The Interplay Between Environmental Chemical Exposures and Obesity Proceedings of a Workshop (2016) / Chapter Skim
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7 Obesity Policy Solutions Discussed at the Workshop
7 Obesity Policy Solutions Discussed at the Workshop
Pages 123-138
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From page 123... ...
Concerning policies regarding environmental exposures and obesity, Bhojani said, a key question will be whether sufficient and clear evidence should be required before the next step is taken, whether that would be too late and the next steps should be taken in the absence of such evidence, and, if that is the choice, exactly how that would be done. The session consisted of presentations by four speakers1 and then a wide-ranging discussion period involving not just the speakers but the Roundtable members and members of the workshop audience.
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From page 124... ...
That is, there are harmful environmental chemicals that are ubiquitous, and one study found that 43 chemicals were seen in virtually every pregnant woman in the United States. Furthermore, research has shown that environmental chemicals can cross the placenta, and a number of the environmental chemicals that women are exposed to are known to affect fetal development.
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From page 125... ...
So, once ACOG had a committee opinion to work from, it began working at the national and state levels to regulate environmental chemicals. ACOG has identified various policy gaps.
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From page 126... ...
Concerning environmental chemicals that promote obesity, she said, the good news is that there are ample data that may be used to take action and reduce public exposures to the endocrine disrupters like bisphenol A (BPA) , arsenic, and persistent organic pollutants that had been presented as case studies at the workshop.
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From page 127... ...
The reason is that, unlike attempts to change individual behavior practices, which often revert to the original practices even after changes have been made, environmental interventions have the potential to create permanent changes that affect an entire population. In many cases, she said, environmental interventions have been cost-effective ways of reducing exposure to hormone disrupters.
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From page 128... ...
For example, she said, a number of savvy consumers began to avoid products with high levels of high-fructose corn syrup, which led to an increased use of organic brown rice syrup as a sweetener in many processed foods. "And now we are realizing that rice, and especially brown rice, is loaded with arsenic," she said, "so people who are buying supposedly more healthy processed food are actually buying food with arsenic in it." The Environmental Working Group, Lunder said, has been working to identify the most obvious problems concerning consumer exposures, problems for children, and the safety of the food supply and trying to fix them.
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From page 129... ...
LaKind and her colleagues observed similar inconsistencies for reports on associations between urinary BPA levels and various types of assessments for heart disease. Similar inconsistencies were found for studies examining associations between the levels of phthalate metabolites and obesity, type 2 diabetes, and cardiovascular disease.
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From page 130... ...
It should be well written, concise, and easy to understand. In particular, because many members of the public have a difficult time understanding environmental exposures, policy needs to be written in a way that they can easily understand and that allows them to implement it in their daily lives.
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From page 131... ...
She works with the Pediatric Environmental Health Specialty Unit, a national organization of networks across the country that does environmental health consults for families. It provides a document that offers various recommendations on how to reduce exposures to phthalates and BPA: buy low-fat dairy products such as skim milk and low-fat cheeses, buy fresh or frozen fruits and vegetables when possible, avoid canned and processed foods, and so on.
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From page 132... ...
The lesson is this: it can be very difficult to advise people on how to avoid these exposures because even the most careful, doctor-designed programs may not do what they are expected to do. DISCUSSION The discussion period began with a question from a Web audience member, Janet Young, who referred to Judy LaKind's comments about inconsistencies in studies on the effects of environmental chemicals and commented that in 2009 Chemical and Engineering News reported that gut bacteria influence the toxicity and effectiveness of pharmaceuticals.
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From page 133... ...
Sheela Sathyanarayana commented that it is known that the highest exposure concentrations for many of these chemicals, because they are derived from the diet, come at night after an entire day of eating. Thus, when they do their studies they ask their study participants to get samples at night.
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From page 134... ...
Thus, many changes may be made without the creation of new regulations, but those changes will not come quickly enough, she said, as long as there are such large gaps in knowledge about these chemicals. Frank Loy commented that TSCA reform is the biggest single legislative effort that the health community and the environmental community are going to see but that it will inevitably be a bipartisan effort, which means that, from the health community's point of view, it will not be the absolutely ideal bill.
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From page 135... ...
With the advent of biomonitoring, it has become possible to get very good measurements of what a person has been exposed to, but it is often difficult to interpret all those data because the idea of source apportionment -- knowing exactly how much exposure is coming from each type of source -- has been lost. While the traditional methods of exposure science, which inherently included source apportionment, might feel outdated to some people, she said, they are extremely important and capture information not available from biomonitoring.
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From page 136... ...
There are often changes in processing over time, which changes the sorts of chemicals that the foods are exposed to -- and contaminated with -- during processing, so it can be difficult to say exactly where certain chemical exposures arise. Linda McCauley of Emory University asked if any of the clinicians at the workshop might comment on the best ways for health practitioners to talk with members of the public about the various issues related to environmental exposures and obesity.
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From page 137... ...
The question, then, is how to get issues related to environmental exposures and obesity to be considered part of that broader effort to fight obesity. Dealing effectively with environmental exposures and obesity will require an effort broader than that which has been waged to date, she said.
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From page 138... ...
In press. Environmental epidemiology harmonization to improve public health decision-making: A three-part proposal.
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