Food contaminants and potential risk of diabetes development: A narrative review

Overview of foodborne hazards associated with inflammation and metabolic health

Access to safe and nutritious food is key to ensuring health and well-being and is critical to meeting the United Nations' Sustainable Development Goals. However, a synthesis of the associations between foodborne illness and malnutrition, such as metabolic health, remains a gap in the literature base. In this review, we summarized existing evidence on the impacts of biological and chemical hazards on nutrition-related health outcomes, specifically overweight and obesity, inflammation, metabolic disease, thyroid function, cancer development, and adverse birth outcomes, examining physiological mechanisms, epidemiological associations, and animal studies. Mechanisms between some foodborne hazards, such as H. pylori, and adverse pregnancy outcomes, e.g., gestational diabetes mellitus, or between nitrates and impaired thyroid function, are relatively well-studied. However, evidence on the effects of many other chemical hazards on metabolic and human health remains limited: for example, while arsenic exposure is associated with adverse birth outcomes, the limited availability of dose-response studies and other challenges limit ascertaining its causal role. Untangling these associations and physiological mechanisms is of high relevance for both high- as well as low- and middle-income countries. Emerging technologies and novel assessment techniques are needed to improve the detection and understanding of understudied and complex foodborne diseases, particularly those arising from chemical hazards. These evidence gaps are highlighted in this review, as well as the need for establishing surveillance systems for monitoring foodborne diseases and metabolic health outcomes across populations.

In silico analysis of endocrine-disrupting potential of triclosan, bisphenol A, and their analogs and derivatives

Owning to the increasing body of evidence about the ubiquitous exposure to endocrine disruptors (EDCs), particularly bisphenol A (BPA), and associated health effects, BPA has been gradually substituted with insufficiently tested structural analogs. The unmanaged excessive use of antimicrobial agents such as triclosan (TCS) during the COVID-19 outbreak has also raised concerns about its possible interferences with hormonal functions. The similarity of BPA and estradiol, as well as TCS and non-steroidal estrogens, imply that endocrine-disrupting properties of their analogs could be predicted based on the chemical structure. Hence, this study aimed to evaluate the endocrine-disrupting potential of BPA substitutes as well as TCS derivatives and degradation/biotransformation metabolites, in comparison to BPA and TCS based on their molecular properties, computational predictions of pharmacokinetics and binding affinities to nuclear receptors. Based on the obtained results several under-researched BPA analogs exhibited higher binding affinities for nuclear receptors than BPA. Notable analogs included compounds detected in receipts (DD-70, BTUM-70, TGSA, and BisOPP-A), along with a flame retardant, BDP. The possible health hazards linked to exposure to TCS and its mono-hydroxylated metabolites were also found. Further research is needed in order to elucidate the health impacts of these compounds and promote better regulation practices.

Empowering Student Pharmacists to Counsel Patients on Endocrine Disrupting Chemicals through Interactive Role-Play

Preparing the next generation of pharmacists to succeed in practice and provide premier care starts with ensuring pharmacy education standards are met and align with innovative practices and that education incorporates topics that are important to promoting health. For example, recent reports link endocrine disrupting chemicals (EDCs) to numerous diseases such as reproductive disorders, metabolic diseases, and developmental abnormalities. Considering the suboptimal awareness and knowledge about EDCs, it is imperative to provide public health education through a pharmacy curriculum. The objective of this study was to evaluate student pharmacists' perceptions of the impact of a role play activity on their knowledge of EDCs and counseling skills. A secondary objective was to explore student pharmacists' perceptions of how role play might impact their future career as a pharmacist. A retrospective qualitative study consisting of a lecture, a pre-brief, a low-fidelity simulation centered on role-play, and debrief to develop knowledge of EDCs to practice counseling skills, and a post reflection was implemented to explore this aim. Third year student pharmacists who were enrolled on the public health elective course were eligible to participate in the study. All reflections were de-identified, imported into a qualitative software, Dedoose®, Version 9.2.6 and thematically analyzed using an inductive approach. Thematic analysis revealed three master themes, which tell the story of an initial lack of familiarity with EDCs that was rectified by the lecture and low-fidelity simulation. In the first theme, we can see that all of the participants noted their positive perceptions of the low-fidelity simulation, especially the role playing on a topic they lacked familiarity with. In the second theme, participants revealed the activity's impact on their performance or behaviors. Finally, the third theme explores the future implications of a pharmacist's impact on public health. This novel study contributes to a growing body of literature on the impact of pharmacy education practices and instruction on public health. The findings suggest that pharmacy educators might consider incorporating role playing instruction for public health topics, EDCs, or topics not traditionally taught in the pharmacy curriculum.

Food packaging and endocrine disruptors

OBJECTIVES

Narrative review evaluating food contamination by endocrine disruptors present in food packaging.

DATA SOURCE

The terms "endocrine disruptors" and "food packaging" were used in combination in the PubMed, MEDLINE and SciELO databases, evaluating studies, in humans, published in Portuguese, English, French and Spanish between 1990 and 2023.

DATA SYNTHESIS

Packaging, especially those made from plastic or recycled material, is an important source of food contamination by endocrine disruptors. Bisphenols and phthalates are the endocrine disruptors most frequently associated with food contamination from packaging. However, many unknown substances and even those legally authorized can cause harm to health when exposure is prolonged or when substances with additive effects are mixed. Furthermore, the discarding of packaging can cause contamination to continue into the environment.

CONCLUSION

Although packaging materials are essential for the transport and storage of food, many of them are associated with chemical contamination. As it is not possible to exclude them from our routine, it is important to develop research aimed at identifying the endocrine disruptors present in them, including the effects of chronic exposure; and that regulatory agencies and industry come together to reduce or prevent this risk. Additionally, consumers must be instructed on how to purchase products, handle them and prepare them to reduce the migration of chemical substances into food.