The Interplay Between Environmental Chemical Exposures and Obesity Proceedings of a Workshop (2016) / Chapter Skim
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6 Research Needs
6 Research Needs
Pages 111-122
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From page 111... ...
An important need is to identify environmental chemicals that cause weight gain or changes in body composition, she said. Another important need is to understand the windows of susceptibility.
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From page 112... ...
In doing toxicological studies, it would be valuable to maintain the lab animals long enough to see effects, particularly when the research is looking at developmental effects. Researchers often hold animals just to weaning, Birnbaum noted, or perhaps until puberty, but to see the sorts of effects on weight and metabolism that are of interest, it will be important to keep the animals at least until they are 1 year of age.
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From page 113... ...
Researchers should be shifting their focus from solely on obesity to paying more attention to the metabolic syndrome and diabetes, Birnbaum suggested, because it is not obesity per se that is the major health risk but, rather, diabetes and metabolic issues. It would be valuable to coordinate the epidemiological studies with the animal studies, she said.
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From page 114... ...
The fate and transport of environmental chemicals -- as well as human exposure to such chemicals -- are affected by both natural and anthropogenic changes in the environment, she said. The human-driven changes in the environment vary across the world, depending on societal demands for land and natural resources and the changes in resource consumption that are driven by economic prosperity.
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From page 115... ...
The research needs identified in the USGS strategy include the systematic evaluation of sources; the distribution and state of EDCs in the environment; identification of the routes of exposure to EDCs of fish, wildlife, and humans; studies of how EDCs accumulate in animal and human tissues; research into the effects of simultaneous exposures to mixtures of chemicals; investigations into the mechanisms of action of EDCs and the mechanisms by which EDCs cause adverse effects; improvements in analytical techniques, laboratory methods, and biological assays for identifying EDCs in the environment; investigations into less studied endocrine pathways involving metabolism, behavior, fat storage, bone development, and immunity; and the identification of new potential EDCs. "Those challenges that we have identified as a research strategy specifically for EDCs can, as I said, connect very well to the kinds of challenges that I heard articulated over the last day and a half," she said.
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From page 116... ...
Researchers should be looking for animal models for some of the things that affect the body composition of offspring in humans, such as maternal obesity, preexisting obesity prior to pregnancy, high maternal weight gain during pregnancy, and gestational diabetes. With such models, researchers could start to ask how these various factors make the offspring more likely to be affected by the mother's exposure to certain environmental chemicals.
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From page 117... ...
If one thinks of obesity as the result of an energy surplus, he said, the obvious solution is to reduce that energy surplus by decreasing energy intake or increasing energy expenditure, which in turn is done either by increasing activity or by increasing metabolic need. Clinicians have tried to attack obesity in this way by asking people to eat less or to move more or by using drugs or surgery to reduce intakes or increase expenditures.
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From page 118... ...
I think that is a strategy that requires a multifactorial approach to a multifactorial disease." DISCUSSION Linda Birnbaum began the discussion by noting that the collection of environmental chemicals that had been talked about at the workshop was much smaller than the complete list of chemicals of concern. There was no mention of pesticides, for instance, and little talk of nicotine and tobacco smoke, even though there are some striking data connecting maternal smoking with both obesity and type 2 diabetes in offspring.
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From page 119... ...
Because so many of the EDCs are waterborne or water mediated, he said, it might offer some additional insights to deal more with fish, which live in a water environment all the time. Suzette Kimball responded to that comment by saying that there is a fairly robust body of ongoing research concerning bioaccumulation, looking at how these chemicals of interest reach higher and higher levels as you move up the food chain, and fish are the species of choice in that work.
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From page 120... ...
Birnbaum responded that NIH is in the process of launching a major research initiative on precision medicine that will eventually involve more than 1 million subjects compiled mainly from existing studies. "The idea," she explained, "is to have access to the electronic health records and expand that with additional questionnaires, so you would have both biomedical exams and extensive questionnaire data and potentially take biological specimens and so on." The project might offer the opportunity to include some environmental factors as well, she said.
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From page 121... ...
One audience member asked what sort of funding proposals researchers should be submitting, given that everyone agrees that understanding obesity will require understanding multiple factors and how they interact but that the funding agencies still seem to respond best to very focused proposals. Are the funding agencies ready for some interdisciplinary research with experts from various fields coming together and trying to answer questions about obesity?
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From page 122... ...
"We can't really afford 10 or 20 or 30 years of understanding the entire biology of a system before we start taking action to protect people," she said. The same thing is true for treatment, she said, because so many people are already obese and are struggling with such diseases and diabetes and the metabolic syndrome.
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