[Endocrine disruptors and metabolic diseases: a major public health challenge].

The purpose of this research note is to summarize the current state of knowledge on the impact of environmental exposures on the development of obesity and diabetes. In France, the incidence of diabetes almost doubled between 2000 and 2008 (+ 93%), affecting 1.8 million people. The prevalence of obesity has almost doubled in 10 years. Since the 1980s, the focus of the fight against obesity and diabetes has been on hygienic and dietary measures. However, it is now clear that these measures have failed to reverse the trend. Chronic diseases such as obesity and diabetes have resulted in a dramatic increase in public health spending. A growing body of data has highlighted the important role of chemical pollution in the epidemic of metabolic diseases, particularly substances classified as endocrine disrupting chemicals (EDCs). By altering the endocrine function of organs such as adipose tissue, liver, pancreas, and skeletal muscle, EDCs disrupt the metabolism of carbohydrates and lipids, leading in turn to insulin resistance and diabetes and obesity, which both increase the risk of cardiovascular complications. The traditional toxicological principle that "the dose makes the poison" does not reflect the complexity of the deleterious effect of EDCs either alone or in combination. EDC-induced patho-physiological alterations can be programmed during the fetal period, before appearing later in life. A new paradigm evaluating the toxicological properties of EDCs is needed to support new recommendations in terms of prevention policy, at both national and European levels.