​Yes, eating out of cans that have a BPA lining can actually kill you! A study published last month in JAMA showed that people over age 20 with high levels of BPA in their urine have about a 50% greater risk of death than people with low levels. Bisphenol A (BPA) is a chemical produced in vast quantities and used as the inner lining on food containers; BPA is part of the family of compounds that come from polycarbonate plastics and epoxy resins.

Researchers tested nearly 4,000 adults for BPA levels in their urine and followed them for more than 9 years and noted that there was a 49% higher rate for all-cause mortality and was 46% higher for deaths related to heart disease. (JAMA Netw Open. 2020;3(8):e2011620. doi:10.1001/jamanetworkopen.2020.11620).

The population studied comes from one of the most reliable databases in the United States. The National Health and Nutrition Examination Survey (NHANES) is a nationally representative health survey program of the resident population in the United States. It is administered by the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention (CDC).

Past studies on BPA have shown that consuming it increases your risk for weight gain, diabetes, hypertension, and heart disease, but this is the first solid evidence that consuming BPA can kill you. The basic action of BPA is to disrupt hormone activity and blood sugar control, so it should not surprise you that it leads to diabetes, hypertension, and heart disease.

The authors controlled for multiple risk factors in this population, including age, sex, race/ethnicity, educational level, family income, smoking status, alcohol drinking, physical activity, and dietary intake; and even after factoring in all these variables, it remains clearly a toxic compound.

BPA has been banned in France, Canada, Belgium, and Sweden, yet it is still commonly used in most of the USA and is consumed daily by millions of people.

Where is BPA found?

Bisphenol A is a polycarbonate plastic coating. BPA is used extensively in food and drink packaging, including water and infant bottles and medical devices. Epoxy resins are used as lacquers to coat metal products such as food cans, bottle tops, and water supply pipes. Some dental sealants and composites may also contribute to BPA exposure. Thermal paper in the form of sales receipts also contains these polycarbonate compounds.

If you are concerned about your level of BPA, you can ask your doctor to measure it with a urine test, although this type of testing will not likely be covered by your insurance. More important than testing your level would be to avoid future BPA consumption, as once you stop ingesting it, your body will remove the BPA you have stored over time.

What about other chemical liners used in cans as a BPA substitute?

Unfortunately, a can may be labeled BPA free, but still use other toxic compounds as a liner. An example is a compound called BPS. BPS is an analog of BPA with a similar structure of 2 phenol groups on each side of a sulfonyl group. Polymers made of repeating BPS units are called polyethersulfone (PES).

The original reason used to substitute BPS for BPA has been that BPS is considered less likely to leach into food and drink. However, as BPS has become more common in society and is being used in BPA-free products, there have been reports that as many as 81% of people in the United States and Asia are testing positive for BPS exposure in their urine samples, so the bottom line is that we do absorb BPS, not just BPA.

BPS has been shown to be associated with a variety of similar serious health issues (including weight gain, obesity, abnormal blood sugar control, and cancer). BPA, BPS, and PES are all biochemically very similar so it would be best to avoid all of these plastic liners. Thoene M, Dzika E, Gonkowski S, Wojtkiewicz J. Bisphenol S in Food Causes Hormonal and Obesogenic Effects Comparable to or Worse than Bisphenol A: A Literature Review. Nutrients 2020 Feb; 12(2): 532.

What Should You Do to Avoid Toxic Compounds in Food Packaging and Containers?

• Avoid canned foods (look for products stored in glass, porcelain, or stainless steel).
  • Yes, some cans are BPA free and it is stated on the can label, but you also need to confirm that they do not use other toxic liners made of other compounds such as BPS and PES. It takes serious research to be sure that cans are toxin-free.
• Don’t heat your food in a plastic container; polycarbonate plastic food containers often contain BPA or other similar polycarbonate plastics and they will be released into the food with heating.
• Avoid drinking or eating out of products stored in plastics. Plastic containers have recycle codes on the bottom. Some, but not all, plastics that are marked with recycle codes 3 or 7 may be made with BPA, and other plastics may contain BPS. In particular, do not drink out of plastic bottles with codes 3 or 7.
• Use baby bottles that are BPA free. (Many but not all places have banned BPA in baby bottles.)
• When having dental work, confirm with your dentist that they are not using any products that contain BPA, BPS, PES, or other polycarbonate compounds.
• Avoid touching thermal sales receipts as the ink contains polycarbonate compounds. Cashiers that handle them often should wear gloves.

It may sound depressing to have to worry about the toxicity associated with processed foods, but the good news is that real food does not have plastic liners that can poison you. Learn to enjoy eating foods that are made from scratch with vegetables, fruits, beans, nuts, spices, herbs, oils from glass bottles, and clean protein sources—they taste better that way too!

I wish you the best of health!

Steven Masley, MD, FAHA, FACN, CNS