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Food or Poison: Brominated Vegetable Oil

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Food or Poison: Brominated Vegetable Oil

What is Brominated vegetable oil (E443)?

Brominated vegetable oil (BVO) is a vegetable oil that has been modified with bromine. BVO was first used as a food additive in the 1920s-1930s and is still regularly used in soft drinks in North America. It is added as an emulsifier (a substance that helps to form and stabilize an emulsion), mainly in citrus sodas, energy drinks, and other beverages in the US. BVO keeps the citrus flavoring in fruit-flavored beverages from floating to the top of the drink.

Why use BVO in Beverages?

Compounds that are not soluble in water and have lower density than water, like citrus oils, tend to gradually separate from the water in a mixture and come to the surface. BVO is made by adding bromine to the double bonds of unsaturated fatty acids in vegetable oil (soy oil being one of the most used oils), significantly increasing the density of the oil1. By blending BVO with non-soluble ingredients (like citrus oil), the density can be adjusted to that of a soft drink preventing separation1. This is the reason why BVO was used in some of the top-selling soft drinks in the U.S.

The History of BVO

1920s – BVO starts to be used as a food additive in the 1920s2.

1958 – The US Food and Drug Administration (FDA) considered BVO generally recognized as safe (GRAS) and placed BVO on its original “GRAS list2.”

1969 – Toxicity studies by the Canadian Food and Drug Directorate led the FDA to remove BVO from the GRAS list. Interim usage levels were established at 15 per million (ppm) – before this date, manufacturers were using BVO at a level of up to 150 ppm in beverages.

1970 – The World Health Organization’s evaluation of BVO could not draw any conclusions on the safety of BVO due to a lack of suitable toxicological data1. “Chronic toxic effects have not been studied and long-term studies were not available so formal acceptable daily intake (ADI) values could not be determined3.” The FDA concluded that the use of BVO in food was not GRAS2.

2022 – The FDA published a study in the journal Food and Chemical Toxicology that evaluated potential health effects related to BVO consumption in rodents4. On the FDA website, you can read “The FDA measured the amounts of BVO present in the animal food and brominated fats in tissues from test animals. We also fed test animals amounts of BVO that simulate real-life exposure. The data from the study suggests that oral exposure to BVO is associated with increased tissue levels of bromine and that at high levels of exposure, the thyroid is a target organ of potential negative health effects in rodents. The agency also conducted a study to identify the level of BVO in the body after consumption of BVO2.”

2023 – FDA issued a proposed rule that, if finalized, would revoke the regulation allowing the use of BVO in food5. According to the FDA “animal and human data, including new information from recent FDA-led studies on BVO, no longer provide a basis to conclude the use of BVO in food is safe.”

Symptoms of Exposure

According to the Center of Disease Control (CDC), bromine works by directly irritating the skin, mucous membranes, and tissues6. The ingestion of bromine-containing compounds can cause different effects depending on the compound. Ingesting a large amount of bromine in a short period of time would be likely to cause symptoms such as nausea and vomiting (gastrointestinal symptoms)6. Long-term exposure has been linked to headaches, memory loss, and impaired coordination.

Health Effects of BVO

Animal Studies

The toxicology of BVO has been the object of several studies conducted in rats, showing that bromine accumulates in the liver, heart, and adipose (fat) tissue of those animals, and may cause heart lesions in higher doses4,7,8,9. One study showed myopathy, or “muscle disease,” when muscle fibers don’t function properly. This was probably due to fat storage in muscle tissues induced by feeding rats BVO10. The effects of BVO have also been studied in pigs where large amounts of bromine were found in fatty tissues, but also in the kidneys, livers, hearts, and thyroids of the pigs fed BVO11.

One of the most concerning studies that led to the ban of BVO in California, and now the proposal from the FDA to also ban it, was a 2022 study done in rats. This study showed an increase in bromine levels in the heart, liver, and inguinal (groin area) fat. According to the researchers, the “data expand upon previous observations in rats and pigs that oral exposure to BVO is associated with increased tissue levels of inorganic and organic bromine, and that the thyroid is a potential target organ of toxicity4.”

The potential toxicity for the thyroid is one of the biggest concerns of using BVO as a food additive. Exposure to bromine may contribute to thyroid issues also related to iodine deficiency. Both bromine and iodine are halide compounds (these also include fluoride and chlorine), which means they have a very similar chemical structure. Bromine can compete for the receptors in the thyroid that capture iodine. Low levels of iodine (low iodine diet and no supplementation) combined with bromine exposure, can lead to many health issues related to thyroid function.

Human Studies

A 1971 study published in the British Journal of Nutrition evaluated the bromine content of human tissue comparing the United Kingdom, Germany, and Holland12. The study determined a much higher level of bromine in fatty tissues in adults from the United Kingdom (where BVO was permitted at 80 ppm until September 1970) than in Germany (BVO use was prohibited) and the Netherlands (where BVO had been banned in 1950)12. The levels of bromine in fatty tissues were exceptionally high in UK children up to the age of 15. The authors suggested that the high bromine levels found in the fat of tissues from the UK, and especially in children, were due to the use of these bromine compounds12.

Scary case reports from excessive consumption of soft drinks

Bromism (chronic bromide toxicity) is not common, and early cases of bromism were initially associated with the consumption of bromine-containing drugs such as sleeping medications and anti-epilepsy drugs. However, there is one shocking case report of bromism from excessive cola consumption in 199713.

A person who consumed two to four liters of BVO-containing soft drink daily (a cola containing brominated vegetable oil) suffered from severe bromism. Bromism is characterized by symptoms such as headache, fatigue, ataxia (a neurological sign consisting of a lack of voluntary coordination of muscle movements that can include changes in walking, speech changes, and abnormalities in eye movements), and memory loss. In this case, the symptoms progressed over a period of 30 days. Before the doctors were able to determine bromism, the patient continued to deteriorate, until he was no longer able to walk. Eventually, a diagnosis of severe bromism was made and his serum bromide was confirmed at 3180 mg/L13. The normal range for bromide concentration in serum is 3.2-5.6 mg/L14.

The mainstay of treatment for bromism includes aggressive rehydration and saline loading, which enhances excretion (elimination of bromide) from the kidneys. However, saline loading failed to improve this patient’s condition. Only hemodialysis (a process of filtering the blood of a person whose kidneys are not working normally) helped improve his clinical condition, and only then his serum bromide levels were reduced13.

A more recent case was reported of intoxication from excessive ingestion of BVO-containing soft drinks15. In this case, the patient was diagnosed with bromoderma, a rare cutaneous hypersensitivity reaction to bromine exposure. The patient, a 63-year-old man, presented with a two-week history of tender, ulcerated, lumps (erythematous nodules) on his hands and fingers. These symptoms are similar to those reported in association with intoxication by brominated swimming pool disinfectants, and exposure to the pesticide methyl bromide. The patient consumed 8 liters of a BVO-containing soft drink daily for several months15. The patient’s serum bromine level was 9.6 mg/l, which is equivalent to about twice the normal level (3.2-5.6 mg/L)14,15.

World Ban

BVO has been banned in many countries, including Europe, Japan, Australia, and New Zealand.

Ban in the US

On November 2, 2023, the FDA proposed to revoke the regulation authorizing the use of brominated vegetable oil (BVO) in food5, following a law set in California (from The California Food Safety Act from October 2023) that prohibits the manufacturing, distribution and sale of food and beverages that contain BVO16.

On the FDA website you can find:

“The FDA conducted studies that clearly show adverse health effects in animals in levels more closely approximating real-world exposure. Therefore, the FDA can no longer conclude that this use of BVO in food is safe2.”

However, the FDA proposal is still just a proposal.

The new law in California won’t be implemented until 2027.

Some big brand-name beverages, such as Gatorade, Mountain Dew, Fanta, and Powerade used BVO but have since removed it, due to toxicity concerns and the bad reputation associated with this food additive in recent years. Coca-Cola and PepsiCo announced the removal of BVO from all their beverages in 2014.

However, BVO is still used and can be found in some smaller store-brand sodas and regional beverages, including Food Lion-brand sodas, some Great Value-brand sodas, and Sun Drop citrus soda.

According to the Environmental Working Group, there are at least 79 products on the US market that use BVO as an ingredient, most of which are sodas. You can find a full list of products containing BVO here.

Our recommendation is to avoid soft drinks and completely stay away from BVO-containing beverages!

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