Kim Goodsell was running along a mountain trail when her left ankle began turning inward, unbidden. A few weeks later she started having trouble lifting her feet properly near the end of her runs, and her toes would scuff the ground. Her back started to ache, and then her joints, too.
This was in 2002, and Kim, then 44 years old, was already an accomplished endurance athlete. She cycled, ran, climbed, and skied through the Rockies for hours every day; she was a veteran of Ironman triathlons. She’d always been the strong one in her family. When she was four, she would let her teenage uncles stand on her stomach as a party trick. In high school, she was an accomplished gymnast and an ardent cyclist. By college, she was running the equivalent of a half marathon on most days. It wasn’t that she was much of a competitor, exactly—passing someone in a race felt more deflating than energizing. Mostly Kim just wanted to be moving.
So when her limbs started glitching, she did what high-level athletes do, what she had always done: she pushed through. But in the summer of 2010, years of gradually worsening symptoms gave way to weeks of spectacular collapse. Kim was about to head to Lake Superior with her husband, CB. They planned to camp, kayak, and disappear from the world for as long as they could catch enough fish to eat. But in the days before their scheduled departure, she could not grip a pen or a fork, much less a paddle. Kim, a woman for whom extreme sports were everyday pursuits, could no longer cope with everyday pursuits. Instead of a lakeside tent, she found herself at the Mayo Clinic in Rochester, Minnesota.
After four days of tests, Kim’s neurologist told her that she had Charcot–Marie–Tooth disease, a genetic disorder that affects the peripheral neurons carrying signals between the spinal cord and the extremities. It’s rare and carries a varying suite of symptoms, but Kim’s are typical, starting at the feet and heading upward. The neurologist explained that as her neurons died, the surviving cells picked up the slack by sprouting new branches—a workaround that masked the underlying degeneration until the rate of cell death outpaced the rate of compensation. Hence Kim’s crash.
The neurologist told her to come back in a year so he could check how quickly the disease was progressing, but it would certainly progress. Charcot–Marie–Tooth has no cure.
The Goodsells drove home, and Kim, exhausted, slept for two days. When she woke up, she got to work. “My reaction to things that I have no control over is to find out as much as I can about them,” she says. She started by reviewing her clinic notes, and quickly she noticed something odd: there was hardly any mention of her heart.
I've mentioned Doug Rouch's work with the Urban Food Initiative that makes use of good food that would otherwise be discarded. Here is a paper in JAMA Pediatrics that offers more commentary (outside their paywall)
Since this episode, independent scientists have focused their efforts on in vivo testing. Deborah Kurrasch, from the University of Calgary, turned to zebra fish to study the effects of BPS on embryo development. Brain development in zebra fish is similar to that in humans but much easier to track. When the fish were dosed with BPS in similar concentrations to that found in a nearby river, neuronal growth exploded, rising 170 percent for fish exposed to BPA and a whopping 240 percent for those exposed to BPS. As the fish aged they began zipping around their tank much faster and more erratically than the unexposed fish. The researchers concluded that increased neural growth likely lead to hyperactivity. “Part of the problem with endocrine disruptors is they usually have a U-shaped dose response profile,” Kurrasch says. “At very low doses they have activity and then as you increase the dose it drops in activity. Then at higher doses it has activity again.” She found a very low dose—1,000-fold lower than the daily recommended amount for humans—can affect neural growth in zebra fish.
In another study, Hong-Sheng Wang, an associate professor at the University of Cincinnati, found that both BPA and BPS cause heart arrhythmia in rats. He tested almost 50 rats, giving them the chemicals in doses akin to concentrations found in humans. Even at such low concentrations the rats’ hearts began to race, but curiously only those of the females. They found that BPS blocked an estrogen receptor found only in female rats, which lead to the disruption of calcium channels—a common cause of heart arrhythmia in humans.
These in vivo studies agree with in vitro studies claiming that BPS is a hazard. But the problem doesn’t stop with removing bisphenol S from the market as was done for bisphenol A. The problem, according to Kurrasch, lies in the lack of industry regulation. Currently, no federal agency tests the toxicity of new materials before they are allowed on the market. “We’re paying a premium for a ‘safer’ product that isn’t even safer,” Kurrasch says. There are many types of bisphenols out there, so part of the public’s responsibility “is making sure [manufacturers] don’t just go from BPA to BPS to BPF or whatever the next one is.”
It is necessary and laudable to push for improving nutrition, advancing child and maternal health, and ending open defecation in India. However, we cannot close the malnutrition gap without addressing the social norms and economic rationales that deprive girls and younger siblings of the resources they need.
The fight for gender equality is a crucial part of this. Many recent policy efforts in India have focused on improving girls’ education; for these to have bite, they must be paired with efforts to equalize property ownership and job opportunities. A 2005 law granted daughters the right to inherit equally with their brothers, but enforcement is weak. And the participation of women in the labor force is actually declining in India today.
As long as this is the case, it will be hard to convince parents to invest in their children more equally. Parents will continue to lavish resources on their eldest sons if they see them as their only support in old age. But if we can improve the economic prospects for India’s women, we may be able to reduce the malnutrition of their children.
(a tip of the hat to Bjarne)
Ten years ago The New Yorker featured a fascinating Burkhard Bilger piece on human height. An individual's height is complicated and may or may not indicate something about their health. But when a large group of people are studied over time it can be a proxy for relative health.
The graph in question showed the heights of American slaves, servants, soldiers, and apprentices in the early seventeen-hundreds. To produce it, Komlos searched through Colonial newspapers for descriptions of runaways and deserters, until he had gathered ten thousand seven hundred and forty-two heights. “You can drown in these data,” he said. “But they also allow you to get closer to these guys.” He showed me an ad from the Pennsylvania Gazette, dated September 26, 1771. An Irish servant named Nathaniel Anster had run away for the third time. He was thirty years old, with a sandy complexion and short bushy hair. He had on a felt hat and a striped blanket coat, was “much inclined to strong drink,” and had “a natural propensity to steal.” He was also five feet seven inches tall. When Komlos had gathered enough heights, he averaged them out and plotted them on this graph.
The immediate point was clear: America was a good place to live in the eighteenth century. Game was abundant, land free for the clearing, settlement sparse enough to prevent epidemics. On Komlos’s graph, even the runaway slaves are five feet eight, and white colonists are five feet nine—a full three inches taller than the average European of the time. “So this is the eighteenth century,” Komlos said, slapping the files. “This is not problematic. It shows that Americans are well nourished. Terrific.” He reached into a cardboard folder and pulled out another series of graphs. “What is problematic is what comes next.”
Around the time of the Civil War, Americans’ heights predictably decreased: Union soldiers dropped from sixty-eight to sixty-seven inches in the mid-eighteen-hundreds, and similar patterns held for West Point cadets, Amherst students, and free blacks in Maryland and Virginia. By the end of the nineteenth century, however, the country seemed set to regain its eminence. The economy was expanding at a dramatic rate, and public-hygiene campaigns were sweeping the cities clean at last: for the first time in American history, urbanites began to outgrow farmers.
Two Chicago-area researchers, Michal Maimaran and Ayelet Fishbach, phrase their research in terms of what they call "food instrumentality"—the idea that a given type of food is good for achieving a goal. Carrots are good for your vision, spinach makes you strong, and so on. The researchers suspect that this idea interacts with a quirk in the reasoning of young children: they tend to think of things as only serving a single purpose. If carrots are good for your vision, the reasoning goes, they're not likely to be good for your tastebuds at the same time.
Over a series of experiments with children three to five years old, the authors tested foods that were given various purposes: makes you strong, helps you read, or helps you count. In each case, the same foods were offered to a set of control children without any message. By a variety of measures, a positive message about the food undermined the cause: the children rated it as less tasty, planned on consuming less, and actually did consume less when they were given the chance to eat it.
An unusually tall friend is often asked what she ate as a kid when mother's with kids in tow see her. They're probably betting she will give some healthy advice, but sometimes she tells them that she sometimes out-competed the family dog for his food when she was a toddler...
Many officials admit, however, that China’s heavy metal soil contamination is an enormous challenge. Last year, Zhuang Guotai, the head of the MEP’s Department of Nature and Ecology Conservation, told a conference of market-listed environmental protection companies, “In comparison with efforts to clean up air and water pollution, we’ve hardly got started with soil. But once the market is opened up, soil remediation will be on a far bigger scale than either air or water cleanup.”
If the scale of China’s soil pollution is unprecedented, remediation, too, must be large-scale. Zhuang admitted however, that, as well as legislative and technological difficulties, funding for soil remediation was the biggest challenge, as total cleanup costs could eventually reach $1.6 trillion. A private industry body, the Jiangsu Institute of the Environmental Industry, has predicted that between 2014 and 2020 China’s soil remediation market could be worth nearly $110 billon.
For now, however, financing for these projects is tight. In 2013 the Chinese government launched 42 soil remediation trials, but only two involved funding of more than $16 million. Funding for the 16 projects unveiled so far totals about $96 million, almost entirely from government subsidies.
The federal Clean Water Act is intended to limit pollution from fixed points like industrial outfalls and sewer pipes, but most of the troublesome phosphorus carried into waterways like Lake Erie is spread over thousands of square miles. Addressing so-called nonpoint pollution is mostly left to the states, and in many cases, the states have chosen not to act.
Beyond that, the Supreme Court has questioned the scope of the Clean Water Act in recent years, limiting regulators’ ability to protect wetlands and other watery areas that are not directly connected to streams, or that do not flow year-round.
Wetlands, in particular, filter phosphorus from runoff water before it reaches rivers and lakes. A federal Environmental Protection Agency proposal to restore part of the Clean Water Act’s authority has come under fire in Congress, largely from Republicans who view it as an infringement on private rights and a threat to farmers.
Some efforts to control pollution have found powerful opponents in agriculture and the fertilizer industry, which, for example, has fought limits on lawn fertilizers in Florida towns and on overall pollution of the Chesapeake Bay. The principal industry lobby, the Fertilizer Institute, is part of a coalition of industry and agricultural interests that are opposing federal efforts to restore some coverage of the Clean Water Act.
With Lake Erie in peril, both Ohio and federal authorities have taken some steps to rein in phosphorus pollution. Some of the $1.6 billion that Congress has allotted for a Great Lakes Restoration Initiative has gone to create wetlands and teach farmers ways to reduce fertilizer use and runoff. The Ohio government runs a Lake Erie Phosphorus Task Force that brings together interests from conservation to agriculture to industry to devise solutions to rising pollution.
But as in many places, Ohio has stopped well short of actually ordering the sources of phosphorus runoff to cap their production. A hefty Nutrient Reduction Strategy paper issued last year cites sheaves of demonstration projects, voluntary phosphorus reduction goals and watershed plans, but makes no mention of enforceable limits on pollution.