluoride exposure are linked to lower IQ in children. The report acknowledges a potential neurological risk from high fluoride levels even though it wasn’t explicitly intended to assess the health effects of fluoride in drinking water alone.

According to the U.S. Centers for Disease Control and Prevention, fluoride, a mineral that occurs naturally in water and soil, strengthens teeth and reduces cavities by replacing minerals lost over time. Scientists found that people with higher natural fluoride in their water had fewer cavities, leading to a push for more Americans to use fluoride for better dental health. The addition of low levels of fluoride to drinking water has long been considered one of the greatest public health achievements of the last century.

Ashley Malin, a University of Florida researcher who has studied the effect of higher fluoride levels in pregnant women on their children, said,

“I think this (report) is crucial in our understanding” of this risk.” She proclaimed it to be the most rigorously conducted report of its kind.

The much-anticipated report from the National Toxicology Program, part of the Department of Health and Human Services, summarizes a review of studies conducted in Canada, China, India, Iran, Pakistan, and Mexico. The report concludes that drinking water containing more than 1.5 milligrams of fluoride per liter is consistently associated with lower IQs in kids.

The report didn’t attempt to specify the exact number of IQ points that might be lost at various levels of fluoride exposure. However, some studies reviewed in the report indicated that IQ was 2 to 5 points lower in children with higher exposures.

In 2015, federal health officials lowered the recommended fluoridation level in water to 0.7 milligrams per liter from the previous 1.2 milligrams per liter. The World Health Organization considers 1.5 milligrams per liter as the safe limit for fluoride in drinking water. A report shows that around 0.6% of the U.S. population, approximately 1.9 million people, are served by water systems with naturally occurring fluoride levels of 1.5 milligrams per liter or higher.

The Environmental Protection Agency has a long-standing requirement that water systems contain no more than 4 milligrams of fluoride per liter. This standard aims to prevent skeletal fluorosis, a disorder that can cause weaker bones, stiffness, and pain.

Malin said that the report raises questions about how to protect people and what makes the most sense. The 324-page report didn’t reach a definitive conclusion about the risks of lower levels of fluoride, stating that more study is needed. It also did not address what high fluoride levels might do to adults.

The American Dental Association, which supports water fluoridation, criticized earlier versions of the new analysis and Malin’s research. A spokeswoman stated that the organization’s experts were still reviewing the report.

A growing body of research indicates a potential link between elevated fluoride levels and brain development. Researchers are particularly concerned about the effects on developing fetuses and young children who consume water mixed with baby formula. Animal studies have shown that fluoride may affect neurochemistry and cell function in brain areas associated with learning, memory, executive function, and behavior.

In 2006, the National Research Council found limited evidence from China suggesting neurological effects in people exposed to high fluoride levels, prompting a call for more research.

Subsequent research prompted the National Toxicology Program to begin reviewing existing studies in 2016 to determine whether new fluoride-limiting measures were necessary.

“Since fluoride is such an important topic to the public and to public health officials, it was imperative that we made every effort to get the science right,” said Rick Woychik, director of the National Toxicology Program, in a statement.

Malin suggested that pregnant women reduce their fluoride intake from water and certain types of tea. She also proposed policy discussions about mandating fluoride content on beverage labels.

If you’re curious about how much and what kind of fluoride your state puts in its water, this site has details.

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We’ve been saying it for years!

And finally, Congress is listening… maybe.

Senator Ron Johnson (R-Wis.) hosted a Congressional “roundtable” discussion with a dozen doctors and other experts from the health & wellness world. Max Lugavere, Dr. Casey Means, Dr. Marty Makary among them.

But it was Jillian Michaels, best known for her role as a tough-love trainer on “The Biggest Loser,” that received a standing ovation after delivering her passionate speech about the epidemic of chronic diseases linked to obesity impacting multiple generations of Americans.

In her speech, she brazenly called out the companies behind ultra-processed foods (UPFs) for promoting harmful products that have spawned a tidal wave of long-lasting devastating health effects, such as heart disease, high blood pressure, diabetes, obesity, cancer, particularly breast and colorectal, digestive issues, and cognitive decline.

In 2020, approximately 71.5 million Americans, 50 and older, had at least one chronic disease. By 2050, this number is projected to nearly double, increasing by more than 99% to reach 143 million.

Currently, more than 42% of Americans are obese. 

“If this current trend is allowed to persist, the stakes will be untenable. We are in the middle of an extinction-level event,” Michaels sternly warns.

She believes the epidemic stems from the combination of Big Pharma, Big Food giants, and industrial agriculture, which use pesticides, herbicides, preservatives, and additives. Michaels argues that these entities have betrayed public trust by promoting products that have perpetually fueled the obesity epidemic.

“It seemed unthinkable to question whether a corporation would poison us for profit [and] it was this betrayal of trust that allowed them to insidiously infiltrate every part of our lives. These monster corporations have mastered the art of distorting the research, influencing the policy, buying the narrative, engineering the environment, and manipulating consumer behavior.”

UPFs undergo multiple stages of processing, adding synthetic ingredients with little nutritional benefit. According to a report in the British Medical Journal, consuming large amounts of highly processed food can increase the risk of developing heart disease by 50%. The research also suggests that eating UPFs raises the risk of obesity by 55%, sleep disorders by 41%, type 2 diabetes by 40%, and depression by 20%.

If that’s not enough, people who ate a diet of primarily UPFs were 9% more likely to die from neurodegenerative diseases like dementia, Parkinson’s, ALS, and Huntington’s disease. A different study in the BMJ  found that people who ate a diet of mostly UPFs had an overall 4% higher risk of death for any reason, at all times.

But that’s not all! UPFs can also disrupt the balance of good and bad bacteria in the gut. Changes to the microbiome can promote inflammation, spur tumor growth, hinder carcinogen clearance, and impair the immune system’s ability to fight cancer cells.

Michaels stressed the importance of making lifestyle changes, including regular exercise and healthy eating, to combat the growing epidemic.

She also called for greater awareness and education about the impact of diet and physical activity on overall health, urging people to prioritize preventive measures to reduce their risk of chronic diseases.

She ardently cautioned, “While I have been fortunate enough to pull many back from the edge, over the course of my 30-year career, I have lost just as many, if not more than I have saved. I have watched them slip through my fingers, mothers that orphaned their children, husbands that widowed their wives. I have even watched parents forced to suffer the unthinkable loss of their adult children.”

“They were literally sacrificed at the altar of unchecked corporate greed.”

The entire 4-hour roundtable is available here.

While actual congressional action is unlikely anytime soon, individual action can happen NOW. Take steps today to move more and replace UPFs with whole, single ingredient foods like poultry, fish, fruits and vegetables. It’s not an easy change, but we owe it to the people who love us to take steps to improve our health, one day at a time. We want you to live better, longer.

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On June 27, 2024, the Supreme Court threw a wrench into efforts to resolve the national opioid crisis by rejecting Purdue Pharma’s bankruptcy settlement. The controversial deal, which had been approved by a lower court, offered billions of dollars for addiction treatment and prevention programs but also shielded members of the Sackler family, Purdue’s owners, from any future lawsuits related to the opioid crisis. The 5-4 decision, with a conservative majority siding against the settlement, leaves open questions about how Purdue will proceed with its bankruptcy case and how the Sacklers will be held accountable for their alleged role in the crisis.

Purdue Pharma, the manufacturer of OxyContin, a powerful opioid painkiller, filed for bankruptcy in 2019 facing a mountain of lawsuits from states, municipalities, and individuals who accused the company of aggressively marketing OxyContin while downplaying its addictive properties. The proposed settlement, valued at up to $6 billion, would have seen the Sacklers contribute a significant portion of the funds while giving up ownership of Purdue. However, a key aspect of the deal was the inclusion of a broad release of liability, which would have prevented future lawsuits against the Sackler family.

This provision sparked outrage from many critics who argued that the Sacklers, accused of prioritizing profits over public safety, were escaping accountability with a slap on the wrist.

The majority opinion, authored by Justice Neil Gorsuch, did not address the specifics of the Sackler family’s actions. Instead, the Court focused on the legality of the broad release granted under the settlement. Gorsuch wrote, “The Code empowers bankruptcy courts to discharge a debtor’s debts, not to extinguish the claims of creditors against third parties.” He argued that the bankruptcy code was not intended to provide such sweeping legal protection to non-debtors like the Sacklers.

The decision has significant implications for future bankruptcy cases, particularly those involving large corporations with potential third-party liability. Legal experts believe it could impact other ongoing bankruptcy proceedings, including the $2.4 billion plan for the Boy Scouts of America, which also includes a release of liability for sexual abuse claims.

This ruling leaves Purdue’s future uncertain. The company could pursue any number of new legal avenues taking additional years to work through the legal system. That means the distribution of funds for things like addiction treatment programs will almost certainly be delayed.

This ruling also paves the way for individual lawsuits against the Sackler (who have distanced themselves from operations with Purdue) family to proceed. These lawsuits could delve deeper into the family’s alleged role in Purdue’s marketing practices and potentially expose them to significant financial penalties. However, such litigation can be lengthy and complex, and again, make years of legal wrangling almost inevitable.

The Supreme Court’s decision comes at a critical juncture in the fight against the opioid crisis. According to the Centers for Disease Control and Prevention, over 500,000 people in the United States have died from opioid overdoses since 1999. The crisis continues to claim thousands of lives each year, devastating families and communities across the country.

The rejected settlement offered a potential source of funding for addiction treatment and prevention programs. With that option now off the table, the onus falls on federal and state governments to increase their own funding for these critical resources.

The Supreme Court’s decision may have thrown a curveball, but the fight against the opioid crisis is far from over. The coming months will likely see renewed efforts to hold Purdue Pharma and the Sackler family accountable, while the search for solutions to this devastating public health emergency continues.

Sources:

https://www.yahoo.com/news/supreme-court-rejects-nationwide-settlement-182142638.html
https://apnews.com/article/supreme-court-purdue-pharma-opioid-crisis-bankruptcy-9859e83721f74f726ec16b6e07101c7c
https://www.supremecourt.gov/opinions/23pdf/23-124_8nk0.pdf
https://apnews.com/article/supreme-court-purdue-pharma-opioid-crisis-bankruptcy-9859e83721f74f726ec16b6e07101c7c

The Environmental Protection Agency (EPA) has issued an enforcement alert advising water utility systems to take immediate action to safeguard the nation’s drinking water from cyberattacks.

This alert underscores the growing concern about the vulnerability of critical infrastructure to malicious cyber activities. The EPA recently reported that 70% of the water systems inspected in the U.S. do not fully comply with the requirements of the Safe Drinking Water Act. The agency also found that some of these systems have critical cybersecurity vulnerabilities, such as default passwords that have not been updated and single logins that can easily be compromised.

What could all of this mean? The EPA stated that possible impacts of cyberattacks include disruptions to water treatment and storage, damage to pumps and valves, and alteration of chemical levels to hazardous amounts.

EPA Deputy Administrator Janet McCabe said in a press release, “In many cases, systems are not doing what they are supposed to be doing, which is to have completed a risk assessment of their vulnerabilities that includes cybersecurity and to make sure that plan is available and informing the way they do business.”

The EPA highlighted additional information in the press release and enforcement alert. The warning stated that China, Russia, and Iran have disrupted some water systems with cyberattacks and may have embedded the capability to disable them in the future.

Late last year, a group linked to Iran called “Cyber Av3ngers” targeted multiple organizations, including a small Pennsylvania town’s water provider. Earlier this year, a group of “hactivists” linked to Russia attempted to disrupt operations at several Texas utilities. Also, according to the alert, a cyber group linked to China, known as “Volt Typhoon,” has compromised the information technology of multiple infrastructure systems, including drinking water, in the U.S. and its territories.

“By working behind the scenes with these hacktivist groups, now these (nation-states) have plausible deniability, and they can let these groups carry out destructive attacks. And that, to me, is a game-changer,” said Dawn Cappelli, a cybersecurity expert with the risk management firm Dragos Inc., in an interview with the Associated Press (AP).

This latest alert is in response to a previous warning issued in March regarding potential cyberattacks against U.S. water systems. The letter, sent by the White House and the EPA to all 50 U.S. governors, highlighted concerns that threat actors affiliated with the Iranian Government Islamic Revolutionary Guard Corps (IRGC) have carried out “malicious cyberattacks” against U.S. infrastructure, including drinking water systems.

In the March 18 letter, Michael S. Regan, EPA administrator, and White House National Security Adviser Jake Sullivan wrote to all 50 U.S. governors warning that:

“Drinking water and wastewater systems are an attractive target for cyberattacks because they are a lifeline critical infrastructure sector but often lack the resources and technical capacity to adopt rigorous cybersecurity practices.“

The EPA said it would provide free training for water utilities to address these issues. Water providers should avoid using default passwords, create a cybersecurity risk assessment plan, and have functioning backup systems. Many of the 50,000 U.S. water providers have limited staff and budgets, primarily focusing on meeting basic needs and regulations.

Kevin Morley, from the American Water Works Association, stressed that revamping utility systems is difficult and costly. He stated that community water systems need substantial federal funding to combat cyberattacks. He also noted that small and large water companies have unique and evolving needs, suggesting a reasonable approach for everyone.

All of this just serves as a reminder that it’s a good idea to have a backup or emergency supply of potable water. FEMA & the CDC recommend one gallon per person, per day. In other words, a two-week supply of water for a family of four is at least 56 gallons!

Whether because of a natural disaster, train-derailment, or cyber attack, it’s critical to have a plan B!

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In the United States, the majority of cars use flame retardants in their seat foams, coverings, and other parts of the vehicle cabins. This complies with the Federal Motor Vehicle Safety Standard (FMVSS 302) and helps make sure we don’t burst into flame… At least, that’s the theory.

Unfortunately, some studies have shown that exposure to certain flame retardants can lead to a host of health concerns like neurological issues, hormone disruption, and cancer-related death.

According to a recent study published in the journal Environmental Science & Technology, researchers from Duke University and the Green Science Policy Institute found that the air inside the cabins of certain cars manufactured in 2015 or later contains flame retardants, which could be harmful to human health. Furthermore, the study found that these harmful flame retardants in the air were two to five times higher during summer than in winter.

In this study, 101 American car owners with a model year of 2015 or newer were asked to participate. They were asked to hang a silicone passive sampler on their rearview mirror for seven days. A silicone passive sampler is a tool that can be used to measure various types of pollutants present in the air, including flame retardants such as brominated and organophosphate (OPEs).

According to researchers, OPEs were the most commonly found fire retardant in the silicone passive samplers.

“OPEs are increasingly used as both flame retardants and plasticizers — i.e., chemicals that change the properties of plastics — in various materials,” said Heather M. Stapleton, PhD, Ronie-Richele Garcia-Johnson Distinguished Professor in the Nicholas School of the Environment at Duke University and corresponding author of this study.

Car interiors often contain large amounts of plastic components that are sources of OPEs, including foam in the roof lining, seats, and dashboard electronics. A probable carcinogen, TCIPP, was detected in car cabins in 99% of cases, with levels ranging from 0.2 to 11,600 ng/g. TCIPP was also found to be the dominant fire retardant in car seat foam.

“TCIPP is a chlorinated organophosphate flame retardant that has been used extensively in some textiles, building insulation, and furniture,” Stapleton said. “It has been increasingly used following the phase-out of its close chemical cousin, which is considered a probable human carcinogen.”

“New data suggest that TCIPP may also be carcinogenic. Some recent epidemiology and toxicology studies also suggest TCIPP may be neurotoxic at high exposures and impact thyroid hormone regulation.”

They also found that the presence of TCIPP in foam resulted in almost nine times higher concentrations during the summer months.

Chemicals are released from plastics at higher rates in warmer areas, which means that the concentration of these chemicals in the cabin air of a vehicle parked in such areas will be higher.

What’s more, using flame retardant chemicals in car seats has not been proven to save lives. In fact, data shows that such chemicals in seat foam lead to the generation of more smoke and toxic chemicals during a fire.

“It’s also important to note that these chemicals do not stop materials from burning; they only slow the rate at which they burn, and while they burn, they are creating dangerous conditions — i.e., more smoke and toxic chemicals,” Stapleton explained. “We need to address fire safety with different technologies and approaches, such as using inherently non-flammable materials or redesigning flame retardants so they do not escape from materials over time.”

Ventilating your car during the hot summer months can help reduce the risk of exposure to flame retardants and other possible carcinogens.

“And if possible, park your car in the shade or use a sun visor to minimize the car interior temperature during the day,” she continued. “I also recommend that people open the car windows and ventilate the air before getting into the car to drive. If you have an automatic starter, it would be best to start the car for a few minutes before driving and put the air conditioner on to cool the interior temperature.”

Many vehicles also allow the ability to recirculate air within or utilize outside air when heating/cooling. Consider avoiding using the recirculating air feature.

The research raises awareness about potential environmental exposures to harmful compounds. Identifying these exposures is an important first step in clinical practice, as defining absolute risks for cancer development remains challenging. Millions of people drive or travel daily, and this exposure is obviously toxic. Research is needed to modernize regulations for material requirements in vehicles and develop alternative materials that do not contain harmful compounds.

For years, birth workers and maternal advocates in the US have been horrified by the rates of maternal mortality reported yearly. How could the best funded healthcare system in the world be failing mothers so badly?

New research by Rutgers Health and other universities suggests that it may not be. In fact, they believe the numbers have been catastrophically miscalculated due to flawed surveillance techniques.

According to the National Vital Statistics System (NVSS) of the Centers for Disease Control and Prevention (CDC), maternal death rates have tripled over the last twenty years. In 2021, the reported rate reached 32.9 deaths per 100,000 live births, significantly higher than in any other developed country. 

But, according to this new study published on March 12 in the American Journal of Obstetrics & Gynecology, maternal mortality rates in the United States have remained constant and are comparable to those in other developed nations.

Maternal deaths refer to deaths that occur during pregnancy, childbirth, or shortly after due to conditions that are directly related to or worsened by pregnancy or birth. Deaths caused by accidents or unrelated to the deceased’s pregnancy or recent delivery should not be included in the maternal death rate. Unfortunately, the researchers believe a critical flaw in the reporting methodology of the National Vital Statistics System (NVSS) often results in those unrelated deaths being added in.

Cande Ananth, the Chief of the Division of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School, is the study’s senior author. According to Ananth, “The CDC has acknowledged in the past that errors were artificially inflating numbers, but their efforts to correct those errors haven’t worked.” 

“On the contrary, official estimates show maternal death rates nearly doubling between 2018 and 2021, which clearly hasn’t happened. Still, many media outlets have reported these figures as correct, and it’s important to set the record straight,” Ananth added. “Accurate numbers are important to know where we stand and how we need to allocate money and effort to make improvements going forward.”

The study finds that improvements in obstetrical care have actually decreased death rates, but deteriorations in patient’s general health have offset those gains, resulting in keeping the overall death rate stable.

So what’s the flaw?

In 2003, the inclusion of a simple pregnancy checkbox on U.S. death certificates led to an increase in maternal death rate estimates. An errant checkmark was all that was necessary to cause a death to be included. Even when the deceased woman was over 85 years old or biologically male, if the death certificate with had a positive pregnancy checkbox, it was added to maternal rates. It was these errors resulted in the CDC discontinuing the reporting of maternal death rates entirely between 2007 and 2017.

As of 2018, the NVSS restricts the use of checkbox information to women aged between 15 and 44. However, the NVSS still categorizes a significant number of non-maternal and incidental deaths as maternal deaths.

“If you’re pregnant and die in a car crash, that’s not a maternal death,” Ananth said. “A big change driving recent increases in the official numbers stems from the tendency to include more and more cancers unrelated to pregnancy in maternal death rates. A woman who had a diagnosis of breast cancer before conception and then died after the pregnancy ended or – a woman who would have died if she’d never gotten pregnant – will be counted as a maternal death.”

The study’s authors calculated maternal death rates for two distinct periods: 1999 to 2002 and 2018 to 2021. They used two approaches to arrive at these rates. Firstly, they employed the methodology stated by the National Vital Statistics System (NVSS) and obtained figures that almost matched the officially published rates. Secondly, they limited maternal deaths to those cases where pregnancy was listed as a cause of death at least once on the death certificate.

According to the CDC method, the maternal death rate was 9.65 per 100,000 live births during the 1999-2002 period and increased to 23.6 during the 2018-2021 period. However, the alternative method calculated the death rates at 10.2 and 10.4 per 100,000 live births, respectively. These statistics radically contradict the previously held belief that maternal death rates in the United States have been increasing. Fortunately, as stated by Ananth, this does not seem to be the case.

Researchers found that healthcare during pregnancy and after delivery has improved in many areas. There was a significant reduction in maternal deaths caused by infections, hypertensive disorders, and other treatable causes. Although there was a slight narrowing of differences in death rates by race, significant differences remain, with Black women having the highest death rate and Hispanic women the lowest.

“Our study, which identified maternal deaths using a pragmatic definition-based methodology, showed stable rates of maternal mortality and a reduction in deaths from obstetrical complications,” said K. S. Joseph, lead author of the new study and a professor of obstetrics and gynecology at the University of British Columbia, Canada. “Moreover, the analysis by cause-of-death provides evidence that can enable focused prevention initiatives targeted at high-risk and vulnerable subpopulations.”

This is fantastic news. If our goal is zero deaths as a result of pregnancy complications, we cannot make accurate decisions about how to change care without accurate information. We’re excited to see further improvements in care as a result of this better data.

Sources:

https://www.cdc.gov/nchs/nvss/deaths.htm
https://www.ajog.org/article/S0002-9378(24)00005-X/fulltext
https://www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr69-02-508.pdf