Randomized Intervention Trial to Decrease Bisphenol A Urine Concentrations in Women: Pilot Study

A Personalized Intervention to Increase Environmental Health Literacy and Readiness to Change in a Northern Nevada Population: Effects of Environmental Chemical Exposure Report-Back

BACKGROUND

Interventions are needed to help people reduce exposure to harmful chemicals from everyday products and lifestyle habits. Report-back of individual exposures is a potential pathway to increasing environmental health literacy (EHL) and readiness to reduce exposures.

OBJECTIVES

Our objective was to determine if report-back of endocrine-disrupting chemicals (EDCs) can reduce EDC exposure, increase EHL, and increase readiness to change (i.e., to implement EDC exposure-reduction behaviors).

METHODS

Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before (n = 424) and after (n = 174) a report-back intervention. Participants used mail-in kits to measure urinary biomarkers of EDCs. The report-back of results included urinary levels, information about health effects, sources of exposure, and personalized recommendations to reduce exposure.

RESULTS

EHL was generally very high at baseline, especially for questions related to the general pollution. For questions related to chemical exposures, responses varied across several demographics. Statistically reliable improvements in EHL responses were seen after report-back. For readiness to change, 72% were already or planning to change their behaviors. Post-intervention, women increased their readiness (p = 0.053), while men decreased (p = 0.007). When asked what challenges they faced in reducing exposure, 79% cited not knowing what to do. This dropped to 35% after report-back. Participants with higher propylparaben were younger (p = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates (p = 0.02-0.003 and p = 0.001-0.003, respectively). After report-back, monobutyl phthalate decreased among the 48 participants who had valid urine tests before and after the intervention (p < 0.001).

CONCLUSIONS

The report-back intervention was successful as evidenced by increased EHL behaviors, increased readiness to change among women, and a decrease in monobutyl phthalate. An EHL questionnaire more sensitive to chemical exposures would help differentiate high and low literacy. Future research will focus on understanding why men decreased their readiness to change and how the intervention can be improved for all participants.

Effects of Behavioral, Clinical, and Policy Interventions in Reducing Human Exposure to Bisphenols and Phthalates: A Scoping Review

BACKGROUND

There is growing interest in evidence-based interventions, programs, and policies to mitigate exposures to bisphenols and phthalates and in using implementation science frameworks to evaluate hypotheses regarding the importance of specific approaches to individual or household behavior change or institutions adopting interventions.

OBJECTIVES

This scoping review aimed to identify, categorize, and summarize the effects of behavioral, clinical, and policy interventions focused on exposure to the most widely used and studied bisphenols [bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF)] and phthalates with an implementation science lens.

METHODS

A comprehensive search of all individual behavior, clinical, and policy interventions to reduce exposure to bisphenols and phthalates was conducted using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. We included studies published between January 2000 and November 2022. Two reviewers screened references in CADIMA, then extracted data (population characteristics, intervention design, chemicals assessed, and outcomes) for studies meeting inclusion criteria for the present review.

RESULTS

A total of 58 interventions met the inclusion criteria. We classified interventions as dietary (n = 27 ), clinical (n = 13 ), policy (n = 14 ), and those falling outside of these three categories as "other" (n = 4 ). Most interventions (81%, 47/58) demonstrated a decrease in exposure to bisphenols and/or phthalates, with policy level interventions having the largest magnitude of effect.

DISCUSSION

Studies evaluating policy interventions that targeted the reduction of phthalates and BPA in goods and packaging showed widespread, long-term impact on decreasing exposure to bisphenols and phthalates. Clinical interventions removing bisphenol and phthalate materials from medical devices and equipment showed overall reductions in exposure biomarkers. Dietary interventions tended to lower exposure with the greatest magnitude of effect in trials where fresh foods were provided to participants. The lower exposure reductions observed in pragmatic nutrition education trials and the lack of diversity (sociodemographic backgrounds) present limitations for generalizability to all populations. https://doi.org/10.1289/EHP11760.

Interventions to Reduce Exposure to Synthetic Phenols and Phthalates from Dietary Intake and Personal Care Products: a Scoping Review

PURPOSE OF REVIEW

A scoping review was conducted to identify interventions that successfully alter biomarker concentrations of phenols, glycol ethers, and phthalates resulting from dietary intake and personal care product (PCPs) use.

RECENT FINDINGS

Twenty-six interventions in populations ranging from children to older adults were identified; 11 actively removed or replaced products, 9 provided products containing the chemicals being studied, and 6 were education-only based interventions. Twelve interventions manipulated only dietary intake with a focus on bisphenol A (BPA) and phthalates, 8 studies intervened only on PCPs use and focused on a wider range of chemicals including BPA, phthalates, triclosan, parabens, and ultraviolet absorbers, while 6 studies intervened on both diet and PCPs and focused on phthalates, parabens, and BPA and its alternatives. No studies assessed glycol ethers. All but five studies reported results in the expected direction, with interventions removing potential sources of exposures lowering EDC concentrations and interventions providing exposures increasing EDC concentrations. Short interventions lasting a few days were successful. Barriers to intervention success included participant compliance and unintentional contamination of products. The identified interventions were generally successful but illustrated the influence of participant motivation, compliance, ease of intervention adherence, and the difficulty of fully removing exposures due their ubiquity and the difficulties of identifying "safer" replacement products. Policy which reduces or removes EDC in manufacturing and processing across multiple sectors, rather than individual behavior change, may have the greatest impact on population exposure.

Lifestyle interventions to reduce endocrine-disrupting phthalate and phenol exposures among reproductive age men and women: A review and future steps

Non-persistent endocrine-disrupting chemicals (EDCs), including phthalates and phenols, are ubiquitous in both the environment and human body. A growing body of epidemiologic studies have identified concerning links between EDCs and adverse reproductive and developmental health effects. Despite consistent evidence, risk assessments and policy interventions often arrive late. This presents an urgent need to identify evidence-based interventions for implementation at both clinical and community levels to reduce EDC exposure, especially in susceptible populations. The reproductive life cycle (menarche to menopause for females and after pubertal onset for males) includes some of the most vulnerable periods to environmental exposures, such as the preconception and perinatal stages, representing a key window of opportunity to intervene and prevent unfavorable health outcomes. This review aims to synthesize and assess behavioral, dietary, and residential EDC-driven interventions to develop recommendations for subsequent, larger-scale studies that address knowledge-gaps in current interventions during the reproductive life cycle. We selected 21 primary interventions for evaluation, in addition to four supplemental interventions. Among these, accessible (web-based) educational resources, targeted replacement of (known) toxic products, and personalization of the intervention through meetings and support groups, were the most promising strategies for reducing EDC concentrations. However, we document a paucity of interventions to prevent phthalate and phenol exposures during the reproductive years, especially among men. Accordingly, we recommend additional, larger clinical and community-based intervention studies to reduce EDC exposure. Specifically, future intervention studies should focus on short-term, mid-, and long-term exposure reduction to phthalates and phenols. The latter, especially, is required for the development of clinical and public health guidelines to promote reproductive and developmental health globally.

Use of Cosmetic Products in Pregnant and Breastfeeding Women and Young Children: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives

We conducted a literature review focusing on the use and health effects of cosmetics, especially among pregnant and lactating women and young children. Based on these data, we propose clinical practice guidelines for health care professionals to use for informing and advising their patients. These include the recommendations that families: (1) reduce the number and the frequency of use (grade B) and the amount applied (expert consensus) of all cosmetic products during the perinatal period and among children; (2) prefer simple, fragrance-free, and rinsable products, with short ingredient lists (expert consensus); and (3) for children, avoid industrial wipes and prefer water, with suitable soap when necessary.

Diet quality and exposure to endocrine-disrupting chemicals among US adults

Human exposure to endocrine-disrupting chemicals (EDCs) may increase risk for chronic disease. Diet is a significant source of EDC exposure, yet healthy diets recommended for chronic disease prevention have not been thoroughly examined for associations with EDC exposure. Using data from the National Health and Nutrition Examination Survey 2013-2016, we examined associations of dietary patterns with exposure to non-persistent EDCs potentially consumed through diet. EDCs were measured in spot urine samples. Diet was assessed using 24-h recalls. Multivariable linear regression was used to examine associations of three healthy diet scores [Healthy Eating Index (HEI), relative Mediterranean Diet (rMED), and Dietary Approaches to Stop Hypertension] and fast-food consumption with EDCs. In fully adjusted models, no diet was associated with exposure to the bisphenols, phthalates, or polycyclic aromatic hydrocarbons examined. A 1-point increase in rMED (of 18 possible points) was associated with 2.7% (95% CI: 1.7%, 3.8%) greater urinary nitrate. A 10-point increase in HEI (of 100 possible points) was associated with 5.3% (95% CI: 2.8%, 7.9%) greater nitrate and 6.8% (95% CI: 4.5%, 9.2%) greater perchlorate. Because perchlorate and nitrate can disrupt thyroid hormone production, we conducted an exploratory analysis to examine whether these chemicals mediate an association between diet and thyroid hormones. A 10-point increase in HEI was associated with 0.6% reduced serum total thyroxine (95% CI: 1.7%, 0.5%) among all adults, with 57.5% of the effect explained by perchlorate. Nitrate mediated an association of rMED with modestly reduced total triiodothyronine among females. Most EDCs examined had no association with the diets evaluated, indicating that recommended healthy diets were not protective against EDC exposures. As observed with two thyroid antagonists, some recommended diets may increase EDC exposures and related adverse health outcomes. Additional work should identify effective food production and processing practices to reduce dietary exposures to potentially harmful EDCs.

Interventions on Reducing Exposure to Endocrine Disrupting Chemicals in Human Health Care Context: A Scoping Review

Purpose

Inevitability of exposure to endocrine disrupting chemicals (EDCs) in daily lives of modern society is increasing interests in developing and implementing interventions to prevent or reduce harmful health effects of EDCs in various academic areas. This is a scoping review of intervention studies aimed at reducing exposure to EDCs in the text of human health care.

Methods

Scoping review methodology was used to explore the extent, range, and nature of current literature. A comprehensive systematic search of PubMed, CINAHL, Cochrane, PcycINFO, EMBASE, and RISS was performed for studies published to date. The authors followed Arksey and O’Malley’s stages; 1) identification of research questions; 2) identification of relevant studies using a total of six electronic databases; 3) study selection; 4) charting the data; and 5) collation, summarization and reporting of the data.

Results

A total of 2114 articles were retrieved, from which 13 articles were included in the final review. Among the 13 studies, 12 conducted interventions regarding dietary modification or replacement of household or personal goods. The duration of interventions ranged from at least three days to a maximum of six months, including six studies with a period of less than ten days. The participants were all healthy populations, eight of which were for adults, three for children or adolescents, and two for families. Outcome of the interventions were measured through concentration of EDCs in urine or/and house air. The effects of the interventions were inconsistent, with 11 studies showing significant changes of EDC concentration while no significant change was found in two studies.

Conclusion

The results indicate a need for randomized controlled trials, participant-centered studies promoting active participation and practices of subjects, studies specifying subgroups of participants, and studies including families as units in interventions.

Nutritional interventions to ameliorate the effect of endocrine disruptors on human reproductive health: A semi-structured review from FIGO

Background

Endocrine disrupting chemicals have harmful effects on reproductive, perinatal, and obstetric outcomes.

Objective

To analyze the evidence on nutritional interventions to reduce the negative effects of endocrine disruptors on reproductive, perinatal, and obstetric outcomes.

Search strategy

A search of MEDLINE (PubMed), Allied Health Literature (CINAHL), EMBASE, Web of Science, and the Cochrane Database was conducted from inception to May 2021.

Selection criteria

Experimental studies on human populations.

Data collection and analysis

Data were collected from eligible studies. Risk of bias assessment was completed using the Cochrane risk of bias tool and the ROBINS‐I Tool.

Results

Database searches yielded 15 362 articles. Removing 11 181 duplicates, 4181 articles underwent abstract screening, 26 articles were eligible for full manuscript review, and 16 met full inclusion criteria. Several interventions were found to be effective in reducing exposure to endocrine disruptors: avoidance of plastic containers, bottles, and packaging; avoidance of canned food/beverages; consumption of fresh and organic food; avoidance of fast/processed foods; and supplementation with vitamin C, iodine, and folic acid. There were some interventional studies examining therapies to improve clinical outcomes related to endocrine disruptors.

Conclusion

Dietary alterations can reduce exposure to endocrine disruptors, with limited data on interventions to improve endocrine‐disruptor–related clinical outcomes. This review provides useful instruction to women, their families, healthcare providers, and regulatory bodies.

Nutritional interventions shown to reduce exposure to endocrine disruptors include avoidance of canned/processed or plastic‐packaged foods. Consumption of fresh/organic foods and vitamin C, iodine, and folic acid also reduce exposure.

Impact of perinatal environmental health education intervention on exposure to endocrine disruptors during pregnancy-PREVED study: study protocol for a randomized controlled trial

Background

The suspected or actual effects on health of endocrine-disrupting chemicals (EDC) and their ubiquitous presence in everyday life justify the implementation of health promotion interventions. These interventions should ideally be applied during critical windows like pregnancy. Perinatal environmental health education interventions may help to reduce EDC exposure during pregnancy.

Methods/design

PREVED (Pregnancy, PreVention, Endocrine Disruptors) is an open-label randomized controlled trial assessing the impact of environmental health education intervention on EDC exposure during pregnancy. Inclusion, consent, and randomization take place during the first trimester. The participants are randomly allocated into three groups: (i) control group (information leaflet on EDCs), (ii) intervention group in neutral location (information leaflet and workshops in a meeting room), and (iii) intervention group in contextualized location (information leaflet and workshops in a real apartment). Workshops are organized between the second and third trimesters of pregnancy. Main outcome is the percentage of participants who reported consuming manufactured/industrial food. Secondary outcomes are as follows: (i) psycho-social dimensions, (ii) EDC concentrations in urine, (iii) EDC concentration in colostrum, and (iv) percentage of participants who reported consuming paraben-free personal care products.

Discussion

PREVED is a ground-breaking intervention research project dedicated to perinatal environmental health education that aims to identify pollutant sources in daily life and to offer accessible and realistic alternative solutions, by promoting the sharing of know-how and experience in a positive and non-alarmist approach.

Trial registration

ClinicalTrials.gov: NCT03233984 (current status: ongoing). Retrospectively registered on 31 July 2017 (https://clinicaltrials.gov/ct2/show/NCT03233984) because when the first participant was enrolled in this non-drug intervention, ClinicalTrials.gov was centered in therapeutic trials.

The World Health Organization Trial Registration Data Set is in Additional file 1.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05813-5.

BPA, BPAF and TMBPF Alter Adipogenesis and Fat Accumulation in Human Mesenchymal Stem Cells, with Implications for Obesity

Bisphenol A (BPA) is an endocrine-disrupting chemical used in the production of plastics, and is linked to developmental, reproductive, and metabolic disorders including obesity. Manufacturers have begun using ‘BPA-free’ alternatives instead of BPA in many consumer products. However, these alternatives have had much less testing and oversight, yet they are already being mass-produced and used across industries from plastics to food-contact coatings. Here, we used human female adipose-derived stem cells (hASCs), a type of adult mesenchymal stem cell, to compare the effects of BPA and BPA alternatives on adipogenesis or fat cell development in vitro. We focused on two commonly used BPA replacements, bisphenol AF (BPAF) and tetramethyl bisphenol F (TMBPF; monomer of the new valPure V70 food-contact coating). Human ASCs were differentiated into adipocytes using chemically defined media in the presence of control differentiation media with and without 17β-estradiol (E2; 10 μM), or with increasing doses of BPA (0, 0.1 and 1 μM), BPAF (0, 0.1, 1 and 10 nM), or TMBPF (0, 0.01 and 0.1 μM). After differentiation, the cells were stained and imaged to visualize and quantify the accumulation of lipid vacuoles and number of developing fat cells. Treated cells were also examined for cell viability and apoptosis (programmed cell death) using the respective cellular assays. Similar to E2, BPA at 0.1 μM and BPAF at 0.1 nM, significantly increased adipogenesis and lipid production by 20% compared to control differentiated cells (based on total lipid vacuole number to cell number ratios), whereas higher levels of BPA and BPAF significantly decreased adipogenesis (p < 0.005). All tested doses of TMBPF significantly reduced adipogenesis and lipid production by 30–40%, likely at least partially through toxic effects on stem cells, as viable cell numbers decreased and apoptosis levels increased throughout differentiation. These findings indicate that low, environmentally-relevant doses of BPA, BPAF, and TMBPF have significant effects on fat cell development and lipid accumulation, with TMBPF having non-estrogenic, anti-adipogenic effects. These and other recent results may provide a potential cellular mechanism between exposure to bisphenols and human obesity, and underscore the likely impact of these chemicals on fat development in vivo.

Effects of a dietary modification intervention on menstrual pain and urinary BPA levels: a single group clinical trial

BACKGROUND

Exposure to endocrine-disrupting chemicals (EDCs) occurs mainly through dietary intake. Due to current lifestyle trends, young people tend to consume fast food, to use disposable products, and to utilize convenient household items, all of which are major sources of EDCs. This study aimed to investigate the effects of a dietary modification intervention on menstrual pain and urinary bisphenol A (BPA) levels throughout three menstrual cycles in female college students who experienced severe menstrual pain. We also analyzed participants' adherence to the intervention and examined whether their level of adherence was associated with differences in the effects of the intervention.

METHODS

A single-group pretest and repeated posttest experimental design was employed. Thirty female college students with a score of 5 or higher on a menstrual pain scale were recruited through convenience sampling. During three menstrual cycles, menstrual pain was scored on a 10-point scale after each cycle, and urinary BPA levels were measured from the first morning urine collected after each cycle. The intervention involved three components: small-group education, follow-up monitoring, and peer support via social network communication. Statistical analyses were conducted using Friedman one-way repeated-measure analysis of variance by ranks, non-parametric two-way analysis of variance, and the Wilcoxon signed-rank test as a post-hoc test.

RESULTS

The dietary modification intervention had significant effects on menstrual pain at all three time points of menstrual cycles (χ2 = 119.64, p = 0.000) and on urinary BPA levels until the 2nd menstrual cycle (χ2 = 205.42, p = 0.000). Slightly fewer than half (43.3%) of the participants were highly adherent. Menstrual pain differed according to adherence level (F = 4.67, p = 0.032) and decreased over time through the third cycle post-intervention (F = 18.30, p = 0.000). Urinary BPA levels also decreased significantly (F = 7.94, p = 0.000), but did not differ according to adherence level.

CONCLUSIONS

The dietary modification intervention was effective and sustainable for reducing menstrual pain and urinary BPA levels. Detailed information about EDCs and dietary experiences seemed to encourage the young women to become more concerned about EDCs and to perform self-protective actions. Further experimental research is suggested to examine the relationships of EDCs with various health indicators in women.

TRIAL REGISTRATION

KCT0005472 at 2020-9-24 retrospectively registered.

Development and feasibility of randomized trial to reduce urinary bisphenols in women with obesity

BACKGROUND

Bisphenol exposure is widespread and correlated with diabetes and cardiovascular disease. Previous intervention studies have successfully lowered bisphenol exposure among women of normal weight. The primary objective of this study was to develop and test the feasibility of a 3-week behavioral change intervention, rooted in social cognitive theory, to lower a broad range of bisphenols (BPA, BPS, and BPF) in women with obesity.

METHODS

Thirty women with obesity (31.1 ± 5.6 kg/m², 21.1 ± 3.1 years) were randomly assigned to an intervention or control. The intervention included weekly face-to-face meetings to reduce bisphenol exposures from food, cosmetics, and packaged products. Fasting urinary bisphenols, creatinine, and weight were assessed at study entry and after 3 weeks.

RESULTS

The intervention was evaluated as feasible (100% of enrollment and recruitment, 96% of retention and attendance at lesson plan visits, and 96% of a collection of urine samples). Adherence to the intervention was estimated based on completion of self-monitoring records; the number of daily records completed was 7.7 ± 1.3 (mean ± SD) after week 1, 7.1 ± 1.5 after week 2, and 4.4 ± 0.9 after week 3. In secondary analysis, there was a significant treatment × time effect on creatinine-corrected urinary BPS (- 1.42 μg/g creatinine in the intervention vs. - 0.09 μg/g creatinine in the control group).

CONCLUSION

In women with obesity, the 3-week intervention was considered feasible with promising preliminary results of decreasing BPS concentrations. These data warrant future large-scale clinical trial interventions to reduce bisphenol exposure and determine whether reductions in bisphenols positively impact diabetes and cardiovascular disease risk markers. This study was retroactively registered at ClinicalTrial.gov Identifier NCT03440307.

Endocrine-disrupting chemicals: implications for human health

Since reports published in 2015 and 2016 identified 15 probable exposure-outcome associations, there has been an increase in studies in humans of exposure to endocrine-disrupting chemicals (EDCs) and a deepened understanding of their effects on human health. In this Series paper, we have reviewed subsequent additions to the literature and identified new exposure-outcome associations with substantial human evidence. Evidence is particularly strong for relations between perfluoroalkyl substances and child and adult obesity, impaired glucose tolerance, gestational diabetes, reduced birthweight, reduced semen quality, polycystic ovarian syndrome, endometriosis, and breast cancer. Evidence also exists for relations between bisphenols and adult diabetes, reduced semen quality, and polycystic ovarian syndrome; phthalates and prematurity, reduced anogenital distance in boys, childhood obesity, and impaired glucose tolerance; organophosphate pesticides and reduced semen quality; and occupational exposure to pesticides and prostate cancer. Greater evidence has accumulated than was previously identified for cognitive deficits and attention-deficit disorder in children following prenatal exposure to bisphenol A, organophosphate pesticides, and polybrominated flame retardants. Although systematic evaluation is needed of the probability and strength of these exposure-outcome relations, the growing evidence supports urgent action to reduce exposure to EDCs.

Determinants of Protective Behaviors Against Endocrine Disruptors in Young Korean Women

PURPOSE

A convenience-oriented lifestyle in young people is accompanied by greater consumption of and exposure to endocrine disruptors, which can affect reproductive health, especially in women. We aimed to identify factors that influence protective behaviors against endocrine disruptors among female college students in South Korea.

METHODS

Using a cross-sectional survey design, we recruited 199 female college students. A self-administered questionnaire was used, and data were collected at the site.

RESULTS

A healthy lifestyle, information utilization, receiving peer advice on avoiding exposure to endocrine disruptors, and a history of environmental illnesses were found to be significant factors, explaining 42.0% of the variance in protective behaviors against endocrine disruptors.

CONCLUSION

Health consequences of environmental hazards and importance of maintaining a healthy lifestyle need to be emphasized in young women's healthcare. Health professionals should advocate for and empower women to protect themselves against endocrine disruptors.

Rationale and design of a randomized controlled trial examining oral administration of bisphenol A on hepatic glucose production and skeletal muscle insulin sensitivity in adults

Previous observational studies have shown that the endocrine disrupting chemical bisphenol A (BPA) is associated with type 2 diabetes, but few studies have examined direct effects of BPA on human health. The purpose of this study is to determine whether orally administered BPA at the US Environmental Protection Agency (EPA) safe dose of 50 μg/kg body weight has an adverse effect on hepatic glucose production and skeletal muscle insulin sensitivity. Forty, non-habitually active, healthy adults of normal weight will be enrolled. Participants will begin with a 2-day baseline energy balance diet low in bisphenols in which urine and blood will be collected, and standard tests performed to assess the primary outcome measures of hepatic glucose production (via [6,6-²H] glucose infusion) and skeletal muscle insulin sensitivity (via euglycemic hyperinsulinemic clamp technique). Secondary outcome measures are fasting hormones/endocrine factors (insulin, glucose, C-peptide, Pro-insulin, adiponectin, 17-beta-estradiol, free fatty acids) related to the pathogenesis of type 2 diabetes. Participants will then be randomly assigned to a 4-day energy balance diet plus oral administration of BPA at 50 μg/kg body weight (Diet + BPA) or 4-day energy balance diet plus oral administration of placebo (Diet + No BPA); all outcome measures will be reassessed after 4 days. Findings from this study will provide a framework for other studies in this area, and provide much needed experimental evidence using gold standard measures as to whether oral BPA administration over several days poses any risk of type 2 diabetes.

•

Bisphenol A is associated with type 2 diabetes.

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Few studies have examined oral bisphenol A administration on the pathogenesis of type 2 diabetes.

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This study will examine oral bisphenol A administration on hepatic glucose [6,6-²H] suppression.

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This study will examine insulin sensitivity (euglycemic hyperinsulinemic clamp technique).

Pilot Study on the Effect of Orally Administered Bisphenol A on Glucose and Insulin Response in Nonobese Adults

OBJECTIVE

To determine the effects of varying doses of orally administered BPA on indices of glucose metabolism.

METHODS

Eleven college students (21.0 ± 0.8 years; 24.2 ± 3.9 kg/m2) were randomized in a double-blinded, crossover fashion separated by >1 week to placebo (PL), deuterated BPA at 4 µg/kg body weight (BPA-4), and deuterated BPA at 50 µg/kg body weight (BPA-50). Total BPA, glucose, insulin, and C-peptide were assessed at baseline, minutes 15, 30, 45, 60, and every 30 minutes for 2 hours in response to a glucose tolerance test.

RESULTS

There was a significant condition × time interaction for total BPA (P < 0.001) such that BPA increased more rapidly in BPA-50 than BPA-4 and PL (P = 0.003) and increased more rapidly in BPA-4 than PL (P < 0.001). There were no significant condition × time interactions on glucose, insulin, and C-peptide. Significant condition main effects were observed for glucose such that BPA-50 was significantly lower than PL (P = 0.036) and nearly lower for BPA-4 vs PL (P = 0.056). Significant condition main effects were observed such that insulin in BPA-50 was lower than BPA-4 (P = 0.021), and C-peptide in BPA-50 was lower than BPA-4 (t18 = 3.95; Tukey-adjusted P = 0.003). Glucose, insulin, and C-peptide areas under the curve for the 3-hour profile were significantly lower in BPA-50 vs PL (P < 0.05).

CONCLUSION

Orally administered BPA protocol appeared feasible and has immediate effects on glucose, insulin, and C-peptide concentrations.

Exposure assessment to bisphenol A (BPA) in Portuguese children by human biomonitoring

Exposure to bisphenol A (BPA) is known to be widespread and available data suggests that BPA can act as an endocrine disruptor. Diet is generally regarded as the dominant BPA exposure source, namely through leaching to food from packaging materials. The aim of this study was to evaluate the exposure of 110 Portuguese children (4-18 years old), divided in two groups: the regular diet group (n = 43) comprised healthy normal weight/underweight children with no dietary control; the healthy diet group (n = 67) comprised children diagnosed for obesity/overweight (without other known associated diseases) that were set on a healthy diet for weight control. First morning urine samples were collected and total urinary BPA was analyzed after enzymatic hydrolysis via on-line HPLC-MS/MS with isotope dilution quantification. Virtually, all the children were exposed to BPA, with 91% of the samples above the LOQ (limit of quantification) of 0.1 μg/L. The median (95th percentile) urinary BPA levels for non-normalized and creatinine-corrected values were 1.89 μg/L (16.0) and 1.92 μg/g creatinine (14.4), respectively. BPA levels in the regular diet group were higher than in the healthy diet group, but differences were not significant. Calculated daily BPA intakes, however, were significantly higher in children of the regular diet group than in children of healthy diet group. Median (95th percentile) daily intakes amounted to 41.6 (467) ng/kg body weight/day in the regular diet group, and 23.2 (197) ng/kg body weight/day in the healthy diet group. Multiple logistic regression analysis revealed that children in the healthy diet group had 33% lower intakes than children in the regular diet group (OR 0.67; 95% CI 0.51-0.89). For both groups, however, urinary BPA levels and daily BPA intakes were within the range reported for other children's populations and were well below health guidance values such as the European Food Safety Authority (EFSA) temporary tolerable daily intake (t-TDI) of 4 μg/kg body weight/day. In addition, lower daily BPA intakes were more likely linked with the inherent dietary approach rather than with high BMI or obesity.

Bisphenol A urinary level, its correlates, and association with cardiometabolic risks in Lebanese urban adults

Bisphenol A (BPA) is an endocrine disruptor with multiple purported metabolic effects. This study aimed to measure BPA among Lebanese population, to identify its predictors, and to explore any link to metabolic disorders. A representative sample of 501 adults from Lebanon was recruited in a cross-sectional study. Urinary BPA was measured, and data were collected for anthropometric measurements, medical history, food intake, and laboratory markers of metabolic conditions. BPA data was divided into tertiles. A total of 89% of the subjects had detectable urinary BPA levels, with an overall mean of 3.67 ± 4.75 μg/L and a mean creatinine-adjusted BPA of 2.90 ± 4.79 μg/g. There was a significant positive association with female gender and older age for being in the highest BPA tertile. BPA level was linked to metabolic syndrome (MetS), obesity, type-2 diabetes (T2D), hypertension, and dyslipidemia. After adjustment, the trend remained for BPA in association with MetS and T2D. Though urinary BPA in the Lebanese population was higher in older women, the levels were similar to world-reported figures. Our results suggest a link with metabolic disorders but not at a significant level. These findings call for longitudinal and broader sample measurements.