Protecting Children from the Perils of Plastic: The People’s Pharmacy Podcast

Transcript

Joe Graedon (00:00:00):

I’m Joe Graedon.

 

Terry Graedon (00:00:01):

And I’m Terry Graedon.

 

Joe Graedon (00:00:02):

Welcome to this podcast of The People’s Pharmacy.

 

Terry Graedon (00:00:02):

You can find previous podcasts and more information on a range of health topics at peoplespharmacy.com.

 

Joe Graedon (00:00:13):

Where would we be without plastic? Parents rely on plastic pacifiers, plastic toys, and plastic bike helmets. This is The People’s Pharmacy with Terry and Joe Graedon.

 

Terry Graedon (00:00:27):

Plastics are incredibly convenient, lightweight, and unbreakable. They make great food containers. Now they’re everywhere, including in us. Is that a problem?

 

Joe Graedon (00:00:45):

Young people have more plastic in their bodies relative to their size than older folks.

 

Terry Graedon (00:00:50):

One major source of plastic is ultra-processed food. Microscopic particles of plastic are often embedded in the food and are also in the packaging. Can busy parents feed their kids without relying on ultra-processed food?

 

Joe Graedon (00:01:05):

Coming up on The People’s Pharmacy, protecting children from the perils of plastic.

 

Terry Graedon (00:01:14):

In The People’s Pharmacy Health Headlines: Doctors could predict women’s risk of heart disease decades in advance if they use three common blood tests. Research published in the New England Journal of Medicine demonstrates that inflammation and a blood lipid called lipoprotein A are critical, along with LDL cholesterol. Researchers analyzed high-sensitivity CRP, LDL cholesterol, and LP-little a levels in the 1990s for nearly 30,000 participants of the Women’s Health Study. Thirty years later, these healthy, middle-aged women had experienced more than 3,600 cardiovascular events. People with the highest levels of CRP were 70% more likely to have had one. High levels of LDL cholesterol increased the risk by 36%, while women with high levels of LP little a were 33% more likely to have had a heart attack or stroke.

 

Terry Graedon (00:02:16):

When there’s a history of heart attacks in families, often lipoprotein A levels are high. It’s estimated that about 30% of the world’s population has elevated levels of LP little a. Many physicians believe that diet has no impact on this biomarker.

 

Joe Graedon (00:02:38):

A new study in the American Journal of Clinical Nutrition reveals, however, that eating more saturated fat lowers LP little a levels modestly. Carbohydrates, on the other hand, raise LP little a levels.

 

Terry Graedon (00:02:52):

Of course, this research completely contradicts the usual dietary advice for controlling heart disease risk. Diet can also lower C-reactive protein, which is a measure of inflammation. Anti-inflammatory foods include dark green leafy vegetables, blueberries, flaxseed, and cocoa.

 

Joe Graedon (00:03:11):

The European Society of Cardiology has just updated its guidelines for treating high blood pressure. Hypertension in Europe is now defined as 140 over 90, but there’s a new category. Doctors are encouraged to treat elevated blood pressure higher than 120 over 70.

 

Terry Graedon (00:03:32):

This is a major change from previous European guidelines. Physicians there are being urged to start treatment with lifestyle changes such as exercise and diet. If that does not lower blood pressure adequately, they’ll be expected to prescribe antihypertensive medications. Exceptions are made for patients who get dizzy when they stand up or those over 85 years of age.

 

Joe Graedon (00:03:55):

Patients with a history of cancer are rarely given advice about diet. Data from the UK Biobank showed that individuals who ate the most ultra-processed foods were 17% more likely to die and 22% more likely to die from cancer than those who ate the least.

 

Terry Graedon (00:04:23):

This was based on records of almost 14,000 volunteers with a history of cancer. The median follow-up was more than 10 years. The authors conclude, quote, “Current research results support the recommendation for individuals with a history of cancer to consume unprocessed or minimally processed foods, such as fruits and vegetables.”

 

Joe Graedon (00:04:38):

Medications such as Enbrel, Humira, and Remicade work in part by blocking the action of the inflammatory compound called tumor necrosis factor, or TNF. These drugs are used to treat conditions like rheumatoid arthritis or psoriatic arthritis.

 

Terry Graedon (00:04:54):

A systematic review of 15 randomized trials of green tea found that this natural compound significantly reduced circulating levels of TNF in people with metabolic syndrome.

 

Joe Graedon (00:05:08):

Plastic is ubiquitous in our environment. Now, scientists report that autopsies show micro- and nanoplastic particles in our brains.

 

Terry Graedon (00:05:11):

Even worse, these tiny shards of plastic are increasing over time. The researchers compared autopsy data gathered in 2016 to tissue samples gathered in 2024. Levels of micro- and nanoplastics are now roughly 50% higher than they were eight years ago.

 

Joe Graedon (00:05:38):

The researchers note that the amount of plastic particles in brain samples was 7 to 30 times higher than that seen in livers or kidneys. They conclude that plastic appears to accumulate selectively in brain tissue, which could be worrisome as global rates of dementia continue to rise.

 

Terry Graedon (00:05:57):

And that’s the health news from The People’s Pharmacy this week.

 

Joe Graedon (00:06:02):

Welcome to The People’s Pharmacy.

 

Terry Graedon (00:06:16):

I’m Terry Graedon.

 

Joe Graedon (00:06:16):

And I’m Joe Graedon.

 

Terry Graedon (00:06:18):

Plastic has been around for a little more than a century. The original compound, Bakelite, was employed as an electrical insulator.

 

Joe Graedon (00:06:21):

Today, plastic material is ubiquitous. We use it in buildings, cars, pipes, bottles, and packaging, to name just a few of the many places plastic appears in modern life.

 

Terry Graedon (00:06:40):

But plastic is showing up in us as well. Micro- and nanoplastic particles are found in the blood and organs of humans in increasing concentrations.

 

Joe Graedon (00:06:49):

To help us better understand the implications of plastic on human biology, we turn to The People’s Pharmacy pediatrician.

 

Terry Graedon (00:06:58):

Dr. Alan Greene is the founder of DrGreene.com, the pioneer physician website. He’s founding president of the Society for Participatory Medicine and author of Feeding Baby Green and From First Kicks to First Steps. His first children’s book, Flower Moon, was published in 2023.

 

Joe Graedon (00:07:13):

Welcome back to The People’s Pharmacy, Dr. Alan Greene.

 

Dr. Alan Greene (00:07:20):

Terry, I can’t tell you how happy I am to be back on The People’s Pharmacy with you and Joe.

 

Terry Graedon (00:07:23):

Well, Dr. Greene, we have to tell you, it is always a joy to speak with you. And we are now excited to talk to you about something that has been worrying us for almost, if you can believe it, 50 years. I’ll never forget the movie The Graduate.

 

Joe Graedon (00:07:34):

Yes.

 

Terry Graedon (00:07:34):

And Dustin Hoffman was told just one word: plastics. It was the wave of the future.

 

Dr. Alan Greene (00:07:47):

And now it’s the wave of the disaster.

 

Terry Graedon (00:07:48):

Can you tell us about the problems of plastic, especially for children, and not just those plasticizers, the BPA and the bisphenols and the phthalates, but the microparticles of plastic and what they’re doing to us, especially our kids?

 

Dr. Alan Greene (00:08:02):

You’re right. The Graduate was so on point. Plastics were huge, just like they predicted. Back in 1906, when there was an earthquake in San Francisco, there were zero synthetic plastics in the world. There were zero synthetic plastics in the soil, in the water, in the air, in animals, in the ice in Antarctica. There were zero. But in 1907, synthetic plastics were invented and introduced into our environment. And then they really took off in World War II. And then they really took off after that because they’re so convenient in so many ways and inexpensive. But as a result, little bits of broken-down plastics, a micron in size, a nanometer in size, maybe five millimeters in size—these shards are showing up literally everywhere. They’re in our soil, in our food, in our water, in so many products that we use in our lives every day and every corner of the environment, including in Antarctica.

 

Terry Graedon (00:09:21):

Where are they coming from?

 

Dr. Alan Greene (00:09:34):

So the plastics were manufactured to last. But they last in a way that they slowly break down into little pieces. Then they get into our body. And the question is, they’ve been found in multiple places in our bodies. We now know that there are microplastics or nanoplastics, these little shards that are present in our kidneys and that are present in our livers and that are present in our brains. Just in 2024, there was a study out of New Mexico showing that microplastics were in every single placenta that was studied. And then just in May 2024, in every human testicle that was studied. Dog testicles too, but they were much, much higher in human testicles.

 

Joe Graedon (00:10:22):

And what are they doing in our testicles? Because it seems like that’s not a good place, especially given that they’re endocrine disruptors.

 

Dr. Alan Greene (00:10:38):

So up until recently, there hasn’t been a clear-cut answer to that. Back in 2005, I was the physician on a study with the Environmental Working Group where we measured umbilical cord samples to see what chemicals were there. We found 287 different chemicals, industrial chemicals, in baby’s blood at the moment of birth. And in their umbilical cord, they’ve been coursing through their bodies while they were developing before birth, including plastic ingredients and byproducts. But we didn’t know what that meant. We do know in this study in May, looking at shards of plastic and testicles of dogs, the higher the level of plastics, the lower the sperm count of the dog. And this makes sense. We’ve known for a while that phthalates, one of the plasticizers used to make plastics softer, does lower sperm count and sperm concentration. And we’re headed for a bit of a disaster in that regard. From the time my dad was born until 1990, male sperm counts dropped from 113 million per milliliter to 66, almost in half. Not enough that that meant most people were having problems with fertility. Usually, you have to drop down to about 48 was the number I learned in med school for that to become an issue with male fertility. But right now in the U.S., we’ve just dropped to a sperm concentration of 47.

 

Terry Graedon (00:12:12):

Dr. Greene, that sounds a lot like The Handmaid’s Tale.

 

Dr. Alan Greene (00:12:15):

It sounds a lot like The Handmaid’s Tale. Margaret Atwood was prescient in a lot of ways.

 

Terry Graedon (00:12:20):

Now, we’ve been talking about the effect of microplastic particles, which have been seen in both dog testes and human testes. And we’ve been talking about the effects on reproductive health for men. What about the effects on reproductive health for women? And do we have micro pieces of plastic in our bodies, too? And are they having an impact?

 

Dr. Alan Greene (00:12:36):

We definitely have them in males and females, both in reproductive organs and almost everywhere there we look in the body. We still don’t know the impact of this brand-new experiment. Really, up until 2024, one would say that there is means, motive, and opportunity for plastics to be able to cause problems. But there hadn’t been a real clear-cut link to the problems of these new materials in different places in our body. But that changed when there was a big article, a big study that was published in the New England Journal of Medicine, where they looked at coronary artery plaques on people that had a problem in the coronary arteries. It was severe enough that they needed to have surgery. And they went and measured to look at how much plastic was there, to see if plastics, little plastic shards that they could see under the microscope, made a difference in the outcomes.

 

And a few things. One, they found that about 60% of the plaques that they identified did have plastics in them. Most of them did have plastics in them. And oddly, the amount of plastic was higher the younger the person was. Same thing, sadly, was found in the testicles of men. The younger the person, the more likely they were to have increased plastics. So the thought was that since these folks were younger with the higher levels of plastics, perhaps they would have a better outcome. But they followed them for three years, and they found that those who had the microplastics in the plaque in their artery were four and a half times more likely to have stroke, heart attack, or death within 34 months. Four and a half times more.

 

Terry Graedon (00:15:18):

Dr. Greene, I’m wondering, as you tell me that younger people have more plastic particles in their bodies, I’m thinking, well, the amount of plastic in our environment has been steadily increasing. Old people like Joe and me, who were born in the 1940s, we weren’t overexposed to plastics when we were very young, when we were children. But people who have been born in the 1990s, the 2000s, the 2010s, plastic is just kind of ubiquitous, isn’t it?

 

Dr. Alan Greene (00:15:56):

It’s everywhere. And our exposure to plastics is doubling about every 10 to 15 years and still going up. So yeah, it is the young who are at the highest risk from this.

 

Joe Graedon (00:16:21):

So the question is, how does the plastic get into our body in the first place?

 

Dr. Alan Greene (00:16:26):

And there’s lots of ways. We know it does come in some when we inhale it. It’s in the air. It does come in some through personal care products that go on our skin, and that’s important to try to avoid phthalates in your personal care products. But far and away, the big way is when we directly put the plastic into our body through what we eat and what we drink primarily.

 

And there was an interesting study this year done up in Toronto where they were looking at plastic levels in foods. This was primarily proteins because often the thinking was that because seafood is in the ocean where there’s lots of microplastics now that maybe they’ll have the highest level compared to maybe cows are different and maybe tofu is different and maybe seafood and maybe poultry is different.

 

Joe Graedon (00:17:16):

And what, among all the protein sources, which ones have the highest levels of microplastics?

 

Dr. Alan Greene (00:17:21):

And it turned out differently than they expected. It turned out that the type of protein made very little difference. What made a difference was how processed the food was.

 

So back in 2009 in Brazil, they came up with a study called NOVA rankings of ultra-processed food. And level one means the food is the way you would find it in nature.

 

Joe Graedon (00:17:48):

Alan, let’s hold that thought because we want to talk more about ultra-processed food and how the plastic gets into it right after the break. Okay?

 

Dr. Alan Greene (00:17:58):

Okay.

 

Terry Graedon (00:17:59):

You’re listening to Dr. Alan Greene, the People’s Pharmacy Pediatrician.

 

Joe Graedon (00:18:05):

After the break, we’ll find out where all that plastic in our bodies is coming from. What do we mean when we talk about ultra-processed food? It’s not just the food, but also the packaging. How can parents pressed for time limit the amount of ultra-processed food they feed their kids? We should also be alert when it comes to pacifiers and teeth aligners.

 

Terry Graedon (00:18:26):

You’re listening to The People’s Pharmacy with Joe and Terry Graedon.

 

Terry Graedon (00:18:36):

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Joe Graedon (00:19:00):

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Terry Graedon (00:19:41):

Welcome back to The People’s Pharmacy.

 

Joe Graedon (00:19:52):

I’m Joe Graedon.

 

Terry Graedon (00:19:53):

And I’m Terry Graedon.

 

Joe Graedon (00:19:54):

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Terry Graedon (00:20:11):

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Joe Graedon (00:20:15):

When we say plastic is ubiquitous, it really is. Plastic is found not just in the obvious places, like water bottles, backpacks, and flip-flops, but also in us. Studies have found teensy plastic particles in our brains, livers, and coronary arteries.

 

Terry Graedon (00:20:27):

Young people have more plastic inside them relative to their size than older folks. How can parents protect their children from the perils of plastic?

 

Joe Graedon (00:20:38):

We’re talking with Dr. Alan Greene, a pediatrician in private practice. Dr. Greene is the founder of DrGreene.com, a pioneering physician website. He also founded La Connexion and was the founding president of the Society for Participatory Medicine. He’s the author of Feeding Baby Green, Raising Baby Green, and From First Kicks to First Steps. He published his first children’s book, Flower Moon, in 2023.

 

Terry Graedon (00:21:14):

Dr. Greene, you’re saying that the type of protein in this study didn’t make nearly as much difference as how processed it was. Can you tell us more about that, please?

 

Dr. Alan Greene (00:21:26):

Yeah, this was a dramatic finding. And back in 2009 in Brazil, they came up with this rating for how processed food is. It’s called the NOVA Classification. And Class 1 is food the way you’d find it in nature, like an apple or a carrot or something like that, an ingredient you would find growing from the land or from the water. Level 2 are other ingredients that you would find in a kitchen, like a home kitchen or even a restaurant kitchen. Level 3 are things that are made in a factory but made from real foods. And then Level 4 are things that are primarily the main ingredients are factory-made ingredients. And it could be an extrusion or a chemical or an emulsifier or whatever it is, or artificial color, flavor, preservative. And those are ultra-processed.

 

Joe Graedon (00:22:20):

Well, Alan, I’m going to interrupt you because we can talk about this in an abstract way.

 

Terry Graedon (00:22:28):

Yeah.

 

Joe Graedon (00:22:29):

People want to know, well, what precisely are you talking about when it comes to foods? And I think for the most part, it’s all that stuff that’s in a bag or a box.

 

Terry Graedon (00:22:36):

Right.

 

Joe Graedon (00:22:36):

And it’s in the middle of the supermarket. So let’s just name some things that equal ultra-processed because I think, you know, a lot of us just go, oh, chips, no biggie. You know, chips are great. They go well with guacamole. You know, cheese and crackers, not a problem. What do you mean when you say ultra-processed foods, especially when it comes to children? So just give us some examples, please.

 

Dr. Alan Greene (00:23:01):

So it matters how the food is prepared. So for instance, a chocolate chip cookie that’s made at home with flour and butter and real ingredients is entirely different. That would be like a level two than a chocolate chip cookie that you buy in a package made in a factory with artificial and chemical ingredients. And the same with chips that you would find in a bag or breakfast cereal is an ultra-processed food that you buy in the store in a box. Almost everything in a can or box or bag in the middle of the store made in a factory is ultra-processed food. Also, at some restaurants. Some restaurants cook in the kitchen, but most fast food restaurants, it’s just heated ultra-processed foods. So they’re another example of it.

 

Terry Graedon (00:23:42):

And here’s the thing. Back when, again, my parents were young, there were essentially no ultra-processed foods. But today in the United States, if you look at the calories kids get during childhood, 67% on average comes from ultra-processed foods. It’s not just some, it’s most. I mean, it’s 67% in an election to be a landslide. We have a landslide of ultra-processed foods going into our kids and adults, but especially in our kids.

 

Joe Graedon (00:24:31):

Now, Dr. Greene, one of the things that occurs to me is not just the processing itself, but also the packaging. Because I look at kids walking around sucking on plastic tubes of yogurt. The yogurt might be perfectly fine, but what about the plastic tubes?

 

Dr. Alan Greene (00:24:50):

Yeah, we don’t want to be putting plastic tubes in our mouth, whether they’re straws or tubes of yogurt. It’s just directly there, and the friction is helping to break off these little particles that get into our bodies. And we know that ultra-processed foods have a big impact on health. And it looks like the nanoplastics and microplastics may be one of the big reasons for that.

 

Terry Graedon (00:25:11):

Well, we’ve been talking about these little tiny particles that we can’t see in things like yogurt, things like even our water bottles, and in lots of foods. But we haven’t said a word about the chemicals that are leaching from those plastic containers into the foods.

 

Joe Graedon (00:25:33):

So Consumer Reports did a really elegant study several months back and published it, demonstrating that the paper and the boxes and the packaging will allow the migration of things like bisphenols or phthalates into the food. So it’s like a double whammy, right?

 

Dr. Alan Greene (00:26:02):

That’s right. And the dyes from the papers and the labels go inside, too. So, yeah, we know that bisphenol A is a bad thing, a bad plastic. It was originally developed as an artificial estrogen. But in the 1930s, they decided to use one called DES instead to give to women. And the DES had its own horrible health outcomes. And instead, BPA was used because it makes plastic hard and clear. And so it’s added to many hard, clear plastics, or has been, until it began getting phased out in 2012. But the things that replaced it, BPS and other bisphenols, sometimes are more estrogenic. It’s changing our hormones. And the phthalates also are known endocrine disruptors. They’re the things added to vinyl to make it soft.

 

Terry Graedon (00:27:00):

So one thing we can do is try to choose healthier plastics.

 

Dr. Alan Greene (00:27:02):

And one way to do that is to look at, for recycling numbers 1, 2, 4, and 5, they’re the least known bioactive problems. That doesn’t mean they’re safe, but it means that we don’t know the bioactive problems there. Whereas recycling symbols 3 and 6 and 7 often have the plasticizers that we know are problematic.

 

Joe Graedon (00:27:24):

Well, it’s not just plastic containers. Because we can think about, oh, recycling of, you know, the numbers that you’ve just mentioned. But what about cans? Because, you know, parents buy a lot of, like, canned soup. And we think, oh, yeah, what could be better than chicken soup with rice? It’s the ideal child’s food for lunch. Or maybe they’re getting, you know, some other canned products that seem quite safe. They may be getting beverages in cans, taking them to school. And cans themselves are lined with plastic. It’s not just a metal, because metal would leave a, perhaps, a flavor that’s not so desirable. So what about the plastic containers?

 

Dr. Alan Greene (00:28:19):

If the lining of the can is an epoxy resin with plasticizers in it that themselves are problematic. In fact, the highest levels of BPA found in people are the ones who consume a lot of canned foods. So it comes back to the thing I said at the beginning. We’re looking for real foods cooked in a kitchen. Could be a restaurant kitchen. Could be your home kitchen. But not the packaged, factory-produced foods. That’s the biggest difference we can make in our health overall, in reducing our exposure to plastics.

 

Terry Graedon (00:29:02):

And I would include in that processed water.

 

Dr. Alan Greene (00:29:04):

Tap water is, what we get at home, is often our very best source. Yeah, use a filter is great. But the water that we buy in bottles, in single-use plastic bottles and multi-use plastic bottles, even in glass bottles, often has plastics in it from the factory.

 

Joe Graedon (00:29:16):

Dr. Greene, it sounds as though you are suggesting that for parents to protect their kids from plastic, they need to also avoid ultra-processed foods.

 

Terry Graedon (00:29:31):

And we did see recently a study on children in ultra-processed foods. Can you tell us about the health markers that were detected?

 

Dr. Alan Greene (00:29:35):

There have been a number of studies looking at pretty much every dimension. The more ultra-processed foods that a child eats, the higher the risk that they become obese. The higher the risk they have a lifelong increased risk of cancer or heart disease. One of the most interesting studies that came out just in the last year was called the Framingham Offspring Study, where they looked at the people who were offspring of the kids, now adult kids, of the folks who had been in the original major heart study. And they looked at how many servings per day on average they had of ultra-processed foods. So one can of soda, one serving of ultra-processed food. One cup of cereal, commercial cereal, one serving of ultra-processed food. And they found the average person to study had seven and a half servings a day. But the thing that was interesting was they looked at the ones who had one more than that or two more than that or one less than that and two less than that. And it was pretty consistent. For every additional serving, you had a 5% increased risk of a major heart event. And for every decreased serving, you had a 5% decrease. So just by switching to the foods you’re already eating, not having to learn to like new vegetables or learn to like new foods, just whatever you eat now, doing a homemade version of it or a kitchen-made version of it, you can reduce your cardiac risk by up to 35%.

 

Terry Graedon (00:31:03):

That’s huge.

 

Dr. Alan Greene (00:31:06):

It’s huge. And then you can add on top of that eating better foods. But just doing it homemade is great.

 

Joe Graedon (00:31:13):

It sounds as though you’re suggesting we all should be spending a little more time in the kitchen.

 

Terry Graedon (00:31:20):

What do you say to parents who say, I just don’t have time to shop and cook and, you know, simmer the soup for hours?

 

Dr. Alan Greene (00:31:29):

It’s hard. But thankfully, one of the things I love most about the internet is the amazing number of fast, simple, few-ingredient recipes for kids and for adults. And there are things that you can put on, put in a crock pot, and have it made while you’re not working on it. So there are an abundance of delicious, easy meals that you can learn and do. I get that it’s hard, but we’re going to invest time and money and attention in our health one way or another. I think one of the best ways to do it is investing time and money and attention in the food that we eat ourselves and share with our families.

 

Terry Graedon (00:32:06):

Dr. Greene, I want to talk a little bit about newborns because as a pediatrician, you are especially concerned about that stage of life. And not everyone can breastfeed. So what does a woman do if for one reason or another she can’t breastfeed her newborn, but she doesn’t want to feed them ultra-processed stuff? So give us some insights on what to do for a neonate.

 

Dr. Alan Greene (00:32:33):

That’s such a good question. The best alternatives right now to breast milk when you can’t breastfeed for one reason or another are for babies in the first four to six months are commercial formulas. They’re well-made to be as close to breast milk as they can get. But you want to serve those in a way that you’re mixing with clean water, which doesn’t mean bottled water. It means filtered tap water as much as possible, not every single time, but as much as practical. And in bottles that are made of some kind of inert material. It could be silicone, which is made largely from sand and then pressed in a way that is safe. It’s not a plastic. And one of the cleanest plastics that you can find, or glass bottles. I’m a fan of shatterproof glass bottles as well.

 

Terry Graedon (00:33:24):

So you’re saying that silicone is, as far as we can tell, not plastic and not providing the same kinds of risks that plastic does.

 

Dr. Alan Greene (00:33:33):

Exactly. And so I would choose those for pacifiers and for teethers as well, or a cloth pacifier teether, not plastic ones.

 

Joe Graedon (00:33:46):

Whoa, whoa, whoa. How would somebody know that they’re getting a safe pacifier?

 

Dr. Alan Greene (00:33:54):

It would say medical grade silicone on it.

 

Terry Graedon (00:33:59):

So always look for the medical grade and look for the silicone and avoid the plastic. I think a lot of people have a hard time figuring this out because I’m assuming that a pacifier looks like plastic.

 

Dr. Alan Greene (00:34:10):

Yeah, a lot of them do. And the hard plastic ones especially are a bad idea for babies. And having said that, putting plastic in your mouth, I should just comment. There’s, in the British Dental Journal, part of the Nature Group, just had an article about all the aligners adults are putting in their mouth and kids are putting in their mouth, calling in the question whether the plastics in there are a major source of microplastics and nanoplastics in the body. When I first got dental aligners, I tried to find one without BPA, and I couldn’t find one. I stopped using them at that time because of it. Now they’re available.

 

Terry Graedon (00:34:50):

So if we were to look at your kitchen, how do you store food? Because a lot of people like to use those plastic storage items. And then when they buy even, you know, any kind of beverage, they often come in plastic. So what do the Greenes do?

 

Dr. Alan Greene (00:35:01):

As much as we can, we store food in glass or occasionally in ceramic. And it’s just, it both feels good, but also every opportunity to reduce plastic is a great opportunity. We also use the vacuum extraction thing sometimes to keep the air out so food will last longer. Oh, I should also mention wine bottles. There’s a study showing that ones with plastic corks have much higher levels of plastic in them than the ones that have the cork corks. It’s worth looking to. And one other thing you won’t find in our kitchen is plastic cutting boards. Because when food is on a cutting board and chopped and the knives are going back and forth through it, you introduce plastics.

 

Terry Graedon (00:35:52):

Lots of little bits, those particles that you’ve been talking about, the micro and nanoparticles.

 

Joe Graedon (00:35:56):

Right.

 

Terry Graedon (00:35:57):

So, Dr. Greene, if we put you in charge, maybe of the EPA or the food industry, what would you tell everyone that they should be doing differently in the way they make food, make beverages, and the way we consume food and beverages for the future?

 

Dr. Alan Greene (00:36:10):

There are a few things I would want. One is to make a concerted effort to teach children and adults the joy of preparing food together as an activity for home. The more that we eat and drink things that we can prepare at home, the better. And I would want that to be part of school, learning how to do that. The second thing is to provide alternatives for people who want to reduce plastics in their food, in their packaging, in general there. I would want to have safety tips go out like never microwave in plastic. That introduces millions or billions of particles of plastics every time it’s done. And people still think it’s okay. And then do a lot of research in new material use that is safer for the environment and safer for each other. The plastics were originally designed to be able to be super long-lasting. I’d be excited to have them designed to fall apart after they’re used.

 

Announcer (00:37:38):

You’re listening to Dr. Alan Greene, a pediatrician and the founder of DrGreene.com, the pioneer physician website. He was founding president of the Society for Participatory Medicine and author of Feeding Baby Green and From First Kicks to First Steps. His first children’s book, Flower Moon, was published in 2023.

 

Terry Graedon (00:38:04):

After the break, we have a continuation of our conversation with Dr. Alan Greene. What about plastic exposure in medications? We also asked Dr. Greene what medicines he would take to a desert island if he were caring for kids there. He’ll tell us what you do about common problems like allergies or diarrhea. We’ll also get tips on treating poison oak or poison ivy.

 

Announcer (00:38:29):

You’re listening to The People’s Pharmacy with Joe and Terry Graedon.

 

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Joe Graedon (00:40:04):

Welcome back to The People’s Pharmacy.

 

Terry Graedon (00:40:16):

I’m Terry Graedon.

 

Joe Graedon (00:40:16):

And I’m Joe Graedon.

 

Terry Graedon (00:40:18):

The People’s Pharmacy is made possible in part by CocoaVia Dietary Supplements. CocoaFlavanol supplements that support cognitive and cardiovascular health made with proven concentrated flavanol extract.

 

Joe Graedon (00:40:32):

More information at CocoaVia.com.

 

Terry Graedon (00:40:35):

You’ve been listening to Dr. Alan Greene describe the problems with plastics and how he advises parents to protect their children. A few weeks after that initial conversation, we visited Dr. Greene at his Crescendo MD office in Portola Valley, California. The conversation we had with him there ranged beyond the perils of plastic to common kids’ ailments and what to do about them.

 

Joe Graedon (00:41:06):

Dr. Alan Greene is a pediatrician and the founder of DrGreene.com, the pioneer physician website. He’s founding president of the Society for Participatory Medicine. He also founded La Connexion, a not-for-profit organization linking physicians, health technology, and resources from the U.S. to empower health care workers in underserved countries. Dr. Greene has written Feeding Baby Green, Raising Baby Green, and From First Kicks to First Steps. His first children’s book, Flower Moon, was published in 2023.

 

Terry Graedon (00:41:48):

Dr. Greene, there are so many pills these days that are either coated in plastic or come in plastic capsules. Why could that be a potential problem?

 

Dr. Alan Greene (00:42:02):

Yeah, as soon as people become aware of how plastics are so pervasive in our environment and want to reduce their exposure to plastics, one of the first things that comes up is, wait, I’m looking at this plastic capsule that my supplement comes in, that I really like to take, or that my medicine comes in. And the good news is, many or most of those are not actual plastic. The capsules are made often from gelatin or from cellulose, if they’re vegetarian capsules. And they truly break down. They dissolve in the stomach so that the medicine can get into your body.

 

Terry Graedon (00:42:42):

How can you tell?

 

Dr. Alan Greene (00:42:44):

And there’s a great question, Terry. The way you can tell is to take one of them and just put it in the bathroom sink in some water and wait for a few minutes. And if it dissolves, it’s not going to break down into those little shards that we’re concerned about with microplastics and nanoplastics. They just dissolve. And I wish more materials would be made that way.

 

Joe Graedon (00:43:06):

Why aren’t they?

 

Dr. Alan Greene (00:43:08):

Plastic is designed to be able to last and to last in weather. And so it stays and just breaks off pieces, tiny pieces, rather than dissolving. But many things could be made that way.

 

Terry Graedon (00:43:21):

Dr. Greene, we’re wondering, if you had to go off to a desert island and you were taking care of a classroom of children, what medications would you take? What medications are essential for something like that?

 

Dr. Alan Greene (00:43:37):

Well, on a desert island, there’s a few things I would want with me. And first would be supplies for an allergic reaction, because that’s something that happens fast. You need stuff with you. You can’t wait. So that would include, I would be a fan of having epinephrine of one kind or another in case there’s an emergency.

 

Terry Graedon (00:43:53):

EpiPen?

 

Dr. Alan Greene (00:43:54):

Or Auvi-Q, either brand. I like Auvi-Q. Personally, the medicine’s the same.

 

Joe Graedon (00:43:57):

But spell that.

 

Dr. Alan Greene (00:43:58):

It’s A-U-V-I hyphen Q. And the nice thing about that is it would fit in a jeans pocket. It’s shaped like a deck of cards. And it talks you through what to do in the emergency, which a lot of people forget. And I’ve seen a lot of people, I’ve seen several people do the EpiPen wrong. And so either one is great. Whatever you have is great. But I just kind of like the convenience of that form.

 

Terry Graedon (00:44:15):

And then you want an antihistamine.

 

Dr. Alan Greene (00:44:16):

And people tend to think of Benadryl as being the great one. I would probably prefer Zyrtec. Both Benadryl and Zyrtec work very rapidly, within seven minutes or so. Both are about equally effective. Benadryl lasts for four to six hours. But the allergic reaction may come back after that. And Zyrtec lasts for 24 hours. So it gives you longer coverage. It doesn’t make you drowsy. And then if the Benadryl does wear off in the middle of the night, you know you’re covered if you’ve got the Zyrtec.

 

Joe Graedon (00:44:54):

And what situations would you want to be using an antihistamine?

 

Dr. Alan Greene (00:44:58):

In an allergic reaction to a food or to a plant, that would be one great time to use it. You might also just use it for pollen allergies or other allergies to something on that island.

 

Terry Graedon (00:45:08):

What else?

 

Dr. Alan Greene (00:45:10):

So other things that I would have with me are something to help with vomiting. Because if somebody does eat something or gets sick and they’re vomiting and vomiting, that can be problematic and [they can] get dehydrated. And nothing can ruin a trip like a lot of vomiting. So I would have prescription ondansetron with me to be able to interrupt that if needed.

 

Joe Graedon (00:45:42):

Well, Dr. Greene, as you mentioned vomiting, I’m thinking diarrhea often goes along with. What are you taking for that?

 

Dr. Alan Greene (00:45:48):

Yeah, diarrhea is a problem. So one thing that I would bring for that, in case it’s a traveler’s kind of infectious diarrhea, is azithromycin, the antibiotic, to help treat the problem. Beyond that, a lot of people think about doing something like Imodium to stop the diarrhea. I’m not a fan of doing that quickly because diarrhea is the body’s way of getting that out of your system. You want to get rid of whatever infection’s there. But after a bit, you might want to use Imodium to stop that. There is, I helped develop a long time ago, something called DiaResQ, that is a colostrum-based treatment that helps people get rid of diarrhea more quickly without stopping it up. The big thing I would have, though, number one, number one, number one, is WHO oral rehydration solution. You get the crystals that you can mix with water to be able to keep you really well hydrated.

 

Terry Graedon (00:46:47):

Is there anything else you’d like to take to a desert island?

 

Joe Graedon (00:46:50):

But first, let’s find out about the poison oak.

 

Dr. Alan Greene (00:46:53):

One of the most exciting things I’ve learned about just this year from a colleague of mine who is a wilderness expert, a wilderness medicine expert, Alan Giannotti, is something called Zanfel. It’s Z-A-N-F-E-L. It’s over the counter, and it’s a poison oak wash. And it is fantastic. It breaks down the urushiol oil that causes the rash, some of which sometimes stays in the rash for a while. So it’s useful after you’ve been out where you might have been exposed. Just wash yourself with it right away. But even once the rash starts, I’ve seen it work on people so dramatically. The itching goes away. The rash gets better quickly. It’s like magic for poison oak.

 

Terry Graedon (00:47:30):

Really, it’s expensive, but it’s really worth it.

 

Dr. Alan Greene (00:47:33):

And it should work for poison ivy as well.

 

Joe Graedon (00:47:35):

Yes, poison ivy, poison sumac as well.

 

Dr. Alan Greene (00:47:38):

And it can prevent the need for steroids for really severe cases.

 

Terry Graedon (00:47:41):

So we’re back from the desert island.

 

Joe Graedon (00:47:43):

Okay.

 

Terry Graedon (00:47:44):

We’re in everyday life. And you’re the pediatrician, and you have a parent bring a child into your office with a bad bellyache. What’s going on? And how do you figure it out? And what do you do?

 

Dr. Alan Greene (00:47:54):

There’s several possibilities. But one of the most common is constipation, where somebody is really backed up. And they’re backed up so much that they still either leak a little loose stool around, or they push out a daily stool, but their colon is full and expanding. And when I suggest to parents, and I think this might be constipation, often they think I’m a little crazy, that no, they’re having a bowel movement. No, they’re having liquidy stools. But constipation can still be the problem. And it can cause pain so significant that people go to the ER thinking it’s appendicitis. It can be intense, the pain that goes on. So sometimes we can tell by the history and by the physical exam. But I actually like using a point-of-care ultrasound to be able to just very quickly look at the belly and show everybody, look how much stool is here. And then we begin to deal with how to treat that.

 

And there’s a bunch of different ways that you can do it. There are over-the-counter laxatives. One of the things that I like using is there was a study several years ago of seniors who had chronic constipation comparing Miralax to two kiwi fruit a day. And the two kiwi fruit was as effective as Miralax at cleaning out the gut. So I will often do that with kids since they like kiwi. And for them, usually just one is enough.

 

Joe Graedon (00:49:36):

So what happens if it’s not constipation and the child is going, oh, my tummy hurts?

 

Dr. Alan Greene (00:49:42):

There becomes more of a detective problem trying to sort it out. It could be some kind of gastritis or even an ulcer in kids.

 

Terry Graedon (00:49:46):

Oh, wait a minute. How do kids get ulcers?

 

Dr. Alan Greene (00:49:50):

Generally, it’s a problem with H. pylori the same way it would be in an adult.

 

Joe Graedon (00:49:57):

And I assume stress can also be a protective problem.

 

Dr. Alan Greene (00:50:01):

Stress is involved, yeah.

 

Terry Graedon (00:50:03):

So if it’s a kid’s ulcer, are we talking Prilosec or Nexium?

 

Dr. Alan Greene (00:50:06):

Yes, the same kind of treatment as an adult.

 

Joe Graedon (00:50:09):

And if it’s not heartburn and if it’s not gastritis, when would you suspect appendicitis? How could a parent know they should go to the emergency department?

 

Dr. Alan Greene (00:50:18):

A couple of things. I want to tell you one little secret exam tool you can use to help differentiate. And that is to have the child lie down and then bang really hard on their heel with your hand until they say, ow. And then you say, where does it hurt? And if they say, my heel, you’re hitting my heel, it hurts, then it’s not appendicitis. But if you’re hitting their heel and they say, ow, and point to where their appendix is, then that’s something you want to be really concerned about.

 

Terry Graedon (00:50:46):

A simple trick.

 

Joe Graedon (00:50:47):

Wait a minute. How does that happen? Why would hitting a heel make your appendix hurt if you have appendicitis?

 

Dr. Alan Greene (00:50:54):

So the appendix during appendicitis is very inflamed. It’s swollen, red, and tender. And the peritoneum, the lining of the belly right around the appendix, is also tender and inflamed. And that jostling is enough to produce pain right there if it’s inflamed.

 

Terry Graedon (00:51:06):

Any other things, like fever, would bellyache with fever be a tip-off?

 

Dr. Alan Greene (00:51:10):

Fever can be a tip-off. Appendicitis typically has a fever. But so can acute gastroenteritis.

 

Joe Graedon (00:51:18):

Let’s talk about fever.

 

Terry Graedon (00:51:20):

We’d like to talk about treating fever in kids. Because we have been kind of alarmed to see how often parents will just treat the fever as though it were a problem.

 

Dr. Alan Greene (00:51:34):

That’s such a good question. So historically, going back a few generations, if a child had a fever, it was terrifying because they might have an infectious disease. This might be their last infectious disease. So there’s this deep-rooted cultural fear of fevers. But the reality is fever is part of our body’s way of dealing with an infection. It’s a sign. It’s a signal that something’s going on. But it’s not the problem. It’s the solution. So in general, I recommend to parents not to be freaked out by the fever, but to let it ride unless the child is unable to sleep, because sleep is at least as important as the fever. Unable to drink, because hydration is important. Then I try to bring the fever down. There’s no reason that it needs to stay above 102 and a half or so to be helpful. So if they’re uncomfortable and it’s 103 or 103 and a half, 104, fine bringing it down. But there’s not a rush.

 

Terry Graedon (00:53:07):

When do you determine that a fever is too high and does need to be brought down? At what level do you intervene?

 

Dr. Alan Greene (00:53:22):

It’s more how the child’s doing than the actual degree. Now, people get scared of febrile seizures. But febrile seizures happen from rapid rise of temperature, particularly the first fever and illness, not from the height of the temperature per se. But for an otherwise healthy kid, I wouldn’t treat it unless it’s interfering with sleep or drinking fluids or their child’s really uncomfortable. Usually, at 103, 104, one of those will be the case.

 

Joe Graedon (00:54:03):

Another common childhood problem, ear infections. What do you do?

 

Dr. Alan Greene (00:54:07):

Ear infections are very common. Thankfully, not as common as they were pre-pandemic. The numbers have gone down quite a bit. Used to be, because they’re bacterial infections, people would want to treat with antibiotics right away to try to get rid of them. We now understand that about 85% of ear infections will get better on their own within 48 to 72 hours without antibiotics. So, unless the child’s in severe pain or has a fever with the ear infection, any child at least age 2 or over, I will wait 48 to 72 hours to see what happens. Treat the pain for them so they feel more comfortable. And hopefully, it’ll go away without the antibiotics. The advantage is it keeps your microbiome healthier. You’re less likely to get a repeat infection. And it doesn’t take any longer if you start the antibiotics at 72 hours than immediately.

 

There was a really interesting study a few years ago with chinchillas, because chinchillas have ears closest to human ears for a model. And researchers wanted to figure out how quick you start the antibiotics to get better the fastest. And their assumption was, if you do it within six hours or do it within four hours, the faster you are, the faster it’ll go away. So, they intentionally gave the chinchillas ear infections, poor chinchillas, and then started different ones on antibiotics at different hours afterwards. And it turned out the ones who got better the fastest is 48 to 72 hours later.

 

Joe Graedon (00:55:47):

And presumably, the reason is, if you don’t get the antibiotics right away, the immune system, our own immune system, kicks in and begins doing the fight. And the antibiotics take care of that last yard. But if you start right away, then our own immune system doesn’t gear up as quickly. And so, it takes longer to go away.

 

Terry Graedon (00:56:06):

Dr. Alan Greene, thank you so much for talking with us on The People’s Pharmacy today.

 

Dr. Alan Greene (00:56:13):

It is always such a delight to be with you, Joe, and with you, Terry.

 

Terry Graedon (00:56:16):

You’ve been listening to Dr. Alan Greene.

 

Joe Graedon (00:56:20):

That’s G-R-E-E-N-E. Dr. Greene is a pediatrician and the founder of DrGreene.com, the pioneer physician website. He was founding president of the Society for Participatory Medicine. His books include Feeding Baby Green, Raising Baby Green, and From First Kicks to First Steps. His first children’s book, Flower Moon, was published in 2023. Dr. Greene is a founding partner of the Collaborative on Health and the Environment, and he’s a board member of the Lundberg Institute. Most recently, he co-founded La Connexion, a not-for-profit organization that links physicians, health technology, and resources from the United States to empower healthcare workers in underserved countries.

 

Terry Graedon (00:57:15):

Lynn Siegel produced today’s show.

 

Joe Graedon (00:57:17):

Dave Graedon edits our interviews.

 

Terry Graedon (00:57:21):

B.J. Liederman composed our theme music.

 

Joe Graedon (00:57:23):

This show is a co-production of North Carolina Public Radio, WUNC, with The People’s Pharmacy.

 

Terry Graedon (00:57:33):

The People’s Pharmacy is made possible in part by CocoaVia Dietary Supplements. CocoaVia Memory and Focus is a unique formula made with a special blend of ingredients that work together to promote attention and support long-term memory. It supports five areas of brain performance in one capsule.

 

Joe Graedon (00:57:50):

More information is available at CocoaVia.com.

 

Terry Graedon (00:57:59):

Today’s show is number 1,398. You can find it online at PeoplesPharmacy.com. That’s where you can share your comments about today’s interview.

 

Joe Graedon (00:58:07):

You could also reach us through email. We’re radio at PeoplesPharmacy.com.

 

Terry Graedon (00:58:11):

Our interviews are available through your favorite podcast provider, including YouTube. You’ll find the podcast on our website on Monday morning, and we would love to get your comments about plastic.

 

Joe Graedon (00:58:18):

Have you figured out a way to reduce the amount of plastic in your home environment?

 

Terry Graedon (00:58:32):

And how do you store your food? We’d be very curious.

 

Joe Graedon (00:58:38):

At PeoplesPharmacy.com, you can sign up for our free online newsletter. That way you get the latest news about important health stories.

 

Terry Graedon (00:58:47):

When you subscribe, you also have regular access to information about our weekly podcast. That way you can find out ahead of time what topics we’ll be covering.

 

Joe Graedon (00:59:01):

In Durham, North Carolina, I’m Joe Graedon.

 

Terry Graedon (00:59:05):

And I’m Terry Graedon. Thank you so much for listening.

 

Joe Graedon (00:59:08):

Please join us again next week.

 

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