Dr. Sabine Donai (2:04)

Absolutely.

Host 2 (2:05)

You can say yes or no or if you have to, one sentence answer.

Dr. Federica Amarti (2:09)

Super.

Host 2 (2:10)

All right, I'm going to kick us off.

Host 1 (2:12)

Have I got plastic in my brain right now?

Dr. Sabine Donai (2:16)

Yes.

Dr. Federica Amarti (2:17)

Mine. Next. Does my food contain little bits of plastic? Yes.

Host 2 (2:22)

Is plastic production contributing to climate change?

Dr. Sabine Donai (2:25)

Of course.

Dr. Federica Amarti (2:26)

Can microplastics impact heart health?

Dr. Sabine Donai (2:30)

Absolutely.

Host 2 (2:31)

And finally, what's the most common misconception you hear about microplastics?

Dr. Sabine Donai (2:36)

That it's all about the environment rather.

Host 2 (2:38)

Than about our health and is about our health.

Dr. Sabine Donai (2:41)

It's entirely about our health.

Host 2 (2:44)

So I really looking forward to getting into this. We've not discussed this at all. But before we get into the details of the microplastics, how big is this plastic problem? How much plastic are we producing and is this any different than it was 50 years ago?

Dr. Sabine Donai (2:59)

Oh la la. Okay. Yes. You're ready for this. Plastics really came only into the world about 1950s, really. When we started talking about plastics, when I think it was Bakelite that was first. First produced and then 1960s, it really exploded. And it was actually 1960s, I think that was the first time that we appreciated the environmental impact of plastics. And now, of course, it's just gone completely out of hand. Okay. I think it's 2014, something that we only really started talking about microplastics and the impact on the environment, not even realizing the impact on our health, which clearly we're going to be talking about today. And the policies only really started coming in, I think, last year. I'm a clinician, so I'm not environmental. I know what's in our bodies and we'll talk about it for sure. But if I see how much we actually come in contact with as a human, you can only imagine how much there is in the world.

Dr. Federica Amarti (4:01)

Since 2000, the amount of plastic production in the world has doubled. So even though we've known this problem for a long time, production's still going up. It's expected to triple in the next 20 years. So it's a real problem. And there's a huge lobby behind plastics which pushes this narrative that plastics are necessary.

Host 2 (4:18)

So just the raw amount of plastic that's going into the world is just going up and up. Can you talk about this term microplastics? What is a microplastic? How's it formed?

Dr. Sabine Donai (4:31)

There are two types of microplastics. The ones that are created small, okay, you've got small little beads of. I mean, anything that is smaller than 5 millimeters is considered as a microplastic. And it really goes from 5 millimeters down to nanometers, clearly. So you have your primary ones which are formed small little beads that we can use in cosmetics and in factories and things like that. And then you have those that actually are produced as a bigger plastic, but then becomes a microplastic because of erosion, because of whether it's chemical, whether it's heat, whether it is just the degradation of the plastic itself becomes smaller and smaller and smaller particles. And that's what we're dealing with now. So when people often think about plastic, they think, I can see plastic. And of course we can. What we can't see is the degradation of that plastic because plastic is not inert. Okay, it takes a very long time, but there's small little pieces that actually gets abrased off that plastic all the time. And that's what microplastics Are.

Host 2 (5:37)

When I think about sort of plastic pollution in the world, I tend to think about stuff washed up on beaches, like enormous plastic icebergs somewhere in the middle of the Pacific and things like this. But these are, I'm thinking about like big pieces of plastic. And you're saying, however, that these microplastics are tiny little chips of plastic that are sort of coming off all of these bigger pieces of plastic.

Dr. Sabine Donai (6:00)

Spot on. So if you imagine you have your plastic bag that might wash up in the ocean, you have your stones and you have your waves and everything just brushes against it and with that brushing against it, you have this little small pieces that break off and they have different sizes and forms and some of them are round and some of them are fibrous. And you have different kinds of plastic depending on what the original source was. And they become smaller and smaller and smaller. And that's where the problem comes in. Because first of all, we can't see them. So we kind of ignore that they're there. They're not water soluble. They're very small particles of plastics that we now in contact with on a day to day basis. I mean, it's in the water, it is in the air, it is in the soil. It's absolutely everywhere. We can't get away from it. I mean, wastewater, clearly it's got a massive source of microplastics for sure, but so is air.

Host 2 (6:56)

How's it in the air around me?

Dr. Sabine Donai (6:57)

How's it in the air around it? I mean, a big source of microplastics and it's about between 20 and 35%, I think even comes from friction of tires on the roads. So tires are made from rubber. And just the pure friction, as I mentioned earlier, I mean, it's this, it's the other chemical or heat, or it is the nature of the plastic that is not entirely inert that actually starts wearing down. So each time when you drive your car on the road, you have microplastics that actually get released. Now that attaches to dust particles. And it's not just roads. I mean, there's lots of pollution clearly in the air. And we see that in people that live in different countries or that live in urban environments versus non urban environments. And the amount of plastics that we find is significantly different.

Host 2 (7:44)

Is it more if I'm living in a city?

Dr. Sabine Donai (7:46)

Unfortunately, yes.

Host 2 (7:47)

Yeah, I can see the tires. Slightly scary. How else is this plastic sort of getting into the environment around me?

Dr. Sabine Donai (7:55)

There are many, many sources of plastic clearly. Okay, there's pollution through production of plastics. That gets released into the air. We have found plastic in rainwater, the soil itself, the dust itself. I mean, in your house, I mean, each time when you vacuum clean, I mean, you're actually releasing the plastic into your air that you're then breathing in. So because they're such tiny, tiny particles, they will attach to, as I said, to dust particles, to rain, to everywhere. And we are in contact with it through breathing, through eating, through, whether it's through ingestion, through our skin. There's many, many sources of plastic that we unfortunately come in contact with. Now, a lot of house dust comes from your fibre, from your clothes. If you're washing with unnatural fibers, which a lot of us, then what happens if you dry, all those little fibers of plastic will actually get released in the air. So we find a lot of people that actually have got the tumble dryer that vents within the home. The amount of plastic that we find in the air is about 20 to 50 times higher than in people that don't have a tumble dryer that vents into the home. And then each time when you vacuum clean, you're just flaring it up again and you're breathing it in again. And it's just this ever ending cycle. Even if I look around, I mean, there's cleaning dusters that you use and I just look at them and say, oh, they're not cotton, they're microfibers.

Host 2 (9:21)

That means it's plastic rather than.

Dr. Sabine Donai (9:23)

Yes. And there's a lot of good use for plastics if you want. Okay. The problem is that we don't seem to have thought this through all the way and say, what is it going to do? Not just to the environment, and it's because it's doing it to the environment that eventually it's doing it to us as humans.

Dr. Federica Amarti (9:40)

And actually, I'd love to touch on that. Of course, you're a clinician, so I'd love for you to tell us a bit more about where plastics can be useful and where they're maybe necessary and then we can touch on where they're really sort of, they've become part of daily life, but not necessarily helping us.

Dr. Sabine Donai (9:54)

I mean, definitely within medicine, we use plastic a lot. They're good uses for it. Okay. I mean, it's going to be really hard to somehow reinvent the world and say we're going to be doing without plastic. But I think an awareness is necessary on a what is it doing into the environment? And then obviously, how does it translate into human health?

Host 2 (10:17)

And how long do these microplastics persist in the environment before they're like broken down and become safe.

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Dr. Sabine Donai (11:44)

Oh la la. Okay, that depends which plastic. Okay. Because there's different types of plastic, but you're really looking at the half life of about 50 years, if not longer.

Host 2 (11:54)

50 years?

Dr. Sabine Donai (11:55)

50 years, yeah. And a half life. So that means half and half and half and half. So you're really looking at very long time. So are they like the forever chemicals that we're talking about as well? No. Okay. So they can break down, but they break down in smaller and smaller and smaller and smaller and smaller pieces. So in a way they do remain, if you see what I mean, but.

Host 2 (12:16)

They'Re not, because I think we're used to this idea, this natural cycle. Like you produce some waste and then it gets broken down by little bugs or bacteria. Bacteria or whatever. And that isn't the case with all of these plastics.

Dr. Sabine Donai (12:28)

No, that is not the case. And that is the problem. Because it is not, because you can't see it, that eventually it's not there. But the problem with plastics, if I may touch on that now, is not just the plastic itself, because plastic in the main always comes with other chemicals attached to it. So when we talk about the problem with microplastics, yes, you have the physicality of the plastic and that doesn't get broken down. There's nothing natural that Actually can break it down other than in smaller and smaller pieces. But most plastics, there's chemicals attached to it, BPA or bps or phthalates. For example, if we think of black plastic and you often have these trays of food. When I have a sushi, I mean, it's in a black tray. And black plastic in the main gets produced from recycled electrical equipment. Now because it's electrical equipment, it's often treated with a fire retardant to make it safe. Those chemicals actually then translate into your food tray. So yes, we're dealing with two problems now. Okay, We've got a problem of the plastic tray and the microplastic bitty bits that eventually will come off it. Definitely if we heat it and food in it, obviously, I mean it speeds up the, the degradation of the plastic with about 60 to 80%. So really much faster. But on top of that, now you have got the chemicals as well. So you have your double whammy of toxins into your system.

Dr. Federica Amarti (13:56)

And it's these chemicals that give plastic different properties. So sometimes you want bendy plastic, sometimes you want really durable plastic. And it's exactly as to being these cocktails that give the plastic the properties you want, but they also carry health risks. Yeah, as we've touched on, it's definitely useful for medicine and in some uses, but we're still using a lot of plastics. Why is this still happening? Why are we still using so much plastic when we know that it contributes to climate change in a major way and is also impacting health?

Dr. Sabine Donai (14:24)

It's a useful way of actually creating things because it is so moldable and it's cheap. Do I think that we should start looking at different ways of manufacturing the same capabilities? Of course we should. The problem is that I'm always fearful that we actually go from one problem into another. As we had with bpa. For example, it's called bisphenol A and it's like a plasticizer and a plasticizer. It's added to your plastics to make your plastic very bendable. Your plastic bottle, for example, there will be BPA in that we know that there's been some health impacts on bpa. So now you find a lot of articles that you can buy. It says, and it made a big thing of it, it's BPA free, which is great. But the substance still remains that there's a bendable plastic. So what has happened is it's been replaced now in the main by bps, because it's fairly recent. It's only been a couple of Years now. We don't know the impact of the BPS as yet, but it's just another chemical and there's no regulation to actually somehow highlight that there's a BPS in there. You can just somehow almost see that trajectory. Okay, what has happened? Why would bps now suddenly be healthy if BPA is actually unhealthy? So my worry is that, yes, we might be starting to replace plastics, but we're going to be replacing it with something else that again, is unnatural. And so many substances we in contact with that are completely unnatural to us humans, our system does not know what to. We live in an environment that is significantly different to where our genetics are stuck. I mean, our genetics last changed about 30,000 years ago, but our environment is significantly different now. So our ability to cope with that and to deal with that is completely compromised.

Dr. Federica Amarti (16:10)

Now what Sabine's talked about is this real driver from a commercial point of view. Plastics are part of the petrochemical industry. So petrochemical industry makes a lot of money. There's a really strong lobby to continue with plastics and to really push the narrative that they're safe, that you can recycle them effectively. You know, it's quite obvious how much plastics have grown is really driven by commercial interest. It's not all driven by need.

Host 2 (16:35)

It's really interesting. One follow up on this BPA bps. I was thinking you're going to tell me I'm really naive, but I always assumed that a plastic bottle is inert. So, you know, it's like might have this stuff in it. You're saying there's something to make it bendy, but doesn't matter because I pour the water in, I pour the water out. The plastic bottle is still there before and afterwards. Just the same as like, I've got a mug here right now and I don't worry about it's, you know, yellow, but I'm not worrying that the yellow in the mug is going into my drink.

Dr. Sabine Donai (17:05)

Yes. So your physical bottle is still there. However, as I mentioned earlier, there's two problems with the plastic. One is the plastic itself and the little particles that might come off it. Now, plastic can leak, so it's not entirely inert. The moment it heats up, the plastic starts leaking. So you lose the little, little bits of plastic in your water. Now you might say that's great, okay, my water is in the fridge, so I've got no problem with that. But you've got no idea how that water has traveled. It would have been in a truck that wasn't refrigerated because there's no need to refrigerate water that might have been heated. So by the time you actually buy it, you've got no idea how often that water has been heated already.

Host 2 (17:46)

So you're saying, I think I've got this bottle of water. It looks completely fine, but actually tiny, tiny bits of the plastic from the bottle could have sort of broken off and are inside the water, but just so small that I can't see them.

Dr. Sabine Donai (18:00)

I'm going to correct you there. The could was wrong.

Host 1 (18:03)

It is, it is, it is.

Host 2 (18:05)

How do you know that?

Dr. Sabine Donai (18:06)

Because we've tested it many, many times over, even in glass bottles, sadly.

Host 2 (18:10)

How big are these pieces of plastic that you're talking about in these water that you've been testing?

Dr. Sabine Donai (18:15)

So they're anything between about 10 and 30 nanometers.

Host 2 (18:20)

Can you help us to understand what.

Dr. Sabine Donai (18:22)

That is versus 10 meter is what, a thousandth of a millimeter? So they're really, really tiny. But okay. The problem with being so tiny, you might say, well, that's so small, that's absolutely fine. I can't see them. So no worries at all. The smaller the particles, the easier it is to get through your cell wall. So suddenly you have particles that actually can travel through biological membranes. And that's where the problem as a clinician comes in. Clearly.

Host 2 (18:52)

And how many of these do you find in a bottle of water?

Dr. Sabine Donai (18:57)

Well, it depends which water, where to travel to. There's a variety, but it's not just bottle to water. Okay, not just plastic bottles. I mean, that's an easy one. But as I said, we've measured glass bottles. Water, which also has got plastics in it because it. And unfortunately, as I mentioned earlier, whether it is from rainwater, you can find plastics. Sea salt has got plastic in it. I mean, so the water that you get from mineral water even has got plastics in it. And they're not even talking about water that you get from the tap, which. The volume of plastic is the highest of all three of those.

Host 2 (19:34)

How many of these tiny pieces? Just give me a sense. Would there be like 100 tiny pieces in my water bottle or.

Dr. Sabine Donai (19:42)

Oh, no, no way. Way more. Way more. Hundreds of thousands of pieces within a liter of water.

Host 2 (19:50)

Wow. Hundreds of thousands of pieces of this tiny plastic in something that I've been thinking is completely inert and the water is completely pure, which is why if I'm buying bottled water, I don't buy a lot of bottled water because I've been convinced that's bad for environmental reasons. And that the tap water is perfectly healthy. But you're.

Dr. Sabine Donai (20:09)

Can we talk about tap water?

Host 2 (20:10)

Well, let's talk about tap water.

Dr. Sabine Donai (20:12)

So tap water in the main comes from waste, gets cleaned for bacteria, so it is healthy from that point of view. So it's not going to make you ill like you might find in more or less developed countries that you say, don't drink the tap water because it's not being cleaned. So we absolutely find in definitely in first world countries where you say, fine, you can drink the tap water because there's no bacteria, there's no viruses, there's no dirt in it. But tap water does not get cleaned from microplastics, does not get gleaned from herbicides, pesticides from pfas, so forever chemicals, from hormones, so nothing of that gets cleaned out of your tap water. So it's definitely one of the biggest sources of environmental toxicity that we find.

Dr. Federica Amarti (20:58)

Now, I think it's important here to say that drinking water is still the healthiest option when we think about the drinks available to us. But how can we make sure, especially actually in the uk, we've got a big problem with our tap water. We have some of the highest levels of hormones and actually cocaine is highest in London in the water system, because Sapina's point, we don't filter that out.

Dr. Sabine Donai (21:18)

I find the problem is when you start highlighting the toxic world we're living in, you can find yourself a little bit, as in, I feel now in a strange, can't do this, can't do that, can't even tumble dry my clothes. Where do I go from here? And it can be very terrifying. And in a way I want it to be terrifying because I think the awareness needs to come in there and say, hold on, okay, which kind of environment have we created? What can we do about it? And how can we protect ourselves? And. And that's going to be the most important part to talk about eventually.

Host 2 (21:50)

Well, this feels like the right point to transition to. Does any of this matter? Right, so you could be saying there's all of these little bits of plastic, but who cares? The fact you're sitting there, I think you're going to say, no, it does matter because it's not only out there in the water and I presume in food we eat as well.

Dr. Sabine Donai (22:09)

Yes, indeed.

Host 2 (22:10)

You mentioned right at the beginning there might be plastic in my brain, like how much of this plastic ends up in us?

Dr. Sabine Donai (22:18)

Okay. I think there's two answers to that question or two levels, really. I mean, a lot ends up in us because first of all, we inhale it, and the vast majority we actually do. And then we ingest a lot. There's a smaller amount that actually gets absorbed through the skin. Now we have got an ability to get rid of it. Okay, so we have got a system that is our detoxification system that does work in the main, if you're not genetically compromised, that is. But the problem with the microplastics, as well as all the other chemicals and environmental toxins we expose to is what we call bioaccumulating. Okay. Today is the one on top of the other, on top of the other, and our system gets overwhelmed. So have I ever measured anybody over the years and years that we've been measuring toxicity in humans that had not had any toxins in them? No, I have not. Okay, we all have it. I think we must just take it as a given now and say, you will have plastics in you. This actually was a trial that has recently come out from the University of New Mexico where they looked at the brains of people that had deceased. And they looked at brains, 2016 versus 2024, so eight years difference. They looked at the liver, the kidneys and the brain. They found that the brain had about 60% higher concentration of microplastics than the liver and the kidney. So a lot of microplastics end up in our brains. And the difference between 2016 and 2024 in just eight years was double.

Host 1 (23:57)

Wow, double.

Dr. Sabine Donai (23:58)

And it had nothing to do with age. That was the interesting fact that you say, oh, it's not. The older the people get, the more plastic they had. Because you would have thought and say, well, fine, if somebody's 80, of course they're going to have more plastic than somebody of age 50 because it accumulated. Accumulates. No, the difference was absolutely, as in the amount of plastics that they were exposed to. The difference between 2016 and 2024, the sad thing was, is that they found that people that had dementia had the highest concentration of plastics in their brain. We can't say whether this is causative at this stage. It was a fairly small study. There was only 300 people in there. But it does make you think. No.

Dr. Federica Amarti (24:38)

Yeah, really interesting. So you talked earlier that microplastics can cross. Some of them can cross these barriers. So, like the blood brain, barri, which, you know, historically sort of as being impenetrable and nothing can get through unless it's selected. So how do these microplastics and nanoplastics, how do they cross over? And can you tell us specifically about Your work on the blood brain barrier and how it can be compromised throughout.

Dr. Sabine Donai (24:58)

Our system, clearly, and specifically in our brain as well. Okay, we've got blood supply that is meant to be producing and delivering nutrients to our organs, okay, including our brain. And the other way back, actually waste products to go out now, because our brain is our brain and that's all about survival in some precious organ. The lining of the blood vessels going into the brain are very specialized. They've got very, very tight junctions. And why evolutionary it was created like that is to protect our brain from anything that is not welcome in the brain. So whilst certain particles can, for example, get into your heart or can get into your liver, they cannot get into your brain because of this barrier. That's what we call the blood brain barrier. It's like a dam. When it works well, it is very efficient. Unfortunately, whether it's environmental toxins, inflammation, closed head injuries can compromise that blood brain barrier. And we can measure that. And if that blood brain barrier is compromised, then larger particles can suddenly get into your brain, and your brain doesn't want that, so it starts reacting to that and you get this massive inflammatory response into your brain. So that's one area, how microplastics get into your brain. The second one, and probably even more important one, is straight to your nose. So as we inhale microplastics, the problem is that you have got almost a direct highway from your nose into your brain because there's no blood brain barrier. You have your olfactory nerve, your nerve that allows you to smell, goes straight from your nose into your brain, and there's no blood brain barrier. So what happens is that the particles that you breathe in almost hitchhike onto the nerve and they're found in people that have been deceased. Again, the olfactory bulb, it's like the nerve node, the first one that sits at the base of your brain where the nerve comes in, it's just full of plastic.

Host 2 (26:48)

Coming back to my thinking about my Evian bottle being inert. And I understand it's not just Evian, it's just they advertise water more than anyone else. So it springs to mind in the same way you've been arguing that this isn't just inert. You're, I imagine, also saying that you're not convinced that this plastic in my brain is inert either.

Dr. Sabine Donai (27:07)

Well, how can it be? I mean, it's completely unnatural substance in your brain. Who would say, yeah, I'll sign up for that? You would not want that. I mean, are there enough clinical trials to somehow say, no, this is definitely going to cause dementia or cognitive decline or autoimmune disease or whatever. No. And I doubt whether we will ever get there, because who's going to put their hand up and say, I'll be part of the trial? Nobody's going to say, let's just ingest a hell of a lot of plastics. So empirically we can start seeing those causative links. Definitely. That's where it becomes quite worrying. As a clinician, they're saying, if I start measuring, as we've been doing, toxic levels within people, then I cannot see how I can ignore that, because it causes a massive inflammatory response within our system and our detoxification pathways are completely and utterly overwhelmed.

Dr. Federica Amarti (28:01)

And so, Sabine, I know that you are one of the only people, in fact, I think, in the uk, certainly, and one of the few in the world that can screen your patients for plastics. So when you do that, how many do you tend to find in your patient's blood?

Dr. Sabine Donai (28:14)

So now everybody's gonna get a fright because we have never seen anybody with no plastics in their blood. Now, the moment it's in your blood, it has bypassed your gut already, and therefore the moment it's in your blood, you can assume it's gonna be in your organs. Now, we measure three different sizes of plastics because we always keen as to where they're coming from. So we're measuring the really small ones, like less than 1 nanometer, and those are the ones you tend to inhale. Then we measure the ones between 1 and 10 nanometers, which are the ones you tend to ingest, and then the bigger ones between 30 and 70 nanometers, and those are the ones in the main, you actually get through clinical, like a drip, which, again, is plastic, of course, that you get straight into your veins. So on average, the vast majority of plastics, we find, I would say always about 85, if not 90% of the people that we're measuring are the very small ones. And that therefore becomes an increased worry, because the ones that we ingest, at least if it goes through our gut, there are some ways for us to allow them to be helped out, if you want. The ones that you inhale are the ones that we're really struggling with as, how am I going to get rid of it? And yet those are the ones that we find highest. So in the biggest ones, the ones that we find the lowest, the ones that you get through medical treatments, how much do we find? I think the lowest I've ever seen was about 8, and that's 8 particles per milliliter blood. And the highest we've seen was about 170 particles per milliliter blood. We definitely find people that live in urban cities. We've had people that cycle because it's healthy and they cycle to work and they cycle through London and then we find a lot of particles in their blood purely because they're just breathing it in all the time.

Dr. Federica Amarti (29:59)

Right.

Dr. Sabine Donai (29:59)

Because they're not cycling with a mask. You're trying to do the right thing. And you say, well, no, I can't even cycle to work because I'm just going to be full of plastics in my brain now. I mean, we've got clients from Nigeria where there's heavy pollution, and those levels are really, really high.

Dr. Federica Amarti (30:13)

I'd love to ask you about the role of these plastics in blood vessel health. Could you tell us a bit more about what we think might be happening with heart health, blood vessels and plastics?

Dr. Sabine Donai (30:23)

We've got a blood vessel wall which we call an endothelium, tries to make it as smooth as possible for the blood really just to flow nicely. Now, anything that irrit that blood vessel wall, the system's going to react to that as an inflammatory response. And that can be anything, as we probably know, from cholesterol to blood pressure to being overweight. Okay. Plastics do exactly the same thing. It irritates that endothelium, that blood vessel wall, and the blood vessel wall starts reacting to that, so it creates more plaque. So they found people that have had strokes of vascular disease, definitely in the carotid arteries going to the brain, in the plaque that is sitting there. They found plastic particles in the plaque itself. So you have that plaque that narrows the blood vessel wall, which puts you at risk of heart attacks and strokes. But what can happen is that a piece can kind of break off. And then those would be the people that say, I've never had a problem, and suddenly, okay, I had a heart attack out of the blue, is because then the piece breaks off and it travels down the artery and then clogs up suddenly. And that's exactly what the plastics does. That makes it very unstable. So you have that sudden event without actually getting any warning.

Host 2 (31:35)

I think what you're saying is that if I have a lot of these plastics in my blood, it's sort of irritating my immune system in a similar way to if I was, you know, having lots of saturated fat or something in my food, which we've talked about often on this podcast, is sort of leading you to fur up your arteries.

Dr. Sabine Donai (31:51)

Exactly. But More than that.

Host 2 (31:54)

So worse than the saturated fat. And then you're saying there's a second effect, though, which is because there's like plastic in these sorts of. Of furring, it's more likely to break free from, like, the side of my blood vessel and then float around and end up in my heart and then cause like a blockage there and a heart attack.

Dr. Sabine Donai (32:12)

Exactly.

Host 2 (32:13)

So that sounds pretty bad.

Dr. Sabine Donai (32:15)

Yes.

Host 2 (32:16)

Because I know that all of this is very new science. How strong is the evidence today that if you were to get yourself tested and you have, you know, one of these really high plastic levels, that that's really sort of significantly increased your risk of these sort of furine and heart attacks and things like this?

Dr. Sabine Donai (32:33)

Yeah, I mean, you're spot on. I mean, it is a young science, but I think there is sufficient indication now to somehow say we need to start taking this serious.

Dr. Federica Amarti (32:42)

I would like to pick one thing up, though. I think that the risk of heart attacks and the risk of deferring, the bigger risk still comes from poor diet, smoking, excessive alcohol consumption. The plastics play almost, almost like an additional role. Diet is still like, absolutely a primary player when it comes to preventing these kinds of conditions.

Dr. Sabine Donai (33:02)

The plastics alone is not going to give you furrowing of your arteries. Okay. I think we need to understand that where there already is risk factors for furrowing of your arteries, the plastics make it more unstable, and that's where the additional problem comes in. But it's not just vascular disease and it's not just brain. And we haven't talked about hormonal health. Yeah, it's not so much the plastics per se, but it's those added chemicals like the BPA and the phthalates. Okay. They're very. What we call hormone disruptors.

Host 2 (33:32)

Could you explain what this hormone disrupting thing is?

Dr. Sabine Donai (33:36)

How your hormones work is that you have got. You produce a hormone and then it's almost like a key that needs to get into a key lock to open a door. So you have a receptor and the hormone needs to attach to the receptor to actually actually be effective. Now, what these chemicals often do, they actually kind of block these receptors. So you might have sufficient hormones. Okay. But they actually can't really be activated. They can't really do. So there's significant research now that actually proves the impact on fertility of bisphenol A, without a doubt. And phthalates.

Host 2 (34:09)

That's the BPA that you were talking about before.

Dr. Sabine Donai (34:11)

Yes. So, I mean, I actually want to say something else about bpa, because I think it's something that people are completely unaware of very often, and that is receipts. So you go to a shop and you get a receipt and somebody wants a receipt. I mean, I'll be the first one to say no, but I don't want the receipt. I don't want to touch that. For us, maybe getting a receipt once a day is not a problem. But people that work on a till and give out receipts every day, I feel like on a shout out and say, just don't do this or wear specific gloves, like nitrile gloves. Okay. It's not printed with ink. There's a layer of bpa, the one we've talked about earlier, that is on your paper and it gets activated by heat and that's how the numbers come up. Then you're going to touch that and you've got BPA on your fingers, okay. And then you might be grabbing your sandwich or whatever it is and you're going to put it in your mouth. It is a big source actually of BPA exposure and they've definitely seen in people that actually handle receipts very often. Okay. They've got very low testosterone levels. They're the infertility. Your likelihood of actually absorbing BPA if you've got a hand sanitizer on your hands or you've got some hand cream on hands, okay. Is about 150 times higher, I think it is. So you're trying to do the right things and you put on some hand sanitizer and now I'm going to touch your receipt. Okay. And now you're really absorbing that BPA so much through your skin, of course.

Host 2 (35:29)

And you're saying that then lowers my testosterone levels.

Dr. Sabine Donai (35:32)

Testosterone levels, exactly. Men are so much more susceptible than women.

Dr. Federica Amarti (35:35)

Actually, many couples who change their exposures to these things as part of a lifestyle and dietary change actually do improve their chances of fertility.

Dr. Sabine Donai (35:44)

The more we bring BPA down and we actually get rid of the environmental chemicals without needing a testosterone supplement, you can see testosterone levels just go up. And with that, your strength goes up, your cognition goes up, your energy goes up, your muscle mass goes up, which then has massive positive benefits.

Host 2 (36:01)

Is there any evidence that these microplastics are also linked to this hormone disruption you're talking about?

Dr. Sabine Donai (36:07)

Yes, on bisphenol A. There are loads of trials on that. Okay, so that has been well researched and that's why it is the one that we tend to see as in BPA free. BPA free. Because the awareness has definitely come in and the manufacturers has, I said, have started now to eliminate BPA from a lot of products. Fertility, as we know, is becoming a big problem in women. And male hormones and hormone disruption is a big problem, whether it's anything from prostate cancer to breast cancer, clearly. And then I'm not even talking about cognitive decline. The vast majority of environmental toxins actually have an impact on our hormones. Patients that we do get with cancer, we often check what we call a DNA additive. It's a chemical that actually physically kind of attaches onto your DNA and changes the way DNA expresses itself. And in the main, the DNA addicts we find, particularly in people with breast cancer are those chemicals that actually do change the way you actually responding to your hormones. And there's no doubt that that is then 100% linked to the increased risk of breast cancer or prostate cancer. Without a doubt.

Dr. Federica Amarti (37:16)

We've talked about lots of exposures, touching, breathing, and we've touched on the fact that foods also contribute. So what do know about plastics in our food? What do we know about where they crop up most and which dietary patterns of foods are kind of the worst culprits?

Dr. Sabine Donai (37:31)

Well, when I think of food and plastic, I think there's three different elements to that, isn't it? I mean, there's one is food packaging, which is a big one. I mean, if I'm going to buy my cold sushi, okay, the likelihood that that sushi has been in there for a very long time and it's not been heated, therefore am I really going to be worried too much about getting a lot of plastic from that? That unlikely. But if I would get a takeaway and that is in plastic and they've put a warm curry in there and then I'm going to warm it up in the microwave, that is a big problem. Okay. So I would definitely not do that. So there's contamination to food, but there's in food itself, okay. There are plastics that have been found in food. Clearly the biggest culprit in that would be fish. Even in the wild Alaskan salmon, you find plastics. Now, I think it's mainly in the digestive tracts of the fish that you find the microplastics, those to those, whether it's the shellfish that you would be eating, mussels and things like that, where you eat the whole thing, or whether it's sardines, which are super healthy from an oil point of view, but you tend to eat the whole fish and therefore you eat the intestine with it, where you find most of the microplastics. So the bigger fish, where you actually leave out the intestine tend to be a little bit healthier, but then they've eaten a lot of the small fish, so that accum adds into that. So you can a bit of a catch. 22. Red meat would be the same. Okay. There's a lot of microplastics in the feed to beef.

Host 2 (39:01)

So just to confirm, you're saying fish is bad, but then you're like red meat, which has got nothing to do with the oceans. You're basically saying it's in the same situation as.

Dr. Sabine Donai (39:07)

Well, it's not as bad. I would say fish is definitely on the top. Okay. So then beef would be less than that. Vegetables. We do find microplastics in vegetables because the soil is full of microplastics now. But out of all the foods that we can eat, for sure, I would say the vegetables and the fruit are the least affected. Well, those are the ones that will help actually eliminate them as well. It's a double benefit in saying, well, fine, A, it is very healthy food, least in microplastics, and they will help you eliminate the microplastics. So we're all for that.

Dr. Federica Amarti (39:41)

10 out of 10.

Dr. Sabine Donai (39:42)

Yes.

Host 1 (39:43)

If, like me, as you've been listening.

Host 2 (39:45)

To this podcast, you've realized there are things that you want to change in.

Host 1 (39:48)

Your life in in order to reduce.

Host 2 (39:49)

Your exposure to microplastics.

Host 1 (39:51)

I imagine many of your friends and.

Host 2 (39:53)

Family will feel the same way.

Host 1 (39:54)

If so, please share this episode with them.

Host 2 (39:57)

I'm confident they'll appreciate it. I would like to shift to what can we do about this? It seems pretty clear to me that I can't completely avoid this microplastic. I'm thinking right now, I'm sitting in this studio breathing it in. Could you now tell us about. About actionable advice that also doesn't leave us sort of so paranoid that we're sort of unwilling to live our lives?

Dr. Sabine Donai (40:21)

And I've been down that rabbit hole, okay? I've been there. I said, I can't breathe, I can't eat, I can't sleep. And I think it is all about relativity. I think we need to accept that the world is what it is and then say, what are the easy wins? Okay? There are things we can all do, and the first thing we need to do is put things in perspective. So it is not by touching one receipt that you're going to get plastics in your brain and you're going to get Alzheimer's. Okay, that's clearly not what we are saying, but I think it is about creating an awareness that plastics is not just a problem of the oceans. So what can we do? I think your biggest win, the way I see it and the biggest impact that I've seen people have made is water. There's such a thing called reverse osmosis water. Have you heard of that?

Host 2 (41:11)

Please explain.

Dr. Sabine Donai (41:11)

Okay, so there's water filters and the vast majority of water filters that you might be aware of, they'll take out heavy metals but they won't take out those smaller particles. So reverse osmosis filter is a type of filter that actually really cleans the water completely. It also cleans it from the good minerals because you kind of need to remineralize the water then but they've become quite affordable now. Okay. And therefore it is a good way to somehow say at least when I'm going to be boiling my rice or steaming my vegetables or whether I'm going to drink water or tea or anything. I mean tea is another one we need to talk about. Actually I think I saw you earlier tipping your tea bag. I said there's a lot of microplastics that come from a tea bag.

Host 2 (41:54)

A lot of the newer, more upmarket bags say that they're made from like non plastic compostable from plant. Is that actually going to be fine for me or is it a better option?

Dr. Sabine Donai (42:06)

Yeah, absolutely.

Host 2 (42:07)

And that isn't going to cause these problems because it comes from or loosely leaf tea clearly.

Dr. Sabine Donai (42:11)

For example, I mean in my kitchen I use cling film but I use cling films made from sugar cane. There are now thankfully quite a lot of alternatives. So water, a reverse osmosis I think is a very good option.

Dr. Federica Amarti (42:23)

And Sabine, what do you think about the sort of more accessible filters? The jugs?

Dr. Sabine Donai (42:28)

Yeah, yeah. I mean at home I've got an on the counter one and perfectly fine. I mean we've measured it afterwards and they work very well.

Host 2 (42:34)

Your top tip is water.

Dr. Sabine Donai (42:37)

Correct.

Host 2 (42:38)

What else should I do?

Dr. Sabine Donai (42:39)

I think what would be worthwhile doing always is just avoid warming food in plastic. I think that's not negotiable to start warming food in glass rather than in plastic. I think it's a no brainer. Utensils in the kitchen, whether you use spatula, I mean don't use plastic ones, I mean just use wooden ones. Okay. So they're very easy wins. I think once you start looking around in your kitchen at your say actually do I need to drink out of a plastic bottle of water? No, I mean you can buy a metal bottle which I've got and they inert a soup tin it's made out of metal, so you might think it's fine, but it's lined with plastic on the inside, just like your coffee cup. You go to any coffee shop, okay, you buy some coffee, it's made out of paper on the outside, but it's got a plastic lining on the inside.

Dr. Federica Amarti (43:33)

And going to your kitchen utensils, well, as go back to stainless steel, porcelain, so using things that are like your grandma would have cooked in and less of the plastic coated non stick cookware.

Host 2 (43:44)

So ceramic, glass, metal, not plastic.

Dr. Sabine Donai (43:48)

Exactly.

Dr. Federica Amarti (43:49)

Children's toys nowadays, including things like teething toys, are made of plastic and often coated with the PFAS and other chemicals.

Host 2 (43:56)

So I send my daughter, who's 6, into school every morning with a plastic water bottle. And my son, who's almost 18, I did that similarly for 10. I'm pretty sure gonna tell me that I need to do something differently?

Dr. Sabine Donai (44:10)

No, you need to do exactly that. But put clean water in it and don't put it in a plastic one. You start putting things into perspective and say, okay, as a totality, this is what I can do, this is sensible, and that's all I do. And then I move on. It's a two pronged approach. One is try to reduce input. Okay. And the biggest ones would be water would be physical plastics that you warm your food in to. It is indeed dry cleaning. Clothes try to wear natural fabrics. Am I going to wear only cotton when I go to the gym? No, I wear lycra when I go to the gym. Okay. And I know when I sweat my pores will be a little bit more open. I probably will absorb a little bit. But that is way more comfortable in the gym than wearing something in cotton. So it is about the balance. Okay, for sure. And then it's about what can we do to actually try to eliminate it. And we've got a beautiful detoxification system. And just let's stimulate.

Host 2 (45:04)

What can I do to detox myself of these plastics then?

Dr. Sabine Donai (45:08)

I'm not sure whether detox is the right word because you're never going to get rid of it entirely. But can you eliminate as much as possible? And then it comes down to our gut. The vast majority that we ingest can be eliminated through our gut. As long as you don't have what we call a leaky gut. Soluble fibers are brilliant because what they do is do two things actually. They improve transit through your gut. So this is the speed of things. Okay? So just make sure you get constipated. You can just see that you have more likely to really absorb things in your system. If you actually just have that transit going nice and smoothly, that will help. So that's where fibers come in. That's where water drinking does come in. Bacteria as well help. Things like mushrooms help. There are definitely things we can take. I mean, there was a trial, actually, I think it was with fenugreek. They had water, put a lot of, lot of plastics in there. They put a fenugreek in there and then measured it again. And almost, I think something like 80, 85 of the plastics were gone. Okay. So the fenugreek just kind of completely encapsulated the plastics. Now that is in water, it's not in human, but you can kind of somehow see if that does it in a glass of water. Okay, how is it not going to help in my gut? So there's a lot of fibers that will help. Okra did the same thing that actually just will grab those micro plastics, encapsulate it and through the transit through your gut, actually eliminate it.

Dr. Federica Amarti (46:32)

So you can poop the plastic.

Host 2 (46:34)

And Federica, do I need to take some sort of supplement to get these soluble fibres?

Dr. Federica Amarti (46:37)

No, absolutely not. So it's exactly what we've been talking about diet wise. So it's having your whole grains, your legumes, so beans, peas, lentils, your nuts and seeds, plenty of fruits and vegetables, 30 plants a week, something we talk about a lot at Zoe really helps with that. But also herbs and fragrant spices are really helpful too.

Dr. Sabine Donai (46:53)

Or your berries. Our liver and our gut has got a two phase detoxification process. And that second phase, which helps you, your toxins become more water soluble, it's going to be very helpful to eliminate those plastics. And that's where your greens come in, your broccoli and your kale and your sprouts and your berries, they're really very helpful to really start eliminating and to supporting your detoxification.

Dr. Federica Amarti (47:20)

I was struck when you were talking about the blood brain barrier, the similarities between the blood brain barrier and the gut barrier, they work together. And when we have this inflammation and we really want to help dampen that, and we know that colorful fruits and vegetables like berries help with that as well.

Host 2 (47:33)

So if I can be eating a really good diet that is reducing my inflammation in general, that could potentially be reducing the damage that these plastics are doing that are going to be elsewhere in my body because of what I'm breathing in.

Dr. Sabine Donai (47:46)

I mean, there's enough animal studies that prove that that does make a difference. So if we can Translate an animal to a human, I think we can, and kind of transposition that and say, listen, yes, actually that is gonna make an impact. So that's definitely a strategy I adopt. Okay. And I would advise anybody to do. We can see that the impact of a healthy diet that focuses on elimination and capturing those things makes a difference in the blood levels of the plastics that we're measuring. The ones that we struggling with are the ones that we're breathing in. Then you say, well, how can I eliminate that? Now you've got what we call a glymphatic system, which is the waste disposal from the br. So it's very similar to the lymphatic system in our body, but from the brain. And it's by stimulating that which you do with deep sleep and exercise, which is going to make a difference as.

Host 2 (48:37)

Well, it is possible that your body itself could be pushing these plastics out.

Dr. Sabine Donai (48:42)

I can't prove that because no trials have been done, but it makes clinical sense that that would happen because the particles are small enough to actually get into your brain, they're small enough to actually be as a waste to come out. So if we see, for example, PFAs coming out and we know that that actually gets reduced with the impact of stimulating your glymphatic drainage, I can't see why microplastics wouldn't be doing exactly the same thing.

Dr. Federica Amarti (49:10)

You can get air filters for your home. Some vacuums have HEPA filters in them so that when you are vacuuming, the microplastics get stuck in the vacuum and don't go back.

Dr. Sabine Donai (49:20)

Well, I mean, actually I think it was two weeks ago or three weeks ago, somebody came out with a product that you can just put on any washing machine now that actually captures the microplastics.

Host 2 (49:31)

If you had to give just one piece advice to somebody who's listening to this, what would that be?

Dr. Sabine Donai (49:38)

I think the easiest one would be as in stop cooking with plastic because that's something everyone can do and it's having that awareness of plastic is not just something I can physically. It is something that eventually is going to be internalized and is going to inflame my system. And it's actually fairly easy to control if I'm just becoming aware of it.

Host 2 (50:01)

Sabine, I would like to do a quick summary if that's right. And please correct me because it's a brand new subject. So the first thing that springs to mind is try not to handle any receipts if you can avoid it. They are full of BPA that's going to Reduce your testosterone. It's a big issue for fertility. It's bad for cancer. And I think we're all being told, as we become a bit older as men, that this happens anyway, and you don't really want that. So just say no to the receipt. Your brain is full of microplastics because you're breathing in these microplastics all the time, and there's a sort of highway straight in through your nose. Your water is also full of microplastics, so you're drinking it and everything. If you're drinking through a plastic bottle, and if you're drinking a Starbucks coffee, you are effectively drinking through a plastic bottle. You just didn't think about it. Then again, you're surrounded by this, and your food is also full of microplastics. So it's all slightly terrifying, but you are saying there's very different levels between these. And the reason why this is a big problem is that the plastic isn't a natural substance. Natural substances just get broken down. But because plastic isn't, there aren't all these bacteria and things that are just used to breaking it down. Over, you know, like, a few months.

Dr. Sabine Donai (51:14)

They have found bacteria now that. Breaking down it down.

Dr. Federica Amarti (51:17)

We're getting there.

Dr. Sabine Donai (51:17)

Yeah, they're getting there.

Host 2 (51:19)

But today, if I leave my plastic out, it's not being broken down, and therefore, what you're saying is that it just breaks into these tiny, tiny little pieces. And when we talk about microplastics, they aren't what I thought they were, which is like, very small bits that I can see. They're actually tiny, tiny. And so my water bottle can be full of them, but I can't see it because it's so small. And it's not getting broken down, and it's going into my body, it's ending up getting into my blood and then into everywhere else in these tiny, tiny pieces. Part of the problem is the plastic alone, but part of the problem is these plastics tend to have other chemicals attached to them. And again, we talked a lot about this bpa, because historically that's been used. And so these chemicals are also causing problems. And we talked about how these can affect your hormones, affect fertility, but affect other risks. And then we said, there are things that you can do. And the first thing, which I love that both of you said is, like, put this in perspective, that you can suddenly be obsessed about this. Actually, if you had a choice between this and improving your diet, you'd still say, like, improving your diet is gonna have a bigger impact on your long term health. So, you know, don't say, oh, I'll focus on the plastics and then I'm just gonna eat a terrible diet. So don't get paranoid, but think about what you can do. Water is where there's a lot of plastic. And so you know, Sabine, you're saying in your own house you put in the reverse osmosis water supply that radically reduces the amount of plastic you're doing. And there's also things that don't have to be built in that can just be freestanding. And you use that not just for the water you're drinking, but for cooking.

Dr. Sabine Donai (52:52)

Correct.

Host 2 (52:52)

As well. Don't reheat, you know, takeaways and other things that are plastic in your microwave, which I definitely do. So don't do that. Don't put things into plastic storage that you then reheat. Definitely do. And interesting. You said if you use cling film or Saran wrap, you can get like a sugar cane version of that, something that's like plant based and then you won't have any of these problems.

Dr. Federica Amarti (53:16)

Or do what I do and just put another plate on top.

Host 2 (53:19)

Get rid of your plastic utensils that you cook with because again, you can swap to something that's like wood or metal. You take that out, replace your plastic bottle, reduce the amount of plastics in your clothing where you don't need it, particularly if I'm putting it in the tumble dryer and spraying plastics all over me.

Host 1 (53:36)

And then lastly, really good news.

Host 2 (53:38)

If you're eating the sort of healthy Zoe diet that we talk a lot about, then actually you could be eliminating a lot of this plastic from your gut already. Because these soluble fibers that Federica was explaining or in a lot of the plants and plant varieties we're talking about can help to take this. And if we can be eating a really healthy diet that's reducing inflammation, we should not proven. But you said we should be able to help these processes to sort of help remove this and not have the worst side effects.

Dr. Sabine Donai (54:06)

Definitely.

Host 2 (54:07)

So some light at the end of what feels like a rather dark and depressing tunnel.

Dr. Sabine Donai (54:12)

No, I think there's only light because the moment you have an awareness, you can take an action and I think that can only be positive. Reinforcing a diet that is balanced, that is healthy for you and that is going to help actually clear out the environment that has become quite toxic. It's a win win. No.

Host 1 (54:29)

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Host 2 (54:31)

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Host 1 (54:33)

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Host 1 (54:50)

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