Real vs Perceived Risk

Always seems riskier thadriving to the airport

What is risk and what makes us run to the overpriced spas and the vitamin stores in a desperate attempt to purge the “toxins” in our body. The bottom line is that its fear and with fear, the ability to make rational decisions is limited.

Consider the following points on Risk (Schneier, 2003: Beyond Fear):

  • People exaggerate spectacular but rare risks and downplay common risks. They worry more about earthquakes than they do about slipping on the bathroom floor, even though the latter kills far more people than the former.
  • People have trouble estimating risks for anything not exactly like their normal situation. Americans worry more about the risk of mugging in a foreign city, no matter how much safer it might be than where they live back home.
  • Personified risks are perceived to be greater than anonymous risks. Display a few innocent children being poisoned by money hungry capitalists who don’t care about toxic chemicals in children products and there is a major uproar
  • People underestimate risks they willingly take and overestimate risks in situations they can’t control. When people voluntarily take a risk, they tend to underestimate it. When they have no choice but to take the risk, they tend to overestimate it.
  • Similarly, people overestimate even more those risks that they can’t control but think they, or someone, should. While we can’t really prevent criminals like the two snipers who terrorized the Washington, DC, area in the fall of 2002 from killing, most people think we should be able to.
  • Last, people overestimate risks that are being talked about and remain an object of public scrutiny.

As listed above, we are more apt to perceive a unique, unfamiliar threat that we have very little control off as being high on the list of toxic things causing our health deterioration vs a familiar common risk that we may perceive as one which we can somehow control. This brings me to the idea that the common populace is typically uninformed or incorrectly informed with respect to toxicological risk. Take for instance the recent issue with BPA shown in various studies to have reproductive effects even when given is really small doses in infants. This had environmental groups and the general population in an uproar with strong accusations flung at the regulatory agencies that likely did not have adequate data to have made informed decisions. I may be an optimist but the evaluation of risk is not an exact science, regulatory agency are not out to injure people and issues such as miscalculation of BPA risk may be one of many steps in reassessment of how risk is evaluated. So a positive outcome is served. For BPA, parents may have little control over their children’s exposure. No manufacturers are going to advertise in bold red letters “contains BPA: may be harmful to your children” on baby bottles. This leaves the decision to the consumer and in almost all cases, consumers are not all well informed so there is less potential to avoid BPA –containing products. This brings us to the point. BPA is a unique risk, sensationalized by the media. Is that really the product of concern? How about a more common, lethal risk that we willingly expose our children to on a daily basis. Sugar. For a young child, feeding seems only attractive if there is sugar included somewhere – either as a prize after eating or as part of the meal, for example sugar frosted cornflakes or fruit loops or highly sugared ice cream. This is giving parents the benefit of the doubt that Twinkies would not even make this list. Anyone reading this article is likely not a person who feeds their family Twinkies. These are everyday risk that are responsible for the morbidity of a large number of people in the United States. Take diabetes for instance. Childhood diabetes is likely unrelated to toxic chemicals (as we know them, ie dioxins, PCBs etc). Rather, poor diets high in fats and sugars. I am constantly overwhelmed by the resistance to measures forcing children to eat less sugar such as taxing soft drinks, removing soda vending machines from school. These are commendable measures but not enough since these would need to be removed from the supermarkets as well as most parents provide this type of diet to their children. What kills most people? Dioxin or sugar? The answer would be sugar. Biggest killer in the USA is cardiovascular diseases. These are associated to a large part to diet. Second frequent killer is cancer. At least two third of cancers are a lot easier to prevent than we think. It is difficult to assess the contribution of environmental chemicals to the cancer death rate, the public has been working systematically to bring to light, all possible dangers – only of adequately sensationalized.

There is a lot of information that suggests that being fat and unhealthy makes the other risks factors worse. So how about we consider fixing those aspects we can control – such as dietary fats and sugars and continue public outcry on those that we have limited control over such as contamination of our environment.

What am I missing?

How many of the people munching on Twinkies and downing them with soda are worried about BPA in their diet? Not many, if I were to guess. However, consider then, the concerned parent who rightfully wants to make sure that the children are not exposed to more toxicants than they should. Here, is the level of concern regarding a proper diet higher on the list of concerns than the chemicals added to the food? The advocates for environmental toxification tend to be more vocal than the nutritionists.

Maybe that’s what needs to change. If dietary factors were corrected as quickly as BPA was taken out plastics, we could save at least 40% of the lives lost per year. That’s about 1 million people.

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LivingToxic Newsletter_January 2011

Newsletter Jan2011

Advanced glycation end products (AGEs) are a group of compounds that form constantly in the body under normal physiologic conditions. Accumulation of AGEs has been implicated in aging and progression of age related diseases such as Alzheimer’s, atherosclerosis, chronic renal failure and diabetes mellitus. Rate of formation is dramatically increased with hyperglycemia (high blood sugar) and with oxidative stress (generation of free radicals). The accumulation of AGEs in tissue is also considered as a way of determining glycemic memory, a toxic remnant of times when we were high on glucose. Read full article at LivingToxic Newsletter_January 2011.

Read More LivingToxic Newsletter_January 2011.

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Decaffeinating the Youth: A ban on energy drinks

These may need IDs too

Beverage manufacturers are not obligated to add caffeine levels to energy drink labels. It’s not surprising that after the popularity of drinks or shots such as 5-hour energy, the caffeine business has reached new highs, even worldwide. Hot coffee in the winter and cool caffeinated energy drinks in the summer and you have yourself a balanced caffeine diet. In addition to caffeine, these drinks contain supra-useless doses of Vitamin B, taurine, ginseng, guarana and carbohydrates such as sugar. Recently, several states banned alcoholic caffeinated beverages after recorded deaths of teens drinking the sugar-alcohol-caffeine elixir. This no doubt proved to be a toxic concoction. It was also shown that alcohol mixed with energy drinks had dramatically higher rates of serious alcohol-related consequences. Not surprising since all three components (sugar alcohol and caffeine) are known to be lethal at attainable doses either chronically or acutely. Caffeine can kill people. So can alcohol and sugar. Levels of taurine, guarana and ginseng found in energy drinks, though associate with encephalopathy, are not expected to amount to serious toxicity.

The aftermath of alcoholic 4loco is a recent bid by a New York Suffolk County Lawmaker to ban energy drinks for people under the age of 19. This brings about the usual question of “if they can kill people in war, at the age of 18, they can’t drink coffee?” Ludicrous, I suppose, but both kill people and I guess fighting in a war is “for the greater good” vs overdosing on caffeine to finish a term paper for a degree that may not land you a job.

The LD50 of caffeine is about 192 mg/kg in rats. This means in humans, a dose of approximately 13 grams can kill a man. Maybe even less depending on preexisting conditions such as heart and vascular issues. You would need to drink about 70 jolt endurance shots (140 ounces or 4 liters). To put it into coffee language, it would take about 108 cups of coffee to send you packing, permanently. Looking at these rather larger numbers, its not surprising that people consider caffeine consumption as safe.

Besides death, what can we say about caffeine toxicity? With respect to this present call for a ban in youths, what are the adverse effects of energy drink ingredients to youths?  Commonly reported adverse effects seen with caffeine in the quantities present in most energy drinks are insomnia, nervousness, headache, and tachycardia (increased heart rate). Four documented case reports of caffeine-associated deaths were found, as well as four separate cases of seizures associated with the consumption of energy drinks (Clauson, 2010).

An underappreciated toxicity is insomnia. Inability to rest, mend and restore on a frequent basis has a profound effect in the immune system, metabolism, aging and general cognition. While I do not agree with the bid to ban energy drinks for the youth, there is not much guarantee that Generation Y will take responsibility for their long term health.

Table 1: Levels of caffeine in popular drinks

Courtesy of Energy Fiend. Visit website for comprehensive list.

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A new reason why caffeine should be avoided!

I am not totally convinced that caffeine is that bad for you. Mostly because I ignore vast amounts of literature with data indicating that another “cup ‘o joes” may be what lands you in some sort of institution.

Research coming out of the UK investigated caffeine, stress and proneness to psychosis. The authors found a correlation between the number of cups a day (more the 7 cups) and an increase in hallucinations including hearing voices and seeing things that were not there.

It is proposed that stressors (life, school, work, being a Patriots fan etc) is associated with increase in cortisol. Cortisol is thought to play a role in the development of psychotic experiences. I appreciate that the authors did say that people who drink multiple cups of coffee a day are probably already stressed. Which comes first? The stress followed by a trip to Starbucks leading to hallucinations;  or the seventh “skinny caramel latte extra shot” followed by seeing people that are not there.

Word of advice: between the cardiovascular effects and other stimulatory effects of caffeine, recoloring of teeth and hallucinations – maybe just keep the amount of coffee under 7 per day!. If coffee was a drug, the FDA probably wouldn’t approve it.

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