Dr Rupy: In today's episode, we're going to be addressing aluminium in cookware and specifically foil. Every time I use foil on social media, I always get comments about how toxic foil is to the brain, how I shouldn't be promoting this given my position as a doctor, how it increases your risk of dementia. So I decided to review the evidence for these claims with the team and do a thorough dive into the topic and find out whether there's actually any evidence for these inflammatory comments. So today, we're going to talk about what aluminium actually is, how it's handled by the body, whether foil actually leaches aluminium into food and then into us, and finally, what practical steps we can take to reduce our exposure if we think aluminium is toxic. And obviously, we're going to answer that question right at the top. Remember, you can watch this podcast on YouTube for free. It's one of the best ways to support the Doctor's Kitchen and the work we do. Make sure you're subscribed. And you can also download the Doctor's Kitchen app for free from the App Store, and yes, we are working on Android and other platforms to make it more available. We have over 600 recipes now with more being added every single month, and you can filter those recipes according to your chosen health goals. And you can check out the Eat, Listen, Read newsletter as well as seasonal Sundays. We do a deep dive into ingredients, into recipes, into the background of ingredients and food, the culinary history. People absolutely love this newsletter, and if you don't subscribe, it is for free. You can check it out on the doctorskitchen.com right now.
Dr Rupy: Is aluminium foil toxic? Should we be throwing away our aluminium foil that we tend to use in cookware for other alternatives? There are lots of people online who think aluminium foil is neurotoxic, it adds to our overall exposure, and it can impact our likelihood of disease, particularly when it comes to things like Alzheimer's. Today, we're going to do a deep dive into aluminium, what it is, whether we should be replacing cookware and other exposures to aluminium. If you can't listen to the whole thing, here are the three main takeaways from the research that me and the team have done in response to lots of people online commenting that I shouldn't be using aluminium foil when cooking. Should you use foil? Ideally, actually not. So this is news to me. If you can replace your foil on a daily basis in your daily cooking or food storage with alternatives, then I would actually recommend now, after looking at the research, to do so. The amount of aluminium foil or aluminium from the foil that leaches into food is actually still being investigated and may not be alarming today by today's standards, but aluminium is actually omnipresent in our daily lives. It's in lots of different products, as you'll find out in today's episode, and so it adds to our cumulative exposure. So from a preventative medicine perspective, I actually recommend minimising our exposure with small changes like replacing aluminium foil, and it's probably worth trying. That being said, I would not lose sleep over it. So if you still want to use aluminium foil every now and then for cooking, as I probably will do when it comes to Christmas time and I'm roasting loads of veggies, I really think that although we can reduce our exposure from daily use, I wouldn't stress too much about using aluminium foil, even in small amounts. Using foil is not the end of the world. Exposure to aluminium, as I've found out after doing this deep dive with the team, is inevitable, but the levels in the body should remain low because we are quite efficient at removing small amounts of aluminium in our body. The main excretion mechanism is actually through our kidneys via urine. But it's the accumulation of aluminium from multiple sources that we need to be worried about. So if we can minimise exposure, that's great, but the body is able to handle some exposure to aluminium and other light and heavy metals. Aluminium is a light metal. Number three, there are alternatives to try. So from what you use on a regular basis for storage, you could use beeswax, you could use unbleached parchment paper. You could also use different trays and containers that are made out of glass or steel. There are also some interesting cookware materials instead of aluminium, and a lot of pans have aluminium in the core, but that generally doesn't leach out. Ceramic is also a really good option as well. Let's get into a bit more detail. We're going to be diving into some common household items that we all use, and aluminium foil is going to be the mainstay of what we're going to be talking about. That's where we have some research, but it is limited. And I just want to preface that everything that we say or everything that sounds like a recommendation has to be taken into the context of the lack of research there is in the materials that we use in cooking, which is kind of disconcerting considering the potential negative effects as borne out by animal and other lab studies. But the goal of this episode, as the other ones, like we did on organic food, for example, you can find that in the library at the doctorskitchen.com or on YouTube, is to be a little bit more aware and investigative about the choices that we make on a regular basis. So, we're going to dive into what aluminium is, how it's handled by the body, I've already given some idea as to how the body majorly handles it, but it's not just the kidneys, whether foil leaches aluminium into food, and what practical steps we can actually take to reduce our exposure. I think whenever approaching this topic, I think those are the four main questions that I would want to ask, and hopefully we can give you some extra information, some tools to navigate this complicated world of what's toxic and what's not toxic, and really it comes down to dose. So, aluminium, it's a lightweight metal. So a lot of people group it into the heavyweight metals like lead and cadmium, but it's a lightweight metal. It's one of the most abundant metallic elements on the planet in the Earth's crust, around 8% of the Earth's crust is aluminium, and it can be found in numerous rocks as well. You'll find it in natural sources like the soil, rocks, air, and even some plants. And it's rarely found alone. It's very unlikely that you'll find aluminium alone. It's pretty, it's sort of social. It mixes with other elements to form compounds. Some of those I'm probably going to mispronounce, called bauxite and cryolite. I probably said that wrong, but it doesn't matter. You don't need to know the names. But basically, aluminium never really occurs in pure metallic form in nature. So it's unlikely that we would have evolved to develop the detoxification mechanisms relevant or required to remove aluminium. And it also doesn't have any biological purpose in us. It's not like iron, it's not like other elements that we require, zinc, it's it doesn't have any purpose in nutrition. The reason why it's also found in things like water and air is through weathering of those natural rock compounds. So the breaking down of those rocks into minerals on the surface of the Earth, that transfers into the soil. There's also uptake into the plants as they grow. So there are certain plants that actually have more aluminium in than others. We haven't gone into a deep dive into the amount of aluminium that you'll find in specific types of ingredients like tea, potatoes, herbs and spices. The amount is likely to be negligible, not really going to be adding to your cumulative exposure. And I think that would probably encourage a bit of health anxiety that we want to make sure that we're not doing either. I really don't think it's necessary to know the various amounts per plant. So I would sort of discount the amount of aluminium that you get from plants, but it is something that we are looking into. The second main source, apart from natural sources, are anthropogenic sources, i.e., man, woman made, related to human activities, things like mining, irrigation, treatment processes for water, metal-based industries, obviously, that leach materials into the various reservoirs that leads for it to go into our drinking water, etc, etc. Also, on a sort of macro picture, human activity leads to increasing acid rain that weathers the rocks, releases more aluminium into the environment, etc, etc, as it does with a lot of other compounds as well. The other thing, apart from human activities that increase aluminium into the environment, is we are also adding aluminium to products, things like foil, obviously, but also cosmetic products, personal care products. It's a very common product in antiperspirants, which we'll get into, deodorants, toothpaste. It's also used as a food additive for a number of different purposes that we will talk about. Breakfast cereals, cake, biscuits, coffee, milk powder, infant milk powder, that's kind of scary, the amount of aluminium that we find in baby formula. Bread, soft drinks. It's used obviously for cooking, like we've said, foil, but also kitchen utensils, certain types of containers, pans, baking trays. It's used as an adjuvant in some vaccines because it stimulates more of an immune response, although that would be a short-term exposure. It's also added to pharmaceuticals, things like buffered aspirin, antacids. So there is a multitude of different ways in which we can increase exposure to aluminium. And we'll talk a bit about the amount of aluminium that is recognised as tolerable. When I saw this list of aluminium products, it really got me thinking about why it's used in so many different ways. This simple metallic compound, like why is it used in like a multitude of different industries? And it's because of its versatile properties. It's ubiquity in nature, which means it's cost-effective in terms of mining the natural resource. It's used, I mean, the one that most people have probably heard of is antiperspirants using aluminium because it forms this temporary plug in the sweat gland that stops sweat going to the skin surface. That's pretty well recognised. There is a wider picture as to why you wouldn't want to do that. So apart from the fact that you're introducing aluminium into the body, you are at the same time blocking an excretion mechanism that the body has harnessed, has evolved to do as a way of removing the byproducts of metabolism, urea, other components of sebum, and even a mechanism by which we remove heavy metals like cadmium. So one of the reasons why sauna actually might be beneficial from a detoxification process is because you are encouraging sweating and removal of these products. So if we're blocking that with an antiperspirant, although it's just usually used around the armpits and perhaps the back, it's just something to be aware of. And there's that's part of a wider conversation. In food products, the reason why you add aluminium is because it's got multiple properties: firming, raising agent, anti-caking agent to improve texture and taste as well. It can also be used as the coating for nanoparticles in sunscreens. So there's lots of ways in which we can use it. And I think the wider point is not that any of these particular things are bad, but more so that we are exposed to aluminium in lots of different ways and from multiple different sources. So the question is, is aluminium harmful to human health? Like I said earlier, aluminium has no known biological role. It's not known to serve any particularly useful purpose for living organisms, living cells, yet it enters our body every single day via inhalation, skin contact, ingestion from food and drinking water. So the question is like, twofold, how much aluminium is bad and how do our bodies process aluminium? So most aluminium, and I want to stress this point because I think people who are on the side of not worrying about aluminium will make this point, and it's a fair point, and that is most aluminium passes unabsorbed through the GI tract, through the gastrointestinal tract. We poop it out, it gets excreted in faeces. The body only seems to absorb around an average of 0.1% of the aluminium we ingest, which is great, which means we can tolerate quite a bit. And like I've said in previous podcasts, the human body is a detoxification machine. We are geared to remove environmental toxins, metabolites, etc, etc. It's the reason why people who smoke a known carcinogen every single day, 10, 20, sometimes 40 times a day, only succumb to something as significant as cancer, even though this is a known carcinogen, sometimes decades, sometimes never, but sometimes decades after that whole practice. So I'm not on the side of we shouldn't, that's the reason why we shouldn't worry about it, but I also want to stress the point that we are pretty resilient human, we are pretty resilient beings. So the body only absorbs a very, very, very small amount of the aluminium that we ingest. The small amounts of aluminium that are actually ingested into the bloodstream are excreted by the kidneys. Under normal situations, a healthy body is able to efficiently excrete most of the absorbed aluminium. And I'm, I've put all the references to the studies that we've used in the show notes. You'll find it on the doctorskitchen.com, you'll find it on YouTube as well if you're watching this on YouTube. And these are from archives of toxicology from multiple international journals if you want to look at the workings out. Other routes of excretion, apart from the kidneys, there is intriguing data on aluminium, the aluminium content of sweat, which suggests that perspiration is a potentially neglected mechanism of removal of aluminium from the body, which again begs the question as to why we would encourage or even allow aluminium in antiperspirants. But we haven't gone into detail on that. We're sticking with food in this particular episode. So, when it gets into circulation, we're typically able to excrete it, but what happens if the body cannot excrete all the absorbed aluminium? What if we're ingesting lots and lots of aluminium, let's just say, for example's sake. The devil really is in the dose of aluminium, and the devil is also in accumulation of aluminium as well. And it's this body burden concept that we've touched about before on the podcast with, you know, Professor Schwann, with the organic episode, with a number of other episodes that we're also planning. This body burden, this accumulation of materials, there appears to be a bit of murky ground there. In some situations, like exposure to high levels of aluminium over a long period of time, or in people who have impaired excretion functionality, i.e., those people with impaired renal function, your kidneys don't work, you might be on dialysis, aluminium can accumulate in tissues by binding to a particular circulating transport protein called transferrin. Transferrin, you've probably heard of before if you've ever been diagnosed or investigated for anaemia, specifically iron deficiency anaemia. Sometimes we do blood tests for this protein, transferrin. It's a type of carrier protein, the official name is a glycoprotein. It's usually tasked with transporting iron around the body. It binds to the exact chemical formula is Fe3+. It binds to it very, very tightly but reversibly. So it's a really good protein carrier because it can deliver iron to the necessary sites. And in an environment where you have low iron stores or low iron, what happens is you get upregulation of your transferrin protein because you want more carriers to try and sniff out all the available iron that you can. So this is why we look at transferrin levels in the blood during those investigations. It can also bind to other metals, and in this case, aluminium. And importantly, it can cross the blood-brain barrier, which is obviously a necessary thing for it to be able to do, but just something to remember a little later on when we talk about the potential harms of aluminium excess in the body. And I want to remind myself to always say aluminium excess in the body because I think that's an important, the likelihood is we all have aluminium in our body, but it's the excess of aluminium that potentially has consequences. Increasing data, and we'll talk a bit more about the evidence around the harms of aluminium. So we've talked about how we process it, kidneys, major, major thing. Um, accumulation, something to, to, to think about. But increasing data links high levels of aluminium to health problems. But the primary source of this evidence, this data, comes from lab and animal studies or people exposed to very, very high levels of aluminium, such as people who worked in aluminium factories, for example, or patients who are undergoing dialysis. So where your kidneys don't work and you have to rely on essentially on a machine to do the filtration of your blood for you, you can understand why if your kidneys aren't working, you can accumulate aluminium in the body. That being said, even though they are very unique circumstances, we can garner an idea of the potential effects of aluminium exposure, and there are a few interesting findings that I think are relevant to this discussion. So, studies looking at aluminium in aluminium workers, so people who work in these factories, exposed to high levels of aluminium reported increased risks of health problems such as cognitive impairment and cancers. So cognitive impairment, you can understand why that might be the case. You've got this transferrin, you've got high levels, it can cross the blood-brain barrier, can go into the brain where it can cause some issues. In recent years, on that note, researchers have detected elevated aluminium content in the brain tissue of patients with neurological diseases such as Alzheimer's and Down syndrome. Now, I want to pause here for a second because you or someone else online may look at that and make the incorrect assumption that aluminium is causative. But that's not what you can garner from this particular research. It remains unclear as to whether aluminium deposits were causative or symptomatic of the disease. So if you have Alzheimer's, maybe the aluminium deposits that we find in brains of people who have had Alzheimer's and have passed, are the result of the disease rather than the cause of the disease. That there is uncertainty. Um, as to, you know, which one came first. But there is a potential mechanism of action that we have to be aware of because lab studies have also suggested that aluminium, like I said, maybe via the transferrin protein, can cross the blood-brain barrier and promote the generation of what we call reactive oxygen species, which we have mechanisms to mitigate that, you know, antioxidants that we generate within each cell, as well as the ingestion of antioxidant-rich ingredients. Um, but ultimately what happens is that this generation of ROS, reactive oxygen species, can cause the downregulation of key brain essential molecules that are involved, for example, in the formation of synapses. So synapses or synapses, as our Americans like to say, are the connections between our neuronal cells. Um, and at high doses, there is an understanding, a mechanism whereby it can be neurotoxic. Um, and in animal studies, and again, I just want to highlight, just exacerbate the point here, that in animal studies, they have been shown to demonstrate behavioural disorders. So there is a potential mechanism of action. There is a potential scenario for even at normal levels of exposure, normal, we'll get into that in a second, um, you can accumulate aluminium, and there are studies looking at very high exposures in aluminium workers where they have higher risks of cognitive impairment and cancers. You know, if you are a worker in a metal plant, there's probably some other risk factors that you are going to be exposed to that could also cause those issues as well. We haven't had time to dive too deep into those. These papers came from PLOS One, a 2021 paper, and the American Journal of Industrial Medicine. Um, so perhaps they actually did cater for the exact, the enhanced exposures from toxic fumes, smoking habits, unhealthy behaviours, etc, etc. Um, but there does appear to be some association with aluminium in particular. According to the German Institute for Risk Assessment, and I think this is another takeaway, perhaps I should have done this at the start, that even in healthy people, aluminium can accumulate in the body if it is absorbed frequently and regularly, especially in the skeletal system, muscles, kidneys, liver, and brain. And once stored in the body, aluminium is only excreted very, very slowly. And so their main concern relates to the potential negative effects on the nervous system, kidneys, and bones. And so if you do have this high exposure, let's say, let's say you do work in an aluminium factory for a small amount of time, or, you know, you have impaired renal function, or perhaps you've ingested aluminium through some other mechanism, maybe through scratch pans or whatever it might be. Um, there is the risk that you cannot excrete it once it is accumulated, because we tend to only remove it very, very slowly. And that's according to the German Institute for Risk Assessment. Overall, the data are lacking when it comes to the health effect of low frequency exposure to aluminium that probably applies to most people watching or listening to this. And the effect on the general population is unclear. But this is where I sort of put my pragmatic preventative medicine hat on, my PPM, my PPMH, my pragmatic preventative medicine hat on. When I look at the inconsistencies in the data or the lack of, and I look at the potential mechanism of action, and we do have some human studies, and there are easily accessible alternatives to practices like using aluminium foil or aluminium in cookware or aluminium in personal care products. The reasonable suggestion would be to avoid until proven otherwise, until it's unequivocally proven as safe, because the effect on the general population is pretty unclear. We do have multiple insults from other elements of our exposure, you know, whether it's from pollution or, you know, other sort of toxic byproducts of the, uh, in the kitchen in general. Um, so, you know, even though there are some cases that are contradictory, I think we need more large-scale studies to better understand the relationship between aluminium exposure in daily life and different health comes. And I'm sort of getting to the conclusion a little bit earlier here, but I would just avoid where possible and not sweat the details where I can't. So, for example, if I'm going to go out and get a burrito and they wrap it in that very like thin foil, I'm not going to freak out about it. And we'll get into some of the studies about wrapping and marinating a little bit later to give you some sense of exactly how much aluminium is leached into food. Um, but generally, I'm not going to freak out, but I am going to make some conscious efforts to minimise exposure if it is on a daily basis, things like foil. Let's talk about the regulations, what the regulators are saying before we get on to aluminium and food and the different ways in which you can get into food. There are actually regulations in place that dictate the acceptable level of aluminium without an appreciable, appreciable risk to human health. This is what they've described it as. And it's what is referred to as the tolerable weekly intake, the TWI. And in 2008, the European Food Safety Authority, EFSA, derived a tolerable weekly intake, TWI, of 1 milligram per kilogram of body weight per week. So 1 milligram per kilogram of body weight per week. Later on, there was a joint expert committee on food additives of the FAO and the WHO, and they reviewed new animal scientific evidence and derived another higher threshold of 2 milligrams per kilogram of body weight per week. So it described, this basically describes the amount of aluminium that can be consumed each week over a lifetime without any health risks. Now, the issue with that is, we're deriving most of that from animal data and not really from human data. And if you've listened to any podcast or you've listened to, you know anything about study design or how we actually generate recommendations, you can't rely purely on, um, animal experiments alone. We are very different, even though we, we have very much the same genetics, you know, most of our genome is very similar to to mice and other mammals, like dogs, but, you know, the effect, particularly when it comes to pharmaceuticals, is vastly different. Um, so I have a little bit of an issue with that, but for the purposes of the, this exploration of aluminium and food, we're going to just accept that that is the accurate and true representation of how much a human body can tolerate per week. Um, the question is, let's assume that is the, uh, the tolerable weekly intake upper limit. Um, are we exceeding this limit? That is the question that we would want to, we would want to answer. And there was a risk assessment study published in 2019 that was in the journal Archives of Toxicology. You'll find the reference in the Doctor's Kitchen show notes on the website. They estimated the overall exposure to aluminium based on data and food consumption on the aluminium content of foods and cosmetics and product data. And they concluded, so the overall exposure, they concluded that when taking into account the overall exposure from foods, cosmetics, pharmaceuticals, it is possible to reach or exceed the tolerable weekly intake. So, let's, let's just step back for a second. TWI, 2 milligrams per kilogram of body weight per week. Is it, is that the accurate amount? Yes, let's just assume it is. Is it possible to go above that with all the other sources of aluminium in our diet, in our cosmetics, etc, etc? Well, yes, it is. According to this particular journal, just from three or four years ago, it is. So, with that in mind, we should be finding ways to reduce our overall aluminium exposure. It could be important for health and, and general well-being. And as this is the Doctor's Kitchen podcast, we're going to focus on food. I did not have time on this occasion to review the evidence on cosmetics and personal care products, but it's safe to say you probably want to employ the same strategy of reducing exposure to them where possible. That's all I'm going to say. I'm constantly looking for additives of aluminium in, in products now, personal care products, particularly where they're not really necessary. Um, so we're going to talk about aluminium and food. Processing, packaging, and storage. These are the three areas that we're going to be looking at. Wrapping food, particularly meat and fish, is a very common practice. Um, it's, storing food is very practical. I use aluminium foil all the time when I'm marinating chicken, well, I'm pescatarian now, so when I'm marinating fish or a bone of monkfish or whatever, like, it's just a really easy way of using a hardy, malleable material. It locks in those flavours. It's um, you know, it's a, it's a very good conductor of heat. It can also keep things cool as well if you take it out for a little while. It's just really easy to use. But, as I found out from whenever I use aluminium foil online or on social media, there's a lot of people talking about the toxicity of using foil. So we wanted to explore four key questions. Does aluminium actually leach into food from wrapping or is it just from cooking or warming or the other reasons as to why we'd use foil? So can I just, if I'm just wrapping it, does that have that much of an effect? If it does, you know, is the amount of aluminium biologically significant? Is the transfer of aluminium into my meat or whatever product I'm marinating, is that actually significant? Are there certain ingredients or certain additives that might make it worse, like acids, vinegars, etc? Does that increase the leaching? Um, and does removing the aluminium foil and containers actually make a difference? Well, you'd assume it would do if the amount was biologically significant and there is actually leaching in food. So, in short, number one, the question to number one, does aluminium foil actually leach into food? Yes, it does. Um, there are studies that found that the aluminium content in different foods increases when they are prepared using foil or containers, aluminium containers. There are two studies, they're very limited studies, that's one thing I want to just point out here, and we probably, we definitely need more, um, given that it's such a common ingredient, a common practice. There are two studies that measured aluminium concentrations in foods cooked with foil compared to control samples cooked without foil. And they found a statistically significant increase in aluminium content when the foods were baked in aluminium foil. That was from the Journal of Environmental Research and Public Health, um, and the food scientific, uh, nutrients 2019 as well. The team and I also came across an intervention study which is one of the only ones that we've actually found, and this specifically looked at preparing food with foil. They looked at 11 participants who provided urine samples for chemical analysis. The control phase was where all participants ate meals that were not prepared with aluminium foils and containers. And an exposure phase where the meals were wrapped with aluminium foil, so things like marinating the meat in a marinade over overnight and also keeping the food warm in aluminium containers for at least two hours. And what they found was that the mean aluminium concentrations found in the urine during the exposure phase went up. So there was a measurable aluminium burden just from consuming a diet that's either had preparation and warming with aluminium foil and containers. This study specifically looked at warming food and wrapping food, not cooking food. So it's potentially reasonable to suggest that aluminium content leaching into the food could have been increased by cooking. And the only real reason as to why I don't, the only reason why I think they didn't look at cooking is because they used various different products like fish, chicken, other sorts of meats. The cooking times would have varied, and so to ensure a standardised exposure phase, warming the food and keeping the food warm in aluminium for two hours was a nice sort of standard rather than cooking that might have required different temperatures because, as any cook knows, you can't cook your red meat the same temperature as your, as your fish. Um, so from a standardised point of view, that's probably why they opted for that, but it didn't, it doesn't totally reflect, I think, how aluminium foil is used from a cooking perspective, but certainly from a preparation, marination perspective. Um, the sceptical view of that whole study would be, well, that's great. It, you know, it just shows that the kidneys are doing their job. You know, you put some aluminium in the food, your aluminium concentration in your urine goes up. That's to be expected. But the issue is the accumulation and the multiple exposures. So, you know, in answer to the second question that everyone is asking is, you know, is the amount that was found in the food, is that biologically significant? The study concluded that the aluminium contents found in the investigated samples and in the urine were not alarming and far below the dose at which there could be an adverse effect. So it's probably unlikely to exceed the tolerable weekly intake by using foil alone. However, in the same study, the authors also did point out that when you intake these foods, when you consume these foods several times a week, using the same preparation methods with aluminium, and you're also using other products with aluminium in them, it's reasonable to suggest that the aluminium content and the amount of exposure could have an impact on those who are at high risk, so people with chronic renal failure, for example, or smaller children, and you could reach that tolerable weekly intake as well that is set as a safe limit for everyone. So it is definitely something, even though in that particular experiment, it was a low amount, it is something to bear in mind considering the number of different exposures that we do have on a daily basis. The third question, what, if anything, makes that migration of aluminium from cookware, containers, foil worse into food? Now, this one didn't look at cooking, unfortunately. Um, but looking at some other studies that were commissioned by the European Commission in 2018, it seems to be temperature. So, again, that was just warming food, potentially using foil at a high temperature increases the leaching effect. Also, the length of food contact. So if you're going to be marinating overnight in foil, it's reasonable to suggest that there's going to be more leaching. Uh, also the pH and salt concentration. So, for example, if you've got an acid like you're marinating in red wine vinegar, for example, or apple cider vinegar, whatever vinegar you like. Um, the high salt content of food as well. Things like, even ingredients like tomatoes or rhubarb, uh, salted fish, cheese, these sort of, uh, elements of acidity could increase the migration of aluminium. Even things like lemon. When I think about how I'm going to be marinating a piece of fish, you know, it's going to be lemon, it's going to be sherry vinegar, it's going to be, you know, etc, etc. All these different acids, that's why you want to, you sort of want to penetrate the meat. Um, so we'll go through some other mechanisms that you can use. So we didn't specifically look at the studies looking at the acidity of food and why that might increase leaching. But from the European Commission paper, uh, they commissioned another committee called the Scientific Committee on Health, Environmental and Emerging Risks, also known as Sheer, which I absolutely love. Um, they specifically were looking at aluminium in toys, um, but their paper also looks at dietary exposure, quoting a 2013 paper that estimated leaching from cookware. And I've put the paper in the show notes as well that you can have a look at. So, there appears to be a biologically significant amount of aluminium if you think about the cumulative exposure. There definitely is migration of aluminium. There are some things that make it worse, temperature, acidity, etc, etc. The question, I guess, is, you know, if you're going to bother removing foil from your cookware, does it actually make a significant difference? And the intervention study that I mentioned earlier, uh, published in the Environmental International Journal, the, the team looked at what happens when they stop exposing participants to aluminium food contact materials. And in the last 10 days of the, the last 10-day phase of that experiment, they gave participants, uh, meals that were prepared without aluminium and analysed their urinary concentrations. And of course, it was significantly lower when they didn't use those the foil and the containers. So that small, yet potentially significant burden of aluminium was reversed. Um, so it can potentially mellow health concerns if you're not going to be using foil, but we're not really sure about, you know, how much aluminium was accumulated over that time anyway. It's a very small time. It's unlikely to have a significant thing, but it's, it's more the, hopefully you're getting the theme that it's about the burden of aluminium rather than the individual instances where you do use aluminium or you're exposed to it for whatever. Um, there are some, uh, ethical and sustainability reasons not to use aluminium in cookware, specifically foil. Uh, we're not going to have time to go into that today, but it is certainly a concern that a lot of people would have, uh, outside of the conversation as to whether this is a preventative health measure. We focused our research on foil because we, I do get a lot of questions about foil. It is used a lot. Uh, but there are other ways in which aluminium get into our diets. Um, you know, aluminium compounds, apart from, you know, having some aluminium in fruits and vegetables, cereals, cocoa, you know, some exposure from the diet is going to be inevitable and I think you just have to to live with that. Um, I can't see a world where people would opt for or really care about low aluminium foods. Um, and we haven't even looked at like, you know, how small a burden that that represents. Um, but aluminium compounds appear to be added, uh, by and large to processed foods, uh, to achieve certain characteristics like I talked about before, regarding texture and taste. Um, and it was suggested in a study in Japan and a recent report published by the European Commission that processed foods represent the largest contribution to dietary intake of aluminium. Now, I don't know whether that was specifically looking at foods and not other sources of aluminium related to food like foil and wrapping and foil. Um, but that is yet another reason to try and remove processed foods from your diet. And they cited specifically foods like confectionery, processed cheese, cereals, which, you know, I would recommend steering clear of either way. Um, so the likelihood is, you know, we're probably exposed to too much aluminium in our daily life, um, from a combination of sources. Um, we did want to look at a few things that could potentially alleviate the effects of aluminium exposure. Uh, but I want to preface this and just say that we did not find much. Um, so, you know, it's not like we can ingest a chelating agent to take out some of the aluminium that might be accumulated. I would love to say, oh, you can just, you know, add a few ingredients to your diet and it will take out that, no, that's not, that's really not the case. And I have found some erroneous sites on the internet suggesting that that's what you can do to minimise your exposure to not just aluminium, but other metals. And I, I think the studies that we found certainly are low quality, few and far between, mostly done in animals. Um, and I think it's definitely an area to look at in the future, but not something that I would be staking my reputation on, uh, and saying that it's particularly reliable. Uh, of the studies that we found, because people always want to know, uh, there was an interesting study in animal models that found treatment with garlic, um, also known as Allium sativum, and black cumin had a positive effect on evading the harmful effects of aluminium in the liver, kidney, and testes. Again, it's an animal study, mildly interesting. Um, I would not recommend adding garlic and black cumin to your diet for those reasons. Flavour, fill your boots, but not, but not for removing aluminium. Um, there's also some mention of silicon-rich mineral water to facilitate the removal of aluminium via the urine. Very interesting. Uh, one small intervention study published in 2013 in the Journal of Alzheimer's Disease, um, the researchers found that drinking silicon-rich water increased the urinary excretion of aluminium in participants with and without a diagnosis of Alzheimer's disease. However, the mineral water was provided by Spritzer Mineral Water Company, who also provided funding. So, that's all to say, you know, we need longer-term and rigorous studies on larger samples that aren't confounded by potentially, um, funding bias. Um, you know, I'm not saying that it doesn't help, it might do, but, you know, we would really want to see a repetition of that study, uh, as interesting as it is, you know, to to actually dive into a, what the mechanism of is, and b, whether it's actually a reasonable suggestion to add silica to, um, to your drinking water. So, um, if we can't alleviate the accumulation or increase the removal of aluminium, we need practical tips on how to reduce exposure. Um, so if you think about the seesaw or the sort of like, uh, the two sort of, um, uh, pulling and pushing mechanisms of how we, we, uh, ingest and remove aluminium. Um, what are the things that we can do to reduce our exposure? First three things that I want to talk about. A, this is not another reason to stress out about food. We're, we're really in an era where we're trying to question the healthiness of everything. And I feel even addressing this topic can be, uh, health anxiety promoting for a lot of people. So, you know, this is purely to guide better choices and not create more anxiety around, um, uh, you know, your kitchen. We can tolerate a lot. Please do remember that. You know, it's more about supporting general health rather than trying to remove every single toxin from our environment. And this is not about good or bad. Aluminium is not yet another compound to vilify and remove in place of another one, just like we've done with BPA, which, you know, it is horrible to see because you see all these plastic containers that just say BPA free, and what they've done is just introduce another compound that is now showing it has potentially worse effects than BPA. Um, so again, it's not just one of those things that I want to see aluminium free. Um, I think we, we need to be a lot more mindful about just using good old-fashioned basic, uh, elements and basic containers that we know are beneficial and not harmful to us. So, with all that being said, these are my four main tips to minimise aluminium in your daily life. Cookware in the kitchen. I'm going to be replacing foil and containers for baking. Um, with things like unbleached parchment paper, like I said earlier, trays made from glass, stainless steel, ceramic, cast iron. Um, depending on what you're cooking, metal bakeware can be a better conductor of, uh, of, of heat than, than glass pans. A tip that I use, if you do have like Pyrex or whatever, um, is to put the, uh, the pan or baking material into the oven first, preheat, then take it out, being careful, making sure you're wearing oven gloves, and then add your elements to it because it does take a little while, particularly if you're using like thick ceramic, for example, to get that heat to penetrate through, um, which is why foil is, is so good in that respect. Um, you can also use an oven-safe lid instead of foil or unbleached parchment paper, which is a common use for foil that I used to do, and still will do every now and then, but like, you know, in the, in the spirit of reducing exposure, I'm probably going to do that less and just use a lid. Uh, for food storage, I would do the same thing. So reusable cloths, beeswax, really, really, um, cost-effective actually. So we did a little bit of math with the, with the team. If you get a good quality foil, uh, you know, 10, 20 metres, it can cost a few quid every, every time. It could be three, four pounds. Uh, if you're buying a beeswax cloth for, and this is purely for marination of of meats or or veggies, um, they can cost five or six pounds, and then you've got multiple uses out of them. So over time, a beeswax cloth or other eco materials that you can use, much, much better, cost-effective, and you don't have the exposure as well to aluminium. Um, you can wash them, reuse them all, that kind of stuff. So I think that's, uh, that's a, that's a good sort of, um, alternative to wraps. I'd also use things like glass, uh, containers. I'm definitely using more glass containers with Tupperware. And actually, you'll find some products online that have recycled plastic on the outside, so you don't risk smashing your glass Tupperware all over the floor. Uh, I'd also reduce, number three, this is, reduce processed foods. It goes without saying for lots of other health reasons. If there is anything extra that you needed to sort of convince you to reduce processed foods, it is the potential aluminium content. As we saw earlier, aluminium additives are another source of exposure. So generally reducing them is, you know, it's something that I've actually started doing and checking food labels. That's another thing that I would suggest doing. Um, when you buy food, try and read the labels. There are examples of aluminium in lots of different ways. Aluminium sulfate, sodium aluminium phosphate, also known as E541, that's an emulsifying agent used in processed cheese, like cheese spread. I dare anyone that kind of stuff. Sodium alumino silicate, E554, that's an anti-caking agent in powdered or granulated food products like soup powders, for example, uh, cake mixes, uh, coffee, powdered milk. You find these additions in multiple different products, many of which that I perhaps wouldn't have questioned and just used every now and then, but now I'm, I'm really thinking a bit more about the potential negative, extra negative effects of processing. Um, these are, these are things that I'm going to be looking out for. I think in future, we will talk a bit more about personal care products and also, um, how those add to our exposure and the other elements of, uh, personal care products. So, phthalates, um, with a P, so PTH, um, and also parabens, uh, SLS, a number of other products that are, um, problematic. Uh, we talked about them briefly with Professor Schwann on the, uh, in the context of infertility, but there is a wider, um, context, uh, with these products as well in terms of overall toxic burden that could be exacerbating the, um, the likelihood of, of conditions. I really hope I've given some clarity on this trendy topic. I hope I've done justice, uh, to give you a reasonable approach to aluminium in general, particularly as it relates to foil that I will be using less, but I will not be completely excluding from the kitchen. Um, and the core message that we are really trying to deliver here is to make small improvements that compound over time, because the body can likely handle a lot of stress and we are very, very resilient, but there are small tweaks that we can do that aren't obtrusive, that aren't costly, that potentially have a much bigger effect, uh, later down the line as well. And we'll link to all those studies and sources that we, we, um, we talked about today, uh, on the show notes in the doctorskitchen.com as well. If you have other topics that you want me to talk about, tweet them at us, join the newsletter, send, uh, us some feedback via the newsletter. We look through all of them. Um, we've got a whole bunch of other topics that we want to address as well in the sort of cookware space. We want to create some more recommendations and obviously, the Doctor's Kitchen app, all the digital products that we're putting out there as well. The best way to support us right now is to subscribe on the YouTube, download the app, try it, give us feedback on that. We'd love to hear from you. And we're also developing even more health goals. We're currently researching fertility and menopause health goals for the app, so you can have that as a health goal filter and lots of other recipes coming your way soon. Thank you so much for listening and I will see you here next time.
Dr Rupy: Thanks so much for listening to this episode of The Doctor's Kitchen podcast. Remember, you can support the pod by rating on Apple, follow along by hitting the subscribe button on Spotify, and you can catch all of our podcasts on YouTube if you enjoy seeing our smiley faces. Review show notes on the doctorskitchen.com website and sign up to our free weekly newsletters where we do deep dives into ingredients, the latest nutrition news, and of course, lots of recipes by subscribing to the Eat, Listen, Read newsletter by going to the doctorskitchen.com/newsletter. And if you're looking to take your health further, why not download the Doctor's Kitchen app for free from the App Store? I will see you here next time.
