Styrofoam Really Is Bad for Your Health

by Carole Jackson, Bottom Line Health

My niece is a college student, and forget about the healthy snacks that my sister once plied her with — frozen blueberries, raw carrots and peppers, Greek yogurt. Now she and her roommates subsist on salty soups in Styrofoam containers that they heat in the communal microwave. This, too, will pass, I know, but a recent US Department of Health and Human Services (HHS) report provides greater cause for concern. In June, the National Institute of Environmental Health Sciences (NIEHS), part of HHS, added styrene — the chemical used in the manufacture of Styrofoam cups and food containers — to its list of substances that are “reasonably anticipated” to cause cancer. Styrene has also been linked to nerve damage and hormonal disruption.

The Chemicals Leach Into Your Food

Styrofoam is made from the plastic polystyrene, which is based on building blocks called styrene monomers. When you drink your steaming cup of coffee or spoon your chicken noodle soup or chili out of a Styrofoam cup, you also take in small doses of chemicals that leach from it. “Trace amounts of styrene as well as various chemical additives in polystyrene migrate into food — particularly when liquids are hot,” explains Olga Naidenko, PhD, a senior scientist at the Environmental Working Group ( “This is a problem, because polystyrene is very commonly used as disposable packaging for hot food and beverages” — and has been for many years!

The HHS says that the levels released from food containers are very low — but for me, that’s not very comforting when I think about the literally thousands of doses that we each have taken in over the years. Then, too, every day we are bombarded with a multitude of toxins in the environment. It all adds up… so now, are you willing to accept toxic industrial chemicals in your soup?

Don’t Swallow It

Reducing exposure to cancer-causing agents is something we all want, but it takes knowledge and action on each person’s part to achieve that…

  • Boycott Styrofoam. Do not eat or drink out of Styrofoam containers (even if you’re a college student). I know it sounds obvious, but in today’s food culture, that’s easier said than done. It’s especially important not to consume anything hot, oily, acidic (including tomato sauce-based foods) or alcoholic from Styrofoam, since heat, oil, acid and alcohol increase leaching. This rules out, for example, hot drinks, citrus beverages, dressed salads, take-out burgers and, of course, beer and wine. Don’t store food in Styrofoam — there are plenty of other packaging options. Be especially cognizant when you’re eating out at a restaurant and find yourself asking the waiter if he/she will pack up what you didn’t finish so that you can take it home. Ask if they have alternatives to Styrofoam, or even bring your own container from home.
  • Choose healthier food and beverage containers. Eat and drink out of toxin-free glass, ceramic, stoneware or BPA-free plastic — not Styrofoam. (Read about health concerns with the chemical BPA in standard plastic containers in the July 4, 2011 issue of Daily Health News.)
  • Beat the heat. Whatever else you do, don’t microwave food in Styrofoam. Reheat leftovers in glass, ceramic or stoneware.
  • BYOC. Bring your own cup to coffee shops and diners that use Styrofoam for beverages. Some ecofriendly businesses in my neighborhood even give you 25 cents off to encourage you to do the right thing for the environment — which happens to be the right thing for your body as well.
  • Vote with your feet. Patronize food establishments that provide recyclable cardboard take-out containers, not Styrofoam.


Olga Naidenko, PhD, senior scientist, Environmental Working Group, Washington, DC. EWG is a nonprofit, research-based organization dedicated to protecting public health and the environment.

Are You Using Probiotics Correctly?

by Carole Jackson, Bottom Line Health

Last week, as you may recall, I wrote about prebiotics, those behind-the-scenes digestive health assistants that serve to nurture probiotics, their more widely celebrated colleagues. Known to help increase bowel regularity while decreasing gas and bloating, probiotics are making their way onto more and more top-10 health lists so it’s not so surprising to find them tucked into all manner of foods and beverages, with labels slapped on touting their health benefits.

However, the formula for using probiotics to optimize your health is somewhat more nuanced than merely spooning up a daily serving of yogurt! That’s okay — giving you the “story behind the story” is exactly what Daily Health News is here to do. So read on to learn the real secret to putting probiotics to work for you.

Probiotics Go Mainstream

Probiotics are definitely getting more respect. A friend told me that her doctor gave her the name of a probiotic supplement when he handed her an antibiotic prescription, telling her to take them to replenish the valuable intestinal bacteria that the antibiotics would suppress. Probiotics have made their way into the hospital world, too — they’re given to patients to help prevent deadly intestinal diseases that have resulted from antibiotic-resistant superbugs… researchers are studying their use for premature babies… and a few doctors even are urging consideration of a new hand-hygiene protocol that involves dipping caregivers’ hands into probiotic solutions after scrubbing in order to recolonize the skin with good bacteria.

Maybe those doctors are also telling patients to buy probiotic-fortified foods at the supermarket — and there’s nothing wrong with doing so. But Leo Galland, MD, director of the Foundation for Integrated Medicine in New York City, wants us to understand that we won’t achieve any meaningful benefits by relying on these probiotic-fortified food sources alone.

Why We Need Supplements

Dr. Galland explained that acid naturally present in most probiotic-containing foods suppresses these helpful bacteria, at least partially — so it’s impossible to know how many cultures survive and are of benefit. He believes that supplements are a better route since they reliably deliver a beneficial number of probiotic organisms.

However, he pointed out that specific types of probiotics can be used to address specific health concerns. This is another argument for supplements instead of probiotic-fortified foods and another reason why it’s important to work with a doctor (a naturopathic physician or a gastroenterologist experienced in working with prebiotics and probiotics) who can ascertain what’s best for you, how much you should take and at what times of day.

Dr. Galland told me that he tends to prescribe specific types of probiotics in certain situations. For example…

  • For people with no particular health concerns, Dr. Galland might suggest 20 billion Colony Forming Units (CFUs) of combined lactobacillus and bifidobacterium “as a good general preventative for intestinal and respiratory tract infections.”
  • For people taking antibiotics, Saccharomyces boulardii (S. boulardii, brand name Florastor) usually is the best choice (though actually this particular probiotic is not a bacteria but a yeast). It’s also helpful in boosting effectiveness of Flagyl (metronidazole) and is used to treat Clostridium difficile colitis and antibiotic-associated colitis, as well as other bacterial and nonbacterial intestinal infections. Note: Dr. Galland said that S. boulardii should be taken only for the duration of antibiotic or Flagyl treatment, after which he switches his patients to a bacteria-based probiotic.
  • For patients having abdominal surgery, Dr. Galland prescribes Lactobacillus plantarum for a few weeks before and after surgery, since research shows that it helps reduce postoperative infections. Other studies demonstrate that lactobacillus probiotics can help to reduce frequency of diarrhea and abdominal pain in cancer patients as well.
  • For gas and bloating, Dr. Galland said that certain soil-based organisms (called “SBOs” — for instance, one kind is Bacillus laterosporus) can be helpful. These probiotics aren’t normally found in the human digestive system and they won’t take up permanent residence, so patients who find them beneficial may want to continue taking them daily even after their symptoms have subsided, he added.

what’s best for you?

As with prebiotics, Dr. Galland said that it may take some trial and error to identify which probiotics are helpful in achieving the desired results without upsetting your system. He has found Lactobacillus plantarum beneficial for many of his patients, but it isn’t always the right choice. Dr. Galland told me that experienced doctors often use sophisticated stool test results to identify the types of bacteria already in a patient’s system, since this information can help determine the best course of pre- and probiotic therapy, along with other natural supplements that will yield good results.

If you want to try adding probiotics to your personal health regimen, talk to a doctor with expertise in this area and expect to start slowly and watch closely to see what works best. (You’ll know it’s working if it helps diminish digestive difficulties, such as gas, indigestion and irregular bowel movements.) This may mean that you end up trying several different types of probiotics before you find what helps your system function best. Stick with it though, since these beneficial bacteria have the potential to transform your health for the better.


Leo Galland, MD, founder and director, Foundation of Integrated Medicine, New York City.

The Key to Exercise Motivation

Like many people, I manage to exercise almost every day, but I’m not always motivated to do my best. And there are periods when “almost every day” doesn’t happen either. Sound familiar? Well, I’m happy to tell you that researchers have discovered a way that we can all improve our exercise performance merely by teaming up with the right kind of partner — and that partner does not have to be a human being. A “virtual” partner can be just as effective.

All this came to light during recent experiments at Michigan State University, where researchers asked test subjects to compare how well they were able to do plank exercises, in which you strengthen abdominal muscles by lying facedown on a mat and pushing up with your feet and your forearms until your body is suspended several inches above the mat, straight as, yes, a plank. The object is to keep your body suspended for as long as possible.

The main purpose of the research — to be published in an upcoming issue of Journal of Sport & Exercise Psychology — was to show the participants’ level of motivation and persistence depending on whether they exercised with a partner or alone. Results consistently showed greater performance when a participant had a partner. In fact, even a virtual partner spurred performance when compared with a participant exercising alone. How, you may be asking, did the researchers observe the impact of a “virtual” partner?

In several tests, participants could see themselves on a nearby EyeToy, the camera device designed for PlayStation 2, the popular video game console. Alongside the EyeToy was a second screen on which participants saw a person — someone they had been introduced to briefly, and in person, as their new exercise partner. What participants didn’t know was that the partner on the screen was virtual. That is, it was a tape of a person exercising, which actually had been recorded the day before. Since the participants would be viewing their partners through a video link connected to a television screen, they wouldn’t know the difference and would, in fact, think of their partner as live.

Participants were told that they and their partners were a team of two whose rating would be determined by whichever team member got the worse score. For example, if a participant was able to stay suspended for 40 seconds, but the partner could remain suspended for two minutes, the team score would be 40 seconds. Results showed that the intensity and duration of exercise were always greater when participating with a partner. In one test, participants were offered a reward (a membership at a fitness club) for getting a high score. In a follow-up test, no reward was offered, but with the partner “present,” the team produced a higher score than when a reward was offered.


Results surprised even the lead researcher, Deborah Feltz, PhD, university distinguished professor and chairperson of Michigan State’s department of kinesiology. I spoke with her about the findings and about that all-important topic “motivation.” As Dr. Feltz put it, “It appears that working as part of a team and helping a teammate is stronger motivation than the prospect of a reward” — and a good part of that motivation, she said, appears to be based on the concern of letting a teammate down or on being identified as the weak link in the team.

Of course, participants did think that they were watching their partners perform live, but Dr. Feltz said it probably wouldn’t have made much difference if they had known that the video had been taped earlier. Many other studies, she said, have shown that people routinely treat computers — whether robotlike or with screens that display words — as if they’re human. “If you doubt that, just think about all the people who curse the GPS in their cars when it gives wrong directions,” she said. An upcoming study at Michigan State will focus specifically on using computer-generated partners in physical exercise, Dr. Feltz said.

In light of this research and other studies, Dr. Feltz had this advice for anyone who wants to exercise more effectively…

  • Instead of giving yourself a reward for exercising, choose a partner with whom you can work out.
  • The best exercise partner is someone who is slightly more fit or proficient than you are. This is because doing as well as, or better than, the partner becomes a goal. Conversely, it can be discouraging to work out with someone who is far more competent than you are. In fact, the study found that participants lost motivation if they believed that they could never keep up with their partners… and working out with someone who is far less competent than you isn’t great, as it’s all too easy to become bored.

In the next few years, Dr. Feltz expects we’ll see many video health games that take advantage of the notion of working out with virtual partners. Imagine a brave new world where we’ll all be exercising often and more effectively, not wanting to let our partners — virtual though they may be — feel that we haven’t done our utmost!


Deborah Feltz, PhD, an expert in sports psychology, is a university distinguished professor at Michigan State University in East Lansing and chairperson of the department of kinesiology.

When Lightning Strikes

by Carole Jackson, Bottom Line Health

The weather outside is frightful, inside it’s so delightful… it’s awfully early in the year to sing this song, but it’s what came to mind as I was researching this story on a particular hazard of summertime weather — lightning. It’s far more “frightful” than snow or ice — lightning can kill you instantly. While some of us may already know exactly what to do when there’s lightning around, it’s remarkable how many people don’t know or simple don’t take lightning seriously enough. I decided to seek out the latest information on staying safe.

A Bolt from the Blue

In the summer months, lightning is predictably unpredictable — there’s lots of it and you don’t always see it coming. You’ve heard the term “a bolt from the blue”… it derives from the fact that lightning has been known to light up a bright blue sky (though not so often as a dark and stormy one), and it can travel as far as 10 miles, not only vertically but horizontally as well. Hot summer weather raises the likelihood of thunderstorms, which always bring lightning (whether you see it or not).

According to the National Weather Service, lightning strikes ground some 25 million times a year here in the US, hitting an estimated 400 people and killing about 40, who typically die from severe burns, cardiac arrest and/or respiratory arrest. While 90% of those who have been hit by lightning survive, they often suffer serious side effects that can include paralysis, internal and external burns, deafness, ringing in ears, amnesia and/or confusion, personality change, depression, sleep disturbances, memory dysfunction, headache, fatigue, joint stiffness and muscle spasms.

To learn how to stay safe and what to do if you’re ever with someone struck by lightning, I consulted our contributing medical editor Richard O’Brien, MD, an emergency physician in Scranton, Pennsylvania, who told me he sees lightning victims every summer.

While everyone seems to understand that lightning is dangerous, many are unclear on what they need to do to protect themselves. So, one by one, we went through the facts that are most important to know…

Are You Grounded?

The most important thing to understand about lightning, said Dr. O’Brien, is that it wants to find a way to get into the earth — it’s called “grounding.” The human body, water and metal all are excellent conductors of electricity and will get it to ground very effectively. Rubber, concrete and wood, on the other hand, are protective.

“When thunder roars, go indoors.” This is the catchy phrase that the National Weather Service uses to educate people on the most important thing you can do to stay safe from lightning — get out of its way. Get inside a safe building (one that is fully enclosed with a roof, walls, electricity and plumbing) or seek shelter in a car with a metal roof and the windows up (not a convertible, even with the roof up). “There is no such thing as being safe outdoors in a thunderstorm,” said Dr. O’Brien. Even if you are inside, remember that lightning has been known to strike through glass. Stay as far away as possible from windows and skylights. Lightning also has been known to strike through electrical outlets. If it hits an outside wire (phone/cable/electric), it can conduct into the jacks in the house, Dr. O’Brien explains.

Stay dry and disconnected. You can use a cell or cordless phone safely during a thunderstorm as long as the handset is not plugged in or attached to the base. Note that by using a cordless phone you still risk drawing an electrical surge to the base and destroying it. Under no circumstances should you talk on a landline. Any electrical device, handheld or otherwise including an electric stove, is a magnet for lightning, especially when it is using power. Stay out of the shower or bath and don’t use the sinks. “Lightning can come through the plumbing,” notes Dr. O’Brien. “If it hits the house, it looks for ground (your metal pipes) and if you’re in the shower, naked and wet, you’ve had it.” If you must go outdoors, remember there is no such thing as safe phone use — even a cell or cordless.

Be patient. Wait to go outdoors until you’ve heard no thunder for 30 minutes.

If Lightning Strikes …

If you or someone near to you is struck by lightning, get help immediately. Call 9-1-1 (from a safe location if there is one!). If the person is unconscious and without a pulse, perform CPR. The 911 operator can help with advice as well. As a quick guide to CPR, the American Heart Association says to use both hands and push on the chest “hard and fast” to the tempo of the old Bee Gees song Stayin’ Alive.

There’s no need to fear being electrocuted yourself if you touch a person who has been struck by lightning, said Dr. O’Brien — but you do need to protect yourself from another bolt of lightning. Take whatever measures you can to get yourself and the victim out of danger as fast as possible.

During these summer months, it’s important to be aware that lightning is a clear and present danger — take it seriously!


Richard O’Brien, MD, attending emergency physician at Moses Taylor Hospital, and associate professor of emergency medicine at The Commonwealth Medical College of Pennsylvania, both in Scranton.

Not-So-Great Expectations: The “Nocebo” Effect

by Carole Jackson, Bottom Line Health

You’re probably well acquainted with the “placebo effect,” in which a medication or other medical intervention makes you feel better simply because you expect it will… but you may not know that this sweetly innocent power of suggestion has a dark side, too. Researchers call it the “nocebo” effect, and it operates exactly the same way but in reverse. Instead of reacting to the expectation that a treatment will solve a medical problem, the nocebo effect makes people suggestible to experiencing nasty side effects from it, such as aches, nausea, balance problems — you get the idea. So just being told that a particular drug might cause you to feel bad may bring on problems. In other words, many of us who do take drugs are running around suffering from unpleasant side effects that may well be concoctions of our minds rather than the medication!

Take the Bad with the Good

With the goal of educating all of us in this lesser-known phenomenon, I contacted Ted Kaptchuk, LAc, an acupuncturist and associate professor of medicine at Harvard Medical School, a leader in placebo and nocebo research, a field that’s attracting increased attention. Dr. Kaptchuk said that though the nocebo effect is much less widely known, it occurs in the very same types of drug tests in which the placebo effect is encountered. Some of the test subjects given sham pills end up experiencing adverse reactions, the same ones that they’ve been told they might experience if given the actual medication. For instance, if test subjects believed (falsely) that they were taking aspirin, some of them might experience nausea, vomiting, stomach pain and/or heartburn — each of which can be a side effect of real aspirin.

Interestingly, studies have shown that different parts of the brain produce the placebo and nocebo effects, Dr. Kaptchuk said, but the mechanisms are similar for both…

  • Expectation: Use of certain words, descriptions and even colors create unconscious suggestions about what responses/reactions are appropriate
  • Conditioning: A side effect experienced in the past makes one more likely to experience it in similar situations in the future
  • Anxiety: Emotional state may increase susceptibility to manifest emotional disturbance as physical symptoms
  • Selective attention: Being asked to focus on the presence or absence of symptoms makes one more likely to think the symptom is being experienced

The nocebo effect is harder to study, however. While researchers are already exploring ways to harness the placebo effect for actually treating several conditions, including irritable bowel syndrome, Dr. Kaptchuk said that it is much harder — practically and ethically — to conduct useful experiments that aim to make people feel worse.

Say No to Nocebo

Nevertheless, he said, scientists are designing nocebo research that focuses on precisely what causes it (and to what degree) and also how to prevent it. Until we know more, Dr. Kaptchuk said, we would all do well to understand that being suggestible to negative effects is real and to take several steps to limit its impact….

  • When a doctor prescribes medication for you, it may help to keep in mind that side effects can be the result of the power of suggestion as described above. For some people, just being conscious that this result can occur may help lessen or even prevent the side effects.
  • When discussing a drug with your doctor, be sure the doctor addresses each potential side effect’s typical frequency of occurrence. Aspirin, for example, can cause nausea — but it does so only rarely. By knowing that a side effect is rare, you can harness the power of suggestion by telling yourself that you are very unlikely to experience it.

That’s called the power of positive thinking!

Ted Kaptchuk, LAc, associate professor of medicine at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston.

Mind Over Milkshakes

by Carole Jackson, Bottom Line Health

Imagine drinking a sensible fruit-and-protein-powder smoothie. Now stop a minute, clear your mind, and imagine you’re drinking a luscious milkshake made with premium ice cream — you know, something really rich and creamy. Which one would make you feel fuller?

I know what your answer is (same as mine when I did this thought experiment). But the real (and surprising) answer is, the shake that makes you feel fuller in real life depends on what you think you’re drinking, not on what you actually are drinking. And that suggests an intriguing way that we can all use psychology to sidestep overeating.

In a clever study exploring the mind’s ability to control how the body responds to food, Yale University doctoral candidate Alia J. Crum gave an identical 380-calorie milkshake to two groups of people, telling one group it was an indulgent 620-calorie shake… and the other that it was a sensible 140-calorie shake.

It was the same drink, but it brought wildly different results in the two groups, not only mentally, but also physically. When researchers took blood samples from each participant and measured his/her level of ghrelin, the body’s “hunger hormone” (the lower the level, the less hungry you feel), they found lower levels in the “high-fat shake” group — as low, in fact, as if they actually had consumed the high-fat drink — than in the “low-fat shake” group. And remember, they were all drinking the same shake! “Mind Over Milkshakes,” as the study was dubbed, was published online recently in Health Psychology.

What does this tell us? In short, Crum said, it tells us that the gut can be tricked into feeling full or feeling unsatisfied depending on what people believe they’re eating.

Crum was not surprised by the fact that the mind-set produced physiological effects — it’s well-known that emotions affect us physically — but she had expected the exact opposite of what happened. “Originally we assumed that thinking the shake was ‘sensible’ would be better for the body. Instead, we found that thinking the shake was ‘indulgent’ was better,” because it left people more satisfied.

Can we trick our brains into thinking a food is indulgent when we know it’s not? Yes, Crum said, as long as we redefine what indulgence means — and infuse a celebratory feel to traditional, minor excesses, such as allowing ourselves a small side order of French fries, one slice of pizza and even an occasional full-fat milkshake.

Taking extra time for a leisurely meal is an indulgence, Crum notes, as is focusing on tasty ingredients in healthy foods. Even a salad can be turned into something indulgent, Crum said, if we make a point of seeing the cheese, nuts, croutons or specially made dressing as part of a real treat. “I don’t think we have to trick the mind into thinking food is higher or lower in calories,” Crum told me. “Instead of focusing on how much we are eating, we should focus on stopping and appreciating the food, allowing ourselves to have the sense that whatever we eat is something special and more than enough.”

We all know the old adage “mind over matter,” and yet we seldom marshal the determination to do what we know we can do — and that is to realize the power we have to make changes. Just say to yourself, mind over milkshake… take the time to really enjoy everything you eat or drink… and see what happens.


Alia J. Crum, doctoral candidate, department of psychology, Yale University, New Haven, Connecticut.