By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Bisphenol A (BPA)—a chemical used to harden plastic—is nothing new. It has been around since the 1890s and nowadays is a component of countless consumer products.
Likewise, the fact that BPA has been linked to several health concerns is nothing new either. Since the 1930s, it’s been well known that when BPA gets in the body, it acts as an endocrine disrupter. In plain English, this means that BPA can mess with the body’s hormonal balance and interfere with proper hormone function. Specifically, BPA is chemically similar to estrogen, so it mimics that hormone in the body. This can lead to problems with reproductive, sexual, and behavioral development, weight gain, and even increase risk of certain cancers.
What is new, however, is the growing realization of just how dramatically BPA can affect humans over the long term. Until recently, human studies on BPA’s effects have been sparse. Most research had been conducted on animals—but it was strong and convincing enough that scientists took notice of the potential dangers.
Recent research now sheds light on BPA exposure and mortality among adults in the US—and the results are eye opening.
Before getting into that, I want to provide a little more detail about what exactly BPA is, where it’s found, and what the major concerns regarding this compound are.
What Is BPA?
BPA is produced in very large quantities for use in polycarbonate (hard) plastics and epoxy resins (used as lacquers to coat metal products and prevent corrosion). As such, items that contain BPA include:
- Plastic cups, plates, bottles, storage containers, toys, and packaging
- Impact-resistant safety equipment
- Medical devices
- Dental sealants and composites
- Canned goods (specifically the interior linings of cans)
And that’s not all—it’s in some paper products too! A powdered form of BPA is added to heat-sensitive paper like sales receipts, tickets (lottery, movie, airline, etc.), and shipping labels.
Basically, you can’t escape BPA…it’s everywhere. Roughly 6 billion pounds of BPA is produced annually worldwide. In 2002, researchers discovered 41% of 139 US streams tested had measurable levels of the chemical.1
While it’s a pervasive in our environment, human exposure actually comes primarily through consuming foods and beverages that have been in contact with the compound. Studies show that 93% of the population has detectable levels of BPA in their urine.2
Food that is stored in plastic containers or in cans lined with BPA are the biggest culprits (which is why all of my Vervana products come in glass jars or bottles). A higher amount of BPA seeps into food when plastic containers are heated (such as in the microwave), or if the plastic is scratched up. Something as seemingly as insignificant as grabbing a sales receipt is also problematic as BPA is easily transferred onto skin and then absorbed that way.
The liver quickly metabolizes BPA, and the body excretes it through urine within a day. This means a single exposure really shouldn’t cause an issue. However, BPA is ever-present. Our bodies are continually being blasted with this chemical—when we drink from plastic water bottles, cut produce on plastic cutting boards, open up a can of tomatoes, and so on.
Is there any wonder why the vast majority of people regularly have measurable levels of BPA in their bodies?
Health Problems Linked to BPA
Research has connected constant BPA exposure with several serious health concerns:
- Fertility and reproductive problems. A review that reexamined research conducted between 2007-2016 concluded that BPA may alter female fertility by affecting the function of the fallopian tubes, ovaries, uterus, hypothalamus, and pituitary gland. It can also disrupt normal monthly cycles and embryo implantation. In men, BPA is linked to chromosome abnormalities, higher levels of immature sperm, decreased sperm motility, and overall poor sperm/semen quality. Erectile dysfunction has also been noted.3-4
- Cardiovascular disease. A 2010 study that included nearly 3,000 people concluded, “Higher BPA exposure, reflected in higher urinary concentrations of BPA, is consistently associated with reported heart disease in the general adult population of the USA.” Other studies have found a connection between BPA and angina, hypertension, heart attack, arrhythmia, and coronary and peripheral arterial disease.5-6
- Cancer. Since BPA mimics estrogen, research shows it interacts with certain cell receptors that promote the development of hormone-dependent cancers such as breast, prostate, and ovarian.7
- Obesity. Not only does BPA impede normal hormone function, it can also interfere with insulin production, which can lead to an increase fat storage. An analysis of 4,733 adults discovered urinary BPA to be positively associated with obesity.8
- Diabetes. A 2018 meta-analysis looked at 16 studies conducted between 1980-2018 and determined that BPA exposure is “positively associated with type 2 diabetes risk.”9
- Attention-Deficit/Hyperactivity Disorder (ADHD). To investigate the possible relationship between BPA and ADHD, researchers tested the urine of 215 children with ADHD and 253 without the condition. The results indicated significantly higher concentrations of BPA in the affected kids compared to the controls. Boys appeared to be more susceptible than girls.10
Unfortunately, this is just the tip of the iceberg. Other concerns attributed to BPA overexposure include poor fetal development (especially the brain), asthma, early puberty, and cognitive disorders like Alzheimer’s.
One of the most recent studies on BPA risks, published in the prestigious JAMA, answers the question, “Is exposure to BPA associated with long-term risk of mortality?” The answer, sadly, is yes.
The researchers wrote, “In a cohort study of 3,883 adults in the United States, participants with higher urinary bisphenol A levels were at higher risk for death during approximately 10 years of observation…. The findings in this study suggest that a higher level of bisphenol A exposure is associated with an increased risk of long-term all-cause mortality.”11
FDA Maintains BPA Is Safe
Despite all this evidence, the FDA’s response has been lackluster. The agency continues to maintain that BPA is not nearly as dangerous to human health as the research indicates—even “safe” at low levels. They appease consumers by saying they continue to monitor the research.
One small victory, however, came in 2012 when the agency amended regulations and enforced a ban on the use of BPA in baby bottles, sippy cups, and the lining of infant formula cans. Of course, they say this decision was “not based on safety,” but other factors.12
Many manufacturers have voluntarily stopped utilizing BPA in the manufacture of their products, and you can now find countless merchandise labeled “BPA free.” Roughly 50 BPA-free alternatives exist, but I remain very wary of all of them. Early studies suggest that BPA substitutes like bisphenol S (BPS) and diphenyl sulfone are no less dangerous than BPA.13
In fact, about 81% of Americans now have measurable levels of BPS in their urine!14
Minimize Your Exposure
While it’s an unfortunate fact that BPA is so pervasive in our society, there are ways to limit your exposure. The goal is progress…not perfection. You simply can’t avoid it completely. But the following steps can at least protect you from the most common causes of BPA exposure.
- Avoid plastics whenever possible. Just get rid of as much of it as you can—cups, plates, utensils, storage containers, etc. Use glass, stainless steel, ceramic, or porcelain containers to store food. Avoid drinking water bottled in disposable or reusable plastic. It’s equally terrible for the environment as it is for you. Reusable glass, or unlined food-grade stainless steel water bottles, are readily available online and at big box stores.
- Don’t heat plastics. This has been shown to degrade the plastic, allowing even more BPA to leech into food. Transfer meals onto a non-plastic plate before reheating in a microwave. (Or do it the old-fashioned way—reheat on a baking sheet in the oven!) If you do have any plastics, hand wash them instead of putting them in the dishwasher.
- Avoid or limit canned food. Fresh fruits and veggies should always be your top choice, and frozen is the next best option. For other prepackaged foods, search for those that are sold in glass jars or cardboard brick-shaped cartons. If you do buy canned, here’s a list of BPA-free canned foods. Also, avoid sodas and other canned beverages. They have absolutely no nutritional benefit, and most soda cans have a BPA lining to prevent the beverage from taking on a metallic taste.
- Say “no” to paper receipts. Most retailers now have the option to email you a receipt. If you do need the physical receipt, wash your hands as quickly as possible after handling it.
- Talk to your dentist. Make sure sealants he/she uses are BPA free.
Remember, money talks. The louder we as consumers can be in demanding safer products, the faster manufacturers will be forced to comply. In the case of BPA (and its equally questionable counterparts like BPS), “safer” almost always means plastic-free.
Limiting or eliminating plastic and other BPA-containing products is a winning proposition not just for your health, but for the environment too. So do your part to seek out more health-conscious alternatives, avoid products packaged in potentially harmful plastics—and hopefully, brands will soon start to realize that customers really do take safety seriously.
- Kolpin DW, et al. Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in US Streams, 1999-2000: A National Reconnaissance. Environ Sci Technol. 2002;36(6):1202-11.
- Calafat A, et al. Exposure of the US Population to Bisphenol A and 4-Tertiary-Octylphenol: 2003-2004. Environ Health Perspect. 2008 Jan;116(1):39-44.
- Ziv-Gal A and Flaws JA. Evidence for Bisphenol A-Induced Female Infertility—Review (2007-2016). Fertil Steril. 2016 Sep 15;106(4):827-56.
- Radwan M, et al. Urinary Bisphenol A Levels and Male Fertility. Am J Mens Health. 2018 Nov;12(6):2144-51.
- Melzer D, et al. Association of Urinary Bisphenol A Concentration with Heart Disease: Evidence of NHANES 2003/06. PLoS One. 2010 Jan 13;5(1):e8673.
- Gao X and Wang H. Impact of Bisphenol A on the Cardiovascular System—Epidemiological and Experimental Evidence and Molecular Mechanisms. Int J Environ Res Public Health. 2014 Aug;11(8):8399-413.
- Gao H. Bisphenol A and Hormone-Associated Cancers: Current Progress Perspectives. Medicine (Baltimore). 2015 Jan;94(1):e211.
- Do MT, et al. Urinary Bisphenol A and Obesity in Adults: Results from the Canadian Health Measures Survey. Health Promot Chronic Dis Prev Can. 2017 Dec;37(12):403-12.
- Hwang S, et al. Bisphenol A Exposure and Type 2 Diabetes Mellitus Risk: A Meta-Analysis. BMC Endocr Disord. 2018;18:81.
- Li Y, et al. Relationship Between Bisphenol A Exposure and Attention-Deficit/Hyperactivity Disorder: A Case-Control Study for Primary School Children in Guangzhou, China. Environ Pollut. 2018 Apr;235:141-9.
- Bao W, et al. Association Between Bisphenol A Exposure and Risk of All-Cause and Cause-Specific Mortality in US Adults. JAMA Netw Open. 2020 Aug;3(8):e2011620.
- US Food and Drug Administration. Bisphenol A (BPA): Use in Food Contact Application. Updated June 27, 2018.
- Service RF. BPA Substitutes May Be Just as Bad as the Popular Consumer Plastic. Science Magazine. 2018 Sep 13.
- Bilbrey J. BPA-Free Plastic Containers May Be Just as Hazardous. Scientific American. 2014 Aug 11.
© Stephen Sinatra, M.D. All rights reserved.