The role of environmental toxins in disease

Holistic integrative health can be a global solution for the health of people and the planet, said Mimi Guarneri, MD, FACC, ABOIM, co-founder and medical director at Guarneri Integrative Health, Inc., at the 2020 Integrative Healthcare Symposium in New York City.

Western medicine is good in acute care, said Guarneri, but that acute care does not promote health. Practitioners must focus on creating health through nutrition, sleep, mind-body practices, and, by and large, cleaning up the planet, she said.

Cardiovascular disease is one of the leading causes of death in the world. In the U.S., adult obesity rates have reached epidemic proportions, almost one in 10 adults has diabetes, and cases of non-alcoholic fatty liver disease are on the rise. These conditions are preventable, Guarneri said.

“We have to change the paradigm,” said Guarneri. “How dare we keep doing what we do.”

The industrialized food system may have had good intentions, but has dangerous consequences, Guarneri said. The average U.S. farm uses three kilocalories of fossil energy in producing one kilocalorie of food energy, a ratio that does not include the energy used to process and transport the food.

One of the largest beneficiaries of federal agricultural subsidies are the cattle ranchers whose animals graze on federal lands for less than one third the price they would pay on private land. Total subsidies in the federal grazing program cost taxpayers at least $500 million a year, not counting the cost of the environmental degradation caused by overgrazing, Guarneri said.

Industrial agriculture has also resulting in monocultures eroding biodiversity among plants and animals. Chemical pesticides and fertilizers are polluting soil, water, and air, harming both the environment and human health. Soil is eroding much faster than it can be replenished, taking with it the land's fertility and nutrients that nourish both plants and those who eat them. Water is consumed at unsustainable rates.

Animal-based foods are associated with chronic disease, Guarneri said. For example, pesticide residues enter human bodies through air, water, and food and raise risks for certain cancers as well as reproductive and endocrine system disorders. Concentrated, high-speed meat production leads to a greater risk from foodborne pathogens, and excessive use of antibiotics in animal agriculture leads to antibiotic resistance.

Evidence has emerged showing environmental toxins affect mitochondrial function and subsequently induce insulin resistance, Guarneri said. Research published in The Lancet said climate change is the largest health threat in this century. The American Medical Association also released a statement that said, “more attention also needs to be paid to the economic and regulatory policies that encourage the production of unhealthy, non-sustainable food at low immediate financial cost to consumers, at the expense of poorer health outcomes that cost far more to treat with medications and procedures than investments in healthy food.”

This is common sense, Guarneri said. She challenges practitioners and patients to think about the "why" of diagnoses, eliminating the ill-to-the-pill approach and not falling back on sick-to-the-supplement. 

Many consumers believe genetics determine health or disease. However, Guarneri said 70 to 90 percent of chronic disease is influenced by physiology and biochemistry, environment, and lifestyle, with lifestyle being the most significant.

Over time, genes have not changed, but environment has, Guarneri said. We are at a tipping point where we must take action for the health of people and the planet.

The United Nations Sustainable Development Goals include ending poverty, zero hunger, and good health and wellbeing. Guarneri offers a wellness route map, which includes:

• Health and social care as part of a community
• Early intervention and preventative care
• Meaningful scorecard information in real time
• Integrated care in partnership
• Health and wellbeing
• Chronic illness management focused on a return to health
• Integration in culture, practice, and training
• A balanced use of resources where waste becomes a resource
• Caring community
• Healing environments

The first goal of medicine is to establish the conditions for health and wholeness, thus preventing disease and illness, Guarneri said. The second goal of medicine is to cure.

The earth is also the clinician’s client. Humans are part of a local ecosystem and disturbing an ecosystem can affect the health and wellbeing of humans, she said.

“Medicine, in general, should not add to the illnesses of humans or the earth,” said Guarneri. “Medical care should not damage other species on the earth or the ecosystem. We have to think differently.”