Chemicals and the Obesity Epidemic: The Link

From the Safer Chemicals, Health Families website

http://www.saferchemicals.org/resources/obesity.html

Includes link to April 2010 report from the Washington Toxics Coalition.

http://www.saferchemicals.org/PDF/resources/obesity_factsheet.pdf

Tired of being a guinea pig?

Toxic chemicals are everywhere

There are ten of thousands of chemicals in your life, some of which can be harmful.

We are all exposed

Many toxic chemicals are found in the bodies of virtually every person on the planet, even those living in remote communities. In fact, the blood of nearly every American contains hundreds of chemicals, including those used in flame retardants, food packaging and even rocket fuel.

I Am Not a Guinea Pig is a new online campaign created by the Environmental Defense Fund (EDF) that provides tools and information Americans from all walks of life can use to press for fundamental reform of our nation’s toxic chemical law, the Toxic Substances Control Act (TSCA).  (EDF press release)

The “I Am Not a Guinea Pig” campaign is aimed at helping to ensure that the voices of millions of Americans who are concerned about and affected by exposures to untested and unsafe chemicals are heard as Congress begins the first serious effort to overhaul the 34-year-old TSCA.

The campaign will use a variety of social media, including a website, a Facebook page with daily updates, and a #NAGP Twitter hashtag.  It supports the efforts of the Safer Chemicals, Healthy Families coalition to enact an effective chemical safety law.

The campaign’s goal is to engage Americans across the country to push for substantive reform of our toxic chemicals law.

To encourage support for a strong bill, EDF has joined with other members of Safer Chemicals, Healthy Families, a coalition that EDF helped found that includes over 200 health and environmental groups representing 11 million people across the nation. Key coalition partners in EDF’s campaign include:

• Autism Society
• Health Care Without Harm
• Learning Disabilities Association of America
• Moms Rising
• Reproductive Health Technology Project
• Teens Turning Green

The “I Am Not a Guinea Pig” website describes how we’re all exposed to toxic chemicals.  It includes a short video on “Chemicals in Your Home” and other videos on exposure to toxic chemicals.

The site notes that some groups are especially at risk

Teens and Toxic Chemicals in Products

Many teens don’t realize products they use every day may contain chemicals that can disrupt their still-developing biochemistry.

Kids & Chemicals: Developing Brains At Risk

Exposure to toxic chemicals in the womb, during infancy and childhood can result in lifelong problems with learning, behavior and development.

Health Professionals and Toxic Chemicals

Health care institutions regularly use a surprising number of highly toxic materials that can affect the health of doctors, nurses and other hospital staff.

President’s Cancer Panel recommendations for individuals

I had difficulty copying these from the 7+ MB report (my Adobe Acrobat kept crashing).  Then I discovered that Acrobat Reader 9 lets you save a PDF as text!

Full report URL – http://deainfo.nci.nih.gov/advisory/pcp/pcp08-09rpt/PCP_Report_08-09_508.pdf

Note: I added the links below—they were not in the original report (and they may or may not be sanctioned by the Panel or the U.S. government).

President’s Cancer Panel – What Individuals Can Do: Recommendations

Much remains to be learned about the effects of environmental exposures on cancer risk. Based on what is known, however, there is much that government and industry can do now to address environmental cancer risk. The Panel’s recommendations in this regard are detailed above. At the same time, individuals can take important steps in their own lives to reduce their exposure to environmental elements that increase risk for cancer and other diseases. And collectively, individual small actions can drastically reduce the number and levels of environmental contaminants.

CHILDREN

1. It is vitally important to recognize that children are far more susceptible to damage from environmental carcinogens and endocrine-disrupting compounds than adults. To the extent possible, parents and child care providers should choose foods, house and garden products, play spaces, toys, medicines, and medical tests that will minimize children’s exposure to toxics.
Ideally, both mothers and fathers should avoid exposure to endocrine-disrupting chemicals and known or suspected carcinogens prior to a child’s conception and throughout pregnancy and early life, when risk of damage is greatest.

CHEMICAL EXPOSURES

2. Individuals and families have many opportunities to reduce or eliminate chemical exposures. For example:

• Family exposure to numerous occupational chemicals can be reduced by removing shoes before entering the home and washing work clothes separately from the other family laundry.
• Filtering home tap or well water can decrease exposure to numerous known or suspected carcinogens and endocrine-disrupting chemicals. Unless the home water source is known to be contaminated, it is preferable to use filtered tap water instead of commercially bottled water.
• Storing and carrying water in stainless steel, glass, or BPA– and phthalate-free containers will reduce exposure to endocrine-disrupting and other chemicals that may leach into water from plastics. This action also will decrease the need for plastic bottles, the manufacture of which produces toxic by-products, and reduce the need to dispose of and recycle plastic bottles. Similarly, microwaving food and beverages in ceramic or glass instead of plastic containers will reduce exposure to endocrine-disrupting chemicals that may leach into food when containers are heated.
• Exposure to pesticides can be decreased by choosing, to the extent possible, food grown without pesticides or chemical fertilizers and washing conventionally grown produce to remove residues. Similarly, exposure to antibiotics, growth hormones, and toxic run-off from livestock feed lots can be minimized by eating free-range meat raised without these medications if it is available. Avoiding or minimizing consumption of processed, charred, and well-done meats will reduce exposure to carcinogenic heterocyclic amines and polyaromatic hydrocarbons.
• Individuals can consult information sources such as the Household Products Database to help them make informed decisions about the products they buy and use.
• Properly disposing of pharmaceuticals, household chemicals, paints, and other materials will minimize drinking water and soil contamination. Individuals also can choose products made with non-toxic substances or environmentally safe chemicals. Similarly, reducing or ceasing landscaping pesticide and fertilizer use will help keep these chemicals from contaminating drinking water supplies.
• Turning off lights and electrical devices when not in use reduces exposure to petroleum combustion by-products because doing so reduces the need for electricity, much of which is generated using fossil fuels. Driving a fuel-efficient car, biking or walking when possible, or using public transportation also cuts the amount of toxic auto exhaust in the air.
• Individuals can reduce or eliminate exposure to secondhand tobacco smoke in the home, auto, and public places. Most counseling and medications to help smokers quit are covered by health insurance or available at little or no cost.

RADIATION

3. Adults and children can reduce their exposure to electromagnetic energy by wearing a headset when using a cell phone, texting instead of calling, and keeping calls brief.

4. It is advisable to periodically check home radon levels. Home buyers should conduct a radon test in any home they are considering purchasing.

5. To reduce exposure to radiation from medical sources, patients should discuss with their health care providers the need for medical tests or procedures that involve radiation exposure. Key considerations include personal history of radiation exposure, the expected benefit of the test,
and alternative ways of obtaining the same information. In addition, to help limit cumulative medical radiation exposure, individuals can create a record of all imaging or nuclear medicine tests received and, if known, the estimated radiation dose for each test.

6. Adults and children can avoid overexposure to ultraviolet light by wearing protective clothing and sunscreens when outdoors and avoiding exposure when the sunlight is most intense.

SELF-ADVOCACY

7. Each person can become an active voice in his or her community. To a greater extent than many realize, individuals have the power to affect public policy by letting policymakers know that they strongly support environmental cancer research and measures that will reduce or remove from the environment toxics that are known or suspected carcinogens or endocrine-disrupting chemicals. Individuals also can influence industry by selecting non-toxic products and, where these do not exist, communicating with manufacturers and trade organizations about their desire for safer products.

Health Affairs special issue on child obesity (March 2010)

Health Affairs special issue on child obesity

http://content.healthaffairs.org/content/vol29/issue3/

Includes articles on obesity trends, prevention, connections with food and agriculture policy, effect of schools, lessons learned from states and localities, and more.

Note: Unfortunately it looks like you will have to pay to read the articles, but access to the abstracts (and the policy briefs listed below) is free.

From the Health Affairs blog

Child Obesity: Health Affairs Explores Strategies For Combating Epidemic

Health Affairs Policy Briefs Examine Child Obesity

• Overview: The State Of Childhood Obesity In America
• The Role Of Agriculture Policy In Reducing Childhood Obesity
• Food Marketing And Distribution’s Role In The Fight Against Childhood Obesity
• Speeding Up Progress In Fighting Obesity In Schools
• Lessons From States On Fighting Childhood Obesity
• The Pervasive Effects Of Environments On Childhood Obesity

Institute of Medicine report on “Bridging the Evidence Gap in Obesity Prevention” – is their framework comprehensive enough?

The Institute of Medicine is the health arm of the National Academy of Sciences.  On April 23, 2010, it released a report, “Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making.”

New Framework Recommended for Decision Making and Research on Obesity Prevention

http://www.nationalacademies.org/morenews/20100423.html

April 23, 2010 — To battle the obesity epidemic in America, health care professionals and policymakers need relevant, useful data on the effectiveness of obesity prevention policies and programs. A new report from the Institute of Medicine identifies a new approach to decision making and research that uses a systems perspective to gain a broader understanding of the context of obesity and the many factors that influence it.

http://www.iom.edu/obesityframework

Is the IOM systems approach missing what could be a large component of the system?

The Institute of Medicine states that it is adopting a systems approach to obesity prevention.  That sounds pretty comprehensive, right?

Well, maybe not.  Cutting to the chase, this report appears to be limited to looking at obesity prevention interventions and not all obesity causes.  The focus is entirely on caloric and energy balance.  But what if, as Dr. Robert Lustig and others have argued, what you eat and how it is metabolized are factors in the obesity epidemic?  Energy intake and energy expenditure might not reveal the whole picture.

And what about the possibility that environmental exposure to chemicals might be a factor?  Quickly skimming the report, I found Figure 4-5, “The obesity ‘system’: a broad causal map” (p. 4-12 (p.80) of the online version of the report) shows a blurry version of the diagram, but I was able to find the original on Slide 9 of the presentation, “System Dynamics Simulation in Support of Obesity Prevention Decision-Making.”

Bobby Milstein and Jack Homer, For Institute of Medicine Committee on an Evidence Framework for Obesity Prevention Decision-Making, Irvine, California, March 16, 2009
http://www.iom.edu/~/media/Files/Activity%20Files/PublicHealth/ObesFramework/IOMIrvine16Mar09v52MilsteinHomer.ashx

The “map” shows Prevalence of Overweight & Related Diseases being affected by two causes, Healthiness of Diet & Activity Habits and Genetic Metabolic Rate Disorders.

But what if metabolic rate disorders are not strictly genetic, but can be epigenetic or can be directly caused by chemical exposure?

That idea does not appear to have crossed their minds.  The framework and approach that are recommended look like they have merit, but I would argue that the authors are not looking at as large a system as they should be.

The environmental factors they do mention are along the lines of the “activity environment” and the food environment.”

Without acknowledging the effects exposure to chemicals might have on people’s propensity towards overweight and obesity the report is more limited than it should have been.  The focus is totally on social and behavioral interventions.  While diet and activity are probably the most important factors in obesity for most people, it appears that no thought has been given to the possibility that by reducing exposure to chemicals we might be able to prevent or at least reduce the rates and extent of overweight and obesity.

Links to Report Information

There are links to several different items here.  The links above are to a news release and the Institute of Medicine (IOM) Report web page (i.e. the page for the project/activity).  Links below are to the full text of the report online, the report recommendations, a four page report brief, as well as links to a webcast and podcast of the briefing on the release of the report, links to related resources (which duplicate some of the other links), and links to pages on the meetings that led to the creation of the report.

Full Report online

Report at a Glance

• Recommendations (HTML)
• Report Brief (4 pp.) (PDF, HTML)

Report: Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making

Released: April 23, 2010

http://www.iom.edu/Reports/2010/Bridging-the-Evidence-Gap-in-Obesity-Prevention-A-Framework-to-Inform-Decision-Making.aspx

• Report in Brief (4 pp.)
• Full Report (for purchase from National Academies Press) with more info and a link to full text online
• Full Report online
• Listen to the Briefing
• IOM Report Web Page

A Framework for Decision-Making for Obesity Prevention: Integrating Action with Evidence

http://www.iom.edu/Activities/PublicHealth/ObesFramework.aspx

Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making

http://www.nap.edu/webcast/webcast_detail.php?webcast_id=420

April 23, 2010

Running Time: 00:58:04

Format: RealAudio (Requires free RealPlayer)  Podcast: (mp3)

To battle the obesity epidemic in America, health care professionals and policymakers need relevant, useful data on the effectiveness of obesity prevention policies and programs. A new report from the Institute of Medicine identifies a new approach to decision making and research that uses a systems perspective to gain a broader understanding of the context of obesity and the many factors that influence it.

Related Resources:

Report Briefs

Full Report

Project Website

Previous Meetings

• Public Report Briefing – Bridging the Evidence Gap in Obesity Prevention April 23, 2010 (11:00 AM)
• Workshop: the Application of Systems Thinking to the Development and Use of Evidence in Obesity Prevention Decision Making March 16, 2009 (9:30 AM) – Includes links to presentations and audios in the right sidebar. (Though I couldn’t get the sections to work using either Firefox or IE.  That was also true for the meeting below.)
• Workshop: Meeting the Challenges of Generating Useful Evidence and Using it Effectively in Obesity Prevention Decision-Making January 8, 2009 (9:30 AM) – Includes links to presentations and audios in the right sidebar.