Twenty Million Pieces

What I Put Into the World

🔗 = External Link to a Study or Report

I'm not an activist, at least not yet. I probably will be when I'm in my seventies. I'm definitely not self righteous, and I have no desire for power. My motivation is simple. I see the need to make amends and to take some accountability for my own behavior.

My previous juice company grew to 85 stores. I did a rough calculation once, and I figured that my ideas and concepts put at least 20 million single use plastic items into the environment. That reality didn't fully land on me until near the end, before I sold my interest. It started with customers, one after another, praising the product and then saying, "God, you've got to get rid of that plastic." I always felt a little embarrassed that I wasn't innovative enough, seventeen years ago, to solve that problem when I started the company.

Back then, the idea that plastic pollution ends up inside people sounded like an environmentalist scare line. That is no longer where the evidence sits. A run of peer reviewed studies over the past decade has moved the question from whether tiny plastic particles reach human tissue to what they do once they arrive. Here is a clear look at the research, starting on our plates and ending inside our arteries.

It Starts With What We Eat

Some of the earliest hard evidence came from the seafood counter. In a widely cited 2015 study, Chelsea Rochman and colleagues bought wild caught fish straight from markets and found plastic debris and textile fibers inside a quarter of the fish sold in California and 28 percent of those sold in Indonesia, published in 🔗 Scientific Reports. Shellfish tell a similar story. Van Cauwenberghe and Janssen reported that farmed mussels carried higher microplastic loads than wild caught ones, in 🔗 Environmental Pollution.

The worst case on the plate is shellfish and small whole fish like sardines and anchovies, because you eat the digestive tract, which is exactly where most particles collect. With filleted fish, most of the plastic stays behind in the gut and gills that get thrown away.

Then It Shows Up in Us

This is where the findings became difficult to wave off. Microplastics have now been documented across the human body.

Researchers found them in the human placenta, in a 2021 study memorably titled "Plasticenta," in 🔗 Environment International. The team examined six placentas from consenting women with healthy pregnancies and found twelve plastic fragments, each between 5 and 10 micrometers, in four of them. The particles turned up on the side facing the baby, on the side facing the mother, and in the membranes surrounding the fetus. Every fragment was pigmented. Three were identified as polypropylene, and the rest carried pigments used in paints, coatings, adhesives, cosmetics, and personal care products.

They turned up in lung tissue as well, in Amato-Lourenço and colleagues' 2021 paper in the 🔗 Journal of Hazardous Materials. Examining lung tissue taken during routine autopsies in São Paulo, Brazil, the team found microplastics in 13 of 20 samples, most of them polypropylene and polyethylene, the same plastics found in the cups, lids, and bottles we handle every day. They were detected in human stool, by Schwabl and colleagues in the 🔗 Annals of Internal Medicine, and in colon tissue, by Ibrahim and colleagues in 🔗 JGH Open. Then Leslie and colleagues reported plastic particles circulating in human blood, in a 2022 paper in 🔗 Environment International.

The Study That Changed the Conversation

The turning point came in 2024. Marfella and colleagues published a study in the 🔗 New England Journal of Medicine that did something new. They took carotid plaque, the fatty buildup surgeons remove from clogged neck arteries, from 257 patients and analyzed it with a sensitive technique called pyrolysis gas chromatography mass spectrometry. Polyethylene showed up in the plaque of 150 of those patients. Over the next 34 months, the patients whose plaque contained plastic had a much higher risk of heart attack, stroke, or death from any cause, with a hazard ratio of about 4.5, meaning roughly four and a half times the risk.

The Honest Caveats

None of this proves that plastic causes heart attacks, and the researchers said so plainly. The Marfella study shows an association, not causation, and the authors noted the link could reflect other factors they did not measure, including patients' lifetime exposures and general health. Other scientists wrote to the journal raising a sharper concern, that the samples may have been contaminated by plastic in the operating room itself, since the study used no dedicated anticontamination protocol or blank control samples, and surgical settings are full of polyethylene and PVC. The broader field also still struggles to explain what the biological changes seen in fish actually mean for the fish, let alone for the people eating them.

The Research Keeps Expanding

The list of places plastic has been found keeps growing, and some of the newest work is the most striking. In 2025, Nihart and colleagues reported the bioaccumulation of microplastics in decedent human brains in 🔗 Nature Medicine, finding strikingly high concentrations compared with liver and kidney, levels that appeared to rise between 2016 and 2024, and even higher amounts in brains from people with documented dementia. Because bold claims invite scrutiny, that paper is best read alongside the journal's own discussion of the methodological debate, 🔗 Challenges in studying microplastics in human brain.

Other recent detection studies have pushed into new tissue. Yang and colleagues found microplastics in human heart tissue in patients undergoing cardiac surgery, in 🔗 Environmental Science and Technology. A 2024 team detected plastics inside human thrombi, the clots that cause heart attacks and strokes, sampled from the brain, heart, and legs, in 🔗 this multimodal analysis, a possible mechanistic bridge to the cardiovascular findings. On the reproductive side, Zhao and colleagues characterized microplastics in human testis and semen in 🔗 Toxicological Sciences, and a multi site study in China linked mixed exposure to sperm dysfunction in 🔗 eBioMedicine. Researchers have even detected microplastics in human breast milk, in the 🔗 Journal of Clinical Medicine, extending the concern to the very start of life.

For readers who want the big picture rather than single findings, three recent syntheses stand out: the 🔗 Lancet Countdown on health and plastics, a review of disease risk in 🔗 The Lancet Planetary Health, and a scoping map of every tissue where particles have been found so far in the 🔗 Journal of Global Health.

Where That Leaves Us

The first half of the question is essentially settled. Plastic particles are getting into the human body through the food we eat, the water we drink, and the air we breathe. The second half, what those particles do once they are inside, is still being worked out. I don't need the final answer to know which side of it I want to be on.

Choosing Glass

When I started goodsugar, I had nobody to model myself after. There were no role models. I remember spending the better part of a year during Covid scrolling through a website that connects buyers with manufacturers in India and China, searching for every kind of packaging imaginable. Eventually I said to myself, you can't make packaging simpler than glass. Glass might break, and it's a little heavier, but it's the right thing. It makes the product look a hundred times better, and no plastic is leaching into anything we serve. And guess what, we don't break that much glass. We found a phenomenal vendor for our mason jars and lids, and I still can't believe how low the prices are. The customers love it. They're loyal, and they bring their jars back for fifty cents each.

It's also the intelligent choice. In our food category, we hold ourselves up as the smart ones. We tell everybody what healthy means. If we were packaging our food in plastic, after everything the research now shows, we'd be hypocrites.

I don't like being so hard on myself or on anyone else, because this isn't about who we really are. It's just a behavior, and behavior can change with awareness and willingness.

Key Citations

Marfella R, Prattichizzo F, Sardu C, et al. "Microplastics and Nanoplastics in Atheromas and Cardiovascular Events." New England Journal of Medicine. 2024;390(10):900 to 910. DOI: 🔗 10.1056/NEJMoa2309822. A prospective, multicenter, observational study in which carotid plaque was removed from 257 patients undergoing carotid endarterectomy and tested for micro and nanoplastics using pyrolysis gas chromatography mass spectrometry. Polyethylene was found in the plaque of 150 patients, and 31 of those also had measurable polyvinyl chloride. Patients with plastic in their plaque had more than four times the risk of heart attack, stroke, or death over nearly three years. It is the first observational study to link plastic particles in human tissue to adverse cardiovascular events. When citing it, note that the authors stressed the results do not prove causation and may reflect unmeasured factors, and that critics flagged possible contamination from the plastic rich surgical environment.

Leslie HA, van Velzen MJM, Brandsma SH, Vethaak AD, Garcia-Vallejo JJ, Lamoree MH. "Discovery and quantification of plastic particle pollution in human blood." Environment International. 2022;163:107199. DOI: 🔗 10.1016/j.envint.2022.107199. The team built a method using double shot pyrolysis gas chromatography mass spectrometry to measure plastic particles of 700 nanometers and larger in whole blood from 22 healthy volunteers. Four high production volume polymers were quantified in blood for the first time, with PET, polyethylene, and styrene polymers the most common, followed by polymethyl methacrylate, at a mean total concentration of 1.6 micrograms per milliliter. About 80 percent of donors had plastic in their blood. It is the first study to show that plastic particles are bioavailable for uptake into the human bloodstream.

Every Study Referenced, in Order

🔗 Plastic in market seafood, Rochman et al., Scientific Reports 2015: https://www.nature.com/articles/srep14340

🔗 Microplastics in farmed mussels, Van Cauwenberghe and Janssen, Environmental Pollution 2014: https://www.sciencedirect.com/science/article/abs/pii/S0269749114002425

🔗 Microplastics in human placenta, Plasticenta, Environment International 2021: https://www.sciencedirect.com/science/article/pii/S0160412020322297

🔗 Microplastics in human lung tissue, Amato-Lourenço et al., Journal of Hazardous Materials 2021: https://www.sciencedirect.com/science/article/abs/pii/S0304389421010888

🔗 Microplastics in human stool, Schwabl et al., Annals of Internal Medicine 2019: https://www.acpjournals.org/doi/10.7326/M19-0618

🔗 Microplastics in human colon tissue, Ibrahim et al., JGH Open 2021: https://onlinelibrary.wiley.com/doi/10.1002/jgh3.12457

🔗 Microplastics in human blood, Leslie et al., Environment International 2022: https://doi.org/10.1016/j.envint.2022.107199

🔗 Microplastics in arterial plaque and cardiovascular events, Marfella et al., New England Journal of Medicine 2024: https://doi.org/10.1056/NEJMoa2309822

🔗 Microplastics in human brains, Nihart et al., Nature Medicine 2025: https://www.nature.com/articles/s41591-024-03453-1

🔗 Methodological debate on the brain study, Nature Medicine 2025: https://www.nature.com/articles/s41591-025-04045-3

🔗 Microplastics in human heart tissue, Yang et al., Environmental Science and Technology 2023: https://pubs.acs.org/doi/10.1021/acs.est.2c07179

🔗 Microplastics in human blood clots, thrombi study 2024: https://pubmed.ncbi.nlm.nih.gov/38614011/

🔗 Microplastics in human testis and semen, Zhao et al., Toxicological Sciences: https://pubmed.ncbi.nlm.nih.gov/36948312/

🔗 Microplastic exposure and sperm dysfunction, eBioMedicine 2024: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(24)00405-5/fulltext

🔗 Microplastics in human breast milk, Journal of Clinical Medicine 2024: https://www.mdpi.com/2077-0383/13/14/4029

🔗 Lancet Countdown on health and plastics: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01447-3/abstract

🔗 Disease risk review, The Lancet Planetary Health 2025: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(25)00268-2/fulltext

🔗 Tissue scoping review, Journal of Global Health 2024: https://jogh.org/2024/jogh-14-04179/