Environmental toxins, obesity, and diabetes: an emerging risk factor.

T he inviolable assumption that obesity is simply a thermodynamic problem of calories in/calories out is being dissembled by the science linking environmental toxins to obesity and diabetes. Exposure to environmental toxins in the absence of increased caloric intake induces weight gain and insulin resistance. Stated simply, toxins are an invisible, unappreciated cause of obesity and diabetes. Clearly, our sedentary, high-stress lifestyle and our high-glycemic, trans fat– and saturated fat–rich, low-fi ber, phytonutri-ent-poor diet contributes to the epidemic of diabetes and obesity. But the increasing burden of environmental toxins, including persistent organic pollutants and heavy metals, can no longer be ignored as a key etiologic factor in the epidemic of obesity and diabetes , or what should be called " diabesity, " the continuum of metabolic dysfunction mild insulin resistance to end-stage diabetes. Diabesity is our modern plague. The many conditions that exist under the umbrella of diabesity affect more than one billion people worldwide. More than 100 million Americans (including 50% of those over age 65) suffer from the condition in its various forms. The Centers for Disease Control and Prevention estimates that nearly 24 million Americans (including 23% of those over age 60) suffer from type 2 diabetes. 1 More than 50% of people over 65 have diabesity. Nearly 6 million diabetics are undiag-nosed. Diabetes and the resultant cardiovascular mortality is a global problem outpacing infectious disease as a cause of morbidity and mortality in developing countries. 2 It now affects more than 240 million people worldwide and is projected to affect 380 million by the year 2030. This is nearly 10 times the number of people affected by HIV/AIDS worldwide. 3 Diabesity has been identifi ed as one of the leading causes of cardiovascular disease, 4 dementia 5 and cancer. 6 Consider this: From 1983 to 2008, the number of people in the world with diabetes increased seven-fold, from 35 million to 240 million. Shouldn't our main question be why this is happening , rather than what new drug we can fi nd to treat it? Diabesity also places a large economic burden on our society. The direct and indirect costs of diabetes in America in 2007 amounted to $174 billion. The cost of obesity is also signifi cant, amounting to $113 billion every year. During the past 10 years, these two conditions cost America alone a total of $3 trillion. That's three times the estimated cost …