Report it to the FDA.

Joanna Hayden, PhD, CHES

A study published in the Journal of the American Medical Association – Internal Medicine this week found adverse reactions from cosmetic products are seriously underreported to the Food and Drug Administration (FDA). Over a period of 12 years from 2004-2016, there were on average 400 adverse reactions to cosmetic products reported each year. In contrast, one company alone received 21,000 complaints of adverse reactions from consumers about their hair conditioner products. The FDA received 127 complaints about the same products.

The journal article is available here: http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2633256

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Cosmetics are defined by the FDA as "articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body...for cleansing, beautifying, promoting attractiveness, or altering the appearance" (FD&C Act, sec. 201(i)).  This includes skin moisturizers, perfumes, lipsticks, nail polish, eye and face makeup, cleansing shampoos, hair dyes, and deodorants, as well as any substance intended for use as a component of a cosmetic product.

Have you ever had a bad reaction to a cosmetic products? Given the sheer number of these products we use on a regular basis, it’s probably pretty safe to assume you have. Now, think about what you did when it happened - Did you register a complaint with the FDA, contact the company, bring the product back to the store or just throw it away?  Chances are good you either returned it or threw it away. Maybe a few of you contacted the company. But, how many registered a complaint with the FDA? Based on the results of the research above, we all need to be more vigilant in doing this for each other and here’s why -  

        There is no FDA, approval process for cosmetics before they         can be sold, as there is for drugs. Instead, the cosmetic                     companies are legally responsible to ensure their products             are safe. However, the companies are not legally required to         conduct safety testing of any  products or ingredients and if         they do test, they are not required to share the results with             FDA.    

So, the next time you have an adverse reaction to a cosmetic product, bring it back to the store, but also use the link below to register a complaint with the FDA.

For more information:

Food and Drug Administration

To report a cosmetic related complaint

Center for Food Safety and Applied Nutrition
Data base of Adverse Events -

FDA authority over Cosmetics

Joanna Hayden, PhD, CHES

The results of a study published in the Journal of the American Medical  Association last week found that about 3 percent of adults in the U.S. are taking more than 4,000 international units (IUs) (IU - is a unit of measurement) of Vitamin D a day, an amount beyond the upper limit considered safe. This is up from 0.2 percent 10 years ago. The recommended daily amount of Vitamin D is 600 IUs for adults under 70 and 800 IUs for those 70 and older.

Journal article preview: http://jamanetwork.com/journals/jama/article-abstract/2632494

Article summary: https://medlineplus.gov/news/fullstory_166773.html

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Vitamin D is the sunshine vitamin.  We make it in our bodies when ultraviolet light from the sun interacts with substances in our skin,  from the foods we eat and from supplements we take. We need it to absorb calcium from our intestines, to maintain calcium and phosphorus balance for bone health, and for proper immune system, nervous system and muscle function.

We need between 600-800 IUs of vitamin D a day from all sources. However, as the results of this study show, more of us than ever are taking amounts in excess of what may be safe. Yes, taking vitamins in excess can be hazardous to our health. Think of vitamins like you would aspirin or acetaminophen. If you have a head ache, you take two tablets. You wouldn’t take 10 tablets figuring if two stops the pain, 10 will do it better – yet some of us are doing just that with vitamin D.

According to the National Institutes of Health, Office on Dietary Supplements, (NIH-ODS) long term (three months or more) vitamin D intake greater than 4,000 IU a day, can have a negative effect on health. When intakes rise above 10,000 IU a day, there is a greater risk of some cancers  particularly cancer of the pancreas, greater risk of heart attack, and greater risk of fractures among older adults. When intake goes beyond 40,000 IU a day, it can result in toxicity which causes high calcium levels in the blood, or hypercalcemia. Hypercalcemia can weaken bones, affect nerve, heart and brain function and cause kidney stones. The risk of toxicity occurs with high intakes from supplements and food. It does not happen with vitamin D produced in body from sun exposure.

Knowing that the recommended daily amount is between 600 – 800 IU, from all sources, talk with your health care provider before taking quantities above the recommended amounts. If you’ve been taking vitamin D supplements, talk to your health care provider about having your vitamin D blood levels tested to see if you  need as much as you’re taking. If you are taking any of the following prescription medications - prednisone or cortisone, cholesterol lowering drugs or seizure medications - make sure your health care provider knows you are taking vitamin D supplements. Some of these interact with vitamin D.

Use the list  below from the NIH-ODS to re-evaluate your intake of supplements in light of the amount of vitamin D you’re getting in your diet.

                     Food                                               IUs per serving   
Cod liver oil, 1 tablespoon                                       1,360          

Swordfish, cooked, 3 ounces                                      566

Salmon (sockeye), cooked, 3 ounces                         447

  Tuna fish, canned in water,  3 ounces                    154

  Orange juice  1 cup                                                       137
(check product labels, as amounts vary)

Milk, nonfat, reduced fat, and whole,               115- 124
vitamin D-fortified, 1 cup

Yogurt 6 oz (check label amounts vary)                    80

Margarine, fortified, 1 tablespoon                               60

Sardines, canned in oil, drained, 2 sardines            46

Liver, beef, cooked, 3 ounces                                        42

Egg, 1 large (vitamin D is found in yolk)                    41

  Ready-to-eat cereal .75 - cup                                        40
(check label, amounts added vary)

Cheese, Swiss, 1 ounce                                                       6

For more information see:

Vitamin D Council

National Institutes of Health – Office of Dietary Supplements
Vitamin D Fact Sheet

Joanna Hayden, PhD, CHES

Based on the results of a rigorous review of the scientific research, The American Heart Association published an advisory this week in the journal Circulation  recommending replacement of saturated fats in the diet with poly-unsaturated and mono-saturated fats as this was found to reduce the risk of cardiovascular disease by as much as 30%, a result comparable to the reduction achieved with statins or cholesterol lowering drugs.

For the complete journal article: http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510

For a summary of the article: https://medlineplus.gov/news/fullstory_166625.html

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If you have been diagnosed with high cholesterol, this information is for you!

Cholesterol is actually a wax- like substance that our livers make. We use it to make hormones and the walls of our cells.  Cholesterol by itself doesn’t mix well in our blood so, it attaches to a lipoprotein (fat and protein).  You know two of these, LDL or low density lipoprotein and HDL or high density lipoprotein. LDL or  ‘bad’ cholesterol is the one that sticks to the walls of our arteries and increases the risk of heart attacks and strokes.  HDL or high density lipoprotein is the type that keeps our arteries clean by bringing cholesterol it back to the liver so it can be broken down.

Think of this like bags of garbage and garbage trucks. LDL is the bag of garbage you put in the street in front of your house on garbage day. HDL is the garbage truck. On garbage day, you put  bags of garbage (LDL) in the street in front of your house. The garbage truck (HDL)  comes along and picks up the bags and your street is clear. But,  if you put out more  garbage bags than the truck can fit, some bags are left in the street. If you do the same thing the next week, and the next, eventually your street will be blocked with garbage bags.  – i.e. you’ll have a heart attack. So, it makes sense to have enough garbage trucks (HDL) to pick up all the garbage bags (LDL). A good number is 1 garbage truck (HDL) for every 4 garbage bags (LDL).  More garbage trucks per garbage bag, the better. This is the HDL, LDL ratio you might have heard about. So, someone with a HDL:LDL ratio of 1 to 2 (one truck for every two bags) has less of a heart attack risk than someone with a 1 to 6 ratio (one truck for every 6 bags).

What does this have to do with saturated fat in the diet, you ask? A lot.  The liver uses saturated fat to make cholesterol - the more saturated fat we eat, the more cholesterol we make and the extra gets carried in the blood as LDL.  If we don’t have enough HDL to offset it, it collects in our arteries and increases our risk of heart attack and stroke.

Saturated fats are abundant in our typical American diets. They are in animal products (meats, full fat dairy, butter, cheese, ice cream, etc.) and some vegetable oils especially coconut and palm kernel oils. (Yes, coconut oil – see the journal article for studies on this.) What the results of the American Heart Association review found was when saturated fat in the diet is reduced,  LDL goes down and along with it cardiovascular disease risk. 

The American Heart Association recommends a saturated fat intake of about 13 grams a day for someone who eats around 2000 calories or between 5-6 % of the total number of calories. (To figure out how many grams of saturated fat is right for you do some simply math:
1. add up your daily calorie intake.
2. multiply by 5 or 6%
3. divide the number by 9 (fat = 9 calories per gram of food)
4. Now you have the number of grams you should aim for each day.

(If you eat 1500 calories, 6% = 90 calories or 10 grams of fat)

Saturated fat grams are listed on food labels, so it’s easy to count them up, just be mindful of the serving sizes. 

The Texas Heart Institute offers these suggestions for reducing your intake of saturated fat:

  1. Eat more fruits and vegetables.
  2. Eat more fish and chicken. Substitute ground turkey or chicken for ground beef. Remove the skin from chicken before cooking.
  3. Eat leaner cuts of beef and pork, and trim as much visible fat as possible before cooking.
  4. Bake, broil, or grill meats; avoid frying. Avoid breaded meats and vegetables.
  5. Use fat-free or reduced-fat milk instead of whole milk. Instead of sour cream, try nonfat plain yogurt or a blend of yogurt and low-fat cottage cheese. Use low-fat cheeses.
  6. In recipes, use two egg whites instead of one whole egg.
  7. Avoid cream and cheese sauces, or make recipes with low-fat milk and cheese.
  8. Instead of chips, snack on pretzels or unbuttered popcorn.
  9. Limit hydrogenated fats (shortening, lard) and animal fats (butter, cream) if you can. Use liquid oils, particularly canola, olive, safflower, or sunflower.
  10. Read the nutrition labels on all products. Many "fat-free" products are very high in carbohydrates, which can raise your triglyceride levels.
  11. Compare the fat content of similar products. Do not be misled by terms like "light" and "lite."
  12. When eating in a restaurant, ask that the sauces and dressings be served on the side.
  13. Look for hidden fat. For example, refried beans may contain lard, or breakfast cereals may have significant amounts of fat.
  14. Try cooking with herbs, spices, lemon juice, etc., instead of butter or margarine.

            Use the chart below to help you choose healthier fats.


A 30 year study published in the British Medical Journal this week found an association between alcohol consumption, brain shrinkage in the area responsible for cognitive skills, and diminished “language fluency” ( a measure of memory and thinking skills). Regular, moderate drinkers (4-7 drinks a week) were 3 times more likely to have more brain shrinkage and less language fluency, (i.e. memory and thinking  skills), as compared to non-drinkers. Further, the greater amount of alcohol consumed, the faster the mental decline.

Summary of the study is at: https://medlineplus.gov/news/fullstory_166301.html
Complete journal article is at: http://www.bmj.com/content/bmj/357/bmj.j2353.full.pdf

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While the association between alcohol and cognitive decline is not the news here, what is newsworthy is the amount of alcohol found associated with it – amounts within the U.S. guidelines for safe drinking.  Presently, the U.S. 2015-2020 guidelines suggest if alcohol is consumed, it be done so in moderation. Moderation is defined as no more than 1 drink per day for women (7 per week) and 2 drinks for men (14 per week). For men, the amount is well above the 4-7 drinks a week found associated with brain shrinkage and cognitive decline in the study.

One drink is defined as the following:

12 fluid ounces of regular beer (5% alcohol)
5 fluid ounces of wine (12% alcohol)
1.5 fluid ounces of 80 proof distilled spirits (40% alcohol)

The tricky part is that not all beers, wines or distilled spirits (hard liquors) are created equal. So, while a 5 oz. glass of one wine may be equal to one drink, a 5 oz glass of another might be equivalent to 1.4 drinks. It all has to do with the alcohol content of the beverage and of course,  the amount you pour in your glass!

Use the chart below to help you determine the number of ‘drinks’ you take in each week.

              Alcoholic Drink-Equivalents of Select Beverages

Drink Description                                   Drink-Equivalents

Beer, beer coolers, and malt beverages 

12 fl oz at 4.2% alcohol                                                      0.8
12 fl oz at 5% alcohol (reference beverage)                      1
16 fl oz at 5% alcohol                                                            1.3
12 fl oz at 7% alcohol                                                           1.4
12 fl oz at 9% alcohol                                                           1.8


5 fl oz at 12% alcohol (reference beverage)                    1
9 fl oz at 12% alcohol                                                            1.8
5 fl oz at 15% alcohol                                                             1.3
5 fl oz at 17% alcohol                                                            1.4

Distilled spirits

1.5 fl oz 80 proof distilled spirits (40% alcohol)           1
Mixed drink with more than 1.5 fl oz 80 proof
     distilled spirits (40% alcohol)                                   > 1

Given the findings of this study, if you drink, it may be wise to bring your drinking more in line with the 2016 U.K. guidelines of no more than 5 drinks per week. See the links below for tips on  cutting back on alcohol.             

For more information 

Rethinking Drinking
National Institute on Alcohol and Alcohol Abuse  

Tips on cutting down
UK National Health Service

U.S. Dietary Guidelines 2015-2020 for alcohol: https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/


Joanna Hayden, PhD, CHES

A study published in the Journal of Food Protection looking into the effectiveness of handwashing with cold water vs hot/warm found cold water just as effective at removing bacteria as hot/warm water.

Summary of the journal article: http://www.medicalnewstoday.com/articles/317712.php

Journal article abstract: http://jfoodprotection.org/doi/10.4315/0362-028X.JFP-16-370?code=fopr-site

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This study challenges the long held belief that warm/hot water is needed for handwashing to effectively remove bacteria. As it turns out, cold water works just as well and washing hands for as little as 10 seconds does a decent job.

As far as antibacterial soap goes, according to the results of this study, it wasn’t that much more effective than using regular soap. Given the rising problem with antibiotic resistant bacteria, it’s best to avoid using it.

We all know that handwashing helps prevent infections, but the Centers for Disease Control (CDC) reminds us that:

  • Handwashing helps prevent diarrhea, respiratory infections and may even help prevent skin and eye infections because:

                     Bacteria, viruses and other disease causing germs get  
                      into the body through the eyes, nose and mouth
                      without us realizing it when we touch our faces with
                      our hands.

                      Bacteria, viruses and other disease causing germs
                      from unwashed hands can get into food and drinks
                      when people prepare or consume them. Some can
                      multiply in certain types of foods or drinks, under
                      certain conditions, and  make people sick – for
                      example botulism or salmonella.

                        Bacteria, viruses and other disease causing germs
                        from unwashed hands can be transferred
                        to objects, like handrails, table tops, or toys, and
                        then picked up by another person’s hands.

  • Handwashing not only keeps us individually healthier, it helps keep our communities healthier too.    

                               Reduces the number of people who get sick with
                               diarrhea by 31%
                                Reduces diarrheal illness in people with
                                weakened immune systems by 58%
                                Reduces respiratory illnesses, like colds, in the
                                general population by 16-21%

  • Remember to wash your hands:

                     Before eating food
                     Before, during, and after preparing food
                     Before and after caring for someone who is sick
                     Before and after treating a cut or wound
                    After using the toilet
                    After changing diapers or cleaning up a child who has                         used the toilet
                     After blowing your nose, coughing, or sneezing
                     After touching an animal, animal feed, or animal                                 waste
                     After handling pet food or pet treats
                     After touching garbage

  • To properly wash your hands, the CDC recommends the following:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  2. Lather your hands by rubbing them together with the soap. ...
  3. Scrub your hands for at least 20 seconds. ...
  4. Rinse your hands well under clean, running water.
For more information:

Centers for Disease Control – How and When to Wash Your Hands

Mayo Clinic – Handwashing Do’s and Don’ts