Reacción a "Prenatal exposure to a mixture of endocrine disruptors is associated with poorer metabolic health in childhood"

As far as my experience goes, it is a high quality work with solid data and methods. It is published by internationally renowned scientists in a leading journal in medicine and public health. 

This study confirms previous results from testing compounds at the individual level. It confirms that prenatal exposure to persistent endocrine disruptors, i.e. compounds that accumulate in fatty tissues, including metals such as mercury, organochlorine pesticides, polybrominated diphenyl ethers (PBDEs) used as flame retardants in plastics among other materials and perfluoroalkyl substances (PFAS), which are widely used in everyday objects, are associated with an obesogenic effect and poorer metabolic health in children aged 6-11 years. 

The study looks at exposure of mothers by groups of endocrine disruptors rather than individually. It is closer to the actual exposure we suffer; we are not exposed to a single endocrine disruptor, but to a mixture of them. The sample of mothers used is large, more than 1,100, which has made it possible to analyse the association with parameters related to metabolic disturbances in offspring by sex. It is, in fact, one of the few studies to analyse sex differences and find that girls are more susceptible to exposure to PFASs and PCBs. 

There are several limitations that the authors identify in the study. One that I think is important to highlight is the large variability in the measurement of non-persistent endocrine disruptors such as phthalates and phenols. This is important because these disruptors have been associated with an obesogenic and diabetogenic effect when studied individually and this study does not confirm this association. This is a result to be taken with great caution.  

There is increasing evidence from both experimental animal studies and epidemiological studies of the obesogenic, diabetogenic and metabolic deleterious effect of exposure to endocrine disruptors. Similarly, at the clinical level, obesity and even type 2 diabetes occur in younger individuals. Poor metabolic health in childhood predisposes to metabolic syndrome in adulthood. Obesity is a public health problem that requires policy and regulatory change and should not be tackled by diet and drugs alone. The 2030 strategy needs to be enforced and exposure to endocrine disruptors needs to be limited at European level. For the time being, at the individual level we can try to reduce exposure as much as possible, especially in periods of increased susceptibility such as pregnancy and the first three years of life.