Consumption of pesticides treated fruits and vegetables linked with reduced fertility in women

Regular dietary consumption of fruits and vegetables treated with pesticides is linked to lower probability of live births and success rates of ARTs according to a study from Harvard T.H. Chan School of Public Health published October 30, 2017 in JAMA.

Animal exposure to pesticides at environmentally relevant concentrations is known to decrease the number of live births. Whether this holds good for humans is topic for research in recent years, the effects of high dose exposure causing reproductive injuries is already known.

More than 600 different pesticides chemicals, resulting into 1000s of combinations are available in US market with more than 450 kg applied every year.

Occupational exposure to high dose of some older pesticides are known to cause reproductive injury in exposed males causing infertility and azoospermia.

This prospective epidemiological study uses sophisticated biological markers to identify the effects of subclinical everyday exposure pesticide residues in fruits and vegetables on female fertility.

The study recruited 325 women undergoing infertility treatment as part of the Environment and Reproductive Health (EARTH) study. The women filled out study questionnaire about the daily consumption of fruits and vegetables. Women’s exposure to pesticides was calculated based on US government database of average pesticide residues on fresh fruits and vegetables.

The study found that women who ate more than two servings (2.3) of high-pesticide fruits or vegetables each day, compared with women who ate an average of one each day, were 18% less likely to become pregnant and 26% less likely to have a live birth than women with the lowest exposure.

If you can exchange one high-pesticide fruit or vegetable a day for a low-pesticide one, your odds of pregnancy are increased by 79% and live birth by 88% say the researchers.

Strawberries, spinach and peppers, tend to consistently make into the list of ‘dirty dozen’, a list of 12 most contaminated fruits and vegetables, while others, like peas and avocados, rank lower.

Jorge Chavarro, associate professor of nutrition and epidemiology at Harvard Chan School and senior author of the study, said that women trying to conceive may want to limit their intake of high-pesticide fruits and vegetables or eat organic versions, or choose low-pesticide produce such as avocados, onions, or oranges. “I am now more willing to buy organic apples than I was a few months ago,” he told TIME.

When the researchers modeled the effect of swapping one high-pesticide fruit or vegetable a day for a low-pesticide one, they found 79% higher odds of pregnancy and 88% higher odds of a live birth.

Dr. Yu-Han Chiu, a research fellow in the department of nutrition at the Harvard T.H. Chan School of Public Health and first author of the study told CNN "Although we did find that intake of high-pesticide-residue fruits and vegetables were associated to lower reproductive success, intake of low-pesticide-residue fruits and vegetables had the opposite association."

The researchers agree that the study just show an ‘association’ and more work is needed before a direct ‘causation’ can be established. Also, the results pertain to certain subset of women who already had reproductive issues and were seeking fertility treatment.

The study is accompanied by a commentary by Philip J. Landrigan titled

Pesticides and Human Reproduction

Which fruits you should buy organic

It's not always possible or affordable to buy completely organic produce. Nutritionist Lisa Drayer shows us which fruits to look for in the organic section.

Source: CNN

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Endocrine Disruptors linked to Endometriosis, Fibroids and rising healthcare costs!

 European Union data revealed that Women are facing a potential risk of several reproductive disorders being exposed common chemicals in the household and incurring huge public health cost.

Endocrine-disrupting compounds (EDCs) act as covert bombers of environmental toxins on human body. They are ubiquitous in our environment, entering our bodies without our knowledge-plastic linings in cans, water bottles, toys and most recently in the thermal paper used in cash register and gas pump receipts.

The recent study led by Patricia Hunt, PhD, at Washington State University was published online March 22, 2016 in the Journal of Clinical Endocrinology & Metabolism. The researchers found that exposure to controversial chemicals, like phthalates and diphenyldichlorethene (DDE), increase a woman’s likelihood of developing endometriosis and fibroids, causing reproductive health problems and incurring a whopping sum of  estimated €1.4 billion ($1.5 billion) a year in health care expenditures and lost earning potential to European Union.

Senior author Leonardo Trasande, MD, MPP, associate professor of pediatrics, environmental medicine & population health at NYU Langone Medical Center, New York, opines that this is just the tip of the iceberg of the entire female reproductive disease burden due to EDC.

Hunt and her colleagues identified other chemicals namely dioxins and polychlorinated biphenyls (PCBs), among others -- but decided to focus on phthalates and diphenyldichlorethene (DDE) as most robust set of data existed for these chemicals. 

DDE is a breakdown product of the insecticide DDT that, although banned in the United States in 1972 and in Europe starting in the 1970s still lingers in the environment and enters our body through food. The main exposure to phthalates is through eating food and drink stored in plastic containers that have phthalates.

In both cases, the epidemiological evidence was low and toxicological evidence was moderate but of all the total cases 20%–39% cases were attributed to these chemicals.

The researchers determined that 145,000 cases of endometriosis among women aged 20 to 44 years and 56,700 cases of uterine fibroids in Europe could be attributed to exposure to endocrine-disrupting chemicals.

In women 15-54 of age, the exposure to DDE was measured in 12 studies by taking a sample of cord blood. They then adapted an Intergovernmental Panel on Climate Change (IPCC) model for determining the probability of causation. The women were separated into groups according to degree of exposure, with the lowest level used as the base and than the odds ratio for developing fibroid was calculated.

The process for phthalate attributable endometriosis was similar, but the investigators relied on data from a large biomonitoring study called as DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale (DEMOCOPHES). Human biomonitoring (HBM) involves collecting samples from human volunteers – blood, hair, saliva or urine – and measuring the levels of indicators of chemicals uptake (known as biomarkers) that are of interest.

The authors further added that "Although it is highly appropriate to focus on these extremely important uterine tract health deficits, [polycystic ovary syndrome], infertility, and pregnancy complications also affect a considerable number of women, have major cost implications, and are increasingly linked to EDC exposures." For instance, phthalate exposure has a 40% to 69% likelihood of causing 618,000 additional assisted reproductive technology procedures each year, and a 20% to 69% likelihood of causing 42,400 new cases of childhood obesity each year.

The director of the National Institute of Environmental Health Sciences and the National Toxicology Program Linda S. Birnbaum said “Some of these chemicals, including PCBs and dioxins, have already been restricted through a treaty called the Stockholm Convention on Persistent Organic Pollutants, which went into effect in 2004.”

The current study is important because it focused on chemicals that have not been restricted, and in the case of DDE -- which persists in the environment -- are not able to be restricted.

"This study is kind of a wake-up to say endocrine disruptors impact the female reproductive system, and we have some evidence they are associated with an increase in endometriosis and fibroids and it costs a lot of money," Birnbaum said.

Not all researchers are convinced by the methodology. They say that to imply causation based on current data is highly speculative because most of the data is based on observational study and trials is human are hard to do.

Even with all the questions that remain, and few regulations in place, "there are safe and simple steps that families and women can take to reduce exposure to endocrine-disrupting chemicals," Trasande said.

"They can eat organic, reduce canned food consumption, which reduces exposure to BPA, and avoid packaged or highly processed food, which is a major route for phthalates to enter food. They can also open windows to allow chemical dust, which accumulates on the carpet and electronics, to circulate out of homes."

Although the study had several limitations: it focused on adult EDC exposure only; it relies on assumption of causation; and it focuses only on two reproductive disorders and two EDCs, it does draws attention on urgent need of  further research , government regulations and public awareness on the issue of toxic chemicals in the environment.

References:

http://press.endocrine.org/doi/10.1210/jc.2015-2873

http://saferchemicals.org/health-report/chemicals-and-our-health/reproduction/

http://www.aboutlawsuits.com/endocrine-disruptor-women-study-97423/

http://www.medpagetoday.com/OBGYN/GeneralOBGYN/56864

http://www.eu-hbm.info/democophes

http://www.thedoctorwillseeyounow.com/content/womens_health/art4602.html

https://www.endocrine.org/news-room/current-press-releases/womens-health-endocrine-disruptors-diabetes-research-will-be-in-spotlight-at-endo-2016