Is there a link between BPA and diabetes?
Consumers who are concerned about the link between chronic diseases and chemical compounds in their food are likely to be aware of |Bisphenol A. According to the Environmental Working Group, BPA is a chemical that is used to manufacture two materials used in food packaging: polycarbonate and epoxy resins. While the former is used to make shatter-proof plastic, the latter lines most of the 131 billion cans of various food and beverages sold in the U.S.
The ubiquity of BPA has caused concern because of its nature as a synthetic form of estrogen and ability to disrupt the endocrine system. One of the chronic diseases that has been tied to excessive consumption of BPA is diabetes. While there are certainly studies that link BPA to diabetes and other illnesses, the amount of evidence that is available is not entirely clear or easy to interpret.
What is the burden of diabetes?
According to the U.S. Centers for Disease Control and Prevention, about 9.3 percent of the country's population is living with diabetes, totaling 29.1 million individuals. That includes 8.1 million people who have yet to be diagnosed.
Between 90 and 95 percent of diabetes cases are Type 2, which is associated with advanced age or obesity. It is particularly problematic with African-American, Hispanic, Native American and Asian/Pacific Islander populations.
The long-term danger of diabetes is that it causes cumulative damage to the blood vessels if not controlled adequately. As a result, patients face a major risk of high blood pressure, heart disease, kidney disease, stroke, limb amputations, fatty liver disease, gum disease, nerve damage, hearing loss and, in men, erectile dysfunction. Without proper control, diabetes will significantly decrease quality of life for patients.
Is there a link to BPA?
Between 2008 and 2013, scrutiny over the negative impact of cumulative BPA consumption increased, leading to a series of studies linking the chemical compound to conditions ranging from cardiovascular disease to diabetes. Most of these studies measured BPA consumption in human subjects by analyzing urine samples for signs of BPA metabolism. However, one team of researchers from the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, wrote an editorial in the Journal of Clinical Endocrinology & Metabolism, in which they questioned the designs of these studies and proposed that more research was needed.
Previously, animal studies showed that BPA can lead to insulin insensitivity, glucose intolerance and hyperinsulinemia. However, there is dispute about whether the metabolism of BPA works the same in humans as it does in animals. Additionally, the editorial writers noted that BPA is found not just in food, but also air particles, dental sealant, some types of paper and even water.
Much of the data linking BPA to diseases such as diabetes had been collected from the National Health and Nutritional Examination Survey between 2003 and 2008. It focused on the population of one country and tried to account for confounding factors such as socioeconomic position and dietary intake.
Although data from this survey indicated a link between BPA and diabetes, the editorial writers argued that data needs to be collected from more than one country. When it came to the confounding factors, the authors pointed out that economically disadvantaged groups tend to eat packaged foods, which are both energy dense and likely to come in contact with BPA through packaging. This makes the impact of BPA more difficult to discern.
Ultimately, the editorial writers called for more prospective studies to be conducted, but acknowledged that this may be difficult given the limitations of testing methods and population size requirements.
"As a potentially highly modifiable risk factor (if in fact the hypothesis can be proven), the public health implications may be vast," the authors wrote. "In terms of intervention, it will be easier and more cost-effective to the health care system to ban BPA rather than implement population-wide, behaviour/lifestyle change-based interventions to tackle obesity, cardiovascular disease and diabetes, all of which we know have limited long-term efficacy. Until more large-scale, well-designed, prospective studies are conducted, controversy is only set to continue."
According to the EWG, consumers who are still concerned about BPA can reduce its presence in their homes by limiting the amount of canned food they purchase or buying foods in packages labelled as BPA-free.
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