GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II) 271

Global Health Crisis Caused by the Collision of Biological and

Cultural Evolution: Pre-Natal Influences on Acute and Chronic
Diseases in Later Life¹
E. TROSKO, James𝑎, ,
𝑎
Center for Integrative Toxicology, Institute for International Health, Michigan State University, Department of Pediatrics/Human
Development, College of Human Medicine, East Lansing, Michigan 48824, USA

Abstract – In the context of finite global resources for sustained healthy human survival, popu-
lation explosion, increased environmental pollution, decreased clean air, water, food distribution,
diminishing opportunities for human self-esteem, increased median life span, and interconnected
causes of acute infectious and chronic diseases, the need to understand the factors leading to
human diseases will be necessary for both the long term prevention and for managing short-
term crises heath problems. e transition of our pre-human nutritional requirements for sur-
vival to our current unequal and culturally- shaped diet has created a biologically mismatched
human dietary experience. While genetic, gender, and developmental stage factors contribute to
human diseases, various environmental and culturally-determined factors are now contributing
to both acute and chronic diseases. e transition from the hunter-gatherer to an agricultural -
dependent human being has brought about a global crisis in human health. Initially, early humans
ate seasonally-dependent and calorically-restricted foods, during the day, in a “feast or famine”
manner. Today, modern humans eat diets of caloric abundance, at all times of the day, with foods
of all seasons and from all parts of the world, that have been processed and which have been
contaminated by all kinds of factors. No longer can one view, as distinct, infectious agent –re-
lated human acute diseases from chronic diseases. Given the predicted increase in the number
of new births before the end of this century, a serious effort must be made to provide a healthy
in utero environment for the most vulnerable stage of human development in order to prevent
alterations in organ-specific adult stem cell numbers and stem cell –based diseases later in life.
is new concept provides a mechanistic explanation for how pre-natal maternal environmental
or dietary exposures can now affect diseases later in life (Barker Hypothesis). is concept points
to a moral imperative to provide new global strategies for beer nutritional education and dietary
opportunities for pregnant women in various cultures and economic circumstances.

Keywords – One Health; Barker hypothesis; prenatal development; “metabolic diseases”; biological
evolution; cultural evolution; food safety; epigenetic toxicology

“As we look out upon the world today, there is no ex- 1. Baground to the ”sustainable One Health” con-
cuse for optimism or no reason for despair. We have gone cept
far in the wrong direction. We have recklessly squandered
the wealth of the earth and the wealth of human nature. Currently, while many classic infectious diseases still
But we are learning what we have done. In that knowl- plague the world’s 7 billion people, a major global health
edge is the possibility of a beer performance.”(Oo, 1940, crisis is occurring, in that, obesity-related “metabolic dis-
p. 192) eases” (diabetes, cardiovascular and cancers) are starting
to drain the world’s limited health care resources. One of
the unifying concepts, that seems to link acute infectious
diseases ( viral, bacterial, and parasitic) with the chronic
diseases (birth defects, diabetes, cancers, cardiovascular,
¹is article is based on a presentation given during the 2nd GRF Davos One Health Summit 2013, held 17-20 November 2013 in Davos, Switzerland
([Link]
272 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II)

Alzheimer’s, Parkinson’s, cataracts, etc.), is the predom- eases. omas Mathus in his An Assay of the Principle
inate role that chronic inflammation plays in either the of Population, (Appleman, 1976) also knew “Sustainable
genesis or promulgation of these diseases.(Trosko and Tai, One Health” “when he saw it”.
2006) We should now view acute infectious diseases as be-
ing integrated with non-communicable chronic diseases 2. e tragedy of the global ”commons”: use of knowl-
via the inflammatory responses. edge without a global bioethic
However, before more detailed elaborations of how
to resolve this global health crisis, which includes how In more contemporary literature, Rachel Carson’s book,
human activity is impacting earth’s natural systems, on Silent Spring, (1962) illustrates how cultural evolution,
which all life, including human life, depends on for nor- through the use of technologies, impacts the ecological
mal health (Myers et al, 2013), one needs to come to some environment, which, in turn, impacts both animal and hu-
consensus on the definition of a “Sustainable One Health” man health. Moreover, Garre Hardin’s insight of “One
concept. e following assumptions must be made clear. Health” in his “Tragedy of the Commons” (Hardin, 1968)
e first is that, usually, one must understand the cause clearly shows that he “knew it when he saw it”. A re-
or causes of diseases, i.e. mechanisms, of an identifiable lated view was expressed by Van Rensselaer Poer: (Pot-
problem before efficacious solutions can be implemented ter, 1974)
to solve the problem. at is, one can’t apply a solu-
tion to a problem for which one has no idea what are “When I first read Hardin’s article [on the
the critical components leading to the problem. In recent tragedy of the commons], I wondered if the
years, the term, “One Health” has emerged in the litera- users of the early English commons weren’t
ture (see: Nassiri, 2013), but no satisfying definition has prevented from commiing the fatal error of
led to the fundamental identification of the complex com- overgrazing by a kind of ’bioethics’ enforced
ponents that interact, which leads to the global health cri- by the moral pressure of their neighbors. In-
sis. It is reminiscent of a famous remark by Justice Poer deed, the commons system operated success-
Stewart (1964), which he made during the classic search fully in England for several hundred years.
for the definition of “obscenity”: Now we read that, before the colonial era in
the Sahel, ’over pasturage was avoided’ by
”I shall not today aempt further to define the
rules worked out by tribal chiefs. When deep
kinds of material I understand to be embraced
wells were drilled to obtain water ’the bore-
within that shorthand description; and per-
holes threw into chaos the traditional system
haps I could never succeed in intelligibly do-
of pasture use based on agreements among
ing so. But I know it when I see it, and the mo-
tribal chieains.’ us, we see the tragedy of
tion picture involved in this case is not that.”
the commons not as a defect in the concept of
To date, especially at the recent “One Health-One a ’commons’ but as a result of the disastrous
Planet” workshop [[Link] a transition period between the loss of an ef-
general conceptual Venn diagram, of the overlapping of fective bioethic and its replacement by a new
Ecological Health, Animal Health and Human Health bioethic that could once again bring biolog-
spheres of influence, led to the link between all three that ical realities and human values into a viable
was accepted as the arena of “One Health”. at was fine, balance.”
in the manner that “I know it when I see it”, but it pro-
vided lile rational foundation as to what might be the In that tragedy, cultural traditions based on eons of
fundamental “primal force” or basic concept that might experience, allowed groups of people, their food source
give substance to finding solutions to prevent or treat the of domesticated animals, when depended on scarce wa-
root cause(s) of the “global heath” crisis. Indeed, one gen- ter and vegetation, to exist. However, when a perceived
erally understands that when the ecological conditions technological fix of providing new sources of water, un-
are depleted or polluted, plant, animal and human life are leashed new cultural behaviors, which trashed traditional
jeopardized. While it has been pointed out that the term, values and led to the devastation of that delicate balance
hence, concept of “One Health” has appeared in the recent of water, vegetation, and human well-being. One might
literature, the idea that all life’s existence depended on a even view the local “Tragedy of the Commons”, demon-
precarious dynamic of adapting to inevitable changes in strated in the Sahara, is now being played out as a ”Global
the total environment by both mutations and epigenetic Tragedy of the Commons” because of a lack of a “Global
changes in the genome has been known for a long time. Bioethic”. en, Barry Commoner’s book, “e Closing
erefore, it would be hard to argue that Charles Darwin Circle: Nature, Man and Tenology” (Commoner, 1971)
and Alfred R. Wallace’s concept of biological evolution demonstrated that he saw how cultural evolution, as man-
do not need to be considered when considering the root ifested by unguided technology, could affect the domains
causes of current concept of One Health. Pushing it to of ecological & animal health to affect human health.
another extreme, the Eastern concept of the “Yin & Yang” When Rene Dubos, a Nobel Prize recipient, wrote his
idea of health, as well as the Pythagorean view of the bal- book, So Human An Animal (Dubos, 1968, p. 148), he
ance of “natural elements”, informs us that very early in- also had a view of “Sustainable One Health”, which should
sights of complex interactions determined health or dis- cause us to pause to consider his take on how biological
 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II) 273

and cultural evolution contributes to our concept of “One Poer, 1988) In his insights, he acknowledges the founda-
Health”. In the book, he stated: tions of a “One Health” concept to Aldo Leopold .(Leopold,
1948) To understand the fundamental implications of how
“On a hot and humid Friday during midsum- human choices of how to create and then use or not
mer, I landed at Kennedy Airport early in the use new ideas and technologies, one must first recog-
aernoon. e taxicab that was taking me nize that human choice involves not only “facts”, but “val-
home was soon caught in a traffic jam, which ues”.(Trosko, 2003) Since this raises the classic dilemma of
gave the driver an opportunity to express his the “Naturalistic Fallacy”, it must be made clear that Pot-
views on the state of the world. Noting my ter was not advocating that the “ought” (or “value)” can be
foreign accent, he assumed that I was un- derived directly from the “is” (“Fact”), but rather that no
acquainted with the United States and pro- human value can be maintained in ignorance or defiance
ceeded to enlighten me on the superiorities of the “is” or of the biological realities of human nature
of the America life. “You probably are sur- (Trosko, 1984). Max Oo, a philosopher, pointed this out
prised by this heavy traffic so early on Fri- nicely when he stated that:
day aernoon”, he remarked, as the cab stood
still in the sultry air saturated with gasoline “e universe is run by natural forces and
fumes. “e reason there are so many peo- laws, not by moral laws. However, human
ple on the road at this time of hour is that we societies that live in the natural world must
have plenty of leisure in this country and all live by moral laws. If those moral laws con-
of us can afford an automobile”. As we moved tradict or ignore the nature laws, it will be the
our coats and mopped our brows, he added human societies, not the physical universe,
forcefully, “In the United States we all live like which suffer the consequences of such defi-
kings”. ance.” (Oo, 1940)
Later in his book, where he addressed the problem of e real problem in this “fact” versus “value” dilemma
global pollution and diseases and miserable survival (his is that, at best, all scientific facts are incomplete; at worse,
view of one health), his greatest concern was not that the they can be dead wrong. On the other hand, human val-
human species would die out, but we would LEARN TO ues are not acquired without real life factual experiences;
ADAPT TO THIS GLOBAL POLLUTION PROBLEM! (em- in other words, they are not independent of any “fac-
phasis added). tual” components. e “Two Cultures” gap [between the
As insightful as to the role historical role of how sciences and the humanities] (Snow, 1959) is not really a
cultural evolution impacted our biological evolution and gap between two distinctively and mutually exclusive do-
its subsequent effect on One Health, the book, Guns, mains of human experiences.
Germs, and Steel: e Fates of Human Societies, by Part of trying to understand how to understand and
Jared Diamond (1997) clearly demonstrates how the emer- to deal with the “One Health” concept, specifically within
gence of human culture has changed, and is shaping the reality of the biological evolutionary roots of all life,
our “One Health” problem. One does not even need in their many local environments having to deal with in-
to elaborate on even more dramatic examples of how evitable physical/chemical evolution and now ever-laser-
this inevitable dynamical interaction of our cultural evo- speed cultural evolutionary changes, one must recognize
lution (especially, technological advances) is affecting that all human beings are not “prisoners” of biological “in-
the current “One Health” concerns, when the issues of stincts”, but as “victims” of their being “designing”, cul-
“global warming”, of the increasing global “metabolic dis- tural beings. e Diaspora of these human beings caused
eases” (Ray, 2009; Ezzati and Riboli, 2012), or of the Hi- them to adapt and survive in various different physical
roshima/Nagasaki, Chelyabinsk, and Fukushima nuclear environments (arid, temperate, frigid) , hunting, planting
effects on One Health are now discussed. or domesticating foods, as well as symbiotically cultivat-
ing gut microbiomes (Sonnenburg, 2010; Claesson et al,
3. Global Bioethic of “One Health” 2012; Ezenwa et al, 2012; Tremaroli and Backhed, 2012;
Yatsunenko et al, 2012). To help maintain those survival
While it might seem intuitively obvious that all living or- behaviors, human generated abstract world views, includ-
ganisms ( bacteria, buerflies, fish, birds, mammalians, ing views of human nature, life philosophies and religions.
human beings) require energy for life through adequate, As a result, today, we live in a pluralistic world, with pre-
nutritious and safe ,continuous supplies of foods, the sit- scientific views of human nature, philosophies and 21 ma-
uation on earth today has made the future for quality jor formal religions. is seems to be an obvious source of
survival very precarious. is, then, provides the moral identifying the problem that has contributed to the crises
and ethical dimensions of cultural evolution come into in the destruction of our ecological, animal and human
our holistic understanding of “One Health”. e term, health relationships.
Bioethics” was introduced by Van R. Poer, not as a sub- In this pluralistic world, since humans do have a “na-
class of medical ethics aer new technologies give physi- ture” (Trosko, 1984; Trosko, 2003), who will determine
cians choices that patients might make, but the broader what it is or whose religious or philosophical/political
view of ethics when humans make choices affecting the world view is the correct one? Can any view of human
total human, animal and ecological spheres.(Poer,1972; nature actually provide the principles to shape ethical be-
274 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II)

havior to prevent further destruction of our environment billion) and an increase to 10 billion by the end of this Cen-
and to help shape a future that will minimize human mis- tury, providing adequate and safe supply of foods , grown
ery and lead to a more sustaining “One Health” global pol- in steadily deteriorating ecosystems, poses a major threat
icy in a pluralistic and ever-changing world? to meeting the need for nutritious diets for all stages of
Obviously, current physical and chemical resources, human development. Diets can influence the onset or pre-
which are needed to maintain all life on our earth, are vention of all diseases, acute and chronic, as will be illus-
finite or in fragile conditions, in local and global ar- trated later. Both the quality and quantity of safe, nutri-
eas. Moreover, the qualitative and quantitative natures of tious foods are needed to reduce the risk to preventable
those resources have changed from the first day of Earth’s diseases, in order to assure “acceptable” survival (Trosko,
creation to the day life first appeared. e impact of non- 2007a; Trosko, 2007b; Trosko, 2008).
human life on the ecosystem, on which all life depends,
although not insignificant (i.e. role of phytoplankton’s 4. Current global diseases due to the collision between
to shi our atmosphere from an non-oxygen atmosphere biological and cultural evolution
to an oxygenated atmosphere), has been minuscule, both
with regard to scale and time, compared to that which has Ironically, the biological evolution of the human species,
been altered by the appearance of Homo sapiens. While together with the cultural evolution of technologies (use
non-human living organisms leave behind their existence of tools and fire, domestication of animals, agriculture,
some detritus and ecosystem changes, their detritus has technologies of mobilization, communication, energy pro-
been basically bio-degradable and life was able to adapt duction, sanitation, and scientific understanding, which
to the changes. On the other hand, human existence cre- has led to increasing the quality and quantity of life for
ates a non-biodegradable detritus, such as “walls” (physi- the human species), has led to the crises that have chal-
cal structures and abstract ideas). ese “walls”, then, cre- lenged the quality of the global ecology (air, water, land
ate and force new human existence. (Flusserr, 1974) use, global temperature, non-renewable resources, etc.),
It is difficult, today, to develop a personal or cultural on which all life depends.( Trosko, 2007a; Trosko, 2008)
view of the world, because of those rather indestructible is has come about because the short-term use of these
“walls” of our ancestors who shaped our early socializa- technologies has contributed to inevitable changes in the
tions. ere is no “universal” view of human nature, from very ecology that supports all life. It turns out the human
which a new strategy for providing a “Global, Sustaining, species is biologically built to react to short term posi-
One Health” policy can be generated. Since our current tive and negative feedback of its action- induced conse-
global survival is being jeopardized by an exploding hu- quences. Although we have a limited capacity to use our
man population, global pollution of air, water, limiting intellect to predict some long term positive & negative
nutritional foods, miserable human existence for billions consequences, our predictive certainty is not very good,
of human beings [Poer 1988], unrealistic or bankrupt and, even in the case where we can predict some negative
ideologies, and conflicting philosophical/political theories consequences, we assume we will be able have technolog-
and religious theologies [Sagan 1995; Trosko 1984; Trosko ical fixes to deal with them, if and when they might come
2003], it seems that a universal or global “Sustaining One about.
Health” strategy will not be developed or implemented. Equally important in this current collision of bio-
While aempts are being made (Pang et al, 2010; Chre- logical evolution with cultural evolution and inevitable
tien, 2011), the integrative foundation has yet to be used changes in the earth’s environment is the fact that hu-
to formulate a meaningful strategy for global implemen- man population (currently 7 billion) will reach 10 billion
tation. One needs only to examine the recent example of by the end of this Century. Given the absolute require-
how the One Health Venn diagram of the complex interac- ment for adequate supplies of nutritious and safe foods,
tions of ecological, animal and human health is being ex- questions, related to the production of foods on/in safe
acerbated by natural -and human- made disasters (recent environments ( land, water), the quality of that food ( non-
tsunami/Fukushima nuclear accident in Japan). Given no contaminated with radioactive- , chemical- or biological-
international strategy to forge a new paradigm to prevent toxicants/toxins, etc.), must be made. Issues such as: (a)
the serious threat to decent human existence in this case, Will be there be an adequate supply of enough & safe
it does not bode well for the future, as more of these events foods?; (b) How to provide a quality of life when most
will occur with wider impacts. humans will be living in urban environments?; (c) How to
Given various terms have been made to describe hu- provide enough and the right types of food when there
man survival (“mere”, “miserable”, Idealistic”, “irresponsi- will be fewer individual farmers will be supplying that
ble”, and “acceptable”), Van R. Poer ( Poer, 1995; Poer, food?; (d) How to deal with much of that food which will
2003, p. 43.) proposed that the term, “acceptable survival,” be subject to exposure to contaminants?; (e) What can be
as a bioethical goal of global survival, instead of the term, done when the foods available might not be adequate for
“sustainable development”, because, in most contexts, it is nutrition requirements?; () Much more energy, including
an economic concept with no moral or ethical constraints. nuclear energy, will be needed to grow, process and trans-
On the other hand, “acceptable survival” means accept- port the food; (g) Since foods are now realized to be a ma-
able to a universal sense of what is morally right and good jor contributor or protector of both acute and chronic dis-
and what will continue in the long term. With the steady eases, how can they be utilized reduce the global burden
and uncontrolled human population growth ( currently, 7 of “metabolic diseases”?; and () If organ-specific adult hu-
 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II) 275

man stem cells can be increased or decreased by nutrients trol group for the survivors of the atomic bomb survivors
during pregnancy. (Trosko, 2011; Trosko, 2014), which in Hiroshima and Nagasaki. In the cancer studies, aside
could lead to alteration of risks to chronic diseases later from leukemias found in children exposed to the bomb,
in life, i.e., e Barker hypothesis. (Barker. 2004; Hashmi an increase of breast cancer, aributed to the atomic bomb
et al, 2012; Barker et al, 2013) radiation, decades aer exposure, were found in women
e transition of our pre-human nutritional require- who were exposed at a relatively young age. (Ron, 1998)
ments for survival to our current unequal and culturally- One reason these breast cancers were aributed to the ra-
shaped diet has created a biologically mismatched hu- diation exposure was because the background frequency
man dietary experience (Trosko, 2007a). While genetic was so low in the Japanese population not exposed to
(O’Rahilly, 2009)-, gender-, and developmental stage- fac- the atomic bombs. One explanation for this low back-
tors contribute to human diseases, various environmental ground frequency was the traditional Japanese diet of a
and culturally-determined factors are now contributing to low caloric diet, soy products, raw fish, vegetables, green
both acute and chronic diseases. (Daar et al, 2007; Yach tea, lile cigaree smoking, etc.). Further supporting this
et al, 2005). e transition from the hunter-gatherer to an explanation comes from epidemiological findings of the
agricultural -dependent human being has brought about a Diaspora of Japanese to other countries (Hawaii, Brazil,
global crisis in human health. (Milton, 2000; Kiple, 2000; United States), where the frequency of breast cancer of
Teaford and Ungar, 2000; Mariani-Costantini, 2000; Cor- these Japanese women mimicked the frequency of non-
dain et al, 2000; McCully, 2001; Arjamaa and Vuorisalo, Japanese women of these new countries. One potential
2010; Wrangham, 2012; Wilking, M., et al, 2013) Initially, dietary factor that might be responsible for the low breast
early humans ate seasonally-dependent and calorically- cancer frequency in Japan at that period of history is the
restricted foods, during the day, in a “feast or famine” natural chemical compounds of soy products, including
manner. Today, modern humans eat diets of caloric abun- genistein [and also, Bowman-Birk inhibitor]. (Trosko,
dance, at all times of the day, with foods of all seasons 2007a; Trosko and Suzuki , 2009)
and from all parts of the world, that have been processed A mechanistic explanation has been given to explain
and which have been contaminated by all kinds of factors. the role of these dietary factors on breast cancer , in that,
(Trosko, 2007a; Trosko, 2007b; Trosko, 2008) Unsafe food based on the assumption that breast cancers arise from
can be a serious threat to human health and survival as normal human adult breast stem cells [Tai et al, 2005],
a result of ignorance, economic profit- seeking, political dietary soy products, during pregnancy, could decrease
and economic value decisions, a weapon of terrorism, as the adult breast stem cell pool of the developing female
well as the consequence of global conflicts, as we are now fetus. is hypothesis is based on the observation that
witnessing. normal human adult stem cells, when exposed to non-
In addition, no longer can one view, as a distinct form cytotoxic levels of genistein in vitro, differentiate. (Hsieh
of disease, infectious agent –related human acute diseases and Chang, 1999) Extrapolated to the new born female,
from non-communicable chronic diseases. Given the pre- she would be born with fewer breast adult stem cells, such
dicted increase in the number of new births before the end that, at puberty, she would have few adult breast stem
of this century (3 billion), a serious effort must be made to cells to (a) provide progenitor breast cells and therefore, to
provide a healthy in utero environment for the most vul- produce large breasts; and (b) be targets for breast cancers.
nerable stage of human development, in order to prevent Based on the observation that the bone seems to be a fre-
alterations in organ-specific adult stem cell numbers and quent metastatic site for breast cancer metastasis, it might
stem cell –based diseases later in life. is new concept suggest that the human breast “cancer stem cell” finds a
provides a mechanistic explanation for how pre-natal ma- favorable environment or “niche” in bone tissue. Further-
ternal environmental or dietary exposures can now affect more, another observation of the traditional Japanese diet,
diseases later in life [Barker Hypothesis]. during in utero development, might also cause bone adult
To strengthen the notion that planning to have one fo- stem cells to differentiate, thereby lowering the number of
cused strategy to contribute to a global “One Health” plan, stem cells in the bone aer birth, causing a small stature
by using the Barker Hypothesis as a hypothesis-driven of the young Japanese at that era. In addition, the high
initiative, one must have evidence that there might be a frequency of osteoporosis in Japanese women of that era
reasonable rationale for success. While there are many could be the consequence.
animal experiments and human epidemiological exam- Today, the Japanese diet is being influenced by the
ples to support the Barker Hypothesis, only a few will be Western diet, and therefore, breast cancer frequencies
noted. Circumstances during the Second World War sug- and the stature of the Japanese are increasing. If this
gested that the starvation diets (low caloric intake and bad hypothesis is true, then the Barker Hypothesis could
nutrition of the diets of pregnant women [Dutch famine be explained by many factors (Nutrition/diets; drugs,
of 1944] dramatically influenced the health of their new- stress, environmental pollutants, etc.), by increasing adult,
borns. (Roseboom, et al., 2006) organ-specific stem cells, and altering their differentia-
Another dramatic illustration of a different kind of a tion/apoptosis, can alter development and disease suscep-
beer nutrient content of a severe low caloric diet comes tibility/resistance later in life.
from the atomic bomb survivors in Japan. Prenatal di- Another example of the role of nutrition/diet on early
etary exposure of the classic Japanese diet in the non- development, supporting the Barker hypothesis, is from
atomic bomb population provided the background con- the linkage of folate deficiency on severe birth defects in
276 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II)

human beings. [Mills and, Signore, 2004) Dietary supple- for global ONE HEALTH’S strategy for intervention ?
ments of folates clearly have been linked to a reduction of
these birth defects. . 5. Narrowed focus on meeting the goal of preventing
Not only nutritional or dietary factors during preg- prenatal-induced diseases later in life (Barker hyopoth-
nancy can be shown to be correlated with developmental esis): education and clinical intervention for prenatal
alterations leading to birth defects or diseases later in life, and perinatal nutrition to lower risk of ronic inflam-
but exposures to drugs and other environmental factors, mation
support the Barker hypothesis. When the drug, thalido-
mide, was prescribed in the late 1950’s to treat anxiety, in- While trying to intervene, globally, to ensure a One
somnia and morning sickness in pregnant women, it was Health strategy in the face of this inevitable collision of
shown that the in utero exposure, during a “critical win- biological and cultural evolution, knowing the complex-
dow” of development, was associated with devasting birth ity of the problem, involves interactions that affect all lev-
defects in about 10,000 children. (Franks, M.E., et al., 2004) els of our biology and the ecosystem. All elements of our
As dramatic an example, another drug, DES (diethyl- culture, social systems, pluralistic philosophies, religious,
stilbesterol), when given to pregnant women, lead to an- political systems and their associated economic systems,
other classic demonstation that is consistent the Barker have become more global in nature. Clearly, to tackle the
Hypothesis. (Cousins, 1980) In this case, when these preg- solution by a “systems” strategy would be like trying to
nant women exposed their female fetuses to DES during synchronize the tentacles of an octopus or “herding cats”.
a critical period of their development, the daughters were Fundamentally, finding a health plan for a global “ONE
predisposed to a high risk of vaginal cancers when they HEALTH” strategy, with limited physical and financial
reached puberty. resources, as well as incomplete scientific knowledge of
Although there are many newer epidemiological and each of the interacting ecological, animal and human
animal experiments supporting the Barker hypothesis, re- spheres and of competing cultural values, might be an im-
cent demonstration, using experimental pregnant rats, possible goal. It would entail understanding that all life
suggested a global –distributed chemical, bis-phenol A, (bacteria, plants, animals and human beings) depends on
can give rise to males which are predisposed to prostate various forms of foods and nutrients, generated by in-
cancers later life, even though these new borns were not evitable changes in optimum global temperature, suffi-
exposed to bis-phenol A aer birth.( Ho, et al, 2006) Most cient clean air, soil and water.
importantly, if the pregnant rats were exposed to both soy Indeed, we would need simultaneous policies to re-
products and bis-phenol A, then these newborn rats had duce pollution of the air, water and soils. We would need
their risk to prostate cancers later in life reduced, even public policies to reduce risks to bad personal and public
though, again, they were not exposed to soy products af- behavior. Economic policies would have to be institution-
ter they were born. is clearly indicates that the in utero alized to prevent inequalities of opportunities, social poli-
exposures to both the environmental pollutant and di- cies to provide equal justice and less stress, etc. Yet each
etary factors affected something during critical periods of of these human social, economic, political policies inter-
embryonic/fetal development. In this case, these demon- acts with each level of the ecological sphere, the animal
strate that in utero exposures could influence cancer fre- and human health spheres. In reality, we are so far from
quencies later in life. ese experiments could support the integrating them into an adaptable One Health strategy.
explanation of the role of dietary factors in the Japanese While not suggesting that specific intervention should not
survivors of the atomic bombs. be aempted in each individual specific sphere (eradica-
Finally, several implications can be drawn of these, tion of global viral infection, such as polio eradication;
and other Barker Hypothesis-related, studies. e first reduction of carbon dioxide emissions; reduction of land
is that the mechanistic nature by which these dietary, use for red meat production; beer medical treatments for
drug, physiological or environmental pollutant chemi- all chronic diseases, etc.), there could be choices that di-
cals work is via “epigenetic” action. Chemicals, such rectly affect the most vulnerable of humans, namely, the
as thalidomide, DES, bis-phenol A, genistein, [others up-coming 3 billion newborns. erefore, trying to be re-
such as, TCDD, DDT, retinoids, alcohol, phenobarbi- alistic, in suggesting a rather “small” component of this
tal, etc.], are not “genotoxicants”, able to damage ge- complex, moving global crises, and in trying to reduce
nomic DNA to cause mutations. Epigenetic toxicants unnecessary and preventable suffering in those three mil-
can, by altering gene expression in stem cells dur- lion new babies, one might consider that a global objec-
ing in uterine development, cause these organ-specific tive might be to try to provide the best nutrition for all
stem cells to increase or decrease their numbers by those young women who might become pregnant during
pre-mature differentiation or apoptosis, thereby, alter- this century, in order to implement knowledge gained by
ing the growth/function of specific organs later in life. understanding the Barker hypothesis.
So the question is, “Could prenatal nutrition and di- Consequently, while the overall objective to feed the
etary factors, including caloric restriction/caloric abuse, current and future population with adequate and nu-
nutrient depletion/overexposure, dietary behavior(eating tritious foods is so complex, in that it involves politi-
paerns/daytime/nighime), whole foods/bioactive food cal/economic issues, new technologies, education, eco-
component supplements, specific microbiome microenvi- toxicology and human toxicological understanding, engi-
ronments of the pregnant mother, etc), be a major target neering issues of energy production, water/air/soil qual-
 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II) 277

ity assessment, long- and short range transportation of

foods; food processing issues, and cultural/sociological
sensitivities to foods, a more sharply focused objec-
tive will be needed to carve out a manageable project
that could serve as an experimental model to tackle
this interconnected and complex problem on a global
scale.(McMichael, 2001;Rosset, 2011; Helbing, 2013; En-
borg, 2009) To make the issue even more complex, be-
cause of the natural selection of genes needed to cope
with local ecological food sources of each ethnic group
( arid Mideast, tropical South America, frigid arctic re-
gion, temperate Europe, isolated sea-dependent islands),
no universal nutritious diet can be made. Complicating
this task of providing the best diet for each genetically-
different individual, gender, stage of development is the
Diaspora of people from those genes needed for healthy
development and the Diaspora of foods from all over the
world. ( MacPherson and Gushulak, 2001).
Whatever this One Health-One Planet Initiative
Workshop decides to do to tackle this complex problem,
it must be an integrated approach that can demonstrate, Figure 1: Global Incidences of Human Colon Can-
cer. From: Red meat consumption and
in a relatively short time, that it can generate solid scien-
cancer: reasons to suspect involvement of
tific information on a quantitative basis (a “deliverable”)
bovine infectious factors in colorectal cancer
and that the approach can be scaled up to meet the global [Link]
challenge. It is here that the ultimate goal is not only for
human survival, it must be for “acceptable” human sur-
vival to provide only nutritious foods, safe foods, means One of the proposed mechanisms involved is chronic
for economic growth, reduction of political and ecological inflammation. Both infectious agents (viruses, parasites,
instabilities, but also to prevent those human diseases that microbes) and physical and chemical agents, in and on
are affected by foods. We know today that inadequate nu- foods, as well as over-abundance of calories, can interact
trition and over-abundant calories (as well as inadequate to induce chronic inflammation. (Trosko and Tai, 2006)
exercise) contribute to most of human acute and chronic Nutritious foods have the potential to prevent chronic in-
diseases. One of the growing major global health problem flammation, the common link between infectious & non-
today is excess calories and bad nutritious foods that can communicable chronic diseases. Moreover, the real moral
lead to the obesity-related “metabolic diseases”[diabetes, issue is that newborn children, who have neither con-
cardiovascular and cancer] (Swinburg, et al, 2011)). is trol of their genes nor the in utero environment that their
is so well illustrated with the data on the incidences of hu- mothers provide them during development, can have their
man colon cancer in various countries with different and risks to preventable chronic diseases later in their life
changing dietary habits of eating red meat over the last 30 modified by beer diets for their mothers. e scientific
years. challenge is that there is no universal nutritional/dietary
remedy for all genotypes, genders or stages of develop-
ment. e psychological, social, cultural, economic and
hence political challenges are to find the means to edu-
cate and to provide the individual and population nutri-
tional/dietary needs without irreversibly disrupting the
global ecosystem needed for the acceptable survival for
all.

6. Conclusion

e identification of the problem to be solved by initiating

a “Sustainable One Health” paradigm, fundamentally, in-
volves insuring sufficient clean air, water and sufficient
nutritional foods in an ever-changing physical, biologi-
cal and cultural world. In this brief “Commentary”, one
might come to a depressing conclusion that the number
of interacting controllable and uncontrollable elements
will be impossible to implement a systems and interdisci-
plinary intervention strategy at all levels (ecological; an-
imal and human) within a framework of a global plural-
278 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II)

istic value systems and of the current economic and po- J.R., Fitzgerald, A.P., Shanahan, F., Hill, C., Ross, R.P., O’Toole,
litical/religious forces. It is exacerbated by what the R. P.W. ( 2012): Gut micro biota composition correlates with diet
Hutchins, President of the University of Chicago stated and health in the elderly. Nature 488:178-84.
was the problem, namely the divorce of knowledge [or
Commoner, B. (1971): e Closing Circle: Nature, Man and Tech-
“wisdom”] from understanding:
nology”. Knopf, N.Y.
e most characteristic feature of the modern Cordain, L., Miller, J.B., Eaton, S.B., Mann, N., Holt, S.H.A., Speth,
world is bewilderment. Anyone who says he J.D. (2000): Plant-animal subsistence ratios and micronutri-
knows anything is at once suspected of affec- ent energy estimates in worldwide hunter-gather diets. Am.J.
tion or falsehood… We do not know where we Clin. Nutr., 71: 682-692.
are going, or why; we have almost given up
the aempt to find out….Certainly we have Cousins, L., Karp, W., Lacey, C., Lucas, W.E. (1980): Reproduc-
more facts about the world, about ourselves, tive outcome of women exposed to diethylstilbestrol in utero.
and the relations among ourselves than were Obstet Gynecol 56: 70-76.
available to any our ancestors… If, as we have
Daar, A.S., Singer, P.A., Persad, D.L., Pramming, S.M., Mahews,
been convinced since the Renaissance, the D.R., Beaglehole, R., Berstein, A., Borysiewicz, L.K., Colagiuri,
advance of the race is direct proportion to S., Ganguly, N., Glass, R.I., Finegood, D.T., Koplan, J., Nabel,
the volume of information it possesses, we E.G., Sarna, G., Sarrafzadegan, N., Smith, R., Yach, D., Bell,
should by now have reached every imagin- J. ( 2007): Grand challenges in chronic non-commmunicable
able human goal. We have more information, diseases. Nature 450: 494-496.
more means of geing more information, and
more means of distributing information than Diamond, J. (1997): Guns, Germs, and Steel: e Fates of Human
any time in history, nevertheless, we are be- Societies. W.W. Norton & Company, New York.
wildered. (Hutchins, 1936).
Dubos, R. (1968): So Human An Animal. Charles Scribner’s Sons,
New York.
However, while President Hutchins was absolutely
correct, (and parenthetically, his words are as relevant Enborg, V.K. (2009): Food Humanity, Habitat and How we get to
today as they were in 1936), our moral bioethical im- 2050. New York Times.[[Link]
perative is not to give up and do nothing, but to find 10/28/opinion/[Link]?_r=1\&th\&enmc=th].
some integrative ways to give meaning to the explod-
ing amount of facts and technologies and to start using Ezenwa, V.O., Gerardo, N.M., Inouye, D.W., Medina, M., Xavier,
our current knowledge to prevent preventable human dis- J.B. (2012): Animal behavior and the micro biome. Science
eases, by preventing preventable irreversible destruction 338: 198-199.
of the ecology and animal health, as well as using our
Ezzati, M., Riboli, E. (2012): Can Noncommunicable diseases be
knowledge beer to treat the diseases to both humans and prevented? Lessons from studies of populations and individ-
animals and the damage to the ecology. uals. Science 337:1482-1487.

References Flusserr, V. (1974): Walls. Main Currents in Modern ought.

30: 136-138.
Arjamaa, O. Vuorisalo, T. (2010): Gene-cultural co-evolution and
the human diet. American Scientist 98: 140-147. Franks, M.E., Macpherson, G.R., Figg. W.D. (2004): Review:
alidomide. e Lancet, 363:1802-1811.
Appleman, P. (1976): An Essay on the Principles of Population by
omas Robert Malthus, Text, Sources, and Background Crit- Hardin, G. (1968): Tragedy of the Commons, Science 162: 1243-
icism, Edited by P. Appleman, W.W. Norton & Co., New York, 1248.
1976
Hashmi, A., Soomro, J.A., Iqbal, Z., Soomro, T.K., Saleem, K.
Barker D. J. (2004): e developmental origins of adult disease. J (2012): Maternal obesity a global health problem and its impli-
Am Coll Nutr 236: 588s–595s. cations on maternal and fetal health. Reproductive Sys. Sex-
ual Discord 1: 1-4.
Barker, D., Barker, M., Flemming, Lampl, M. (2013): Support
mothers to secure future public health. Nature 209: 209-211. Helbing, D. (2013): Globally networked risks and how to re-
spond. Nature 497: 51-59.
Carson, R. (1962): Silent Spring, Houghton Mifflin, Boston.
Ho, S.M., Tang, W.Y., de Frauto, J.B., Prins, G.S. (2006): Develop-
Chretien, J.-P. (2011): U S Global Health Strategy. JAMA 305: mental exposures to estradiol and bisphenol: A increases sus-
1238-1239. ceptibility to prostate carcinogenesis and epigenetically reg-
ulates phosphodiesterase type 4 variant 4. Cancer Res. 66:
Claesson, M.J., Jeffeery, I.B., Conde, S., Power, S.E., O’Connor, 5624-5632.
E.M., Cusack, S., Harris, H.M.B., Coakley, M., Lakshmi-
narayanan, B., O’Sullivan, O., Fitzgerald, G.F., Deane, J., Hsieh, C.Y., Chang, C.C. (1999): Stem cell differentiation and
O’Connor, M., Harnedy, N., O’Connor, K., O’Mahoney, D., van reduction as a potential mechanism for chemoprevention of
Sinderen, D., Wallace, M., Breenan, L., Stanton, C., Marchesi, breast cancer. Chinese Pharm J 51:15–30.
 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II) 279

Hutchins, R. M. (1936): e Higher Learning in America, In: M. Ron, E. (1998): Ionizing radiation and cancer risks: evidence from
Oo, e Human Enterprise, Yale University Press. p.107. epidemiology, Radiat. Res. 150: 30–41.

Kiple, K.F., ed. (2000): e Cambridge World History of Food. Roseboom, T, Rooij, S. de, Painter, R. (2006): e Dutch famine
Cambridge University Press. and its long-term consequences for adult health”. Early Hu-
man Development 82: 485–491.
Leopold, A. (1949): e land ethic. In: A Sand County Almanac.
Oxford University Press, Inc. New York. Rosset, P. (2011): Preventing hunger: Change economic policy.
Nature 479: 472-473.
MacPherson, D.W., Gushulak, B.D. (2001): Human mobility and
population health. Perspectives Biol. Med. 44: 390-401. Sagan, C. (1995): e Demon- Haunted World: Science as a Can-
dle in the Dark, Random House, New York.
Mariani-Costantini, A. (2000): Natural and cultural influences on
the evolution of the human diet: Background of the multifac- Snow, C.P. (1959): e Two Cultures. Cambridge University Press,
torial processes that shaped the eating habits of Western so- London.
cieties. Nutrition 16: 483-486.
Sonnenburg, J L. (2010): Genetic pot luck. Nature 464: 837-838.
McMichael, P. (2001): e impact of globalization, free trade
and technology on food and nutrition in the new millennium. Stewart, P. (1964): Supreme Court opinion on obscenity, concur-
Proc. Nutrition Soc. 60: 215-2220. ring in Jacobellis v. Ohio, 378 US 184.

Mills, J.L., Signore, C. (2004): Neural tube defect rates before and Swinberg, B.A., Sacks, G., Hall, K.D., McPherson, K., Finegood,
aer food fortification with folic acid. Birth Defects Res A D.T., Moodie, M.L., Gortmaker, S.L. (2011): e global obesity
Clin Mol Teratol. 70 (11):844-845. pandemic: shaped by global drivers and local environments.
e Lancet 378: 804-814. Tai, M. H., Chang, C.C., Kiupel, M.,
Milton, K. (2000): Back to basics: Why foods of wild primates Webster, J.D., Olson, L.K. and Trosko, J.E. (2005): Oct-4 ex-
have relevance for modern human health. Nutrition, 16: 480- pression in adult human stem cells: evidence in support of the
483. stem cell theory of carcinogenesis. Carcinogenesis 26: 495-
502.
McCully, K.S. (2001): e significance of wheat in the Dakota
Territory, human evolution, civilization and degenerative dis- Teaford, M.F., Ungar, P.S., (2000). Diet and the evolution of the
eases. Perspectives Biol. Med. 44: 52-61. earliest human ancestors. [Link]. Acad. Sci. USA 97:
13506-13511.
Myers, S.S., Gaffikin, L., Golden, C.D., Ostfeld, R.S., Redford, K.
H. Redford, Rickes, T.H., Turner, W.R., Osofsky, S.A. (2013): Tremaroli, V., Backhed, F. (2012): Functional interactions be-
Human Health impacts of ecosystem alteration. Proc. Natl. tween the gut micro biota and host metabolism. Nature 489:
Acad. Sci. USA 110:18753-18760. 242-249.

Nassiri, R. (2013): One health approach roadmap: A university Trosko, J.E. (1984): Scientific views of human nature : Impli-
perspective. One Health: One Planet, One Future. 2nd GRF cations for the ethics of technological intervention. In: e
One Health Summit 2013, Davos, Switzerland, p.62-63. Culture of Biomedicine. D. Heywood Brock, ed., University of
Delaware Press, Newark, New Jersey.
O’Rahilly, S. (2009): Human genetics illuminates the paths to
metabolic disease. Nature 462: 307-314. Trosko, J.E. (2003): Scientific concepts of human nature and their
implications to bioethics in a scientific and technologically-
Oo, M. (1940): e Human Enterprise. Cros and Sons, New altered world. J. International Soc. Bioethics 9: 68-83.
York.
Trosko, J.E. (2007a): Stem cells and cell-cell communication in
Pang, T., Daulaire, N., Keusch, G., Leke, R., Piot, P., Reddy, S., the understanding of the role of diet and nutrition in human
Rys, A., Szlezak, N. (2010): e new age of global health gov- diseases. J. Food Hygiene & Safety 22: 1-14.
ernance holds promise. Nature Medicine 16: 1181.
Trosko, J.E. (2007b): Aging as the ‘Systems’ breakdown of com-
Poer, V.P. (1971): Bioethics: Bridge to the Future; Prentice –Hall, munication between the quality and quantity of stem cells. In
Inc. Englewood Cliffs, New Jersey. : e Manefesto for a Long Life [ Il Manifesto Della Lunga Vita].
Marandola, P. & Maroa, F., eds., Sperling & Kupfer Editori
Poer, V.R. (1988): Global Bioethics: Building on the Leopold S.p.A, Milan, Italy, pp. 58-62.
Legacy, Michigan State University Press, East Lansing, Michi-
gan. Trosko J.E. (2008): Role of diet and nutrition on the alteration of
the quality and quantity of stem cells in human aging and the
Poer, V.R. (1995): Global Bioethics: Converting sustainable de- diseases of aging. Curr. Pharm. Des. 14: 2707-2718.
velopment to global survival. Medicine & Global Survival 2:
185-191. Trosko, J.E. (2011): e gap junction as a ‘Biological Rosea
Stone’: Implications of evolution, stem cells to homeostatic
Poer, V. R. (1974): e Tragedy of the Sahel Commons. Science regulation of health and disease in the Barker Hypothesis. J.
185: 813. Ray, L.B. (2009): Evolution of Metabolic Diseases. Cell Commun. & Signaling, 5: 53-66.
Sci. Signal. 2: ec396.
Trosko, J.E. (2014): Induction of iPS Cells and of Cancer Stem
280 GRF Davos Planet@Risk, Vol 2, No 4 (2014): Special Issue on One Health (Part II/II)

Cells: e Stem Cell or Reprogramming Hypothesis of Can- Yach, D., Leeder, S.R., Bell, J., Krstnasamy, B., (2005). Global
cer? e Anatomical Record. 297:161–173 (2014). Chronic Diseases. Science 307: 317.

Trosko, J.E., Suzuki, K. (2009): Adult stem cells, the Barker Hy- Yatsunenko, T., Rey, F.E., Manary, M.J., Trehan, I., Dominguez-
pothesis, epigenetic events and low level radiation effects. In: Bello, M.G., Contreras, M., Magris,M., Hidalgo, G.,Baldassano,
Radiation Health Risk Sciences. Nakashima, M., Takamura, N., R.N., Anokhin, A.P., Health, A.C., Warner, B., Reeder, J.,
Tsukasaki, K., Nagayama, Y., Yamashita, S., eds., Springer Pub- Kuczynski, J., CaporasoJ.G., Lozupone, C.A., Lauber, C.,
lisher, Tokyo, pp. 216-226. Clemente, J.C., Knights, D., Knight, R., Gordon, J.I. (2012): Hu-
man gut micro biome viewed across age and geography. Na-
Trosko, J.E., Tai, M.H. (2006): Adult stem cell theory of the multi- ture 486: 222- 227.
stage, multi-mechanism theory of carcinogenesis: Role of In-
flammation on the promotion of initiated stem cells. In: In-
fection and Inflammation: Impacts on Oncogenesis. Dimar,T., Citation
Zaenker, K.S. Schmidt, A. Eds. Karger, Basel, 2006, pp. 45- 65.
Trosko, J. E. (2014): Global Health Crisis Caused by the Col-
Wilking, M., Ndiaye, M., Mukhtar, H., Ahmad, N.(2013): Circa- lision of Biological and Cultural Evolution: Pre-Natal In-
dian rhythm connections to oxidative stress: Implications for fluences on Acute and Chronic Diseases in Later Life. In:
human health. Antioxidants & Redox Signaling 19: 192-208. Planet@Risk, 2(4), Special Issue on One Health: 271-280,
Davos: Global Risk Forum GRF Davos.
Wrangham, R., (2012). e evolution of human nutrition. Cur-
rent Biology 23: 354-355.