As naturopaths, we practice medicine based on our founding principle, Vis Medicatrix Naturae: the healing power of nature. When the obstacles to healing are removed and the essential building blocks are present, the body has an inherent ability to heal itself. The most fundamental and time tested of these are clean water, clean food and good rest. These principals have been tested by the founders of naturopathic medicine and will continue to be true into the future. However, in our world today, having access to clean water, food, and rest is getting more difficult. In this article we will explore ways to help raise awareness about how these fundamentals apply in our world today and how simple modifications in your recommendations to patients can make a big difference in the patient’s health and the health of the planet.
Imagine a 37-year-old female patient coming into your office. She has a family history of breast cancer and was diagnosed with a benign breast lump, a fibroadenoma, when she was 31 years old. She is concerned because she has recently read on the internet that there may be a correlation with fibroadenomas and the development of breast cancer in the future.1 She is coming to your clinic because she would like advice on ways to prevent developing breast cancer. When addressing breast cancer etiology and prevention, one of the things you may consider is the role that estrogen plays. Knowing how estrogen gets recirculated via reabsorption in the gut, particularly with decreased bowel transit time, you may suggest that she drink more water, among other things. But did you think to tell her to not drink her water out of plastic?
Toxin Exposure
Many of our favorite sporty hard plastic water bottles contain estrogen mimickers, specifically bisphenol A, which has been shown to bind to estrogen receptors in humans and induce changes associated with carcinogenesis in the breast tissue of mice.2 It has also been shown to increase insulin resistance, increase the risk of miscarriage and aneuploidy, stimulate behavioral changes associated with ADHD, and is associated with early puberty.3-7 Bisphenol A (BPA) is found in water bottles, baby bottles, food storage containers, the lining of most food cans and in some dental sealants. And you thought mercury was bad! Plastics in this class usually have a number 7 (meaning “other” plastic) stamped on the bottom of the container. In most cases, this means they are made from polycarbonate. Be aware though that newer plant-based bio-plastics (polylactic acid or PLA) may have the number 7 as well. Industry sources cite studies showing that “human exposure to BPA from food contact use of polycarbonate plastic is very low and poses no known risk to human health”.8 Clearly there is some controversy regarding the safety of these products. However, if there are serious concerns about their safety, when practicing preventative medicine it is better to be safe than sorry, until we know that they truly are safe.
Diet
Next, you would want to address your patient’s diet. You might recommend increasing fiber, fruits and vegetables, foods rich in polyphenols such as curcumin and genistein, and decreasing simple carbohydrates. By telling her to increase fruits and vegetables however, you also have a good opportunity to educate her about organic foods and reducing exposure to pesticides. For example, many pesticides have been shown to have estrogen-like effects, and have been found in higher amounts in women with breast cancer versus those with benign breast disease.9 Despite being banned in the U.S., pesticides like DDT, aldrin, and hexachlorobenzene can persist in our environment and exert their powerful effects for decades. In combination with other pesticides, they can exert their effects on human breast tissue at levels that, when alone, would be considered safe.10
Dietary changes alone cannot completely eliminate our exposures, but a recent study of children showed how much we can decrease pesticide exposure through diet. In the study, the researchers examined the urine of 23 children and compared the amounts of pesticides excreted when eating a conventional diet compared to an organic diet. When eating their usual conventional diet, the levels of metabolites of malathion and chlorpyrifos were significantly higher than when eating similar foods which were organic. The levels of these pesticide metabolites dropped quickly and dramatically when the children were switched to an organic diet, some to non-detectable levels.11 Organophosporus pesticides, such as malathion, have been shown to increase the malignant potential of breast cells.12 In vitro studies have shown that curcumin (found in Curcuma longa) and isoflavonoids such as genistein (found in Glycine max and other legumes), have been shown to effectively inhibit the growth of both ER-positive and ER-negative breast cancer cells, even those induced by pesticides and other environmental exposure.13 Once again when preventing disease, it is important to reduce exposure to unnecessary and potentially unsafe chemicals.
Rest
And finally, you are likely to recommend to your patient that she reduce her stress, relax on the couch more often and get plenty of good sleep. A good-quality resting environment should be quiet, dark, clean, uncluttered and free from harmful contaminants. You may recommend that your patient evaluate her home and bedroom, looking for potential sources of exposure, such as unwanted noise, light, dust, and mold. What she may not know is that there may be endocrine disrupting chemicals, such as PBDEs, polybrominated diphenyl ethers, that are used as flame retardants in the foam of mattresses and couches. PBDEs are chemically related to dioxins and PCBs, and persist in humans, wildlife and the environment. While few human studies have been conducted, neonatal exposure to PBDEs has been shown to affect learning and memory functions in adult animals. In-utero exposure to PBDEs in male rats leads to decreased levels of sex steroids, decreased anogenital distance (associated with feminization), and increases in sexually dimorphic behavior typically associated with females.14 PBDEs have also been shown to decrease levels of thyroid hormone, and to act as an agonist to alpha and beta estrogen receptors.15, 16 While still widely used in the United States, the European Union has banned PBDEs and is currently phasing them out of production.
Prevention
So how can you teach your patients to avoid potential harm from these chemicals? First and foremost, tell your patients to switch from plastic water bottles, especially polycarbonate (#7) and PVC (#3), to glass or stainless steel water bottles. If they insist on continuing to use plastic, recommend that they avoid washing their bottles with harsh detergents or in the dishwasher, and dispose of them once they are old and scratched. Because these chemicals are more harmful at particular times of human development, infants are especially vulnerable. If your patients have children, encourage them to use non-polycarbonate or non-PVC baby bottles and sippy-cups. Safer options include polyethylene (#2) or polypropylene (#5) plastic bottles, or those with the disposable polyethylene (#4) inserts. Silicone nipples are a safer alternative than the latex variety. The use of plastics in the microwave should be avoided. Also stay away from any plastics containing phthalates (used as a softener) as well as plastics numbered with #3, #6 and #7 in general. Recommend your patients use home water filtration devices, so that water is not being stored in plastic jugs in the home.
Advise limiting the use of canned foods, and encourage cooking foods from scratch. Recommend that your patients eat organic foods whenever possible, using the Dirty Dozen and Terrific Twelve guide when shopping. For the home, suggest vacuuming frequently to reduce PBDE exposure through household dust and counsel patients against the use of pesticides both indoors and outdoors whenever possible. Finally, recommend that they consider buying an organic cotton mattress for themselves and their children made with wool, which has natural flame retardant qualities.
As a physician, there are ways that you can have an impact as well. Rather than feeling overwhelmed and helpless, work with your patients and your community to make good choices that support your health and the health of the environment. Educate your patients and friends and write letters to policy makers voicing concerns about the effects of these products on our collective health. Purchase safe products for use in your practice. Support companies who are committed to not using PBDEs such as Intel, Volvo, Sony, Hitachi, IKEA, and Toshiba, among others.17 And let the money you spend and the actions you take send a clear message about the world in which you want to live. By educating your patients about how the choices they make can impact their health and how they may reduce their exposures to harmful substances in their everyday life, you can effect even greater change, improving your patient’s health and the health of the world in which we live.