Ecological medicine is best described as a systems approach to health.
(Systems thinking is the process of understanding how things influence one another within a whole, according to Wikipedia).
Ecological medicine considers the interactions between individuals and the environment, and their health consequences:
INPUTS; the impact of nutritional and environmental factors on the individual,
PROCESSING; the way we handle inputs and how that determines our health,
OUTPUTS; the impact of each individual’s actions on the environment, upon which we all depend.
INPUTS from the environment to the individual:
Individual intakes and levels of macro- and micro-nutrients, for which we are dependent on the environment, help to determine our 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 crucial factor. Levels in our tissues follow close behind.
Falling levels of selenium in food and human tissue samples have been linked to falling male fertility. Indoor lifestyles enabled by technology deprive us of sunlight and vitamin D - finally being acknowledged as an important factor in health. 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.
Oils and fats are essential components, both structural and functional, of our bodies. But 50 years of the still-unproven saturated fat-cholesterol theory of heart disease etc has actually led to deficiencies in essential fats and deteriorating public health.
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 deplete our bodily defences.
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. Sitting at the top of the food chain we are subject to the biomagnification effect; we are even more poisoned than what we eat.
Pesticides, flame retardants and many other non-natural molecules, together with heavy metals such as mercury and lead, 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, allergies, auto-immune disease, autism, neurodegenerative diseases, cancer and more.
Classical toxicology assumed that for every substance there exists a threshold level below which it can do no harm. But that threshold keeps moving downward, as our exposures move inexorably upward. And this applies to agents such as electromagnetic fields just as much as to polluting chemicals.
PROCESSING by the individual
Dr Stephen Davies, one of the founders of this society, described the Nutrient-Toxin Interface - the principle that the more toxins to which we are exposed the more nutrients we need to deal with them. This struggle plays out in two main areas;
Multiple factors can alter our immune responses to elements of air, food, water and the environment. Once triggered, the immune system can develop inappropriate and harmful responses to external factors (allergy) and to internal ones (auto-immunity), as well as failing to eradicate threats both external (infections) and internal (cancer, mutations, ageing).
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 all increasing. The reasons for this 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 Environment); certain genomic variations can make allergies and sensitivities much worse (see Individuality).
Auto-immune diseases are, in effect, allergic reactions to our own tissues. There is an epidemic of these diseases too. Toxic exposures, genetic variations and lack of nutrients are known to increase the risk of developing them.
The BSEM has also long been concerned about the risk of allergic responses triggered by genetically modified foods, on which the evidence continues to grow.
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, and has always been a key text for us. 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, for example, that polymorphisms which influence our ability to detoxify can increase by more than ten-fold our risk of developing problems such as allergies or Alzheimer’s, and can predispose to heart disease, cancer, and most diseases of the modern age. Other common polymorphisms can greatly increase individual requirements for B vitamins and other nutrients.
Many of us carry genetic polymorphisms that can trigger, exacerbate or prolong inflammation. Chronic inflammation predisposes to, or is involved in, a range of diseases including obesity, diabetes, heart disease, cancer, psychological disorders and neurodegenerative diseases.
Chemicals in the body can also have epigenetic effects; they can directly influence the switching on and off of genes. This can even impair our ability to deal with other toxic factors, leading to a vicious cycle of damage to cells.
Our actions, not least in healthcare, influence the sustainability of the planetary environment. In the UK, health amounts to 7.5% 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; contraceptive, chemotherapeutic and psychotropic 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.
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.
In the visionary words of a USA senator; ‘How can we heal the person if we don’t heal the planet?’ We have a duty of care for the planet too.