Whether you've been gulping down your daily vitamins since childhood or you've decided it's time to supplement your diet with the essential nutrients of a multivitamin, more and more adults are relying on subscription services to deliver their daily nutrition.
From personalized vitamins to adaptogenic mushroom powders, there's probably a vitamin subscription company that meets your needs. With most you can even fill out a questionnaire to make sure you're getting the right supplements for your needs.
But are all of these brands, with their sleek matte pill bottles and transparent capsules, created equally?
<p>Let's break down the differences between some of the leading vitamin subscription companies so you can choose the best brand for you and the environment. </p><h2>What to Look for in a Vitamin Subscription Service</h2><p>These days, there are more and more daily vitamin packs available. Dietary supplements are just another industry that has jumped onto the subscription train. As a consumer, it can be hard to cut through the noise around vitamins, supplements, superfood powders, prenatal, and other "good for you" dietary additions. </p><p>How can you be sure that a vitamin subscription service is right for you and reach your health goals? There are a few things to look out for.</p><p><strong>First, where does the company source its ingredients? </strong>Just like with food, where your vitamins come from matters. And because there aren't strict governmental regulations on supplements, it's even more important to investigate how transparent your vitamin brand is. </p><p><strong>Look for a brand that promises to include no fillers, additives, or preservatives in their products.</strong> Gluten-free and corn-free vitamins is also a good sign, as corn and wheat are often used as fillers to bulk up pills without any nutritional benefit. </p><p>Many of the brands below offer full transparency about where their products come from and even the specific suppliers they work with. You should check each ingredient of each vitamin in your subscription box. </p><p><strong>The other important question to consider from a sustainability perspective is packaging. </strong>If you're having vitamins delivered to your home every 30 days, <a data-linked-post="2645932261" href="https://www.ecowatch.com/5-sustainable-alternatives-to-plastics-2645932261.html" target="_blank">tiny plastic bottles</a>, lids, cardboard, and bubble wrap can add up quickly. </p><p>Several companies listed below offer refillable packaging and use <a data-linked-post="2630725070" href="https://www.ecowatch.com/organic-vs-conventional-food-ewg-2630725070.html" target="_blank">only materials that can be reused</a>, recycled, and often composted. Choose from a brand that wants to deliver a daily dose in as little plastic as possible. </p><h2>8 Best Vitamin Subscription Brands 2021</h2><p><em>Each product featured here has been independently selected by the writer. If you make a purchase using the links included, we may earn commission.</em><em><br/></em></p>
<p>When selecting a vitamin subscription service to commit to, it's important to consider everything from the ingredients to the packaging materials. Some subscriptions use a simple questionnaire and an algorithm to pick your vitamin regimen. Others may ask you to submit to a blood test or DNA test. How personalized you want your program to be is up to you.</p><p>We recommend consulting a healthcare professional or registered dietician if you're making any major decisions about your health. Also take into considerations any potential allergens or the availability to supporting health products at your local drugstore to build out your routine. </p><p>We think these are the year's 8 best vitamin subscription services to balance your diet and keep you and the planet thriving.</p><p><em><strong>Lizzy Briskin</strong> is the founder of Earthen Food Co. She is a chef, food writer, and recipe developer who helps people eat more mindfully for themselves and the environment, without overthinking it.</em></p>
Seed
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU3Ny9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYzMDE4MjEyOX0.UjQub-j6NLVz8WA0QAPF0YGt-tH0a_CLRfIKTf3K99E/img.png?width=980" id="1f98d" class="rm-shortcode" data-rm-shortcode-id="f56f5a619c86a4608b4fb848339136e8" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="271" />Seed
<p>Seed has carefully and thoroughly applied sustainability measures to every step of its manufacturing, packaging, and customer experience.</p><p>New customers receive a welcome kit made of compostable foam and algae paper containing a glass jar of <a href="https://www.ecowatch.com/best-probiotic-2648792610.html" data-linked-post="2648792610" target="_blank">probiotics</a> and a portable vial for travel. </p><p>When you run out, a refill comes in a compostable pouch insulated by non-GMO corn foam. Wondering how to dispose of that foam? Run it under water and watch it disappear! </p><p>Seed's zero-waste approach to packaging and shipping is setting the standard for every industry when it comes to sustainability. This is gut health with ocean health in mind.</p><p><strong>Why buy: </strong>recyclable and biodegradable packaging; vitamin refill program; plant-based; preservative-, gluten- and corn-free</p><p><strong>Price: </strong>$49.99 per month</p>GEM
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU3Ni9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxODkwOTA4Nn0.tPMTyjYmcF7OcAmZZOAB1YII_J8Q5POED9n62IQG4Bc/img.png?width=980" id="63619" class="rm-shortcode" data-rm-shortcode-id="9990850d587084fa1b16e2891bf54b3d" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" />GEM
<p>GEM is unlike any other supplement subscription on the market. Instead of sending powders or pills, your monthly GEM delivery contains chewable nutrition gummies made with whole-food ingredients like spirulina, <a href="https://www.ecowatch.com/ways-to-eat-chia-seeds-2635903173.html" data-linked-post="2635903173" target="_blank">chia seeds</a>, quinoa and dates.</p><p>Their ingredients are carefully selected from trusted sources for maximum nutritional benefits. They're also minimally processed. In fact, each bite looks like something you could mix up in a food processor at home. </p><p>What's more, your first month is delivered in a refillable tin and every subsequent month's bites come in a compostable pouch for waste-free packaging.</p><p><strong>Why buy: </strong>chewable, real food supplements made with plant-based ingredients; zero-waste, refillable packaging</p><p><span></span><strong>Price:</strong> $39 per month</p>Nurish by Nature Made
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU2My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY3MDY5NTE3OX0.e6fEFQjiZWwXwvtHT_wInjXPw0pgLVRw5DWtY2kGxIk/img.png?width=980" id="3e21b" class="rm-shortcode" data-rm-shortcode-id="d42f2d2b383f1f9eeff59dd4b1050a91" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="389" />Nurish
<p>We like that Nurish by Nature Made's subscription line of personalized vitamins come backed by 50 years of experience in the vitamin and supplement space. You have probably seen Nature Made's magnesium, calcium, or vitamin B12 at your local drug store.</p><p>Every pill is made in small batches and each order is individually inspected for quality and accuracy. Nature Made is also closely partnered with the US Pharmacopeia, a non-profit that sets purity and potency standards for supplements. </p><p>Their personalized supplement offerings include products for men's health, prenatal and post-natal vitamins, brain health, and diabetes health.</p><p><strong>Why buy:</strong> Small batch, all ingredients vetted by nutritional scientists</p><p><span></span><strong>Pric</strong><strong>e:</strong> $20+ per month</p>Care/of
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU2Mi9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY0ODY1MTYyMH0.r5na5WclQl-T_a9y-DQczxTQcw0Q23QfjTiZqIBOUh4/img.png?width=980" id="17de7" class="rm-shortcode" data-rm-shortcode-id="81e557d041e10992d87a946ac92736c6" data-rm-shortcode-name="rebelmouse-image" data-width="500" data-height="366" />Care/of
<p>Care/of has made a loud and public commitment to increasing the sustainability of their single-serving, daily dose personalized vitamins. The brand recently switched to fully compostable, plant-based packaging, the first step on their way towards a more sustainable business. </p><p>Care/of offers both western-style letter vitamins and traditional ayurvedic herbs like <a href="https://www.ecowatch.com/health-benefits-of-ashwagandha-2641294107.html" data-linked-post="2641294107" target="_blank">ashwagandha</a> and reishi for those looking for alternative solutions. </p><p>The brand is also transparent about its sourcing from around the world, and it maintains close relationships with the producers who supply their products.</p><p><strong>Why buy:</strong> plant-based, compostable vitamin packs; all products tested a minimum of three times</p><p><span></span><strong>Price: </strong>$5+ per month</p>Persona
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU2MC9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYyNjY3OTAzNX0.zUQESzO3C7nrBJcjJuwSUCMV77jlx-VkptX_yrt1Has/img.png?width=980" id="d6b1b" class="rm-shortcode" data-rm-shortcode-id="cf50ee169c7a9efc1e8a903bd45bb818" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="260" />Persona
<p>Persona is probably the most clinically-viable brand on this list. New customers take an in-depth personalized nutritional assessment designed by an in-house Medical Advisory Board of doctors and health experts. Board members include Michael Roizen Chief Wellness Officer at the Cleveland Clinic, and Robin West, Team Doctor for the Washington Nationals. This team of experts, along with Persona's nutritionists, relies on cutting-edge research to ensure the brand's recommendations are up to date and each customer gets the exact right vitamin regime for her needs.</p><p><strong>W</strong><strong>hy buy:</strong> all ingredients carefully sourced from trusted resources; all products meet FDA regulations and meet Good Manufacturing Practices standards</p><strong>Price: </strong>$0.12 per dayRitual
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU1OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1MDkzNzMwOX0.extaCx9xfCODpYTrMd-Iq86MRgBkBMH871m4cAZdJaw/img.jpg?width=980" id="07a44" class="rm-shortcode" data-rm-shortcode-id="fe2db8e572c270f58a4038808fc0d73b" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" />Ritual
<p>We like that Ritual makes all of its sources and suppliers fully traceable and available to consumers. Its website details the backstory of each carefully-sourced ingredient and the human supplier. This level of transparency is hard to find in the supplement world, and really sets Ritual apart.</p><p>This women-founded and led business takes female health seriously and provides nuanced and targeted supplements to uniquely meet women's' nutritional needs. </p><p><strong>Why</strong><strong> buy:</strong> vegan; gluten-free; allergy-free; non-GMO, free of synthetic fillers</p><p><span></span><strong>Price:</strong> $30+ per month</p>Vivo Life
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU1OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2OTM4MzYwMn0.8h7NvG97JhS4TeL9XV1EWfoEsbBXTT6VOxzOcLDW0EY/img.jpg?width=980" id="6ba6b" class="rm-shortcode" data-rm-shortcode-id="e83318f6b884615bcf1a5f2069a76a85" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="282" />Vivo Life
<p>Vivo Life is a leader in the supplement space when it comes to environmental consciousness. In addition to making only 100% plant-based supplements that cover everything from <a href="https://www.ecowatch.com/plant-based-protein-powder-2648794018.html" data-linked-post="2648794018" target="_blank">plant-based protein powders</a> to omega-3 vitamins to adaptogenic mushroom lattes, Vivo Life also plants a tree for every order made through their website. </p><p>The brand also goes a step further to ensure that all of its packaging, including shipping materials, are recyclable and made with 100% recycled materials. And the cherry on top comes from being certified carbon neutral, meaning Vivo offsets all of its carbon emissions to partners who reinvest the emissions into renewable energy projects.</p><p><strong>Why buy:</strong> Certified carbon neutral; 100% plant-based products; 1 tree planted for every website order; carbon-neutral delivery</p><p><span></span><strong>Price: </strong>$14+ per month</p>Form Nutrition
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzU1Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyODg0MDM4N30.CRUSKxGshSRIuC_TTASadpQlfHcIkwuRWhq846QKpSc/img.jpg?width=980" id="a01d8" class="rm-shortcode" data-rm-shortcode-id="1e6e9e6551f405e2f4049a3c0b10229b" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="267" />Form
<p>Form's B-Corp Certification speaks for itself: this brand is committed to doing right by the environment. All of their packaging is plastic-free.</p><p>Protein powders come in compostable bags and vitamins are shipped in reusable, recyclable glass bottles. Form also has a customer recycling program to return empty pill bottles for cleaning and reuse. </p><p>In addition to fully traceable ingredients and a plant-based commitment, Form offers some of the highest-quality and most sustainable vitamins on the market.</p><p><strong>Why buy: </strong>fully plant-based; every purchase supports the Form Feeding Fund; Certified B-Corp</p><p><span></span><strong>Price:</strong> $29+ per month</p>
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For decades, Burt's Bees has been one of the leading names in cosmetic and skincare products developed with sustainability in mind. Not only do they create high-quality products from natural ingredients, but they're attentive to the ways in which their production, packaging, and distribution methods impact the world around them. For those who value environmental stewardship and wise corporate citizenship, Burt's Bees is iconic.
Perhaps it was only a matter of time before the company expanded its all-natural skincare and cosmetic line to include products that harness the potent, holistic effects of CBD. In this post, we'll offer a quick guide to the products included in the new Burt's Bees CBD line, as well as some further comments about the company as a whole.
<h2>Why CBD?</h2><p>First, it may be worth asking why all of this matters. What's the big deal about CBD, anyway?</p><p>CBD is short for cannabidiol, one of the most prevalent, active ingredients in the cannabis plant (marijuana). CBD has been linked with a <a data-linked-post="2648638251" href="https://www.ecowatch.com/organic-cbd-oil-2648638251.html" target="_blank">number of positive, holistic health effects</a>; in fact, it's been FDA-approved as a treatment for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/" target="_blank">epilepsy and seizures</a>, while much anecdotal evidence positions it as an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/" target="_blank">anti-inflammatory agent</a>.</p><p>Crucially, legally-available CBD products have little or no <em>THC</em>, which is the psychoactive ingredient in the marijuana plant; in other words, you can enjoy the therapeutic benefits of CBD without any risk of getting high.</p><h2>The Burt's Bees Story</h2><p>With that said, let's get back to Burt's Bees.</p><p>The company was founded in the early 1980s by Burt Shavitz and Roxanne Quimby, veterans of the art community who sought refuge and contemplation in the prairies of Maine. Eventually, their interests led them to beekeeping, and into developing lip and skincare products developed from homegrown beeswax.</p><p>From the very beginning, their mission was to develop products that drew from the power of nature, while also taking seriously their responsibility to preserve, protect, and respect nature.</p><p><br/></p><p class="shortcode-media shortcode-media-rebelmouse-proxy-image">
<a href="https://upload.wikimedia.org/wikipedia/commons/0/0e/Burt%27s_Bees_Products%2C_Sep_2012.JPG" target="_blank"><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vbWVkaWEucmJsLm1zL2ltYWdlP3U9JTJGd2lraXBlZGlhJTJGY29tbW9ucyUyRjAlMkYwZSUyRkJ1cnQlMjUyN3NfQmVlc19Qcm9kdWN0cyUyQ19TZXBfMjAxMi5KUEcmaG89aHR0cHMlM0ElMkYlMkZ1cGxvYWQud2lraW1lZGlhLm9yZyZzPTYzNCZoPWM1ZTJmZTNjZWU3YTQzYmQwN2JiMzA5NTQzODJmZDE5ZTI4NTVmODFjZWExY2IwZjEwNTMyM2VmZmI3NzVhMTQmc2l6ZT05ODB4JmM9MjMzMjg4MjMwMCIsImV4cGlyZXNfYXQiOjE2MzQ2MDIzNTB9.-xDHPO21EBocR2q-qehbyHJl9kdn7xtuoQ4yGq9AWig/img.jpg" id="5f2e7" class="rm-shortcode" data-rm-shortcode-id="656954a7f6b3ca9326350734a85dea76" /></a>
<small class="image-media media-caption" placeholder="Add Photo Caption...">File:Burt's Bees Products, Sep 2012.JPG - Wikipedia</small>
</p><h3>Sustainability at Burt's Bees<br/></h3><p>There are a number of ways in which Burt's Bees continues to live out its commitment to sustainability to this day.</p><h3>All Ingredients Come from Nature</h3><p>The company strives for 100 percent natural ingredients in all of their products, and generally comes pretty close. (Their skincare products are all 95 percent natural, at a bare minimum.) Everything they make is absent <a data-linked-post="2628289611" href="https://www.ecowatch.com/chemicals-in-cosmetics-damage-childrens-health-2628289611.html" target="_blank">parabens</a> and other concerning, artificial chemicals.</p><h3>No Products are Tested on Animals</h3><p>Burt's Bees products are all "<a data-linked-post="1881939362" href="https://www.ecowatch.com/13-eco-labels-to-look-for-when-shopping-1881939362.html" target="_blank">Leaping Bunny Certified</a>." What this means is that they never test their products on animals, or ask any third parties to conduct animal testing on their behalf.</p><h3>Eco-Friendly Sourcing</h3><p>The company also demonstrates a responsible approach to sourcing, visiting all their ingredient harvesting sites to ensure a commitment to stewardship and sustainability.</p><h3>Environmentally Friendly Packaging</h3><p>All Burt's Bees products are completely recyclable. They avoid over-packaging, and their plastics are made up largely of recycled materials. </p><p>The bottom line: Burt's Bees is a company with serious eco-credentials… and that makes them a logical choice for expansion into the world of natural, sustainably sourced CBD.</p><h2>About Burt's Bees CBD Products</h2><p>Currently, Burt's Bees offers five products that are made with <a data-linked-post="2649092883" href="https://www.ecowatch.com/full-spectrum-cbd-oil-2649092883.html" target="_blank">full spectrum CBD</a>. What this means is that their CBD includes trace elements of all parts of the plant, including other <a data-linked-post="2649030477" href="https://www.ecowatch.com/cannabis-terpenes-2649030477.html" target="_blank">cannabinoids and terpenes</a>. According to many CBD experts, this provides a more potent and effective product overall. </p><p>All of the company's CBD ingredients are sourced from hemp that's grown and harvested in Colorado, using the most sustainable, organic agricultural practices. </p><p>Another important note about Burt's Bees CBD products: All of them are rigorously third-party tested. Independent lab results are key whenever you buy CBD, because it allows you to get a good sense of the purity, quality, and potency of what you're buying. You can get batch-specific test results for any Burt's Bees product simply by visiting their website.</p><h2>So, what about the specific products in the Burt's Bees CBD line?</h2>
<h2>Sustainably Sourced CBD Products</h2><p>It's important to emphasize that <em>all </em>of these products are made with transparently sourced CBD ingredients, as well as the company's usual high standards of eco-friendly packaging. In other words, this is a great opportunity to enjoy some of the benefits of CBD skincare, with all the sustainability and sound environmental stewardship that Burt's Bees is known for.</p><p>We're happy to recommend these products as good entry points into CBD skincare. Always remember, when shopping for CBD products, look for third party test results and transparency about sourcing information, all of which Burt's Bees makes readily available.</p><p><em><strong>Josh Hurst</strong> </em><em>is a journalist, critic, and essayist. He lives in Knoxville, TN, with his wife and three sons. His writing on natural health, nutrition, and supplements has appeared in Health, Shape, and Remedy Review.</em></p>
CBD Hand and Foot Cream
<a href="https://cbdburtsbees.pxf.io/vo9nv" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM0OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY3NDQwMzIwMX0.yut4GH7F5tlKS3t1NdEhuUEaqvr2XMWFGV0mdb4Lzds/img.jpg?width=980" id="cfaa6" class="rm-shortcode" data-rm-shortcode-id="2d6798afd5e1082f405a7c2d34d3ef6e" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Meanwhile, Burt's Bees also offers a cream that's perfectly soothing for your calloused feet or hard-working hands. It's made not only with 200mg of CBD, but also with a host of other natural ingredients designed to moisturize and replenish. You can get the CBD hand and foot cream for just $20. We especially recommend this product for anyone who has been thinking about trying CBD for psoriasis. </p>
$20
CBD Facial Oil
<a href="https://cbdburtsbees.pxf.io/NnvKV" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM0Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjg3NjAxNn0.5A-FpEfSoN7ltOiR8GeHZH_pHF2X3QiWJOCCVqrwlO8/img.jpg?width=980" id="70913" class="rm-shortcode" data-rm-shortcode-id="471a3ec6fee14af68b0960b05c79d581" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Looking for a natural, soothing way to revitalize your skin? Burt's Bees' facial oil combines the replenishing powers of CBD with other proven ingredients from the natural world, including jojoba, rosehip, and evening primrose oils. This face oil is made with 100mg of CBD.</p>
$35
CBD Lip Oil
<a href="https://cbdburtsbees.pxf.io/O6vRW" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM0OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNTkxNTExOH0.8Z07egVJkChyX3IOJL4Oljf28JZbt9E__uxizfFMHdQ/img.jpg?width=980" id="b5e05" class="rm-shortcode" data-rm-shortcode-id="d5ab7e24b0357917309d942794235f7a" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Burt's Bees is famous for their lip balms, so it's no surprise that they offer a CBD-infused variant. Made with 10mg of CBD, this balm has a wonderfully cooling effect on the lips. The addition of shea butter helps increase its moisturizing effect. </p>
$10
CBD Lip Treatment
<a href="https://cbdburtsbees.pxf.io/n9Z1A" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM1MC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNjI3NzYyNn0.v5b0PL5yDE_TmcZgkCe4O5Bia3hm3e7kysu6tIxQqGI/img.jpg?width=980" id="f8767" class="rm-shortcode" data-rm-shortcode-id="2cb9ac0fb9572ce3d54dffeda4f31a64" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>An additional option for those seeking CBD-powered lip care. This one is meant to be used while you sleep, allowing it plenty of time to revitalize and restore badly chapped lips. Made with 15mg CBD, you can get the Burt's Bees lip treatment online now.</p>
$14
CBD Body Cream
<a href="https://cbdburtsbees.pxf.io/KoveN" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTI2NTQyOX0.Q7UG8UhBwqPk45uu4iZP5HzSDVVDuMm0g2DY9UBRSKE/img.jpg?width=980" id="e2a7c" class="rm-shortcode" data-rm-shortcode-id="b9b0b1c5600a13e48cca46646edd195e" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Last but not least, check out the <a href="https://cbd.burtsbees.com/products/cbd-body-cream" target="_blank">Burt's Bees CBD Body Cream</a>, made with 250mg CBD plus rich, botanical scents. It's designed to leave your skin soft and fully moisturized for a full 24 hours, and you can get it for just $30.</p>
$30
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For decades, Burt's Bees has been one of the leading names in cosmetic and skincare products developed with sustainability in mind. Not only do they create high-quality products from natural ingredients, but they're attentive to the ways in which their production, packaging, and distribution methods impact the world around them. For those who value environmental stewardship and wise corporate citizenship, Burt's Bees is iconic.
Perhaps it was only a matter of time before the company expanded its all-natural skincare and cosmetic line to include products that harness the potent, holistic effects of CBD. In this post, we'll offer a quick guide to the products included in the new Burt's Bees CBD line, as well as some further comments about the company as a whole.
<h2>Why CBD?</h2><p>First, it may be worth asking why all of this matters. What's the big deal about CBD, anyway?</p><p>CBD is short for cannabidiol, one of the most prevalent, active ingredients in the cannabis plant (marijuana). CBD has been linked with a <a data-linked-post="2648638251" href="https://www.ecowatch.com/organic-cbd-oil-2648638251.html" target="_blank">number of positive, holistic health effects</a>; in fact, it's been FDA-approved as a treatment for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/" target="_blank">epilepsy and seizures</a>, while much anecdotal evidence positions it as an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/" target="_blank">anti-inflammatory agent</a>.</p><p>Crucially, legally-available CBD products have little or no <em>THC</em>, which is the psychoactive ingredient in the marijuana plant; in other words, you can enjoy the therapeutic benefits of CBD without any risk of getting high.</p><h2>The Burt's Bees Story</h2><p>With that said, let's get back to Burt's Bees.</p><p>The company was founded in the early 1980s by Burt Shavitz and Roxanne Quimby, veterans of the art community who sought refuge and contemplation in the prairies of Maine. Eventually, their interests led them to beekeeping, and into developing lip and skincare products developed from homegrown beeswax.</p><p>From the very beginning, their mission was to develop products that drew from the power of nature, while also taking seriously their responsibility to preserve, protect, and respect nature.</p><p><br/></p><p class="shortcode-media shortcode-media-rebelmouse-proxy-image">
<a href="https://upload.wikimedia.org/wikipedia/commons/0/0e/Burt%27s_Bees_Products%2C_Sep_2012.JPG" target="_blank"><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vbWVkaWEucmJsLm1zL2ltYWdlP3U9JTJGd2lraXBlZGlhJTJGY29tbW9ucyUyRjAlMkYwZSUyRkJ1cnQlMjUyN3NfQmVlc19Qcm9kdWN0cyUyQ19TZXBfMjAxMi5KUEcmaG89aHR0cHMlM0ElMkYlMkZ1cGxvYWQud2lraW1lZGlhLm9yZyZzPTYzNCZoPWM1ZTJmZTNjZWU3YTQzYmQwN2JiMzA5NTQzODJmZDE5ZTI4NTVmODFjZWExY2IwZjEwNTMyM2VmZmI3NzVhMTQmc2l6ZT05ODB4JmM9MjMzMjg4MjMwMCIsImV4cGlyZXNfYXQiOjE2MzQ2MDIzNTB9.-xDHPO21EBocR2q-qehbyHJl9kdn7xtuoQ4yGq9AWig/img.jpg" id="5f2e7" class="rm-shortcode" data-rm-shortcode-id="656954a7f6b3ca9326350734a85dea76" /></a>
<small class="image-media media-caption" placeholder="Add Photo Caption...">File:Burt's Bees Products, Sep 2012.JPG - Wikipedia</small>
</p><h3>Sustainability at Burt's Bees<br/></h3><p>There are a number of ways in which Burt's Bees continues to live out its commitment to sustainability to this day.</p><h3>All Ingredients Come from Nature</h3><p>The company strives for 100 percent natural ingredients in all of their products, and generally comes pretty close. (Their skincare products are all 95 percent natural, at a bare minimum.) Everything they make is absent <a data-linked-post="2628289611" href="https://www.ecowatch.com/chemicals-in-cosmetics-damage-childrens-health-2628289611.html" target="_blank">parabens</a> and other concerning, artificial chemicals.</p><h3>No Products are Tested on Animals</h3><p>Burt's Bees products are all "<a data-linked-post="1881939362" href="https://www.ecowatch.com/13-eco-labels-to-look-for-when-shopping-1881939362.html" target="_blank">Leaping Bunny Certified</a>." What this means is that they never test their products on animals, or ask any third parties to conduct animal testing on their behalf.</p><h3>Eco-Friendly Sourcing</h3><p>The company also demonstrates a responsible approach to sourcing, visiting all their ingredient harvesting sites to ensure a commitment to stewardship and sustainability.</p><h3>Environmentally Friendly Packaging</h3><p>All Burt's Bees products are completely recyclable. They avoid over-packaging, and their plastics are made up largely of recycled materials. </p><p>The bottom line: Burt's Bees is a company with serious eco-credentials… and that makes them a logical choice for expansion into the world of natural, sustainably sourced CBD.</p><h2>About Burt's Bees CBD Products</h2><p>Currently, Burt's Bees offers five products that are made with <a data-linked-post="2649092883" href="https://www.ecowatch.com/full-spectrum-cbd-oil-2649092883.html" target="_blank">full spectrum CBD</a>. What this means is that their CBD includes trace elements of all parts of the plant, including other <a data-linked-post="2649030477" href="https://www.ecowatch.com/cannabis-terpenes-2649030477.html" target="_blank">cannabinoids and terpenes</a>. According to many CBD experts, this provides a more potent and effective product overall. </p><p>All of the company's CBD ingredients are sourced from hemp that's grown and harvested in Colorado, using the most sustainable, organic agricultural practices. </p><p>Another important note about Burt's Bees CBD products: All of them are rigorously third-party tested. Independent lab results are key whenever you buy CBD, because it allows you to get a good sense of the purity, quality, and potency of what you're buying. You can get batch-specific test results for any Burt's Bees product simply by visiting their website.</p><h2>So, what about the specific products in the Burt's Bees CBD line?</h2>
<h2>Sustainably Sourced CBD Products</h2><p>It's important to emphasize that <em>all </em>of these products are made with transparently sourced CBD ingredients, as well as the company's usual high standards of eco-friendly packaging. In other words, this is a great opportunity to enjoy some of the benefits of CBD skincare, with all the sustainability and sound environmental stewardship that Burt's Bees is known for.</p><p>We're happy to recommend these products as good entry points into CBD skincare. Always remember, when shopping for CBD products, look for third party test results and transparency about sourcing information, all of which Burt's Bees makes readily available.</p><p><em><strong>Josh Hurst</strong> </em><em>is a journalist, critic, and essayist. He lives in Knoxville, TN, with his wife and three sons. His writing on natural health, nutrition, and supplements has appeared in Health, Shape, and Remedy Review.</em></p>
CBD Hand and Foot Cream
<a href="https://cbdburtsbees.pxf.io/vo9nv" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM0OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY3NDQwMzIwMX0.yut4GH7F5tlKS3t1NdEhuUEaqvr2XMWFGV0mdb4Lzds/img.jpg?width=980" id="cfaa6" class="rm-shortcode" data-rm-shortcode-id="2d6798afd5e1082f405a7c2d34d3ef6e" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Meanwhile, Burt's Bees also offers a cream that's perfectly soothing for your calloused feet or hard-working hands. It's made not only with 200mg of CBD, but also with a host of other natural ingredients designed to moisturize and replenish. You can get the CBD hand and foot cream for just $20. We especially recommend this product for anyone who has been thinking about trying CBD for psoriasis. </p>
$20
CBD Facial Oil
<a href="https://cbdburtsbees.pxf.io/NnvKV" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM0Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjg3NjAxNn0.5A-FpEfSoN7ltOiR8GeHZH_pHF2X3QiWJOCCVqrwlO8/img.jpg?width=980" id="70913" class="rm-shortcode" data-rm-shortcode-id="471a3ec6fee14af68b0960b05c79d581" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Looking for a natural, soothing way to revitalize your skin? Burt's Bees' facial oil combines the replenishing powers of CBD with other proven ingredients from the natural world, including jojoba, rosehip, and evening primrose oils. This face oil is made with 100mg of CBD.</p>
$35
CBD Lip Oil
<a href="https://cbdburtsbees.pxf.io/O6vRW" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM0OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNTkxNTExOH0.8Z07egVJkChyX3IOJL4Oljf28JZbt9E__uxizfFMHdQ/img.jpg?width=980" id="b5e05" class="rm-shortcode" data-rm-shortcode-id="d5ab7e24b0357917309d942794235f7a" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Burt's Bees is famous for their lip balms, so it's no surprise that they offer a CBD-infused variant. Made with 10mg of CBD, this balm has a wonderfully cooling effect on the lips. The addition of shea butter helps increase its moisturizing effect. </p>
$10
CBD Lip Treatment
<a href="https://cbdburtsbees.pxf.io/n9Z1A" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM1MC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNjI3NzYyNn0.v5b0PL5yDE_TmcZgkCe4O5Bia3hm3e7kysu6tIxQqGI/img.jpg?width=980" id="f8767" class="rm-shortcode" data-rm-shortcode-id="2cb9ac0fb9572ce3d54dffeda4f31a64" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>An additional option for those seeking CBD-powered lip care. This one is meant to be used while you sleep, allowing it plenty of time to revitalize and restore badly chapped lips. Made with 15mg CBD, you can get the Burt's Bees lip treatment online now.</p>
$14
CBD Body Cream
<a href="https://cbdburtsbees.pxf.io/KoveN" ><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MzM1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTI2NTQyOX0.Q7UG8UhBwqPk45uu4iZP5HzSDVVDuMm0g2DY9UBRSKE/img.jpg?width=980" id="e2a7c" class="rm-shortcode" data-rm-shortcode-id="b9b0b1c5600a13e48cca46646edd195e" data-rm-shortcode-name="rebelmouse-image" data-width="400" data-height="400" /></a><p>Last but not least, check out the <a href="https://cbd.burtsbees.com/products/cbd-body-cream" target="_blank">Burt's Bees CBD Body Cream</a>, made with 250mg CBD plus rich, botanical scents. It's designed to leave your skin soft and fully moisturized for a full 24 hours, and you can get it for just $30.</p>
$30
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There are new lifestyle "medicines" that are free that doctors could be prescribing for all their patients. Marko Geber / Getty Images
By Yoram Vodovotz and Michael Parkinson
The majority of Americans are stressed, sleep-deprived and overweight and suffer from largely preventable lifestyle diseases such as heart disease, cancer, stroke and diabetes. Being overweight or obese contributes to the 50% of adults who suffer high blood pressure, 10% with diabetes and additional 35% with pre-diabetes. And the costs are unaffordable and growing. About 90% of the nearly $4 trillion Americans spend annually for health care in the U.S. is for chronic diseases and mental health conditions. But there are new lifestyle "medicines" that are free that doctors could be prescribing for all their patients.
<p><a href="https://www.lifestylemedicine.org/" target="_blank" rel="noopener noreferrer">Lifestyle medicine</a> is the clinical application of healthy behaviors to prevent, treat and reverse disease. More than ever, <a href="https://adventisthealthstudy.org/?rsource=publichealth.llu.edu/adventist-health-studies" target="_blank">research</a> <a href="https://www.nurseshealthstudy.org/" target="_blank">underscores</a> <a href="https://sites.sph.harvard.edu/hpfs/" target="_blank">that</a> <a href="http://www.commissiononhealth.org/Home.aspx" target="_blank">the "pills"</a> today's physician should be prescribing for patients are the six domains of lifestyle medicine: whole food plant-based eating, regular physical activity, restorative sleep, stress management, addiction reduction or elimination, and positive psychology and social connection.</p><p>We are a primary care <a href="https://www.workpartnersblog.com/workpartners-thought-leaders-to-present-at-2019-health-benefits-conference-expo/" target="_blank">preventive medicine physician</a> and a <a href="https://mirm-pitt.net/our-people/faculty-staff-bios/yoram-vodovotz-phd/" target="_blank" rel="noopener noreferrer">computational immunologist</a>, both committed to applying state-of-the-art research to <a href="https://www.ardmoreinstituteofhealth.org/lmrsummit" target="_blank" rel="noopener noreferrer">inform the clinical practice of lifestyle medicine</a>. <a href="https://doi.org/10.3389/fmed.2020.585744" target="_blank" rel="noopener noreferrer">Our findings and recommendations</a> were just published. We highlight the key take-home points for each of the areas below.</p>
<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU0MTcxNi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjU1OTYyMn0.vx49NmD7LdCrMdp7X5fspiRcqGsz0eb4sbub_5noFrI/img.jpg?width=980" id="e93c6" class="rm-shortcode" data-rm-shortcode-id="8ffb03955ed95a9c49ad34848dd8677b" data-rm-shortcode-name="rebelmouse-image" data-width="1200" data-height="946" />
Use the Healthy Eating Plate as an evidence-based guide for creating healthy, balanced meals. ©2011, Harvard University, CC BY-NC
<h2>Whole-Food, Plant-Based Eating</h2><p>Diets high in fruits, vegetables and whole grains and lower in animal products and highly processed foods have <a href="https://eatforum.org/content/uploads/2019/01/EAT-Lancet_Commission_Summary_Report.pdf" target="_blank" rel="noopener noreferrer">been associated</a> <a href="http://doi.org/10.1001/jama.288.20.2569" target="_blank" rel="noopener noreferrer">with prevention</a> of many diseases. These diets have also <a href="http://doi.org/10.1001/jama.288.20.2569" target="_blank" rel="noopener noreferrer">improved health</a> <a href="https://doi.org/10.7812/TPP/17-025" target="_blank" rel="noopener noreferrer">and even reversed</a> common <a href="https://www.cdc.gov/chronicdisease/about/costs/index.htm" target="_blank" rel="noopener noreferrer">cardiovascular, metabolic, brain, hormonal, kidney and autoimmune diseases as well as 35% of all cancers</a>.</p><p>We believe that future research should include larger trials or new research methods with <a href="http://doi.org/10.1001/jamainternmed.2020.2790" target="_blank" rel="noopener noreferrer">emphasis on quality of diet</a>. This would include more data on the micronutrient composition and protein sources of plant versus animal-based foods – not just proportion of fat, carbohydrates and protein. Such trials should include children, as many adult disorders are seeded as early as infancy or in utero.</p><h2>Regular Physical Activity</h2><p><a href="https://wonder.cdc.gov/wonder/prevguid/m0042984/m0042984.asp" target="_blank" rel="noopener noreferrer">For decades, surgeon generals' guidelines</a> have emphasized that daily moderate-to-vigorous aerobic physical activity has both immediate and long-term health benefits. For example, why we age and the rate at which we age – chronological age versus biological age – is determined by multiple molecular processes that are directly influenced by physical activity. And now scientists are gaining a better understanding of the <a href="https://doi.org/10.1016/j.cmet.2015.05.011" target="_blank" rel="noopener noreferrer">cellular and molecular changes that exercise</a> induces to reduce disease risk.</p><p>Research priorities for scientists and physicians include obtaining a deeper understanding of the type, intensity and frequency of activity, and better insights into the molecular and <a href="https://doi.org/10.1016/bs.pmbts.2015.07.005" target="_blank" rel="noopener noreferrer">cellular alterations</a> <a href="https://doi.org/10.1016/bs.irn.2019.06.002" target="_blank" rel="noopener noreferrer">that occur with exercise</a>.</p>
<h2>Restorative Sleep</h2><p>Sleep helps the cells, organs and entire body to function better. <a href="https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html" target="_blank" rel="noopener noreferrer">Regular uninterrupted sleep</a> of seven hours per night for adults, eight to 10 hours for teenagers and 10 or more for children is necessary for <a href="https://doi.org/10.5665/sleep.3298" target="_blank" rel="noopener noreferrer">good health</a>.</p><p>Though understudied, there is evidence that high-quality sleep can reduce <a href="https://doi.org/10.5665/sleep.3298" target="_blank" rel="noopener noreferrer">inflammation, immune dysfunction, oxidative stress, and epigenetic modification</a> of DNA, all of which are <a href="https://doi.org/10.1016/S1389-9457(08)70013-3" target="_blank" rel="noopener noreferrer">associated with or cause chronic disease</a>.</p><p>Therefore, research into the biological mechanisms that underlie the restorative properties of sleep could lead to environmental or population-based and policy approaches to better align our natural sleep patterns with the demands of daily life.</p><h2>Stress Management</h2><p>Though some stress is beneficial, prolonged or extreme stress can overwhelm the brain and body. <a href="https://doi.org/10.1111/j.1467-8721.2006.00450.x" target="_blank" rel="noopener noreferrer">Chronic stress increases the risk of cardiovascular disease</a>, <a href="https://doi.org/10.1111/cns.12490" target="_blank" rel="noopener noreferrer">irritable bowel disease</a>, <a href="http://doi.org/10.1016/j.tem.2016.04.007" target="_blank" rel="noopener noreferrer">obesity</a>, depression, asthma, arthritis, autoimmune diseases, cardiovascular disease, cancer, diabetes, neurological disorders and obesity.</p><p>One of the most powerful mechanisms to reduce stress and enhance resilience is by <a href="https://doi.org/10.1056/NEJMp1917461" target="_blank" rel="noopener noreferrer">eliciting a relaxation response</a> using mind-body therapies and cognitive behavioral therapy.</p><p>More research is need to gain a better understanding of how these therapies work.</p>
<h2>Addiction Reduction and Elimination</h2><p>Many social, economic and environmental factors have fueled the national rise in substance abuse generally and, most tragically, the opioid epidemic.</p><p>Physicians and researchers are beginning to understand the underlying physiology and psychology of addiction.</p><p>Yet the <a href="https://doi.org/10.17226/25310" target="_blank" rel="noopener noreferrer">continued stigma and disjointed or absent access</a> to services remains a challenge. Clinicians and scientists need to explore how to predict who is more vulnerable to addiction and find ways of preventing it. <a href="https://doi.org/10.1080/00952990.2018.1546862" target="_blank" rel="noopener noreferrer">Treatment that incorporates integrated care</a> focused on all the patient's needs should be prioritized.</p><h2>Positive Psychology and Social Connection</h2><p>Maintaining a positive mindset through the practice of gratitude and forgiveness has a significant impact on psychological and subjective well-being, which are, in turn, associated with <a href="https://doi.org/10.1007/s10902-019-00082-1" target="_blank" rel="noopener noreferrer">physical health benefits</a>.</p><p>Social connectivity, namely the quantity and quality of our relationships, has perhaps <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674503816" target="_blank" rel="noopener noreferrer">the most powerful health benefits</a>.</p><p>Conversely, <a href="https://doi.org/10.1037/0033-2909.119.3.488" target="_blank" rel="noopener noreferrer">social isolation</a> – such as <a href="https://doi.org/10.2105/AJPH.2016.303431" target="_blank" rel="noopener noreferrer">living alone, having a small social network</a>, participating in few social activities, and feeling lonely – <a href="https://doi.org/10.1212/01.WNL.0000147473.04043.B3" target="_blank" rel="noopener noreferrer">is associated with greater mortality</a>, increased morbidity, lower immune system function, depression and cognitive decline.</p><p>Further study is needed to uncover how an individual's biology and chemistry change for the better through more social interactions.</p>
<h2>Inflammation's Role in Lifestyle-Related Diseases</h2><p>Unhealthy lifestyle behaviors produce a vicious cycle of inflammation. While inflammation is a healthy, natural way the body fights infections, injury, and stress, too much inflammation actually promotes or exacerbates the diseases described above.</p><p>The inflammatory response is complex. We have been using machine learning and computer modeling to <a href="https://www.springer.com/gp/book/9783030565091" target="_blank" rel="noopener noreferrer">understand, predict, treat and reprogram inflammation</a> – to retain the healing elements while minimizing the detrimental more chronic ones. Scientists are unraveling new mechanisms that explain how chronic stress can turn genes on and off.</p><h2>Overcoming Challenges and Barriers</h2><p>We and others who study lifestyle medicine are now discussing how we can leverage all of these approaches to improve <a href="https://www.frontiersin.org/files/Articles/585744/fmed-07-585744-HTML/image_m/fmed-07-585744-g001.jpg" target="_blank" rel="noopener noreferrer">clinical studies on the impacts</a> of lifestyle interventions.</p><p>At the same time we and our colleagues realize that there are environmental challenges and barriers that prevent many people from embracing these lifestyle fixes.</p><p>There are food deserts where healthier foods are not available or affordable. Unsafe neighborhoods, harmful chemicals and substances create constant stress. Poor education, poverty, cultural beliefs and racial and ethnic disparities and discrimination must be addressed for all people and patients to appreciate and embrace the six "pills."</p><p>The application of lifestyle medicines is particularly important now because unhealthy lifestyles have caused a pandemic of preventable chronic diseases that is now exacerbating the COVID-19 pandemic, which disproportionately <a href="https://doi.org/10.1177/1559827620950276" target="_blank" rel="noopener noreferrer">afflicts those with these conditions</a>.</p><p>Ask your doctor to <a href="https://www.guidetogoodhealth.com/Articles/LifestyleMedicine.asp" target="_blank" rel="noopener noreferrer">"prescribe" these six "pills"</a> for a longer and better life. After all, they're free, work better than or as well as medications and have no side effects!</p>
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<em><a href="https://theconversation.com/profiles/yoram-vodovotz-1193610" target="_blank">Yoram Vodovotz</a> is a </em><em>Professor of Surgery, University of Pittsburgh.<br/>
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<em><a href="https://theconversation.com/profiles/michael-parkinson-1193974" target="_blank">Michael Parkinson</a> is a </em><em>Senior Medical Director of Health and Productivity, UPMC Health Plan & Workpartners, University of Pittsburgh.<br/>
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<em>Disclosure statement: </em><em>Yoram Vodovotz is a co-founder of, and stakeholder in Immunetrics, Inc. </em><em>Michael Parkinson, MD, MPH is founder of P3 Health (Prevention, Performance & Productivity).</em>
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<em></em><em>Reposted with permission from <a href="https://theconversation.com/they-dont-come-as-pills-but-try-these-6-underprescribed-lifestyle-medicines-for-a-better-longer-life-152791" target="_blank">The Conversation</a>.</em>
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An empty school bus by a field of chemical plants in "Cancer Alley," one of the most polluted areas of the U.S. that stretches from New Orleans to Baton Rouge, where oil refineries and petrochemical plants reside alongside suburban homes. Giles Clarke / Getty Images
By David Konisky
On his first day in office President Joe Biden started signing executive orders to reverse Trump administration policies. One sweeping directive calls for stronger action to protect public health and the environment and hold polluters accountable, including those who "disproportionately harm communities of color and low-income communities."
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<p><br>To lead this effort Biden has nominated <a href="https://www.nytimes.com/2020/12/17/climate/michael-regan-epa.html" target="_blank" rel="noopener noreferrer">Michael Regan</a> to head the U.S. Environmental Protection Agency (<a href="http://www.ecowatch.com/tag/epa">EPA</a>). Regan, who currently heads North Carolina's Department of Environmental Quality, would be the first Black man to serve as EPA administrator in the agency's 50-year history. His appointment has fueled expectations that the agency will <a href="https://www.eenews.net/stories/1063721111" target="_blank" rel="noopener noreferrer">make environmental justice a top priority</a>.</p><p>The EPA <a href="https://www.epa.gov/sites/production/files/2017-09/documents/epa_office_of_environmental_justice_factsheet.pdf" target="_blank" rel="noopener noreferrer">first created an Office of Environmental Justice in 1992</a>, but I know from <a href="https://scholar.google.com/citations?user=SnSvL-sAAAAJ&hl=en" target="_blank" rel="noopener noreferrer">my research on decades of the agency's work</a> that it has never given the issue sustained attention. Despite <a href="https://doi.org/10.1088/1748-9326/10/10/105002" target="_blank" rel="noopener noreferrer">activism</a> from a growing environmental justice movement, widespread evidence that <a href="https://doi.org/10.1146/annurev-environ-082508-094348" target="_blank" rel="noopener noreferrer">pollution over-burdens poor and minority communities</a>, and a Clinton-era <a href="https://www.archives.gov/files/federal-register/executive-orders/pdf/12898.pdf" target="_blank" rel="noopener noreferrer">executive order</a> that mandated federal action, <a href="https://mitpress.mit.edu/books/failed-promises" target="_blank" rel="noopener noreferrer">the EPA has largely failed</a> to modify its programs, policies and decision-making processes in response.</p>
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<p>The agency's toolkit for taking on environmental injustice is limited. Current environmental laws do not require it to craft policies to address unequal pollution burdens, and in some cases they make it difficult to do so. Several <a href="https://www.congress.gov/bill/116th-congress/senate-bill/2236/text" target="_blank">House and Senate members have introduced</a> <a href="https://www.congress.gov/bill/116th-congress/house-bill/5986/text" target="_blank">bills to give the EPA such a mandate</a>, and they may try again in the new Congress. But the agency can get started before that happens.</p>
<h2>Boost Inclusion and Enforcement</h2><p>In my view, EPA officials can advance environmental justice immediately by striving for inclusive decision-making. This means not just listening to people of color and other communities suffering from pollution burdens, but empowering them to be involved in decisions that affect their lives.</p><p>Historically the EPA has too often taken an "announce-and-defend" approach to its decisions. By giving these communities more voice, I believe the agency will make better decisions and show that it is committed to changing its <a href="https://mitpress.mit.edu/books/inside-out" target="_blank" rel="noopener noreferrer">historical insensitivity</a> to environmental justice goals.</p><p>Second, EPA leaders should prioritize enforcement activities in overburdened communities. Numerous studies have shown that federal and state agencies conduct fewer inspections and impose lighter penalties when offending pollution sources are located in low-income neighborhoods and communities of color. Researchers have documented this pattern on issues including <a href="https://doi.org/10.1017/S0022381613000170" target="_blank" rel="noopener noreferrer">air pollution</a>, <a href="https://doi.org/10.1111/ssqu.12397" target="_blank" rel="noopener noreferrer">drinking water</a> and <a href="https://doi.org/10.1111/ssqu.12160" target="_blank" rel="noopener noreferrer">hazardous waste management</a>.</p><p>EPA enforcement has <a href="https://www.epa.gov/enforcement/enforcement-annual-results-fiscal-year-2019" target="_blank" rel="noopener noreferrer">declined for many years</a>, so the agency needs to ramp up these efforts overall. But its leaders have full discretion to target enforcement toward companies located in communities that are heavily polluted. And they can use existing resources, such as the <a href="https://www.epa.gov/ejscreen" target="_blank" rel="noopener noreferrer">EJSCREEN mapping tool</a>, to help identify these communities.</p><p>EPA officials will need to coordinate these enforcement efforts with the U.S. Department of Justice, which is responsible for prosecuting cases. In addition, the EPA will need to set clear expectations that states, which do the lion's share of enforcement, also prioritize environmental justice communities.</p>
<div id="d8964" class="rm-shortcode" data-rm-shortcode-id="df5954a2a0e147a6292baacc1851f18a"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1340399106414567425" data-partner="rebelmouse"><div style="margin:1em 0">Quoted in story re: our 25-year fight 2 reduce polluting clusters of waste transfer stations in the communities of… https://t.co/x2ytpTDetm</div> — Eddie Bautista (@Eddie Bautista)<a href="https://twitter.com/eddiebautista08/statuses/1340399106414567425">1608411025.0</a></blockquote></div>
<h2>Spotlight Discrimination and Analyze New Rules for EJ Impact</h2><p>Another thing the EPA can do now is make better use of its authority under the Civil Rights Act of 1964. Specifically, Title VI of the Civil Right Act prohibits organizations that receive federal funds from <a href="https://www.epa.gov/ogc/facts-title-vi-civil-rights-act-1964" target="_blank" rel="noopener noreferrer">discriminating against protected groups</a>. This includes state and local agencies that issue permits and carry out other activities to implement federal pollution control laws.</p><p>As external assessments have shown, the EPA has an <a href="https://publicintegrity.org/topics/environment/pollution/environmental-justice-denied/" target="_blank" rel="noopener noreferrer">abysmal record of applying Title VI</a>. Historically it has not been willing to make findings of discrimination, or in many cases even to conduct serious investigations of credible allegations. In one of the few exceptions, when Michigan officials approved siting the <a href="https://www.epa.gov/sites/production/files/2017-01/documents/final-genesee-complaint-letter-to-director-grether-1-19-2017.pdf" target="_blank" rel="noopener noreferrer">Genesee Power Station</a> in a predominantly Black neighborhood of Flint, Michigan, over community objections, the agency's finding that this was discriminatory came 25 years after the initial complaint.</p><p>The EPA can improve this process by opening its door to Title VI claims and handling them promptly and fairly. Doing so will show environmental justice communities that it takes their concerns seriously, and make clear to state and local agencies that discrimination is not acceptable.</p>
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Michael S. Regan, President Biden's nominee to lead the U.S. Environmental Protection Agency, grew up near a coal-burning power plant in North Carolina and has pledged to "enact an environmental justice framework that empowers people in all communities." NCDEQ
<p>A fourth immediate action the EPA can take is to make it routine practice to consider environmental justice in its rule-making. President Clinton's 1994 executive order suggested doing this, but unlike traditional cost-benefit analysis, it is <a href="https://doi.org/10.1017/S0143814X18000077" target="_blank">not a regular part</a> of agency decision-making.</p><p>Fortunately <a href="https://www.epa.gov/environmentaljustice/technical-guidance-assessing-environmental-justice-regulatory-analysis" target="_blank">the EPA already has guidance</a> that was published in 2016 showing how to do environmental justice analysis. Through more careful attention to how new rules affect low-income communities and communities of color, the agency can make its decisions more transparent and adopt policies with fewer impacts on already overburdened communities.</p><p>Achieving environmental justice is a long-term project, and the EPA is just one of many government agencies that need to change their ways before the U.S. can make progress. Eventually Congress will need to provide the EPA with new tools. Until that time, the agency can more effectively use its current authorities to get started.</p>
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<em>David Konisky is a professor of public and environmental affairs at Indiana University.</em><br/>
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<em>Disclosure statement: David Konisky does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</em>
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<em>Reposted with permission from <a href="https://theconversation.com/biden-has-pledged-to-advance-environmental-justice-heres-how-the-epa-can-start-152512" target="_blank">The Conversation</a>.</em>
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President Joe Biden signs executive orders in the State Dining Room at the White House on Jan. 22, 2021 in Washington, DC. Jabin Botsford / The Washington Post via Getty Images
By Andrew Rosenberg
The first 24 hours of the administration of President Joe Biden were filled not only with ceremony, but also with real action. Executive orders and other directives were quickly signed. More actions have followed. All consequential. Many provide a basis for not just undoing actions of the previous administration, but also making real advances in public policy to protect public health, safety, and the environment.
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<p>These first executive orders address huge challenges — the <a href="https://www.washingtonpost.com/health/biden-coronavirus-executive-actions/2021/01/21/9a4ab954-5b56-11eb-8bcf-3877871c819d_story.html" target="_blank" rel="noopener noreferrer">pandemic</a>, <a href="https://ucsusa.org/about/news/biden-expected-rejoin-paris-agreement-day-one-bring-us-back-international-fold" target="_blank" rel="noopener noreferrer">climate change</a>, <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government/" target="_blank" rel="noopener noreferrer">racial justice</a>, and <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/01/22/fact-sheet-president-bidens-new-executive-actions-deliver-economic-relief-for-american-families-and-businesses-amid-the-covid-19-crises/" target="_blank" rel="noopener noreferrer">economic</a> uncertainty. Among these actions, President Biden also issued a critically important order on "<a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-protecting-public-health-and-environment-and-restoring-science-to-tackle-climate-crisis/" target="_blank" rel="noopener noreferrer">Protecting Public Health and the Environment and Restoring Science to Tackle the Climate Crisis</a>," which includes some provisions that have received much less attention than they warrant. They go to the heart of much of UCS' work and advocacy.</p>
<p>Section 1 of the order is clear and inspiring:</p><p>"Policy. Our Nation has an abiding commitment to empower our workers and communities; promote and protect our public health and the environment; and conserve our national treasures and monuments, places that secure our national memory. Where the Federal Government has failed to meet that commitment in the past, it must advance environmental justice. In carrying out this charge, the Federal Government must be guided by the best science and be protected by processes that ensure the integrity of Federal decision-making. <em>It is, therefore, the policy of my Administration to listen to the science; to improve public health and protect our environment; to ensure access to clean air and water; to limit exposure to dangerous chemicals and pesticides; to hold polluters accountable, including those who disproportionately harm communities of color and low-income communities; to reduce greenhouse gas emissions; to bolster resilience to the impacts of climate change; to restore and expand our national treasures and monuments; and to prioritize both environmental justice and the creation of the well-paying union jobs necessary to deliver on these goals."</em> (emphasis added)</p>
<p>Music to my ears. Listening to the <a href="http://www.ecowatch.com/science/">science</a> is not just about the pandemic, it is about serving the needs of the public. For protecting public health and safety in our communities. For worker safety. For protections for all with justice and equity, particularly communities of color and low-income communities that have long suffered much of the burden of pollution and environmental harms. These are exactly the <a href="https://ucsusa.org/resources/roadmap-science-decisionmaking" target="_blank" rel="noopener noreferrer">changes</a> that UCS has been advocating for and will pay enormous dividends in improving public health and safety, with specific attention to ensuring those benefits are for all communities.</p><p>As ordered by our president, all agencies and departments in the Executive Branch must immediately review and address actions taken between January 20, 2017 and January 20,2021 that conflict with these policy goals. And suspend, revise, or rescind those found to be in conflict with the new president's policy goals as soon as possible.</p>
<p>For example, these actions will include, but are not limited to:</p><ul><li>Reversing the climate- and health-harming rollback of <a href="https://blog.ucsusa.org/julie-mcnamara/epa-methane-rollbacks-natural-gas-bridge-becomes-piece-of-crumbling-infrastructure" target="_blank">methane emissions</a> standards.</li><li>Redoing the fuel economy and emissions standards for cars and light trucks that were <a href="https://blog.ucsusa.org/dave-cooke/trump-administration-finalizes-car-rule-which-will-worsen-economy-public-health" target="_blank" rel="noopener noreferrer">gutted</a> under the <a href="https://blog.ucsusa.org/dave-cooke/trump-administration-finalizes-car-rule-as-handout-to-fossil-fuel-industry" target="_blank" rel="noopener noreferrer">last administration</a>, while also moving forward with <a href="https://blog.ucsusa.org/dave-cooke/under-biden-administration-a-new-decade-has-dawned-passenger-car-regulations-must-keep-up?_ga=2.51189737.1374580234.1611258477-310247935.1607440719" target="_blank" rel="noopener noreferrer">ambitious standards</a> that will dramatically reduce emissions and increase transportation electrification in the future.</li><li>Reconsidering rollbacks of <a href="https://blog.ucsusa.org/julie-mcnamara/while-you-werent-looking-energy-efficiency-became-one-of-our-nations-top-energy-resources" target="_blank" rel="noopener noreferrer">energy efficiency standards</a>.</li><li>Undoing attacks on <a href="https://blog.ucsusa.org/julie-mcnamara/epas-brazen-mercury-rule-proposal" target="_blank" rel="noopener noreferrer">mercury and air toxics</a> standards for coal plants.</li><li>Reconsidering changes to the way <a href="https://blog.ucsusa.org/julie-mcnamara/manipulation-of-benefit-cost-analysis-hides-bodies-in-the-fine-print" target="_blank" rel="noopener noreferrer">costs and benefits</a> are calculated.</li><li>Revoking the rule that <a href="https://ucsusa.org/about/news/epa-rule-restricting-science-puts-agencys-mission-risk-0" target="_blank" rel="noopener noreferrer">limits the science</a> that the EPA can use in rulemaking.</li><li>Reestablishing the interagency working group on the "<a href="https://blog.ucsusa.org/rachel-cleetus/the-social-cost-of-carbon-underscores-an-obvious-fact-climate-change-is-costly" target="_blank" rel="noopener noreferrer">social cost</a> of greenhouse gas emissions to determine the social benefits of limiting global warming as critical input to evaluating regulatory proposals, and requiring an interim SCC, SCN and SCM within 30 days which will be used until final values are published.</li><li>Erasing the shortcutting of <a href="https://blog.ucsusa.org/derrick-jackson/environmental-racism-in-action-the-trump-administrations-plans-to-gut-nepa" target="_blank" rel="noopener noreferrer">environmental reviews</a> of federal projects under the National Environmental Policy Act (NEPA).</li></ul><p>Within 30 days agencies must submit a full list of actions from the last four years that will be considered for review and revision or cancellation within the next year.</p>
<h3>(Measured) Excitement at UCS</h3><p>I danced around the room with my dogs at the push toward restoring NEPA analyses. Doing a thorough NEPA analysis, which the shortcuts held back, means that agencies must seek public input more extensive than just notice and public comment during the rulemaking process. And critically it means that alternatives to a proposed action must be considered and vetted with the public, with the full analysis available to anyone who wants to understand the ramifications of a particular policy action. That includes, now with the new order, considering the impacts of climate change and on environmental justice. We need these analyses and public discussion — they are a key part of decisionmaking in our constitutional democracy.</p><p>I am definitely not the only one at UCS who gets excited by these wonky, technical pronouncements.</p><p>My colleague <a href="https://blog.ucsusa.org/author/jonna-hamilton" target="_blank" rel="noopener noreferrer">Jonna Hamilton</a> raised a glass to toast the drive to more ambitious fuel economy and emissions standards, saying it's time to ensure that the auto companies make the next generation of vehicles that consumers want to drive. Strong standards will help the transition to electric vehicles, which <a href="https://blog.ucsusa.org/dave-reichmuth/are-electric-vehicles-really-better-for-the-climate-yes-heres-why" target="_blank" rel="noopener noreferrer">reduce emissions</a>, no matter where they are charged.</p><p><a href="https://blog.ucsusa.org/author/rachel-cleetus" target="_blank" rel="noopener noreferrer">Rachel Cleetus</a> breathed a sigh of relief that the government will be restoring the use of the social cost of carbon (and the social cost of methane and the social cost of nitrous oxide) for regulatory purposes. And that the Council on Environmental Quality will be updating its guidance on the consideration of greenhouse gases for NEPA analyses. With <a href="https://blog.ucsusa.org/brenda-ekwurzel/2020-ends-hottest-decade-on-record-decadal-temperature-chart-as-iconic-as-co2-keeling-curve" target="_blank" rel="noopener noreferrer">2020 ending the hottest decade on record</a> globally, and bringing a record-breaking <a href="https://www.noaa.gov/stories/record-number-of-billion-dollar-disasters-struck-us-in-2020" target="_blank" rel="noopener noreferrer">22 extreme weather and climate related disasters</a> in the US that killed at least 262 people and each cost more than a billion dollars, it's high time we took the costs of climate change seriously!</p><p>And <a href="https://blog.ucsusa.org/author/gretchen-goldman" target="_blank" rel="noopener noreferrer">Gretchen Goldman</a>, swinging her young sons in the air in joy, was thrilled to see that revoking the limits on science was named as a top priority of the Biden administration! The so-called Transparency Rule would do <a href="https://ucsusa.org/about/news/epa-rule-restricting-science-puts-agencys-mission-risk-0" target="_blank" rel="noopener noreferrer">widespread damage</a> to the EPA's ability to use the best available science on everything from air pollution standards to pesticide regulation. Finding a way to get rid of <a href="https://undark.org/2019/11/21/opinion-trump-epa-transparency-rule/" target="_blank" rel="noopener noreferrer">this harmful rule</a> will allow the EPA to fully carry out its mission of protecting public health and the environment.</p><p>This order does a lot more to revoke bad policies. It also calls on the Secretary of the Interior to review the <a href="http://www.ecowatch.com/tag/national-monuments">national monuments</a> with a view to restoring them to 2017 boundaries. It declares the environmental review of oil and gas leasing in the Arctic National Wildlife Refuge inadequate, placing a moratorium on leasing. It revokes the permit for the Keystone XL pipeline because it is inconsistent with the economic and climate goals of the new administration. And part of those stated goals as laid out in the policy section of the order includes respecting the voices of the Indigenous communities whose lands, livelihoods, and culture were given short shrift in the permitting process to date.</p>
<h3>Another Less Noticed, Even Wonkier, Remarkable Day One Action</h3><p>Another <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/modernizing-regulatory-review/" target="_blank" rel="noopener noreferrer">Presidential Directive</a> of critical importance to the mission and work of UCS is titled "Modernizing Regulatory Review." It calls for the Office of Management and Budget, through its Office of Information and Regulatory Affairs (OIRA), to re-focus the role and content of reviews of regulations proposed by federal agencies.</p><p>The new process OIRA is tasked with designing and implementing in consultation with agencies across the government will:</p><ul><li>Reflect new developments in science.</li><li>Fully account for benefits of regulations that are difficult to quantify.</li><li>Take into account the distributional consequences of regulations to ensure they appropriately benefit, and not inappropriately burden, disadvantaged, vulnerable or marginalized communities.</li><li>Find ways for OIRA to work more proactively and effectively with agencies to obtain the benefits to the public that come with regulatory initiatives.</li><li>Improve efficiency, transparency, and inclusiveness in the interagency review process.</li></ul><p>For example, consider the review of the previous administration's rules that would limit the science that the EPA can use as the basis for implementing public health protections. That rule requires that the underlying data of any study be publicly available to be fully considered by the agency. That would necessarily exclude studies that rely on confidential health information in most cases, or give those studies lower credence, not on the basis of their scientific merit, but because of an artificial barrier labeled as "transparency" concerns. <a href="https://blog.ucsusa.org/genna-reed/we-told-omb-why-epas-so-called-transparency-rule-is-a-trap" target="_blank" rel="noopener noreferrer">OIRA has reviewed</a> both the proposed and final rules and deemed them not economically significant, despite the fact that they affect all of the work that EPA does. Under an improved review process, the rule would have never moved through the process because it will in fact overburden, yet again, vulnerable communities.</p><p>Though OIRA's work is often behind the scenes and rarely fully acknowledged, the agency plays a critical role in either advancing or hindering the regulatory process. In order for the Biden administration to meet its goals on climate, the pandemic, racial justice, and economic recovery, that process has to become better and more effective. OIRA involvement must add real value to the benefit of the public. It is heartening and remarkable that this directive is a Day One action of the new administration.</p>
<h3>Toward Real Action</h3><p>By no means do the first executive orders accomplish the huge tasks before this administration. But it is an extraordinarily good start.</p><p>Now these orders need to turn into real actions from top to bottom in the federal government and in partnership with state and tribal governments as well as internationally. None of the challenges we face will be solved without action at all levels.</p><p>Our excitement at UCS is tempered by the enormous amount of work that needs to turn this promising vision into a reality. We will make our voices heard to hold the administration and Congress to account. Please join us in doing so.</p>
<p><em>Andrew Rosenberg is the director of the UCS Center for Science and Democracy.</em></p><p><em>Reposted with permission from <a href="https://blog.ucsusa.org/andrew-rosenberg/consequential-biden-actions-nobody-is-talking-about" target="_blank">Union of Concerned Scientists</a>.</em></p>
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A Healthy Microbiome Builds a Strong Immune System That Could Help Defeat COVID-19
25 January
Health + Wellness
Probiotic rich foods. bit245 / iStock / Getty Images Plus
By Ana Maldonado-Contreras
Takeaways
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
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In the past two decades scientists have learned our bodies are home to more bacterial cells than human ones. This community of bacteria that lives in and on us – called the microbiome – resembles a company, with each microbe species performing specialized jobs but all working to keep us healthy. In the gut, the bacteria balance the immune response against pathogens. These bacteria ensure the immune response is effective but not so violent that it causes collateral damage to the host.
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Bacteria in our guts can elicit an effective immune response against viruses that not only infect the gut, such as <a href="http://doi.org/10.3390/v10020096" target="_blank">norovirus</a> <a href="http://doi.org/10.1126/science.1258025" rel="noopener noreferrer" target="_blank">and rotavirus</a>, but also those infecting the lungs, such as <a href="https://doi.org/10.1073/pnas.1019378108" rel="noopener noreferrer" target="_blank">the flu virus</a>. The beneficial gut microbes do this by ordering specialized immune cells to produce potent antiviral proteins that ultimately eliminate <a href="https://doi.org/10.1016/j.cell.2020.04.022" rel="noopener noreferrer" target="_blank">viral infections</a>. And the body of a person lacking these beneficial gut bacteria won't have as strong an immune response to invading viruses. As a result, infections might go unchecked, taking a toll on health.
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<p><a href="https://scholar.google.com/citations?user=4y55zc0AAAAJ&hl=en" target="_blank" rel="noopener noreferrer">I am a microbiologist</a> fascinated by the ways bacteria shape human health. <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">An important focus of my research</a> is figuring out how the beneficial bacteria populating our guts combat disease and infection. <a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">My most recent work focuses on the link</a> between a particular microbe and the severity of COVID-19 in patients. My ultimate goal is to figure out out how to enhance the gut microbiome with diet to evoke a strong immune response – for not just SARS-CoV-2 but all pathogens.</p>
How Do Resident Bacteria Keep You Healthy?
<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>Chronic Disease and Microbes
<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>Discovering Microbes That Predict COVID-19 Severity
<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>From Your Site Articles
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U.S. President Joe Biden sits in the Oval Office as he signs a series of orders at the White House in Washington, D.C. on January 20, 2021. Jim Watson / AFP / Getty Images
President Joe Biden officially took office Wednesday, and immediately set to work reversing some of former President Donald Trump's environmental policies.
<p><br>As he did on his campaign and transition website, Biden emphasized the <a href="https://www.ecowatch.com/climate-change/" target="_self">climate crisis</a> as one of the major challenges facing his administration, along with the coronavirus pandemic and systemic racism.</p><p>"A cry for survival comes from the planet itself," Biden said in his <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/01/20/inaugural-address-by-president-joseph-r-biden-jr/" rel="noopener noreferrer" target="_blank">inaugural address</a>. "A cry that can't be any more desperate or any more clear."</p><p>Hours after his inauguration, Biden signed a total of 17 executive orders, memorandums and proclamations, <a href="https://www.nytimes.com/2021/01/20/us/biden-executive-orders.html" rel="noopener noreferrer" target="_blank">The New York Times reported</a>. Some of these orders had important implications for the climate and environment.</p>
<h3><br>1. Rejoining the Paris Agreement</h3><p>Biden honored a <a href="https://www.ecowatch.com/paris-climate-agreement-biden-2648649350.html" target="_self">campaign promise</a> by <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/01/20/paris-climate-agreement/" rel="noopener noreferrer" target="_blank">rejoining</a> the <a href="https://www.ecowatch.com/tag/paris-agreement" target="_self">Paris Agreement</a> on his first day in office.</p><p>The agreement recommits the U.S. to reducing greenhouse gas emissions enough to limit global warming to well below two degrees Celsius above pre-industrial levels. Under Trump, the U.S. officially exited in <a href="https://www.ecowatch.com/paris-agreement-us-withdrawal-2648618695.html">November 2020</a>.</p><p>Biden's reversal means the U.S. will now rejoin the agreement 30 days from Jan. 20.</p><h3>2. Cancelling the Keystone XL Pipeline</h3><p>Biden also signed a massive order titled "<a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-protecting-public-health-and-environment-and-restoring-science-to-tackle-climate-crisis/" rel="noopener noreferrer" target="_blank">Protecting Public Health and the Environment and Restoring Science to Tackle the Climate Crisis</a>." This order included revoking Trump's 2019 permit for the controversial <a href="https://www.ecowatch.com/tag/keystone-xl" target="_self">Keystone XL</a> pipeline.</p><p>The 1,700-mile pipeline would have carried around 800,000 barrels of oil a day from Alberta, Canada to the Texas Gulf Coast, <a href="https://apnews.com/article/joe-biden-alberta-2fbcce48372f5c29c3ae6f6f93907a6d" rel="noopener noreferrer" target="_blank">The Associated Press reported</a>. The Obama administration <a href="https://www.ecowatch.com/breaking-president-obama-rejects-keystone-xl-pipeline-1882117930.html" target="_self">revoked the permit in 2015</a>, but the Trump administration <a href="https://www.ecowatch.com/trump-dakota-access-pipeline-2211697835.html" target="_self">reversed course</a>.</p><p>Construction on the controversial project halted Wednesday in light of Biden's action, The Associated Press reported.</p>
<h3><br>3. Reversing Trump's Rollbacks</h3><p>The same executive order also empowered agencies to review Trump's many environmental rollbacks. It established commitments to listen to science, protect public health and the environment and conserve sites of national interest. Additionally, the order asked federal agencies to review any Trump regulations that violated these commitments.</p><p>The order specifically highlighted four rollbacks to be halted, altered or revoked: <a href="https://www.ecowatch.com/epa-methane-emissions-regulations-2646947182.html" target="_self">methane emissions</a> in the oil and gas sector, <a href="https://www.ecowatch.com/trump-fuel-efficiency-proposal-2592345279.html" target="_self">fuel efficiency standards</a> for cars and light trucks, energy efficiency standards for appliances and buildings, and air pollution controls, including the decision to limit <a href="https://www.ecowatch.com/epa-secret-science-rule-health-2649767248.html" target="_self">certain scientific studies</a> for setting public health policies.</p><p>Further, Biden called for a review of the <a href="https://www.ecowatch.com/shrinking-bears-ears-grand-staircase-escalante-2645172719.html" target="_self">shrinking</a> of Bears Ears and Grand Staircase Escalante National Monuments and the opening the Northeast Canyons and Seamounts Marine National Monument to <a href="https://www.ecowatch.com/trump-commercial-fishing-2646161692.html" target="_blank">commercial fishing.</a> Biden also paused <a href="https://www.ecowatch.com/anwr-oil-lease-fail-2649791991.html" target="_self">oil and gas leasing</a> in the Arctic National Wildlife Refuge.</p>
<h3>4. Stopping Border Wall Construction</h3><p>Biden also signed an <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/proclamation-termination-of-emergency-with-respect-to-southern-border-of-united-states-and-redirection-of-funds-diverted-to-border-wall-construction/" rel="noopener noreferrer" target="_blank">executive order</a> stopping construction of the wall along the U.S. border with Mexico.</p><p>While the order did not mention the environment, several conservation groups have <a href="https://www.ecowatch.com/trump-border-wall-endangered-species-2410320620.html" target="_self">opposed the wall</a> for its <a href="https://www.ecowatch.com/border-wall-bulldozer-arizona-organ-pipe-2640888439.html" target="_blank">impacts</a> on wildlife and ecosystems. One <a href="https://www.ecowatch.com/border-wall-endangered-species-2642927676.html" target="_self">study</a> found that wall construction could threaten eight species with extinction. It also imperils the <a href="https://www.ecowatch.com/border-wall-national-butterfly-center-2638893129.html" target="_self">National Butterfly Center in Texas</a>, home to important pollinators.</p><p>Biden's initial actions prompted excitement from world leaders and environmental groups.</p><p>"Welcome back to the Paris Agreement!" French President Emmanuel Macron <a href="https://twitter.com/EmmanuelMacron/status/1351955511814615042" rel="noopener noreferrer" target="_blank">tweeted</a>.</p><p>However, everyone, including Biden, acknowledged that more work remained.</p>
<p>"They are just executive actions. They are important but we're going to need legislation for a lot of the things we're going to do," Biden said according to <a href="https://www.nytimes.com/2021/01/20/climate/biden-paris-climate-agreement.html" target="_blank">The New York Times</a>.</p><p>Biden's climate plan calls for a zero-emissions electricity sector by 2035, and zero emissions across the board by 2050. The plan will likely require approval from Congress, and some Republicans are already fighting Biden's actions. Montana Senator Steve Daines said he would introduce legislation requiring the president to get Senate approval for rejoining the Paris agreement. Daines also plans to introduce legislation that would approve the Keystone XL pipeline.</p><p>Meanwhile, Indigenous groups praised Biden's action on Keystone XL but called for him to revoke the permits of other pipelines.</p><p>"It is imperative that we keep the pressure on President Biden to put an end to ALL fossil fuel infrastructure and projects, making the ones that are near or on Indigenous territories of top priority," Tasina Sapa Win Smith, co-founder of Cheyenne River Grassroots Collective, said in a <a href="https://www.mynewsletterbuilder.com/email/newsletter/1414959334" target="_blank">statement</a> from the Indigenous Environmental Network.</p>
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A wild mink in Utah was the first wild animal in the U.S. found with COVID-19. Peter Trimming via Wikipedia, CC BY-SA
By Jonathan Runstadler and Kaitlin Sawatzki
Over the course of the COVID-19 pandemic, researchers have found coronavirus infections in pet cats and dogs and in multiple zoo animals, including big cats and gorillas. These infections have even happened when staff were using personal protective equipment.
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<p>More disturbing, in December the United States Department of Agriculture confirmed the first case of a <a href="https://www.nytimes.com/2020/12/15/science/covid-wild-mink-utah.html" target="_blank">wild animal infected with SARS-CoV-2</a>, the virus that causes COVID-19. Researchers found an infected wild mink in Utah near a mink farm with its own COVID-19 outbreak.</p><p>Are humans transmitting this virus to wildlife? If so, what would this mean for wild animals – and people too?</p>
<h2>How Viruses Hop Between Species</h2><p>We are <a href="https://scholar.google.com/citations?hl=en&user=iAQr9XwAAAAJ" target="_blank" rel="noopener noreferrer">two scientists</a> who study <a href="https://scholar.google.com/citations?hl=en&user=pgjLWAEAAAAJ" target="_blank" rel="noopener noreferrer">viruses in wildlife</a> and are currently <a href="https://sites.tufts.edu/CoVERS" target="_blank" rel="noopener noreferrer">running a study</a> investigating the potential for SARS-CoV-2 transmission from humans into domestic and wild animals.</p><p>When viruses move from one species into another, scientists call it spillover. Thankfully, <a href="https://doi.org/10.1038/nrmicro.2017.45" target="_blank" rel="noopener noreferrer">spillover doesn't occur easily</a>.</p><p>To infect a new species, a virus must be able to bind to a protein on a cell and enter the cell while dodging an immune system the virus hasn't encountered before. Then, as a virus works to avoid <a href="https://doi.org/10.1016/j.coviro.2011.07.002" target="_blank" rel="noopener noreferrer">antibodies and other antiviral attackers</a>, it must replicate at a high enough volume to be transmitted on to the next animal.</p><p>This usually means that the more closely related two species are, the more likely they are to share viruses. Chimpanzees, the species most closely related to humans, <a href="https://www.sciencemag.org/news/2020/05/primatologists-work-keep-great-apes-safe-coronavirus" target="_blank" rel="noopener noreferrer">can catch and get sick from many human viruses</a>. Earlier this month, veterinarians at the San Diego Zoo announced that the zoo's <a href="https://zoo.sandiegozoo.org/pressroom/news-releases/gorilla-troop-san-diego-zoo-safari-park-test-positive-covid-19" target="_blank" rel="noopener noreferrer">troop of gorillas was infected with SARS–CoV–2</a>. This indicated it is possible for this virus to jump from humans to our close relatives.</p><p>Some viruses tend to stay in a single species or in closely related species, while other viruses seem innately more capable of large species jumps. Influenza, for example, can infect a <a href="https://www.cdc.gov/flu/other/index.html" target="_blank" rel="noopener noreferrer">wide variety of animals, from sparrows to whales</a>. Similarly, coronaviruses are known to <a href="https://dx.doi.org/10.1038%2Fs41579-018-0118-9" target="_blank" rel="noopener noreferrer">regularly jump between species</a>.</p><p>The question of how many and which species can be infected by SARS-CoV-2 – and which ones might be able to support continued circulation of the virus – is an important one.</p>
<h2>Searching for COVID-19 in Wildlife</h2><p>For human-to-wildlife spillover of SARS-CoV-2 to occur, an animal needs to be exposed to a high-enough viral dose to become infected.</p><p>The highest-risk situations are during direct contact with humans, such as a <a href="https://www.nytimes.com/2020/08/01/science/Covid-bats.html" target="_blank" rel="noopener noreferrer">veterinarian's caring for an injured animal</a>. Contact between a sick person and a pet or farm animal also poses a risk, as the domestic animal could act as an intermediate host, eventually passing the virus to a wild animal.</p><p>Another way COVID-19 could spill over from humans into animals is through indirect infection, <a href="https://www.smithsonianmag.com/smart-news/can-marine-mammals-catch-covid-19-new-study-says-its-possible-180976471/" target="_blank" rel="noopener noreferrer">such as through wastewater</a>. COVID-19 and other pathogens can be detected in waste streams, many of which end up dumped, untreated, into environments where wildlife like marine mammals may be exposed. This is thought to be how <a href="https://doi.org/10.1371/journal.pone.0062259" target="_blank" rel="noopener noreferrer">elephant seals in California became infected with H1N1 influenza</a> during the swine flu pandemic in 2009.</p><p>To study whether spillover of SARS-CoV-2 is happening, our team at Tufts is partnering with veterinarians and licensed wildlife rehabilitators across the U.S. to collect samples from and test animals in their care. Through the project, we have tested nearly 300 wild animals from over 20 species. So far, none – from bats to seals to coyotes – have shown any evidence of COVID-19 by swab or antibody tests.</p><p>Other researchers have launched targeted surveillance of wild animals in places where captive animals have been infected. The first confirmed infection in a wild mink was found during <a href="https://promedmail.org/promed-post/?id=8015608" target="_blank">surveillance near an infected mink farm</a>. It's not yet clear how this wild mink got the coronavirus, but the high density of infected minks and potentially infectious particles from them made it a high-risk location.</p>
<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTUwNjgyMC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1OTA3ODk3OX0.-nR4pFCXOW974_jiSjY0HHR2_8gVL5cA8eYdLMSd5tI/img.jpg?width=980" id="fc711" class="rm-shortcode" data-rm-shortcode-id="b901ace8188e316e4e411e7c5c690d83" data-rm-shortcode-name="rebelmouse-image" data-width="1200" data-height="800" />
Gorillas have been affected by human viruses in the past and are susceptible to the coronavirus. Thomas Fuhrmann via Wikimedia Commons, CC BY-SA
<h2>Bad for Animals, Bad for Humans</h2><p>When a virus infects a new species, it sometimes mutates, adapting to infect, replicate and transmit more efficiently in a new animal. This is called host adaptation. When a virus jumps to a new host and begins adapting, the results can be unpredictable.</p><p>In late 2020, when SARS-CoV-2 jumped into farmed mink in Denmark, <a href="https://www.who.int/csr/don/03-december-2020-mink-associated-sars-cov2-denmark/en/" target="_blank" rel="noopener noreferrer">it acquired mutations that were uncommon in humans</a>. Some of these mutations occurred in the part of the virus that most vaccines are designed to recognize. And it didn't just happen once – these mutations <a href="https://doi.org/10.1126/science.abe5901" target="_blank" rel="noopener noreferrer">independently arose in mink farms multiple times</a>. While it's not yet clear what impact, if any, these mutations may have on human disease or the vaccine, these are signs of host adaptation that could allow novel variants of the virus to persist and reemerge from animal hosts in the future.</p><p>Another risk is that SARS-CoV-2 could cause disease in animals. Ecologists are especially concerned about endangered species like the <a href="https://www.aaha.org/publications/newstat/articles/2020-12/endangered-black-footed-ferret-gets-experimental-covid-19-vaccine-in-colorado/" target="_blank" rel="noopener noreferrer">black-footed ferret</a>, which is closely related to minks and thought to be very susceptible to the virus.</p><p>Human-to-wildlife spillover has happened before. In the late 20th century, the Ebola virus jumped from humans into great apes and has resulted in <a href="https://doi.org/10.1038/543S56a" target="_blank" rel="noopener noreferrer">devastating consequences for these endangered animals</a>. More recently, a human respiratory virus has been <a href="https://doi.org/10.1007/s10393-020-01506-8" target="_blank" rel="noopener noreferrer">detected in threatened mountain gorilla populations</a> and has caused deaths as well.</p><p>But perhaps the biggest risk to humans is that spillover could result in the coronavirus establishing a reservoir in new animals and regions. This could provide opportunities for reintroduction of COVID-19 into humans in the future. This month researchers published a paper showing that this had already happened on a small scale with <a href="https://doi.org/10.1126/science.abe5901" target="_blank" rel="noopener noreferrer">human–to–mink–to–human transmission on mink farms</a> in Denmark.</p><p>While our team has found no evidence of COVID-19 in wild animals in the U.S. at this time, we have seen convincing evidence of regular spillover into dogs and cats and some zoo animals. The discovery of the infected wild mink confirmed our fears. Seeing the first wild animal with natural COVID-19 is alarming, but sadly, not surprising.</p>
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<em>Jonathan Runstadler is a professor of infectious disease and global health at the Cummings School of Veterinary Medicine, Tufts University.</em>
</p><p>
<em>Kaitlin Sawatzki is a postdoctoral infectious disease researcher at Tufts University.</em>
</p><p>
<em>Disclosure statements: </em><em>Jonathan Runstadler receives funding from NIH/NIAID. </em><em>Kaitlin Sawatzki receives funding from the NIH/NIAID.</em>
</p><p>
<em>Reposted with permission from <a href="https://theconversation.com/is-covid-19-infecting-wild-animals-were-testing-species-from-bats-to-seals-to-find-out-151467" target="_blank">The Conversation</a></em><em>.</em><br/>
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Samples of chocolate, strawberry and taro ice cream in the Chinese city of Tianjin tested positive for coronavirus. Alex Lau / Conde Nast via Getty Images
Ice cream samples in the Chinese municipality of Tianjin have tested positive for traces of the new coronavirus.
<p>The virus showed up in samples of chocolate, strawberry and taro ice cream produced by the Tianjin Daqiaodao Food Company that were submitted for inspection, Chinese media reported Friday, <a href="https://www.huffpost.com/entry/ice-cream-tianjin-covid-19_n_600215fbc5b697df1a05b059" target="_blank">according to HuffPost</a>.</p><p>"If you have recently purchased this product, please contact the community to report," a government press release read, as <a href="https://www.snopes.com/fact-check/ice-cream-covid19/" target="_blank">Snopes.com reported</a>. "At present, the traceability of the source of the virus is still in progress."</p>
<p>The press released obtained by Snopes was released on Jan. 15 by the Tianjin Municipal People's Government. It stated that the company had been temporarily shuttered and all of its employees were in quarantine. As of Jan. 14, 700 of the 1,662 employees had tested negative for the virus and the rest were still awaiting their results.</p><p>In total, there were more than 4,800 boxes of contaminated ice cream. Around 2,090 were still in storage, but 2,750 had already shipped. Of those, more than 930 stayed in Tianjin while around 1,800 were sent outside the city, which is close to Beijing.</p>
<p>Government officials said they were working to locate all of the ice cream sold in Tianjin, <a href="https://apnews.com/article/beijing-tianjin-coronavirus-pandemic-wuhan-china-a75ec51c11338190c483c78d65c3348d" target="_blank">The Associated Press</a> reported. They also informed authorities in other municipalities where the ice cream was sold. So far, there is no evidence that anyone has been infected by the ice cream.</p><p>The ice cream was made with whey powder imported from Ukraine and milk powder imported from New Zealand.</p><p>University of Leeds virologist Dr. Stephen Griffin told <a href="https://news.sky.com/story/covid-19-ice-cream-tests-positive-for-coronavirus-in-china-12188761" target="_blank">Sky News</a> that the positive test was probably not cause for alarm.</p><p>"It's likely this has come from a person, and without knowing the details, I think this is probably a one-off," he said.</p>
<p>Griffin speculated that the ice cream probably became infected during the production process or because of poor hygiene at the factory. The ice cream's cold temperature and fat content would then have allowed the virus to survive.</p><p>"We probably don't need to panic that every bit of ice cream is suddenly going to be contaminated with coronavirus," Griffin told Sky.</p><p>SARS, which is related to the new coronavirus, has been shown to survive as an infectious virus up to 28 days at around 39 degrees Fahrenheit, HuffPost pointed out. It also survived for an extended amount of time at colder temperatures.<br></p><p>The Centers for Disease Control and Prevention (CDC) has said the risk of contracting the virus from food or food packaging is low. "Currently, there is no evidence that food is associated with spreading the virus that causes COVID-19," the CDC website <a href="https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/food-and-COVID-19.html#:~:text=Currently%2C%20there%20is%20no%20evidence%20that%20food%20is%20associated%20with,thought%20to%20be%20very%20low." target="_blank">reads</a>.</p>
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A new study invites parents of cancer patients to answer questions about their environment. FatCamera / Getty Images
By Jennifer Sass, Nsedu Obot Witherspoon, Dr. Philip J. Landrigan and Simon Strong
"Prevention is the cure for child/teen cancer." This is the welcoming statement on a website called 'TheReasonsWhy.Us', where families affected by childhood cancers can sign up for a landmark new study into the potential environmental causes.
<p>The study is a joint project between Texas Children's Hospital, part of the world's largest medical center, and The Oliver Foundation, founded by the parents of a 12-year-old boy who died 36 hours after he was diagnosed with acute myeloid leukemia, one week after the onset of headaches.</p><p>After signing up, participants are contacted by the hospital's medical school, <a href="https://www.bcm.edu/news/baylor-launches-landmark-online-pediatric-cancer-study" rel="noopener noreferrer" target="_blank">Baylor College of Medicine</a>, to fill out a questionnaire about their environment going back from pre-conception through pregnancy and childhood, to identify chemical contaminants in the places that they live, learn, work and play, to the point where they developed cancer.</p><p><a href="https://www.texaschildrens.org/find-a-doctor/michael-scheurer-phd-mph" rel="noopener noreferrer" target="_blank">Dr. Michael Scheurer</a>, director of the childhood cancer epidemiology and prevention program at Texas Children's Hospital, the nation's largest pediatric cancer center, is quoted in <a href="https://www.theguardian.com/us-news/2019/jul/30/toxic-america-families-seek-answers-childhood-cancers" rel="noopener noreferrer" target="_blank">The Guardian</a> saying: "[This research] … will allow families who might not live near one of the existing study centers to participate as they are comfortable. In the end, if we see that several kinds of cancers share some risk factors that's important information, but we want to start with a very homogeneous group of cancers and start looking into these patients first. Signposts will pop up along the way."</p><p>When Oliver died in 2015, his parents Simon and Vilma Strong struggled to understand what may have led to their son's cancer, and whether it could have been prevented. They agonized over having used Roundup – the herbicide containing glyphosate, which is <a href="https://www.iarc.who.int/featured-news/media-centre-iarc-news-glyphosate/" rel="noopener noreferrer" target="_blank">linked to leukemia</a> – to kill weeds in their yard and garden. Or could it have been the crumb rubber artificial turf athletic fields, made with toxic petrochemicals, where their goalkeeper son had played soccer?</p>
<p>In addition to cancer, exposures to harmful chemicals can lead to learning and behavioral impairments, developmental delays, reproductive harm, and chronic diseases including autoimmune disease, asthma, and obesity. The important work of preventing these health harms can only be done if we increase our efforts to identify the causes— including industrial and environmental pollutants— and reduce or replace them to prevent harmful exposures.</p><p>Sadly, as the 2020 <a href="https://www.cancerfreeeconomy.org/wp-content/uploads/2020/09/CFE_ChildhoodCancerPrevention_Report_F2.pdf" target="_blank">Childhood Cancer Prevention Report</a> confirms, <a href="https://curesearch.org/Incidence-Rates-Over-Time" rel="noopener noreferrer" target="_blank">childhood cancer incidence rates</a>, the number of new cases per 1,000 children, have steadily increased over the last few decades across all racial/ethnic groups. Cancer is now responsible for more than <a href="https://curesearch.org/Childhood-Cancer-Deaths-Per-Year" rel="noopener noreferrer" target="_blank">half of all childhood and teenage deaths</a>, making this study all the more urgent.</p><p>Oliver's family may never know exactly what led to the cancer that took his life. But the study they've helped to launch can identify the environmental contributors to cancer and other diseases – and that knowledge can inform policies and practices to better protect families from toxic products and pollution.</p>
<p><em>Reposted with permission from <a href="https://www.ehn.org/environmental-causes-child-cancer-2649926729.html" target="_blank">Environmental Health News</a>.</em></p>
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How to Stay Safe With a More Contagious Coronavirus Mutation on the Loose
18 January
Health + Wellness
The new variant, known as B.1.1.7, spread quickly through southeastern England in December, causing case numbers to spike and triggering stricter lockdown measures. Hollie Adams / Getty Images
By Suresh Dhaniyala and Byron Erath
A fast-spreading variant of the coronavirus that causes COVID-19 has been found in at least 10 states, and people are wondering: How do I protect myself now?
<p>We saw what the new variant, known as B.1.1.7, can do as it <a href="https://www.sciencemag.org/news/2020/12/mutant-coronavirus-united-kingdom-sets-alarms-its-importance-remains-unclear" target="_blank">spread quickly through southeastern England</a> in December, causing case numbers to spike and triggering stricter lockdown measures.</p><p>The new variant has been estimated to be <a href="https://cmmid.github.io/topics/covid19/uk-novel-variant.html" target="_blank">50% more easily transmitted than common variants</a>, though it <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7003e2.htm?s_cid=mm7003e2_e" target="_blank" rel="noopener noreferrer">appears to affect people's health in the same way</a>. The increased transmissibility is believed to arise from a <a href="https://www.biorxiv.org/content/10.1101/2020.12.29.424708v1" target="_blank" rel="noopener noreferrer">change in the virus's spike protein</a> that can allow the virus to more easily enter cells. These and other <a href="https://doi.org/10.1101/2020.12.24.20248834" target="_blank" rel="noopener noreferrer">studies on the new variant</a> were released before peer review to share their findings quickly.</p><p>Additionally, there is some evidence that patients infected with the new B.1.1.7 variant may have a <a href="https://www.medrxiv.org/content/10.1101/2020.12.24.20248834v1.full" target="_blank" rel="noopener noreferrer">higher viral load</a>. That means they may expel more virus-containing particles when they breathe, talk or sneeze.</p><p>As professors who study <a href="https://www.clarkson.edu/people/byron-erath" target="_blank" rel="noopener noreferrer">fluid dynamics</a> <a href="https://www.clarkson.edu/people/suresh-dhaniyala" target="_blank" rel="noopener noreferrer">and aerosols</a>, we investigate how airborne particles carrying viruses spread. There is still a lot that scientists and doctors don't know about the coronavirus and its mutations, but there are some clear strategies people can use to protect themselves.</p>
Airborne Particles Are Still the Biggest Problem
<p>The <a href="https://theconversation.com/why-it-matters-that-the-coronavirus-is-changing-and-what-this-means-for-vaccine-effectiveness-152383" target="_blank" rel="noopener noreferrer">SARS-CoV-2 variants</a> are believed to spread primarily through the air rather than on surfaces.</p><p>When someone with the coronavirus in their respiratory tract coughs, talks, sings or even just breathes, infectious respiratory droplets can be expelled into the air. These droplets are tiny, predominantly in the range of <a href="https://www.sciencedirect.com/science/article/pii/S0021850211001200?casa_token=KtyrsEfbeqcAAAAA:vv10sSxm33tzg0EQvNMIFtV7GCu5gE9QAzuyzHKr2_4Cl0OFkUJoGwzn4d0ZnEWS19NsOTuH" target="_blank" rel="noopener noreferrer">1-100 micrometers</a>. For comparison, a human hair is about 70 micrometers in diameter.</p><p>The larger droplets fall to the ground quickly, rarely traveling farther than 6 feet from the source. The bigger problem for disease transmission is the tiniest droplets – those less than 10 micrometers in diameter – which can remain suspended in the air as aerosols for <a href="https://academic.oup.com/cid/article/50/5/693/325466" target="_blank">hours at a time</a>.</p><span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="bb67b83dcafe589f350daf3df60fa29d"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/UNCNM7AZPFg?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
<p>With people possibly having more virus in their bodies and the virus being more infectious, everyone should take extra care and precautions. Wearing face masks and social distancing are essential.</p><p>Spaces and activities that were previously deemed "safe," such as some indoor work environments, may present an elevated infection risk as the variant spreads.</p><p>The concentration of aerosol particles is usually highest right next to the individual emitting the particles and decreases with <a href="https://aip.scitation.org/doi/10.1063/5.0025476" target="_blank">distance from the source</a>. However, in indoor environments, aerosol concentration levels can quickly build up, similar to how <a href="https://theconversation.com/what-a-smoky-bar-can-teach-us-about-the-6-foot-rule-during-the-covid-19-pandemic-145517" target="_blank" rel="noopener noreferrer">cigarette smoke accumulates within enclosed spaces</a>. This is particularly problematic in spaces that have poor ventilation.</p><p>With the new variant, aerosol concentration levels that might not have previously posed a risk could now lead to infection.</p>
<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ5Njc1My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY0MTg5MzExM30.2KlkIn9wVomwIkIEvkEpjx9alJ61pU4Onv54-nS-Ric/img.png?width=980" id="7052f" class="rm-shortcode" data-rm-shortcode-id="64f0b78347b7911d5eee1f15d7999b22" data-rm-shortcode-name="rebelmouse-image" data-width="1290" data-height="932" />
Daily case reports and 7-day rolling average as of Jan. 16, 2021.Chart: The Conversation, CC-BY-ND Source: COVID Tracking Project Get the data
What Can You Do to Stay Safe?
<p>1) Pay attention to the type of face mask you use, and how it fits.</p><p>Most off-the-shelf face coverings are not 100% effective at preventing droplet emission. With the new variant spreading more easily and likely infectious at lower concentrations, it's important to select coverings with materials that are most effective at stopping droplet spread.</p><p>When available, N95 and surgical masks consistently perform the best. Otherwise, face coverings that use <a href="https://www.sciencedirect.com/science/article/pii/S2352431620301802?casa_token=-Dj6nGBAm24AAAAA:qq9BpbzCKaPDFcV73ohA2fCnhE_Zlkss6Bei3kUwq9QYndhHj0Vafbbd-ef_855lx6knDfUt" target="_blank">multiple layers of material</a> are preferable. Ideally, the material should be a tight weave. High thread count cotton sheets are an example. Proper fit is also crucial, as gaps around the nose and mouth can <a href="https://pubs.acs.org/doi/10.1021/acsnano.0c03252" target="_blank" rel="noopener noreferrer">decrease the effectiveness by 50%</a>.</p><p>2) Follow social distancing guidelines.</p><p>While the current social distancing guidelines are not perfect – <a href="https://theconversation.com/what-a-smoky-bar-can-teach-us-about-the-6-foot-rule-during-the-covid-19-pandemic-145517" target="_blank" rel="noopener noreferrer">6 feet isn't always enough</a> – they do offer a useful starting point. Because aerosol concentrations levels and infectivity are highest in the space immediately surrounding anyone with the virus, increasing physical distancing can help reduce risk. Remember that people are infectious <a href="https://medical.mit.edu/faqs/COVID-19#faq-10" target="_blank" rel="noopener noreferrer">before they start showing symptoms</a>, and they many never show symptoms, so don't count on seeing signs of illness.</p><p>3) Think carefully about the environment when entering an enclosed area, both the ventilation and how people interact.</p><p>Limiting the size of gatherings helps reduce the potential for exposure. Controlling indoor environments in other ways can also be a highly effective strategy for reducing risk. This includes <a href="https://theconversation.com/what-a-smoky-bar-can-teach-us-about-the-6-foot-rule-during-the-covid-19-pandemic-145517" target="_blank" rel="noopener noreferrer">increasing ventilation rates</a> to bring in <a href="https://theconversation.com/keeping-indoor-air-clean-can-reduce-the-chance-of-spreading-coronavirus-149512" target="_blank" rel="noopener noreferrer">fresh air and filtering existing air</a> to dilute aerosol concentrations.</p><p>On a personal level, it is helpful to pay attention to the types of interactions that are taking place. For example, many individuals shouting can create a higher risk than one individual speaking. In all cases, it's important to minimize the amount of time spent indoors with others.</p><p>The CDC has warned that B.1.1.7 could <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7003e2.htm?s_cid=mm7003e2_w" target="_blank" rel="noopener noreferrer">become the dominant SARS-CoV-2 variant</a> in the U.S. by March. Other fast-spreading variants have also been found in <a href="https://virological.org/t/genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-manaus-preliminary-findings/586" target="_blank" rel="noopener noreferrer">Brazil</a> and <a href="https://www.who.int/csr/don/31-december-2020-sars-cov2-variants/en/" target="_blank" rel="noopener noreferrer">South Africa</a>. Increased vigilance and complying with health guidelines should continue to be of highest priority.</p>From Your Site Articles
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Kevin Maillefer / Unsplash
By Lynne Peeples
Editor's note: This story is part of a nine-month investigation of drinking water contamination across the U.S. The series is supported by funding from the Park Foundation and Water Foundation. Read the launch story, "Thirsting for Solutions," here.
In late September 2020, officials in Wrangell, Alaska, warned residents who were elderly, pregnant or had health problems to avoid drinking the city's tap water — unless they could filter it on their own.
<p style="">More than 3,000 miles (4,800 kilometers) away, the people of <a href="https://www.documentcloud.org/documents/7208933-Scituate-Water-Notification-9-10-2020.html" rel="noopener noreferrer" target="_blank">Scituate, Massachusetts</a>, received a letter that same month cautioning about the same group of contaminants in their <a href="https://www.ecowatch.com/tag/drinking-water">drinking water</a>.</p>
<p>At issue wasn't any of the well-known and widely feared water infiltrators such as <em>E. coli </em>or <a href="https://ensia.com/features/drinking-water-contamination-pfas-health/" target="_blank">per- and polyfluoroalkyl substances (PFAS)</a>. The culprit chemicals tainting taps from <a href="https://www.floridatoday.com/story/news/local/environment/2016/05/31/elevated-disinfection-byproducts-taint-cocoa-water/85184636/" target="_blank">Cocoa, Florida</a>, to the <a href="https://auburnpub.com/news/local/several-cayuga-county-water-systems-violate-standard-for-chlorination-byproduct/article_d5568ecc-edd0-55b1-a858-37aaf2b1c82f.html" target="_blank">Finger Lakes of New York</a> to a correctional facility in <a href="https://www.jdsupra.com/legalnews/drinking-water-enforcement-tennessee-98500/" target="_blank">Only, Tennessee</a>, are, in fact, less recognized yet more ubiquitous: disinfection by-products.</p><p>"Take a glass of water. You may or may not have pesticides, pharmaceuticals, PFAS and lead in it. Usually not," says Susan Richardson, a professor of biochemistry at the University of South Carolina in Columbia. "But there's always something that is in your drinking water, and that's disinfection by-products."</p><p>Aptly named, the chemicals form in water when disinfectants that are widely used to kill pathogens in municipal drinking water facilities react with organic compounds. These compounds may be present in the water as a result of natural processes such as the decay of leaves and animal matter, as well as human activities that may release solvents, pharmaceuticals, pesticides and industrial chemicals. Exposure to disinfection by-products through drinking, bathing or <a href="https://pubs.acs.org/doi/abs/10.1021/acs.est.6b00808" target="_blank">swimming</a> has been linked to potential <a href="https://www.sciencedirect.com/science/article/abs/pii/S2213343720302876" target="_blank" rel="noopener noreferrer">increased risks</a> of <a href="https://www.ewg.org/childrenshealth/23264/study-disinfection-byproducts-drinking-water-may-increase-risk-low-birth" target="_blank" rel="noopener noreferrer">low birthweight babies</a>, birth defects, <a href="https://pubmed.ncbi.nlm.nih.gov/29676755/" target="_blank" rel="noopener noreferrer">miscarriages</a> and <a href="https://ehp.niehs.nih.gov/doi/full/10.1289/EHP4495" target="_blank" rel="noopener noreferrer">cancer</a>.</p><p>"Disinfection is hugely important. We've got to kill those pathogens," says Richardson. "We had millions of people dying from waterborne illnesses before we started disinfecting water in the 1800s."</p>
<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ1OTg0Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MjIyNTA3OH0.DKXIFu4fZ0XqVAZV7df25Oy2M3D8In7XWlMAwuQZJbA/img.jpg?width=980" id="a78a8" class="rm-shortcode" data-rm-shortcode-id="83c6c4c4dcac6fa45d912d7316b69bdb" data-rm-shortcode-name="rebelmouse-image" data-width="1440" data-height="426" /><p>Cholera and typhoid fever were once deadly and pervasive threats. Still today, when concentrations of disinfectants fall too low, drinking water can become a breeding ground for dangerous pathogens such as <a href="https://ensia.com/features/legionella-pathogens-drinking-water/" target="_blank">Legionella</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/12638998/" target="_blank"><em>E. coli</em></a><em>, </em>even <a href="https://www.nytimes.com/1991/04/19/world/cholera-kills-1100-in-peru-and-marches-on-reaching-the-brazilian-border.html" target="_blank">cholera</a>.</p><p>"It's a trade-off between inactivating pathogens that are going to make people sick today versus the long-term, low-level risk of chemicals in the water," says Christy Remucal, an associate professor of civil and environmental engineering at the University of Wisconsin–Madison.</p><p><a href="https://www.sciencedirect.com/science/article/abs/pii/S2213343720302876" target="_blank">Striking a balance</a> may be even more challenging today as waters become increasingly compromised due to population growth, wastewater intrusion, energy exploration, climate change — and now the Covid-19 pandemic, according to Richardson.</p><p>During the pandemic, many places have increased use of chlorine for disinfection in indoor and outdoor settings and during wastewater treatment, resulting in the potential for higher levels of disinfection by-products. Authors of a <a href="https://pubs.acs.org/doi/10.1021/acs.est.0c04394" target="_blank" rel="noopener noreferrer">study</a> published in October warn that this "upsurge and overuse of chlorine-based disinfectants" may pose a threat to human health "by impacting water quality."</p><p>Concentrations of harmful chemicals have also likely increased in buildings left vacant during Covid-19 shutdowns. The longer that water sits in pipes, explains Richardson, the longer it has to react with disinfectants and form more by-products.</p><p>Still, Gregory Korshin, a professor of civil and environmental engineering at the University of Washington in Seattle, encourages perspective on the issue of disinfection by-products. The answer, he and others say, is not to stop disinfecting water, nor is it for everyone to buy bottled water.</p><p>"There is a dark side of disinfection," adds Korshin. "But this doesn't compromise the notion that drinking water in the U.S. is safe."</p>
Unintended Consequences
<p>Chemists first discovered disinfection by-products in treated drinking water in the 1970s. The trihalomethanes they found, they determined, had resulted from the reaction of chlorine with natural organic matter. Since then, scientists have identified more than 700 additional disinfection by-products. "And those only represent a portion. We still don't know half of them," says Richardson, whose lab has identified hundreds of disinfection by-products. </p><p>Identification of disinfection by-products is incredibly difficult, she explains, because these chemicals are not simply flowing down a river from an industrial site or running off a farm. "They didn't exist before," she adds. "It's a complete unknown — there's no preconceived idea of what these chemicals look like."</p><p>Another research team recently discovered more previously unidentified disinfection by-products. As they described in a January 2020 <a href="https://pubs.acs.org/doi/abs/10.1021/acs.est.9b04926" target="_blank">study</a>, potentially carcinogenic chemicals are formed through the interaction of chlorine and not only organic matter in the environment but also manmade materials that include phenols such as <a href="https://ensia.com/features/what-will-it-take-to-rid-our-store-shelves-of-bpa/" target="_blank" rel="noopener noreferrer">bisphenol A (BPA)</a> and other plasticizers, as well as sunscreen agents and antimicrobials.</p><p>"These phenol compounds are incredibly widespread because of their properties," says Carsten Prasse, a coauthor on the study and an assistant professor of environmental health and environmental engineering at Johns Hopkins University. He highlights their use in both plastic pipes and plastic bottles, which frequently carry drinking water.</p>
What’s Regulated and What’s Not?
<p>The U.S. Environmental Protection Agency (EPA) currently regulates 11 disinfection by-products — including a handful of trihalomethanes (THM) and haloacetic acids (HAA). While these represent only a small fraction of all disinfection by-products, EPA aims to use their presence to indicate the presence of other disinfection by-products. "The general idea is if you control THMs and HAAs, you implicitly or by default control everything else as well," says Korshin.</p><p>EPA also requires drinking water facilities to use techniques to reduce the concentration of organic materials before applying disinfectants, and regulates the quantity of disinfectants that systems use. These rules ultimately can help control levels of disinfection by-products in drinking water.</p><a href="https://www.ewg.org/tapwater/reviewed-disinfection-byproducts.php" target="_blank"><img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ1OTg1OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0MzYyNTAwNX0.1IaCMF-b4X9jtCSFsZuQfRvQCO54EqgfRcGulUoMP10/img.jpg?width=980" id="36d2f" class="rm-shortcode" data-rm-shortcode-id="e8502b4c0de9cbd99651d4978548af81" data-rm-shortcode-name="rebelmouse-image" data-width="1144" data-height="1036" /></a>
Click the image for an interactive version of this chart on the Environmental Working Group website.
<p>Still, some scientists and advocates argue that current regulations do not go far enough to protect the public. Many question whether the government is regulating the right disinfection by-products, and if water systems are doing enough to reduce disinfection by-products. EPA is now seeking public input as it considers potential revisions to regulations, including the possibility of regulating additional by-products. The agency held a <a href="https://www.epa.gov/dwsixyearreview/potential-revisions-microbial-and-disinfection-byproducts-rules" target="_blank">two-day public meeting</a> in October 2020 and plans to hold additional public meetings throughout 2021.</p><p>When EPA set regulations on disinfection by-products between the 1970s and early 2000s, the agency, as well as the scientific community, was primarily focused on by-products of reactions between organics and chlorine — historically the most common drinking water disinfectant. But the science has become increasingly clear that these chlorinated chemicals represent a fraction of the by-product problem.</p><p>For example, bromide or iodide can get caught up in the reaction, too. This is common where seawater penetrates a drinking water source. By itself, bromide is innocuous, says Korshin. "But it is extremely [reactive] with organics," he says. "As bromide levels increase with normal treatment, then concentrations of brominated disinfection by-products will increase quite rapidly."</p><p><a href="https://pubmed.ncbi.nlm.nih.gov/15487777/" target="_blank">Emerging</a> <a href="https://pubs.acs.org/doi/10.1021/acs.est.7b05440" target="_blank" rel="noopener noreferrer">data</a> indicate that brominated and iodinated by-products are potentially more harmful than the regulated by-products.</p><p>Almost half of the U.S. population lives within 50 miles of either the Atlantic or Pacific coasts, where saltwater intrusion can be a problem for drinking water supplies. "In the U.S., the rule of thumb is the closer to the sea, the more bromide you have," says Korshin, noting there are also places where bromide naturally leaches out from the soil. Still, some coastal areas tend to be spared. For example, the city of Seattle's water comes from the mountains, never making contact with seawater and tending to pick up minimal organic matter.</p><p>Hazardous disinfection by-products can also be an issue with desalination for drinking water. "As <a href="https://ensia.com/features/can-saltwater-quench-our-growing-thirst/" target="_blank" rel="noopener noreferrer">desalination</a> practices become more economical, then the issue of controlling bromide becomes quite important," adds Korshin.</p>Other Hot Spots
<p>Coastal areas represent just one type of hot spot for disinfection by-products. Agricultural regions tend to send organic matter — such as fertilizer and animal waste — into waterways. Areas with warmer climates generally have higher levels of natural organic matter. And nearly any urban area can be prone to stormwater runoff or combined sewer overflows, which can contain rainwater as well as untreated human waste, industrial wastewater, hazardous materials and organic debris. These events are especially common along the East Coast, notes Sydney Evans, a science analyst with the nonprofit Environmental Working Group (EWG, a collaborator on <a href="https://ensia.com/ensia-collections/troubled-waters/" target="_blank">this reporting project</a>).</p><p>The only drinking water sources that might be altogether free of disinfection by-products, suggests Richardson, are private wells that are not treated with disinfectants. She used to drink water from her own well. "It was always cold, coming from great depth through clay and granite," she says. "It was fabulous."</p><p>Today, Richardson gets her water from a city system that uses chloramine.</p>Toxic Treadmill
<p>Most community water systems in the U.S. use chlorine for disinfection in their treatment plant. Because disinfectants are needed to prevent bacteria growth as the water travels to the homes at the ends of the distribution lines, sometimes a second round of disinfection is also added in the pipes.</p><p>Here, systems usually opt for either chlorine or chloramine. "Chloramination is more long-lasting and does not form as many disinfection by-products through the system," says Steve Via, director of federal relations at the American Water Works Association. "Some studies show that chloramination may be more protective against organisms that inhabit biofilms such as Legionella."</p><p>If a drinking water facility fails to meet EPA regulations for disinfection by-products, one relatively easy and cheap modification is to add ammonia to the existing treatment, turning chlorine to chloramine. Many large community water systems in the U.S. now use chloramine. By doing so, according to Richardson, they have dropped levels of regulated disinfection by-products by up to as much as 90%.</p><p>However, there is one major drawback to this shift: the creation of potentially more harmful by-products. "It might push down on regulated disinfection by-products, but then other things pop up that are even more toxic," says Richardson, whose research team discovered previously unknown disinfection by-products in chloraminated drinking water. One of those finds, <a href="https://pubs.acs.org/doi/10.1021/es304786b" target="_blank">iodoacetic acid</a>, is the <a href="https://pubmed.ncbi.nlm.nih.gov/30919613/" target="_blank" rel="noopener noreferrer">most DNA-damaging disinfection by-product</a> known to date.</p><p>Prasse underscored the concern: "From a regulatory perspective, we could say we're fine. But it's a false sense of security."</p><p>Rather than continuing on the toxic treadmill of replacing one potentially toxic chemical for another, a more effective solution may be to focus upstream in the treatment process — such as keeping organics out of the system in the first place. "That requires engineers, chemists, toxicologists and regulators to come together and figure something out," says Prasse.</p>
Alternative Approaches
<p>When he moved to the U.S. from Germany, Prasse says he immediately noticed the bad taste of the water. "You can taste the chlorine here. That's not the case in Germany," he says.</p><p>In his home country, water systems use chlorine — if at all — at lower concentrations and at the very end of treatment. In the Netherlands, <a href="https://dwes.copernicus.org/articles/2/1/2009/dwes-2-1-2009.pdf" target="_blank">chlorine isn't used at all</a> as the risks are considered to outweigh the benefits, says Prasse. He notes the challenge in making a convincing connection between exposure to low concentrations of disinfection by-products and health effects, such as cancer, that can occur decades later. In contrast, exposure to a pathogen can make someone sick very quickly.</p><p>But many countries in Europe have not waited for proof and have taken a precautionary approach to reduce potential risk. The emphasis there is on alternative approaches for primary disinfection such as ozone or <a href="https://www.pbs.org/wgbh/nova/article/eco-friendly-way-disinfect-water-using-light/" target="_blank" rel="noopener noreferrer">ultraviolet light</a>. Reverse osmosis is among the "high-end" options, used to remove organic and inorganics from the water. While expensive, says Prasse, the method of forcing water through a semipermeable membrane is growing in popularity for systems that want to reuse wastewater for drinking water purposes.</p><p>Remucal notes that some treatment technologies may be good at removing a particular type of contaminant while being ineffective at removing another. "We need to think about the whole soup when we think about treatment," she says. What's more, Remucal explains, the mixture of contaminants may impact the body differently than any one chemical on its own. </p><p>Richardson's preferred treatment method is filtering the water with granulated activated carbon, followed by a low dose of chlorine.</p><p>Granulated activated carbon is essentially the same stuff that's in a household filter. (EWG recommends that consumers use a <a href="https://www.ewg.org/tapwater/reviewed-disinfection-byproducts.php#:~:text=EWG%20recommends%20using%20a%20home,as%20trihalomethanes%20and%20haloacetic%20acids." target="_blank" rel="noopener noreferrer">countertop carbon filter</a> to reduce levels of disinfection by-products.) While such a filter "would remove disinfection by-products after they're formed, in the plant they remove precursors before they form by-products," explains Richardson. She coauthored a <a href="https://pubs.acs.org/doi/10.1021/acs.est.9b00023" target="_blank" rel="noopener noreferrer">2019 paper</a> that concluded the treatment method is effective in reducing a wide range of regulated and unregulated disinfection by-products.</p><br><img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTQ1OTg2MC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0MjI3OTk2NX0.XuxufjUTyOygRCpgnG2jXqOIy4isl7Vz1QlnMmKSyHM/img.jpg?width=980" id="003a3" class="rm-shortcode" data-rm-shortcode-id="0da178217c0a9dd4c3c880e1c05a86f9" data-rm-shortcode-name="rebelmouse-image" data-width="1144" data-height="312" />
Greater Cincinnati Water Works installed a granulated activated carbon system in 1992, and is still one of relatively few full-scale plants that uses the technology. Courtesy of Greater Cincinnati Water Works.
<p>Despite the technology and its benefits being known for decades, relatively few full-scale plants use granulated active carbon. They often cite its high cost, Richardson says. "They say that, but the city of Cincinnati [Ohio] has not gone bankrupt using it," she says. "So, I'm not buying that argument anymore."</p><p>Greater Cincinnati Water Works installed a granulated activated carbon system in 1992. On a video call in December, Jeff Swertfeger, the superintendent of Greater Cincinnati Water Works, poured grains of what looks like black sand out of a glass tube and into his hand. It was actually crushed coal that has been baked in a furnace. Under a microscope, each grain looks like a sponge, said Swertfeger. When water passes over the carbon grains, he explained, open tunnels and pores provide extensive surface area to absorb contaminants.</p><p>While the granulated activated carbon initially was installed to address chemical spills and other industrial contamination concerns in the Ohio River, Cincinnati's main drinking water source, Swertfeger notes that the substance has turned out to "remove a lot of other stuff, too," including <a href="https://ensia.com/features/drinking-water-contamination-pfas-health/" target="_blank" rel="noopener noreferrer">PFAS</a> and disinfection by-product precursors.</p><p>"We use about one-third the amount of chlorine as we did before. It smells and tastes a lot better," he says. "The use of granulated activated carbon has resulted in lower disinfection by-products across the board."</p><p>Richardson is optimistic about being able to reduce risks from disinfection by-products in the future. "If we're smart, we can still kill those pathogens and lower our chemical disinfection by-product exposure at the same time," she says.</p><p><em>Reposted with permission from </em><em><a href="https://ensia.com/features/drinking-water-disinfection-byproducts-pathogens/" target="_blank">Ensia</a>. </em><a href="https://www.ecowatch.com/r/entryeditor/2649953730#/" target="_self"></a></p>
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