Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / What's the deal with microplastics?

Transcript

What's the deal with microplastics? · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:01
  Speaker 1: Emily, I have a very important and very difficult challenge
• 0:05
  Speaker 1: for you today.
• 0:06
  Speaker 2: I'm ready.
• 0:07
  Speaker 1: I am going to give you a word and you
• 0:11
  Speaker 1: have to tell me. You have to distinguish whether this
• 0:13
  Speaker 1: is a type of plastic or a spell from the
• 0:18
  Speaker 1: Harry Potter universe. Okay, are you ready?
• 0:21
  Speaker 3: I'm actually I know a lot about Harry Potter, so
• 0:23
  Speaker 3: I think I'm going to be really good at this.
• 0:25
  Speaker 1: Okay, but do you know a lot about plastics. Let's
• 0:28
  Speaker 1: find out.
• 0:29
  Speaker 2: Less that I know about Harry Potter. But I'm optimistic.
• 0:31
  Speaker 1: All right, let's try it first. One Avi Foor's plastic incorrect.
• 0:36
  Speaker 1: That is a Harry Potter spell that transforms objects into birds.
• 0:40
  Speaker 1: What let's try on evalka spell? Sorry. That is a
• 0:46
  Speaker 1: type of plastic ethylene vinyl alcohol copolymers that's used in
• 0:51
  Speaker 1: food and medical packaging. How about loupital That is a
• 0:55
  Speaker 1: spell that is a plastic thermoplastic. It's used in automotive, electronic,
• 1:01
  Speaker 1: and medical devices. You're not doing too well, but you're
• 1:05
  Speaker 1: gonna pull it out here. Langlock spell. That is a spell?
• 1:10
  Speaker 4: Yes, nice, it is a jinx that makes you unable
• 1:14
  Speaker 4: to speak langlock okay, grillamid plastic very good, a high
• 1:20
  Speaker 4: performance nylon used in sporting goods.
• 1:22
  Speaker 1: Two more Vectra plastic awesome liquid crystal polymer for thin
• 1:28
  Speaker 1: walled electronics and aerospace applications. And lastly Ferula plastic. That
• 1:37
  Speaker 1: is a spell. It is a bandaging charm if you
• 1:41
  Speaker 1: are wounded. Point being there's a lot of plastics out there.
• 1:46
  Speaker 3: I thought your point was going to be I'm terrible
• 1:48
  Speaker 3: at this, but thank you for making a point more neutral.
• 1:52
  Speaker 1: You know you might need a bandaging charm after that performance.
• 1:56
  Speaker 1: But yes, I wanted to bring this up because plastics
• 2:00
  Speaker 1: are everywhere. They are ubiquitous, they are in all the
• 2:04
  Speaker 1: products we use, and of course, according to recent research,
• 2:08
  Speaker 1: they are also inside of us.
• 2:11
  Speaker 3: And we're going to find out whether that's actually a
• 2:13
  Speaker 3: problem when we do our deep dive later today.
• 2:15
  Speaker 1: Microplastics stick with us.
• 2:20
  Speaker 2: I'm Emily Oster, I'm an economist and a data expert.
• 2:23
  Speaker 1: And I'm Perry Wilson, I'm a medical doctor.
• 2:25
  Speaker 3: It's Thursday, March nineteenth, twenty twenty six. And this is
• 2:29
  Speaker 3: wellness actually.
• 2:31
  Speaker 1: Because you're getting a staggering amount of health and wellness
• 2:34
  Speaker 1: information nowadays from every source imaginable, and some of it
• 2:38
  Speaker 1: is awesome and.
• 2:39
  Speaker 2: Some of it is well actually both.
• 2:43
  Speaker 3: Fortunately we're both people who know how to read studies,
• 2:47
  Speaker 3: how to parse the data, and can tell you what's
• 2:49
  Speaker 3: worth thinking.
• 2:50
  Speaker 2: About and what you can safely ignore.
• 2:52
  Speaker 1: But before we dig in, a note that this podcast
• 2:55
  Speaker 1: is for educational purposes and should not be construed as
• 2:57
  Speaker 1: medical advice. We don't know your unique situ, so talk
• 3:00
  Speaker 1: to your doctor for personal health decisions.
• 3:03
  Speaker 3: This week, we'll ask life in plastic is it fantastic?
• 3:09
  Speaker 3: As we explore what's the deal with microplastics? Perry and
• 3:13
  Speaker 3: I will give the official smasher pass, and then we'll
• 3:15
  Speaker 3: get to your question of the week. But first, let's
• 3:18
  Speaker 3: do the health news roundup after the break.
• 3:32
  Speaker 1: Okay, welcome back. This week in health news, Emily, I
• 3:35
  Speaker 1: want to start with the FDA. You may remember back
• 3:39
  Speaker 1: to that infamous press conference on autism where President Trump
• 3:45
  Speaker 1: appeared and said that pregnant women should avoid taking seenomnifin
• 3:49
  Speaker 1: or tail and all because it causes autism. At that
• 3:53
  Speaker 1: same conference, FDA Director Marty McCarry said that a therapy
• 3:59
  Speaker 1: might exist called lucovorren, which, according to him quote could
• 4:03
  Speaker 1: benefit twenty forty fifty percent of kids with autism. You know,
• 4:09
  Speaker 1: that's a huge number and a huge statement to make
• 4:12
  Speaker 1: for a therapy that's already FDA approved for other indications.
• 4:15
  Speaker 1: It's available, it can be bought today. Well as of
• 4:18
  Speaker 1: a couple of days ago, the FDA did indeed approve
• 4:22
  Speaker 1: Luca worn, but for an incredibly rare genetic condition that
• 4:27
  Speaker 1: limits the delivery of folate to the brain. Fully it's
• 4:30
  Speaker 1: a form of B vitamin. This condition affects less than
• 4:33
  Speaker 1: one in a million people in the United States, so
• 4:37
  Speaker 1: maybe a couple hundred, and they do indeed have an
• 4:40
  Speaker 1: autism like syndrome. But this is a far cry from
• 4:44
  Speaker 1: fifty percent of people with autism. So what do you
• 4:47
  Speaker 1: make of this disconnect between what gets said in the
• 4:50
  Speaker 1: press and what gets passed by the FDA.
• 4:54
  Speaker 3: So I think this is a good example of where
• 4:56
  Speaker 3: an early stage finding was translated to mean more than
• 5:02
  Speaker 3: it did, partly for political reasons and partly because the
• 5:07
  Speaker 3: fact that people would like there to be a better
• 5:08
  Speaker 3: treatment for autism. So Luke of Wren did show some
• 5:12
  Speaker 3: has shown some initial promise in some kids with autism,
• 5:16
  Speaker 3: particularly around speech issues, and so there was sort of
• 5:20
  Speaker 3: some like early stage, very small scale, not really randomized
• 5:25
  Speaker 3: evidence that suggested that this could be something to explore,
• 5:30
  Speaker 3: but I think the bulk of the very good evidence,
• 5:33
  Speaker 3: as the FDA pointed out, is not consistent with that,
• 5:36
  Speaker 3: and it isn't really clear what the mechanism would be.
• 5:38
  Speaker 3: So in terms of treating the particular folate condition in
• 5:44
  Speaker 3: this very small number of people, it's clear what the
• 5:46
  Speaker 3: mechanism is, but in general, there's not a lot of
• 5:51
  Speaker 3: reason to think that this would this would be helpful. So,
• 5:54
  Speaker 3: you know, I think it's a good example of where
• 5:56
  Speaker 3: there's kind of an unfortunate interaction between people really wanting
• 6:00
  Speaker 3: there to be.
• 6:01
  Speaker 2: A simple answer to something and a politically expedient set
• 6:06
  Speaker 2: of claims.
• 6:07
  Speaker 3: I mean, they had promised a cure and an answer
• 6:09
  Speaker 3: to ausism by September, and it was getting to be
• 6:11
  Speaker 3: the end of September, and this was.
• 6:12
  Speaker 2: What was on the table. It's kind of how I
• 6:14
  Speaker 2: read it.
• 6:15
  Speaker 3: I'm curious if people will continue to experiment with this
• 6:18
  Speaker 3: on their own. I mean, there's not much to keep
• 6:21
  Speaker 3: parents from asking for this for their children because it
• 6:25
  Speaker 3: is approved, even if they don't have this condition. My
• 6:28
  Speaker 3: guess is we will still see a fair.
• 6:29
  Speaker 2: Amount of that.
• 6:30
  Speaker 1: I think, absolutely, absolutely, yeah, I mean, Luca worn I
• 6:33
  Speaker 1: mean it is. It's not that dangerous a drug. It
• 6:36
  Speaker 1: is a sort of modified form of foll late basically,
• 6:39
  Speaker 1: and as you said, it's already have to approve for
• 6:41
  Speaker 1: other indications, so you can get it off label. And
• 6:43
  Speaker 1: I think people people are desperate, and desperate people will
• 6:47
  Speaker 1: try what is available. Can't really blame them for that.
• 6:50
  Speaker 2: Yeah, all right.
• 6:52
  Speaker 3: Next up, I want to ask you about chat GPT
• 6:55
  Speaker 3: and whether it's replaced you yet. In particular, Nature this
• 6:59
  Speaker 3: week has suggested that Chatgypt is actually not great at
• 7:03
  Speaker 3: triaging actual medical emergencies, and so I'm curious what you
• 7:09
  Speaker 3: made of these findings and whether I mean, I think
• 7:13
  Speaker 3: there's a much more interesting question, broader interesting question about
• 7:17
  Speaker 3: what is the role of AI in medicine, But let's
• 7:19
  Speaker 3: keep to the narrower question of Chatgypt as a triage maganism.
• 7:24
  Speaker 1: Yeah, yeah, yeah, a medicine is a little bit big.
• 7:27
  Speaker 1: First of all, let me just say, Emily, that is
• 7:30
  Speaker 1: such a deep and insightful question. I'm sorry, I was
• 7:33
  Speaker 1: trying to be chat GPT.
• 7:34
  Speaker 2: That's not how chat Gypt would say. I was like, wow,
• 7:37
  Speaker 2: that's a great question.
• 7:39
  Speaker 1: You've cut to the center of this challenging issue. Don't
• 7:44
  Speaker 1: use chat GPT to tell you whether it go to
• 7:48
  Speaker 1: the emergency room or not. That's that's what this study says.
• 7:51
  Speaker 1: And you know, to some extent like yes, probably everyone
• 7:54
  Speaker 1: kind of knows this deep down in their heart. But
• 7:56
  Speaker 1: my actual concern is that there are a lot of
• 7:59
  Speaker 1: sort of edge medical conditions that really are an emergency
• 8:02
  Speaker 1: but that people might not think are an emergency. And
• 8:06
  Speaker 1: those are the times where you might go to AI
• 8:08
  Speaker 1: right like, if you have crushing substernal chest pain, you're
• 8:12
  Speaker 1: probably not going to chat GPT and being like should
• 8:14
  Speaker 1: I go to the er, right, like someone's going to
• 8:15
  Speaker 1: get you to the emergency room. And in this study,
• 8:19
  Speaker 1: things like that got triaged appropriately by chat GPT. The
• 8:22
  Speaker 1: stuff that didn't were the cases and these were all
• 8:24
  Speaker 1: cases made by clinicians, like they were designed to be
• 8:28
  Speaker 1: things that if a clinician heard, they would send you
• 8:30
  Speaker 1: to the emergency room. And the cases where it really failed,
• 8:34
  Speaker 1: which were emergencies, should have gone to the emergency room
• 8:37
  Speaker 1: and got under triage. In about half of cases or
• 8:40
  Speaker 1: conditions for example, like diabetic keto acidosis, where the symptoms
• 8:45
  Speaker 1: are things like you know, fatigue, vomiting, excessive urination, where
• 8:51
  Speaker 1: you know, a non medical person might convince themselves that okay,
• 8:54
  Speaker 1: like that's you know, I've got the flu or something
• 8:56
  Speaker 1: like that, And indeed chat GPT was sayingle let's see
• 8:59
  Speaker 1: how goes in twenty four to forty eight hours. A
• 9:01
  Speaker 1: similar case was a case with impending respiratory failure, where
• 9:06
  Speaker 1: it's like, you've got to get to the emergency room
• 9:08
  Speaker 1: and chat EPT about fifty percent of the time said
• 9:10
  Speaker 1: let's give it some time. What's really interesting is that
• 9:13
  Speaker 1: it could be gas lit a little bit. So if
• 9:15
  Speaker 1: in the prompt they use the same symptoms, but they
• 9:18
  Speaker 1: added a sentence that was like my family says I'm overreacting,
• 9:23
  Speaker 1: or like my family says everything's fine and I look good,
• 9:26
  Speaker 1: it would actually be less likely to say that you
• 9:28
  Speaker 1: should go to the emergency room. So it's sort of
• 9:30
  Speaker 1: it'll be like, okay, Well, as long as people around
• 9:32
  Speaker 1: you think that things are okay, it's okay, okay.
• 9:35
  Speaker 3: So here is the issue with this that I have,
• 9:37
  Speaker 3: And not to say that I think we should be
• 9:38
  Speaker 3: using AI for our triage, but when I talk to
• 9:42
  Speaker 3: pediatricians about the question of whether you should bring your
• 9:44
  Speaker 3: kid to the doctor, one of the core questions people
• 9:48
  Speaker 3: ask is how does your kids seem? That is the
• 9:51
  Speaker 3: most important pediatrician question. If you say my kids had
• 9:54
  Speaker 3: a fever for two days, a fever is one hundred
• 9:56
  Speaker 3: and four, the question they ask is does a fever
• 9:58
  Speaker 3: come down with treatment? And how does your kids seem?
• 10:00
  Speaker 3: Do they seem very sick? And so if you said you, actually,
• 10:03
  Speaker 3: they don't really seem that's sick, that's like a really
• 10:05
  Speaker 3: important piece of information. So I'm sort of wondering here
• 10:09
  Speaker 3: whether there's something in the construction that's almost like a
• 10:12
  Speaker 3: little too negative on the AI.
• 10:15
  Speaker 1: I see what you're saying, But the fact is that
• 10:17
  Speaker 1: these cases are designed that like no rational actor would
• 10:20
  Speaker 1: tell you to wait it out right, no matter what
• 10:23
  Speaker 1: the people around you are saying. Like, the kids are
• 10:26
  Speaker 1: a little bit different, for one, because their symptoms can
• 10:29
  Speaker 1: often seem quite a bit more extreme than adults are
• 10:32
  Speaker 1: used to. So like a fever of one hundred and
• 10:33
  Speaker 1: four in an adult is like what is crazy and
• 10:36
  Speaker 1: something really bad is happening a fever and a one
• 10:38
  Speaker 1: hundred four in a kid is like Sunday night, right,
• 10:40
  Speaker 1: Like that's nothing. So, So there is that issue the
• 10:43
  Speaker 1: thing that like I kept coming back to with this
• 10:46
  Speaker 1: is that I actually hate the you should probably go
• 10:50
  Speaker 1: to the doctor right now like default of the world,
• 10:54
  Speaker 1: Like any time anything gets posted online or like any
• 10:58
  Speaker 1: question gets asked, there's this very kind of I think
• 11:00
  Speaker 1: medico legal thing, which is like even when the person's
• 11:03
  Speaker 1: clearly okay to be like, uh, it's fine, but why.
• 11:06
  Speaker 2: Don't you get check check with your doctor, check.
• 11:08
  Speaker 1: With the doctor, go get checked out, Like there's that
• 11:10
  Speaker 1: default because God forbid you miss something. And I was
• 11:13
  Speaker 1: actually surprised that chat GPT didn't just like jump to
• 11:17
  Speaker 1: the like, oh yeah, go to the R, Go to
• 11:19
  Speaker 1: the R, go to the our conclusion. So I think
• 11:21
  Speaker 1: there is a spot here. It's got to be better
• 11:24
  Speaker 1: than this. But you know, given how overburdened our healthcare
• 11:27
  Speaker 1: system is, the truth is there are plenty of people
• 11:30
  Speaker 1: in the emergency room right now who could be managed
• 11:34
  Speaker 1: just fine at home or could wait it out twenty
• 11:36
  Speaker 1: four hours, and that's a tough triage decision to make.
• 11:38
  Speaker 1: We're not ready to have AI do it yet, but
• 11:40
  Speaker 1: you know, maybe we'll get there. Maybe maybe.
• 11:43
  Speaker 2: Okay.
• 11:43
  Speaker 3: Last thing that we want to talk about was a
• 11:46
  Speaker 3: new study about pain during sexual activity.
• 11:49
  Speaker 2: Do you want to you want to tee this one up.
• 11:52
  Speaker 1: I This study came across my desk, and I'm like,
• 11:55
  Speaker 1: I had that experience looking at the data that I
• 11:58
  Speaker 1: was like, oh my god, am I thing in a
• 12:01
  Speaker 1: parallel universe? Like this is so bonkers out there that
• 12:04
  Speaker 1: I don't know what to make of it? And then
• 12:05
  Speaker 1: I had the second thought that this is me being
• 12:07
  Speaker 1: a man, being the problem. And so so Emily, I
• 12:09
  Speaker 1: need you to weigh in on this. Let me give
• 12:11
  Speaker 1: you the details here. So, this is a survey study
• 12:14
  Speaker 1: of college students who is just published in the International
• 12:18
  Speaker 1: Journal of Sexual Health two hundred and sixty three college
• 12:20
  Speaker 1: students who are reporting on their sexual activities, specifically asking
• 12:25
  Speaker 1: about pain with various types of sexual activity, so non
• 12:29
  Speaker 1: penetrative sex, penetrative sex, et cetera. And the key table
• 12:34
  Speaker 1: from this is kind of crazy. To give you a
• 12:37
  Speaker 1: sense of the numbers here, looking at the key table
• 12:40
  Speaker 1: of the individuals who reported being engaging in penile vaginal intercourse,
• 12:46
  Speaker 1: ninety one percent of women reported pain, forty nine point
• 12:50
  Speaker 1: one percent of men reported pain, and those numbers are
• 12:55
  Speaker 1: pretty similar across the board. Fifty one percent of college
• 12:59
  Speaker 1: men reported pain from non penetrative sexual activity, forty five
• 13:03
  Speaker 1: percent of women reported pain from non penetrative sexual activity,
• 13:07
  Speaker 1: and so I saw this. The theme of this paper was, actually,
• 13:10
  Speaker 1: they're trying to not stigmatize discussion of pain in the space,
• 13:14
  Speaker 1: particularly for men, because men were much less likely to
• 13:17
  Speaker 1: report to their partner that they were experiencing pain than
• 13:21
  Speaker 1: women were. And sure, that's important. Communication is important. But
• 13:25
  Speaker 1: just like on the surface, these numbers seem really high, Emily,
• 13:29
  Speaker 1: or am I a man that doesn't you know, isn't
• 13:31
  Speaker 1: thinking about this the right way?
• 13:33
  Speaker 2: So yes, I agree with you. I think these numbers
• 13:36
  Speaker 2: are very surprising.
• 13:38
  Speaker 3: I find the numbers for men actually particularly surprising. Maybe
• 13:45
  Speaker 3: I am biased by the fact that I mostly talk
• 13:47
  Speaker 3: to women who have recently had children, but pain during
• 13:50
  Speaker 3: sex is like quite common postpartum and sort of somewhat
• 13:54
  Speaker 3: more common for women, I think, quite a lot more
• 13:56
  Speaker 3: common than for men. The fact that half of men
• 13:58
  Speaker 3: are reporting pain during sexual intercourse, even for non penetrative
• 14:02
  Speaker 3: sexual activity, I'm not really sure. I don't I'm not
• 14:05
  Speaker 3: a man. I don't really know what this is. So
• 14:07
  Speaker 3: I find that part confusing. I will say that this
• 14:11
  Speaker 3: is a pretty small sample, and I am wondering about
• 14:15
  Speaker 3: the recruitment strategy. So you know, if you did this
• 14:19
  Speaker 3: on a nationally representative sample of college students, I would
• 14:22
  Speaker 3: be really surprised if you told me I went to
• 14:26
  Speaker 3: a college and I told people I'm doing a study
• 14:28
  Speaker 3: about pain during sex and or about you know, discomfort
• 14:32
  Speaker 3: during sex, and here are some questions. Maybe I'm not
• 14:35
  Speaker 3: as surprised that you've pulled in a set of people
• 14:37
  Speaker 3: who have a particular who are coming to you because
• 14:41
  Speaker 3: they have something to say.
• 14:42
  Speaker 2: So for me, this is maybe a little bit more
• 14:45
  Speaker 2: of a of a kind.
• 14:45
  Speaker 3: Of well, what's your sample question, rather than you know,
• 14:50
  Speaker 3: I have totally misunderstood people's sexual behavior.
• 14:53
  Speaker 1: But well, I mean their point is, of course that
• 14:55
  Speaker 1: men don't talk about it as much, that there's like
• 14:58
  Speaker 1: a stigma associated with this. I also should point out
• 15:02
  Speaker 1: this isn't pain every time you have sex. The question
• 15:05
  Speaker 1: was worded like, you know, do you ever have pain
• 15:08
  Speaker 1: when you have sex? Which will tend to inflate numbers
• 15:11
  Speaker 1: a little bit. But this is good to talk about, right, Like,
• 15:15
  Speaker 1: you know, if you have a sexual partner, this is
• 15:17
  Speaker 1: not something you should not be suffering in silence. I
• 15:20
  Speaker 1: promise sex will be better with better.
• 15:22
  Speaker 2: Communication, totally could not agree with that more.
• 15:25
  Speaker 1: And that's it for the health news of the week.
• 15:27
  Speaker 1: After the break, we'll ask what's the deal with microplastics?
• 15:37
  Speaker 1: All right, we are back and today we are trying
• 15:40
  Speaker 1: to figure out what the deal is with microplastics. I mean,
• 15:44
  Speaker 1: we hear about this everywhere. Plastics probably not a good thing.
• 15:48
  Speaker 1: It's certainly not good for the environment. What effect does
• 15:51
  Speaker 1: it have on us? But Emily, before we like get
• 15:54
  Speaker 1: into it, got to define our terms. What is a microplastic?
• 15:59
  Speaker 1: What does that even mean?
• 16:00
  Speaker 3: So a microplastic is just a small plastic, as the
• 16:04
  Speaker 3: name would suggest, I.
• 16:06
  Speaker 1: Mean, a Latin scholar, I see exactly.
• 16:09
  Speaker 3: These are tiny plastic particles that happen when you decay
• 16:14
  Speaker 3: larger plastic particles. So think you know a water bottle
• 16:18
  Speaker 3: or carpeting or any of the enormous number of things
• 16:23
  Speaker 3: in our world that.
• 16:23
  Speaker 2: Are created by plastics. Those things are whether they decay,
• 16:28
  Speaker 2: they they give off little teeny pieces of plastic.
• 16:33
  Speaker 3: And so a microplastic is a plastic particle that's less
• 16:36
  Speaker 3: than five millimeters in diameter. People will sometimes also talk
• 16:39
  Speaker 3: about nanoplastics, which are less than one micrometer, and you
• 16:44
  Speaker 3: want to think about it, like there's a macroplastic, which
• 16:46
  Speaker 3: is what you know, and then eventually the microplastics come
• 16:49
  Speaker 3: off and then they turn into nanoplastics, and that is
• 16:52
  Speaker 3: kind of happens over time.
• 16:54
  Speaker 1: Yeah, like little flakes. I've seen people, you know, is
• 16:57
  Speaker 1: this started as an environmental concern, like before it got
• 17:00
  Speaker 1: into people. You know, scientists were looking at like the
• 17:03
  Speaker 1: ocean and lakes and filtering water and pulling out all
• 17:07
  Speaker 1: these tiny pieces of plastic out of the water. I've
• 17:09
  Speaker 1: seen those videos which are sort of disturbing.
• 17:11
  Speaker 3: And fish eat them. They're all over fish. So there's
• 17:14
  Speaker 3: like a lot of evidence. I mean, I think it's
• 17:17
  Speaker 3: an important place to start in this discussion, which is
• 17:20
  Speaker 3: sometimes when we talk about this health stuff, you sort
• 17:22
  Speaker 3: of come to the end and be like, man, it's
• 17:24
  Speaker 3: really not actually a big deal at all. This is
• 17:26
  Speaker 3: a place where it's definitely true that relative to fifty
• 17:30
  Speaker 3: years ago, there's way more plastic in the world, and
• 17:32
  Speaker 3: because it decays over time, this is way more microplastics.
• 17:35
  Speaker 2: It's also particularly true that's not good.
• 17:37
  Speaker 3: You know, no one's going to go out there and
• 17:39
  Speaker 3: be like, hey, it's great that the fish are full
• 17:41
  Speaker 3: of tiny pieces of plastic, Like, that's awesome. I think
• 17:44
  Speaker 3: the question for us today is really going to be
• 17:46
  Speaker 3: like how problematic is this and how how should people
• 17:49
  Speaker 3: think about it in their lives?
• 17:50
  Speaker 2: Not like is it awesome? But fish are full of plastic?
• 17:53
  Speaker 1: Because no, yes, clearly not. But like everything, right, are
• 17:58
  Speaker 1: we going to worry about this? Would you rather have
• 17:59
  Speaker 1: a fish that has a bunch of plastic in it
• 18:01
  Speaker 1: or a fish that has a bunch of mercury in it?
• 18:03
  Speaker 4: Like?
• 18:04
  Speaker 1: There are environmental toxins all over the place, and uh,
• 18:08
  Speaker 1: you know, some of them get sort of more attention
• 18:10
  Speaker 1: than others.
• 18:11
  Speaker 3: Yeah, And we should also say plastic has brought a
• 18:13
  Speaker 3: lot of important things to people in the world, so
• 18:17
  Speaker 3: it's not an all bad activity. It is part of
• 18:19
  Speaker 3: why we are not dead most of the time.
• 18:22
  Speaker 1: That's a that's a great point. We probably can't completely
• 18:25
  Speaker 1: do without plastics exactly.
• 18:26
  Speaker 3: Okay, So one question people will have when they when
• 18:29
  Speaker 3: they start with this, which is why would these plastics
• 18:31
  Speaker 3: be a problem. So if we accept that they're you know,
• 18:33
  Speaker 3: they're in fish, maybe they're in people, we'll talk about
• 18:36
  Speaker 3: didy to.
• 18:36
  Speaker 2: What extent, But isn't this just like an inert substance.
• 18:42
  Speaker 2: Isn't this just kind of not important? Why why am
• 18:46
  Speaker 2: I worried? Am I basically? Am I just pooping it out?
• 18:48
  Speaker 2: Why am I not just pooping this out?
• 18:50
  Speaker 1: Perry? Yeah, it's a good point because we think of
• 18:52
  Speaker 1: plastic really it's kind of the fundamental thing that doesn't
• 18:56
  Speaker 1: react with anything else. Right, It's like why we store
• 18:58
  Speaker 1: our food and plastic. I mean, it's also light and
• 19:01
  Speaker 1: it doesn't break like glass and stuff like that, but
• 19:03
  Speaker 1: you know, we do. We have lab tests that are
• 19:06
  Speaker 1: in plastic and things like that. It's just supposed to be.
• 19:08
  Speaker 1: In fact, the reason we have microplastics is because the
• 19:11
  Speaker 1: plastic doesn't break down into its constitutive molecules very readily.
• 19:16
  Speaker 1: That being said, the human body is more than willing
• 19:19
  Speaker 1: to interact in bad ways with things that are chemically inert.
• 19:24
  Speaker 1: Doesn't just have to be a chemical reaction, and I
• 19:27
  Speaker 1: think maybe the prototypical example of this is asbestos, which
• 19:31
  Speaker 1: is an inert fiber. Your body doesn't it doesn't cause
• 19:34
  Speaker 1: a chemical reaction in your body, but it is quite irritating,
• 19:38
  Speaker 1: and your white blood cells will see those things and
• 19:41
  Speaker 1: ingest them, and of course that can lead to cancer. Mesotheliomas,
• 19:45
  Speaker 1: the cancer associated with asbestos exposure, so we know the
• 19:47
  Speaker 1: body doesn't like is not a chemistry lab. It's much
• 19:50
  Speaker 1: more sophisticated than that, and there's you know, quite clear
• 19:54
  Speaker 1: evidence in the lab that exposing cells and tissues two
• 20:00
  Speaker 1: microplastics can cause them to do bad things, particularly on
• 20:04
  Speaker 1: the inflammatory side. So if you take a bunch of
• 20:06
  Speaker 1: white blood cells in a petri dish and you sprinkle
• 20:09
  Speaker 1: some microplastics on there, the white blood cells will see
• 20:12
  Speaker 1: them and start releasing you know, what are called cytokines
• 20:16
  Speaker 1: and chemokinds, which are these inflammatory molecules that basically say, like,
• 20:19
  Speaker 1: there's a problem here.
• 20:21
  Speaker 2: Listen.
• 20:21
  Speaker 3: I got to stop you for this because one of
• 20:23
  Speaker 3: the wellness influencer terms this is slightly off topic. One
• 20:26
  Speaker 3: of the things you hear about all the time is inflammation, right, like,
• 20:30
  Speaker 3: I'm so afraid of being inflamed.
• 20:33
  Speaker 2: Why is this a problem? Why am I so concerned
• 20:35
  Speaker 2: about being inflamed?
• 20:37
  Speaker 1: So there's good inflammation and bad inflammation. When you have
• 20:41
  Speaker 1: an injury or an infection, your immune system targets cells
• 20:45
  Speaker 1: and antibodies and stuff to that area and does inflammation.
• 20:50
  Speaker 1: And what inflammation is is an offensive set of chemicals
• 20:56
  Speaker 1: to destroy the thing that is there. Now, if that
• 21:00
  Speaker 1: is a bunch of bacteria or something like that, then great,
• 21:03
  Speaker 1: and your body releases those chemicals to destroy the bacteria.
• 21:07
  Speaker 1: Does do some damage to your own cells as well,
• 21:10
  Speaker 1: but that's sort of a risk you're willing to take.
• 21:13
  Speaker 1: These substances when they're nicely targeted to an injury or
• 21:16
  Speaker 1: an infection work quite well. When they are flowing throughout
• 21:20
  Speaker 1: your body. We do know that they can cause significant
• 21:23
  Speaker 1: problems in the long term. Certain markers of inflammation like
• 21:26
  Speaker 1: sea reactive protein, if they are higher in your blood,
• 21:29
  Speaker 1: you have a higher risk of atherosclerotic cardiovascular disease. There
• 21:33
  Speaker 1: is this sense that there's good inflammation and then inflammation
• 21:36
  Speaker 1: run amok, and there's stuff that we do to ourselves
• 21:39
  Speaker 1: that promote inflammation that aren't giving ourselves infections.
• 21:43
  Speaker 3: So, just to like dramatically simplify, if there are a
• 21:46
  Speaker 3: lot of tiny plastic particles around, it is possible that
• 21:49
  Speaker 3: our body will be like, ah, that's like a thing
• 21:51
  Speaker 3: I need to go fight, and that will cause there
• 21:54
  Speaker 3: to be a lot of these inflammatory markers rooting around
• 21:58
  Speaker 3: in our blood, and that might be bad for our
• 22:00
  Speaker 3: heart because our body's kind of like overreacting to this
• 22:03
  Speaker 3: plastic situation.
• 22:04
  Speaker 1: And inflammation is supposed to be transient, right, It's supposed
• 22:07
  Speaker 1: to be like while you heal your wound, while you
• 22:10
  Speaker 1: cure your infection, and then you're supposed to go back
• 22:12
  Speaker 1: to baseline. But if you're sitting kind of above baseline
• 22:15
  Speaker 1: for a long period of time, it really can have
• 22:17
  Speaker 1: adverse effects. But the problem with the microplastic literature, as
• 22:21
  Speaker 1: I dug into it, is there's a lot of these
• 22:24
  Speaker 1: studies in a Petrie dish, and then there's very few
• 22:28
  Speaker 1: poor quality studies translating this into a human body, And like,
• 22:32
  Speaker 1: the difference is really really big between those two things.
• 22:37
  Speaker 1: You can mess with cells a lot in a Petrie dish.
• 22:39
  Speaker 3: Yeah, for me, this is also where I landed in
• 22:41
  Speaker 3: the microplastics debate, And I think it's sort of important
• 22:45
  Speaker 3: to help people kind of separate two things.
• 22:47
  Speaker 2: So one is maybe maybe a three things.
• 22:50
  Speaker 3: So one is the question of like how much microplastics
• 22:53
  Speaker 3: are in people's bodies?
• 22:55
  Speaker 2: Could that be bad based on what we know from
• 22:58
  Speaker 2: the lab?
• 22:59
  Speaker 3: And the third is like is it bad given those
• 23:02
  Speaker 3: two things together? And I feel like in the the
• 23:05
  Speaker 3: what's been complicated for people in this literature, and I
• 23:08
  Speaker 3: think we should separate those three things. Is that we
• 23:11
  Speaker 3: talk a lot about the first thing, how much microplastics
• 23:13
  Speaker 3: are there. We take a lot about the second thing.
• 23:15
  Speaker 3: You know, what happens if you feed a mouse exclusively
• 23:18
  Speaker 3: a diet of microplastics for its whole life, Like, how's
• 23:21
  Speaker 3: that going? And then and then we sort of assume
• 23:24
  Speaker 3: things about the third thing. And so let's like talk
• 23:27
  Speaker 3: about the first two and then talk about the.
• 23:28
  Speaker 1: Third, right, Yeah, I mean, just to echo that, I
• 23:32
  Speaker 1: was like laughing out loud when I was digging into
• 23:34
  Speaker 1: the literature at how many when you are searching for
• 23:37
  Speaker 1: like human effects of my microplastics. The ratio of review
• 23:41
  Speaker 1: articles and perspective pieces versus like hard data articles was obscene.
• 23:48
  Speaker 1: And there are all these review articles like oh, you know,
• 23:50
  Speaker 1: it probably causes cancer and you're like, oh it does.
• 23:52
  Speaker 1: Let me like read what you say, and it's like, well,
• 23:54
  Speaker 1: if you put it in a Petri diiss, it causes inflammation,
• 23:57
  Speaker 1: and we know that inflammation might cause cancer, and therefore
• 23:59
  Speaker 1: maybe humans it causes cancer. It's like, Okay, that's not evidence.
• 24:02
  Speaker 1: That's you know, connecting dots that you haven't proven are connected.
• 24:06
  Speaker 1: Yet it's quite frustrated.
• 24:08
  Speaker 3: I like in review articles when it's like this might
• 24:11
  Speaker 3: cause cancer and you're like, and then it's like citation.
• 24:13
  Speaker 2: You're like, ooh good, I'd like to read the citation.
• 24:15
  Speaker 3: Then you click, and then it's another review article in
• 24:17
  Speaker 3: which they say that it's like, come.
• 24:19
  Speaker 1: On, man, yeah, give us something to work with here.
• 24:22
  Speaker 2: This is like, now we're in the weeds of like
• 24:23
  Speaker 2: stuff I don't like about lecture. But let's talk about
• 24:25
  Speaker 2: that first question, which is, you know, how like we're
• 24:30
  Speaker 2: going to put these three things together and get to
• 24:32
  Speaker 2: the last thing that people care about. But let's unpack
• 24:34
  Speaker 2: are their microplastics everywhere?
• 24:36
  Speaker 1: Plastic is everywhere. We've talked about that, it's an ubiquitous
• 24:40
  Speaker 1: part of our lives. But microplastics come from a bunch
• 24:43
  Speaker 1: of different sources, right Emily, So, like, what are the
• 24:45
  Speaker 1: major ways that microplastics get into us, into humans?
• 24:49
  Speaker 3: So basically, to get the microplastics into us, we have
• 24:52
  Speaker 3: to actually come in. You don't tend to absorb stuff
• 24:55
  Speaker 3: like that through your skin very much, so it's really
• 24:57
  Speaker 3: kind of stuff you eat and stuff you.
• 24:59
  Speaker 2: Breathe or or inhale.
• 25:00
  Speaker 3: So the major sources for people are stuff in your
• 25:03
  Speaker 3: diet and then like dust, so in your diet, you know,
• 25:09
  Speaker 3: we can find microplastics everywhere. There's this one study, and
• 25:12
  Speaker 3: I honestly think this is an over I'm not totally
• 25:15
  Speaker 3: sure I believe this, but there's one study of tea
• 25:18
  Speaker 3: bags in Canada which has like these tea bags are
• 25:21
  Speaker 3: just like basically exclusively made of microplastics, right.
• 25:26
  Speaker 1: They forgot to put the tea in. They just filled
• 25:27
  Speaker 1: the bag with microplass and they.
• 25:30
  Speaker 3: Just literally put microplastics. But that's not like all tea. Yeah,
• 25:33
  Speaker 3: it's just this particular I think, Yeah, I.
• 25:35
  Speaker 1: Saw this too. This was a study that had the
• 25:38
  Speaker 1: amount of microplastics and a cup of tea like one
• 25:40
  Speaker 1: hundredfold higher than in any other source, which is but if.
• 25:43
  Speaker 3: You put aside this particular terrible tea situation, generally most
• 25:48
  Speaker 3: of people's microplastic disposure is this through indoor dust. So
• 25:52
  Speaker 3: there's just a lot of plastics in indoor dust, with
• 25:54
  Speaker 3: a lot of plastics in your house, and they kind
• 25:56
  Speaker 3: of were indoor spaces and they sort of decay and
• 25:58
  Speaker 3: you and you.
• 25:59
  Speaker 2: Inhale them and then you know of the.
• 26:02
  Speaker 3: Diet stuff, plastic bottles, drinking out of plastic bottles is
• 26:05
  Speaker 3: kind of the biggest thing, and then tapwater, so it's
• 26:08
  Speaker 3: it's sort of stuff you drink and stuff you breathe
• 26:11
  Speaker 3: is the biggest set of issues.
• 26:12
  Speaker 2: You can generally find.
• 26:14
  Speaker 3: Microplastics in a lot of foods, and people store microplastics
• 26:18
  Speaker 3: and they're fat. So human fat has a lot of microplastics.
• 26:21
  Speaker 3: But we're not eating human fat, so that's not like
• 26:23
  Speaker 3: a dietary source.
• 26:24
  Speaker 2: Not usually.
• 26:25
  Speaker 1: Yeah, I should hope not, But it sounds like you're
• 26:27
  Speaker 1: I mean, these are hard things to kind of get.
• 26:30
  Speaker 1: Let's say I'm going to be concerned about microplastics, like,
• 26:32
  Speaker 1: don't breed dust is going to be a tricky one
• 26:34
  Speaker 1: for me, right.
• 26:35
  Speaker 2: Yeah, I think that that's actually an important point from
• 26:38
  Speaker 2: the practical practical standpoint Here is, even if we get
• 26:41
  Speaker 2: to the end of this conversation and we say this
• 26:43
  Speaker 2: is something you should be worried about, it's actually not
• 26:45
  Speaker 2: entirely clear how people could really change their behavior to
• 26:49
  Speaker 2: affect this, And such a large share of your exposure
• 26:52
  Speaker 2: is just going to be through through breathing. But in general, yeah,
• 26:55
  Speaker 2: microplastics are around you.
• 26:56
  Speaker 3: You're getting them in which leads to the question of
• 27:00
  Speaker 3: whether they stay, which I will ask you, which is,
• 27:04
  Speaker 3: to what extent do we actually know that people are
• 27:07
  Speaker 3: retaining these microplastics in their bodily tissues?
• 27:11
  Speaker 2: Why don't they just poop it out? As I've asked
• 27:13
  Speaker 2: you several times that I don't feel like I've gotten
• 27:15
  Speaker 2: a straight answer.
• 27:16
  Speaker 1: Uh, here, I'll give you a straight answer. They do
• 27:18
  Speaker 1: poop it out. In fact, when you measure microplastics in people,
• 27:23
  Speaker 1: one of the highest concentrations of microplastics is in FECs, stool,
• 27:28
  Speaker 1: is in poop, and that's likely because you are getting
• 27:32
  Speaker 1: it in the stuff you eat and it is just
• 27:34
  Speaker 1: passing through you. This is a bit of a problem
• 27:38
  Speaker 1: of size. So you mentioned earlier that microplastics are anything
• 27:43
  Speaker 1: that's five millimeters or less, and to give people a sense,
• 27:47
  Speaker 1: like five millimeters is like like a pencil eraser size.
• 27:51
  Speaker 1: This is it's like micro kind of but not really.
• 27:54
  Speaker 1: You know, like if I swallowed a pencil eraser, which
• 27:56
  Speaker 1: might be made a plastic, like it's passing right through me. Right,
• 27:59
  Speaker 1: You're gonna that that's going to be okay. You get
• 28:01
  Speaker 1: down to the nanoplastic scale, where these things are so
• 28:04
  Speaker 1: tiny that they can, you know, go between cells and
• 28:07
  Speaker 1: stuff like that, there's going to be a lot higher absorption.
• 28:09
  Speaker 1: And clearly there is absorption because there have been plenty
• 28:15
  Speaker 1: of studies looking at human tissues and measuring microplastics in them.
• 28:20
  Speaker 1: You can, you know, depending on the measurement method, you
• 28:24
  Speaker 1: get numbers that are a little bit all over the map.
• 28:27
  Speaker 1: But just to give just to give a sense of
• 28:30
  Speaker 1: where things kind of stand, there have been quite a
• 28:33
  Speaker 1: few studies now that show a reasonable accumulation of microplastics
• 28:38
  Speaker 1: in the placenta. There's been a number of studies looking
• 28:42
  Speaker 1: at microplastics in the kidney, which kind of makes sense
• 28:46
  Speaker 1: because the kidney's the major filtering ordering in of the blood,
• 28:49
  Speaker 1: and so if anything's going to kind of pick up
• 28:51
  Speaker 1: those little tiny micro or nanoplastics, the kidney would make sense.
• 28:54
  Speaker 1: You can find microplastics in the lungs. There's a study
• 28:58
  Speaker 1: showing microplastics in small concentrations, but in breast milk, some
• 29:03
  Speaker 1: in testicles, some in the intestines. So it's really kind
• 29:06
  Speaker 1: of everywhere you look, and perhaps most concerningly but also
• 29:11
  Speaker 1: most controversially, microplastics in the brain.
• 29:16
  Speaker 3: Let me ask you before we on the way to
• 29:18
  Speaker 3: get into microplastics in the brain.
• 29:19
  Speaker 2: I want to ask you. So you said there's microplastics
• 29:21
  Speaker 2: in the kidney. Now you're a kidney doctor, I'm curious
• 29:26
  Speaker 2: how we know that, Like if you see you must
• 29:29
  Speaker 2: see people's kidneys, like after they're dead, presumably sometimes.
• 29:33
  Speaker 1: I mean there are slides prepared from them.
• 29:35
  Speaker 2: Sure, can you like see the microplastics? How do you
• 29:38
  Speaker 2: know that there's microplastics in people's kidneys?
• 29:41
  Speaker 1: There are multiple ways to measure, but yes, you can
• 29:44
  Speaker 1: see them. So under a microscope you can see little
• 29:49
  Speaker 1: irregularly shaped things that don't belong there, and essentially those
• 29:54
  Speaker 1: are microplastics. And in certain tissues you can see even
• 29:58
  Speaker 1: an inflammatory reaction around or you can find them inside
• 30:01
  Speaker 1: white blood cells, like the cells have kind of eaten
• 30:04
  Speaker 1: them or something like that in an attempt to break
• 30:06
  Speaker 1: them down as a foreign body. But some are even
• 30:09
  Speaker 1: too small to see under a typical light microscope. And
• 30:12
  Speaker 1: then there are other methods like mass spectroscopy, where you
• 30:16
  Speaker 1: literally you burn the tissue and the gas that comes
• 30:20
  Speaker 1: out with like you burn it with a laser, and
• 30:21
  Speaker 1: then the gas that comes out you sample and measure
• 30:24
  Speaker 1: the chemicals in the gas that comes out, and you
• 30:26
  Speaker 1: can kind of say oh look, there's like polyethylene there,
• 30:29
  Speaker 1: which it must have come from plastic. And but this
• 30:32
  Speaker 1: is a problem with the literature is it's like it's
• 30:35
  Speaker 1: it's really hard to quantify. Most of the data is
• 30:38
  Speaker 1: in units of like pieces per milligram, Like how many
• 30:42
  Speaker 1: pieces did we count in this miligram of tissue, which
• 30:45
  Speaker 1: is such a sort of random thing to me, Like
• 30:48
  Speaker 1: I want like I want uh grams per million. I
• 30:51
  Speaker 1: don't know milodgram's permilgram.
• 30:53
  Speaker 3: Yeah, so I think it's it's interesting because those numbers
• 30:55
  Speaker 3: don't have any meaning. But the thing, a thing that
• 30:57
  Speaker 3: I think has really stuck with a lot of people
• 31:01
  Speaker 3: in this literature is this paper that said that there's
• 31:05
  Speaker 3: a spoon worth of plastic in your brain.
• 31:08
  Speaker 1: Yeah.
• 31:08
  Speaker 3: This is because it's like one thing to be like
• 31:10
  Speaker 3: there's pieces, I saw them, the mass spishocks, blah blah blah.
• 31:13
  Speaker 3: But this is like, now in my mind there is
• 31:16
  Speaker 3: an actual spoon. And in my head, of course, it's
• 31:19
  Speaker 3: shaped like a spoon. You know, it's like somewhere in here.
• 31:21
  Speaker 1: Yeah yeah, yeah, like someone like shoved it right up
• 31:23
  Speaker 1: your ead.
• 31:24
  Speaker 2: Someone shoved it right up it's like right in there.
• 31:26
  Speaker 2: You know, I could be eating with it.
• 31:28
  Speaker 3: But that feels I think to a lot of people
• 31:30
  Speaker 3: like both very tangible. It is a lot and my
• 31:37
  Speaker 3: understanding is it's probably not true.
• 31:41
  Speaker 1: Let's talk about to get a second.
• 31:42
  Speaker 3: Yeah, I think we got to do the brain because
• 31:44
  Speaker 3: this is like, yeah, we got to do the brain.
• 31:45
  Speaker 1: This is the paper. So so this is a paper
• 31:48
  Speaker 1: that appeared in Nature Medicine obviously got a lot of press.
• 31:52
  Speaker 1: I think the like plastic spoon's worth of plastic in
• 31:55
  Speaker 1: your brain. Just yeah, it's very hard for health reporters,
• 31:59
  Speaker 1: including myself because I wrote about this when it came
• 32:01
  Speaker 1: out to resist totally.
• 32:03
  Speaker 2: The headline rights itself. I mean obviously.
• 32:06
  Speaker 1: Headline rights itself. Let me give you just the data
• 32:09
  Speaker 1: that was in the paper, and then Emily, you tell
• 32:12
  Speaker 1: me why you're skeptical. Here. So, the way the study
• 32:15
  Speaker 1: worked was it was an autopsy based study. So University
• 32:19
  Speaker 1: of Arizona, I think they have like a brain repository
• 32:23
  Speaker 1: that where people have donated their brains after they died
• 32:25
  Speaker 1: over a period of time. And the authors sampled brain
• 32:30
  Speaker 1: tissue from the frontal lobe, the sort of important frontal
• 32:33
  Speaker 1: part of the brain, and they measured nanoplastics here. So
• 32:37
  Speaker 1: incredibly small pieces using mass spectroscopy. So that's that shooting
• 32:41
  Speaker 1: a laser and vaporizing the thing and measuring what comes
• 32:44
  Speaker 1: out of the vaporizer. And they compared this to the
• 32:47
  Speaker 1: microplastics and other tissues. And to give you some numbers here,
• 32:51
  Speaker 1: I'm not even going to say the units but because
• 32:53
  Speaker 1: they don't make much sense, but I'll give you the numbers. So,
• 32:56
  Speaker 1: like in the kidney of these patients or in the
• 32:58
  Speaker 1: kidneys they examined, they was like five hundred units of
• 33:01
  Speaker 1: microplastics per gram, and in the brain there was about
• 33:06
  Speaker 1: five thousand units of microplastics. Program So not only is
• 33:09
  Speaker 1: it in the brain, but they were like, it's in
• 33:12
  Speaker 1: the brain a lot, like more than everywhere else. They
• 33:16
  Speaker 1: also showed that that concentration increased over time, So between
• 33:20
  Speaker 1: twenty sixteen and twenty twenty four, like the amount of
• 33:25
  Speaker 1: microplastics in the brains that they had had increased. And
• 33:28
  Speaker 1: they also showed that brains with dementia had higher levels
• 33:31
  Speaker 1: of microplastics than brains without dementia. And you sort of
• 33:34
  Speaker 1: put that all together and then you start to get
• 33:36
  Speaker 1: like the real ick that I'm hurting myself by, you know,
• 33:40
  Speaker 1: drinking a plastic water bottle.
• 33:42
  Speaker 3: Yeah, And I think that the thing that was maybe
• 33:47
  Speaker 3: on a technical level, more surprising here was people had
• 33:50
  Speaker 3: thought that the microplastics would not be so prevalent in
• 33:53
  Speaker 3: the brain because we have a blood brain barrier which
• 33:56
  Speaker 3: is supposed to protect your brain. Your brain is more
• 33:59
  Speaker 3: important than your kid is no offense, not to you
• 34:01
  Speaker 3: as a kidney doctor, but okay, I agree, were like,
• 34:05
  Speaker 3: your body's like more interested in protecting your brain, And
• 34:07
  Speaker 3: it was sort of the idea that these probably nanoplastics
• 34:11
  Speaker 3: were able to kind of get through the blood brain
• 34:13
  Speaker 3: barrier and populate the brain at these incredibly high levels
• 34:16
  Speaker 3: was disturbing, I think, is mat of point.
• 34:19
  Speaker 1: Yeah, but there's pushback, right, So what's the push.
• 34:21
  Speaker 2: There's a lot of pushback.
• 34:23
  Speaker 3: So I think that the pushback here is really related
• 34:26
  Speaker 3: to how hard this is to measure. So again you're
• 34:30
  Speaker 3: you're like vaporizing this with a laser and seeing what
• 34:34
  Speaker 3: comes out. But the two criticisms that have come up
• 34:38
  Speaker 3: when people have talked about this are one, is it
• 34:41
  Speaker 3: actually microplastics as opposed to something else that you are
• 34:44
  Speaker 3: misinterpreting the chemical signal of for example, fat maybe more
• 34:50
  Speaker 3: similar to plastics. Than other things, and because there's a
• 34:54
  Speaker 3: lot of that kind of tissue in the brain that
• 34:56
  Speaker 3: could lead you to think that it's microplastics when actually
• 34:59
  Speaker 3: it's fat.
• 35:01
  Speaker 2: And when we think about trends over time, since.
• 35:03
  Speaker 3: Fat like obesity has gone up over time, that actually
• 35:06
  Speaker 3: could relate to some of the trends.
• 35:08
  Speaker 2: I think that's one thing people.
• 35:09
  Speaker 3: Have raised, and a second is just that it's really
• 35:11
  Speaker 3: really hard to control this carefully in the laboratory, and
• 35:14
  Speaker 3: people have raised some questions about this particular study and
• 35:17
  Speaker 3: whether they did a good job. This is an example
• 35:19
  Speaker 3: of something where it's so surprising, like it was so
• 35:23
  Speaker 3: surprising to so many people that you really probably would
• 35:27
  Speaker 3: want to do it again, and if it were easier
• 35:30
  Speaker 3: to do, someone would have done it again right away.
• 35:33
  Speaker 2: The issue is now it's both hard to do. You
• 35:35
  Speaker 2: need a lot of brains from dead people who have
• 35:36
  Speaker 2: agreed to let you vaporize their brains for plastic or whatever,
• 35:39
  Speaker 2: and it's just so I think it's a bunch of
• 35:42
  Speaker 2: reasons why this is why it's been hard to replicate,
• 35:45
  Speaker 2: even though there are a lot of people who think
• 35:48
  Speaker 2: is probably not right.
• 35:49
  Speaker 1: Yeah, I think that's such an important thing. I always
• 35:52
  Speaker 1: teach my students. I'll say this a million times. No
• 35:54
  Speaker 1: one study is definitive, right, Like replication is so important
• 35:57
  Speaker 1: because of these issues, Like you don't get all the
• 35:59
  Speaker 1: data in a paper, right, you get the sort of
• 36:02
  Speaker 1: filtered data that the scientists are putting in their paper,
• 36:06
  Speaker 1: and there's ethics about this and stuff, but you don't
• 36:08
  Speaker 1: get to see inside their lab. You don't get to
• 36:10
  Speaker 1: see what's happening. So it really is important to get replication.
• 36:12
  Speaker 1: To put another spin on this, the total amount of
• 36:17
  Speaker 1: microplastics that they calculated would be in the full brain
• 36:20
  Speaker 1: was about a half of a percent of the entire brain,
• 36:25
  Speaker 1: like the weight of the brain zero point five percent
• 36:28
  Speaker 1: of that, which to some neurologists is incredibly high, Like
• 36:33
  Speaker 1: they're like that level that amount of plastic, like, you know,
• 36:36
  Speaker 1: half of a percent throughout the brain is not something
• 36:39
  Speaker 1: we would miss. We would you know, we would clearly
• 36:42
  Speaker 1: see it. And it's so much higher than other tissues
• 36:44
  Speaker 1: that it just kind of doesn't seem plausible on the
• 36:46
  Speaker 1: face of it. But yeah, I guess we'll see.
• 36:48
  Speaker 2: I guess we'll see.
• 36:49
  Speaker 3: All right, So let's just establish whether it's a spoon
• 36:52
  Speaker 3: or a small spoon, A tea spoon ladle of plastic
• 36:56
  Speaker 3: in your brain, that there are plastics in our bodies.
• 36:59
  Speaker 3: And then there's these sort of two other things. So
• 37:02
  Speaker 3: one is, you know, do we have good evidence that
• 37:05
  Speaker 3: in laboratory kind of cell settings plastics are bad? And
• 37:09
  Speaker 3: my read of that is yes, that there's a lot
• 37:12
  Speaker 3: of evidence that if we take labs, either mice or
• 37:17
  Speaker 3: cells or organoids, which are like you try to make
• 37:20
  Speaker 3: like tiny pieces of human organs and you expose them
• 37:23
  Speaker 3: to a lot of microplastics, all kinds of bad stuff
• 37:26
  Speaker 3: happens to them.
• 37:27
  Speaker 2: Yes, yes, fertility issues in mice.
• 37:30
  Speaker 1: Yeah, But like contextually speaking, this is also true of
• 37:34
  Speaker 1: like everything we do to cells and mice and stuff
• 37:37
  Speaker 1: in the lab. Like this will come up again and again,
• 37:39
  Speaker 1: which is you know, if you take a model organism
• 37:42
  Speaker 1: or you take a cell in the petry dish and
• 37:44
  Speaker 1: you sort of stress it out with like whatever you're
• 37:47
  Speaker 1: going to pour on top of it, you know, whether
• 37:49
  Speaker 1: it's microplastics or whether it's like you know, round up
• 37:53
  Speaker 1: pesticide or whatever you do, you're going to get a
• 37:55
  Speaker 1: reaction out of those cells. It's similar to you know,
• 37:59
  Speaker 1: this particular dye, you know, food dye causing cancer or
• 38:02
  Speaker 1: something like that. Right, It's it's like that is the baseline. Again,
• 38:07
  Speaker 1: we always talk about biologic plausibility. Is it plausible that
• 38:10
  Speaker 1: there's a problem. Sure, we have some evidence, kind of
• 38:13
  Speaker 1: the floor of evidence, which is like if you soak
• 38:16
  Speaker 1: a cell in microplastic, it isn't happy about it. But
• 38:19
  Speaker 1: the you know, wellness world tends to run with that
• 38:22
  Speaker 1: and like go conclusion, conclusion, conclusion, conclusion, microplastics cause cancer.
• 38:27
  Speaker 1: Only drink out of like a wooden bowl from now on, right,
• 38:29
  Speaker 1: And we actually need to tie those together, and we
• 38:34
  Speaker 1: haven't tied those together very well yet. But maybe Emily,
• 38:38
  Speaker 1: we can talk about some of the areas that people
• 38:41
  Speaker 1: have said microplastics effects. So I think we talked about
• 38:45
  Speaker 1: the brain. We're not too sure what's going on in
• 38:47
  Speaker 1: the brain yet. But other things that have come out
• 38:51
  Speaker 1: or that people claim about microplastics are like obesity, for example.
• 38:56
  Speaker 1: So so do we think that plastic intake is causal
• 39:02
  Speaker 1: like leads to obesity?
• 39:05
  Speaker 2: I don't think so.
• 39:07
  Speaker 3: All of the literature that I have so let me
• 39:10
  Speaker 3: let me say I've read a bunch of this literature,
• 39:12
  Speaker 3: and it tends to associate levels of microplastic consumption or
• 39:18
  Speaker 3: you know, eating from takeout containers that have a lot
• 39:21
  Speaker 3: of microplastics with obesity. And the problem is that that
• 39:28
  Speaker 3: is an associational study, not a causal study.
• 39:32
  Speaker 2: And so the.
• 39:33
  Speaker 3: Fact that people who are exposed to more microplastics are
• 39:36
  Speaker 3: also more likely to be obese could easily, for example,
• 39:39
  Speaker 3: be explained by microplastic exposure from containers that are more
• 39:44
  Speaker 3: likely to contain process foods, which we know is associated
• 39:47
  Speaker 3: with obesity. So there's just looks so difficult to learn
• 39:52
  Speaker 3: from that kind of evidence. I just think that's I
• 39:55
  Speaker 3: just think that evidence is all such complete garbage.
• 39:58
  Speaker 1: I saw it my favorite graph recently, which looked at
• 40:02
  Speaker 1: the rate of obesity between nineteen seventy six and twenty
• 40:05
  Speaker 1: nineteen and the rate of plastic production between nineteen seventy
• 40:08
  Speaker 1: six and twenty nineteen. It was like, look, they're both
• 40:11
  Speaker 1: going up. It's like, okay, guys, you know, there's a
• 40:15
  Speaker 1: lot of things that have gone up since.
• 40:16
  Speaker 2: A lot of other a lot of other eventyow.
• 40:19
  Speaker 3: But even like, the thing that's amazing about that is
• 40:22
  Speaker 3: like you could draw an interesting causal story there. You'd
• 40:25
  Speaker 3: be like, as it's been easy to make plastics, actually
• 40:28
  Speaker 3: we've that is contributed to like things about our food system.
• 40:32
  Speaker 3: So it could be that there's a like, in a
• 40:35
  Speaker 3: weird way, there's a causal link between plastics and what
• 40:38
  Speaker 3: it has made possible with the food system and obesity.
• 40:41
  Speaker 2: But it's not for microplastics.
• 40:43
  Speaker 1: Yeah.
• 40:44
  Speaker 2: Even if that got for causal, it wouldn't be for
• 40:45
  Speaker 2: this reason, is what I'm saying.
• 40:47
  Speaker 1: It's such a good point.
• 40:48
  Speaker 3: The other place I think that that people talk a
• 40:50
  Speaker 3: lot about this is infertility. Yeah, and so you know,
• 40:54
  Speaker 3: we see microplastics in sperm, we see microplastics in the placenta,
• 40:58
  Speaker 3: and people worry about ertility rates. And I will say
• 41:02
  Speaker 3: in mice evidence again very high exposure to microplastics in
• 41:06
  Speaker 3: mice does seem to interfere with reproduction.
• 41:09
  Speaker 2: What is your read of that literature? In people.
• 41:13
  Speaker 1: Again very clear that there are microplastics in the placenta,
• 41:19
  Speaker 1: and in fact it's one of the tissues that they
• 41:23
  Speaker 1: see more microplastics than in some other tissues for reasons
• 41:26
  Speaker 1: that aren't entirely clear to me, Because the placenta is
• 41:29
  Speaker 1: not like a filtering organ like the liver or the
• 41:31
  Speaker 1: kidneys are, although maybe it is some kind of interface
• 41:35
  Speaker 1: that you know, makes microplastics more prone to be there.
• 41:39
  Speaker 1: The question is does it matter? And it's been very
• 41:43
  Speaker 1: difficult to show that there's a link between the microplastic
• 41:47
  Speaker 1: content in the placenta or a microplastic exposures and birth outcomes,
• 41:51
  Speaker 1: which is the important thing that you know, we care
• 41:53
  Speaker 1: about here. What do you think, Emily, I mean, this
• 41:56
  Speaker 1: is this is your your your wheelhouse.
• 41:58
  Speaker 2: Yeah, I think you know. So.
• 42:00
  Speaker 3: I don't think that there's any compelling evidence of particularly
• 42:04
  Speaker 3: important effects here. I mean, and I guess this gets
• 42:07
  Speaker 3: into where I end up on basically all of these things,
• 42:10
  Speaker 3: you know, cardiovascular disease, dementia, etc. Like Is it possible
• 42:16
  Speaker 3: that there is at some level of microplastics and effect, Yeah,
• 42:20
  Speaker 3: I think so. Is it likely that there's an effect
• 42:23
  Speaker 3: at the levels that we see people being exposed. I
• 42:26
  Speaker 3: don't think we have any evidence of that, and all
• 42:28
  Speaker 3: the literature on this is very very poor. And to
• 42:32
  Speaker 3: the extent you're seeing a correlation, almost certainly like nearly
• 42:36
  Speaker 3: all that correlation is driven by other differences across people
• 42:40
  Speaker 3: and not by the microplastics.
• 42:42
  Speaker 1: Yeah. Sometimes it's helpful to imagine imagine two people, like
• 42:47
  Speaker 1: the ultimate microplastic consumer and then the ultimate like non
• 42:51
  Speaker 1: microplastic person, not because they're deliberately trying to avoid them,
• 42:54
  Speaker 1: but like, what is sort of the image you have?
• 42:57
  Speaker 1: And if I think of like, you know, who's not
• 42:59
  Speaker 1: getting many brighter plastics, well, it's like this this guy
• 43:03
  Speaker 1: out in a log cabin in the woods who's like,
• 43:05
  Speaker 1: you know, hunting and fishing and eating whole foods and
• 43:08
  Speaker 1: you know, doing that kind of stuff and like whittling
• 43:11
  Speaker 1: his own z at block bags from a cherry tree.
• 43:14
  Speaker 1: And then you know, I think of the like microplastic consumer,
• 43:17
  Speaker 1: and you have someone who's you know, yeah, eating a
• 43:19
  Speaker 1: lot of takeout and all that kind of stuff, and
• 43:21
  Speaker 1: those are all what we call confounders. Those are all
• 43:24
  Speaker 1: problems when you're trying to tie microplastics to something because
• 43:28
  Speaker 1: the type of people who have more microplastics in them
• 43:30
  Speaker 1: are different than the type of people who have less
• 43:32
  Speaker 1: microplastics in them, and those differences can matter in terms
• 43:35
  Speaker 1: of all sorts of health outcomes.
• 43:37
  Speaker 3: Yeah, So, I mean, I think I am very skeptical
• 43:41
  Speaker 3: of claims that exposure to microplastics are an important part
• 43:44
  Speaker 3: of people's health. So, like, is it possible they are
• 43:46
  Speaker 3: a little bit of it?
• 43:47
  Speaker 2: Maybe? Is it likely that this is a very important
• 43:50
  Speaker 2: driver of various problems that people have in their health.
• 43:54
  Speaker 2: Just the answer is I think no.
• 43:56
  Speaker 1: I agree, I think this isn't the biggest problem we
• 43:58
  Speaker 1: face health wise. But I also always like to look
• 44:01
  Speaker 1: at like, okay, maybe it's not, but are there easy steady?
• 44:04
  Speaker 1: Like if I care, how easy would it be to
• 44:06
  Speaker 1: change this? And as we've been talking, you know, you've
• 44:10
  Speaker 1: told me about dust being a major contributor of microplastics. Like,
• 44:14
  Speaker 1: all right, I'm not going to change that. But it
• 44:16
  Speaker 1: feels like if you believe the tea study, right, like, okay,
• 44:18
  Speaker 1: maybe I'll just make tea using tea leaves and a
• 44:22
  Speaker 1: stainless steel tea filter. That's pretty easy. Do you think
• 44:26
  Speaker 1: there's like some easy stuff we should be doing. I
• 44:30
  Speaker 1: should I have a Stanley water bottle, like low hanging fruit.
• 44:32
  Speaker 3: Here, So I think there's the lowest hanging fruit is
• 44:36
  Speaker 3: avoiding like non reusable water bottles. So like plastic water
• 44:41
  Speaker 3: bottles are among the higher microplastic giver offers, they are
• 44:46
  Speaker 3: also not very good for the environment. And so there's
• 44:49
  Speaker 3: a kind of double whammy positive of just trying to
• 44:52
  Speaker 3: you know, not be neurotic and never ever use disposable
• 44:58
  Speaker 3: plastic water bottles, but think a little bit about you know,
• 45:02
  Speaker 3: limiting those. I think that's that is the simplest thing.
• 45:05
  Speaker 3: I think for most people that would change their microplastic
• 45:08
  Speaker 3: exposure some and almost every other change you.
• 45:11
  Speaker 2: Would make is totally unrealistic, like don't breathe.
• 45:14
  Speaker 1: Yeah, yeah, yeah, we don't recommend that in the medical spheres.
• 45:18
  Speaker 1: I think for me, yeah, I think I can use
• 45:21
  Speaker 1: a reusable water bottle. I think when I'm reheating my
• 45:24
  Speaker 1: takeout food in the microwave, like maybe I'll transfer it
• 45:27
  Speaker 1: to a bowl that is not plastic before I reheat
• 45:31
  Speaker 1: it in the plastic thing. I don't know that's easy.
• 45:34
  Speaker 2: Sure, yeah, I mean I again, I think that's that
• 45:37
  Speaker 2: could be easy. I think you have to.
• 45:38
  Speaker 3: Ask the question, like what is easy for you? And
• 45:41
  Speaker 3: maybe that's also a question about reusable water bottles. I
• 45:43
  Speaker 3: think we could say, like, here are two things you
• 45:45
  Speaker 3: could do. Use fewer disposable water bottles and don't microwave
• 45:49
  Speaker 3: your takeout, and then you can think about, you know,
• 45:51
  Speaker 3: how feasible are those changes for you?
• 45:54
  Speaker 1: I like it, all right, let's bottom line this thing, Emily,
• 45:59
  Speaker 1: microplastics smash your pass or actually should probably say avoiding
• 46:03
  Speaker 1: microplastics smasher pass.
• 46:06
  Speaker 3: I'm a pass on this because I think that in
• 46:10
  Speaker 3: the space of things people can do with their limited
• 46:14
  Speaker 3: attention and time for their health, trying to avoid all
• 46:18
  Speaker 3: sources of microplastics is not a very good use of
• 46:21
  Speaker 3: that limited time and energy. So, you know, if someone
• 46:26
  Speaker 3: said I'm going to use fewer single use water bottles, sure,
• 46:29
  Speaker 3: I think that's a good thing to do for the
• 46:30
  Speaker 3: environment in general. But from my taste, I think people
• 46:34
  Speaker 3: could think less about microplastics for their own health.
• 46:38
  Speaker 1: I am going to smash this one. I'm going to
• 46:41
  Speaker 1: smash avoiding microplastics primarily from other earth. I think we
• 46:45
  Speaker 1: all should be using less plastics, and I you know,
• 46:48
  Speaker 1: I don't think everything can be avoided, But like, am
• 46:50
  Speaker 1: I going to maybe not reheat my leftovers in the
• 46:54
  Speaker 1: plastic container? Maybe use my you know, aluminum water bottle
• 46:58
  Speaker 1: a little bit more based on what I've seen so far. Yeah,
• 47:01
  Speaker 1: that's some That's a change I can make. Change I
• 47:03
  Speaker 1: can live with.
• 47:04
  Speaker 2: Okay, it's our first disagreement.
• 47:07
  Speaker 1: Is it over?
• 47:09
  Speaker 2: I think it's over.
• 47:09
  Speaker 1: I feel like we.
• 47:10
  Speaker 2: Did a good I feel like we did a good
• 47:11
  Speaker 2: job on that respectful disagreement. Okay, all right, that's it
• 47:17
  Speaker 2: for microplastics. Your mailbag question of the week after the break.
• 47:26
  Speaker 5: Hi, am LeAnn Perry. This is Rachel from Philadelphia, and
• 47:29
  Speaker 5: I have a question about my weight, specifically, how I'm
• 47:33
  Speaker 5: ever supposed to trust.
• 47:34
  Speaker 1: What the scale says.
• 47:36
  Speaker 5: It's always fluctuating by a few pounds, and I really
• 47:39
  Speaker 5: can't figure out where those pounds are coming from. I
• 47:41
  Speaker 5: feel like my eating habits really aren't changing that much.
• 47:44
  Speaker 5: How often should I be weighing myself? And when is
• 47:48
  Speaker 5: a good time of day First thing in the morning,
• 47:50
  Speaker 5: later in the evening. I'm really just trying to get
• 47:53
  Speaker 5: an accurate idea.
• 47:55
  Speaker 1: Thank you, awesome question. I love this question because people
• 47:59
  Speaker 1: get really obsessed with weight. It's part of their daily habit.
• 48:03
  Speaker 1: They get on that scale and on a day to
• 48:06
  Speaker 1: day basis, there's a ton of stuff that makes your
• 48:09
  Speaker 1: weight fluctuate, and none of it is like the fat
• 48:12
  Speaker 1: content in your body. The primary driver of day to
• 48:15
  Speaker 1: day fluctuation and weight is water. So water's very heavy.
• 48:19
  Speaker 1: A leader of water weighs two point two kilograms, which
• 48:21
  Speaker 1: is about five pounds almost. That's a big swing. And
• 48:24
  Speaker 1: you drink water based on how much salt you intake.
• 48:28
  Speaker 1: So the more salt you eat, the more reflexively the
• 48:31
  Speaker 1: more water you go for. That's you can experience that,
• 48:34
  Speaker 1: you know, after driving Chinese food or something. It is
• 48:36
  Speaker 1: literal water weight. That is what is driving day to
• 48:38
  Speaker 1: day weight changes. The only utility of that is to
• 48:41
  Speaker 1: look at large trends over time to get a sense
• 48:44
  Speaker 1: of what's happening with like fat mass, muscle mass, et cetera. Emily,
• 48:47
  Speaker 1: do you weigh yourself every day?
• 48:49
  Speaker 3: I don't weigh myself every day, but I'm going to
• 48:51
  Speaker 3: tell you something that's interesting about water and salt, which
• 48:55
  Speaker 3: is one of the things that I sometimes do before
• 48:59
  Speaker 3: short distance races is take sodium bycarb, which is just
• 49:03
  Speaker 3: a really really really high dose of baking soda which
• 49:06
  Speaker 3: gives you a tremendous amount of sodium, like a billion
• 49:10
  Speaker 3: times not a billion, but like a lot, like a
• 49:11
  Speaker 3: lot of sodium. And it's good for performance in various ways.
• 49:15
  Speaker 3: But it also makes you incredibly thirsty and it makes
• 49:18
  Speaker 3: you retain like an enormous amount of water. And so
• 49:21
  Speaker 3: if you weigh yourself in the morning after a race,
• 49:24
  Speaker 3: after you have taken sodium bycarb, it's like a substantial
• 49:28
  Speaker 3: amount of we gain that sort of like fades out
• 49:31
  Speaker 3: over time. I did once experiment by weighing myself every
• 49:34
  Speaker 3: day for like four or five days after and it
• 49:35
  Speaker 3: took a few days to kind of come back to normal.
• 49:38
  Speaker 1: Yeah, this is classic physiology they teach you in med school.
• 49:41
  Speaker 3: So if you are tracking your weight over time, there
• 49:45
  Speaker 3: are a few different ways you could do. What You
• 49:47
  Speaker 3: could weigh yourself every day, but look for overall trends
• 49:51
  Speaker 3: over time. I tend to think that that makes people
• 49:55
  Speaker 3: who are trying to lose weight very anxious, and so
• 49:57
  Speaker 3: I don't think it's like a generally recommended thing to do.
• 50:00
  Speaker 3: But certainly there are some medical circumstances in which it
• 50:02
  Speaker 3: would make sense. If you are going to weigh yourself
• 50:05
  Speaker 3: every day, try to do it at the same time.
• 50:07
  Speaker 1: Yeah, typically we tell people in the medical field people
• 50:10
  Speaker 1: who should wag themselves. There typically people with heart failure
• 50:12
  Speaker 1: where we really are managing that fluid status that's so important,
• 50:15
  Speaker 1: and we're using it not to see what they're fat
• 50:18
  Speaker 1: or muscle masses. We're using it to assess water weight.
• 50:21
  Speaker 1: So if you don't have heart failure, no need to
• 50:23
  Speaker 1: weigh yourself every day. We do tell people. If you
• 50:25
  Speaker 1: want consistent results, do it first thing in the morning,
• 50:27
  Speaker 1: after you pee. That's it for us today. Stick with
• 50:32
  Speaker 1: us next week when we'll ask what's the deal with
• 50:35
  Speaker 1: stem cell therapy?
• 50:38
  Speaker 3: Wellness Actually is produced in association with iHeartMedia.
• 50:41
  Speaker 2: Our senior producer is Tamar Avisheik.
• 50:44
  Speaker 3: Our executive producer at iHeart is Jennifer Bassett. Our theme
• 50:48
  Speaker 3: music is by Eric Deutsch, and our content is for
• 50:50
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• 51:04
  Speaker 1: Actually pod and don't forget We want to hear from you.
• 51:07
  Speaker 1: Head over to Wellness Actually dot fm and leave us
• 51:10
  Speaker 1: a question for our mailbag or suggest a topic for
• 51:12
  Speaker 1: a future show.
• 51:14
  Speaker 2: We'll let the influencers have the last word.
• 51:16
  Speaker 6: Microplastics. Here's a public service announcement. If you go get
• 51:19
  Speaker 6: a cup of coffee and it's in a paper cup,
• 51:22
  Speaker 6: the entire paper cup is plastic. When they put the
• 51:24
  Speaker 6: hot water in there, you're drinking a cup of plastic.
• 51:26
  Speaker 6: They're already showing that it's disrupting hormones, it's disrupting mitochondria,
• 51:30
  Speaker 6: is disrupting so much heavy in fertility. They're finding plastics
• 51:35
  Speaker 6: in people's testicles anyway, So finding a detoxification while your
• 51:39
  Speaker 6: body is detoxifying in a sauna helps push it all
• 51:42
  Speaker 6: out