Ecological medicine addresses the interactions between the individual and the environment and their health consequences - both the impact of environmental factors on the individual, and that of each individual’s actions on the environment, upon which we all depend.

There are five interlacing aspects:

Nutrition

Individual intakes of macro- and micro-nutrients, for which we are dependent on the environment, determine ability to function in a changing world.

We live in an era of hunger in plenty; of overnutrition and malnutrition. In the UK, over half of adults and nearly one child in four are overweight. Vitamin and mineral levels in food are simultaneously declining, in which depletion of soil nutrients by intensive agriculture is a factor. Levels in our tissues follow close behind.

Modern life demands much of the human body and mind; persistent stresses deplete our nutritional and hormonal resources, and the high and still rising levels of toxins to which we are exposed (see Toxins below) deplete our bodily defences. Indoor lifestyles enabled by technology deprive us of sunlight and vitamin D. Falling levels of selenium in food and human samples have been linked to falling male fertility. Almost 50% of people in the UK recognise some benefit from nutritional supplements, in contrast to many scientists and doctors who reject the empirical logic.

Toxins

Exposure to pollutants and environmental toxins can damage our bodily systems, deplete our resources and trigger disease. They continue to accumulate in the environment, and thus in our food, water, air, and on indoor surfaces.

Pesticides, flame retardants and other non-natural molecules, together with heavy metals, are toxins that accumulate in our tissues. Many are known carcinogens and/or endocrine disruptors. Emerging evidence places them on DNA, altering gene expression, and on mitochondria, interfering with cellular energy production. The potential consequences include chronic fatigue disorders, auto-immune disease, autism, vulnerability to allergies and more.

Many of us carry genetic polymorphisms (see Individuality below) which make us less able to handle and excrete toxins, which can exacerbate or prolong inflammation. Chronic inflammation predisposes to a range of diseases including obesity, diabetes, heart disease, cancer, psychological disorders and neurodegenerative diseases.

Allergy

Multiple factors can alter our immune responses to elements of air, food, water and the environment. Once triggered, the immune system can learn an abnormal and harmful response to external factors.

We live in an allergy epidemic; UK allergy rates rose 27% in just the four years to 2007. Food intolerances, chemical sensitivities and inhalant allergies are the same in this. There is no single reason for this; the reasons include all the factors in this article. Levels of nutrients, essential for immune function, in food and in our bodies are in decline (see Nutrition); levels of toxins are simultaneously rising (see Toxins); certain genomic variations can make allergies and sensitivities much worse (see Individuality). These statements are also true of auto-immune disease, effectively allergy to our own tissues.

The BSEM has long been concerned about the risk of allergic responses triggered by genetically modified foods, on which the evidence continues to grow.

Individuality

Genomic (inherited) and phenotypical (acquired) individuality determines our ability to cope with altered states of nutrition and toxicity, and with multiple other stresses.

Roger Williams’ seminal work Biochemical Individuality: The Basis for the Genetotrophic Concept was published in 1956, but it was not until the completion of the human genome project that we acquired a window into genomic individuality and its effects on health. The window is still small, but already we know that common genetic polymorphisms can dramatically influence our ability to detoxify exogenous chemicals, and that such variations can increase the probability of allergies and sensitivities (see Allergy) more than ten-fold. Failure to excrete toxins can also predispose to heart disease, cancer and most of the diseases of the modern age (see Toxins). Other common polymorphisms can increase individual requirements for vitamins B12 and B2 (see Nutrition).

Environment

Our actions, not least in healthcare, influence the sustainability of the planetary environment. In the UK, health amounts to 8.4% of GDP, in the USA twice that. Not only is the carbon footprint of healthcare enormous, but its capacity to pollute is even greater.

Pharmaceutical manufacturers pollute waters downstream of their factories, especially in the developing world; both contraceptive and chemotherapeutic drugs excreted by patients have been found in UK waters; hospital incinerators can pollute more than municipal ones due to their urban location; plasticisers in IV lines and many other chemical waste products are toxic to both humans and wildlife.

In the words of USA senator Barbara Mikulski; ‘How can we heal the person if we don’t heal the planet?’ How much longer can we afford industrialised medicine? Ecological medicine seeks to develop an ethics of heathcare based on the inward impact of the environment on the individual and on the return loop of individual impact, both of patients and practitioners, on the environment.