Diabetes, Obesity and Cumulative Stressors on Health

Elise Miller, MEd
Director

An article highlighting the soaring rates of type 1 diabetes, “Child’s Plague” by Dan Hurley, was just featured in the May 2010 issue of Discover magazine. Hurley, also author of the recent book Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do about It, bases his statistics on the most recent Centers for Disease Control and Prevention’s report indicating 1.7 per 1000 children are diagnosed with type 1 in the US, and the trend is steadily increasing. In Europe, they expect the rate to double between 2005 and 2020. Theories as to why this is happening are wide-ranging, and the researchers interviewed for the article suggest everything from immune dysfunctions to unsuspected bacteria or viruses as possible culprits. In addition, some mention is made of environmental toxics as potential contributors, but it was clear in the article that this latter hypothesis is not yet a front-burner research issue.

Given the dearth of publicly-available, science-based information on environmental contaminants and type 1 diabetes, CHE partner Sarah Howard, MS, took it on herself as a “hobby” to compile a database on all the scientific literature she could find on this topic. She welcomes input on this ‘work in progress.’

A similar undertaking, though on a much larger scale, is underway at NIEHS regarding environmental toxins that may contribute to type 2 diabetes. Kristina Thayer, PhD, acting director of the National Toxicology Program’s (NTP) Center for the Evaluation of Risks to Human Reproduction (CERHR), who heads this study, says they intend to have a draft literature review to circulate for public comment in November 2010 and will hold a workshop in early 2011.

Given the links between diabetes and obesity, several prominent researchers associated with CHE also recently sent an open letter to First Lady Michelle Obama regarding the range of contributing factors to the epidemic of obesity in the U.S. The letter also highlights one factor that has gotten very little attention to date — namely, endocrine disrupting chemicals known as “obesegens.” These chemicals have been shown in animal studies to reprogram metabolism even before birth, triggering a predisposition to obesity — and associated diseases such as diabetes.

All of these nascent efforts to raise awareness about environmental contributors to diabetes and obesity point to the importance of better understanding common biological mechanisms underlying different diseases. In addition, this emerging research compels us to no longer look at one factor at a time, but instead to develop models that accurately capture the array of interacting factors that impact people’s health — what we might call “cumulative stressors.” These can include social, psychosocial, economic, geographical, physical, chemical and biological determinants. Because these cumulative stressors influence people in different ways, depending on where you grew up, where you currently live, where you work or study, your social environments, the food you eat, access to health care and so forth, we must turn our collective attention in this field to designing better research methodologies that reflect this ‘real life’ complexity so that we can heighten our capacity to translate these findings into effective upstream public health interventions.

To learn more about how leaders in the field are addressing these critical issues, please join us on April 19th for our next CHE national partner call: “Cumulative Stressors on Health.”