In this week's House Call, a reader asked, "If one is lactose intolerant, but has no other intolerance to dairy, (e.g. casein and whey) is it ok to consume dairy products while having Hashimoto's?"
By now, most of my readers probably know how I feel about dairy—it's nature's perfect food—but only if you're a calf. We have no biological requirement for this food, and yet, we've been told over and over again that dairy is a great source of calcium, milk makes healthy bones and we should drink it daily. I'm here to tell you that this is not true.
Based on research and my experience practicing medicine, I typically advise most of my patients to avoid dairy products completely.
Here are some facts to consider:
- Countries with the lowest rates of dairy and calcium consumption (like those in Africa and Asia) have the lowest rates of osteoporosis.
- Research shows that higher intakes of both calcium and dairy products may increase a man's risk of prostate cancer by 30 to 50 percent. Dairy consumption increases the body's level of insulin-like growth factor-1 (or IGF-1)—a known cancer promoter.
- Calcium isn't as bone-protective as we thought. Studies of calcium supplementation have shown no benefit in reducing fracture risk. In fact, vitamin D appears to be much more important than calcium in preventing fractures.
These are just a few of the findings related to the harm that dairy can cause.
About 75 percent of the world's population is genetically unable to properly digest milk and other dairy products—a problem known as lactose intolerance—which is what our reader is asking about.
I often find that symptoms of lactose intolerance are actually caused by difficulty digesting casein, the main protein found in milk, which is often used in other food products as a binding agent. Casein proteins can actually induce inflammation leading to things like eczema, ear infections, congestion and sinus problems. So, I highly recommend avoiding casein, no matter who you are.
Whey protein contains very little lactose, so there is a chance that someone with lactose intolerance might be able to have whey. However, I know some people who can tolerate whey protein and others who cannot, so you might want to test it out for yourself.
Overall, I recommend avoiding dairy, especially if you're lactose intolerant. Dairy consumption can lead to increased cancer risk, increased fracture risk, constipation, irritable bowel, bloating, gas, diarrhea, allergies, eczema and acne. None of that sounds good to me!
One dairy product that many people can tolerate is ghee. Ghee is simply clarified butter which has had all the water and milk solids removed from it. That means it can be consumed by those who are allergic to dairy. Again, some people do well with ghee and others do not. It really depends on the individual.
How to Test for Dairy Sensitivity
I recommend getting off of all dairy—except for grass-fed butter and ghee for three weeks. That means eliminating milk, cheese, yogurt, products with casein and ice cream to see if you feel better. You should notice improvements with your sinuses, post-nasal drip, headaches, irritable bowel syndrome, energy and weight. Then start reintroducing dairy again and see how you feel. If you feel worse, you should try to give it up for life.
If you do consume dairy, always choose grass-fed. If you're going to consume butter or other dairy products, remember that grass-fed is best. The milk these cows produce has an omega-6 to omega-3 ratio of 1:1 which is optimal. Conventionally raised cows eat grains and other crops that make their fatty acid profiles more inflammatory. The milk they produce—and as a result the butter and cheese made from it—contains more omega-6 fats.
Personally, when I eat little to no dairy, I feel much, much better. Give it a shot, what's to lose? Besides all the miserable symptoms and a little weight, that is…
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.
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>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>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>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>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>EcoWatch Daily Newsletter
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Earth had its second-warmest year on record in 2020, just 0.02 degrees Celsius (0.04°F) behind the record set in 2016, and 0.98 degrees Celsius (1.76°F) above the 20th-century average, NOAA reported January 14.
Figure 1. Departure of temperature from average for 2020, the second-warmest year the globe has seen since record-keeping began in 1880, according to NOAA. Record-high annual temperatures over land and ocean surfaces were measured across parts of Europe, Asia, southern North America, South America, and across parts of the Atlantic, Indian, and Pacific oceans. No land or ocean areas were record cold for the year. NOAA National Centers for Environmental Information
Figure 2. Total ocean heat content (OHC) in the top 2000 meters from 1958-2020. Cheng et al., Upper Ocean Temperatures Hit Record High in 2020, Advances in Atmospheric Sciences
Figure 3. Departure of sea surface temperature from average in the benchmark Niño 3.4 region of the eastern tropical Pacific (5°N-5°S, 170°W-120°W). Sea surface temperature were approximately one degree Celsius below average over the past month, characteristic of moderate La Niña conditions. Tropical Tidbits
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