An agroecological Europe in 2050: multifunctional agriculture for healthy eating

Findings from the Ten Years For Agroecology (TYFA) modelling exercise

The Independent Institution for Sustainable Development and International Relations (IDDRI) published its “Ten Years for Agroecologyresearch, showing that a transition to a kind of agriculture that is free from synthetic chemistry is absolutely realistic.

AGROECOLOGY: AN AMBITIOUS AND SYSTEMIC PROJECT

Jointly addressing the challenges of sustainable food for Europeans, the preser-vation of biodiversity and natural resources and the fight against climate change requires a profound transition of our agricultural and food system. An agroeco-logical project based on the phasing-out of pesticides and synthetic fertilizers, and the redeployment of extensive grasslands and landscape infrastructure would allow these issues to be addressed in a coherent manner.

AN ORIGINAL MODELLING OF THE EUROPEAN FOOD SYSTEM

The TYFA project explores the possibility of generalising such agroecology on a European scale by analysing the uses and needs of current and future agri-cultural production. An original quantitative model (TYFAm), linking on a systemic manner agricultural production, production methods and land use, makes it possible to analyse retrospectively the functioning of the European food system and to quantify an agroecological scenario by 2050 by testing the implications of different hypotheses.

PROSPECTS FOR A LESS PRODUCTIVE AGROECOLOGICAL SYSTEM

Europe’s increasingly unbalanced and over-rich diets, particularly in animal products, contribute to the increase in obesity, diabetes and cardiovascular diseases. They are based on intensive, highly dependent agriculture: (i) synthetic pesticides and fertilizers—with proven health and environmental conse- quences; (ii) imports of vegetable proteins for animal feed—making Europe a net importer of agricultural land. A change in diet less rich in animal products thus opens up prospects for a transition to an agroecology not bound to main-tain current yields, thus opening new fields for environmental management.

SUSTAINABLE FOOD FOR 530 MILLION EUROPEANS

The TYFA scenario is based on the widespread adoption of agroecology, the phasing-out of vegetable protein imports and the adoption of healthier diets by 2050. Despite an induced drop in production of 35% compared to 2010 (in Kcal), this scenario: – provides healthy food for Europeans while maintaining export capacity; – reduces Europe’s global food footprint; – leads to a 40% reduction in GHG emissions from the agricultural sector; – regains biodiversity and conserves natural resources.Further work is needed and underway on the socio-economic and policy impli-cations of the TYFA scenario.

Endocrine Disruptors : from Scientific Evidence to Human Health Protection

The European Parliament publishes new report on endocrine disrupting chemicals, 2019

The European Society of Endocrinology welcomes the new European Parliament report on Endocrine Disrupting Chemicals (EDCs) written by Prof Barbara Demeneix of the Muséum National d’Histoire Naturelle in Paris, France and member of the ESE EDC Working Group and Dr Rémy Slama, INSERM (National Institute of Health and Medical Research), Grenoble, France.

Abstracts

Presentation

This study, commissioned by the PETI Committee of the European Parliament, presents the scientific knowledge regarding the health effects of endocrine disruptors, a class of hazards recognized in EU regulation since 1999. This report reviews the scientific evidence regarding the concept of endocrine disruption, the extent of exposure, associated health effects and costs. The existing relevant EU regulations are discussed and recommendations made to better protect human health.

1.1.2 The drug diethylstilboestrol (DES)

DES was developed as a synthetic oestrogen. It was prescribed from the 1940s onwards. Prescriptions were based on the erroneous assumption that it could prevent miscarriage and other pregnancy complications, which was shown to be wrong in 1953. In 1971, the USA Food and Drug Administration (FDA) advised against its use due to vaginal cancers occurrence in girls born to mothers who had used DES, while this cancer usually develops post-menopause. DES was banned in the Netherlands in 1975 and in France and Spain in 1977. Women who took DES have a slightly higher risk of breast cancer, but the most striking effects are seen on offspring exposed during pregnancy. Epidemiology shows in utero DES exposure to be linked not only to vaginal cancer in daughters of exposed women, but also to reproductive tract disorders, infertility and higher rates of spontaneous abortion. Sons display higher rates of genital abnormalities, and increased risks of prostate cancer; in addition, an increased risk of testicular cancer has been suggested. Importantly, effects such as increased risk of malformations of the male genitalia and possibly attention deficit and hyperactivity disorders (ADHD) are also observed in the grandchildren of DES-prescribed women.

In contrast to DDT, which is persistent in the body, DES is quickly eliminated, showing that chemicals can exert effects long after they disappeared from the organism, possibly on successive generations. There are biological mechanisms whereby the organism could keep a memory of exposure. One possibility relates to adverse effects that can be traced to epigenetic modifications. Work on animal models shows that certain DES impacts could result from epigenetic effects on the germ cells (the sperm and egg cells) forming in the in utero DES exposed foetuses).

Both DDT and DES provide examples of compounds able to interact with the endocrine system in humans or wildlife species (DES was designed to mimic a natural hormone, oestrogen; DDT and its metabolites were found to alter hormone production, mimic oestrogen and block androgen actions) and to cause adverse effects. They resonate with a concept developed in 1.7 and 1.9: the Developmental origin of Health and Disease (DOHaD), underlining foetal life as a determinant factor for child and adult health.

The scientific report, commissioned by the Parliament’s Committee on Petitions, provides an excellent overview of the severe threat EDCs pose for EU society and highlights the many shortcomings of current EU policies and legislation. Amongst the many proposed regulatory measures, it urges the European Union to rapidly develop a set of trans-sectorial and harmonised regulations to minimise human and environmental exposure to EDCs. As discussed in the report, based on an extensive literature review, EDCs or suspected EDCs are currently present in all media (water, diet, food contact materials, cosmetics…) and most EU citizens have dozens of (suspected) EDCs in their bodies.

In addition to improved regulatory measures, the report stresses the importance of speeding up test development to effectively identify EDCs and calls for additional research to address the many knowledge gaps in this relatively new scientific area.

These calls for additional regulation and research at the EU level are in line with a recent ESE Statement in response to the disappointing European Commission Communication on EDCs from 7 November 2018, which in ESE’s view lacks ambition to effectively tackle the many challenges in this area.

DES DiEthylStilbestrol Resources

Helping patients choose wisely

New UK recommendations emphasise shared decision making

As the tree of overdiagnosis has grown, efforts have been made to trim the branches. Initiatives such as Preventing Overdiagnosis, Too Much Medicine, Slow Medicine aim to increase our understanding of how it manifests itself. Efforts such as Choosing Wisely are underway to affect policy and change patient expectations and to change well-entrenched medical practices.

Abstract

Overdiagnosis and overtreatment are common, harmful to patients, and expensive. Doctors and patients tend to overestimate the benefit and underestimate harm of interventions. Choosing Wisely is a medically led campaign focusing on engaging doctors and patients in decisions about potentially unnecessary medical tests, treatments, and procedures. It started in the US in 2012 and has now been taken up in 22 countries worldwide, including the UK.

Read the full text on The BMJ, 2018.

“Helping patients choose wisely”

This statement grandly assumes that patients have no wisdom. Whilst it might well apply to many patients, there are equally many who are very well aware and informed of the best course of action to be taken.

bm Patient Karyse Day’s response, 2018.

Effect of environmental and pharmaceutical exposures on fetal testis development and function

A systematic review of human experimental data, 2019

Abstract

BACKGROUND
Overall, the incidence of male reproductive disorders has increased in recent decades. Testicular development during fetal life is crucial for subsequent male reproductive function. Non-genomic factors such as environmental chemicals, pharmaceuticals and lifestyle have been proposed to impact on human fetal testicular development resulting in subsequent effects on male reproductive health. Whilst experimental studies using animal models have provided support for this hypothesis, more recently a number of experimental studies using human tissues and cells have begun to translate these findings to determine direct human relevance.

OBJECTIVE AND RATIONALE
The objective of this systematic review was to provide a comprehensive description of the evidence for effects of prenatal exposure(s) on human fetal testis development and function. We present the effects of environmental, pharmaceutical and lifestyle factors in experimental systems involving exposure of human fetal testis tissues and cells. Comparison is made with existing epidemiological data primarily derived from a recent meta-analysis.

SEARCH METHODS
For identification of experimental studies, PubMed and EMBASE were searched for articles published in English between 01/01/1966 and 13/07/2018 using search terms including ‘endocrine disruptor’, ‘human’, ‘fetal’, ‘testis’, ‘germ cells’, ‘testosterone’ and related search terms. Abstracts were screened for selection of full-text articles for further interrogation. Epidemiological studies involving exposure to the same agents were extracted from a recent systematic review and meta-analysis. Additional studies were identified through screening of bibliographies of full-texts of articles identified through the initial searches.

OUTCOMES
A total of 25 experimental studies and 44 epidemiological studies were included. Consistent effects of analgesic and phthalate exposure on human fetal germ cell development are demonstrated in experimental models, correlating with evidence from epidemiological studies and animal models. Furthermore, analgesic-induced reduction in fetal testosterone production, which predisposes to the development of male reproductive disorders, has been reported in studies involving human tissues, which also supports data from animal and epidemiological studies. However, whilst reduced testosterone production has been demonstrated in animal studies following exposure(s) to a variety of environmental chemicals including phthalates and bisphenol A, these effects are not reproduced in experimental approaches using human fetal testis tissues. Image credit academic.oup.

WIDER IMPLICATIONS
Direct experimental evidence for effects of prenatal exposure(s) on human fetal testis development and function exists. However, for many exposures the data is limited. The increasing use of human-relevant models systems in which to determine the effects of environmental exposure(s) (including mixed exposures) on development and function of human tissues should form an important part of the process for assessment of such exposures by regulatory bodies to take account of animal-human differences in susceptibility.

Effects on offspring of epigenetic inheritance via sperm

Sperm-inherited H3K27me3 impacts offspring transcription and development in C. elegans

In experiments with worms, researchers showed that epigenetic marks on sperm chromosomes affect gene expression and development in offspring.

2019 Study Abstract

Paternal epigenetic inheritance is gaining attention for its growing medical relevance. However, the form in which paternal epigenetic information is transmitted to offspring and how it influences offspring development remain poorly understood.

Here we show that in C. elegans, sperm-inherited chromatin states transmitted to the primordial germ cells in offspring influence germline transcription and development. We show that sperm chromosomes inherited lacking the repressive histone modification H3K27me3 are maintained in that state by H3K36me3 antagonism. Inheritance of H3K27me3-lacking sperm chromosomes results in derepression in the germline of somatic genes, especially neuronal genes, predominantly from sperm-inherited alleles.

This results in germ cells primed for losing their germ cell identity and adopting a neuronal fate. These data demonstrate that histone modifications are one mechanism through which epigenetic information from a father can shape offspring gene expression and development.

Reference. Press release.

Accès aux soins de santé et équité : René Frydman s’adresse à Emmanuel Macron

La recherche française manque de moyens et peine à faire face à la concurrence

Le médecin René Frydman, pionnier de la fécondation in vitro, est spécialiste de la reproduction et du développement de l’assistance médicale à la procréation en France, et producteur de l’émission “Matière à penser” sur France Culture.

Intervention de 3:22:30 à 3:28:55.

“Nous sommes au moment où un projet de loi sur la santé en 2022 est discuté. […] Il me semble que la démocratie sanitaire pourrait être un exemple de cette transition vers le futur.“

René Frydman interroge la possible subdivisions des régions en “territoires de santé” qui tiendraient compte des transports, de la population…

“Nous sommes en perte de vitesse totale” […] “Nous étions participants aux recherches fondamentales du traitement de la reproduction. Aujourd’hui, il est très rare que les Français soient dans les congrès internationaux.”

Il estime qu’il y a une nécessité de rediscuter de la PMA, mais qu’on ne peut pas l’étendre sans un procédé à la hauteur des espérances, ce qui nécessite de prendre en compte la prévention, l’information, la recherche et une vigilance éthique. Il aimerait aussi un plan de lutte contre l’infertilité.

Lire Recherche scientifique : Emmanuel Macron interpellé sur le manque de moyens, franceculture, 18/03/2019.

Effects of PFAs during pregnancy : New research underway in New Hampshire

New research about the effects of per- and polyfluoroalkyl substances on pregnant women and young children is being performed in NH

Andrea Amico, co-founder of the community activist group Testing for Pease, said even though more is being learned nationally about the effects of PFAS exposure on the adult population, there is a gap that needs to be filled when it comes to the next generation.

“Our babies are already born contaminated,” “Children are a very sensitive population and we need to take extra precautions in examining their exposure to make sure they are safe.”

Amico said.

Officials at the Centers for Disease Control and Prevention say some studies already suggest PFAS exposure may affect growth, learning and behavior of infants and older children, as well as lower a woman’s chances of getting pregnant. In Portsmouth, Amico’s organization is working as a community liaison for a $2.6 million federally funded study that will examine the effects of PFAS on the immune systems of kindergarteners exposed to contaminated drinking water at Pease International Tradeport and on Massachusetts’ Cape Cod.

Shaina Kasper, New Hampshire state director for Toxics Action Center, said they hope this research will add to the body of knowledge on PFAS and the effects of exposure in utero and as young children. Researchers from Silent Spring Institute and Northeastern University will examine the children’s immune response before and after their kindergarten booster shots, she said.

At the Geisel School of Medicine at Dartmouth College in Hanover, Assistant Professor of Epidemiology Megan Romano is working with the New Hampshire Birth Cohort to get data for 1,000 women from the Concord and Lebanon regions. She hopes to find out more about PFAS exposure’s effects on gestational weight gain, breastfeeding and early life physical growth of children. Romano said the blood samples she is using were already collected by the cohort in 2009, when there was concern about arsenic in private water wells. The samples were taken from women between 18 and 45 years old who were between 24 and 28 weeks pregnant.

“We’re hoping to have the exposure data back some time in June. It will probably be six or seven months before we have findings we can publish,”

Romano said.

Romano said even though there is not strong evidence yet to support the theory that PFAS exposure could lead to more serious health issues for children, such as pediatric cancers, there are still many areas to explore as scientists learn more about the contaminants. The CDC says PFAS exposure can increase the risk of cancer in adults.

“I think it’s an important question for us to understand more about,”

Romano said.

Earlier this month, officials from the U.S. Environmental Protection Agency unveiled their action plan for per- and polyfluoroalkyl substances. It is the first time the agency has built a multi-media, multi-program, national communication and research plan to address an emerging environmental challenge like PFAS. EPA officials intend to establish a maximum contaminant level for PFOA and PFOS, two of the most well-known and prevalent PFAS chemicals. By the end of this year, they will propose a regulatory determination, which is the next step in the Safe Water Drinking Act process for establishing a MCL. In May of last year, EPA convened a two-day National Leadership Summit on PFAS in Washington, D.C., that brought together more than 200 federal, state and local leaders from across the country to discuss steps to address PFAS. Following that summit, the agency hosted a series of community engagement events, including one in Exeter.

Dix conseils pour déceler le vrai du faux sur les articles de pharmacologie (sociale)

Petite leçon de décryptage d’un article médical

Publié par Luc Perino, médecin généraliste, humeur du 18/03/2019

Les sciences de la santé étant les plus faciles à corrompre, voici dix points devant susciter la méfiance, lors de la lecture d’un article parlant d’un médicament dans la presse générale.

  1. S’il est dit que la maladie concernée est sous-diagnostiquée ou diagnostiquée trop tardivement, l’article est probablement lié à des conflits d’intérêts ou sous influence directe de l’industriel. Manipuler l’opinion par la nécessité d’un diagnostic précoce est très efficace, car conforme à l’intuition populaire.
  2. S’il est question de « fléau du siècle », il faut vérifier si le fléau correspond à la maladie citée. Dire que le cancer est un fléau n’a pas de pertinence pour parler de certains cancers (prostate, col de l’utérus, mélanosarcome) dont chacun a un faible poids dans la mortalité. En outre, la grande fréquence d’une maladie ne signifie pas que l’article qui en parle soit pertinent. Cela devrait plutôt indiquer l’échec de ceux qui en ont la charge.
  3. Lorsqu’il s’agit d’une étude en cours, on peut cesser la lecture dans l’attente de résultats concrets. Car les échecs des études médicamenteuses sont généralement passés sous silence, contrairement aux échecs de la fusée Ariane qui sont tous mentionnés.
  4. Lorsque l’article surexploite le mythe du progrès. Vanter des succès historiques n’est pas suffisant pour anticiper un succès futur. Particulièrement dans le domaine de la santé.
  5. Lorsque l’article se résume à un ou plusieurs témoignages de cas individuels, cela ne suffit pas à établir une vérité médicale. Que ce soit l’exploitation d’un seul incident pour dénigrer un vaccin, ou la satisfaction d’un seul patient pour clamer l’efficacité d’un médicament.
  6. Lorsque la « charité » domine. La compassion et l’altruisme sont communs à tous les primates. Il est raisonnable de penser que les médecins ne font pas exception. Celui qui clame trop ostensiblement sa compassion est suspect. Très souvent la flamboyance de l’altruisme est proportionnelle au coût des thérapeutiques qui le sous-tendent.
  7. L’argument de l’action. En écho au fléau et à la compassion, le fameux « nous devons absolument faire quelque-chose » est une démagogie qui élimine, a priori et sans preuve, la possible supériorité de l’abstention.
  8. Lorsque l’article comporte des attaques ad hominem, comme accuser les adversaires du médicament d’être des intégristes ou des ayatollahs. On peut être intègre sans être intégriste.
  9. Lorsque la démonstration moléculaire est théoriquement trop parfaite. Le réductionnisme ne fonctionne pas pour les pathologies multifactorielles. Il faut attendre les résultats sur la quantité-qualité de vie. Production de recherche et production de santé ne sont pas synonymes.
  10. Enfin il faut déchirer tout article vantant une pharmacologie préventive dans les domaines où il est évident que seule la prévention hygiéno-diététique est efficace. Ce sont hélas les plus nombreux.

En Savoir Plus

Focusing on overdiagnosis as a driver of too much medicine

“Ironically, even though it causes harm, the effects of overdiagnosis look like benefits. People with disease that is overdiagnosed do well because, by definition, their disease was non-progressive. They are “cured” when cure was not necessary in the first place. This creates a cycle that reinforces efforts leading to more overdiagnosis. “

Healthcare is in a tailspin as the rush to offer technology and services turns otherwise healthy people into concerned patients by identifying disease that is not destined to cause them harm.

Abstract

Why overdiagnosis is hard to spot and to explain to individuals

Overdiagnosis, sometimes known as “pseudodisease,” turns people into patients unnecessarily. It identifies deviations, abnormalities, risk factors, and pathologies that were never destined to cause harm (such as symptoms, disability, or death). Overdiagnosis causes anxiety and other negative consequences of labelling; it leads to wasted resources and side effects as a result of unnecessary treatment. Here we consider overdiagnosis in asymptomatic people. Overdiagnosis also occurs (and causes harm) in symptomatic individuals when expanded disease definitions overmedicalise unpleasant ordinary life experiences, but we do not consider it here due to distinct conceptual differences between the two in terms of driving causes and ability to identify overdiagnosis in individuals.

Real but elusive trigger of too much medicine

Overtesting and overtreatment can be identified in a given patient. There is a consensus based on solid evidence that a patient with low back pain but without specific neurological signs or deficits who undergoes magnetic resonance imaging of the spine…

… continue reading on The BMJ, 17 August 2018.

Image credit newlifefoundation.

Nanoplastics damage marine creatures’ natural defences, increasing lethal effects of POPs

Nanoplastic Ingestion Enhances Toxicity of Persistent Organic Pollutants (POPs) in the Monogonont Rotifer Brachionus koreanus via Multixenobiotic Resistance (MXR) Disruption

Nano-sized particles of plastic can be more damaging to marine species than larger sized microplastics, a new study shows.

Lab tests revealed that nanoplastics can damage cell membranes in tiny marine creatures called rotifers (Rotifera), disrupting their natural defences against toxicants.

The researchers found that rotifers that had been exposed to nanoparticles of polystyrene were significantly more susceptible to the lethal effects of persistent organic pollutants (POPs). Reference.

Abstract

Among the various materials found inside microplastic pollution, nanosized microplastics are of particular concern due to difficulties in quantification and detection; moreover, they are predicted to be abundant in aquatic environments with stronger toxicity than microsized microplastics. Here, we demonstrated a stronger accumulation of nanosized microbeads in the marine rotifer Brachionus koreanus compared to microsized ones, which was associated with oxidative stress-induced damages on lipid membranes. In addition, multixenobiotic resistance conferred by P-glycoproteins and multidrug resistance proteins, as a first line of membrane defense, was inhibited by nanoplastic pre-exposure, leading to enhanced toxicity of 2,2′,4,4′-tetrabromodiphenyl ether and triclosan in B. koreanus. Our study provides a molecular mechanistic insight into the toxicity of nanosized microplastics toward aquatic invertebrates and further implies the significance of synergetic effects of microplastics with other environmental persistent organic pollutants.