Chapter 39
Lifestyle+ — 30
Addressing the burden of PFAS in tap water could reduce exposure by 20 percent in the United States. To name just some of the other plethora of sources of PFAS: foods such as butter, processed meat and seafood, clothing, carpeting and furniture, dental floss, fast-food wrappers, microwave popcorn bags, pizza boxes, yoga pants, sneakers, solar panels, nonstick cookware, nail polish, firefighting foam, and artificial turf. And here’s a double whammy: most plastic sandwich bags have high levels of toxic PFAS. The 3M company still uses these in sixteen thousand of their products, and their multidecade cover-up was recently exposed after an employee’s discovery of PFOS (perfluorooctanesulfonic acid, a PFAS) in the blood of people who didn’t work at the company.
Of more than ten thousand PFAS chemicals, the Environmental Protection Agency announced in 2024 its first ever drinking water PFAS standard to regulate, limiting the amounts of only six of them. Clearly, as with microplastics, we have a long way to go.
Ionizing radiation medical imaging studies, including CT (computed tomography, also called CAT) scans and nuclear imaging, are performed far too frequently in the United States, and have been associated with an increased risk of cancer.
There’s also the concern about exposure to metals, including cadmium, tungsten, uranium, cobalt, copper, and zinc, and their relationship to cardiovascular disease. A prospective study of more than sixty-five thousand ethnically diverse participants assessing urinary levels of these six metals found a marked increase in cardiovascular events and all-cause mortality, proportional to the elevated levels.
All these chemicals and pollutants add to what I’ve reviewed on ultra-processed foods, contributing to health hazards that are not adequately recognized or being handled. For example, the marked rise of various cancers in younger adults in recent years may be attributable to these environmental factors.
SOCIAL ISOLATION AND THE BIG PICTURE
The attention to loneliness and social isolation as a critical public health concern has been mounting. Ninety cohort studies that were systematically reviewed, which included over 2.2 million people, demonstrated an association between loneliness and a 32 percent increased all-cause mortality, a 34 percent rise in cardiovascular mortality, and a 24 percent higher cancer-related mortality. It’s important to note that the cause-and-effect relationship of loneliness and these adverse outcomes has not been established. Living alone, without having family and friends visit, without weekly groups, contributes to social isolation. People with obesity are far more likely to face social isolation and loneliness than those without obesity. A UK Biobank study that included nearly four hundred thousand participants with a mean age of fifty-six years, and thirteen years of follow-up, found that among the 23 percent of people with obesity, the less loneliness and social isolation, the lower all-cause mortality. We’re in the earliest stages of determining whether generative AI tools can help reduce loneliness, supplementing or substituting for interactions with people, but a study using GPT-3 in a student population with loneliness and suicidal ideation provided some encouraging preliminary results. We may not like the idea of machines helping our kids avoid suicide, but if such AI works, can we really choose to not use it at least sometimes? Assessing lifestyle+ factors should include the extent to which you or those you care for exhibit social isolation and loneliness, and all the possible countermeasures.