Health & Fitness

Millions of people do their best to eat healthy foods and exercise regularly but forget to give their oral health the same attention in their daily health regimens. It's important to remember that without effectively addressing your dental health, it's difficult to achieve high-level physical health.

Even more concerning are the millions of people who eat a healthy diet and avoid dangerous pharmaceutical drugs, but still expose themselves to harmful chemicals in their everyday personal care products.

For example, parabens and phthalates are widely included in personal care products, as is fluoride in dental products. In addition to avoiding such chemicals, there are many natural products that can help you detoxify from such chemicals and their damaging effects.

Your Physical Health Is Linked to Good Oral Health

I am always surprised at how many people fail to realize the importance of their oral health — not flossing correctly or supporting their oral microbiome. The delicate balance of friendly bacteria in your mouth is as important to overall health as your gut microbiome.

Maintaining oral homeostasis helps protect you from potentially harmful viruses and bacteria in the environment.

Inflamed and diseased gums may also raise your risk of diabetes and heart disease.¹ In fact, 93% of people with gum disease are at risk of having Type 2 diabetes,² while periodontal disease can put you at a 20% to 180% increased risk of heart disease.³

Germ Killing Mouthwashes Are Best Avoided

Despite the widely-held belief that antimicrobial agents and alcohol mouthwashes support oral health by "killing bad bacteria," they actually do far more harm than good.

"Good bugs basically have a harder chance of setting up a healthy, balanced microbiome when you disturb them, denature them or dehydrate them with alcohol-based products," says Dr. Gerry Curatola, founder of Rejuvenation Dentistry.⁴

However, you definitely want to reduce the "bad bugs" that can remain on tooth surfaces and between teeth, encouraging gum inflammation and bacterial colonies. One of the most effective ways to do this is by flossing and/or mechanical scrubbing. Flossing may help prevent tooth decay, periodontal disease, gum disease and plaque buildup, while using a water-flossing system can help remove smaller particles that may not be removable with conventional dental floss alone.

Surveys show only 31.6% of Americans age 30 or over floss daily, even though the benefits are clear.⁵

Many who think their gums look fine may have unrecognized periodontal disease, fooled by the inflammation, which looks "plump." Some dentists recommend making flossing less tedious by doing it while you watch TV, when you can give it more time without being bored.

Another way to avoid toxic chemicals to clean your teeth is to try oil pulling. For example, oil pulling with coconut oil is also scientifically recognized to help eliminate unhealthy biofilm, debris and harmful bacteria from your teeth, acting as a natural detergent but without the damage done by chemical detergents.⁶

I currently do oil pulling with coconut oil for five to 10 minutes first thing in the morning before I eat any food.

Avoid These Dental Hazards

Thanks to the popularity of tooth whitening, many people have become aware of the importance of preserving their tooth enamel. Yet, there is another risk that fewer people are aware of, according to The New York Times.⁷

"[R]esearch shows that brushing too soon after meals and drinks, especially those that are acidic, can do more harm than good. Acid reflux poses a similar problem: While it might seem like a good idea to brush after a reflux episode, doing so can damage your teeth.

Acid attacks the teeth, eroding enamel and the layer below it, called dentin. Brushing can accelerate this process, said Dr. Howard R. Gamble, president of the Academy of General Dentistry. 'With brushing, you could actually push the acid deeper into the enamel and the dentin,' he said."

In one study, researchers evaluated a group of volunteers and the impact that brushing had on their teeth after they drank diet soda. It was found that there was an increase in dentin loss when brushing directly after drinking soda, and up to 20 minutes after consuming the beverage. There was considerably less loss, however, when brushing occurred 30 to 60 minutes afterward.⁸

For years, I've warned against the dangers of fluoride, which not only harms your microbiome but may affect your bones, brain, thyroid and pineal glands, and impair optimal blood sugar levels. Fluoride may also have an adverse impact on sleep patterns, and short-term and working memory.

Moreover, what are commonly called "silver fillings" actually contain 50% mercury,⁹ a well-known neurotoxin and dangerous environmental pollutant. The remainder of the filling is usually a mixture of copper, tin, silver and zinc. Dental amalgam is a toxic pollutant that no one should have in their mouth.

Personal Care Products Are Loaded With Hazardous Chemicals

For years, I have warned about chemicals like dioxane, parabens, phthlates, Methylisothiazolinone (MIT), toulene, triclosan, Sodium Lauryl Sulfate (SLS) and others that are put in everyday products at the public's peril. These chemicals are toxic to humans and the environment, putting people at risk of reproductive health problems and even cancer.

Certain plants are scientifically proven to mitigate the dangers of some of these products and help to detoxify your body. A study published in Food and Function demonstrated that the Indian gooseberry has been shown to be effective in preventing and lessening the toxic effects of alcohol, heavy metals, medications and environmental pathogens or fungi on the liver.¹⁰

Research published in Environmental Toxicology and Pharmacology details chlorella's ability to detoxify heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) — known carcinogens — in the human body.¹¹

Investigational New Drugs wrote that silymarin — extracted from milk thistle — administered in mice "markedly protects against chemically induced renal cancer and acts plausibly by virtue of its antioxidant, anti-inflammatory and antiproliferative activities."¹²

And finally, a study in the Journal of Drug Design, Development and Therapy says that Lycium barbarum polysaccharides (LBPs), an ingredient found in the wolfberry plant, protect the liver from injuries due to exposure to toxic chemicals or other insults and "reduce irradiation — or chemotherapy-induced organ toxicities."

The research also found that LBPs protect against "neuronal injury," amyloid-related harm and factors thought to contribute to Alzheimer's disease.¹³

Anise and Coconut Oil Effectively Treat Head Lice

While the discovery that your child has head lice is usually met with shock and surprise, it's important to remember that it's a common condition and not an indication of lack of good hygiene. However, the infestation doesn't need to be treated with dangerous insecticides.

In fact, when researchers compared a lotion made from permethrin, an insecticide in the pyrethroid family, with coconut oil and anise spray, the coconut oil/anise spray was actually more effective. I've often written about the many benefits of coconut oil for hair, whether you want to condition, moisturize or detangle it, stimulate its growth or banish dandruff.

Here is what researchers with the European Journal of Pediatrics wrote on the subject a few years ago:¹⁴

"We designed a randomized, controlled, parallel group trial involving 100 participants with active head louse infestation to investigate the activity of a coconut and anise spray and to see whether permethrin lotion is still effective, using two applications of product 9 days apart.

The spray was significantly more successful (41/50, 82.0%) cures compared with permethrin (21/50, 42.0% …) Per-protocol success was 83.3% and 44.7%, respectively.

Thirty-three people reported irritant reactions following alcohol contact with excoriated skin. We concluded that, although permethrin lotion is still effective for some people, the coconut and anise spray can be a significantly more effective alternative treatment."

More recently, researchers found that clove oil diluted in coconut oil killed lice in their studies. And, Yunnan verbena oil diluted in coconut oil "showed also a significant efficacy."¹⁵

Another Less Toxic Head Lice Treatment

Other head lice treatments that have been shared anecdotally include soaking your child's hair in vinegar, letting it dry without being rinsed out, then coating the hair with coconut oil and putting a shower cap on overnight. Within a few hours the coconut oil will suffocate the live lice; you need to comb the eggs or "nits" out with a fine-tooth comb, sometimes more than once.

Also, use the hottest settings to wash and dry any linens or clothing exposed to the lice. As with bedbugs and fleas, vacuuming is an important part of getting the situation under control because eggs live on long after the insects are dead.

Recently, a study from the Dierdre Imus Environmental Health Center at Hackensack University Medical Center¹⁶ showed that the application of 100% dimethicone — a widely-used silicon-based organic polymer — may be an effective head lice treatment for children that avoids insecticides too.

Over the span of four years, 58 children ages 3 to 12 were treated with the product LiceMD, which contains dimethicone. The researchers found that after 14 days, 96.5% of the children were rid of live lice and 80.7% were rid of viable eggs. The study recommended dimethicone as "a safe and highly effective treatment for pediatric head lice."

Hot Air May Eliminate Head Lice Without Chemicals

In 2006, the journal Pediatrics noted that head lice were becoming resistant to chemicals and that children were often missing school because of head lice:¹⁷

"Each year millions of children are infested with head lice, a condition known as pediculosis, which is responsible for tens of millions of lost school days. Head lice have evolved resistance to many of the currently used pediculicides; therefore, an effective new treatment for head lice is needed."

Researchers used six different types of hot-air blowers to examine the effectiveness of hot air against head lice, including a wall-mounted dryer, a hand-held blow dryer, and a custom-built blower dubbed "The LouseBuster." The study found that hot air itself may be useful in treatment of head lice:

"[W]e examined the effectiveness of several methods that use hot air to kill head lice and their eggs … Our findings demonstrate that one 30-minute application of hot air has the potential to eradicate head lice infestations. In summary, hot air is an effective, safe treatment and one to which lice are unlikely to evolve resistance."

Along that same line, in 2016, the U.S. Food and Drug Administration approved a device that uses hot air to kill lice.¹⁸ While the device appears to "suck up" eggs like a vacuum, it actually dehydrates eggs with heat, thereby killing them, says its manufacturer. Finally, if treating your child's head lice yourself does not appeal to you, there are specialists in some areas who will come to your home and treat your child's hair nontoxically, including combing out the nits.¹⁹

Use Natural Methods to Avoid Toxins in Cosmetic Products

While advertisers and beauty companies tout their personal care products as essential for your hygiene and health, it's more beneficial — and safer — to use natural products to avoid toxic chemicals that may harm your well-being.

Your oral health is particularly crucial to your overall health. Remember to avoid antimicrobial agents or alcohol-based mouthwashes in favor of regular flossing or mechanical scrubbing, which may help prevent gum disease, tooth decay and plaque buildup.

Be sure to purify your water and refrain from using fluoride-based toothpastes, as fluoride may bring a host of health issues such as upsetting your microbiome and impairing your sleeping patterns, blood sugar levels, and your short-term memory.

For other personal care such as your hair and scalp, you can opt for natural solutions to deal with instances like head lice by using clove oil diluted in coconut oil, hot-air blowers, or seeing a specialist who will treat the issue nontoxically.

Not only will these methods help you avoid harmful chemicals, but they may also assist in benefitting your overall health.

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In the featured video data scientist Jeremy Howard explains why wearing masks could be a key strategy to reduce the spread of novel coronavirus 2019 (COVID-19), stop lockdowns, get the economy back on track and restore society back to normalcy. Howard, founder of fast.ai, a research institute dedicated to make Deep Learning more accessible spent eight years in management consulting at McKinsey & Company before that.

In the Czech Republic, wearing masks in public has been required for the whole country since March 18, 2020. Yet, in the U.S., health officials continue to advise the public against it. February 29, 2020, as COVID-19 cases accelerated, the U.S. Surgeon General Dr. Jerome Adams tweeted a message stating, "Seriously people — STOP BUYING MASKS!"¹

Adams went on to say that masks are not effective in preventing the general public from catching coronavirus, "but if health care providers can't get them to care for patients, it puts them and communities at risk!" — statements that blatantly contradict one another. It's a common refrain that's been echoed by health officials across the U.S. — masks aren't effective, except for health care workers.

But as Howard explains in the video above, in countries that have implemented widespread use of masks in public, COVID-19 cases have remained under control. Further, masks can be made inexpensively at home, which means you're not "stealing" a mask from a health care worker by wearing one in public.

Even some hospitals are asking for donations of medical supplies including homemade masks. If such masks aren't helpful in reducing transmission of viruses like COVID-19, then why ask for them? The answer is that they are effective — as evidenced by a sizable number of studies.

In the Czech Republic, a grassroots campaign started by a social media influencer led to the widespread use of masks in public — a move that's saving lives — and the hope is that similar campaigns will spread in the U.S., the U.K. and other countries around the world where wearing masks in public is still stigmatized.

In Countries With 'Flat Curves,' Wearing Masks Is Normal

Howard cites data showing that in countries where mask wearing is "extremely normal," such as South Korea, Japan, Singapore and Hong Kong, they have managed to flatten the curve of COVID-19 cases, keeping them from spiking. Taiwan is missing from the list, as they had so few cases that they weren't included in the graph.

What happened in Taiwan to keep their cases so limited? Howard notes that they are making up to 10 million masks a day. In an editorial for The New York Times, Zeynep Tufekci, a professor of information science at the University of North Carolina, wrote:²

"[P]laces like Hong Kong and Taiwan that jumped to action early with social distancing and universal mask wearing have the pandemic under much greater control, despite having significant travel from mainland China.

Hong Kong health officials credit universal mask wearing as part of the solution and recommend universal mask wearing. In fact, Taiwan responded to the coronavirus by immediately ramping up mask production."

Even during the 1918 influenza pandemic, if you look at photographs of Americans you'll see they're usually wearing masks — something that was ordered by public health officials under penalty of fine or imprisonment.³ While it's true that health care workers absolutely need masks, the public, too, can benefit greatly from their widespread usage.

Masks and Hand-Washing Cut Virus Transmission by 75%

In 2012, researchers from the University of Michigan noted a need to establish the efficacy of nonpharmaceutical measures for mitigating pandemics, in this case, influenza. They studied whether the use of face masks and hand hygiene reduced rates of influenza and influenza-like illness (ILI) in 1,178 students living in university residence halls.⁴

The students were assigned to one of three groups: face mask and hand hygiene, face mask only or control group during the study. During weeks three to six of the study, a 75% reduction in influenza-like illness was noted among the students using hand hygiene and wearing masks in residence halls.⁵

"Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings," the researchers concluded, adding, "These nonpharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic."⁶

The study used "standard medical procedure masks with ear loops," which would likely be comparable to surgical masks. These are loose-fitting pieces of cloth designed to protect you from droplets, which are released when someone coughs or (sometimes) when they talk.

While the specifics of how COVID-19 is spread are still being investigated, according to the U.S. Centers for Disease Control and Prevention, the virus is thought to spread mainly from person-to-person contact, including through respiratory droplets that are produced when an infected person coughs or sneezes.

"These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs," the CDC states.⁷ N95 respirators offer an even higher level of protection, as they're designed with a full seal intended to protect against airborne or aerosolized pathogens.

As noted by Howard, N95 respirators should be reserved for health care workers performing a limited number of procedures that may expose them to aerosolized pathogens, while surgical masks offer sufficient protection even for most hospital workers — and certainly for the public.

Even Homemade Masks Are Effective

Even wearing homemade masks can offer protection, and as they can be made from materials that are readily available, they shouldn't carry the stigma that you're taking a mask away from a health care worker in need. Researchers with Cambridge University tested common household materials for their effectiveness as masks by exposing them to different sized particles.

Surgical masks were most effective, but all of the materials offered some protection even against very small bacteriophages that are even smaller than coronavirus.⁸ Surgical masks were 89% effective against 0.02-micron bacteriophage particles, while other materials were rated as follows:

Vacuum cleaner bag — 86%	Dish towel — 73%
Cotton blend T-shirt — 70%	Antimicrobial pillowcase — 68%
Linen — 62%	Pillowcase — 57%
Silk — 54%	100% cotton T-shirt — 51%
Scarf — 49%

The study, which was published in the journal Disaster Medicine and Public Health Preparedness, concluded that even homemade masks are better than no protection at all. Researchers explained:⁹

"The median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask …

Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection."

Indeed, Howard also cited virologist Peter Kolchinsky, who tweeted that the public should know that dose matters with COVID-19 exposure. "Masks can help anyone," he wrote, "reducing amount of virus released (even by breathing) or taken in," adding that your immune system is more effective if the infection starts with a low dose.¹⁰

Similarly, a 2008 study published in PLOS One also confirmed that homemade masks are useful. Researchers compared personal respirators, surgical masks and homemade masks worn during a variety of activities and found, “Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence.”¹¹

Yet another study from 2004 found that the use of masks was strongly protective against severe acute respiratory syndrome (SARS) in Beijing. Those who always wore a mask when going out had a 70% reduction in risk compared with those who never wore a mask.¹²

Social Media Campaign Makes Mask Wearing 'Normal'

In the Czech Republic, mask wearing is now seen as a pro-social, selfless act — a measure of kindness for your fellow humans, as wearing a mask not only protects you from others but also protects others from you. According to the CDC, people may spread COVID-19 before they show symptoms.¹³

Asymptomatic transmission of COVID-19 in the U.S. has been downplayed by health officials, but some experts have suggested it could be causing more cases than is currently realized.¹⁴ As such, wearing a mask early on, even if you're not sick, is important to protect yourself and others.

The Czech Republic mask movement was kicked off by social media influencer Petr Ludwig, who made a video about the importance of wearing masks.¹⁵ Hospitals also reached out on social media asking for homemade masks to fill in gaps of mask shortages, and people responded by not only making masks for health care workers but also for the public.

"Mask trees" emerged, on which people would hang homemade masks in public places where anyone in need could pick one up. They were made with bright colors and patterns, distinguishing them from the surgical masks being prioritized to health care workers. Meanwhile, social media and celebrities got involved, urging people to share the information, take a selfie wearing a mask and use the hashtag #masks4all.

The movement quickly spread, and in the Czech Republic the motto for wearing masks centers on kindness: "Your mask protects me, my mask protects you." Now, if you're not wearing a mask in public, you're considered to be antisocial and putting others at risk — a sharp contrast to the U.S., where mask wearing is still far from commonplace.

Signs Masks Are Going Mainstream

Still, there are signs that this may be changing. In an opinion piece for The New York Times, columnist Farhad Manjoo wrote, “It’s time to make your own face mask,” and suggested wearing one not only in a pinch but as you go about your daily life.¹⁶  Please go to The New York Times March 31, 2020, article for more resources on how to make your own masks.

“Say you need to run to the supermarket in an area where there are lots of infections, or you share an apartment with some yahoos who just came back from spring break,” Anna Davis, a researcher at the University, told the Times. Those would be good times to wear a homemade mask, she suggests. Really, any time you go out in public during a pandemic, you and others may benefit from wearing one.

CNN also highlighted the issue, stating that in the coming weeks, more governments may begin advising the public to wear face masks to protect against COVID-19. Speaking with CNN, Ivan Hung, an infectious diseases specialist at the Hong Kong University School of Medicine, explained:

"If you look at the data in Hong Kong, wearing a mask is probably the most important thing in terms of infection control. And it not only brings down the cases of coronaviruses, it also brings down the influenza. In fact, this is now the influenza season, and we hardly see any influenza cases. And that is because the masks actually protected not only against coronaviruses but also against the influenza viruses as well."¹⁷

How to Make a Homemade Mask

While the official CDC guidelines still do not include wearing masks for the general public to protect against COVID-19, The Washington Post reported that, as of March 30, 2020, the CDC was considering changing this and advising people to cover their faces when in public using do-it-yourself cloth coverings.¹⁸

“It's likely only a matter of time before other mask holdouts, most prominently the World Health Organization, follow suit,” CNN added.¹⁹ If you live in the U.S., you do not need to wait for an official announcement, however.

Follow the trends that have already been proven effective in other countries that have effectively "flattened the curve" of COVID-19 by including masks as part of their general precautions. While N95 respirators and surgical masks should be reserved for those on the front lines, it absolutely makes sense to make your own and use it whenever you're in public, even if you're not sick.

The video above shows you how to make a DIY face mask. You can reuse the mask but be sure to clean it regularly by placing it in an oven at 70 degrees C (160 degrees F) for 30 to 60 minutes or expose both sides to an ultraviolet (UV) sterilizer. There are many other videos you can also find online that provide mask making instructions if you want more alternatives, including no-sew options or making a mask out of a T-shirt.

In order to quickly test if your mask is working, Howard suggests going into a room with a smelly odor — if you smell it significantly less when you have your mask on, it's likely working. According to Howard, every country that has controlled COVID-19 and isn't in a lockdown has done all of these things:

1. Rigorous testing regardless of symptoms
2. Rigorous contact tracing
3. Quarantining infected persons
4. Masks for all

In the U.S., the use of surgical masks by the public has been stigmatized due to shortages of personal protective equipment for health care workers. However, wearing homemade masks is a step that virtually everyone can take to protect not only themselves but also the communities around them, especially when used in conjunction with other infection control measures, like hand-washing and healthy diet.

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Scientists have studied oscillating patterns of gene expression, coordinated across time and space within a tissue grown in vitro, to explore the molecular causes of a rare human hereditary disease known as spondylocostal dysostosis.

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Pairing brain scans with virtual-navigation tasks, researchers found that people make less efficient and effective plans when stressed.

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Public health scientists predict that school closures due to the COVID-19 pandemic will exacerbate the epidemic of childhood obesity in the United States. Researchers expect that COVID-19-related school closures will double out-of-school time this year for many children in the US and will exacerbate risk factors for weight gain associated with summer recess.

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New research has detailed the clinical course and treatment of Germany's first group of COVID-19 patients. Criteria may now be developed to determine the earliest point at which COVID-19 patients treated in hospitals with limited bed capacity can be safely discharged.

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Researchers have found that it's actually the mother cell that determines if its daughter cells will divide. The finding sheds new light on the cell cycle using modern imaging technologies, and could have implications for cancer drug therapy treatments.

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An antibody recovered from a survivor of the SARS epidemic in the early 2000s has revealed a potential vulnerability of the new coronavirus at the root of COVID-19.

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While the COVID-19 pandemic has already resulted in mass layoffs in several industries, other essential industries will instead face critical workforce shortages, according to a new report.

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A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot -- worsening damage to heart tissue, a new study shows. A team made the unexpected finding after a series of experiments spanning three years and involving researchers from multiple collaborating institutions.

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While the COVID-19 pandemic has already resulted in mass layoffs in several industries, other essential industries will instead face critical workforce shortages, according to a new report.

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New artificial proteins have been created to function as molecular logic gates. Like their electronic counterparts in computers, these biochemical tools can be used to program the behavior of complex systems, such as gene regulation inside human T-cells. This new advance might improve the durability of future cell-based therapies.

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Live, single-cell imaging shows cellular 'memory' of growth factor availability throughout the cell cycle (and not just snapshot of growth factor availability) influences cells' decision to replicate.

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Female eggs exposed to THC, the psychoactive ingredient in marijuana, have an impaired ability to produce viable embryos, and are significantly less likely to result in a viable pregnancy, according to an animal study.

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A group of scientists, physicians, funders, and policy makers from over 70 institutions from over 30 countries have launched an international coalition to respond to COVID-19 in resource-poor settings.

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A new study led by paleoanthropologists reveals that Lucy's species Australopithecus afarensis had an ape-like brain. However, the protracted brain growth suggests that -- as is the case in humans -- infants may have had a long dependence on caregivers.

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Neuroscientists describe how the common Toxoplasma gondii parasite prompts the loss of inhibitory signaling in the brain by altering the behavior of nearby cells called microglia.

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Researchers know that people are motivated to be vegetarian for different reasons -- the most common in western cultures being health, the environment and animal rights.

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In a new study of mice, researchers have found that an experimental drug that breaks down the amino acid cysteine slows pancreatic tumor growth by causing ferroptosis, an unusual form of cell death.

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Researchers have shown that how we respond to changes in nutrients at a molecular level plays an important role in the aging process, and this is directed by some key genetic mechanisms.

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Researchers have shown that how we respond to changes in nutrients at a molecular level plays an important role in the aging process, and this is directed by some key genetic mechanisms.

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You know that feeling in your gut? We think of it as an innate intuition that sparks deep in the belly and helps guide our actions, if we let it. It's also a metaphor for what scientists call the 'gut-brain axis,' a biological reality in which the gut and its microbial inhabitants send signals to the brain, and vice versa.

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E-cigarettes (vapes) first made headlines due to skyrocketing sales and popularity. Then reports of serious illnesses and deaths related to vaping tobacco and other substances began mounting in summer 2019. By mid-February 2020, the CDC reported more than 2,800 cases of lung injuries requiring hospitalization across all 50 states, and 68 deaths. EVALI, as this illness is now called, continues to generate questions, although emergency department visits related to vaping have been declining.

Why did vaping injuries, and even deaths, seem to occur so suddenly, even though e-cigarettes have been in use for years? Why is EVALI difficult to diagnose? What sort of lung injuries occur and what might be causing them? Why are only some people affected, while others continue to use vape products without apparent illness? And what do we know so far about possible long-term consequences of vaping?

A jump in popularity for vaping

Especially among young adults, e-cigarette use rose quickly in recent years. Among high school seniors, for example, use rates rose from nearly zero in 2011 to almost 29% in 2019, according to the Centers for Disease Control and Prevention (CDC). An estimated 9% of adults 18 and over use vaping products, according to a 2018 Gallup poll.

What is EVALI?

EVALI (e-cigarette or vaping product use associated lung injury) is an inflammatory response in the lungs triggered by inhaled substances. Given a huge range of products — many illicit or counterfeit — and many different ingredients, it’s not surprising that EVALI varies, too. It may occur as pneumonia, damage to tiny air sacs in the lungs (alveoli), or an inflammatory reaction called fibrinous pneumonitis.

Why is EVALI hard to diagnose?

Confirming a diagnosis of EVALI has been difficult because no simple lab test for it is available. Right now, doctors diagnose EVALI based on symptoms, recent use of vaping products, abnormalities found on lung scans, and no evidence of infection. Unfortunately, direct lung examination requires a bronchoscopy, which most patients are too sick to tolerate safely. Data from patients who did undergo bronchoscopy has so far failed to identify the mechanism causing lung injuries.

What do we know about what causes EVALI?

It has been hard to pinpoint the causes of EVALI. There are thousands of vaping products with varying ingredients, including illicit substances. Most likely, more than one specific product or substance is causing severe lung problems. No one knows why some people get EVALI and others do not, but part of this is probably due to the different ingredients they have inhaled.

• The most common brand associated with EVALI is Dank Vape, a brand of products containing THC, the principal psychoactive ingredient in marijuana.
• Exclusively using products with THC increases risk for EVALI. (It’s unclear whether people who used nicotine-only vapes also were exposed to vape products with THC, or whether other ingredients caused the lung injury.)
• Vitamin E acetate is strongly associated with EVALI. It is found largely in counterfeit brands (and recently in Juul products from South Korea). Vitamin E is a supplement considered safe when ingested or applied to the skin. Vitamin E acetate is an oil derivative used in vaping products as a thickener. It is found in about half of the products associated with EVALI. A recent small study found vitamin E deposits in the lung tissue of EVALI patients.
• Other chemical components, including triglycerides, plant oils, petroleum distillates, and diluent terpenes have been found in bronchoscopy specimens of EVALI patients. But none are present in all patients.

Potential long-term health concerns related to vaping

Naturally, severe illness and death from vaping-related lung injury has received a lot of attention. But there are other causes for concern about the long-term health effects of inhaled vapors, including humectants, flavorings, the heating process, and metallic coil corrosion.

• Humectants are additives used to produce vapor, such as propylene glycol or glycerol. Human respiratory cells exposed to humectants in lab experiments show increased inflammation and decreased survival. This raises concern about lung damage when people inhale humectants.
• Thousands of vape flavoring products have been reported. Because these are inhaled, not ingested, they are not regulated by the Flavor and Extract Manufacturers Association (FEMA). Diacetyl, which gives food a buttery or creamy flavor, is one example. Factory workers exposed to high levels of diacetyl in popcorn factories have developed lung injury known as “popcorn lung,” so it is regulated in the workplace by OSHA. Yet diacetyl is used in over 60% of sweet-flavored vapes, and just three to four puffs a day far exceeds exposure limits set by OSHA.
• Heating ingredients to create vapor causes their chemical components to decompose, which may also be a health hazard. For example, heating propylene glycol produces aldehydes, which expose users to five to 15 times the levels of formaldehyde vapor — a known carcinogen — found in tobacco cigarettes.
• Additionally, repeated use of refillable cartridges can cause metal heating coils to decompose, which could lead to inhaling or ingesting heavy metals. The toxic metals manganese and zinc have been isolated from used vaping devices. These can cause illness when ingested at high levels. There are also case reports of lung injury linked with cobalt in vaping liquid. This has been attributed to coil corrosion.

The bottom line

For now, the CDC and FDA strongly recommend that people avoid use of e-cigarettes or vaping products containing THC, especially from the illicit market. Health care workers must report any suspected cases of EVALI to their state department of health. In Massachusetts, new legislation bans the sale of all flavored tobacco products starting in June 2020, and imposes a tax on nicotine vaping products. The United States House and Senate have passed a bill prohibiting sales of tobacco and e-cigarettes to anyone under 21 years old. While these measures are a start, it’s also necessary to regulate the safety of the ingredients in e-cigarettes.

The post EVALI: New information on vaping-induced lung injury appeared first on Harvard Health Blog.

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Evolution is a tinkerer, not an engineer. 'Evolution does not produce novelties from scratch. It works with what already exists,' wrote Nobel laureate François Jacob in 1977, and biologists continue to find this to be true. Case in point: A team of scientists has discovered that multiple opsin proteins, known for decades to be required for vision, also function as taste receptors. The finding represents a light-independent function for opsins, and raises questions about the purpose these proteins served in ancient organisms.

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