Although I do not have to take any prescribed drugs and do not pay much attention to health-related articles, I was vaguely aware that the word "grapefruit" is often mentioned near the word "medicine." Basically it appears that this citrus fruit can react with many drugs in ways which are not helpful.
I was not aware at all that the "Grapefruit Effect" was one of those "accidental scientific discoveries" and that the discovery occurred here in London when Dr. David Bailey was trying to figure out ways to hide the taste of alcohol from those who were participating in a study he was doing on a blood pressure drug. The solution was grapefruit juice and it was a suggestion from his wife that led to an accidental discovery of considerable significance:
“It was really my wife Barbara and I, one Saturday night, we decided to try everything in the refrigerator,” says Bailey. They mixed pharmaceutical-grade booze with all kinds of juices, but nothing was really working; the alcohol always came through. “Finally at the very end, she said, ‘You know, we’ve got a can of grapefruit juice. Why don’t you try that?’ And by golly, you couldn’t tell!” says Bailey. So he decided to give his experimental subjects a cocktail of alcohol and grapefruit juice (a greyhound, when made with vodka), and his control group a glass of unadulterated grapefruit juice.
The blinding worked, but the results of the study were … strange. There was a slight difference in blood pressure between the groups, which isn’t that unusual, but then Bailey looked at the amount of the drug in the subjects’ bloodstreams. “The levels were about four times higher than I would have expected for the doses they were taking,” he says. This was true of both the control and experimental groups. Bailey checked every possible thing that could have gone wrong—his figures, whether the pharmacist gave him the wrong dosage—but nothing was off. Except the grapefruit juice."
Mrs. Bailey died in 2020. Dr. Bailey died on August 27, 2022, both in London, Ontario.
Dr. David Bailey and Western University
London, Ontario is not alone in being a "local news desert." There is still one newspaper in the city, but there is little in it that is concerned with London, where the owners of it no longer reside and where it is no longer printed. The few remaining local reporters do a good job, but they can't cover everything. There are a couple of publications up at Western University, but I have not noticed anything about the death of Dr. Bailey and the writers there have no shortage of crucial issues to report upon.
I admitted at the beginning, my general lack of awareness and I may have missed some stories about Dr. Bailey and the "accidental discovery", but just in case there are none, I have gathered some information from which additional articles could later be constructed by others. Dr. Bailey, like Dr. Barr, is a name Londoners should recognize.
If you are more interested in athletics than pharmacology, I should mention that Dr. Bailey is Canada's Bannister, in that he was the first Canadian to run a mile in under four minutes. Information about Dr. Bailey, the Olympian, is also provided below.
I became aware of Dr. Bailey because of an article in the American magazine, The Atlantic Monthly. I received it via email in December: "No One Can Decide if Grapefruit is Dangerous: The Citrus Can Raise the Level of Dozens of Drugs in the Body -- Sometimes to a Worrying Degree, Sometimes Very Much Not," Katherine J. Wu, Dec. 26, 2022. Dr. Bailey's discovery is discussed and, Dr. Dresser, who was mentored by Bailey is quoted. Dr. George Dresser is in the Department of Medicine at Western. Here is a portion of the article that mentions both of them: "Grapefruit’s medication-concentrating powers were discovered only because of a culinary accident. Some three decades ago, the clinical pharmacologist David Bailey (who died earlier this year) was running a trial testing the effects of alcohol consumption on a blood-pressure medication called felodipine. Hoping to mask the distinctive taste of booze for his volunteers, Bailey mixed it with grapefruit juice, and was shocked to discover that blood levels of felodipine were suddenly skyrocketing in everyone—even those in the control group, who were drinking virgin grapefruit juice.
After running experiments on himself, Bailey confirmed that the juice was to blame. Some chemical in grapefruit was messing with the body’s natural ability to break down felodipine in the hours after it was taken, causing the drug to accumulate in the blood. It’s the rough physiological equivalent of jamming a garbage disposal: Waste that normally gets flushed just builds, and builds, and builds. In this case, the garbage disposal is an enzyme called cytochrome P450 3A4—CYP3A4 for short—capable of breaking down a whole slate of potentially harmful chemicals found in foods and meds. And the jamming culprit is a compound found in the pulp and peel of grapefruit and related citrus, including pomelos and Seville oranges. It doesn’t take much: Even half a grapefruit can be enough to trigger a noticeable interaction, says George Dresser, a pharmacologist at Western University, in Ontario."
Additional information about the "Grapefruit Effect" and Bailey is provided below.
Also An Athlete
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Bailey is on the right. Medalists in the 1500-metre run at the
Winnipeg Pan Am Games. |
At the age of nine, David Bailey lost an eye in an accident and his participation in sports was limited to running. He became quite good at it. His athletic achievements are noted in his Globe and Mail obituary and are provided here:
"He became the first Canadian to run a mile in under four minutes, and represented Canada in the event, which is rarely staged any more, at the 1968 Olympics in Mexico City – after overcoming considerable adversity as a youngster.
David struggled through his early teens and lacked a sense of identity as a result of the eye injury and exclusion from contact sports, according to Harvey Mitro, a runner, writer and long-time friend. But a high-school coach recognized David’s running talent and, in 1961, placed him in the East York Track Club.
The club was led by legendary coach Fred Foot, who later mentored him at the University of Toronto and also worked in the Canadian Olympic program. David flourished under Mr. Foot’s guidance and the opportunity to train, and compete occasionally, with two older athletes: Bruce Kidd and Bill Crothers, who specialized in other distances and would become running legends.
While the three runners trained together, Mr. Kidd, won the 1962 Commonwealth Games six-mile event and competed in the 1964 Olympics. Mr. Crothers, a two-time Olympian during those years, earned an 800-metre silver medal at the 1964 Tokyo Games.
In 1962 at Varsity Stadium in Toronto, David set a world record in the mile for his age group, as a 17-year-old. And, late one Saturday night in June, 1966, in San Diego, he became the first Canadian to run a mile in under four minutes, posting a time of 3:59.1.
But Mr. Foot wanted him to break four minutes in Canada, too, Mr. Kidd recalled. So the coach organized another race, in July of 1967 at Varsity Stadium – without revealing the goal to David so that he would not feel extra pressure.
Mr. Foot instructed Bryan Emery to set a fast first-lap pace and secretly told Mr. Crothers to drop out at the three-quarter mark, according to Mr. Kidd. David was hot on Mr. Crothers’s heels when he quit running.
“I will never forget the look on [David’s] face when he realized what was happening,” Mr. Kidd said. “Bill just stepped off the track after taking the second step in this superb pace-setting job. Dave looked at him with the expression ‘Oh, my God,’ and then just put his shoulder down and just barrelled ahead to that fabulous time.”
He crossed the finish line in 3:57.7, becoming the first Canadian to break the four-minute-mile barrier in Canada.
Individually and as a team member, he garnered multiple conference and Canadian championships at the university level and berths in the U of T and Ontario sports halls of fame, among other accolades. He also captured silver medals in 1,500-metre races at the 1967 Oslo Bislett Games and 1967 World University Games (now Universiade) in Tokyo, and bronze in the mile at the 1967 Pan-Pacific Games in Winnipeg.
In addition, David ran the mile at the 1966 Commonwealth Games in Kingston, Jamaica, and the 1968 Olympics but did not medal."
A Brief Bailey Bibliography
Obituaries: (with some excerpts)
1. Dr. David George Bailey, PhD, Mar. 17, 1945 - Aug. 27, 2022,
Westview Funeral Chapel
"David distinguished himself for two very different reasons in the world of international running, as well as food-drug research. On June 11th, 1966, in San Diego, CA, he became Canada’s first sub-four minute miler in a time of 3:59.1. He sought to top this a year later on July 22, 1967, this time in his home town of Toronto, ON, in a time of 3:57.7. Later in his life, while working on a clinical pharmacology study between a blood pressure lowering drug and alcohol, he discovered the bizarre reaction between some medications and grapefruit juice. So if you ever see a little sticker on your medicine bottle saying “don’t take with grapefruit juice” you can thank Dr. Bailey."
2. "David Bailey, Olympian and Pharmacologist Who Discovered the Grapefruit Effect, Dead at Age 77," Monte Stewart, Globe and Mail, Sept. 23, 2022.
"In the late 1980s, Dr. Bailey, an Olympic runner-turned-pharmacologist, was researching the effects of alcohol on the blood-pressure medication felodipine. Seeking to disguise the alcohol’s taste in his experiment, he tried combining it with grapefruit juice and stumbled upon the fact that his subjects’ consumption of the juice resulted in a greater concentration of the drug in their bloodstreams. He went on to discover that grapefruit juice has this effect because it inhibits an enzyme (CYP3A4) in the human gut that breaks down the medication, so the body consequently absorbs a larger than normal amount of the medication."
At the end of 2022, Dr. Bailey is also mentioned in this G&M article:
"22 Influential People Who Died in 2022..." Dec. 31, 2022.
"David Bailey improved countless lives because of a discovery he made by accident.
3. "Pharmacologist and Olympian David Bailey Dies at 77," Lisa Winter,
The Scientist, Oct. 7, 2022.
"A few years later, Bailey was studying the interactions between alcohol and felodipine, a blood pressure medication. In one clinical trial, he tried using fruit juice to cover up the sharp taste of the alcohol before giving it to participants. He noticed that those who had the juice had much higher concentrations of the drug in their blood afterward, though it wasn’t clear at first whether it was the alcohol or the juice creating the odd reaction.
“So I decided to do a pilot study, on me, to find out,” he told Inside, a publication of the London Health Services Centre, in 2013. “Once I took the drug with water, then I took it with grapefruit juice. My drug levels were five times higher with grapefruit juice. That was a big eureka moment.”
For a good, long article about grapefruit and Dr. Bailey see this interesting article:
"Grapefruit Is One Of The Weirdest Fruits on The Planet: From Its Name, To Its Hazy Origins, To Its Drug Interactions, There's A Lot Going On Beneath That Thick Rind," Dan Nosowitz, Atlas Obscura, Oct. 6, 2020. It begins this way:
"IN 1989, DAVID BAILEY, A researcher in the field of clinical pharmacology (the study of how drugs affect humans), accidentally stumbled on perhaps the biggest discovery of his career, in his lab in London, Ontario. Follow-up testing confirmed his findings, and today there is not really any doubt that he was correct. “The hard part about it was that most people didn’t believe our data, because it was so unexpected,” he says. “A food had never been shown to produce a drug interaction like this, as large as this, ever.”
Some Local Articles:
There is not yet a notice about Dr. Bailey's death on the Western website, but there have been articles about him over the years. Here are some samples.
"Grapefruit-Medication Interactions Increasing," London Health Sciences Centre, Nov. 6, 2012.
"The number of prescription drugs that can have serious adverse effects from interactions with grapefruit are markedly increasing, yet many physicians may be unaware of these effects, states an article published in CMAJ. The article, a review by the researchers who discovered the interactions more than 20 years ago, summarizes evidence to help clinicians better understand the serious effects this common food can have when consumed with certain prescription drugs."
"Grapefruit Part of a Deadly Mix," Adela Talbot,
Western News, Dec. 6, 2012.
"That glass of grapefruit juice you usually have with breakfast isn’t as healthy as you think – if you’re taking certain medications, that is. Perhaps you already knew that.“We discovered the interaction 20 years ago. The science of grapefruit-drug interaction has been extensively studied.The science of the (interaction) is well known, but I don’t think it has been applied the way it needs to be now,” said David
Bailey, professor emeritus in the Schulich School of Medicine& Dentistry’s Division of Clinical Pharmacology.Bailey, along with colleagues George Dresser
and J. Malcolm Arnold, recently published "Grapefruit-medication interactions: Forbidden fruit or avoidable consequences?"
In 2015 there was a contest by the Council of Ontario Universities' Research Matters to determine research that was "Game-Changing". Here are the ones suggested for UWO and Bailey's is among them:
Dr. Charles Drake (1958) - Developed surgical techniques on the repair of ruptured brain aneurysms.
Dr. David Bailey (1991) - Discovered the dangerous interactions between grapefruit and certain medications.
Dr. Fred Possmayer (1981) - Developed a safe way to extract, purify and sterilize surfactant from animals for use in humans, in particular premature babies suffering from respiratory distress.
Dr. Murray Barr (1948) - Co-discovered an inactive chromatin, known as the Barr Body, linked to genetic disorders such as Down’s, Klinefelter’s and Turner syndromes. This led to a simple diagnostic test for certain genetic abnormalities.
Dr. Henry Barnett (1978) - Led a large international clinical trial to show that Aspirin prevents strokes, changing the way doctors managed heart disease.
Drs. Charles Beer and Robert Noble (1958) - Isolated vincaleukablastine, a powerful anti-cancer drug, from the Madagascar periwinkle plant. The drug turned out to be one of the most useful chemotherapeutic agents.
It should be noted that this bibliography is far from complete and is focused more on articles about Dr. Bailey and not on those articles which he authored.
The Bonus:
If you on prescribed meds and want to learn more see:
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