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LB 492
Evolutionary Medicine:
A Different View of the Human Body
David Wenzel
2/13/2011
Evolutionary medicine helps people understand how the human body has developed to
become extremely sophisticated, yet vulnerable to a multitude of negative forces. Evolutionary
medicine takes the large number of mysterious flaws humans have developed and turns them
into questions that can be answered and explained (2008, Nesse, Stearns). The foundation of
evolutionary medicine is thru findings that diseases need both a proximate answer to
mechanisms and an evolutionary answer to why these mechanisms have evolved and left the
human body vulnerable (2008, Nesse, Stears). From maternal-fetal interactions such the battle
over glucose, to chronic inflammatory disease and allergies; evolutionary medicine can bolster
our understandings gained from modern medicine and help to develop new treatment options
never thought possible without an evolutionary understanding.
Human reproduction is a complicated system with many questions that cannot be
answered by modern medicine alone. One complicated question that has an evolutionary
perspective is the occurrence of low birth weight babies and maternal age at menarche. Studies
have found that low birth weight offspring are correlated with mothers who underwent early
menarche (2003, Coall et al). Studies have also linked early menarche with psychosocial stress
early in development, such as father absence, family conflict and major life events. So the
questions begs, why if early menarche occurs under psychosocial stress and leads to low birth
weight offspring have women evolved this occurrence? It would make more sense to hold off
sexual maturity until the mother can ensure a healthier offspring with higher chances of
survival. The answer is a simple evolutionary trade-off. When the mother is under psychosocial
stress she undergoes early menarche in order to undergo early reproduction to minimize the
chance of losing her lineage (2003, Coall et al). This leads to a strategy of early reproduction at
the cost of the offspring in order to ensure the chance of one reaching sexual maturity and
reproducing.
Another oddity of human reproduction is the ever-going battle between the mother and
fetus during gestation. The mother tries to balance the successful birth of her present fetus
with future siblings, which leads to withholding of resources in order to increase her fitness in
the future. The fetus, however, is fully invested in survival and tries to maximize its resources
even at the cost of the mothers fitness (2003, Coall et al). One example of this is the battle for
glucose between the mother and fetus. The developing fetus will secrete human placental
lactogen (hpl) which blocks the mothers insulin and increases blood glucose (1997, Nesse,
Williams). If the mother does not have enough insulin to counteract the Hpl then the mother
will develop gestational diabetes, and could possibly be fatal to both the mother and fetus
(1997, Nesse, Williams). So the question is asked, if the fetal increase in Hpl secretion can lead
to death then why does it occur? The answer is yet another trade-off that humans have
evolved. The fetus needs a large magnitude of glucose to develop so it must risk the chance of
killing its mother in order to have a chance to fully develop and mature sexually in order to
reproduce later in life.
The immune system is a magnificently developed systemthat can fight off an enormous
amount of infections, but is not perfect and still leaves us vulnerable to itself and outside
forces. Evolutionary medicine can help to explain these shortcomings of our immunity and also
give us new treatment options. The occurrence of chronic inflammatory disease, allergies and
autoimmunity has been a mystery to medical researchers. Evolutionary medicine has begun to
help explain the occurrences of these diseases, which have lead to treatments that would have
never come to light through modern medicine alone. Researchers have found an increase in
prevalence of these diseases in developed countries compared to undeveloped ones. The
“Hygiene Hypothesis” suggests these occurrences are related to a decrease in exposure to
pathogens that were a part of our evolutionary history (2007, Rook). Two of these pathogens
are the harmless pathogens associated with untreated water and the helminth worm which are
still common in developing countries. Studies have found that these pathogens become a part
of the micro flora of mammals once exposed and help in the maturation of dendrtic cells and T-
cells (2007, Rook). In the absence of the pathogens the immune system does not develop as
many regulatory cells and in turn leads to allergies, autoimmunity and chronic inflammatory
diseases. One example of this was found in looking at people suffering from multiple sclerosis
(MS) in Argentina (2007, Rook). MS is an autoimmune disease in which the body’s own immune
system attacks and destroys the myelin basic protein of the central nervous systemdrastically
decreasing the speed of an action potential between the synapses between nerves. The
patients were followed up on for 4.6 years and it was found that the patients with parasitic
infections had far fewer inflammatory attacks on the myelin than those who were not infected
with a parasite (2007, Rook). This simple concept of humans in developed countries not being
exposed to “old friends” such as the helminth worm and thus have more allergies and
inflammatory disease may have never been tested without an evolutionary approach to the
dilemma.
Evolutionary medicine along with modern medicine can help in disease treatment
options and also make us think twice before prescribing a certain medication. One example of
this is the discovery and mass use of antibiotics beginning in the 1940s. Most antibiotics are
derivatives of naturally occurring substances in micro-organisms that have evolved as defenses
against other organisms (2009, Gluckman et al). When the antibiotics are applied to bacteria
the bacteria quickly evolve resistance to it through random mutations that occur because of
their large populations and fast regeneration times. Antibiotic resistance can occur in as little as
two to four years after exposure (2009, Gluckman et al). When this occurs, the new bacterial
strain is even more deadly than before. Therefore evolutionary medicine can help to curtail
medical treatments and make you think twice before taking that azithromycin pack when you
have an infection in order to let you immune systemfight it off without the development of an
antibiotic resistant strain.
The field of evolutionary medicine can help to explain the existence of numerous
diseases and shortcomings of the human body. The amalgamation of modern medicine with
evolutionary medicine will help researchers to discover new treatment options for diseases,
explain why diseases occur and curtail treatment for better results. According to Stearns and
Ebert, evolutionary medicine can “shed new light on the evolution of virulence, of antibiotic
resistance, of oocytic atresia, of menopause, of the timing of the expression of genetic disease,
of links between mate choice and disease resistance, and of genomic conflict between mother
and fetus over resource provisioning” leading to numerous new insights that would have never
came to light without an evolutionary perspective (2001, Stearns, Ebert).
Work Cited
Coall D, Chisholm J (2003) Evolutionary Perspectives on Pregnancy: Maternal Age at Menarche
and Infant Birth Weight. Social Science and Medicine. 57: 1771-1781
Ebert, Sterns (2001) Evolution in Health and Disease: A Work in Progress. Department of
Ecology and Evolutionary Biology, Yale University. 76: 416-432
Gluckman P, Beedle A, Hanson M (2009) Principles of Evolutionary Medicine. New York, NY:
Oxford Press
Nesse R, Stearns S, (2008) The Great Opportunity: Evolutionary Applications to Medicine and
Public Health. Evolutionary Applications. 28-48
Nesse R, Williams G (1996). Why We Get Sick. New York, NY: Vintage Books
Rook G (2007) The Hygiene Hypothesis and the Increasing Prevalence of Chronic Inflammatory
Disorders. Royal Society of Tropical Medicine and Hygiene. 101: 1072-1074

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evolutionary Medicine

  • 1. LB 492 Evolutionary Medicine: A Different View of the Human Body David Wenzel 2/13/2011
  • 2. Evolutionary medicine helps people understand how the human body has developed to become extremely sophisticated, yet vulnerable to a multitude of negative forces. Evolutionary medicine takes the large number of mysterious flaws humans have developed and turns them into questions that can be answered and explained (2008, Nesse, Stearns). The foundation of evolutionary medicine is thru findings that diseases need both a proximate answer to mechanisms and an evolutionary answer to why these mechanisms have evolved and left the human body vulnerable (2008, Nesse, Stears). From maternal-fetal interactions such the battle over glucose, to chronic inflammatory disease and allergies; evolutionary medicine can bolster our understandings gained from modern medicine and help to develop new treatment options never thought possible without an evolutionary understanding. Human reproduction is a complicated system with many questions that cannot be answered by modern medicine alone. One complicated question that has an evolutionary perspective is the occurrence of low birth weight babies and maternal age at menarche. Studies have found that low birth weight offspring are correlated with mothers who underwent early menarche (2003, Coall et al). Studies have also linked early menarche with psychosocial stress early in development, such as father absence, family conflict and major life events. So the questions begs, why if early menarche occurs under psychosocial stress and leads to low birth weight offspring have women evolved this occurrence? It would make more sense to hold off sexual maturity until the mother can ensure a healthier offspring with higher chances of survival. The answer is a simple evolutionary trade-off. When the mother is under psychosocial stress she undergoes early menarche in order to undergo early reproduction to minimize the chance of losing her lineage (2003, Coall et al). This leads to a strategy of early reproduction at
  • 3. the cost of the offspring in order to ensure the chance of one reaching sexual maturity and reproducing. Another oddity of human reproduction is the ever-going battle between the mother and fetus during gestation. The mother tries to balance the successful birth of her present fetus with future siblings, which leads to withholding of resources in order to increase her fitness in the future. The fetus, however, is fully invested in survival and tries to maximize its resources even at the cost of the mothers fitness (2003, Coall et al). One example of this is the battle for glucose between the mother and fetus. The developing fetus will secrete human placental lactogen (hpl) which blocks the mothers insulin and increases blood glucose (1997, Nesse, Williams). If the mother does not have enough insulin to counteract the Hpl then the mother will develop gestational diabetes, and could possibly be fatal to both the mother and fetus (1997, Nesse, Williams). So the question is asked, if the fetal increase in Hpl secretion can lead to death then why does it occur? The answer is yet another trade-off that humans have evolved. The fetus needs a large magnitude of glucose to develop so it must risk the chance of killing its mother in order to have a chance to fully develop and mature sexually in order to reproduce later in life. The immune system is a magnificently developed systemthat can fight off an enormous amount of infections, but is not perfect and still leaves us vulnerable to itself and outside forces. Evolutionary medicine can help to explain these shortcomings of our immunity and also give us new treatment options. The occurrence of chronic inflammatory disease, allergies and autoimmunity has been a mystery to medical researchers. Evolutionary medicine has begun to
  • 4. help explain the occurrences of these diseases, which have lead to treatments that would have never come to light through modern medicine alone. Researchers have found an increase in prevalence of these diseases in developed countries compared to undeveloped ones. The “Hygiene Hypothesis” suggests these occurrences are related to a decrease in exposure to pathogens that were a part of our evolutionary history (2007, Rook). Two of these pathogens are the harmless pathogens associated with untreated water and the helminth worm which are still common in developing countries. Studies have found that these pathogens become a part of the micro flora of mammals once exposed and help in the maturation of dendrtic cells and T- cells (2007, Rook). In the absence of the pathogens the immune system does not develop as many regulatory cells and in turn leads to allergies, autoimmunity and chronic inflammatory diseases. One example of this was found in looking at people suffering from multiple sclerosis (MS) in Argentina (2007, Rook). MS is an autoimmune disease in which the body’s own immune system attacks and destroys the myelin basic protein of the central nervous systemdrastically decreasing the speed of an action potential between the synapses between nerves. The patients were followed up on for 4.6 years and it was found that the patients with parasitic infections had far fewer inflammatory attacks on the myelin than those who were not infected with a parasite (2007, Rook). This simple concept of humans in developed countries not being exposed to “old friends” such as the helminth worm and thus have more allergies and inflammatory disease may have never been tested without an evolutionary approach to the dilemma.
  • 5. Evolutionary medicine along with modern medicine can help in disease treatment options and also make us think twice before prescribing a certain medication. One example of this is the discovery and mass use of antibiotics beginning in the 1940s. Most antibiotics are derivatives of naturally occurring substances in micro-organisms that have evolved as defenses against other organisms (2009, Gluckman et al). When the antibiotics are applied to bacteria the bacteria quickly evolve resistance to it through random mutations that occur because of their large populations and fast regeneration times. Antibiotic resistance can occur in as little as two to four years after exposure (2009, Gluckman et al). When this occurs, the new bacterial strain is even more deadly than before. Therefore evolutionary medicine can help to curtail medical treatments and make you think twice before taking that azithromycin pack when you have an infection in order to let you immune systemfight it off without the development of an antibiotic resistant strain. The field of evolutionary medicine can help to explain the existence of numerous diseases and shortcomings of the human body. The amalgamation of modern medicine with evolutionary medicine will help researchers to discover new treatment options for diseases, explain why diseases occur and curtail treatment for better results. According to Stearns and Ebert, evolutionary medicine can “shed new light on the evolution of virulence, of antibiotic resistance, of oocytic atresia, of menopause, of the timing of the expression of genetic disease, of links between mate choice and disease resistance, and of genomic conflict between mother and fetus over resource provisioning” leading to numerous new insights that would have never came to light without an evolutionary perspective (2001, Stearns, Ebert).
  • 6. Work Cited Coall D, Chisholm J (2003) Evolutionary Perspectives on Pregnancy: Maternal Age at Menarche and Infant Birth Weight. Social Science and Medicine. 57: 1771-1781 Ebert, Sterns (2001) Evolution in Health and Disease: A Work in Progress. Department of Ecology and Evolutionary Biology, Yale University. 76: 416-432 Gluckman P, Beedle A, Hanson M (2009) Principles of Evolutionary Medicine. New York, NY: Oxford Press Nesse R, Stearns S, (2008) The Great Opportunity: Evolutionary Applications to Medicine and Public Health. Evolutionary Applications. 28-48 Nesse R, Williams G (1996). Why We Get Sick. New York, NY: Vintage Books Rook G (2007) The Hygiene Hypothesis and the Increasing Prevalence of Chronic Inflammatory Disorders. Royal Society of Tropical Medicine and Hygiene. 101: 1072-1074