What Urinary Hormone Metabolite Testing Tells Us about Estrogen Metabolism and Breast Cancer Risk
When I was a kid at lunch, while my friends were eating those heavenly-looking ultraprocessed Twinkies and Ringdings and making dough balls with their white bread, I ate home-made yogurt or nutbutter sandwiches on a very dense, whole grain bread; or perhaps noshed on some sardines.
Make no mistake, I went through a very rebellious phase involving Oreo cookies when I finally called the food shots in my life. But thankfully, I had gleaned enough from my mom that this phase didn’t last long. Indeed, I developed a deep appreciation for how savvy she was (and still is!) when it comes to keeping food clean, healthy and almost completely free of ultraprocessing and toxic food chemicals. She taught me the importance of avoiding ultra-processed foods and toxic food chemicals, long before it became a public health headline.
Why Food Chemicals Matter for Chronic Disease Prevention
For those of us in functional medicine, environmental toxins – and the important subcategory of harmful food additives – are often an important piece of the puzzle for chronic disease. Food toxins can even affect vulnerability to acute disease. Right from the very beginning of my work to spread the word through blogs, podcasts, webinars, and more, toxins have been part of the conversation here at drkarafitzgerald.com.
For example, my good friend and colleague, Dr. Winston Cardwell, was my second ever podcast guest ,and his tips for maintaining a healthy, low-toxin home are as valuable now as they were when we recorded his episode (now 10 years ago!). More recently just a few weeks ago, Drs. Wright and Wright shared their findings on toxin “resiliency factors,” not just “risk factors,” which is a welcome direction for the field (and yet another indication that the recognition that toxin exposures have massive health implications, even at low doses, has gone “mainstream” – their work happens at the Mount Sinai Institute for Exposomic Research.
Related blog: Policies that reduce ultra-processed food consumption may save more lives than tobacco control.
Some of the most compelling data relate synthetic food dyes with neurobehavioral effects. In a 2022 paper published by the California Office of Environmental Health Hazard Assessment (OEHHA), 16 out of the 25 clinical studies reviewed found a positive association between synthetic food die exposure and adverse behavioral outcomes in children. First author on the paper, Mark Miller, argues “the evidence is compelling from those human studies that children’s consumption of synthetic food dyes can contribute to increases in symptoms like inattention, hyperactivity in some children.”
What’s Really in Our Food?
It’s important to call a spade a spade – what is often called “food” is pretty far removed from what our recent ancestors would have considered edible. In addition to the wider recognition of the need to pay attention to toxins in our environment, I am also heartened to see the broad swath of regulatory changes that have been initiated for food safety at a state level, outside of the purview of the Food and Drug Administration (FDA). Does this trend signal a possible end to the wild west of food chemicals?
FDA Oversight: What’s the Problem?
The history of food chemical regulation in the US has historically been one of, essentially, industry self-policing. Under current US law, more than 10,000 chemicals have been allowed in the food supply and in food contact materials (such as processing equipment and packaging). Many of these were grandfathered in before the 1958 Food Additives Amendment, and an estimated 1,000 more have entered the market through the GRAS (“generally recognized as safe”) process where companies can “self-affirm” safety—without formal FDA (or public) notification or review.
Even when review occurs, it is often industry-led (with all the associated bias that implies). For example, a recent analysis of 451 GRAS evaluations found that 22.4% were made by an employee of the manufacturer, and the remaining 77.6% were made either by a consulting firm or expert panel selected by the manufacturer. Once in use, the FDA lacks the authority to reassess safety. This has led, for example, to the ongoing approval of styrene and methyleugenol, which the US National Toxicology Program classifies as reasonably anticipated to be human carcinogens.
The GRAS process was also established originally during a time before ultra-processed foods became ubiquitous, making it out-of-date for dealing with the reality of today’s industrialized food landscape. A 2021 study published in JAMA reported that young people, aged 2-19 years, consumed a worrying 67% of their total calories from ultraprocessed foods, meaning that our youth are exposed to these chemicals at levels far beyond what was expected when GRAS was first established.
State-Level Food Safety Laws: A Turning Point?
The winds are changing, however. RFK Jr recently directed the acting FDA commissioner to explore revising the GRAS rules in ways that will potentially eliminate the self-affirmation loophole. This is welcome news!
Even before the recent change in federal administration, we had started to see states stepping up to fill this gap in regulatory oversight. In 2023, California passed the California Food Safety Act, banning potassium bromate, propyl paraben, Red Dye No. 3, and brominated vegetable oil (BVO). It followed this up with a school food safety bill targeting artificial food dyes–Blue 1, Blue 2, Green 3, Yellow 5, Yellow 6, Red 3, and Red 40–which are commonly found in cereals, drinks, ice cream, candy, and other processed foods. Manufacturers have until the end of 2006 to comply with the Food Safety Act and end of 2027 to comply with the school safety bill (consumers should still be vigilant until then).
The California laws seemingly sparked a chain effect. Now, over 51 bills are in motion. These bills propose restrictions or bans on titanium dioxide, BHA, BHT, synthetic dyes, and heavy metals in baby food, as well as the chemicals that were targeted in the California legislation.
Below is a summary table detailing state-level legislative actions aimed at restricting specific food additives. This information is based on the latest available data as of April 2025. Of course, this is going to keep evolving, so I recommend checking the Environmental Working Group for updates. In addition, realize that it’s going to take a few years for these regulations to come into effect – and some of these are still pending approval. So, in the meantime, we all need to continue to be vigilant about reducing our exposure to these chemicals wherever reasonably possible, and support the bills that are still in process so that they pass.
What You Can Do Now
While legislation catches up, we can take immediate steps to protect our health:
- Read ingredient labels carefully
- Choose whole, minimally processed foods
- Shop organic where possible
- Follow organizations like the Environmental Working Group (EWG) for updates
- Support local and state initiatives for food safety reform
Final Thoughts
Avoiding toxic food chemicals isn’t always easy—but it’s getting a little easier thanks to growing awareness and shifting regulations. And while federal oversight still has a long way to go, state-level actions offer the beginnings of some hope for safer, cleaner food.
Stay informed, stay engaged—and stay well.
DOWNLOAD MY GUIDE TO AVOIDING THE WORST FOOD ADDITIVES
State Legislation Activity Aimed at Reducing Food Chemicals
| State | Legislation | Additives Targeted | Status |
| Arizona | H.B. 2164 | Synthetic dyes in school foods including Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3, potassium bromate, propyl paraben, titanium dioxide and BVO | Introduced |
| Arkansas | S.B. 9 | Potassium bromate, propyl paraben, Red 3 | Introduced |
| California | California Food Safety Act; California School Food Safety Act | BVO, potassium bromate, propyl paraben, Red 3; synthetic dyes in school meals | Passed, effective 2027 |
| Connecticut | H.B. 147, H.B. 6808, S.B. 968 | BVO, potassium bromate, propyl paraben, Red 3, titanium dioxide, Red 2, Red 4, Green 1, Green 2, Violet 1, Butter Yellow, Orange 1, Orange 2, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, carmoisine, erythrosine. | Introduced |
| Delaware | S.B. 69 | Red 40 | Introduced |
| Florida | H.B. 641, S.B. 1826 | BVO, potassium bromate, propyl paraben, titanium dioxide, Red 3, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3, Red 3, Red 40. | Introduced |
| Hawaii | S.B. 644, S.B. 791 | PFAS in packaging; Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3 | Introduced |
| Illinois | H.B. 2516, S.B. 0073 | Heavy metals in baby food; PFAS | Introduced |
| Indiana | H.B. 1247, H.B. 1655 | BVO, potassium bromate, propyl paraben, Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3; BHA, BHT, titanium dioxide. | Introduced |
| Iowa | H.B. 212 | Margarine, BVO, potassium bromate, propyl paraben, Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3 | Introduced |
| Kentucky | H.B. 439 | BVO, potassium bromate, propyl paraben, titanium dioxide, Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3. | Introduced |
| Louisiana | S.B. 14 | BVO, potassium bromate, propyl paraben, titanium dioxide, ADA, BHA, BHT, Blue 1, Blue 2, Green 3, Red 3, Red 40, Yellow 5, Yellow 6. Warning labels for additional additives. | Introduced |
| Maryland | H.B. 1208, H.B. 97, S.B. 723, S.B. 1136 | BVO, potassium bromate, propyl paraben, Red 3; heavy metals in baby food | Introduced |
| Massachusetts | S.B. 1531, H.D. 2496, S.D. 2521, H.D. 4095 | Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3 | Introduced |
| Minnesota | S.F. 188, H.F. 44 | Ortho-phthalates in packaging | Introduced |
| Missouri | H.B. 260, S.B. 802 | Various food additives including acrylamide, arsenic, BPA, propyl paraben, titanium dioxide, BVO, potassium bromate, cadmium, DEHP, lead, mercury, Blue 1, Red 40, Yellow 5, Yellow 6. | Introduced |
| New Jersey | A. 4132, A. 4367, S.B. 3135 | Potassium bromate, propyl paraben, Red 3, BVO and various restrictions on food packaging chemicals including PFAS, toxic metals, hexavalent chromium, formaldehyde, perchlorate, vinyl chloride. | Introduced |
| New Mexico | H.B. 212 | PFAS in packaging | Introduced |
| New York | A.B. 6520, S. 1239, A.B. 1556, S.B. 6668 | BVO, potassium bromate, propyl paraben, Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3. | Introduced |
| North Carolina | H. 440 | Broad additive ban proposal | Introduced |
| Oklahoma | S.B. 4 | BVO, potassium bromate, propyl paraben, Red 3, Red 40, Blue 1, Blue 2, Green 3, Yellow 5, Yellow 6, titanium dioxide. | Introduced |
| Oregon | H.B. 3015 | Red 3, potassium bromate, propyl paraben | Introduced |
| Pennsylvania | H.B. 507 | Heavy metals in baby food | Introduced |
| Rhode Island | H. 5115, H. 7300 | Red 3, Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, potassium bromate, propyl paraben, BVO. | Introduced |
| Texas | H.B. 1637, H.B. 3137, H.B. 3736, H.B. 4787, H.B. 4971, H.B. 5378, H.B. 5548, S.B. 25, S.B. 314 | Red 40, Yellow 5, Yellow 6, Blue 1, Blue 2, Green 3, aspartame, artificial flavoring, propyl paraben, BHT, MSG, TBHQ, partially hydrogenated oils, sodium benzoate, sodium nitrate, sodium nitrite, methylparaben, high fructose corn syrup, maltodextrin, BPA, arsenic, arrageenan, glyphosate, synthetic growth hormones, titanium dioxide. | Multiple bills introduced |
| Vermont | H. 260, S. 25 | BVO, potassium bromate, propyl paraben, Red 3 | Introduced |
| Virginia | H.B. 1844 | Heavy metals in baby food | Introduced |
| Washington | H.B. 1921 | BVO, potassium bromate, propyl paraben, Red 3 | Introduced |
| West Virginia | S.B. 545 | Synthetic dyes in school foods | Introduced |
(Source: Adapted from Environmental Working Group – Tracking State Food Chemical Regulation in the US)
