Furthermore, we must also take into account
how the nutritional advice of health professionals can influence
fetal life. In the early 1990s, in a London hospital, we encouraged
500 pregnant women at random to eat sea fish. There were theoretical
reasons to anticipate a reduction in the incidence of preterm
births and low weight newborn babies. In fact, the only statistically-significant
effect we could detect in the perinatal period—compared
with a control group of 500 women—was an increased average
head circumference (a marker of brain size).(2) This study has
been recently replicated and enlarged in another British hospital
with similar results (not yet published).
Meanwhile S Olsen and NJ Secher, in Denmark, explored the relationship
between seafood intake in pregnancy and the risk of preterm birth
and low birth weight by interviewing 8,729 pregnant women about
their dietary habits.(3) The occurrence of preterm delivery differed
significantly across four groups of seafood intake, falling progressively
from 7.1% in the group never consuming fish to 1.9% in the group
consuming fish on a regular basis. I was given the opportunity
to interpret the apparent contradictions between the results of
our studies and the results of the Danish studies.(4,5) The Danish
researchers , to a great extent, assessed dietary habits that
preceded the beginning of pregnancy. It is probable that dietary
recommendations in antenatal clinics occur too late to have detectable
effects in the perinatal period. Ideally, we should address the
importance of nutrition before the conception of the baby, as
a way to prepare the intrauterine environment. The importance
of the timing is already well understood regarding the usual recommendation
to take folic acid supplements to reduce the risks of neural tube
defects.
The most effective way to influence the prenatal environment is
to prepare it intentionally.
The age of man-made fat-soluble
chemicals
The concept of timing appears particularly important
concerning the effects of fat-soluble synthetic chemicals on health.
Over the years we all have accumulated hundreds of chemicals in
our adipose tissue that would not have been there sixty years
ago because such chemicals did not exist at that time. Many of
these pollutants have a long half-life and we do not have mechanisms
to break them down; therefore they cannot be eliminated by the
kidneys. Since the 1990s we have gathered sufficient data to realise
that a major threat to the health of future generations is intrauterine
pollution by such man-made molecules. Is during this period that
molecules used by cells to ‘talk’ to each other (e.g.
hormones) can effect the way that genes express themselves. They
are biologically active in parts per trillion, thousands of times
more diluted than the level at which toxicological testing is
usually performed. The majority of the genes in our bodies are
only switched on for short windows of development, and then they
shut down until the next generation. This explains why seemingly
very low levels of chemicals can have biological effects on the
fetus through cell signalling disruption at extremely low levels.
Researchers who wanted to explore the long-term effects of human
milk pollution, which is easily detected and therefore well-documented,
provided the first warnings regarding neurological and intellectual
development. Dutch(6,7,8), American(9), and Spanish(10) studies,
after taking into account many associated factors, concluded that
the focus should be on evaluating intrauterine pollution. The
negative effects of such pollution were detectable in all studies.
On the other hand, the advantages of breastfeeding outweigh the
theoretical risks associated with human milk pollution. Once more
the concept of timing is the key to asking the right questions.
Studies of tooth development also implicated the significance
of intrauterine pollution. After combining the results of animal
experiments and clinical studies(11,12), Finnish dentists concluded
that mineralisation defects of the permanent first molars were
the best available indicator of dioxin exposure during fetal life.
The increasing rates of male genital tract disorders are also
related to intrauterine pollution (increased incidence of cryptorchidism(13),
hypospadias(14), and cancers of the testicles(15), reduced average
sperm counts(16)). The most plausible interpretation is that many
synthetic chemicals accumulated over the years in adipose tissues
are hormonal disruptors (more precisely “oestrogen mimickers”);
they interfere with the development of the testis at the very
beginning of intrauterine life. The increasing male/female ratio
of miscarriages(17) and the decreasing male/female ratio at birth(18)
are also explained by the vulnerability of male fetuses to new
environmental hazards.
New objectives for preconceptional
programmes
This list of preliminary warnings will probably
lengthen in the near future. Meanwhile preconception programmes
must encompass new preoccupations. One new objective should be
to reduce the body’s burden of fat-soluble chemicals during
the period before conception. Our approach is based on lipid mobilisation:
the primary objective is to renew the stored fats. Fasting and
physical activity are two mechanisms that can mobilise stored
lipids and fat-soluble chemicals. When there are more free fatty
acids in the blood and therefore more fat-soluble chemicals, the
body must rely on extra-renal means of excretion (sweat, bile
and intestinal excretion).
Our preconception programme takes these facts into account. It
is based on a series of three-day fasting sessions. The principle
is to lose weight and to mobilize fatty acids during each session
and to recover immediately one’s previous weight between
two sessions (“accordion method”). During a session
there is no other food available except a specially- designed
cocktail made from a mixture of maple syrup, palm tree syrup and
lemon juice (adding 100 ml of ‘Natural tree syrup’
and 100 ml lemon juice to 1300 ml water). Cayenne pepper is added
after dilution (a way to slightly increase the body temperature).
The cocktail can be consumed at any time without restriction.
It provides ideal ratios of zinc to manganese to iron, of calcium
to magnesium and of potassium to sodium. The lemon juice represents
the main source of natural vitamin C. This cocktail provides about
600 calories/24 hours.
Steam baths, saunas and exercise are also combined during a session.
Physical activity is adapted to individual lifestyles. Women must
make sure that they cannot become pregnant before, during or immediately
after a session, when they have more chemicals in their blood.
Lactation is another contraindication.
The duration of the programme is six monthly sessions. During
the sessions, subjects consume two servings a day of powdered
Psyllium husks (seed husks of ‘plantago ovata’). The
lipophilic fibres of psyllium husks increase the purging rate
of fat-soluble toxic wastes.
Our programme had been originally designed for mothers-to-be.
Today the concept of ‘male mediated developmental toxicity’(19,20,21)
justifies the participation of both genders.
Evaluating the efficacy of the "accordian
method"
In order to evaluate the efficacy of the ‘accordion
method’, we compared the data provided by blood samples
before and after a six-month programme.
Thirty-four volunteers (23 women and 11 men) presented themselves
for the first blood sample. Groups of three to four participants
were then given written and oral explanations about the programme.
They also received the necessary ingredients (tree syrup, psyllium
husks, cayenne pepper). The local possibilities for steam baths,
saunas and exercise were discussed according to each case. Fourteen
participants presented themselves for the second blood sample.
A great diversity of reasons was given for not having the second
blood test: two women became pregnant; one attempted an in vitro
fertilization after two fasting sessions; one woman was diagnosed
with cancer; there were several divorces and separations leading
to a lack of interest for the programme. The difficulty of enduring
three-day fasting sessions without disturbing a busy life was
often presented as the main reason.
Among the 14 participants who came for the second blood sample,
seven (five women and a couple) had seriously completed the whole
programme. The other seven could not overcome a great range of
difficulties apparently related to their diminishing motivation.
In an unexpected way, we could therefore compare a study (treated)
group and a control (untreated) group.
The Central Science Laboratory in York (UK) tested for 46 ortho-PCBs,
used as markers of fat-soluble chemicals. Their method has been
validated and published after peer review.(22) The analytical
performance of the laboratory in international comparitive studies(23,24,25),
using essentially the same method, has been judged to be acceptable
or better. Results are calculated using internationally-accepted
(26) Toxic Equivalency Factors and expressed in ?g/kilogramme.
Since 46 PCBs were measured twice among the fourteen participants
who had two blood samples taken, the laboratory provided 1288
results. For each participant we calculated the sum of the 46
results for each blood sample, knowing that the calculations were
limited by the fact that 95.20% of the results (1226) were given
as an upper limit and only 4.80% as a more precise evaluation.
In the treatment group, the average sum per person decreased from
1.87?g to 1.61 ?g. This trend to decrease (14% decrease) could
not reach statistical significance (p=0.11). In the control group,
on the other hand, the average sum per person increased from 1.51?g
to 1.76?g, though the difference was still not statistically significant
(p=0.10): is it what we might expect without the accordion method?
Therefore we must confine ourselves to trends and note that the
trend in the treatment group is to decrease, while the trend in
the untreated group was to increase.
Main lessons from our pilot study
The results of our pilot study confirm the need
for larger studies, if possible in populations with higher than
average body burdens of fat-soluble chemicals.
The major difficulties we had to face at every phase of our pilot
study were predictable. It is still not yet commonly understood
that human health is shaped to a great extent during intrauterine
life and that prenatal pollution is a threat for the health of
the future generations. The first difficulty was funding. The
response of the British National Lottery was a typical example.
After filling countless forms, we received a polite, diplomatic
letter suggesting that there are other priorities than evaluating
the efficacy of a preconceptional programme. Ironically, we learned
recently that National lottery lets £2.4 billion sit in
banks.(27) Finally it was thanks to a donation by an anonymous
person that our study became possible.
The second difficulty was to recruit volunteers. While many young
persons can easily accept nutritional supplements, very few are
sufficiently motivated to follow a six-month programme that interferes
with their lifestyle and involves fasting. Finally, among the
34 participants who presented themselves for the first blood sample,
only seven have completed the whole programme. This fact provides
the evidence that such a preconception programme demands strong
motivation and commitment. However we must emphasize that there
is literally no other approach that would not be invasive. In
further research it would be beneficial to recruit participants
living in the same geographical area. This would make monthly
supportive interviews possible. Furthermore it would be beneficial
to encourage the participation of the males. Several women emphasized
the difficult of preparing meals for another person while fasting.
Other criteria might be used in further studies. For example,
biopsies of adipose tissue might be more reliable than blood samples.
Many other liposoluble molecules than PCBs can also be measured.
We need to improve our understanding of the routes the body can
use to eliminate man-made molecules that suddenly appeared in
the environment some decades ago.
Conclusion
The objective of our pilot study was to initiate a new generation
of research. The development of this new generation of research
implies a necessary new awareness. In the future, preconceptional
counselling must reflect new preoccupations based on the life-long
effects of intrauterine pollutants.
This new generation of research will develop more easily when
“Womb ecology” will be recognized as the most vital
branch of Human Ecology.
Michel Odent.
Acknowledgments:
It is thanks to the precious suggestions, encouragements, and
continuous advice of Vyvyan Howard that our study was possible.
Vyvyan Howard is now Professor of Bioimaging, Centre for Molecular
Biosciences, University of Ulster. He is recognized as an expert
in “feto-toxicology”.
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