By 2020, cancer cases in the United States are expected to increase by 24% in men and 21% in women.

Some of the most common types of cancer expected to rise include melanoma, prostate, liver, kidney, lung and breast cancers.

The Modern Paradox – Luxury is Toxic

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The modern lifestyle is one of luxury and convenience. From beverages to beauty products, todays consumers have a vast array of options to choose from to satisfy their daily needs. Freedom of choice in a competitive marketplace, that is the beauty of living in the United States.

In a minimally regulated system, overconsumption in the pursuit of luxury has become toxic. Companies now use chemicals to enhance products, reduce costs, and increase profits. The Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) are supposed to regulate exposure to toxic chemicals. However, the system has failed. There are approximately 85,000 registered chemicals, but only 200-300 have been tested for safety.

Chemicals are “innocent until proven guilty” in the U.S.

In America’s free marketplace, consumer products are considered safe until proven otherwise. The 1976 Toxic Substances Control Act (TSCA) was enacted to regulate potentially hazardous exposures. However, the act does not require chemicals to be tested for safety before being released to the public.

On June 22, 2016, the TSCA was updated with the passing of the Lautenberg Chemical Safety for the 21^st Century Act (LCSA). The intention is that the EPA will improve the screening of active chemicals used today for toxicity in humans. Whether or not this will actually work is unknown.

The number of chemically engineered goods has and continues to rapidly surpass the regulatory systems in place. Each year, approximately 2,000 new chemicals are introduced into consumer items. Personal care products, foods, and household cleaners are just a few places where they are present. We are all eating, drinking and using toxic products everyday. However, with the backlog in toxicity testing, we may never know what is killing us before it’s too late.

The Covert Killer: Caramel Color

Caramel coloring types III and IV in carbonated beverages contributes to 25% of the U.S. population’s exposure to the carcinogen, 4-Methylimidazole or 4-MEI (1). The U.S. National Toxicology Program (NTP) conducted experimental studies on rats and found that exposure to 4-MEI led to increases in leukemia, as well as adenomas and carcinomas of the lung. While no human data is available yet, these findings were enough to categorize 4-MEI as a carcinogen.

This manufactured caramel color has no other purpose than to make beverages appear darker. Companies believe that by including this chemical into soft drinks, it will ultimately lead to an increase in sales. Apparently, people prefer soda that’s brown not yellow.

CA Proposition 65: Labeling Toxic Consumer Goods

In 2011, California listed 4-MEI as a carcinogen under Proposition 65 of the Safe Drinking Water and Toxic Enforcement Act of 1986. Proposition 65 requires warning labels for any carcinogen exceeding a “no significant risk level” (NSRL). A no significant risk level is the lifetime average daily exposure associated with a 1-in-100,000 cancer risk (1). This amount for 4-MEI is equal to 29 μg/day. In response, soft drink manufacturers announced that they would lower the concentration of 4-MEI in products sold in California.

Years later, did they really follow through?

In a 2015 study by Johns Hopkins University, researchers tested the concentration of 4-MEI in 110 soft drink samples from stores in California, New Jersey, Connecticut, and New York (1). Various brands were tested, including A&W Root Beer, Diet Coke, Malta Goya, Diet Pepsi, Pepsi One and Regular Pepsi. The average and maximum amount of 4-MEI concentrated in beverages varied dramatically across brands and states. The highest and lowest concentrations across all locations was found in Malta Goya (mean: 945.5μg/L; maximum: 1104μg/L) and Diet Coke (mean: 9.8μg/L; maximum: 10.4μg/L).

Researchers found that 4-MEI concentrations were overall higher in samples purchased in the NY area compared to those purchased in CA. This is evidence that Proposition 65 and other state-level interventions can incentivize manufacturers to reduce chemical exposures and associated risks among consumers.

Soda Consumption: A Social Epidemic

The National Health and Nutrition Examination Survey (NHANES) calculated the average daily consumption of carbonated beverages in the United States (1). The highest consumption of soda was found among adolescents (ages 16 to 20 years old) and young adults (ages 21 to 44 years old), with approximately 57% of this population consuming 2-3 cans daily. However, this trend varied by beverage type. Colas were found to be the most popular beverage consumed, regardless of age. In contrast, root beer and pepper colas were the least popular.

Cancer Risk

For this study, risk is defined as the lifetime excess risk of developing cancer associated with the consumption of soft drinks. United States federal regulatory agencies set an acceptable cancer risk goal for consumer products as 1 case per 1,000,000 exposed individuals.

Based on average daily consumption patterns and the concentrations of 4-MEI found in soft drinks, researchers identified which beverages posed the greatest risk for consumers. Malta Goya, Pepsi, Diet Pepsi and Pepsi One resulted in 4-MEI exposures with associated risks exceeding 1 excess case per 10,000 exposed individuals.

The lifetime risk of developing cancer is 100 times greater for consumers of caramel colored soft drinks with 4-MEI (Malta Goya, Pepsi, Diet Pepsi and Pepsi One)

Acceptable Risk: 1 case/1,000,000 exposed individuals

Current Risk: 1 case/10,000 exposed individuals

Cancer Burden

The consumption of soda is contributing to rising rates of cancer. But to what degree?

Burden is the lifetime (70 years) excess cancer cases associated with the consumption of beverages by the U.S. population. The number of people who will develop cancer in their lifetime from Pepsi One is approximately 1,000 in California and 4,000 in New York. Comparatively, the number of Malta Goya consumers predicted to develop cancer in their lifetime is roughly 5,000 in both states.

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What Can We Do?

1. Federal Regulation

Advocates, NGOs and constituents should pressure policy makers to increase regulation on consumer goods with 4-MEI. Toxic exposure to this carcinogen is unnecessary and should be eliminated.

2. FDA Intervention    

The FDA could set a maximum 4-MEI concentration level for beverages sold in the United   States.

3. Avoid Drinking Soda  

Individuals should avoid drinking soda with caramel coloring, especially Malta Goya, Pepsi, Diet Pepsi and Pepsi One.

Ultimately, relying on political regulations is not enough. The process of creating and implementing restrictions on carcinogens is too slow to keep up with the rapid pace of chemical engineering. Everyday, new toxins are being introduced into consumer products. Chemicals are continuously being modified and exposures are on the rise.

However, advocates should still pressure regulatory bodies to progress towards a system that more effectively minimizes harm to the population’s health. California’s Proposition 65 is one example of success where other states should follow.

People have power as consumers. By avoiding the consumption of soda, individuals can make a statement to companies about the quality of products desired. By choosing healthier alternatives to chemically enhanced products, people are shifting trends that influence what businesses produce in the future.

The most effective way to limit toxic exposure is with you. You have the power to create an immediate impact towards a healthier life. You choose what you eat, drink and use everyday. While our products may be toxic, our choices don’t have to be.

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REFERENCES

1) Caramel color in soft drinks and exposure to 4-methylimidazole: a quantitative risk assessment, Tyler Smith, et al., PLOS One, doi:10.1371/journal.pone.0118138, published online 18 February 2015.

2) Another reason to cut back on soda, Consumer Reports, news story accessed 20 February 2015 at consumerreports.org.

3) Popular soda ingredient poses cancer risk to consumers, Johns Hopkins University Bloomberg School of Public Health news release accessed 20th February 2015 Via EurekAlert!