Further to our yesterday article (Yiu, 2019a), the top 2 cancer-incidences are breast cancer and prostate cancer in the world, both are hormone-related cancers. In recent years, more and more studies found the relationship between Endocrine Disrupting Chemicals (EDC) or hormone-disrupting food are related to the increasing incidence of hormone-sensitive cancers.
First of all, according to the IPES-Food (2017) report on the Food-Health Nexus, there are 5 ways that food systems affect our health (Figure 1), viz. (1) Occupational Hazards, (2) Environmental Contamination, (3) Contaminated Foods, (4) Unhealthy Dietary and (5) Food Insecurity. There are 3 compounding factors: (A) Unsanitary Conditions, (B) Climate Change, and (C ) Poverty and Inequality.
The Food-Health Nexus has been causing us insurmountable costs of the sick-care system, including the $7 trillion losses due to Non-communicable Diseases (NDC), and $557 billion on the EDC exposure. (Figure 2)
Focusing on cancer, it is reported that “In 2012, there were 14 million new cases of cancer, and 8.2 million cancer-related deaths globally. Cancer accounted for 16.7% of all healthy years lost in the European Union in 2002, and 12.5% of all healthy years lost in the United States and Canada.” (IPES-Food, 2019, p.48)
Even with such a heavy loss and huge burden to the health-care system is found to be related to, among others, the EDC exposure, but still very little is done in the eradication of EDC in the food production process.
Figure 2 shows the 8 health impacts via the environmental contamination pathways, viz. (1) Foodborne Diseases, (2) Zoonotic Infections, (3) Nitrogen-based Air Pollution, (4) EDC Exposure, (5) Nitrate and Phosphate Contamination from Runoff, (6) AMR Spread, (7) Heavy Metals, and (8) Transport-based Air Pollution and CO2 Emission. (Figure 3)
Let’s focus on EDC exposure and its food-cancer nexus in this article.
- What is EDCs:
“EDCs — chemicals that interfere with hormonal systems — are ubiquitous in food systems, and are generally seen to pose one of the greatest challenges for public health.”
2. Where are EDCs found in the food systems?
“These chemicals are found in: the pesticides used in conventionally grown crops; the hormones used in meat, poultry, and dairy production; the inside lining of canned foods and some plastic containers; compounds used as food preservatives; and, even in non-stick cookware. Contamination of surface water with EDCs can result from agricultural runoff, fish hatcheries and dairy facilities, and livestock operations. There are close to 800 chemicals known or suspected to function as EDCs.”
3. What are the impacts of EDCs on human health?
“A substantial and growing body of evidence is converging upon the conclusion that exposure to EDCs contributes to increased chronic disease burdens. Epidemiological research has identified several likely mechanisms that link long-term, low-dose pesticide exposure to higher risks of developing cancer in adults. Currently, the strongest accumulations of evidence (mechanistic, experimental, animal, and epidemiological) relate to bisphenol-A, phthalates, pesticides, persistent organic pollutants such as polychlorinated biphenyls, polybrominated diethyl ethers, and dioxins, and their links to obesity and diabetes, male reproduction, female reproduction, hormone-sensitive cancers in females (Crain et al., 2008; Roy et al., 2009), prostate cancer (Chia et al., 2010), thyroid, and neurodevelopment and neuroendocrine systems. Furthermore, both paternal and maternal exposure to EDCs in pesticides have been associated with adverse reproductive effects, including miscarriage, preterm birth, stillbirth, neonatal death, and foetal distress. Neurotoxins are known to have strong adverse effects on the developing brain, and in-utero exposure has been linked to a range of developmental impacts. Increased rates of cancer, and specifically brain tumours, have also been identified among the children of agricultural workers.” (IPES-Food, 2017, pp. 27–28)
4. Level of doubt?
It is reported that ‘the Endocrine Society, on the basis of a comprehensive literature review, concluding that recent data “removes any doubt that EDCs are contributing to increased chronic disease burdens related to obesity, diabetes mellitus, reproduction, thyroid, cancers, and neuroendocrine and neurodevelopmental functions” (Gore et al., 2015, p. 601).’ (IPES-Food, 2017, pp.84–85)
The three particular references showing the relationships between EDC exposure and hormone-sensitive cancers are retained as cited here for your easy reference.
Besides EDC exposure, “overconsumption of animal products has also been found to be connected with heart disease, diabetes, and various cancers (Feskens et al., 2013; Green et al., 2016; Melnik, 2012; Oggioni et al., 2015; Tilman and Clark, 2014). Some studies have identified excess insulin-like growth factor (IGF-1) as a driver of cancer cell proliferation in humans, e.g., in breast cancer, and have linked high IGF-1 levels to animal protein regardless of total protein intake levels (Endogenous Hormones and Breast Cancer Collaborative Group et al., 2010; Rowlands et al., 2009; Zhang et al.,2010). Specific types of meat have also been associated with increased NCD risks. Following reclassification in 2015, the WHO considers that processed meats (such as hot dogs, ham, sausages, corned beef, canned meat, and meat-based sauces) may cause colorectal cancer and are associated with stomach cancer (IARC/WHO, 2015). It also considers that red meat (i.e., all muscle meat, such as beef, veal, pork, and lamb) is linked to colorectal, pancreatic, and prostate cancers (IARC/WHO, 2015).” (IPES-Food, 2017, pp41–42)
It probably explains why the incidence rates of breast cancer and prostate cancer in Hong Kong has been sharply increasing by 100% and 200% in the past decade, due to the substantial consumption of red processed meat and dairy products as shown in my previous article (Yiu, 2019b) and the poor monitoring system of food safety in the city. Unfortunately, processed food culture has been deep-rooted in HK. Eating processed and EDC-containing food is nowadays ubiquitous and seems to be unavoidable. Worse still, the government of HK has no action plan for reducing the consumption of processed food or EDC-containing food. Since there is almost zero local food production in HK, if the government does not implement any effective measures on imports and distributions, there is almost no way to avoid consuming processed and EDC-containing food in HK.
Chia, V.M., Li, Y., Quraishi, S.M., Graubard, B.I., Figueroa, J.D., Weber, J.-P., Chanock, S.J., Rubertone, M.V., Erickson, R.L., McGlynn, K.A. (2010) Effect modification of endocrine disruptors and testicular germ cell tumour risk by hormone-metabolizing genes. Int. J. Androl. 33, 588–596. doi:10.1111/j.1365–2605.2009.00975.x
Crain, D.A., Janssen, S.J., Edwards, T.M., Heindel, J., Ho, S., Hunt, P., Iguchi, T., Juul, A., Mc-Lachlan, J.A., Schwartz, J., Skakkebaek, N., Soto, A.M., Swan, S., Walker, C., Woodruff, T.K., Woodruff, T.J., Giudice, L.C., Guillette, L.J. (2008) Female reproductive disorders: The roles of endocrine-disrupting compounds and developmental timing. Fertil. Steril. 90, 911–940. doi:10.1016/j.fertnstert.2008.08.067
Endogenous Hormones and Breast Cancer Collaborative Group, Key, T.J., Appleby, P.N., Reeves, G.K., Roddam, A.W. (2010) Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: Pooled individual data analysis of 17 prospective studies. Lancet Oncol. 11, 530–542. doi:10.1016/S1470–2045(10)70095–4
Gore, A.C., Chappell, V.A., Fenton, S.E., Flaws, J.A., Nadal, A., Prins, G.S., Toppari, J., Zoeller, R.T. (2015) Executive summary to EDC-2: The Endocrine society’s second scientific statement on endocrine-disrupting chemicals. Endocr. Rev. 36, 593–602. doi:10.1210/er.2015–1093
IARC/WHO (2015) IARC Monographs Evaluate Consumption of Red Meat And Processed Meat. International Agency for Research on Cancer of the World Health Organization, Geneva.
IPES-Food (2017) Unravelling the Food-Health Nexus: Addressing practices, political economy, and power relations to build healthier food systems. http://www.ipes-food.org/_img/upload/files/Health_ExecSummary(1).pdf
Rowlands, M.-A., Gunnell, D., Harris, R., Vatten, L.J., Holly, J.M.P., Martin, R.M. (2009) Circulating insulin-like growth factor peptides and prostate cancer risk: A systematic review and metaanalysis. Int. J. Cancer. 124, 2416–2429. doi:10.1002/ijc.24202
Roy, J.R., Chakraborty, S., Chakraborty, T.R. (2009) Estrogen-like endocrine disrupting chemicals affecting puberty in humans: A review. Med. Sci. Monit. Int. Med. J. Exp. Clin. Res. 15, RA137–145.
Yiu, C.Y. (2019a) Incidence Rates and Death Rates of Various Cancers in Hong Kong, Medium, July 16. https://medium.com/@edwardyiu/incidence-rates-and-death-rates-of-various-cancers-in-hong-kong-f376defbd8ff
Yiu, C.Y. (2019b) Meat Consumption Growth in Hong Kong is Alarming, Medium, May 19. https://medium.com/@edwardyiu/meat-consumption-growth-in-hong-kong-is-alarming-872e46bf40ca
Zhang, Y., Ma, B., Fan, Q. (2010) Mechanisms of breast cancer bone metastasis. Cancer Lett. 292, 1–7. doi:10.1016/j.canlet.2009.11.003