2020-2021 Research project

Evaluation of the effectiveness of dietary and lifestyle recommendations to reduce exposure to environmental chemicals in pregnant women: A pilot pre- post study.

Funded by: CIBERESP (Call for projects Intramural Proyectos CIBERESP 2020. Code: P15).

Environmental chemicals represent a very heterogeneous group of ubiquitous agents used in pesticides, plastics, industrial chemicals, among others. Data from biomonitoring programs have found that virtually every European pregnant woman is exposed to many different chemicals on a daily basis (Di Renzo et al., 2015). Robust scientific evidence has demonstrated that preconception and prenatal exposure to toxic environmental chemicals can have a profound and lasting effect on health across the life course (Morrissette et al., 2004; Curl et al., 2019). During pregnancy, chemicals can cross the placenta, and in some cases, such as with halogenated compounds and methyl mercury (Hg), can accumulate in the fetus, resulting in higher fetal exposure than maternal exposure. Moreover, some of these chemicals, the so-called endocrine disrupting chemicals (EDCs), can also interfere with the role of certain hormones, homeostasis, and developmental processes (Fernandez & Olea, 2014). Several systematic reviews have critically evaluated the available body of evidence regarding adverse health impacts of prenatal exposure to environmental chemicals, supporting this hypothesis (Muñoz-Quezada et al., 2013; González-Alzaga et al., 2014; Hernández et al., 2016).
Despite extensive EU policy actions, Europeans remain exposed to “legacy” levels of environmental chemicals, although usually at decreasing concentrations (Porta et al., 2008). For example, the widespread use of organophosphate (OP) pesticides in agriculture and public spaces has led to ubiquitous human exposure and contamination. Remarkably, women in Portugal and Spain have been found to experience from five to seven times higher Hg concentrations than the EU average concentration (EEA, 2018). A third of all babies born in the EU have Hg levels above “the recommended safe limit” (Bellanger et al., 2013), and contamination is worse in countries with higher levels of fish consumption. The potential impact of Hg on child brain development affects the entire lifecourse, and can significantly development and the intelligence quotient (IQ) (Freire et al., 2018).
This evidence has motivated calls to reduce exposure to toxic chemicals in vulnerable populations (Bennett et al., 2016; Hertz-Picciotto et al., 2018), and thus pregnant women are a key population to consider opportunities for exposure reduction during this critical window of human development. Reducing exposure to toxic environmental chemicals is a crucial area of intervention. The primary source of exposure for the general European population to a number of environmental chemicals is through the diet and lifestyle choices (Gasull et al., 2011; Melnyk et al., 2014; Nougadѐre et al., 2012; Oates and Cohen, 2011). The distribution of environmental chemicals also varies according to socio-demographic characteristics (Lewin et al., 2017). Obstetricians, gynaecologists, and other health care professionals are uniquely poised to intervene before and during pregnancy. An important outcome of pregnancy is no longer just a healthy newborn but a human biologically predisposed to be healthy from birth to old age (Coussons, 2013). Patient-centered actions can reduce body burdens of toxic chemicals (i.e. the total amount of chemicals present in the human body at any one time) (ACOG, 2013; Kirk et al. 2017). For instance, previous researches have documented relevant decreases in pesticide internal levels in women after changing from conventional to organic diet (Oatesa et al., 2014). Likewise, avoiding canned food and other dietary sources of bisphenol A (BPA) and analogues has been shown to reduce internal levels of this chemical (ACOG, 2013).
This proposal is framed within previous actions of a multidisciplinary research group that focused on exposure characterization by means of several biomonitoring studies, which have resulted in their leadership in the European Joint Programme HBM4EU (Human Biomonitoring for Europe), among others projects. In addition, our group is committed to public dissemination of science, and we have been involved in social research actions (CSO2014-58144-P, PI: Cristina Larrea) as well as intervention studies during critical windows of development (Olmedo-Requena et al., 2020), which have recently resulted in the publication of guidelines for avoiding chemical exposure during pregnancy and lactation (http://www.ub.edu/toxicbody/es/guia/).

Research team: Juan Pedro Arrébola (Chief Researcher), Cristina Larrea Killinger, Miguel Company, Andrés Fontalba.

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