nhaliday + org:health   75

Dr. Pribut on Runner's Knee (Patellofemoral Pain Syndrome)
Abnormal knee joint moments
Abnormal pronation of the foot
Weak Vastus Medialis
Weak Quadriceps Muscles
Tight Hamstrings or calf muscles
Weak Hip Abductors
Canted Surface

Do posterior muscle stretches (hamstrings and calf muscles)
Do Straight Leg Lifts (Start with 3 sets of 10, work up to 10 sets of 10)
Supine bridges 10-15, Later single leg bridges 8-12
Check Your Feet and Shoes, overpronation often contributes to this problem
org:junk  org:health  health  embodied  fitness  fitsci  running  endurance  biomechanics 
november 2017 by nhaliday
Injury prevention in runners - "skimpy research" | RunningPhysio
Wherever possible RunningPhysio tries to be evidence based but in many cases there is a lack of high quality research. Extensive advice exists on injury prevention in runners and yet the research underpinning that advice is very limited, so limited in fact that one recent study described it as “skimpy”! So we decided we'd examine this “skimpy research”.
org:health  health  fitness  fitsci  evidence-based  running  embodied  analysis  survey  endurance 
october 2017 by nhaliday
EWG's Seafood Calculator | EWG
recommends Salmon (Atlantic), Sardines (Pacific), Mussels, Trout, and Mackerel for me
org:health  fitsci  tools  calculator  dynamic  nutrition  diet  health  metabolic  hypochondria  oceans  org:ngo  cooking  objektbuch  food 
october 2017 by nhaliday
Health Services as Credence Goods: A Field Experiment by Felix Gottschalk, Wanda Mimra, Christian Waibel :: SSRN
A test patient who does not need treatment is sent to 180 dentists to receive treatment recommendations. In the experiment, we vary two factors: First, the information that the patient signals to the dentist. Second, we vary the perceived socioeconomic status (SES) of the test patient. Furthermore, we collected data to construct several measures of short- and long-term demand and competition as well as dentist and practice characteristics. We find that the patient receives an overtreatment recommendation in _more than every fourth visit_. A low short-term demand, indicating excess capacities, leads to significantly more overtreatment recommendations. Physician density and their price level, however, do not have a significant effect on overtreatment. Furthermore, we observe significantly less overtreatment recommendations for the patient with higher SES compared to lower SES under standard information. More signalled information however does not significantly reduce overtreatment.

How much dentists are ethically concerned about overtreatment; a vignette-based survey in Switzerland: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474445/
Are Dentists Overtreating Your Teeth?: https://well.blogs.nytimes.com/2011/11/28/are-dentists-overtreating-your-teeth/
Have you had a rash of fillings after years of healthy teeth? The culprit may be “microcavities,” and not every dentist thinks they need to be treated, reports today’s Science Times.
How Dentists Rip Us Off: https://www.dentistat.com/ReaderDigestArticle.pdf

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october 2017 by nhaliday
Medicine as a pseudoscience | West Hunter
The idea that venesection was a good thing, or at least not so bad, on the grounds that one in a few hundred people have hemochromatosis (in Northern Europe) reminds me of the people who don’t wear a seatbelt, since it would keep them from being thrown out of their convertible into a waiting haystack, complete with nubile farmer’s daughter. Daughters. It could happen. But it’s not the way to bet.

Back in the good old days, Charles II, age 53, had a fit one Sunday evening, while fondling two of his mistresses.

Monday they bled him (cupping and scarifying) of eight ounces of blood. Followed by an antimony emetic, vitriol in peony water, purgative pills, and a clyster. Followed by another clyster after two hours. Then syrup of blackthorn, more antimony, and rock salt. Next, more laxatives, white hellebore root up the nostrils. Powdered cowslip flowers. More purgatives. Then Spanish Fly. They shaved his head and stuck blistering plasters all over it, plastered the soles of his feet with tar and pigeon-dung, then said good-night.


Friday. The king was worse. He tells them not to let poor Nelly starve. They try the Oriental Bezoar Stone, and more bleeding. Dies at noon.

Most people didn’t suffer this kind of problem with doctors, since they never saw one. Charles had six. Now Bach and Handel saw the same eye surgeon, John Taylor – who blinded both of them. Not everyone can put that on his resume!

You may wonder how medicine continued to exist, if it had a negative effect, on the whole. There’s always the placebo effect – at least there would be, if it existed. Any real placebo effect is very small: I’d guess exactly zero. But there is regression to the mean. You see the doctor when you’re feeling worse than average – and afterwards, if he doesn’t kill you outright, you’re likely to feel better. Which would have happened whether you’d seen him or not, but they didn’t often do RCTs back in the day – I think James Lind was the first (1747).

Back in the late 19th century, Christian Scientists did better than others when sick, because they didn’t believe in medicine. For reasons I think mistaken, because Mary Baker Eddy rejected the reality of the entire material world, but hey, it worked. Parenthetically, what triggered all that New Age nonsense in 19th century New England? Hash?

This did not change until fairly recently. Sometime in the early 20th medicine, clinical medicine, what doctors do, hit break-even. Now we can’t do without it. I wonder if there are, or will be, other examples of such a pile of crap turning (mostly) into a real science.

good tweet: https://twitter.com/bowmanthebard/status/897146294191390720
The brilliant GP I've had for 35+ years has retired. How can I find another one who meets my requirements?

1 is overweight
2 drinks more than officially recommended amounts
3 has an amused, tolerant atitude to human failings
4 is well aware that we're all going to die anyway, & there are better or worse ways to die
5 has a healthy skeptical attitude to mainstream medical science
6 is wholly dismissive of "a|ternative” medicine
7 believes in evolution
8 thinks most diseases get better without intervention, & knows the dangers of false positives
9 understands the base rate fallacy

EconPapers: Was Civil War Surgery Effective?: http://econpapers.repec.org/paper/htrhcecon/444.htm
contra Greg Cochran:
To shed light on the subject, I analyze a data set created by Dr. Edmund Andrews, a Civil war surgeon with the 1st Illinois Light Artillery. Dr. Andrews’s data can be rendered into an observational data set on surgical intervention and recovery, with controls for wound location and severity. The data also admits instruments for the surgical decision. My analysis suggests that Civil War surgery was effective, and increased the probability of survival of the typical wounded soldier, with average treatment effect of 0.25-0.28.

Medical Prehistory: https://westhunt.wordpress.com/2016/03/14/medical-prehistory/
What ancient medical treatments worked?

In some very, very limited conditions, bleeding?
Bad for you 99% of the time.

Colchicine – used to treat gout – discovered by the Ancient Greeks.

Dracunculiasis (Guinea worm)
Wrap the emerging end of the worm around a stick and slowly pull it out.
(3,500 years later, this remains the standard treatment.)

Some of the progress is from formal medicine, most is from civil engineering, better nutrition ( ag science and physical chemistry), less crowded housing.

Nurses vs doctors: https://westhunt.wordpress.com/2014/10/01/nurses-vs-doctors/
Medicine, the things that doctors do, was an ineffective pseudoscience until fairly recently. Until 1800 or so, they were wrong about almost everything. Bleeding, cupping, purging, the four humors – useless. In the 1800s, some began to realize that they were wrong, and became medical nihilists that improved outcomes by doing less. Some patients themselves came to this realization, as when Civil War casualties hid from the surgeons and had better outcomes. Sometime in the early 20th century, MDs reached break-even, and became an increasingly positive influence on human health. As Lewis Thomas said, medicine is the youngest science.

Nursing, on the other hand, has always been useful. Just making sure that a patient is warm and nourished when too sick to take care of himself has helped many survive. In fact, some of the truly crushing epidemics have been greatly exacerbated when there were too few healthy people to take care of the sick.

Nursing must be old, but it can’t have existed forever. Whenever it came into existence, it must have changed the selective forces acting on the human immune system. Before nursing, being sufficiently incapacitated would have been uniformly fatal – afterwards, immune responses that involved a period of incapacitation (with eventual recovery) could have been selectively favored.

when MDs broke even: https://westhunt.wordpress.com/2014/10/01/nurses-vs-doctors/#comment-58981
I’d guess the 1930s. Lewis Thomas thought that he was living through big changes. They had a working serum therapy for lobar pneumonia ( antibody-based). They had many new vaccines ( diphtheria in 1923, whopping cough in 1926, BCG and tetanus in 1927, yellow fever in 1935, typhus in 1937.) Vitamins had been mostly worked out. Insulin was discovered in 1929. Blood transfusions. The sulfa drugs, first broad-spectrum antibiotics, showed up in 1935.

DALYs per doctor: https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/
The disability-adjusted life year (DALY) is a measure of overall disease burden – the number of years lost. I’m wondering just much harm premodern medicine did, per doctor. How many healthy years of life did a typical doctor destroy (net) in past times?


It looks as if the average doctor (in Western medicine) killed a bunch of people over his career ( when contrasted with doing nothing). In the Charles Manson class.

Eventually the market saw through this illusion. Only took a couple of thousand years.

That a very large part of healthcare spending is done for non-health reasons. He has a chapter on this in his new book, also check out his paper “Showing That You Care: The Evolution of Health Altruism” http://mason.gmu.edu/~rhanson/showcare.pdf
I ran into too much stupidity to finish the article. Hanson’s a loon. For example when he talks about the paradox of blacks being more sentenced on drug offenses than whites although they use drugs at similar rate. No paradox: guys go to the big house for dealing, not for using. Where does he live – Mars?

I had the same reaction when Hanson parroted some dipshit anthropologist arguing that the stupid things people do while drunk are due to social expectations, not really the alcohol.

I don’t think that being totally unable to understand everybody around you necessarily leads to deep insights.

What I’ve wondered is if there was anything that doctors did that actually was helpful and if perhaps that little bit of success helped them fool people into thinking the rest of it helped.
Setting bones. extracting arrows: spoon of Diocles. Colchicine for gout. Extracting the Guinea worm. Sometimes they got away with removing the stone. There must be others.
Quinine is relatively recent: post-1500. Obstetrical forceps also. Caesarean deliveries were almost always fatal to the mother until fairly recently.

Opium has been around for a long while : it works.

If pre-modern medicine was indeed worse than useless – how do you explain no one noticing that patients who get expensive treatments are worse off than those who didn’t?
were worse off. People are kinda dumb – you’ve noticed?
My impression is that while people may be “kinda dumb”, ancient customs typically aren’t.
Even if we assume that all people who lived prior to the 19th century were too dumb to make the rational observation, wouldn’t you expect this ancient practice to be subject to selective pressure?
Your impression is wrong. Do you think that there some slick reason for Carthaginians incinerating their first-born?

Theodoric of York, bloodletting: https://www.youtube.com/watch?v=yvff3TViXmY

details on blood-letting and hemochromatosis: https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/#comment-100746

Starting Over: https://westhunt.wordpress.com/2018/01/23/starting-over/
Looking back on it, human health would have … [more]
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august 2017 by nhaliday
Whole Health Source: Palatability, Satiety and Calorie Intake
The more palatable the food, the less filling per calorie, and the relationship was quite strong for a study of this nature. This is consistent with the evidence that highly palatable foods shut down the mechanisms in the brain that constrain food intake. Croissants had the lowest SI (47), while potatoes had the highest (323). Overall, baked goods and candy had the lowest SI. They didn't test sweet potatoes, but I suspect they would have been similar to potatoes. Other foods with a high SI include meat/fish, whole grain foods, fruit and porridge.
taubes-guyenet  org:health  fitsci  health  embodied  food  diet  nutrition  metabolic  constraint-satisfaction  wire-guided  correlation  emotion 
july 2017 by nhaliday
Alzheimers | West Hunter
Some disease syndromes almost have to be caused by pathogens – for example, any with a fitness impact (prevalence x fitness reduction) > 2% or so, too big to be caused by mutational pressure. I don’t think that this is the case for AD: it hits so late in life that the fitness impact is minimal. However, that hardly means that it can’t be caused by a pathogen or pathogens – a big fraction of all disease syndromes are, including many that strike in old age. That possibility is always worth checking out, not least because infectious diseases are generally easier to prevent and/or treat.

There is new work that strongly suggests that pathogens are the root cause. It appears that the amyloid is an antimicrobial peptide. amyloid-beta binds to invading microbes and then surrounds and entraps them. ‘When researchers injected Salmonella into mice’s hippocampi, a brain area damaged in Alzheimer’s, A-beta quickly sprang into action. It swarmed the bugs and formed aggregates called fibrils and plaques. “Overnight you see the plaques throughout the hippocampus where the bugs were, and then in each single plaque is a single bacterium,” Tanzi says. ‘

obesity and pathogens: https://westhunt.wordpress.com/2016/05/29/alzheimers/#comment-79757
not sure about this guy, but interesting: https://westhunt.wordpress.com/2016/05/29/alzheimers/#comment-79748

All too often we see large, long-lasting research efforts that never produce, never achieve their goal.

For example, the amyloid hypothesis [accumulation of amyloid-beta oligomers is the cause of Alzheimers] has been dominant for more than 20 years, and has driven development of something like 15 drugs. None of them have worked. At the same time the well-known increased risk from APOe4 has been almost entirely ignored, even though it ought to be a clue to the cause.

In general, when a research effort has been spinning its wheels for a generation or more, shouldn’t we try something different? We could at least try putting a fraction of those research dollars into alternative approaches that have not yet failed repeatedly.

Mostly this applies to research efforts that at least wish they were science. ‘educational research’ is in a special class, and I hardly know what to recommend. Most of the remedial actions that occur to me violate one or more of the Geneva conventions.

APOe4 related to lymphatic system: https://en.wikipedia.org/wiki/Apolipoprotein_E

Look,if I could find out the sort of places that I usually misplace my keys – if I did, which I don’t – I could find the keys more easily the next time I lose them. If you find out that practitioners of a given field are not very competent, it marks that field as a likely place to look for relatively easy discovery. Thus medicine is a promising field, because on the whole doctors are not terribly good investigators. For example, none of the drugs developed for Alzheimers have worked at all, which suggests that our ideas on the causation of Alzheimers are likely wrong. Which suggests that it may (repeat may) be possible to make good progress on Alzheimers, either by an entirely empirical approach, which is way underrated nowadays, or by dumping the current explanation, finding a better one, and applying it.

You could start by looking at basic notions of field X and asking yourself: How do we really know that? Is there serious statistical evidence? Does that notion even accord with basic theory? This sort of checking is entirely possible. In most of the social sciences, we don’t, there isn’t, and it doesn’t.

Hygiene and the world distribution of Alzheimer’s disease: Epidemiological evidence for a relationship between microbial environment and age-adjusted disease burden: https://academic.oup.com/emph/article/2013/1/173/1861845/Hygiene-and-the-world-distribution-of-Alzheimer-s

Amyloid-β peptide protects against microbial infection in mouse and worm models of Alzheimer’s disease: http://stm.sciencemag.org/content/8/340/340ra72

Fungus, the bogeyman: http://www.economist.com/news/science-and-technology/21676754-curious-result-hints-possibility-dementia-caused-fungal
Fungus and dementia
paper: http://www.nature.com/articles/srep15015
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july 2017 by nhaliday
Vegetables | Examine.com
I really wonder if eating 2 servings of Brassica, 2 servings of the Onion family, 2 servings of Garlic, 2 servings of mushrooms, and 2 'other' plants (dark berries?) is as magical as I am imagining it right now. You pretty much have a high dose of everything.
org:health  top-n  links  health  nutrition  diet  fitsci  low-hanging  prepping  metabolic  minimum-viable 
may 2017 by nhaliday
Is soy good or bad for me? | Examine.com
The estimated per capita consumption of soybean oil increased >1000-fold from 1909 to 1999.
https://twitter.com/evolutionarypsy/status/892489043446988800 (increase started during 60s)

Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis: https://www.ncbi.nlm.nih.gov/pubmed/19524224
No significant effects of soy protein or isoflavone intake on T, SHBG, free T, or FAI were detected regardless of statistical model.

some good ones:
pros and cons: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074428/
reproductive consequences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443604/
visuospatial memory: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC64558/
reject (in humans)t: https://www.ncbi.nlm.nih.gov/pubmed/19524224


A: yes
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may 2017 by nhaliday
Secular decline in testosterone levels - Rogue Health and Fitness
A Population-Level Decline in Serum Testosterone Levels in American Men: http://sci-hub.tw/10.1210/jc.2006-1375
Secular trends in sex hormones and fractures in men and women: http://www.eje-online.org/content/166/5/887.full.pdf
Small n and older sample, but interesting that while testosterone decreases have been large for men they’ve been even larger (in % terms) for women; wonder if this contributes to declining pregnancy and sexual frequency, rising depression.

Strangelove: https://youtu.be/N1KvgtEnABY?t=67

People offering human-centric explanations like cell phones: Note also that the sperm quality of dogs has decreased 30% since 1988.

mendelian rand.:
1 SD genetically instrumented increase in BMI was associated with a 0.25 SD decrease in serum testosterone

Ibuprofen linked to male infertility: study: https://nypost.com/2018/01/08/ibuprofen-linked-to-male-infertility-study/

Tucker Carlson: "Men Seem To Be Becoming Less Male": https://www.realclearpolitics.com/video/2018/03/08/tucker_carlson_men_seem_to_be_becoming_less_male.html
Carlson interviewed Dr. Jordan Peterson who blamed the "insidious" movement being driven by the "radical left" that teaches there a problem of "toxic masculinity." He said ideological policies focus on "de-emphasizing masculinity may be part of the problem."


Those are the numbers. They paint a very clear picture: American men are failing, in body, mind and spirit. This is a crisis. Yet our leaders pretend it’s not happening. They tell us the opposite is true: Women are victims, men are oppressors. To question that assumption is to risk punishment. Even as women far outpace men in higher education, virtually every college campus supports a women’s studies department, whose core goal is to attack male power. Our politicians and business leaders internalize and amplify that message. Men are privileged. Women are oppressed. Hire and promote and reward accordingly.

But it also hints at an almost opposite take: average testosterone levels have been falling for decades, so at this point these businessmen would be the only “normal” (by 1950s standards) men out there, and everyone else would be unprecedently risk-averse and boring.
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may 2017 by nhaliday
Meta-analysis: Impact of carbohydrate vs. fat calories on energy expenditure and body fatness
They identified 28 studies that met their criteria for energy expenditure.  Combining the data of these 28 studies, they found that calorie-matched diets predominating in fat vs. carbohydrate have almost identical effects, but higher-carbohydrate diets do lead to a slightly higher energy expenditure.  This difference was statistically significant but of little medical or practical relevance, since it only amounted to 26 Calories per day.  This slightly higher energy expenditure is consistent with the fact that the metabolism of carbohydrate is slightly less efficient than the metabolism of fat, meaning that a bit more energy is wasted*.

Examining the data, the paper’s result is not hard to believe because only 8 of the 28 studies reported that lower-carbohydrate diets led to a higher energy expenditure than higher-carbohydrate diets, and among those 8, the results were only statistically significant in four.  In contrast, 20 studies reported higher energy expenditure with higher-carbohydrate diets, and that was statistically significant in 14.  One can choose individual studies that support either belief, but the overall evidence suggests that the relative carbohydrate and fat content of the diet has little impact on energy expenditure.

Onward to body fatness.  Hall and Guo identified 20 controlled feeding studies that reported changes in body fatness on equal-calorie diets differing in fat and carbohydrate content.  Echoing the energy expenditure finding, they found that diets predominating in carbohydrate or fat have similar effects on body fatness.  Yet higher-carbohydrate diets do lead to a slightly greater loss of body fat per calorie, amounting to a 16 gram per day difference.  This is actually a larger difference than one would predict from the difference in energy expenditure, which would only be 2.8 g/day.
taubes-guyenet  org:health  health  diet  nutrition  fitsci  commentary  study  summary  meta-analysis  field-study  intervention  obesity  comparison  metabolic 
march 2017 by nhaliday
Whole Health Source: The Glycemic Index: A Critical Evaluation
Overall, these studies do not support the idea that lowering the glycemic index of carbohydrate foods is useful for weight loss, insulin or glucose control, or anything else besides complicating your life. I'll keep my finger on the pulse of this research as it expands, but for the time being I don't see the glycemic index per se as a significant way to combat fat gain or metabolic disease.
critique  concept  diet  nutrition  stamina  embodied-cognition  embodied  health  taubes-guyenet  org:health  contrarianism  fitsci  obesity  metrics 
march 2017 by nhaliday
Whole Health Source: The Potato Diet
1. Potatoes have a low calorie density and a high satiety value per calorie.
2. Eating a diet that is composed almost exclusively of one food is low in reward, low-moderate palatability, low in variety, and has a high sensory-specific satiety. Even if you dress up your potatoes as well as you can, you're still eating potatoes. This tends to reduce calorie intake.
3. Potatoes are nutritious enough (including complete protein) that they can be the sole source of calories for an extended period of time. However, they are not a complete source of all micronutrients and deficiencies will eventually arise.
diet  nutrition  food  rhetoric  analysis  models  taubes-guyenet  org:health  health  obesity  fitsci  prepping  minimum-viable  efficiency 
march 2017 by nhaliday
Summary | EWG's 2017 Shopper's Guide to Pesticides in Produce
Three long-term birth cohort studies in the U.S. suggest that pesticides are harming children’s brains. In these studies, researchers found that women’s exposure to pesticides during pregnancy, measured through urine samples, was associated with negative impacts on their children’s IQ and neurobehavioral development, as well as with ADHD [attention deficit hyperactivity disorder] diagnoses. Also, one of the studies looked at structural brain growth using magnetic resonance imaging and found that the gray matter was thinner in children the higher their mothers’ exposure to organophosphates, which are used widely in pesticides. I think that’s quite scary.
org:health  data  analysis  health  food  hypochondria  embodied-street-fighting  embodied  reference  sanctity-degradation  multi  org:edu  science-anxiety  study  summary  developmental  neuro  psychiatry 
march 2017 by nhaliday
Bisphenol A (BPA)
Alternatives to BPA containers not easy for U.S. foodmakers to find: http://www.washingtonpost.com/wp-dyn/content/article/2010/02/22/AR2010022204830.html

Food is main source of BPA for consumers, thermal paper also potentially significant: https://www.efsa.europa.eu/en/press/news/130725
New data resulting from an EFSA call for data led to a considerable refinement of exposure estimates compared to 2006. For infants and toddlers (aged 6 months-3 years) average exposure from the diet is estimated to amount to 375 nanograms per kilogram of body weight per day (ng/kg bw/day) whereas for the population above 18 years of age (including women of child-bearing age) the figure is up to 132 ng/kg bw/day. By comparison, these estimates are less than 1% of the current Tolerable Daily Intake (TDI) for BPA (0.05 milligrams/kg bw/day) established by EFSA in 2006.

For all population groups above three years of age thermal paper was the second most important source of BPA after the diet (potentially accounting for up to 15% of total exposure in some population groups).

Among other key findings, scientists found dietary exposure to BPA to be the highest among children aged three to ten (explainable by their higher food consumption on a body weight basis). Canned food and non-canned meat and meat products were identified as major contributors to dietary BPA exposure for all age groups.

Tips for Avoiding BPA in Canned Food: http://www.breastcancerfund.org/reduce-your-risk/tips/avoid-bpa.html

Holding Thermal Receipt Paper and Eating Food after Using Hand Sanitizer Results in High Serum Bioactive and Urine Total Levels of Bisphenol A (BPA): http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0110509

Bisphenol S Disrupts Estradiol-Induced Nongenomic Signaling in a Rat Pituitary Cell Line: Effects on Cell Functions: http://ehp.niehs.nih.gov/1205826/
common substitute for BPA


Effect of probiotics, Bifidobacterium breve and Lactobacillus casei, on bisphenol A exposure in rats: https://www.ncbi.nlm.nih.gov/pubmed/18540113

What are the sources of exposure to eight frequently used phthalic acid esters in Europeans?: https://www.ncbi.nlm.nih.gov/pubmed/16834635
Food is a main source of DiBP, DnBP, and DEHP in consumers. In this case, consumers have very few possibilities to effectively reduce their exposure.

Are endocrine disrupting compounds a health risk in drinking water?: https://www.ncbi.nlm.nih.gov/pubmed/16823090

How to Avoid Phthalates (Even Though You Can't Avoid Phthalates): http://www.huffingtonpost.com/maia-james/phthalates-health_b_2464248.html
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january 2017 by nhaliday
Lead: America's Real Criminal Element | Mother Jones
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july 2016 by nhaliday

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