White House includes two Tufts-related initiatives in commitments to end hunger, reduce diet-related disease

Innovative new institute and collaborative alliance led by institute and Kaiser Permanente among initiatives highlighted

Business Announcement

TUFTS UNIVERSITY

 

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CARROTS HARVESTED AT THE NEW ENTRY FARM.

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CREDIT: ALONSO NICHOLS/TUFTS UNIVERSITY

Two Tufts-related initiatives have been included in the White House’s new round of public and private sector commitments, announced today by the Biden-Harris administration, to end hunger, improve nutrition, and reduce diet-related disease in the United States by 2030. The White House Challenge to End Hunger and Build Healthy Communities continues the Biden-Harris administration’s work started at the historic White House Conference on Hunger, Nutrition, and Health that was held in September 2022, encouraging stakeholders from all corners to develop bold commitments to help achieve the administration’s five key pillars of national health.

The first Tufts commitment is the establishment of the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University. The Institute will spearhead a variety of collaborative efforts to implement, evaluate, and integrate food-based nutrition interventions and education to promote health, well-being, and health equity through innovative research, training for health care professionals, patient care, policy development, and community engagement. A university-wide initiative that includes the School of Medicine and collaborates with Tufts Medicine, the Institute is led by Dariush Mozaffarian, a cardiologist, Distinguished Professor, and the Jean Mayer Professor of Nutrition at the Friedman School.

This commitment includes current funding of $15 million, including $10 million in grants and gifts and a new investment of $5 million from the University. Additionally, the Institute will raise $10 million in grants and gifts over the next 5 years, which will be further matched by the University with annual support equivalent to payout of a $10 million endowment. 

“Obesity, diabetes, and other chronic, diet-related conditions are a national emergency, driven by food and nutrition insecurity across the nation. The 2022 White House Conference – the first such national effort in more than 50 years – drew attention to these devastating challenges,” said Mozaffarian, who previously served as dean of the Friedman School. “Food is Medicine is one of the most exciting innovations in health care to leverage the critical role of nutrition in health. The Food is Medicine Institute will advance the evidence around this vision, serving as a catalyst to test and scale Food is Medicine interventions, mobilize public, private, and policy stakeholders, reduce health disparities, and create a more equitable and resilient health care system that recognizes the power of nourishing food.”

The Institute was launched at an event in Boston on Oct. 18.

The second commitment will be a collaboration between the Institute and Kaiser Permanente to develop and co-lead a new National Food is Medicine Network of Excellence, bringing together multiple stakeholders such as health care providers and payers, non-profits, the private sector, professional associations, and academic institutions to engage in collaborative efforts to advance Food is Medicine initiatives.

The Network will lead the nation in collaborative efforts to integrate nutritional interventions that both transform and adapt to existing treatment models, harnessing the latest in research and training to enhance patient care and education as well as raise rates of patient buy-in and participation. Network members will share knowledge and convene leaders surrounding Food is Medicine, develop collective and complementary projects, secure joint funding for activities, and work together on education and advocacy to support testing, scaling, and integration of Food is Medicine into health care systems and communities.

“It’s exciting to bring together these two powerhouses in their fields – Tufts in research and education, and Kaiser Permanente in providing equitable, evidenced-based health care, community investments and research – to form a collaborative national alliance to advance the research and practice of Food is Medicine,” said Mozaffarian.

“We recognize that solving for food and nutrition security goes beyond just giving people food. People’s attitudes toward food, the economic tradeoffs they must make, the stigma around food assistance, and social and culture dimensions all play an important role,” said Pamela Schwartz, executive director for Community Health at Kaiser Permanente. “The Network of Excellence will bring together public and private organizations to make a greater impact on reducing hunger, preventing, and treating diet-related disease, as well as improving health equity.”

The Food is Medicine Institute is a direct and enthusiastic response to pillars 2 (Integrate nutrition and health) and 5 (Enhance nutrition and food security research) of the National Strategy on Hunger, Nutrition, and Health. With the National Food is Medicine Network of Excellence, the Institute and Kaiser Permanente further strengthen their shared commitments to these pillars. Both commitments ultimately seek to create a system where consumption of nutritious food is recognized as a fundamental component of health and health care and where all people and communities have the knowledge, resources, and support to achieve optimal health and health equity through nourishing food.

You may be breathing in more tiny nanoparticles from your gas stove than from car exhaust

Gas stoves emit nanocluster aerosol that may get deep into your respiratory system, study shows

Peer-Reviewed Publication

PURDUE UNIVERSITY

 

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BRANDON BOOR, A PURDUE ASSOCIATE PROFESSOR OF CIVIL ENGINEERING, STUDIES HOW EVERYDAY ACTIVITIES LIKE COOKING ON A GAS STOVE CAN AFFECT INDOOR AIR QUALITY.

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CREDIT: PURDUE UNIVERSITY IMAGE/KELSEY LEFEVER

WEST LAFAYETTE, Ind. — Cooking on your gas stove can emit more nano-sized particles into the air than vehicles that run on gas or diesel, possibly increasing your risk of developing asthma or other respiratory illnesses, a new Purdue University study has found.

“Combustion remains a source of air pollution across the world, both indoors and outdoors. We found that cooking on your gas stove produces large amounts of small nanoparticles that get into your respiratory system and deposit efficiently,” said Brandon Boor, an associate professor in Purdue’s Lyles School of Civil Engineering, who led this research.

Based on these findings, the researchers would encourage turning on a kitchen exhaust fan while cooking on a gas stove. 

The study, published in the journal PNAS Nexus, focused on tiny airborne nanoparticles that are only 1-3 nanometers in diameter, which is just the right size for reaching certain parts of the respiratory system and spreading to other organs. 

Recent studies have found that children who live in homes with gas stoves are more likely to develop asthma. But not much is known about how particles smaller than 3 nanometers, called nanocluster aerosol, grow and spread indoors because they’re very difficult to measure.

“These super tiny nanoparticles are so small that you’re not able to see them. They’re not like dust particles that you would see floating in the air,” Boor said. “After observing such high concentrations of nanocluster aerosol during gas cooking, we can’t ignore these nano-sized particles anymore.”

Using state-of-the-art air quality instrumentation provided by the German company GRIMM AEROSOL TECHNIK, a member of the DURAG GROUP, Purdue researchers were able to measure these tiny particles down to a single nanometer while cooking on a gas stove in a “tiny house” lab. They collaborated with Gerhard Steiner, a senior scientist and product manager for nano measurement at GRIMM AEROSOL. 

Called the Purdue zero Energy Design Guidance for Engineers (zEDGE) lab, the tiny house has all the features of a typical home but is equipped with sensors for closely monitoring the impact of everyday activities on a home’s air quality. With this testing environment and the instrument from GRIMM AEROSOL, a high-resolution particle size magnifier—scanning mobility particle sizer (PSMPS), the team collected extensive data on indoor nanocluster aerosol particles during realistic cooking experiments.

This magnitude of high-quality data allowed the researchers to compare their findings with known outdoor air pollution levels, which are more regulated and understood than indoor air pollution. They found that as many as 10 quadrillion nanocluster aerosol particles could be emitted per kilogram of cooking fuel — matching or exceeding those produced from vehicles with internal combustion engines. 

This would mean that adults and children could be breathing in 10-100 times more nanocluster aerosol from cooking on a gas stove indoors than they would from car exhaust while standing on a busy street.

“You would not use a diesel engine exhaust pipe as an air supply to your kitchen,” said Nusrat Jung, a Purdue assistant professor of civil engineering who designed the tiny house lab with her students and co-led this study.

Purdue civil engineering PhD student Satya Patra made these findings by looking at data collected in the tiny house lab and modeling the various ways that nanocluster aerosol could transform indoors and deposit into a person’s respiratory system.

The models showed that nanocluster aerosol particles are very persistent in their journey from the gas stove to the rest of the house. Trillions of these particles were emitted within just 20 minutes of boiling water or making grilled cheese sandwiches or buttermilk pancakes on a gas stove.

Even though many particles rapidly diffused to other surfaces, the models indicated that approximately 10 billion to 1 trillion particles could deposit into an adult’s head airways and tracheobronchial region of the lungs. These doses would be even higher for children — the smaller the human, the more concentrated the dose.

The nanocluster aerosol coming from the gas combustion also could easily mix with larger particles entering the air from butter, oil or whatever else is cooking on the gas stove, resulting in new particles with their own unique behaviors.

A gas stove’s exhaust fan would likely redirect these nanoparticles away from your respiratory system, but that remains to be tested.

“Since most people don’t turn on their exhaust fan while cooking, having kitchen hoods that activate automatically would be a logical solution,” Boor said. “Moving forward, we need to think about how to reduce our exposure to all types of indoor air pollutants. Based on our new data, we’d advise that nanocluster aerosol be considered as a distinct air pollutant category.”

This study was supported by a National Science Foundation CAREER award to Boor. Additional financial support was provided by the Alfred P. Sloan Foundation’s Chemistry of Indoor Environments program through an interdisciplinary collaboration with Philip Stevens, a professor in Indiana University’s Paul H. O’Neill School of Public and Environmental Affairs in Bloomington.

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JOURNAL

PNAS Nexus

DOI

10.1093/pnasnexus/pgae044 

ARTICLE TITLE

Dynamics of nanocluster aerosol in the indoor atmosphere during gas cooking

ARTICLE PUBLICATION DATE

27-Feb-2024

Nano-sized particles emitted from gas stoves

Peer-Reviewed Publication

PNAS NEXUS

 

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SELECTED MEMBERS OF THE RESEARCH TEAM (LEFT TO RIGHT): XIAOSU DING (PURDUE UNIVERSITY), SATYA S. PATRA (PURDUE UNIVERSITY), CONNOR KEECH (DURAG GROUP), JINGLIN JIANG (PURDUE UNIVERSITY), BRANDON E. BOOR (PURDUE UNIVERSITY), AND NUSRAT JUNG (PURDUE UNIVERSITY).

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CREDIT: BRANDON E. BOOR

A study quantifies the emission of extremely tiny particles by gas stoves and finds that the particles could harm human health. Airborne nanoparticles between 1–3 nm, referred to as nanocluster aerosol or NCA, are known to be bioactive and toxic, but measuring such minute particles has been a challenge. Brandon E. Boor and colleagues measured indoor NCA during propane gas cooking in the Purdue zero Energy Design Guidance for Engineers (zEDGE) test house using a novel instrument. Combining measurement data with the general dynamic equation for aerosols, the authors were able to characterize the production and behavior of the extremely tiny particles during cooking operations such as boiling water and cooking grilled cheese sandwiches. These activities emitted as much as ~1016 NCA/kg of cooking fuel, which is as much as or more NCA than produced by vehicles with internal combustion engines. The air around the stove often had higher concentrations of NCA than urban outdoor air. NCA formed during cooking is inhaled by humans and is delivered to the head airways and tracheobronchial region in large amounts, which is concerning, as flame-generated NCA is known to be toxic. According to the authors, indoor NCA should be considered a distinct air pollution category and should be routinely monitored. 

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JOURNAL

PNAS Nexus

ARTICLE TITLE

Dynamics of nanocluster aerosol in the indoor atmosphere during gas cooking

ARTICLE PUBLICATION DATE

27-Feb-2024

COI STATEMENT

G.S. is a full-time employee of GRIMM Aerosol Technik Ainring GmbH & Co. KG, which has a potential direct or indirect financial interest in the subject matter discussed in the manuscript. C.K. is a full-time employee of DURAG Inc., which has a potential direct or indirect financial interest in the subject matter discussed in the manuscript.

Purdue zero Energy Design Guidance for Engineers (zEDGE) test house, located on the Purdue University campus in West Lafayette, Indiana.

Setup of air quality instrumentation during the measurement campaign in the Purdue zEDGE test house.

particle size magnifier-scanning mobility particle sizer (PSMPS) (IMAGE)

PNAS NEXUS

High-resolution online nanoparticle measurements in the Purdue zEDGE test house via the particle size magnifier-scanning mobility particle sizer (PSMPS) from Durag Group.

CREDIT

Brandon E. Boor

 

NREL-led workshop points to path for clean energy future

Two-day gathering of experts in renewable energy technologies yields reliability recommendations

Peer-Reviewed Publication

DOE/NATIONAL RENEWABLE ENERGY LABORATORY

Participants in a workshop organized by the U.S. Department of Energy’s National Renewable Energy Laboratory (NREL) agree on the importance of mitigating degradation rates for the continuing rollout of clean technologies.

Renewable energy is forecast to play an expanded role in meeting future needs, with terawatts of electricity expected to be generated from wind and solar, so the performance of the technologies involved is becoming increasingly important. Any technology degrades over time, so researchers are looking at ways to curb this issue. Mitigating degradation will become a factor for both national energy security and economic health. At such large scales, clean technologies working as long as possible hold the potential for billions of dollars in savings through improved system performance and longevity.

The recommendations derived from the cross-cutting gathering of scientific minds from industry, universities, and national laboratories come amid an increasing reliance on electricity generation from renewable sources and the White House’s goal of a net-zero carbon emission economy by 2050. More than 50 experts outlined an ambitious pathway that could ultimately become part of industry standards.

The workshop followed a year of regular meetings among NREL researchers.

“We hope to inspire other people and more effort on this,” said Dirk Jordan, a distinguished member of research staff at NREL and lead author of a newly published paper outlining the recommendations. “In the paper, we're making the argument we're at a decent scale in terms of renewable energy. But as we hopefully grow that more and more and there's more emphasis on degradation science and understanding the science behind it, it will really pay off in 10 years. But we have to lay the foundations now and invest more in that.”

The paper, “Nanoscale Science for Terawatt/Gigaton Scale Performance of Clean Energy Technologies,” appears in the journal Joule. The other co-authors, all from NREL, are Steven Hayden, Nancy Haegel, Paul Veers, Shaun Alia, Teresa Barnes, Ashley Gaulding, and Katherine Jungjohann.

The cross-disciplinary, two-day workshop examined the commonalities across various technologies, identified areas for synergistic work, and outlined a path forward. Solar, wind, batteries, and electrolyzers are at various stages of technology readiness and deployment, but all share the same challenge. The participants noted the lack of sufficient, accessible reliability data and urged the strengthening of the feedback loop between manufacturers, research and evaluation laboratories, and field tests.

“Several high-level issues were identified,” Jordan said. “Obviously, there's differences between all those technologies, but there are also commonalities.”

The starting point, the participants pointed out, is the need for reliability data. For various reasons, including proprietary concerns, manufacturers have little incentive to publicize this information, and earlier-stage research often does not reach the step where reliability is tested. National laboratories and international research institutions can play a role here, the paper pointed out, by distilling and de-risking proprietary data for public knowledge. They also emphasized the need for “robust and shared collections of actual degradation and failure data.”

Also considered important is an atomistic examination of a technology, which can reveal stressors and allow for the identification of weak points in the material or structure. The researchers pointed to how microscopic examinations of bearings in the failing drivetrains of wind turbines discovered cracks. Manufacturers were able to use this information to solve the problem of unexpected failures caused by the bearings. This understanding allows for design changes to be made that can mitigate degradation.

The various technologies share “a need for ongoing and expanded attention to degradation mechanisms and mitigation across size scales,” the researchers noted. That includes accelerated tests that take different stressors into account, with that information then used to develop standards.

The researchers said identifying the causes of degradation continues to be a challenge for energy storage and electrolysis. Decades-long work into solar and wind has enabled manufacturers to mitigate the degradation rate for those technologies because equipment failures and performance loss in the field generated new ideas to cure the problems. That research contributed to the development of international standards, which in turn has improved the durability of wind turbines and solar modules. Standards development is needed for the other renewable energy technologies as well, according to the journal article.

“Standards typically lag behind cutting-edge technology,” Jordan said. “It takes time to develop standards. Typically, it's done by a committee and based on volunteers. That’s usually a few years. That's a challenge. But they are necessary to ensure reliability in the future. There's no question about that.”

The publication of this report was funded by the Laboratory Directed Research and Development program at NREL.

NREL is the U.S. Department of Energy's primary national laboratory for renewable energy and energy efficiency research and development. NREL is operated for DOE by the Alliance for Sustainable Energy LLC.

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JOURNAL

Joule

DOI

10.1016/j.joule.2024.01.013 

METHOD OF RESEARCH

Commentary/editorial

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Nanoscale science for terawatt/gigaton scale performance of clean energy technologies

ARTICLE PUBLICATION DATE

27-Feb-2024

 

Teens benefit from "forest bathing" – even in cities

First-of-its-kind study quantifies the impact urban and architectural design features have on adolescent mental health

Peer-Reviewed Publication

UNIVERSITY OF WATERLOO

Youth mental health in urban environments is significantly better when more nature is incorporated into city design. 

A new study from University of Waterloo researchers suggests that forest bathing, the simple method of being calm and quiet amongst the trees, observing nature around you while breathing deeply, can help youth de-stress and boost health and well-being.

The study was the first ever to collect on-site, real-time survey data from adolescents about their emotional responses to various urban environments like a transit hub, residential streets, trails, parks, and waterways. Natural urban spaces were consistently related to significantly higher scores in positive outcomes.

"While the findings may not be surprising to most people, what's significant is that for the first time, we're able to specifically say this is how much anxiety is reduced when kids are by a park as opposed to by a city centre," said Leia Minaker, associate professor in the School of Planning and director of the Future Cities Initiative. 

The Future Cities Initiative is the latest in the University of Waterloo's efforts to address the need to create healthy and prosperous urban futures for all.

After standing and looking at an urban lake for just two or three minutes, youth scores on a validated anxiousness scale decreased by nine per cent. On the other hand, their anxiousness scores were 13 per cent higher when standing in a busy downtown location for the same length of time. This is after adjusting for several other factors, including age, gender, ethnicity, mental health diagnosis, and social status. 

With urbanization accelerating rapidly, it's vital to understand urban environments' impact on youth better. Especially given that depression and anxiety are among the leading causes of illness among adolescents.

The study found that nature motifs or patterns on buildings, natural sights in urban environments, such as lakes and public activity parks, and landscape elements, like gardens and trees, enhance positive emotional experiences for youth. While these urban characteristics are unique to adolescents, they might be interpreted differently from adults who pursue other activities. For example, adults might be more likely to walk or run in green spaces, whereas youth are more likely to skateboard or hang out. 

In designing cities with health and sustainability for all age groups in mind, these findings provide clear evidence that planners, city builders, and healthcare providers can use to advocate for specific natural urban design features. 

"Teens are frequently excluded from any kind of decision about the cities they live in," Minaker said. "It's important to get their opinions and quantify their experiences because childhood experiences influence many long-term health and disease outcomes."

The researchers' next step will be to find a link in the mental health data to the long-term economic and social impacts. Future research will assess the mental and physical health of kids living in high-rise apartment buildings, another area of research that is poorly understood in North America. 

The study, Associations between real-time, self-reported adolescent mental health and urban and architectural design concepts, was recently published in Cities & Health.

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JOURNAL

Cities & Health

 

Diet linked to preeclampsia among low-income Hispanic women during pregnancy

A new USC study suggests that interventions in diet during pregnancy could help address this health disparity faced by Hispanic/Latina women.

Peer-Reviewed Publication

KECK SCHOOL OF MEDICINE OF USC

A research study led by the Keck School of Medicine of USC found that certain combinations of foods consumed during pregnancy may be linked to a higher likelihood of developing preeclampsia, a potentially life-threatening blood pressure condition that can have serious consequences for both mother and baby. 

The study, which focuses on low-income Hispanic women in Los Angeles, suggests that different combinations of foods in a woman's diet during pregnancy have the potential to increase or reduce the likelihood of preeclampsia development, and that interventions in diet during pregnancy may help reduce the risk of preeclampsia.

It is known that Hispanic women develop hypertension disorders during pregnancy more frequently than other groups of women, but little research has been done to date to understand this health disparity or find possible interventions. Preeclampsia, a type of hypertensive disorder that typically develops around the 20th week of pregnancy, can put the lives of the mother and fetus at risk for serious pregnancy complications.

Of the 451 Hispanic women involved in the study, 12% developed preeclampsia, twice the national average of 6%, noted Luis E. Maldonado, PhD, MPH, a postdoctoral scholar and research associate in the department of population and public health sciences at the Keck School of Medicine.

“These findings are alarming and underscore the research need to determine factors driving this health disparity and identify effective interventions to prevent it, said Maldonado, who is lead author of the research which was just published in the Journal of the American Heart Association.

One type of diet appeared beneficial, another type detrimental

To determine if a connection existed between diet and the likelihood of developing high blood pressure disorders during pregnancy, the researchers used data collected by the Maternal and Developmental Risks from Environmental and Social Stressors study, or MADRES, an ongoing prospective pregnancy cohort of predominantly low-income Hispanic women in the Los Angeles area. 

The subjects completed two questionnaires related to their consumption of food and beverages during the third trimester of their pregnancy. The team also collected information on high blood pressure disorders from the women’s medical records.

Based on these diet interviews, the researchers identified two significant dietary patterns. In one, the most consumed foods were vegetables, oils, fruits, whole grains, and yogurt. In the second pattern, the women’s diet consisted primarily of solid fats, refined grains, cheese, added sugar, and processed meat. 

The study showed women who adhered the most to a diet high in solid fats, refined grains and cheese were four times as likely to develop preeclampsia than women who adhered the least to this type of diet.  Meanwhile, women who adhered the most (versus women who adhered the least) to a diet primarily focused on vegetables, oils and fruit were least likely to develop preeclampsia during pregnancy. Among the women who were overweight before their pregnancy, a known risk factor for developing preeclampsia, the effect of eating a diet focused on vegetables, oils and fruit was stronger. 

“The combination of foods in the overall diet during pregnancy appear to be related to preeclampsia and this research gives important insight into which food combinations may confer protection or detriment,” said Maldonado. “Diet is a modifiable lifestyle factor which provides a potential intervention point during pregnancy. Our findings suggest low-income Hispanic women at greater risk for preeclampsia may benefit from dietary guidance during prenatal visits to improve intakes of certain combination of foods such as vegetables, oils, and fruit.”

Comparison to Healthy Eating Index 

The researchers also used the dietary information collected to determine how well the women’s diets scored on the Healthy Eating Index and to evaluate whether this metric could shed light on dietary habits that either heighten or diminish the likelihood of developing preeclampsia. The Healthy Eating Index is a measure of diet quality based on recommendations developed by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. 

Although having a higher score on the Healthy Eating Index, which indicates a higher quality diet, was associated with fewer cases of preeclampsia, the relationship was not statistically significant except in the case of women who were overweight prior to becoming pregnant. 

Maldonado noted that the Healthy Eating Index, which is based on dietary recommendations for the U.S. population as a whole, may not be the most suitable guidelines for the prevention of preeclampsia or other hypertension disorders during pregnancy among low-income Hispanic pregnant women based on the study’s findings.

Based on this data, however, Maldonado said the evidence suggests that a diet of vegetables, oils and fruits appears to be most beneficial diet among the diets evaluated in the study for reducing the likelihood of developing preeclampsia among low-income Hispanic women. “In general, further research is still needed to understand which combination of foods in the overall diet are most optimal for the prevention of preeclampsia.”

About this study

Additional authors of the study include Theresa M. Bastain, Carrie V. Breton, Thomas Chavez, Sandra P. Eckel, Shohreh F. Farzan, Brendan H. Grubbs, Rima Habre, Laila A. Al Marayati, and Tingyu Yang of the Keck School of Medicine of USC; Genevieve F. Dunton of the Keck School of Medicine and the USC Department of Psychology; and Claudia M. Toledo-Corral from California State University, Northridge.

This research was supported by grants from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center (P50ES026086, 83615801-0, P50MD01570) funded by the National Institute of Environmental Health Sciences, the National Institute for Minority Health and Health Disparities and the Environmental Protection Agency; the Southern California Environmental Health Sciences Center (P30ES007048) funded by the National Institute of Environmental Health Sciences, and the Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory health (LA DREAMERs) (UH3OD023287), a Zumberge Diversity and Inclusion Research Award to Dr. Farzan and an ECHO Diversity Supplement to Dr. Maldonado (UH3OD023287-06S1) funded by the National Institutes of Health Office of the Director ECHO Program.

 

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JOURNAL

Journal of the American Heart Association

DOI

10.1161/JAHA.123.029848 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Maternal Dietary Patterns during Pregnancy are Linked to Hypertensive Disorders of Pregnancy among a Predominantly Low-Income U.S. Hispanic/Latina Pregnancy Cohort

ARTICLE PUBLICATION DATE

27-Feb-2024

 

Exposure to secondhand smoke during chemotherapy makes treatment less effective, study shows

Research considered first to examine role of secondhand smoke

Peer-Reviewed Publication

UNIVERSITY OF OKLAHOMA

 

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LURDES QUEIMADO, M.D., PH.D.

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CREDIT: UNIVERSITY OF OKLAHOMA HEALTH SCIENCES

People who are diagnosed with head and neck cancer often receive a standard type of chemotherapy as part of their treatment. If they are exposed to secondhand smoke during chemotherapy — even if they have never smoked themselves — the treatment may be far less effective at killing cancer cells. That finding, considered the first of its kind, was revealed in a study recently published by researchers at the University of Oklahoma Health Sciences.

Tobacco use is a well-established risk factor for cancer and a signal of poor outcomes, especially if a person continues to smoke during treatment. However, researchers have understood much less about the effects of secondhand smoke on cancer treatment. Lurdes Queimado, M.D., Ph.D., a professor of otolaryngology at the OU College of Medicine, led the investigation into secondhand smoke exposure, which was published in the International Journal of Molecular Sciences. Her findings have major implications for cancer patients and the physicians who treat them.

“Head and neck cancer is the sixth most common cancer worldwide and is prevalent in Oklahoma, where we also have a high rate of smoking. This is the first time that researchers have examined the impact of secondhand smoke exposure on cancer patients and the mechanism of why it is happening. Our studies will continue, but we think it is important to raise awareness now that people who are exposed to secondhand smoke during treatment will likely have a worse prognosis,” said Queimado, who also directs the Tobacco Regulatory Science Lab in the TSET Health Promotion Research Center, a program of OU Health Stephenson Cancer Center.

In her laboratory, Queimado and her team exposed head and neck cancer cells to secondhand smoke for 48 hours (a control group of cancer cells was not exposed to secondhand smoke). Simultaneously, the cells were treated with cisplatin, a chemotherapy drug commonly used to treat head and neck cancer. The findings were significant: Twice as much chemotherapy was needed to kill the cells than would have been necessary without exposure to secondhand smoke. In addition, the cancer cells that survived chemotherapy treatment were much more likely to replicate indefinitely.

“This was concerning to discover because not only was the effectiveness of the chemotherapy cut in half, but the cells that survived were able to divide and create huge colonies of cancer cells,” Queimado said. “If the chemotherapy can’t kill all the cancer, it will come back. And it will come back sooner because the cells are dividing so quickly. In addition, we cannot simply double the amount of chemotherapy we give to patients because it would be too toxic.”

Queimado and her team took the research a step further to understand how secondhand smoke decreases the effectiveness of chemotherapy. They found that secondhand smoke alters the expression of several proteins involved in drug resistance, effectively restricting chemotherapy’s ability to do its job.

“Cisplatin kills cancer cells by binding to their DNA and keeping the cells from dividing,” she said. “But if cisplatin can’t get into the cell, it’s not going to kill it. Essentially, there are doors to the cancer cells that control how cisplatin gets in and out. In the presence of secondhand smoke, there were fewer doors for cisplatin to enter, and there were many more doors for cisplatin to exit. So not only is less cisplatin getting into the cell, but more of it is leaving the cell before it has a chance to kill it.”

Greg Krempl, M.D., professor and chair of the Department of Otolaryngology – Head and Neck Surgery in the OU College of Medicine, said Queimado’s study broadens the importance smoking cessation during cancer treatment.

“For patients with tobacco-related cancers, smoking cessation has been shown to improve survival, so it is a part of comprehensive cancer treatment plans. This study provides novel data that would suggest including family members in the smoking cessation plan to reduce secondhand smoke exposure during chemotherapy for head and neck cancer may improve outcomes,” Krempl said.

According to tobacco use data, more than 20% of nonsmoking U.S. adults are exposed to secondhand smoke. Exposure is highest among Black people, those living in poverty, and children ages 3 to 11. Each year, secondhand smoke exposure causes more than 41,000 deaths among nonsmoking adults and 900 deaths in infants.

This new study points to the ongoing public health ramifications of both active smoking and exposure to secondhand smoke, said Balaji Sadhasivam, Ph.D., an assistant professor of occupational and environmental health at the OU Hudson College of Public Health. Sadhasivam was the lead author of the research publication.

“Even though this study was conducted in the laboratory, it closely mimics human exposure to secondhand smoke,” Sadhasivam said. “If cancer patients live with someone who smokes, it is important for them to avoid being exposed to smoke while they are being treated. We want to do everything we can to help people have better outcomes from their treatment.”

Cisplatin is the preferred type of chemotherapy for treating head and neck cancer, Queimado said, but physicians may want to consider another drug if they know their patients will be exposed to secondhand smoke during treatment. However, secondhand smoke exposure may affect other drugs, including non-cancer treatments.

“The proteins affected by secondhand smoke are not specific for cisplatin; they are involved in resistance to other drugs. We have not studied that yet, but it is likely that secondhand smoke decreases the effectiveness of several types of drugs.”

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JOURNAL

International Journal of Molecular Sciences

DOI

10.3390/ijms25021032 

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

Cells

ARTICLE TITLE

Exposure to Secondhand Smoke Extract Increases Cisplatin Resistance in Head and Neck Cancer Cells