What is lead doing in protein powder?

Tegan Taylor: Are you a protein powder consumer typically, Norman?

Norman Swan: No, but I’m in a household with teenage boys, and they’re consuming it in vast quantities, I have to say. Despite dinner table conversations about protein and getting them to listen to What’s That Rash?, which they don’t do, we are heavy consumers of protein power.

Tegan Taylor: Fair enough. I’ve just realised I left my Mediterranean diet bell on my desk, and I think I’m gonna need it, so I’m just gonna go and grab it. 

Norman Swan: Hum-di-hum-di-hum-di-hum…Mediterranean diet, Mediterranean diet…where’s the bell? Where’s the bell?

Tegan Taylor: Two hours later. [rings bell]

Norman Swan: I mean, I’ve just been sitting here for ages. We’ve managed to edit the time that you’ve been away for our listeners so they didn’t have to go through what I’ve just gone through to wait for you to come back with your bell. 

Tegan Taylor: It wasn’t that far. I’m pretty fast.

Norman Swan: But this week on What’s That Rash?, the show where we answer the health questions everyone asking, we’re talking about lead in protein powder.

Tegan Taylor: Indeed we are. So today’s question comes from Connor, who says, ‘I’m not much of a gym person, preferring outdoor exercise, but after a layoff I’m starting to exercise (run) a lot more, and a friend has gifted me a massive tub of protein powder ‘for recovery’. I eat well,’ says Connor, ‘I’m not sure I need the powder, but I do love a milkshake so it won’t go to waste. But a recent study caught my attention with regards to heavy metals found in surprisingly high levels in some protein powders. Are they high enough,’ Connor asks, ‘to have a negative accumulative effect? Does this risk mitigate any positive health benefits from flavouring my milkshake with delicious vanilla protein powder?’ And he sent us a study by Consumer Reports. Lynn has also sent us this same Consumer Reports page asking us if there really are any risks of lead in protein powder. Of all of the things I thought to worry about, Norman, this wasn’t one of them.

Norman Swan: Microplastics, ultra-processed…well, these are ultra-processed foods, as the case may be.

Tegan Taylor: Well, that’s true. 

Norman Swan: I mean, it’s not (okay, I’ll give you the chance) the Mediterranean diet…[bell rings]…I didn’t want that trip back to your desk to be wasted.

Tegan Taylor: I’m trying to foreshadow, I’m not being very elegant about it. Don’t worry, it will make sense soon. One thing I think I should say as a bit of a caveat to preface this discussion is we will not talk in much detail today about the benefits of protein powder because we literally have done a whole episode on What’s That Rash? about protein and whether the protein supplements work. So we will link in the show notes to our episode: how much protein do you really need? And my memory of that chat, Norman, is that not only was it informative, it was also very fun, as all of our chats are.

Norman Swan: Very fun, as teenage boys would say after they’ve eaten their protein powder.

Tegan Taylor: How would lead get into protein powder to start with?

Norman Swan: Well, just to summarise the research, the American research found significant quantities of lead in protein powders. And if you had protein powder every day, you would exceed at least the Californian suggested daily limit for lead intake, perhaps not other states in the United States. By the way, we don’t have a limit in Australia, but we’ll come back to that later. 

They go light on how it might have got in there, but there are various sources. So, lead in the environment stays in the environment. It doesn’t disappear, it just stays there. So you’ve got lead in soil, and in parts of the world where you’ve got lead smelters, and we’ve had lead smelters in Australia, Port Pirie, for example. Lead in paint in older houses. Lead was a common component of paint before paints were modernised.

Tegan Taylor: It made it shinier. I always wondered why they put it in and I’m, like, why would you put this thing in the paint? But it made the paint shinier, and it made our petrol give your car more power, so that’s why it was in petrol as well for a while.

Norman Swan: And lead was used on roofing a lot because it was very malleable and could seal between tiles and gutters and so on. There’s still lead in car batteries if you don’t have an electric car, you’ve got a regular car, lead acid batteries. So even though they’ve eliminated a lot of lead from our environment, there’s still a fair bit around and they’re just assuming that it’s coming from various sources. 

And of course in vegetarian protein powders, the dominant protein is pea protein. You get a lot of pea protein in non-vegetarian as well, along with whey. But you might just have a few peas on your plate with your steak, that’s not going to give you much lead, but when you’ve got a massive concentration of peas to make the powder, then that lead can get concentrated from the environment. So that’s the theory as to how it gets in. But there are various sources. You can get machines that might be machining the vegetables that might have some lead in them, we don’t know.

Tegan Taylor: So just to put people’s minds at rest, what was the upshot of…this Consumer Reports study looked at a whole lot of different types of protein, different batches and over different time periods to make sure they were getting a fairly representative sample of the powders. How concerned should people be about lead, given that we’re about to tell them just how very bad it is for your body to have lead in it? 

Norman Swan: Well, you wouldn’t choose to consume lead by choice in reasonable amounts. And therefore if you are taking protein powder for health reasons and there’s lead in there, and you are not controlling necessarily your protein intake, in other words you’re taking plenty of these protein powders, you could actually be taking in a significant quantity. And if it’s teenage kids taking it when they’ve still got growing bodies, children are those who are affected most by lead in the environment.

Tegan Taylor: So Norman, I feel like lead is one of those things that people are like, hm, lead, not good, don’t want that in my body. But can we just maybe recap what the effects of it are? Because you can either have acute lead poisoning or you can have long-term chronic exposure, which carries its own health risks.

Norman Swan: When you consume it, our body stores it, particularly in our bones, and it can leach out of your bones for years to come. So for most people, lead problems are a chronic problem over a matter of years, because it can take a long time for you to get rid of lead from your body. Lead interferes with all sorts of metabolic processes. It increases oxidative stress, which is biological rusting. It can interfere with how sodium and calcium get…so sodium and calcium are important ions in the body which help how nerves communicate with each other, help blood pressure, how our heart and arteries work, all sorts of things in our body. And lead can get in the way of all that. It just starts to interfere in replacing some of these ions in our body with lead. So it’s everywhere, and particularly in the brain, and particularly in children, affecting neurological development. 

Tegan Taylor: Kids are vulnerable in a couple of different ways. Partly it’s behavioural because they’re more likely to put things in their mouths that might contain lead, like chips of paint or dirt that might contain lead. But then also their bodies are smaller, their brains are still developing, and the barrier between…basically their brains are a bit more porous to lead, if I’m not mistaken.

Norman Swan: That’s what they think, yes, that they absorb more, and more gets transmitted around the body.

Tegan Taylor: And then of course they’re then living with those lead effects throughout their whole lives. 

Norman Swan: But of course there’s a long history to our exposure to lead.

Tegan Taylor: Yeah, so it’s something that’s been used by humans for a really long time, and humans have also known for a pretty long time that it’s bad for us, at least in acute amounts. 

Norman Swan: Nicander, a Greek physician and poet in the 2nd century BC, wrote one of the earliest descriptions of lead poisoning. 

Tegan Taylor: He called it gleaming, deadly white lead. Then there’s another one, Nero’s physician, Dioscorides, said lead makes the mind give way. So, like you were saying before, there is this sense of it disrupting our neurons, affecting our cognition.

Norman Swan: They used to have wine glasses made of lead.

Tegan Taylor: Okay, so this is where it gets kind of…it’s not fun, it’s terrible, people died, it’s bad. But the fact that we know so much about how bad lead is now makes the way that we used to use it seem almost ridiculous, because…did you know that lead actually has a flavour?

Norman Swan: It sweetened wine.

Tegan Taylor: It sweetens. So if your vegetables tasted bitter, if you cooked them in a lead pot or a pot with lead in it, it would make them taste a bit sweeter. It was used in the wine vessels, like you said, but it was also used basically as a preservative. So if you were Greek, you added pine tree resin, but if you were Roman, you might have used something called sapa, which was basically like grape juice concentrate, but the vessel that they would cook to reduce the grape juice in would often be made of lead, and so the lead would leech into the liquid, it was cooked for a long time. It’s quite acidic, and it would make it taste really sweet. Would you like to hazard a guess as to how much lead we’re talking about, like in terms of concentration? For reference, the protein powder, the highest amount that we found in the protein powder was 7.7 micrograms per serving. How much do you reckon is in sapa? 

Norman Swan: I can’t imagine.

Tegan Taylor: One gram per litre, one gram of lead per litre. So we’re talking 1,000th of your litre of sapa is lead.

Norman Swan: Yeah, and Herb Needleman, who is the American researcher who we had on the Health Report in the early days of the Health Report, and his research really got lead removed from petrol, and he looked at the history here, and he reckoned that the high prevalence of gout in Roman society was actually due to lead poisoning. 

Tegan Taylor: Yes, it’s called saturnine gout, which…honestly, I think I might need to start a heavy metal band just so I can call it that.

Norman Swan: Indeed. 

Tegan Taylor: And this is why I brought my Mediterranean diet bell in, because, honestly, arguably having high levels of lead in your food is the original Roman diet at least, if not Mediterranean. Did you also know, to stick with alcohol and lead poisoning, that saturnine gout can often be a problem for people who’ve made moonshine, because if they’re using…

Norman Swan: Oh, the piping.

Tegan Taylor: Yeah, so if they’re using an old car radiator or something like that to brew their illicit booze, the solder sometimes used in manufacturing those things has lead in it, and it leeches into the moonshine. 

Norman Swan: And probably what I didn’t make clear earlier is that a lot of piping in the olden days, and still to some extent in older houses where it’s just not been found and removed, were made of lead, just again because of its malleability. 

Tegan Taylor: Well, do you remember what lead’s atomic name is on the periodic table?

Norman Swan: Pb.

Tegan Taylor: Yes, Pb, plumbum, where our word ‘plumbing’ comes from, and the word ‘plumber’, because pipes used to be made of lead.

Norman Swan: You’re on fire today, historical fire.

Tegan Taylor: History, etymology, there’s nothing about this…gory, ancient diseases, there’s nothing about this conversation I don’t love.

Norman Swan: As a Brisbane girl, I’m going to let you tell the Brisbane story here, because we made history in Australia. 

Tegan Taylor: Are you talking about Gibson and Turner? 

Norman Swan: I am, at Brisbane Children’s Hospital.

Tegan Taylor: So, this actually shocked me because it’s so much earlier than I thought. So, like I said before, we’ve known for literally thousands of years that high doses of lead can cause lead toxicity. What we didn’t really know until relatively recently was that chronic exposure to lead can also be really bad for you. I think I thought that the key dates around here were around the 1960s. I was thinking about when lead was being removed from products, but what I didn’t realise is that the first kind of proper published work around it was in the 1800s by two Australian physicians, Gibson and Turner, the first to publish the connection between clinical presentation and the lead content of house paint. And it wasn’t until some decades later…

Norman Swan: And this was in children, with severe neurological disease.

Tegan Taylor: Yes, exactly. And it was sort of dismissed, I think, by the international community as being just a bit of a…I mean, as much as I tease you about being old, Norman, you weren’t around in the 1800s, and here I was about to ask you! But your reading of this? How was it received?

Norman Swan: Well, it obviously wasn’t received with a radical change to the world around them, because the first people to…historically the first people to talk about environmental risk when there’s so much investment in the mining industry, it would not have been particularly well received, and it took another 70 years for a legislative reduction of lead in domestic paints to take place, even though in 1892 they made their first description. So it just shows you the lead time. 

Tegan Taylor: One thing you hinted at before but we didn’t actually put numbers around, was the so-called safe levels of lead, which, as I understand it, there is no recognised safe level of lead, but there is a kind of baseline exposure, because it is in the environment that we’re all exposed to, to varying extents.

Norman Swan: So the Americans set minimum levels, California being amongst the lowest. But we don’t set any minimum level here, and I assume that’s because we’ve accepted in Australia that there’s no safe level, therefore no levels are adequate here. Any lead exposure is bad.

Tegan Taylor: To sort of benchmark us in some sort of way, I mentioned before, 7.7 micrograms per serving in the highest amount that they found in this protein powder. I think we can all agree that’s a lot less than one gram per litre of sapa in Roman times. But how does that compare to other exposures that we know about?

Norman Swan: The US would say, on average, 2.2 micrograms a day for children and 8.8 micrograms a day for women of child bearing age. You wouldn’t want to exceed either of those. So you can see that at 7.7 out of a scoop, albeit that’s the maximum level, it’s getting pretty close to the daily intake for adults, much less children, so it’s not nothing. And the issue here is, in the past, lead poisoning was blamed for the fall of the Roman Empire.

Tegan Taylor: Oh, that along with everything else. I do like the idea that it was lead poisoning, but every single podcast I listen to about the Roman Empire is like; and that was the fall of the Roman Empire.

Norman Swan: That’s right, the Mongols didn’t have lead. Oh, I’m sure they did. But the point here is it’s close to what would be the maximum intake and that’s just from one scoop of the highest lead concentration in protein powders in the United States. You may say, well, we’re not talking here necessarily about acute lead poisoning with all the manifestations we’ve been talking about, but particularly in children we’re talking about subtle effects which lower IQ, lower school performance, and in adults could increase the risk, along with everything else in our environment, of kidney damage, of high blood pressure and maybe even increased risk of dementia. So this in the environment just increases the likelihood of other things going wrong, rather than full-on lead toxicity itself, and that’s the problem here.

Tegan Taylor: I would also add there that it’s not evenly distributed across the population, the risk of exposure. So this isn’t talking about protein powder, this is talking about passive environmental exposure to lead. Because if you’re living in an area that’s had a lot of trucking, for example, with leaded petrol in years gone by, or a place with high levels of lead paint because maybe it’s cost prohibitive to get rid of it, you’re more likely to perhaps be in a lower socio-economic level. And so the people who are at most risk of these harms of lead poisoning are often people who are already vulnerable for lots of reasons.

Norman Swan: Now, in Australia we don’t really know what the levels are in protein powders. The protein powders studied in the United States can be imported into Australia, you can buy them online. So we just don’t know who’s consuming what. There is lead in the Australian food supply. Not a lot of it, but there is some. And on the precautionary principle, which we talk about a lot on What’s That Rash?, you would rather avoid it. And here’s the thing; do you really need the protein powder?

Tegan Taylor: And this is where we come back to our previous episode on What’s That Rash? of, like, do you need to supplement with protein? And you can go and listen to that. I think where we kind of got to there was that there were maybe some groups of people who do benefit from that, especially people who maybe have a limited diet for whatever reason, perhaps they’re older, or perhaps they have other dietary restrictions that mean supplementing is useful for them. But a spoiler alert; a normal, healthy person, you’re probably much better off getting the protein that you need from a balanced diet that matches up with the Australian dietary guidelines. 

Norman Swan: Yeah, and you can boost your protein using that. But there’s no question, as you get older you do need more protein, and if you’re frail and you don’t have an appetite, then supplementary powder is maybe what you need. But perhaps choose an Australian made one, rather than something that’s made in the United States.

Tegan Taylor: Well, Australian made ones we have no data on, and the ones from the US we have data on and it’s worrying. Which one is better, Norman?

Norman Swan: I think just shut your eyes and swallow.

Tegan Taylor: Close your eyes and swallow. That’s one piece of advice from Dr Norman Swan. I will remind you, Norman, of what you told me last time, which you said…

Norman Swan: God, I hate being reminded of what I might have said in the past. Go on. What did I say?

Tegan Taylor: Okay, you said you have to be careful about what ultra-processed foods you eat. Of course protein powders are an ultra-processed food, but these protein powders are mostly okay. Be protein aware; how much do you need for your age, your needs and what your objectives are. Do you still stand by those statements, Dr Swan?

Norman Swan: That sounds remarkably sensible. I wonder where I got all that from? Work out whether you really do need protein powders, given that there’s a chance that there is lead in them, particularly if you’ve imported them from overseas, you just don’t know what’s there. But we don’t know in the Australian context either. If you are taking them, don’t go mad with them, and ideally take your protein from food.

Tegan Taylor: Are you going to give any stronger recommendations to the teenage boys that live in your house?

Norman Swan: It’s going to be an interesting dinner conversation tonight, and I’ll feed-back, I’ll let you know. 

Tegan Taylor: I definitely want to hear what their response is. ‘What would you know?’

Norman Swan: Yeah, ‘Show me the scientific paper.’

Tegan Taylor: Yeah, like, listen to What’s That Rash?, you would get it if you listened.

Well, Connor and Lynn, thank you both so much for asking us a question. You can ask us your questions by emailing thatrash@abc.net.au, which is also where you can send any feedback you have for us.

Norman Swan: What’s in our mailbag?

Tegan Taylor: So Ophelia has messaged in, in response to our episode on fragrances, saying, ‘Hi there. Your episode on scents reminded me of a trial I’ve seen looking into lavender in the treatment of PTSD. I’d be so curious to hear about where the research is at on this, as it’s hard to understand how this could work with such a complex illness.’

Norman Swan: Well, it is a complex illness. This trial that’s being done is being conducted by Professor Michael Berk, who is a world authority, by the way, on bipolar disorder, so he’s one of our leading research psychiatrists, and the argument here is…this is a drug company sponsored trial, so this is concentrated lavender oil in a capsule, and anxiety is part of post traumatic stress disorder, and the idea here is that one element of…if I understand the trial correctly, one element of PTSD, which is crippling, is anxiety. And the question is, is this concentrated lavender oil effective in breaking up the anxiety of PTSD? Not necessarily a cure for PTSD itself, but helping one of the disabling symptoms with few side effects. We don’t know the answer to that question yet, but that’s what sits behind it. PTSD is complex, and maybe we’ll deal with it in a future What’s That Rash?.

Tegan Taylor: Well, Ophelia has added a PS to her message, Norman, saying, ‘I have a theory on why cats are attracted to Norman, despite his dislike for them.’ Would you like to know what it is? 

Norman Swan: Yeah, what is it? 

Tegan Taylor: Ophelia says, ‘I’m guessing his body language is viewed as very polite if he’s avoiding staring at them,’ which says to me…cats are so capricious. You look at them, they don’t want to be friends with you. You don’t look at them, they want to be friends with you.

Norman Swan: So I’m making them work to be my favour.

Tegan Taylor: Treat ’em mean, keep ’em keen. Paul has also written in referencing your cat dislike, Norman. Paul says, ‘In the recent episode about perfumes and fragrances, Norman indicated that his armpit was not particularly scented. Knowing his opinion on cats,’ Paul writes, ‘I thought you might like to know that cats love male human armpits.’ Paul continues, ‘Both my last two cats have gone into apoplexies of ecstasy when snuffling into my armpit after exercise, and having brought this behaviour up in conversation with friends, I know it’s not uncommon. Cats love to snuffle sweaty armpits and seem to prefer male armpits. I don’t know if this information will improve Norman’s opinion of cats, but I would love to know why cats are so attracted to my armpit.’

Norman Swan: Oh, gross. No, when I suggested that I don’t use strong scents, I do use something. And I haven’t noticed cats heading for my armpit, but if they do, then I’ll know I need to do something about my armpits.

Tegan Taylor: That’s right, it’s time to have a shower. If a cat is snuffling your armpit, it’s shower time. Well, you can send your letters of any stripe, cat stripe or otherwise, to thatrash@abc.net.au.

Norman Swan: And we’ll see you next week, protein powder or not.

Tegan Taylor: See you then.