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      An engaged research study to assess the effect of a ‘real-world’ dietary intervention on urinary bisphenol A (BPA) levels in teenagers

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          Abstract

          Objective

          Bisphenol A (BPA) has been associated with adverse human health outcomes and exposure to this compound is near-ubiquitous in the Western world. We aimed to examine whether self-moderation of BPA exposure is possible by altering diet in a real-world setting.

          Design

          An Engaged Research dietary intervention study designed, implemented and analysed by healthy teenagers from six schools and undertaken in their own homes.

          Participants

          A total of 94 students aged between 17 and 19 years from schools in the South West of the UK provided diet diaries and urine samples for analysis.

          Intervention

          Researcher participants designed a set of literature-informed guidelines for the reduction of dietary BPA to be followed for 7 days.

          Main outcome measures

          Creatinine-adjusted urinary BPA levels were taken before and after the intervention. Information on packaging and food/drink ingested was used to calculate a BPA risk score for anticipated exposure. A qualitative analysis was carried out to identify themes addressing long-term sustainability of the diet.

          Results

          BPA was detected in urine of 86% of participants at baseline at a median value of 1.22 ng/mL (IQR 1.99). No effect of the intervention diet on BPA levels was identified overall (P=0.25), but there was a positive association in those participants who showed a drop in urinary BPA concentration postintervention and their initial BPA level (P=0.003). Qualitative analysis identified themes around feelings of lifestyle restriction and the inadequacy of current labelling practices.

          Conclusions

          We found no evidence in this self-administered intervention study that it was possible to moderate BPA exposure by diet in a real-world setting. Furthermore, our study participants indicated that they would be unlikely to sustain such a diet long term, due to the difficulty in identifying BPA-free foods.

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          Most cited references21

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          Estimation of Average Concentration in the Presence of Nondetectable Values

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            Exposure of the U.S. Population to Bisphenol A and 4-tertiary-Octylphenol: 2003–2004

            Background Bisphenol A (BPA) and 4-tertiary-octylphenol (tOP) are industrial chemicals used in the manufacture of polycarbonate plastics and epoxy resins (BPA) and nonionic surfactants (tOP). These products are in widespread use in the United States. Objectives We aimed to assess exposure to BPA and tOP in the U.S. general population. Methods We measured the total (free plus conjugated) urinary concentrations of BPA and tOP in 2,517 participants ≥ 6 years of age in the 2003–2004 National Health and Nutrition Examination Survey using automated solid-phase extraction coupled to isotope dilution–high-performance liquid chromatography–tandem mass spectrometry. Results BPA and tOP were detected in 92.6% and 57.4% of the persons, respectively. Least square geometric mean (LSGM) concentrations of BPA were significantly lower in Mexican Americans than in non-Hispanic blacks (p = 0.006) and non-Hispanic whites (p = 0.007); LSGM concentrations for non-Hispanic blacks and non-Hispanic whites were not statistically different (p = 0.21). Females had statistically higher BPA LSGM concentrations than males (p = 0.043). Children had higher concentrations than adolescents (p $45,000/year). Conclusions Urine concentrations of total BPA differed by race/ethnicity, age, sex, and household income. These first U.S. population representative concentration data for urinary BPA and tOP should help guide public health research priorities, including studies of exposure pathways, potential health effects, and risk assessment.
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              Bisphenol A and human health: a review of the literature.

              There is growing evidence that bisphenol A (BPA) may adversely affect humans. BPA is an endocrine disruptor that has been shown to be harmful in laboratory animal studies. Until recently, there were relatively few epidemiological studies examining the relationship between BPA and health effects in humans. However, in the last year, the number of these studies has more than doubled. A comprehensive literature search found 91 studies linking BPA to human health; 53 published within the last year. This review outlines this body of literature, showing associations between BPA exposure and adverse perinatal, childhood, and adult health outcomes, including reproductive and developmental effects, metabolic disease, and other health effects. These studies encompass both prenatal and postnatal exposures, and include several study designs and population types. While it is difficult to make causal links with epidemiological studies, the growing human literature correlating environmental BPA exposure to adverse effects in humans, along with laboratory studies in many species including primates, provides increasing support that environmental BPA exposure can be harmful to humans, especially in regards to behavioral and other effects in children. Copyright © 2013 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                3 February 2018
                : 8
                : 2
                : e018742
                Affiliations
                [1 ] departmentCollege of Life and Environmental Sciences , University of Exeter , Exeter, UK
                [2 ] departmentResearch Projects , St Lukes campus, University of Exeter , Exeter, UK
                [3 ] departmentRNA-Mediated Disease Mechanisms Group, Institute of Biomedical and Clinical Sciences , University of Exeter Medical School , Exeter, UK
                [4 ] departmentNational Institute for Health Research Exeter Clinical Research Facility , Royal Devon and Exeter National Health Service Foundation Trust , Exeter, UK
                [5 ] departmentMedical School Building 03.11 , University of Exeter Medical School , Exeter, UK
                [6 ] Clyst Vale Community College , Broadclyst, UK
                [7 ] Exeter School , Exeter, UK
                [8 ] South Dartmoor Community College , Ashburton, Devon
                [9 ] Honiton Community College , Honiton, UK
                [10 ] Exeter College , Exeter, UK
                [11 ] Exeter Mathematics School , Exeter, UK
                Author notes
                [Correspondence to ] Dr Lorna W Harries; L.W.Harries@ 123456exeter.ac.uk
                Article
                bmjopen-2017-018742
                10.1136/bmjopen-2017-018742
                5829847
                29431133
                f4f3437a-d173-484d-a84e-0ce8945d6aaa
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

                History
                : 20 July 2017
                : 23 November 2017
                : 24 November 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Categories
                Public Health
                Research
                1506
                1724
                1359
                Custom metadata
                unlocked

                Medicine
                bisphenol a,dietary intervention,public health,community,engaged research,endocrine disrupting chemical,plastic packaging,polycarbonate

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