"Very Hot" Drinks like Tea May Give You Cancer - But Coffee Won't

The World Health Organization just reversed 25 years of warnings about coffee causing cancer - and unleashed a tidal wave of concern for tea drinkers.

"Very Hot" Drinks like Tea May Give You Cancer - But Coffee Won't


Coffee drinkers of the world, rejoice! The World Health Organization just reversed 25 years of warnings and decided that coffee will not give you cancer. In fact, coffee may even protect against certain kinds of cancers.

The report was released by the International Agency for Research on Cancer, a cancer-focused research arm of the WHO. Published in The Lancet Oncology, the IARC asked 23 researchers to review more than 1,000 studies of coffee consumption for both humans and animals. IARC determined that there was "inadequate evidence" of coffee causing pancreatic, breast, bladder or prostate cancers, and "reduced risks" of causing liver or uterine cancers. For more than 20 other cancers, the evidence showing a correlation between coffee and cancer was inconclusive.

However, the IARC cautions that very hot drinks “over 65℃” or 150℉ might actually cause cancer. That finding applied to every hot drink from plain heated tap water to tea. “These results suggest that drinking very hot beverages is one probable cause of esophageal cancer and that it is the temperature, rather than the drinks themselves, that appears to be responsible,” IARC Director Dr. Christopher Wild stated in a press release.

Those are wonderful results for coffee drinkers.

I am a tea drinker.

Coffee does not like me. Tea does. I drink tea every single day, have more varieties in my kitchen than I remember purchasing, and frankenstein my own flavors (including the white peach apple strudel blend I’m drinking while writing this). Telling someone like me that drinking hot liquid may give me cancer -- despite contradictory research showing that green tea might prevent certain cancers -- is infuriating. So I did what I do best when searching for an answer: read.

A 2009 study of tea drinkers in the British Medical Journal cited that, “esophageal cancer was eight times as common among people who drank "very hot" tea, compared to warm or lukewarm tea drinkers.” The correlation worked in reverse as well, with the study stating “by the same comparison, hot tea drinkers were twice as likely as warm or lukewarm tea drinkers to have esophageal cancer.” Tea temperatures for more than 48,000 people were confirmed via digital thermometer for this study, with the “very hot” temperatures averaging 70°C or 158℉.

Those findings were also confirmed by South American studies of mate drinkers. Mate is a strong herbal infusion that is consumed piping hot through a metal straw. A 2010 study published in NCBI cited that, “the effect of maté drinking on the risk of head-and-neck cancers was borderline significant” and “the increased risk associated with maté drinking was more evident in never-smokers and never-alcohol drinkers than in other individuals. Our study strengthens the evidence of an association between maté drinking and esophageal cancer.” Those findings were confirmed yet again in a 2015 longitudinal study in BMC Cancer. The need for confirmation is especially great given that esophageal cancer is the 8th most common kind of cancer in the world.

IARC Cancer Graph.jpg

Distressing as that sounds, the IARC study was purely observational. Cause and effect were not conclusively determined. Also, the effects may be related to the kind of tea favored by participants (black) than other kinds of tea or hot drinks rather than just the temperature it’s consumed at. All the BMJ study showed was that that very hot liquid was more likely to injure cells in the esophagus, which could create opportunities for cancer cells to grow. Besides, as the WHO acknowledged in their press release, there are far more direct causes of esophageal cancer:

Smoking and alcohol drinking are major causes of esophageal cancer, particularly in many high-income countries. However, the majority of esophageal cancers occur in parts of Asia, South America, and East Africa, where regularly drinking very hot beverages is common and where the reasons for the high incidence of this cancer are not as well understood.

The best way to get a definitive answer as to its causes would be to replicate this study -- and perform it again after letting hot drinks cool down. “It is difficult to imagine any adverse consequences of waiting at least four minutes before drinking a cup of freshly boiled tea, or more generally allowing foods and beverages to cool from 'scalding' to 'tolerable' before swallowing,” notes David Whiteman of the Queensland Institute of Medical Research.

Until then, fellow tea drinkers, we’ll have to blow the steam off our cups and wait. Or, we can be encouraged by Dr. David Agus’ roundup of the the latest cancer fighting techniques:

 

Feature image credit: Getty Images

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Gain-of-function mutation research may help predict the next pandemic — or, critics argue, cause one.

Credit: Guillermo Legaria via Getty Images
Coronavirus

This article was originally published on our sister site, Freethink.

"I was intrigued," says Ron Fouchier, in his rich, Dutch-accented English, "in how little things could kill large animals and humans."

It's late evening in Rotterdam as darkness slowly drapes our Skype conversation.

This fascination led the silver-haired virologist to venture into controversial gain-of-function mutation research — work by scientists that adds abilities to pathogens, including experiments that focus on SARS and MERS, the coronavirus cousins of the COVID-19 agent.

If we are to avoid another influenza pandemic, we will need to understand the kinds of flu viruses that could cause it. Gain-of-function mutation research can help us with that, says Fouchier, by telling us what kind of mutations might allow a virus to jump across species or evolve into more virulent strains. It could help us prepare and, in doing so, save lives.

Many of his scientific peers, however, disagree; they say his experiments are not worth the risks they pose to society.

A virus and a firestorm

The Dutch virologist, based at Erasmus Medical Center in Rotterdam, caused a firestorm of controversy about a decade ago, when he and Yoshihiro Kawaoka at the University of Wisconsin-Madison announced that they had successfully mutated H5N1, a strain of bird flu, to pass through the air between ferrets, in two separate experiments. Ferrets are considered the best flu models because their respiratory systems react to the flu much like humans.

The mutations that gave the virus its ability to be airborne transmissible are gain-of-function (GOF) mutations. GOF research is when scientists purposefully cause mutations that give viruses new abilities in an attempt to better understand the pathogen. In Fouchier's experiments, they wanted to see if it could be made airborne transmissible so that they could catch potentially dangerous strains early and develop new treatments and vaccines ahead of time.

The problem is: their mutated H5N1 could also cause a pandemic if it ever left the lab. In Science magazine, Fouchier himself called it "probably one of the most dangerous viruses you can make."

Just three special traits

Recreated 1918 influenza virionsCredit: Cynthia Goldsmith / CDC / Dr. Terrence Tumpey / Public domain via Wikipedia

For H5N1, Fouchier identified five mutations that could cause three special traits needed to trigger an avian flu to become airborne in mammals. Those traits are (1) the ability to attach to cells of the throat and nose, (2) the ability to survive the colder temperatures found in those places, and (3) the ability to survive in adverse environments.

A minimum of three mutations may be all that's needed for a virus in the wild to make the leap through the air in mammals. If it does, it could spread. Fast.

Fouchier calculates the odds of this happening to be fairly low, for any given virus. Each mutation has the potential to cripple the virus on its own. They need to be perfectly aligned for the flu to jump. But these mutations can — and do — happen.

"In 2013, a new virus popped up in China," says Fouchier. "H7N9."

H7N9 is another kind of avian flu, like H5N1. The CDC considers it the most likely flu strain to cause a pandemic. In the human outbreaks that occurred between 2013 and 2015, it killed a staggering 39% of known cases; if H7N9 were to have all five of the gain-of-function mutations Fouchier had identified in his work with H5N1, it could make COVID-19 look like a kitten in comparison.

H7N9 had three of those mutations in 2013.

Gain-of-function mutation: creating our fears to (possibly) prevent them

Flu viruses are basically eight pieces of RNA wrapped up in a ball. To create the gain-of-function mutations, the research used a DNA template for each piece, called a plasmid. Making a single mutation in the plasmid is easy, Fouchier says, and it's commonly done in genetics labs.

If you insert all eight plasmids into a mammalian cell, they hijack the cell's machinery to create flu virus RNA.

"Now you can start to assemble a new virus particle in that cell," Fouchier says.

One infected cell is enough to grow many new virus particles — from one to a thousand to a million; viruses are replication machines. And because they mutate so readily during their replication, the new viruses have to be checked to make sure it only has the mutations the lab caused.

The virus then goes into the ferrets, passing through them to generate new viruses until, on the 10th generation, it infected ferrets through the air. By analyzing the virus's genes in each generation, they can figure out what exact five mutations lead to H5N1 bird flu being airborne between ferrets.

And, potentially, people.

"This work should never have been done"

The potential for the modified H5N1 strain to cause a human pandemic if it ever slipped out of containment has sparked sharp criticism and no shortage of controversy. Rutgers molecular biologist Richard Ebright summed up the far end of the opposition when he told Science that the research "should never have been done."

"When I first heard about the experiments that make highly pathogenic avian influenza transmissible," says Philip Dormitzer, vice president and chief scientific officer of viral vaccines at Pfizer, "I was interested in the science but concerned about the risks of both the viruses themselves and of the consequences of the reaction to the experiments."

In 2014, in response to researchers' fears and some lab incidents, the federal government imposed a moratorium on all GOF research, freezing the work.

Some scientists believe gain-of-function mutation experiments could be extremely valuable in understanding the potential risks we face from wild influenza strains, but only if they are done right. Dormitzer says that a careful and thoughtful examination of the issue could lead to processes that make gain-of-function mutation research with viruses safer.

But in the meantime, the moratorium stifled some research into influenzas — and coronaviruses.

The National Academy of Science whipped up some new guidelines, and in December of 2017, the call went out: GOF studies could apply to be funded again. A panel formed by Health and Human Services (HHS) would review applications and make the decision of which studies to fund.

As of right now, only Kawaoka and Fouchier's studies have been approved, getting the green light last winter. They are resuming where they left off.

Pandora's locks: how to contain gain-of-function flu

Here's the thing: the work is indeed potentially dangerous. But there are layers upon layers of safety measures at both Fouchier's and Kawaoka's labs.

"You really need to think about it like an onion," says Rebecca Moritz of the University of Wisconsin-Madison. Moritz is the select agent responsible for Kawaoka's lab. Her job is to ensure that all safety standards are met and that protocols are created and drilled; basically, she's there to prevent viruses from escaping. And this virus has some extra-special considerations.

The specific H5N1 strain Kawaoka's lab uses is on a list called the Federal Select Agent Program. Pathogens on this list need to meet special safety considerations. The GOF experiments have even more stringent guidelines because the research is deemed "dual-use research of concern."

There was debate over whether Fouchier and Kawaoka's work should even be published.

"Dual-use research of concern is legitimate research that could potentially be used for nefarious purposes," Moritz says. At one time, there was debate over whether Fouchier and Kawaoka's work should even be published.

While the insights they found would help scientists, they could also be used to create bioweapons. The papers had to pass through a review by the U.S. National Science Board for Biosecurity, but they were eventually published.

Intentional biowarfare and terrorism aside, the gain-of-function mutation flu must be contained even from accidents. At Wisconsin, that begins with the building itself. The labs are specially designed to be able to contain pathogens (BSL-3 agricultural, for you Inside Baseball types).

They are essentially an airtight cement bunker, negatively pressurized so that air will only flow into the lab in case of any breach — keeping the viruses pushed in. And all air in and out of the lap passes through multiple HEPA filters.

Inside the lab, researchers wear special protective equipment, including respirators. Anyone coming or going into the lab must go through an intricate dance involving stripping and putting on various articles of clothing and passing through showers and decontamination.

And the most dangerous parts of the experiment are performed inside primary containment. For example, a biocontainment cabinet, which acts like an extra high-security box, inside the already highly-secure lab (kind of like the radiation glove box Homer Simpson is working in during the opening credits).

"Many people behind the institution are working to make sure this research can be done safely and securely." — REBECCA MORITZ

The Federal Select Agent program can come and inspect you at any time with no warning, Moritz says. At the bare minimum, the whole thing gets shaken down every three years.

There are numerous potential dangers — a vial of virus gets dropped; a needle prick; a ferret bite — but Moritz is confident that the safety measures and guidelines will prevent any catastrophe.

"The institution and many people behind the institution are working to make sure this research can be done safely and securely," Moritz says.

No human harm has come of the work yet, but the potential for it is real.

"Nature will continue to do this"

They were dead on the beaches.

In the spring of 2014, another type of bird flu, H10N7, swept through the harbor seal population of northern Europe. Starting in Sweden, the virus moved south and west, across Denmark, Germany, and the Netherlands. It is estimated that 10% of the entire seal population was killed.

The virus's evolution could be tracked through time and space, Fouchier says, as it progressed down the coast. Natural selection pushed through gain-of-function mutations in the seals, similarly to how H5N1 evolved to better jump between ferrets in his lab — his lab which, at the time, was shuttered.

"We did our work in the lab," Fouchier says, with a high level of safety and security. "But the same thing was happening on the beach here in the Netherlands. And so you can tell me to stop doing this research, but nature will continue to do this day in, day out."

Critics argue that the knowledge gained from the experiments is either non-existent or not worth the risk; Fouchier argues that GOF experiments are the only way to learn crucial information on what makes a flu virus a pandemic candidate.

"If these three traits could be caused by hundreds of combinations of five mutations, then that increases the risk of these things happening in nature immensely," Fouchier says.

"With something as crucial as flu, we need to investigate everything that we can," Fouchier says, hoping to find "a new Achilles' heel of the flu that we can use to stop the impact of it."

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