The Exposome and Perpetual Panic
Activist Scientists have Found a New Means to Scare Us
There is a chemical in my soup. There’s a microplastic that might be harmful. There are particles in the air that could be trying to kill me. A food additive may be causing cancer… All of this talk of potential pollution and contamination is increasing my anxiety and mental well-being. I might need a cigarette, a gallon of ice cream and a strong drink to help me relax.
Scientists tied to the International Agency on Cancer and the Ramazzini cult have introduced a new way to describe the world we live in. A world where exposures to dangerous chemicals in the air, water, food and on everything we touch are just lurking, waiting to enter our bodies and kill us … slowly, painfully. They call this place the “exposome” and we have to start changing how we manage the world where our bodies are now being forced to live under these hazardous burdens.
In the exposome, every breath, every bite, every thing we touch, exposes us to carcinogens and other diseases. And they tell us it is getting worse. New synthetic chemicals are constantly coming onto the market, more ultra-processed foods, microplastics, climate change destroying our air quality – all of these new exposures must be creating a heavier disease burden load on our bodies. Cancer rates are increasing, as well as chronic illness, obesity, diabetes … the exposome is a dangerous place… and we need to act.
I went to a conference yesterday in the European Parliament entitled The Exposome Momentum, with two panels of “high-level speakers” hosted by French S&D MEP Christophe Clergeau. The organizers defined the exposome as “the totality of environmental exposures individuals experience throughout their lives and how these influence health.” What I found was simply old (carcinogenic) wine in a new bottle.
A New Way to Perceive NCDs and Environmental Exposures?
The exposome is just another way to define how the environment influences non-communicable diseases (NCDs), except that by giving it a catchy name, the researchers can generate more funding. Like the old approach, what they lack in data they make up for in policy recommendations. We now have the European Exposome Network to try to shift healthcare to this more preventative approach. The “exposomers” have even given their field an “omic” title – exposomics.
This is not a bad thing. Preventative health measures cost far less than curative and it usually consumes a fractional amount of healthcare budgets. Every year we talk about this; every year the costs of curative healthcare escalate; every year we continue to spend much more on curative healthcare.
But listening to speaker after speaker present the unknown risks lurking in the exposome, I came to realize there are two types of preventative approaches:
A proactive prevention approach encourages healthy living and harm reduction to prevent diseases (promoting a good diet, physical activity, the building of health-promoting infrastructure like parks and bike paths…).
A restrictive prevention takes a more precautionary approach, not only placing controls on lifestyles and products, but linking these health goals to major environmental policy issues (fighting climate change, banning plastics and chemicals and reducing environmental emissions).
In the field of environmental health risk management and harm reduction, data is extremely important since priorities have to be set among scarcities of societal goods. But when you have thousands of potential chemical exposures, countless genetic profiles and historical exposures, data is at best speculative. If we look at some of the effects, like the rise of certain cancers in young populations, how much of that is due to environmental exposures (like chemicals and ultra-processed foods) and how much is due to inactivity of young people from sentient (screen-based) lifestyles, combined with anxiety and mental health issues worsened by that screen content?
Make it Complex … Make it Scary
These high-level exposome experts in the European Parliament were more interested on giving advice on chemical exposures, effects on vulnerable populations and anticipated ecological timebombs. Not one person on the panels focused on promoting harm reduction measures (promoting exercise over screen-time, vaping over tobacco, more salads and high-fiber fruits than complex carbohydrates…). These measures have proven to be very effective in improving public health and preventing or delaying NCDs, but as the last Firebreak series showed, health officials don’t want to get into the harm reduction quagmire.
According to Roel Vermeulen, author of the study on human exposome research, published by the European Parliament’s Panel for the Future of Science and Technology (STOA), 90% of diseases are linked to the exposome. Another speaker, on the second panel, Tabea Sonnenchein, also from the Netherlands, claimed the exposome caused 70% of our non-communicable diseases. Clearly there is a need for better data. In showing a graph of the increases in certain cancer rates among younger people, Vermeulen concluded that there was something terribly wrong going on in our exposome.
Vermeulen’s correlation = causation tactics were a bit tiresome in a house that had seen that game played too many times before.
Something happened in the last 30 years to cause certain cancers to increase.
We don’t know what it is…
… But we had better look at chemicals, plastics, pollution, ultra-processed food (or whatever other campaign people here want heard).
I may be woefully misinformed, but allow me to speculate another correlation.
One thing that has certainly changed for the worst (from a public health perspective) over the last 30 years is that young people spend far more time indoors in front of screens, exposing themselves to content that leads to self-esteem and mental health issues. Anxiety can lead to poor sleep rhythms, substance abuse, consumption of comfort foods… Shouldn’t this be a key focal point for researchers like Roel Vermeulen rather than the usual “Industry is to blame” reflex? For the scientists on the panels, bashing the chemical and food industries was more attractive (and easier than blaming the public).
If 50% of NCD health issues could be addressed by the benefits from more physical activity (in the absence of data, I could speculate that it is far higher) then shouldn’t this be the focus for our healthcare authorities to get some quick preventative health wins? For example, authorities could get people exercising more through improved urban infrastructure (instead of removing all of the water fountains from parks and creating urban deserts). As well as incentives for better lifestyles (like subsidizing fruit and vegetables or gym memberships), building better sidewalks, bike paths and hiking trails can make a big difference.
But instead, people stay inside their homes, in front of their screens, lonely, lazy and stressed out about all of those chemicals lurking in their exposome.
The Preventosome
I am the same age as my father was when he had died. Nobody said back then, at 62, that he was too young to have left us. But if I were to not wake up tomorrow, that would be the first thing my loved ones would say. We are living longer and life expectancy is increasing at a rapid rate, including, also, in developing countries. Why is that?
50 years ago, the smog from coal heating and energy generation caused soot to gather on our skin and in our lungs.
Our gasoline was mostly leaded.
Pharmaceuticals, especially in the cardiovascular fields, were rudimentary and not well used.
Food poisoning outbreaks were common and food preservation and packaging were primitive.
Smoking was widespread, in schools and in restaurants.
There were few sidewalks in suburban areas and gyms or health clubs were uncommon.
We have seen 50 years of remarkable exposure prevention and harm reduction, resulting in longer life expectancies and a better quality of life across humanity. But if you hear how exposomers talk about the threats we face today, you would believe none of these improvements matter and that we are worse off today. The Make American Healthy Again political movement in the US has perpetuated this myth, and if you look at their precautionary rhetoric, they share many strategies with the exposome activist scientists.
The only thing worse today than fifty years ago is that these fearmongers are very well funded, have their NGOs in every capital city, controling the media and the narrative.
Where a heart attack would have knocked me out in my 50s a generation ago, lifestyle, diet and medications have kept me in the game. Cancers from a lifetime of exposures might develop (against the dogma of many exposome proponents, these cancers have mostly been a matter of bad luck) but a generation ago, we wouldn’t have lived long enough to have seen the tumors develop.
This, as well as earlier, better detection, is the reason for the increases in cancers.
Within the exposome, we also have the preventosome, where technologies and wearables are making it easy to detect, prevent and fight diseases. My heart rate and blood pressure are monitored from my wrist with every pulse, blood sugar from a small device and body temperature readings are taken while passing a camera. The technologies for early detection of cancers and other diseases means that survival rates are better and the treatment technologies are advancing at a remarkable rate.
I don’t share the negativity and fear-mongering of the exposomers.
The Key to Health: Water, Walking and Will Power
What the exposomers do is take another, precautionary approach to NCD prevention. Reduce potential exposures to harmful pollutants, chemicals, food contents… This is not proactive prevention (like encouraging walking in nature) but restrictive prevention (ie, precaution). Such an approach is reactive and, quite often, arbitrary given how complex such exposures are.
Without a focus on harm reduction first, the best these exposomic activists will achieve is public fear and panic. At worst, their confused messages are health harming. For example:
they seem to be focusing on health risks from synthetic chemicals or processed food, ignoring natural chemicals or calories. In the US in particular, there has been a boom in raw milk consumption, animal fats for frying and naturopathic alternatives to vaccines and medicine.
The irrational fear of (synthetic) pesticides, often amplified by the exposomers, and the higher price of lower yielding organic food, leads to a reduction of fruit and vegetable consumption. It is widely known that the best way to prevent cancers is by eating at least five servings of fruit and vegetables per day.
Some of these scientists focus on minor risks from vaping, and in their confusing messaging, keep more people smoking tobacco.
There is a lot of bias built into the exposomers’ complex hypotheses when so many harm reduction solutions are quite simple and effective. They should concentrate on the message of the three Ws for health: water, walking and will power. Very simple, very effective, but I suppose these activist scientists can’t get much funding for that.
There are many determinants in exposure reduction strategies with high levels of uncertainties. A walk in nature will benefit everyone; but cutting out types of food or lifestyle practices could have different effects on genetic, mental health, metabolic factors… We need to focus on the quick wins and appreciate how much such public health solutions have improved the quality and length of our lives.
Maybe I should stop panicking about what these exposome scientists want me to believe. Instead of that stressed out cigarette, ice cream and hard drink, maybe I’ll just shut my screens off and go for a walk.