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Stone agers in the fast lane: Chronic degenerative diseases in evolutionary perspective
Abstract
From a genetic standpoint, humans living today are Stone Age hunter-gatherers displaced through time to a world that differs from that for which our genetic constitution was selected. Unlike evolutionary maladaptation, our current discordance has little effect on reproductive success; rather it acts as a potent promoter of chronic illnesses: atherosclerosis, essential hypertension, many cancers, diabetes mellitus, and obesity among others. These diseases are the results of interaction between genetically controlled biochemical processes and a myriad of biocultural influences--lifestyle factors--that include nutrition, exercise, and exposure to noxious substances. Although our genes have hardly changed, our culture has been transformed almost beyond recognition during the past 10,000 years, especially since the Industrial Revolution. There is increasing evidence that the resulting mismatch fosters "diseases of civilization" that together cause 75 percent of all deaths in Western nations, but that are rare among persons whose lifeways reflect those of our preagricultural ancestors.
... The multi-factorial origins of obesity are complex; however, an imbalance between energy intake and energy expenditure leading to energy surplus is considered the main reason for weight gain. Excess food intake and high fat/sucrose diets, such as Western diets (WD), predispose one to obesity, characterized by an expansion of white adipose tissue (WAT), elevated free fatty acids (FFA) levels, systemic inflammation (pro-inflammatory cytokines; IL-6, TNFα, IL-1, and MCP-1), mitochondrial dysfunction, oxidative stress, insulin resistance (IR), and ectopic lipid deposition in insulin-sensitive tissues such as liver [1][2][3][4]. Secondarily, other systems may be affected, including the neuroendocrine and reproductive systems, causing hypothalamic-pituitary-adrenal axis (HPA) dysregulation, oxidative damage, and inflammation, thereby impairing gonadal function and fertility. ...
... Obesity is a multisystem disease linked to mitochondrial dysfunction, oxidative damage, and inflammation, primarily affecting critical organs or tissues involved in metabolism (e.g., fat, liver, pancreas, heart, and skeletal muscles) [1][2][3][4], thus significantly increasing comorbidity and mortality risks (e.g., cardiovascular disease (CVD), type 2 diabetes (T2DM), non-alcoholic fatty liver disease (NAFLD), and cancer) [5][6][7][8][9][10]. Excess food intake and weight gain also affect reproductive health by impairing gonadal function and fertility, thereby predisposing overweight and obese couples to reproductive system disorders and poor pregnancy outcomes couples [11]. ...
The Western diet (WD) predisposes to bodyweight gain and obesity and is linked to mitochondrial dysfunction, oxidative damage, inflammation, and multisystem disease, even affecting the reproductive organs, fertility, and pregnancy outcomes. In this study, we investigated the effects of multi-ingredient supplementation (MIS) with antioxidants, phytonutrients, and vitamins (‘Fertility Enhancer’; FE) on white adipose tissue (WAT) expansion, nonalcoholic fatty liver disease (NAFLD), and infertility in WD-fed C57BL/6J mice. Five-month-old male (M) and female (F) mice were fed a low-fat diet (LF) or a high fat/sucrose WD (HF) for six weeks, followed by six weeks of LF (3.64 kcal/g), HF (4.56 kcal/g), or HF combined with FE (4.50 kcal/g). A sub-set of animals were sacrificed at 12 weeks, while the remainder were harem-mated in a 1:2 male-to-female ratio, and singly housed during the gestational period. Two-way, factorial ANOVA analysis revealed a main effect of diet on bodyweight (BW), total body fat, % body fat, white adipose tissue mass, and liver lipid content (all p < 0.001), driven by the anti-obesogenic effects of the ‘Fertility Enhancer.’ Similarly, a main effect of diet was found on PGC1-α mRNA levels (p < 0.05) and mitochondrial protein content (p < 0.001) in perigonadal WAT, with PGC1-α induction and higher complex II and complex III expression in FE vs. HF animals. Copulatory plug counts were higher in FE vs. HE couples (30% vs. 6%), resulting in more litters (4 vs. 0) and higher copulatory success (67% vs. 0%). Although the trends of all histology outcomes were suggestive of a benefit from the FE diet, only the number of atretic follicles and testicular mass were significant. Ovarian IL-1β mRNA induction was significantly attenuated in the FE group (p < 0.05 vs. HF) with CASP1 attenuation trending lower (p = 0.09 vs. HF), which is indicative of anti-inflammatory benefits of the ‘Fertility Enhancer.’ We conclude that supplementation with specific phytonutrients, antioxidants, and vitamins may have utility as an adjunctive therapy for weight management, fatty liver disease, and infertility in overweight and obese couples.
... On one hand, sanitation, housing, and medical care improved human quality of life by decreasing the incidence of infectious disease and overall mortality. On the other hand, the dietary patterns of industrialized regions became more caloric, less energy-dense and less nutrient-rich, whereas physical activity drastically decreased leading to the rise of the so-called diseases of civilization, such as cancer, asthma, obesity, type 2 diabetes mellitus Inflammatory bowel disease (IBD) and atherosclerosis, among others [2]. This hypothesis is highly supported by studies comparing the lifestyle and health of western countries to rural areas in developing countries, where industrialization and globalization didn't cause a huge effect on people's lives [3]. ...
The industrial revolution was the main driver for the “westernization” of human lifestyle,
increasing the intake of highly industrially processed foods, rich in simple sugars and
saturated fats. This new dietary pattern is often referred to as the “western diet”. The issue of using this term is that it lacks a standardized definition. Moreover, the dietary pattern that characterizes this diet is not entirely restricted to the West anymore. In this way, we propose a new definition of the diet that is heavily rooted on the process of food choice management, which is influenced by several documented socio-economic factors, such as geography, income and education. Moreover, we suggest that “Globalized diet” should be preferred as a label for the underlying concept of the “Western diet” since developed countries share more dietary traits among themselves than with developing countries, where the industrial revolution was less impactful, and where the globalized lifestyle has yet to be established.
We are currently reaching out to as many researchers in the food nutrition field to achieve
consensus in our proposed definition as we recognize the importance of standardizing terms for the generation of new knowledge through meta-analysis on broad multi-center nutritional studies.
... These environmental changes and behavioral modifications have led to a disruption of the balance between man's genetic structure and his environment [13]. As a result, there has been an increased interest in the diets of our past, leading to a greater study of the foods consumed during that time and the role that food has played in human evolution [14,15]. In this regard, although it has been argued that the transition from a fibrous plant-based diet to a predominantly meat-based diet is one of the main drivers of evolutionary change [16], it is difficult to reconstruct an accurate picture of the diet of our ancestors. ...
Foods high in carbohydrates are an important part of a healthy diet, since they provide the body with glucose to support bodily functions and physical activity. However, the abusive consumption of refined, simple, and low-quality carbohydrates has a direct implication on the physical and mental pathophysiology. Then, carbohydrate consumption is postulated as a crucial factor in the development of the main Western diseases of the 21st century. We conducted this narrative critical review using MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl databases with the MeSH-compliant keywords: carbohydrates and evolution, development, phylogenetic, GUT, microbiota, stress, metabolic health, consumption behaviors, metabolic disease, cardiovascular disease, mental disease, anxiety, depression, cancer, chronic kidney failure, allergies, and asthma in order to analyze the impact of carbohydrates on health. Evidence suggests that carbohydrates, especially fiber, are beneficial for the well-being and growth of gut microorganisms and consequently for the host in this symbiotic relationship, producing microbial alterations a negative effect on mental health and different organic systems. In addition, evidence suggests a negative impact of simple carbohydrates and refined carbohydrates on mood categories, including alertness and tiredness, reinforcing a vicious circle. Regarding physical health, sugar intake can affect the development and prognosis of metabolic disease, as an uncontrolled intake of refined carbohydrates puts individuals at risk of developing metabolic syndrome and subsequently developing metabolic disease.
... It can be thought of as the optimal Stone Age environment, as the modern situation is typically worse in some respects but better in many others. That is, most differences, or mismatches [61], between the present setting and the EEA are presumably either neutral or beneficiary. We sleep better on soft mattresses rather than on damp soil, and we live longer and healthier thanks to antibiotics. ...
Mental issues are by many considered the main challenge for health authorities in industrialized nations. In this entry, I discuss an approach that may prove useful for ameliorating the situation and thereby improving quality of life. The analysis uses an understanding of the brain based on evolution and neurobiology, so consequently the ideas presented differ somewhat from traditional psychological thinking. Briefly, it appears likely that the problems with psychopathology are partly due to a lifestyle at odds with human nature. The key for finding preventive measures then is to identify the contributing mismatches. Based on the present perspective, therapeutic interventions can be construed as altering the brain by exercising functions that ought to be strengthened. By understanding brain plasticity, and the functions that are likely to need improvement in relation to mental health, we stand a better chance at devising interventions that work.
... Today's people are consumed food poor in magnesium, potassium, fiber, and rich in saturated fatty acids, simple carbohydrates, sodium, and chlorine compared to people who lived in previous periods (Eaton and Konner 1985;Eaton, Eaton, and Konner 1997). These changes in diet and other agricultural nutritional composition changes have been implicated as risk factors in the pathogenesis of "diseases of civilization", including atherosclerosis, hypertension, type 2 diabetes, osteoporosis, certain types of cancer, and CVDs (Eaton, Konner, and Shostak 1988). With these changes, the potential importance of acid-base balance for cardiometabolic risk factors has started to take its place in the literature (Haghighatdoost et al. 2015;Murakami et al. 2008). ...
Diet affects the body's acid-base balance by providing acid or alkali precursors in the metabolism. The importance of the acid-base balance of the diet for cardiovascular diseases, which have become the most important cause of morbidity on the global scale, has started to take its place in the literature. The prediction of endogenous acid production in dietary acid-base balance is expressed as dietary acid load. Although the available information about the effect of dietary acid load on cardiovascular diseases is limited, possible mechanisms are indicated as excessive calcium and magnesium excretion from the kidneys, reduced urinary citrate excretion, and excessive cortisol production. Metabolic acidosis has an important role in the development of cardiometabolic abnormalities, especially insulin resistance. Studies examining the relationship between dietary acid load and cardiovascular disease are limited and there is an inconsistency between studies. Practices for determining risk factors for cardiovascular diseases and preventing their effects are very important for the protection and improvement of health. Considering dietary acid load when planning a diet for individuals with cardiovascular diseases can help increase the effectiveness of the diet. The purpose of this review is to examine the effect of dietary acid load on cardiovascular diseases.
... If metabolic load remains relatively low, through the consumption of traditional diets and maintenance of high physical activity levels, then it will not outstrip metabolic capacity, and conditions such as diabetes should not manifest. This scenario is consistent with data from various populations characterized by relatively short stature, indicating low birth weight, which maintained traditional lifestyles through the twentieth century and demonstrated negligible rates of diabetes (89)(90)(91). It is the superimposition of high metabolic load associated with urbanization (sedentary behavior, diets high in fats and refined carbohydrates) on the background of low metabolic capacity that is predicted to lead to metabolic dysfunction (92). ...
The British Raj has cast a deep and deadly impact on the Indian Continent physically and mentally which continues to haunt the Indian Continent and its peoples wherever they maybe. The thrifty gene hypothesis, proposed back in 1962 by Dr. James Van Gundia Neel, describes how people protected during periods of famine in past by having metabolisms efficient enough to allow survival on small amounts of food. Those who survived were wired to be able to use minimal amounts of energy, and store the rest as fat for the next famine. Famines were administrative disasters in colonial India which the British government never really acknowledged. India has rapidly become a “diabetes capital” of the world, despite maintaining high rates of under-nutrition. Indians develop diabetes at younger age and at lower body weights than other populations. The drastic reduction in stature in India is greater than that observed in most other global regions indicates nutritional stress operating across many generations due to regular famines induced by the undermining of agricultural security during the colonial period. Thus, colonial imperialism not only destroyed Hindutva and continues to destroy through the Socioreligious Order of the Liberal Evangelical Western Democracy (SO LEWD), but caused tremendous damage to the genetics and physical health of Indians.
Winston Churchill in 1942 said that that passion for empire did not, however, entail the duty of protecting the lives of the King's distant subjects, especially Indians, a beastly people with a beastly religion. Churchill repeatedly denied all food exports to India, in spite of the fact that about 2.4 million Indians served in British units during the Second World War .
... maize in Latin America, rice in Asia, wheat in Western countries and millet in Africa), and diabetes was not as prevalent to such an extent; notably, this can still be observed today in some traditional cultures (e.g. hunter-gatherers, simple agriculturists, rudimentary horticulturists, and pastoralists) [53], and/or less developed countries where the prevalence of food ultra-processing is still rare (even if the prevalence of type 2 diabetes appears to parallel the level of food industrialization) [54]. Beyond the role of food (ultra) processing on the matrix structure, other factors are obviously involved in the increased prevalence of type 2 diabetes during the last decades, notably lifestyle factors such as a lower level of physical activity or higher level of sedentary lifestyle due to urbanization [55][56][57] or deregulated eating frequency [58,59]; this latter can also be associated with ultra-processed foods, e.g. ...
Purpose
For decades, it has been customary to relate human health to the nutritional composition of foods, and from there was born food composition databases, composition labelling scores and the recommendation to eat varied foods. However, individuals can fully address their nutritional needs and become chronically ill. The nutrient balance of a food is only a small part of its overall health potential. In this paper, we discussed the proof of concept that the increased risk of chronic diseases worldwide is primarily associated with the degradation and artificialization of food matrices, rather than only their nutrient contents, based on the assumption that “food matrices govern the metabolic fate of nutrients”.
Methods
An empirico-inductive proof of concept research design has been used, based on scientific data linking the degree of food processing, food matrices and human health, notably on the glycaemic index, nutrient bioavailability, satiety potential, and synergistic effects.
Results
We postulate that if the nutrient content is insufficient to fully characterize the diet-global health relationship, one other dimensions is necessary, i.e., the food matrix through the degree of processing. Both matrix and nutrient composition dimensions have been included under the new concept of the 3V index for Real (Vrai), Vegetal (Végétal), and Varied (Varié) foods. The Real metric, reflecting the integrity of the initial food matrix, is the most important, followed by the Vegetal (nutrient origin) and the Varied (“composition” effect) metrics.
Conclusion
Concerning their effects on health, food matrix comes first, and then nutrient composition, and calorie quality matters more than calorie quantity.
... As a reasonable simplification, the EEA can be described as a 'Stone Age', hunter-gatherer, tribal lifestyle. Environmental factors that differ between the present way of living and the EEA have been referred to as mismatches [34]. Most mismatches are likely to be beneficial; the important point is thus to identify the differences that contribute to morbidity. ...
Happiness, or life satisfaction, has become an important factor when considering what should be the objective of a society. Understanding the nature of happiness is thus important. The text offers a biological—specifically evolutionary—framework, which suggests that happiness can be described as the net impact of positive and negative feelings. It follows that a key issue is to explain what these feelings are about. The present situation and options for improving the score of happiness are discussed.
... In contrast, evolution with the mechanism of selection over generations is a rather slow process in organisms with a long generation time and has difficulties to keep pace with fast environmental and societal changes. It is thus conceivable that many biological processes in humans are not fully adapted to the challenges of current environments [10] and this disparity between biological processes that are not fully adapted and the challenges of the current environment can lead to a mismatch [23]. ...
... Anthropological studies have hypothesized that huntergatherers had a slim build, and they were fit and free of chronic diseases such as CVD due to their diet [15,16]. From a public health perspective, the challenge is to know the potential health benefits of a Paleo-style dietary pattern adapted to current lifestyles and food availability. ...
Purpose
To assess the association between a score appraising adherence to the PaleoDiet and the risk of cardiovascular disease (CVD) in a Mediterranean cohort.
Methods
We included 18,210 participants from the Seguimiento Universidad de Navarra (SUN) cohort study. The PaleoDiet score comprised six food groups promoted within this diet (fruit, nuts, vegetables, eggs, meat and fish) and five food groups whose consumption is discouraged (cereals and grains, dairy products, legumes, culinary ingredients, and processed/ultra-processed foods). CVD was defined as acute myocardial infarction with or without ST elevation, non-fatal stroke and cardiovascular death. Cox proportional hazards models adjusted for potential confounders were fitted to assess the association between the PaleoDiet score and CVD risk, and the PaleoDiet and MedDiet indices to explore differences between both diets.
Results
During 12.2 years of follow-up, 165 incident CVD cases were confirmed. A significant inverse association was found between the PaleoDiet score and CVD (HR Q5 vs. Q1: 0.45, 95% CI 0.27–0.76, P for trend = 0.007). A weaker association that became non-significant was observed when the item for low consumption of ultra-processed foods was removed from the score. Joint analysis of PaleoDiet and MedDiet Trichopoulou scores suggested that the inverse association between PaleoDiet and CVD was mainly present when adherence to the MedDiet was also high (HR for high adherence vs low adherence to both diet scores: 0.22, 95% CI 0.08–0.64).
Conclusions
Our findings suggest that the PaleoDiet may have cardiovascular benefits in participants from a Mediterranean country. Avoidance of ultra-processed foods seems to play a key role in this inverse association.
... The modern rise of conditions like obesity, type II diabetes, and cardiovascular disease has led many to posit that an 'evolutionary mismatch' is to blame: our physiology evolved in an environment that primarily offered a plant-based diet, and is therefore ill-suited to the modern nutritional landscape (Eaton et al., 1988). Human evolution did not stop with the transition to agriculture, of course, but ten millennia are not enough to fully adapt to such a wholesale dietary transformation. ...
The immune cells of macaques fed a Western-like diet adopt a pro-inflammatory profile.
... From an evolutionary perspective, the negative health effects of Western diets are hypothesized 78 to be driven by a "mismatch" between human physiology -which evolved to subsist on a plant-79 based diet supplemented with fish and meat but no refined products -and the radically different 80 nutritional environment of many human populations today (Eaton et al., 1988;Lieberman, 2014;81 Stearns & Koella, 2008). . The Mediterranean diet was higher in complex carbohydrates and fiber, and had a lower 166 n-6:n-3 fatty acid ratio (similar to a modern-day, traditional hunter-gatherer type of diet (Cordain 167 et al., 2005)), and lower sodium and refined sugars than the Western diet. ...
Dietary changes associated with industrialization increase the prevalence of chronic diseases, such as obesity, type II diabetes, and cardiovascular disease. This relationship is often attributed to an ‘evolutionary mismatch’ between human physiology and modern nutritional environments. Western diets enriched with foods that were scarce throughout human evolutionary history (e.g. simple sugars and saturated fats) promote inflammation and disease relative to diets more akin to ancestral human hunter-gatherer diets, such as a Mediterranean diet. Peripheral blood monocytes, precursors to macrophages and important mediators of innate immunity and inflammation, are sensitive to the environment and may represent a critical intermediate in the pathway linking diet to disease. We evaluated the effects of 15 months of whole diet manipulations mimicking Western or Mediterranean diet patterns on monocyte polarization in a well-established model of human health, the cynomolgus macaque ( Macaca fascicularis ). Monocyte transcriptional profiles differed markedly between diets, with 40% of transcripts showing differential expression (FDR < 0.05). Monocytes from Western diet consumers were polarized toward a more proinflammatory phenotype. The Western diet shifted the co-expression of 445 gene pairs, including small RNAs and transcription factors associated with metabolism and adiposity in humans, and dramatically altered behavior. For example, Western-fed individuals were more anxious and less socially integrated. These behavioral changes were also associated with some of the effects of diet on gene expression, suggesting an interaction between diet, central nervous system activity, and monocyte gene expression. This study provides new molecular insights into an evolutionary mismatch and uncovers new pathways through which Western diets alter monocyte polarization toward a proinflammatory phenotype.
... This hypothesis has led to the increasing popularity of the Paleolithic diet pattern (hereafter referred to as the evolutionary-concordant diet pattern), estimated from archeological and paleontological evidence and studies of extant hunter-gatherer populations, and characterized by high intake of fruits, vegetables, lean meats, and nuts, and low intake of grains, dairy products, refined fats and sugars, and salt [3,4]. Other lifestyle behaviors that are more evolutionarily concordant include high levels of physical activity, low levels of sedentary behavior, limited alcohol consumption, energy balances that limit excess adiposity, not using tobacco, and high social connectivity [4][5][6]. ...
Purpose
Evolutionary discordance may contribute to the high burden of chronic disease-related mortality in modern industrialized nations. We aimed to investigate the associations of a 7-component, equal-weight, evolutionary-concordance lifestyle (ECL) score with all-cause and cause-specific mortality.
Methods
Baseline data were collected in 2003–2007 from 17,465 United States participants in the prospective REasons for Geographic and Racial Differences in Stroke (REGARDS) study. The ECL score’s components were: a previously reported evolutionary-concordance diet score, alcohol intake, physical activity, sedentary behavior, waist circumference, smoking history, and social network size. Diet was assessed using a Block 98 food frequency questionnaire and anthropometrics by trained personnel; other information was self-reported. Higher scores indicated higher evolutionary concordance. We used multivariable Cox proportional hazards regression models to estimate ECL score–mortality associations.
Results
Over a median follow-up of 10.3 years, 3771 deaths occurred (1177 from cardiovascular disease [CVD], 1002 from cancer). The multivariable-adjusted hazard ratios (HR) (95% confidence intervals [CI]) for those in the highest relative to the lowest ECL score quintiles for all-cause, all-CVD, and all-cancer mortality were, respectively, 0.45 (0.40, 0.50), 0.47 (0.39, 0.58), and 0.42 (0.34, 0.52) (all P trend < 0.01). Removing smoking and diet from the ECL score attenuated the estimated ECL score–all-cause mortality association the most, yielding fifth quintile HRs (95% CIs) of 0.56 (0.50, 0.62) and 0.50 (0.46, 0.55), respectively.
Conclusions
Our findings suggest that a more evolutionary-concordant lifestyle may be inversely associated with all-cause, all-CVD, and all-cancer mortality. Smoking and diet appeared to have the greatest impact on the ECL–mortality associations.
... Pontzer and colleagues estimate that the Hadza population, a huntergatherer society in northern Tanzania, have a daily fiber intake of 80-150 grams, which is 4 to 7.5 times greater than the 20 grams of daily fiber intake found for the average person in the US (27). Eaton and colleagues came to similar conclusions, finding that the late paleolithic diet contains about 100-150 grams of fiber/day, whereas the contemporary American diet contains only 19.7 grams of fiber/day (28). Combined, it can be estimated that the US diet experiences a 75-92.5% fiber loss compared to that of hunter-gatherers. ...
Several factors in Western society, including widespread use of antibiotics, chronic inflammation, and loss of complex eukaryotic symbionts such as helminths, have a dramatic impact on the ecosystem of the gut, affecting the microbiota hosted there. In addition, reductions in dietary fiber are profoundly impactful on the microbiota, causing extensive destruction of the niche space that supports the normally diverse microbial community in the gut. Abundant evidence now supports the view that, following dramatic alterations in the gut ecosystem, microorganisms undergo rapid change via Darwinian evolution. Such evolutionary change creates functionally distinct bacteria that may potentially have properties of pathogens but yet are difficult to distinguish from their benign predecessors.
... Their ability to conserve energy by storing fat provided them with genetic advantage for selecting this genotype for unfavorable conditions (food scarcity). Therefore, these individuals were more likely to survive the periods of famine than lean individuals who were more prone to infectious diseases (Eaton et al., 1988;Chakravarthy and Booth, 2004). We, the modern day humans, have the continuous supply of food and are relatively physically inactive which abrogates the evolutionary programmed feast-famine and physical activityrest cycles. ...
Obesity is one of the biggest public health concerns identified by an increase in adipose tissue mass as a result of adipocyte hypertrophy and hyperplasia. Pertaining to the importance of adipose tissue in various biological processes, any alteration in its function results in impaired metabolic health. In this review, we discuss how adipose tissue maintains the metabolic health through secretion of various adipokines and inflammatory mediators and how its dysfunction leads to the development of severe metabolic disorders and influences cancer progression. Impairment in the adipocyte function occurs due to individuals’ genetics and/or environmental factor(s) that largely affect the epigenetic profile leading to altered gene expression and onset of obesity in adults. Moreover, several crucial aspects of adipose biology, including the regulation of different transcription factors, are controlled by epigenetic events. Therefore, understanding the intricacies of adipogenesis is crucial for recognizing its relevance in underlying disease conditions and identifying the therapeutic interventions for obesity and metabolic syndrome.
Objectives:
To determine the prevalence of, and understand the factors associated with, hypertension among the nomadic Raute hunter-gatherers of Western Nepal.
Design:
A mixed-method study.
Setting:
The study was carried out at Raute temporary campsites in the Surkhet District of Karnali Province between May and September 2021.
Participants:
The questionnaire-based survey included all males and non-pregnant females of the nomadic Raute group aged 15 years and above. In-depth interviews were conducted among purposively selected 15 Raute participants and four non-Raute key informants to help explain and enrich the quantitative findings.
Outcome measures:
The prevalence of hypertension (defined as brachial artery blood pressure of systolic ≥140 mm Hg and/or diastolic ≥90 mm Hg) and its sociodemographic, anthropometric and behavioural covariates.
Results:
Of the 85 eligible participants, 81 (median age 35 years (IQR: 26-51), 46.9% female) were included in the final analysis. Hypertension was found in 10.5% of females, 48.8% of males and 30.9% of the total population. Current alcohol and tobacco use were high (91.4% and 70.4%, respectively), with concerning high rates among youths. Males, older people, current drinkers and current tobacco users were more likely to have hypertension. Our qualitative analysis suggests that the traditional forest-based Raute economy is gradually transitioning into a cash-based one that heavily relies on government incentives. Consumption of commercial foods, drinks and tobacco products is increasing as their market involvement grows.
Conclusion:
This study found a high burden of hypertension, alcohol and tobacco use among nomadic Raute hunter-gatherers facing socioeconomic and dietary transitions. Further research is needed to assess the long-term impact of these changes on their health. This study is expected to help appraise concerned policymakers of an emerging health concern and formulate context-specific and culturally sensitive interventions to limit hypertension-related morbidities and mortalities in this endangered population.
The prevalence of obesity has reached pandemic proportions, and now approximately 25% of adults in Westernized countries have obesity. Recognized as a major health concern, obesity is associated with multiple comorbidities, particularly cardiometabolic disorders. In this Review, we present obesity as an evolutionarily novel condition, summarize the epidemiological evidence on its detrimental cardiometabolic consequences and discuss the major mechanisms involved in the association between obesity and the risk of cardiometabolic diseases. We also examine the role of potential moderators of this association, with evidence for and against the so-called 'metabolically healthy obesity phenotype', the 'fatness but fitness' paradox or the 'obesity paradox'. Although maintenance of optimal cardiometabolic status should be a primary goal in individuals with obesity, losing body weight and, particularly, excess visceral adiposity seems to be necessary to minimize the risk of cardiometabolic diseases.
The Middle Pleistocene is associated with a new level of technology, Mode 2, commonly called the Acheulean Culture. This appears in Africa and Western Asia, but only later in Europe and not at all in Asia. It appears to be an indicator of communication, if not actual migration, among these areas. Climate swings, particularly in Europe, suggest that some forms of shelter and clothing had been invented, but more direct evidence is scarce. Controlled fire appears about a million years ago, but what traces are found suggest it was not widely used. Hunting of larger animals is well documented in the Middle Pleistocene employing weaponry such as lances and throwing spears. Meat consumption appears to have increased in importance, especially in temperate Europe. Strangely, Asian populations did not follow the same behavioral trends.
The consequences of physical attractiveness (PA) are ubiquitous, however not often become a topic of discussion. The consequences, in general, are attributed to preference or discrimination without much deliberation. There is a very thin line between the two. The study makes an attempt to distinguish between preference and discrimination based on PA. In an organizational context, this distinction seems warranted since PA does impact work-related outcomes. The distinction was addressed by examining published studies between 1970 and 2021 on PA in the management and economics field of research. The study highlights when and how preference turns into discrimination and furthers discusses the causes of such discrimination. The causes are equivalent to antecedents; the antecedent to being physically attractive is mostly genes. The antecedents to the discrimination are the attributions that we have associated with being physically attractive. The study highlights these attributions and the reasons for these attributions. To completely understand a phenomenon, it is essential to understand what causes it. Therefore, this study tries to understand what causes discrimination based on PA. The study has implications for diversity and inclusion literature and practice. It also adds to the literature on PA.
Our primitive ancestors had to survive on hunting and foraging success. In the process they were physically active in search of food and they had to endure periods during which food was scarce. Over millions of years of evolution the human species developed metabolic systems designed to generate the high energy required for the daily physical activity associated with hunting and foraging and to ensure survival during periods of prolonged fasting.The genes and gene variants controlling our body’s metabolism that evolved over these millions of years continue relatively unchanged despite the dramatic changes in our lifestyle. A metabolic system designed for high levels of daily physical activity and fat storage for periods of food shortage can be a problem for today’s sedentary lifestyle and abundant energy rich food.KeywordsMetabolic rateEnergy expenditureCaloriesThrifty gene
Wide-ranging and inclusive, this text provides an invaluable review of an expansive selection of topics in human evolution, variation and adaptability for professionals and students in biological anthropology, evolutionary biology, medical sciences and psychology. The chapters are organized around four broad themes, with sections devoted to phenotypic and genetic variation within and between human populations, reproductive physiology and behavior, growth and development, and human health from evolutionary and ecological perspectives. An introductory section provides readers with the historical, theoretical and methodological foundations needed to understand the more complex ideas presented later. Two hundred discussion questions provide starting points for class debate and assignments to test student understanding.
Wide-ranging and inclusive, this text provides an invaluable review of an expansive selection of topics in human evolution, variation and adaptability for professionals and students in biological anthropology, evolutionary biology, medical sciences and psychology. The chapters are organized around four broad themes, with sections devoted to phenotypic and genetic variation within and between human populations, reproductive physiology and behavior, growth and development, and human health from evolutionary and ecological perspectives. An introductory section provides readers with the historical, theoretical and methodological foundations needed to understand the more complex ideas presented later. Two hundred discussion questions provide starting points for class debate and assignments to test student understanding.
Wide-ranging and inclusive, this text provides an invaluable review of an expansive selection of topics in human evolution, variation and adaptability for professionals and students in biological anthropology, evolutionary biology, medical sciences and psychology. The chapters are organized around four broad themes, with sections devoted to phenotypic and genetic variation within and between human populations, reproductive physiology and behavior, growth and development, and human health from evolutionary and ecological perspectives. An introductory section provides readers with the historical, theoretical and methodological foundations needed to understand the more complex ideas presented later. Two hundred discussion questions provide starting points for class debate and assignments to test student understanding.
Wide-ranging and inclusive, this text provides an invaluable review of an expansive selection of topics in human evolution, variation and adaptability for professionals and students in biological anthropology, evolutionary biology, medical sciences and psychology. The chapters are organized around four broad themes, with sections devoted to phenotypic and genetic variation within and between human populations, reproductive physiology and behavior, growth and development, and human health from evolutionary and ecological perspectives. An introductory section provides readers with the historical, theoretical and methodological foundations needed to understand the more complex ideas presented later. Two hundred discussion questions provide starting points for class debate and assignments to test student understanding.
Wide-ranging and inclusive, this text provides an invaluable review of an expansive selection of topics in human evolution, variation and adaptability for professionals and students in biological anthropology, evolutionary biology, medical sciences and psychology. The chapters are organized around four broad themes, with sections devoted to phenotypic and genetic variation within and between human populations, reproductive physiology and behavior, growth and development, and human health from evolutionary and ecological perspectives. An introductory section provides readers with the historical, theoretical and methodological foundations needed to understand the more complex ideas presented later. Two hundred discussion questions provide starting points for class debate and assignments to test student understanding.
Objectives: In a recent paper, Hardy et al. (2022, Journal of Human Evolution 162: 103105) claim that the physiological Neanderthal requirement for plant carbohydrates may have reached 50%-60% of caloric intake, inferred from modern dietary guidelines and a putative need for high carbohydrate intake in pregnant/breastfeeding women and athletes. The aim of this article is to critically reexamine these arguments under the premise that hominins could adapt to hypercarnivorous diets and low carbohydrate consumption. Materials and Methods: Literature on ketogenic and carnivore diets was retrieved. A case report of a male rugby player voluntarily undertaking a carnivore diet under medical supervision is presented. Results: Human metabolism is highly flexible towards adapting to long-term low carbohydrate intakes by producing and utilizing ketone bodies. The evidence base of dietary guidelines is weak, and carbohydrate intake recommendations for athletes and during pregnancy/lactation are uncertain, making a translation to Neanderthal diets questionable. The studied rugby player maintained his sports performance and health over a 4-months period despite minimal carbohydrate intake. Discussion: Human physiology appears to have an extraordinary ability to utilize ketone bodies as a fuel for the brain and skeletal muscle, in particular also during exercise. The translation of dietary guidelines to Neanderthals and interpretation of studies in subjects not adapted to ketosis may be biased by a "glucocentric" perspective supposing that high carbohydrate intake is necessary for maintaining health. Allowing for the possibility of keto-adaption leads to a more coherent integration of archeological and physiological data. K E Y W O R D S carnivore diet, exercise nutrition, ketosis, paleolithic diet, pleistocene
Dietary and lifestyle evolutionary discordance is hypothesized to play a role in the etiology of cardiovascular disease (CVD), including coronary heart disease (CHD), and stroke. We aimed to investigate associations of a previously-reported, total (dietary plus lifestyle) evolutionary-concordance (EC) pattern score with incident CVD, CHD, and stroke. We used multivariable Cox proportional hazards regression to investigate associations of the EC score with CVD, CHD, and stroke incidence among United States Black and White men and women ≥ 45 years old in the prospective REasons for Geographic and Racial Differences in Stroke (REGARDS) study (2003–2017). The EC score comprised seven equally-weighted components: a previously-reported dietary EC score (using Block 98 food frequency questionnaire data) and six lifestyle characteristics (alcohol intake, physical activity, sedentary behavior, waist circumference, smoking history, and social network size). A higher score indicates a more evolutionary-concordant dietary/lifestyle pattern. Of the 15,467 participants in the analytic cohort without a CVD diagnosis at baseline, 1,563 were diagnosed with CVD (967 with CHD and 596 with stroke) during follow-up (median 11.0 years). Among participants in the highest relative to the lowest EC score quintile, the multivariable-adjusted hazards ratios and their 95% confidence intervals for CVD, CHD, and stroke were, respectively, 0.73 (0.62, 0.86; P trend < 0.001), 0.72 (0.59, 0.89; P trend < 0.001), and 0.76 (0.59, 0.98; P trend = 0.01). The results were similar by sex and race. Our findings support that a more evolutionary-concordant diet and lifestyle pattern may be associated with lower risk of CVD, CHD, and stroke.
Cholesterol is one of the essential intrauterine factors required for fetal growth and development. Maternal high cholesterol levels are known to be detrimental for offspring health. However, its long-term effect on offspring skeletal development remains to be elucidated. We performed our studies in two strains of mice (C57BL6/J and Swiss Albino) and human subjects (65 mother-female newborn dyads) to understand the regulation of offspring skeletal growth by maternal high cholesterol. We found that mice offspring from high cholesterol (HC) fed dams had a low birth weight, smaller body length, and delayed skeletal ossification at the E18.5 embryonic stage.Moreover we observed that the offspring did not recover from the reduced skeletal mass and exhibited a low bone mass phenotype throughout their life. We attributed this effect to reduced osteoblast cell activity with a concomitant increase in the osteoclast cell population. Our investigation of the molecular mechanism revealed that offspring from HC-fed dams had a decrease in the expression of ligands and proteins involved in hedgehog signaling. Further, our cross-sectional study of human subjects showed a significant inverse correlation between maternal blood cholesterol levels and cord blood bone formation markers. Moreover, the bone formation markers were significantly lower in the female newborns of hypercholesterolemic mothers compared to mothers with normal cholesterolemic levels. Together, our results suggest that maternal high cholesterol levels deleteriously program offspring bone mass and bone quality and downregulate the hedgehog signaling pathway in their osteoblasts.
Evolutionary biology informs us that the living world is a product of evolution, guided by the Darwinian mechanism of natural selection. This recognition has been fruitfully employed to a number of issues in health and nutrition sciences; however, it has not been incorporated into education. Nutrition and dietetics students generally learn very little or nothing on the subject of evolution, despite the fact that evolution is the process by which our genetically determined physiological traits and needs were shaped. In the present paper, three examples of topics (inflammatory diseases, nutrition transition, and food intolerance) that can benefit from evolutionary information and reasoning are given, with relevant lines of research and inquiry provided throughout. It is argued that the application of evolutionary science to these and other areas of nutrition education can facilitate a deeper and more coherent teaching and learning experience. By recognizing and reframing nutrition as an aspect and discipline of biology, grounded in the fundamental principle of adaptation, revelatory light is shed on physiological states and responses, contentious and unresolved issues, genomic-, epigenomic-, and microbiomic features, and optimal nutrient status and intakes.
Human beings evolved on a diet that was balanced in omega-6/omega-3 fatty acids, and was rich in fruits and vegetables with a ratio of animal to vegetable intake of 35:65. Such a diet is a base-producing anti-inflammatory diet and one in which our genes have been programmed to respond. Current Western diets are acid-producing diets and are also high in omega-6 fatty acids, leading to a proinflammatory state. From an evolutionary perspective a mild systemic metabolic alkalosis, resulting from chronic net-base loading, is the natural and optimal systemic acid–base homeostasis of humans. Western diets that lead to a metabolic acidosis increase susceptibility to kidney disease as has been shown from the proinflammatory biomarkers that produce a cytokine storm. Healthy dietary patterns, including the Dietary Approach to Stop Hypertension (DASH) Study, and Mediterranean diets, such as the diet of Crete, both of which have a healthy dietary pattern, are associated with a lower incidence of chronic kidney disease and may prevent or decrease albuminuria and improve the estimated glomerular filtration rate (eGFR).
Aging-related diseases are the most prevalent diseases in advanced countries nowadays, accounting for a substantial proportion of mortality. We describe the explanatory properties of an evolution-based model of causation (EBMC) applicable to aging-related diseases and intrinsic mortality. The EBMC takes the sufficient and component causes model of causation as a starting point and develops it using evolutionary and statistical theories. Genetic component causes are classified as “early-onset” or “late-onset” and environmental component causes as “evolutionarily conserved” or “evolutionarily recent.” Genetic and environmental component causes are considered to occur as random events following time-to-event distributions, and sufficient causes are classified according to whether or not their time-to-event distributions are “molded” by the declining force of natural selection with increasing age. We obtain for each of these two groups different time-to-event distributions for disease incidence or intrinsic mortality asymptotically (i.e., for a large number of sufficient causes). The EBMC provides explanations for observations about aging-related diseases concerning the penetrance of genetic risk variants, the age of onset of monogenic vs. sporadic forms, the meaning of “age as a risk factor,” the relation between frequency and age of onset, and the emergence of diseases associated with the modern Western lifestyle. The EBMC also provides an explanation of the Gompertz mortality model at the fundamental level of genetic causes and involving evolutionary biology. Implications for healthy aging are examined under the scenarios of health promotion and postponed aging. Most importantly from a public health standpoint, the EBMC implies that primary prevention through changes in lifestyle and reduction of environmental exposures is paramount in promoting healthy aging.
Differences in diet and lifestyle relative to those of our Paleolithic-era ancestors may explain current high incidences of chronic diseases, including colorectal cancer (CRC), in Westernized countries. Previously reported evolutionary-concordance diet and lifestyle pattern scores, reflecting closeness of diet and lifestyle patterns to those of Paleolithic-era humans, were associated with lower CRC incidence. Separate and joint associations of the scores with colorectal adenoma among men and women are unknown. To address this, we pooled data from three case-control studies of incident, sporadic colorectal adenomas (n = 771 cases, 1,990 controls), used participants’ responses to food frequency and lifestyle questionnaires to calculate evolutionary-concordance diet and lifestyle pattern scores, and estimated the scores’ associations with adenomas using multivariable unconditional logistic regression. The multivariable-adjusted odds ratios comparing those in the highest relative to the lowest diet and lifestyle score quintiles were 0.84 (95% confidence interval [CI] 0.62, 1.12; Ptrend:0.03) and 0.41 (95% CI 0.29, 0.59; Ptrend:<0.0001), respectively. The inverse associations were stronger for high-risk adenomas, and among those with both high relative to those with both low diet and lifestyle scores. These results suggest that more evolutionary-concordant diet and lifestyle patterns, separately and jointly, may be associated with lower risk for incident, sporadic colorectal adenoma.
Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.2002919 .
Since the discovery of renin in 1898 as a “pressor hormone” the renin-angiotensin aldosterone system (RAAS) has evolved into an increasingly complex, pleiotropic regulatory system affecting fluid and electrolyte balance; cell proliferation, hypertrophy, survival and death; cognition and neurodegeneration; promoting inflammation and fibrosis; exacerbating co-morbid diseases such as diabetes mellitus; and secondarily the actions of aldosterone, for which angiotensin peptides are the primary activator. The metabolic pathways by which the angiotensin peptides are produced and modified involve an ever-increasing number of enzymes, with an ever-increasing number of receptors mediating effects of the various angiotensin peptides, aldosterone; even those of renin and its precursor prorenin. Given the predominant pathophysiological actions of RAAS, several classes of drugs have been developed to counteract these morbidities; renin and angiotensin-converting enzyme (ACE or ACE-1) inhibitors, AT1 type angiotensin II receptor antagonists, and aldosterone receptor antagonists. With the discovery of multiple angiotensin receptor types came the recognition of a second, counterregulatory arm of the RAAS involving the AT2 type receptor, the enzyme ACE-2, Mas, and Mas-related G protein-coupled receptors (Mrgs). Drugs under development include AT2 receptor agonists, Mas agonists and ACE-2 activators. With the discovery that ACE-2 is the primary receptor by which SARS-CoV-1 and 2 infects cells, its role as a COVID-19 facilitator versus its role as a counterregulator of the RAAS, has initiated considerable scientific debate.
Complex interplay of genetics and environmental factors in developing obesity has attracted a lot of attention in recent years. Different approaches in genetic analysis has illustrated numerous genetic loci that contribute in adiposity traits as monogenic obesity, syndromic obesity, and polygenic obesity. However, current studies are mostly on coding genes. Studies propose that epigenetic modifications such as DNA methylation plays a substantial role in the regulation of genes, involved in obesity-related processes. Also, miRNAs determine the adipocyte fate. Mechanistically they have impact on adipogenesis, adipocyte differentiation, lipid metabolism, glucose homeostasis, and insulin resistance. On the other hand, long non-coding RNAs play a protective role in metabolic dysfunction during obesity. Even though there are huge amount of evidence regarding genetic and epigenetic factors involved in development of obesity, there are lots of questions yet to be answered.
Human memory automatically prioritises locations of high-calorie foods, likely
reflecting an adaptation for foraging in harsh ancestral food environments. We investigated whether this high-calorie bias in human spatial memory yields unhealthy obesogenic implications for individual eating behaviour in present-day food-abundant settings. In an online study, we tested the food spatial memory of a diverse sample of 405 individuals, as well as examined associations between the high-calorie spatial memory bias and the self-reported routine frequency of high-calorie snack consumption, exposure to high-calorie food environments, and BMI of a subset of 316 individuals. The high-calorie spatial memory bias was not directly associated with high-calorie snack consumption frequency or BMI. However, a greater expression of the bias indirectly predicted a higher BMI, by mediating a stronger habit of purchasing high-calorie snack foods. Although individuals from various sociodemographic groups expressed the high-calorie bias in spatial memory, our results suggest that those with a better inhibitory control to high-calorie foods were protected from bias-related tendencies to frequent high-calorie food environments (e.g. fast-food outlets).
Introduction: As of now, no study has combined research from different sciences to determine the most suitable diet for humans. This issue is urgent due to the predicted population growth, the effect of this on the environment, and the deterioration of human health and associated costs.
Methods: A literature review determined whether an optimal diet for humans exists and what such a diet is, followed by six meta-analyses. The standard criteria for conducting meta-analyses of observational studies were followed. A review of literature reporting Hazard Ratios with a 95% confidence interval for red meat intake, dairy intake, plant-based diet, fiber intake, and serum IGF-1 levels were extracted to calculate effect sizes.
Results: Results calculated using NCSS software show that high meat consumption increases mortality probability by 18% on average and increases diabetes risk by 50%. Plant-based and high-fiber diets decrease mortality by 15% and 20% respectively (p < .001). Plant-based diets decreased diabetes risk by 27%, and dairy consumption (measured by increased IGF-1 levels) increased cancer probability by 48% (p < 0.01). A vegetarian or Mediterranean diet was not found to decrease the probability of heart disease. A vegetarian diet can be healthy or not, depending on the foods consumed. A Mediterranean diet with high quantities of meat and dairy products will not produce the health effects desired. The main limitations of the study were that observational studies were heterogeneous and limited by potential confounders.
Discussion: The literature and meta-analyses point to an optimal diet for humans that has followed our species from the beginnings of humankind. The optimal diet is a whole food, high fiber, low-fat, 90+% plant-based diet. This diet allowed humans to become the most developed species on Earth. To ensure people’s nutritional needs are met healthily and sustainably, governmental dietary interventions are necessary.
Since the middle to late 20 th century the majority of children born in the developing world have been likely to enter into post-reproductive age. Currently, child mortality is at its lowest level in human history. While more children are living to post reproductive age, approximately 15% of couples are experiencing infecundity. This is either a result of one or both members of the couple being infecund, or, despite both being fecund, the interaction between them prevents fertility for some reason. Assisted reproductive technologies have provided many infertile couples an opportunity to have children. Assisted reproductive technologies operate by intervening and manipulating gametic and intrauterine natural selection. This paper discusses the possible influence of assisted reproductive technologies on child development. This paper outlines some of the reported changes in children resulting from assisted reproductive technologies. Although, few people are either aware or care about possible long term consequences of relaxed natural selection contributed by medical intervention (i.e. assisted reproductive technologies) we have little understanding to what extent such medical interference may affect long term fitness in humans.
A compelling ecological theory of movement and vigor must explain why humans and other animals spend so much time not moving. When we rest, our somatic maintenance systems continue to work. When our somatic maintenance requirements increase, we place greater subjective value on resting. To explain variation in movement and vigor, we must account for the subjective value of resting.
Human memory appears to be adaptively “biased” towards remembering the locations of (fitness-relevant) high-calorie nutritional resources. It remains to be investigated whether this high-calorie bias in human spatial memory influences how individuals navigate the modern food environment, and whether it is proximally associated with attentional processes. 60 individuals completed computer-based food eye-tracking and spatial memory tasks in a lab setting, as well as a food search and covert food choice task in an unfamiliar supermarket. The high-calorie spatial memory bias was replicated, as individuals more accurately recalled locations of high-calorie relative to low-calorie foods, regardless of hedonic evaluations or familiarity with foods. Although individuals were faster at (re)locating high-calorie (versus low-calorie) items in the supermarket, the bias did not predict a lower search time for high-calorie foods, or a higher proportion of high-calorie food choice. Rather, an enhanced memory for high-calorie food locations was associated with a lower perceived difficulty (i.e. greater ease) of finding high-calorie items in the supermarket, which may potentiate later choice of a high-calorie food. The high-calorie spatial memory bias was also found to be expressed independently of the amount of visual attention individuals allocated to high-calorie versus low-calorie foods. Findings further substantiate the notion that human spatial memory shows sensitivity to the caloric content of a potential resource and automatically prioritizes those with greater energy payoffs. Such a spatial mechanism that was adaptive for energy-efficient foraging within fluctuating ancestral food environments could presently yield maladaptive “obesogenic” consequences, through altering perceptions of food search convenience.
We review the evolutionary origins of the human diet and the effects of ecology economy on the dietary proportion of plants and animals. Humans eat more meat than other apes, a consequence of hunting and gathering, which arose ∼2.5 Mya with the genus Homo. Paleolithic diets likely included a balance of plant and animal foods and would have been remarkably variable across time and space. A plant/animal food balance of 40–60% prevails among contemporary warm-climate hunter-gatherers, but these proportions vary widely. Societies in cold climates, and those that depend more on fishing or pastoralism, tend to eat more meat. Warm-climate foragers, and groups that engage in some farming, tend to eat more plants. We present a case study of the wild food diet of the Hadza, a community of hunter-gatherers in northern Tanzania, whose diet is high in fiber, adequate in protein, and remarkably variable over monthly timescales.
Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
In the same way that in current traditional medicine, it is not conceivable to talk about gerontology and geriatrics without considering the general medical knowledge, similarly, it is not conceivable to discuss evolutionary gerontology and geriatrics regardless of the general concepts of evolutionary medicine.
The widespread uptake of the Anthropocene concept over the past two decades has seen a concomitant rise in cultural forms that trade on nostalgia for Paleolithic life. Mud running, CrossFit, and the Paleo diet exemplify this trend, with the Paleolithic hunter-gatherer at the center of their popular prescriptions for healthy living. In this article, we identify these practices as embodying the anxieties of the Anthropocene as well as its historical and racial elisions. By focusing on the oblique and subtle racializations of Anthropocene health and fitness cultures, we contribute to understandings of the cultural significance of the human body in the Anthropocene and the relationship between the biopolitics of health and geological life, arguing that the body is a key site through which the tensions and inequalities of the Anthropocene are played out. And by unraveling how the Paleolithic imagination is rooted in a distinctly capitalist, Euro-American attitude to the body in nature, we show the Anthropocene to be defined by uneven distributions of health as self-optimization, and health as environmental risk. The Paleolithic imagination demonstrates the tangled politics of race, science, and nature in the twenty-first century, in which global ecological instability, the biopolitics of health, the shadows of colonialism, and consumer capitalism converge.
In high-income countries, one's relative socio-economic position and economic inequality may affect health and well-being, arguably via psychosocial stress. We tested this in a small-scale subsistence society, the Tsimane, by associating relative household wealth (n=871) and community-level wealth inequality (n=40, Gini = 0.15 – 0.53) with a range of psychological variables, stressors, and health outcomes (depressive symptoms [n=670], social conflicts [n=401], non-social problems [n=398], social support [n=399], cortisol [n=811], BMI [n=9926], blood pressure [n=3195], self-rated health [n=2523], morbidities [n=1542]) controlling for community-average wealth, age, sex, household size, community size, and distance to markets. Wealthier people largely had better outcomes while inequality associated with more respiratory disease, a leading cause of mortality. Greater inequality and lower wealth were associated with higher blood pressure. Psychosocial factors didn't mediate wealth-health associations. Thus, relative socio-economic position and inequality may affect health across diverse societies, though this is likely exacerbated in high-income countries.
Mismatch is a prominent concept in evolutionary medicine and a number of philosophers have published analyses of this concept. The word ‘mismatch’ has been used in a diversity of ways across a range of sciences, leading these authors to regard it as a vague concept in need of philosophical clarification. Here, in contrast, we concentrate on the use of mismatch in modelling and experimentation in evolutionary medicine. This reveals a rigorous theory of mismatch within which the term ‘mismatch’ is indeed used in several ways, not because it is ill-defined but because different forms of mismatch are.distinguished within the theory. Contemporary evolutionary medicine has unified the idea of ‘evolutionary mismatch’, derived from the older idea of ‘adaptive lag’ in evolution, with ideas about mismatch in development and physiology derived from the Developmental Origins of Health and Disease (DOHaD) paradigm. A number of publications in evolutionary medicine have tried to make this theoretical framework explicit. We build on these to present the theory in as simple and general a form as possible. We introduce terminology, largely drawn from the existing literature, to distinguish the different forms of mismatch. This integrative theory of mismatch captures how organisms track environments across space and time on multiple scales in order to maintain an adaptive match to the environment, and how failures of adaptive tracking lead to disease. Mismatch is a productive organising concept within this theory which helps researchers articulate how physiology, development and evolution interact with one another and with environmental change to explain health outcomes.
The aim of this meta-analysis was to review the impact of a Paleolithic diet (PD) on selected health indicators (body composition, lipid profile, blood pressure, and carbohydrate metabolism) in the short and long term of nutrition intervention in healthy and unhealthy adults. A systematic review of randomized controlled trials of 21 full-text original human studies was conducted. Both the PD and a variety of healthy diets (control diets (CDs)) caused reduction in anthropometric parameters, both in the short and long term. For many indicators, such as weight (body mass (BM)), body mass index (BMI), and waist circumference (WC), impact was stronger and especially found in the short term. All diets caused a decrease in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), albeit the impact of PD was stronger. Among long-term studies, only PD cased a decline in TC and LDL-C. Impact on blood pressure was observed mainly in the short term. PD caused a decrease in fasting plasma (fP) glucose, fP insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) in the short run, contrary to CD. In the long term, only PD caused a decrease in fP glucose and fP insulin. Lower positive impact of PD on performance was observed in the group without exercise. Positive effects of the PD on health and the lack of experiments among professional athletes require longer-term interventions to determine the effect of the Paleo diet on athletic performance.
Literature concerning the causative factors of atherosclerotic cardiovascular disease shows complex and sometimes contrasting evidence. Most guidelines suggest a strategy aimed at lowering circulating low density lipoproteins (LDL) and ApoB lipoprotein levels. The use of statins and of cholesteryl ester transfer protein inhibitors has led to a number of controversial outcomes, generating a certain degree of concern about the real efficacy and especially safety of these drugs. Literature data show that the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors results in a dramatic reduction of various markers of lipid metabolism (namely LDL); however, several critical scientific papers have questioned the value, the need and especially the safety of these innovative drugs. LDL are a protective factor against lipopolysaccharides and other microbial derivatives. Similarly, these Gram negative bacteria-derived compounds have been identified as probable culprits of cardiovascular atherogenesis; moreover, lipopolysaccharides increase hepatic synthesis of PCSK9, as defense mechanism. This enzyme modulates LDL receptors level in the liver, as well as in other organs, such as adrenal gland and reproductive organs. Hence, PCSK9 inhibition may influence glucocorticoid secretion and fertility. Lastly, the consequent reduction of circulating LDL may relevantly hindrance immune system and favor lipopolysaccharides diffusion.
Background:
The dual crises of climate change and chronic, or non-communicable, disease (NCD) have emerged worldwide as the global economy has industrialized over the past two centuries.
Aims:
In this synthesis I examine humans' dependence on external (non-metabolic) energy expenditure (e.g., fire, fossil fuels) as a common, root cause in these modern crises.
Materials and methods:
Using fossil, archeological, and historical evidence I show that the human lineage has been dependent on external energy sources since the control of fire in the Paleolithic. This reliance has grown with the development of agriculture, the use of wind- and water-power, and the most recently with industrialization and the transition to fossil fuels. To place industrialization in context I develop a Rule of 50, whereby individuals in industrialized economies consume roughly 50-times more external energy and manufacture roughly 50-times more material than do hunter-gatherers.
Results:
Industrialization and mechanization, powered by fossil fuels, have promoted centralization and processing in food production, reduced physical activity, and increased air pollution (including greenhouse gas emissions). These developments have led in turn to NCD and climate change.
Discussion and conclusion:
Climate change and NCD are connected both to one another and to our species' deep evolutionary dependence on external energy. Transitioning to carbon-free energy is essential to reduce the existential risks of climate change, but will likely have only modest effects on NCD. With the impending exhaustion of oil, coal, and natural gas reserves, developing replacements for fossil fuels is also critical to maintaining our species' external energy portfolio.
During competitive events, the pacing strategy depends upon how an athlete feels at a specific moment and the distance remaining. It may be expressed as the Hazard Score (HS) with momentary HS being shown to provide a measure of the likelihood of changing power output (PO) within an event and summated HS as a marker of how difficult an event is likely to be perceived to be. This study aimed to manipulate time trial (TT) starting strategies to establish whether the summated HS, as opposed to momentary HS, will improve understanding of performance during a simulated cycling competition. Seven subjects (peak PO: 286 ± 49.7 W) performed two practice 10-km cycling TTs followed by three 10-km TTs with imposed PO (±5% of mean PO achieved during second practice TT and a self-paced TT). PO, rating of perceived exertion (RPE), lactate, heart rate (HR), HS, summated HS, session RPE (sRPE) were collected. Finishing time and mean PO for self-paced (time: 17.51 ± 1.41 min; PO: 234 ± 62.6 W), fast-start (time: 17.72 ± 1.87 min; PO: 230 ± 62.0 W), and slow-start (time: 17.77 ± 1.74 min; PO: 230 ± 62.7) TT were not different. There was a significant interaction between each secondary outcome variable (PO, RPE, lactate, HR, HS, and summated HS) for starting strategy and distance. The evolution of HS reflected the imposed starting strategy, with a reduction in PO following a fast-start, an increased PO following a slow-start with similar HS during the last part of all TTs. The summated HS was strongly correlated with the sRPE of the TTs (r = 0.88). The summated HS was higher with a fast start, indicating greater effort, with limited time advantage. Thus, the HS appears to regulate both PO within a TT, but also the overall impression of the difficulty of a TT.
The energetic cost of running is relatively high in man. In spite of this, humans are adept endurance runners, capable of running down, for example, zebra and kangaroo. Distance running is made possible for man in part by an exceptional ability to dissipate exercise heat loads. Most mammals lose heat by panting, which is coupled to breathing and locomotor cycles during running. This interdependence may limit the effectiveness of panting as a means of heat dissipation. Because sweating is not dependent on respiration, it may be more compatible with running as a thermoregulatory mechanism. Furthermore, man's lack of body hair improves thermal conductance while running, as it facilitates convection at the skin surface. While horses, for example, have been shown to possess energetically optimal speeds in each gait, the energetic cost for a man to run a given distance does not change with speed. It is hypothesized that this is because bipedality allows breathing frequency to vary relative to stride frequency. Man's constant cost of transport may enable human hunters to pursue the prey animal at speeds that force it to run inefficiently, thereby expediting its eventual fatigue. Given what is known of heat dissipation in Old World Anthropoidea, the bipedality of early hominids, and human exercise physiology, one factor important in the origin of the Hominidae may have been the occupation of a new niche as a diurnal endurance predator.
The dietary pattern, physical work output, and blood lipids were studied in three groups of healthy, young, urban Ethiopian men differing in the degree of "Westernization." The results showed striking increases in serum lipids that were associated with the degree of Westernization of the diet. These changes could not be accounted for by differences in other group characteristics such as age, weight, smoking, or length of residence in Addis Ababa. The effects of the level of physical work output on serum lipids were equivocal because the methods used for the assessment of energy output yielded crude approximations only.
Gas-liquid chromatography analyses have been carried out to investigate the composition of esterified fatty acids in the plasma lipids in 130 Greenland Eskimos, compared with those of 32 Greenland Eskimos living in Denmark and of 31 Caucasian Danes in Denmark. While the Eskimos living in Denmark did not differ substantially from other persons living in Denmark and, from what is found in other studies in Western communities, the Greenland Eskimos showed a completely different pattern. They demonstrated a much higher proportion of palmitic, palmitoleic, and timnodonic acids, while they had a markedly lower concentration of linoleic acid. The total concentration of polyunsaturated fatty acids was lower in Greenland Eskimos than in the other groups. These findings are discussed in the light of the generally accepted opinion of the beneficial effect on plasma lipid levels and on the morbidity of coronary atherosclerosis of a high dietary intake of polyunsaturated fatty acids. As plasma lipid and lipoprotein levels in Greenland Eskimos in a previous study were found markedly lower than those found in Western populations, and as coronary atherosclerosis seems to occur far less commonly among Eskimos in Greenland than among peoples in industrialized countries, it was found difficult to combine these observations with the results from the present study. If dietary differences are the main reason for the differences in plasma lipid concentrations, the results from the present study point more toward qualitative than toward quantitative differences in respect of fatty acid composition of the food.
Taxonomists working with late Cenozoic faunas tend to view living species as starting points for the evaluation of chronospecies (i.e., segments of evolutionary lineages subjectively designated as species) that extend backward in time from the Recent. This practice makes it possible to construct a survivorship curve for late Cenozoic chronospecies by evaluating all fossil lineages believed to have survived to the present day. A survivorship curve is produced by plotting the fraction of these lineages existing at any time that have not undergone enough phyletic evolution that their extant representatives are assigned to new species. This kind of surviviorship curve has been plotted for chronospecies of mammals using the beginning of the Wurm, rather than the Recent, as an endpoint in order to avoid the effects of the Wurm and post-Wurm mass extinction. The survivorship curve reveals that all but a small fraction of established chronospecies have long durations relative to intervals of time during which distinctive higher taxa have arisen. Phyletic turnover of species has been remarkably slow. Most net evolutionary change must have been associated with saltational speciation. Even the large majority of genera must have arisen rapidly by one or more divergent speciation events. Estimates of rates of extinction suggest that the bottleneck effect, in which constriction of a lineage is followed by re-expansion as a distinct species, cannot be a major source of evolutionary change. These conclusions, based on the evaluation of mammalian phylogeny, seem also to apply to other taxa of animals, supporting the punctuational model of evolution. The long durations of hominid species imply that the evolution of humans, like that of other mammals, conforms to this model.
Publisher Summary
This chapter reviews the results of the epidemiologic studies of diabetes in the Pima Indians. It also gives the details of the subjects taken up for these studies and the tests conducted on these subjects. These studies present an extraordinarily high prevalence of hyperglycemia and the specific complications of diabetes, such as retinopathy, in abundance in the Pima Indians. These studies examined the prevalence of glucose intolerance, the distribution of glucose tolerance levels, the characteristics of diabetes, the etiologic factors in diabetes, the factors influencing the pathogenesis of diabetic microangiopathy, and the development of glucose intolerance. Glucagon levels, renal disease, and protein uria and serum creatinine levels were also assessed in these studies. Diabetes mellitus is well recognized as it produces characteristic effects on pregnancy and its outcome. The past pregnancies of females aged 25–44 years were reviewed to determine whether diabetes mellitus produced similar effects in the Pima Indians. Insulin responses among Pima Indians showed different patterns according to the level of glucose tolerance. These studies have enhanced the knowledge of the distribution and determinants of diabetes and its specific complications.
INTRODUCTION
Although the term, epidemiology, has in the past been applied generally, if not exclusively, to the study of communicable diseases, so far as concerns their development among groups, or their manner of transmission from the infected or the carrier to the susceptible person, the methods of such investigations can often be employed with advantage in analyzing the causes and distribution of other diseases. The essential and distinctive feature of epidemiology is the study or knowledge of that part of the natural history of a disease which determines its occurrence or distribution quantitatively and qualitatively in groups of persons, particularly as one case of sickness is related to others, by some common factor of age, sex, race, color, occupation, geographical distribution, or determining element in heredity, environment or hygiene, distinct from the study of disease as it affects the life history of the person by modifying the structures and functions
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The general health status with particular reference to cardiovascular disease and serum lipids has been evaluated in a sample of Pygmies of the Ituri Forest. Malaria, filariasis, treponemal infection, and other diseases were found to be common. The Pygmy blood pressures were not greatly different from the blood pressures observed in studies of Americans. Functional heart murmurs were common. Instances of aortic valve incompetence, essential hypertension, and coarction of the aorta were found. Abnormal electrocardiograms were encountered at about the same frequency as has been reported in population studies in the United States but the repolarization abnormalities observed were more frequent and resembled those previously reported from South Africa. No electrocardiogram definitely diagnostic of myocardial infarction was found, but without anatomical studies the presence of coronary artery disease cannot be excluded. Very low serum cholesterol values were found and this finding is discussed in relationship to the Pygmies' diet, physical activity and coexistant disease.
Although clinical diabetes mellitus is still rare, more Eskimos were intolerant of glucose in 1972 than was true ten years earlier. Also, a higher proportion of the population was overweight. The high tolerance for glucose in these people does not appear to have a genetic basis, but may instead be associated with physical activity and physical fitness.
Current models of hunter-gatherer adaptive strategy indicative variability with latitude (gathering predominant in the tropics, fishing in the mid-latitudes and hunting only in the high latitudes). This article questions the adequacy of the ethnographic data on which predictions about hunter-gatherer subsistence behaviour in some tropical environments are based. As an alternative, the pattern of covariability between plant community structure, large mammal biomass, and rainfall in equatorial regions is used to predict high levels of hunting in certain low latitude environments. The present distribution of animal protein-dependent pastoralists in tropical Africa supports this model. Large mammal hunting may have been of greater significance in the adaptive strategies of prehistoric savanna hunter-gatherers than in those of ethnographically-observed tropical hunter-gatherers. -Author
All of the data presented here - lower weight in seasons of dietary stress coupled with lowered cholesterol and, in some subjects, raised triacylglycerols, are consistent with data reported by Truswell and Hansen (1976, p. 189) and Brontë-Steward et al. (1960, p. 187) which show seasonally lowered serum albumin and variable subscapuler skinfold thickness. These point to fluctuations in nutritional status as a regularly occurring part of žu/õasi life. Losses of serum albumin are accompanied by proportional gains in extracellular water, and thus it is possible that part of the weight and skinfold thickness observed in seasons of stress are due to edema. If so, the condition of zǔ/õasi at such times would not be as good as even the low measurement values suggest. Lee's data (1980) on dietary intake are compatible - precisely - with those presented here, although he argues otherwise. A relatively low year-to-year variance in nutritional status for parallel seasons may be assumed to characterize traditional žu/õasi life. Births to žu/õasi women tend to cluster in association with these variations in žu/õasi biochemistry; at present, however, causal relations among investigated variables cannot be documented. The Frisch-Revelle hypothesis has heuristic value, but it is insufficiently specific to guide field work. At present, "There is still much speculation about the way in which lactation and nutritional status may act in concert to suppress reproductive activity" (Short, 1976). And Ashmore (1981) concludes that fertility control must bemultivariate. Whether the observed seasonal fertility differential among žu/õasi women is due to periodic suppression of ovulation, implantation failures, spontaneous abortions, or some other as yet unperceived - possibly cultural - factors is not known at this time. It is unlikely that the work outlined in this paper (several dimensions of which have not been included here) will solve complex problems of nutritional balance and adequacy of fertility control, among zǔ/õasi or any other population group, but the multivariate approach adopted in the research programme is designed to clarify some of the obscurities under which we now labour and, consequently, to open doors for future investigators.
Anthropometric and biochemical data were collected on 419 Samoan adults representing traditional, westernized and migrant populations with the aim of isolating risk factors associated with a documented rise in heart disease in westernized Samoan populations. Analysis of data revealed that westernization results in a more atherogenic lipid profile with respect to cholesterol, HDL cholesterol and triglycerides. Westernized males also show an increase in blood pressure and obesity when compared with the more traditional group, though these differences are not so distinct in females. The results were interpreted as indicating that changes in diet and activity pattern were most likely associated with the alterations in westernized males whereas a change in diet alone could account for differences in females. Migration alone was found to make no significant change in the likelihood of westernized Samoans developing heart disease.
Measurements were made on samples of urban and rural Maasai, and the values of a number of biochemical, anthropometric and physiological parameters were compared between the two groups. Significant differences were found for weight, upper arm circumference, ponderal index, triceps and subscapular skinfolds, pulse rate and cholesterol. In particular, the mean cholesterol level in the urban sample was much higher than in the rural Maasai. No significant difference was found for triglyceride, fibrinogen or either systolic or diastolic blood pressure. A control group of European males included in the study was found to differ significantly from the rural but not the urban Maasai in the anthropometric variables. Blood pressure and cholesterol levels were significantly higher in the Europeans than in either of the Maasai groups. Possible causes for the differences between the two Maasai groups are discussed.
Proportional mortality rates from coronary heart disease (CHD) are compared among Chinese populations in Hawaii and New York City (N.Y.C.). Hawaii Chinese have a greater proportion of deaths due to CHD than N.Y.C. Chinese. Within the N.Y.C. Chinese population, United States (U.S.)‐born Chinese have a greater proportion of deaths due to CHD than foreign‐born Chinese. Deaths from CHD occur at younger ages among Chinese in Hawaii and U.S.‐born Chinese in N.Y.C. when compared with foreign‐born N.Y.C. Chinese. The results suggest that deaths from CHD increase and occur at earlier ages as Chinese migrant populations become assimilated with the host population.
Data from the files of the Yale Cross-Cultural Survey showed adequate information on the drinking customs of 56 societies, distributed as to location and level of culture. It is found that the customary degree of insobriety of men in any society is positively associated with the type of subsistence economy: the more primitive the subsistence activity, the greater the degree of insobriety; and the customary degree of insobriety is positively associated with the measure of subsistence hazards, including hazards due to acculturation. Data are presented on types of beverage, age and sex differences and status differences, motivation, consequences of drinking, sexual behavior, aggression and social control of alcoholic aggression, anxiety and warfare, sorcery and insobriety, and patterns of drinking behavior. Bibliography of 257 references. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The present research was undertaken to delineate and explain human skeletal size change associated with the shift in subsistence mode from hunting and gathering (1000 B.C.-A.D. 1150) to a mixed economy utilizing, in part, corn agriculture (A.D. 1150–1550) on the prehistoric Georgia coast. The variables analyzed include 20 measurements of external postcranial size involving the femoral, tibial, and humeral skeletal elements. Univariate statistical treatment reveals significant size reduction in many dimensions of the postcranial skeleton (Student's t-test: P<0·05). It is suggested that in keeping with the general phenomenon that bone is deposited in the presence of functional demand and in its absence is resorbed (Wolff's Law), size reductions in the postcranial skeleton reflect a decrease in level of musculoskeletal stress with the shift to sedentism.
Humeral cortical thickness measurements (CCT) were taken from radiographs of four Near Eastern skelctal samples dated to the Epi-Paleolithic (Natufian), Middle Bronze I (MBI), Roman/Byzantine and Early Arab periods.Epi-Paleolithic CCT values in both sexes were significantly higher than those of any other group. In the males, Epi-Paleolithic CCT values were extremely high when compared with those of living populations, while CCT values in the MBI to Early Arabs were within the range considered normal for living populations. In the females Natufian and MBI CCT values fell within the range considered normal for living females, while the Roman/Byzantine and Early Arab CCT values were diagnostic of severe osteopenia. We consider that in the males, the exceptionally high Epi-Paleolithic values relfect functional demands associated with technological constraints and activity patterns of males at that time. In the same female groups, function presumably changed less drastically over time. The exceptionally low CCT values observed in the later groups were attributed to the combination of poor health status and calcium drain caused by pregnancy and lactation.
This presentation should stimulate investigations of the etiologic aspects of specific environmental factors in total cancer incidence and in the incidence of particular types of cancers. Although it is mandatory that attempts are made to remove every factor in the environment demonstrated to increase the risk of cancer, from both a budgetary and public health point of view, it is equally important that sufficient attention is applied to those elements involved in most cancers. With the increasing numbers of news reports regarding hazardous components, the average citizen considers himself immersed in an uncontrollable sea of carcinogens. Although society must and can play an important role in the reduction of those environmental factors that contribute to cancer incidence, the authors have shown that an individual can significantly limit his own risk by appropriately altering his lifestyle.
Restudy of 306 "new immigrant Yemenite" Jews, an ethnic group in which, upon their arrival in Israel, no diabetes was detected, revealed, 25 yr after their immigration, an increased incidence of diabetes and higher plasma and lipoprotein-lipid levels. The prevalence of diabetes (defined as "glucose intolerance") rose to 11.8% (13.2% males and 9.7% females). Obesity in females resulted in increased prevalence of diabetes in all age groups, while in males it affected the older age group only. The male/female diabetic ratio was affected by weight status--in the underweight, diabetes was more prevalent in males, in the overweight, the rate of diabetes in females equaled that of males. In nondiabetics (those with normal glucose tolerance), neither the glucose tolerance nor the insulin response deteriorated with aging. Most diabetics had a delayed insulin response. However, about 50% of nondiabetics and diabetics had insulin response peak at 60 min and similar insulin levels. It appears that in newly discovered adult-onset diabetics in this population there is no shortage of insulin, but rather shortage of insulin action. In nondiabetics, the levels of plasma cholesterol and triglycerides (TG) were higher than levels upon their arrival. In diabetics, the plasma TG, cholesterol, and LDL-cholesterol levels were higher when compared to those of nondiabetics, especially in the group of overweight males. Hyperlipoproteinemia was diagnosed in 27.7% of diabetics and 11.0% of nondiabetics. In diabetics, the HDL/LDL cholesterol ratio was found to be reduced, significantly so in overweight diabetics.
Insulin binding to monocytes was examined in trained athletes (long distance runners) and in sedentary control subjects in the resting state and after 3 h of exercise at 40% of maximal aerobic power. At rest, specific binding of 125-I-insulin to monocytes was 69% higher in athletes than in sedentary controls and correlated with maximal aerobic power. The increase in insulin binding was primarily due to an increase in binding capacity. During acute exercise, insulin binding fell by 31% in athletes but rose by 35% in controls. The athletes had a smaller decline in plasma glucose and a lower respiratory exchange ratio during exercise than did controls. We conclude that physical training increases insulin binding to monocytes in the resting state but results in a fall in insulin binding during acute exercise. Changes in insulin binding in athletes thus may account for augmented insulin sensitivity at rest as well as a greater shift from carbohydrate to fat usage during exercise than is observed in untrained controls.
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IN our recently heightened zeal to treat hypertensive patients with pressure-lowering drugs, we may be overlooking another potent avenue of therapy. The article by Reisin et al. in this issue of the Journal points this paradox out in very clear terms. They advised 81 obese hypertensive patients to eat fewer calories while on an ordinary balanced diet with generous helpings of salty low-calorie foods. These patients lost about 9.5 kg in weight after more than two months on the low-calorie diet. This weight reduction was accompanied by highly significant falls in blood pressure, an average drop of 26 mm Hg . . .
Louis Tobian, M.D.
University of Minnesota Hospital Minneapolis, MN 55455
The high sodium-low potassium environment of civilized people, operating on a genetic substrate of susceptibility, is the cardinal factor in the genesis and perpetuation of “essential” hypertension. The noxious effects begin in childhood, when habits of excess salt consumption are acquired at the family table, and are perpetuated by continuing habit and by increasing use of convenience and snack foods with artificially high concentrations of sodium and low levels of potassium. Present methods of food preparation leach out the protective potassium. Extradietary sodium chloride is a condiment, not a requirement. Some primitive populations clearly preferred potassium chloride to sodium chloride.
In 1971-1972, urines were collected over 24 hours from ambulatory Iglooligmiut who ranged in age from 6 to 76 years. Collections were made every 3-4 months over a calendar year. The mean of each individual's two to four collections was used as the best estimate of that person's average daily excretion for nitrogen, thiamin, riboflavin, N'-methylnicotinamide, calcium, phosphorus, and magnesium. The excretion of the three B vitamins by all age groups was high when compared with interpretive standards. Urea nitrogen comprised 80-90% of total nitrogen excreted by all age groups. Twenty-four-hour mineral excretions did not differ with age and sex group except that adult men excreted significantly more phosphorus. Urinary urea nitrogen and phosphorus were linearly related, suggesting that they have a common source; namely, meat. Winter was generally the season of lowest excretion of the nutrients assayed. Since these nutrients are available from imported foods, particularly during the winter, it would appear that even in the winter the Iglooligmiut are more dependent on hunting and fishing for sources of these nutrients than on the well-stocked commercial grocery outlets.
After a short introduction to mortality statistics as a method of study of disease, 2 instructive tables are given on the death rates in the USA from 1900 to 1969 with regard to 6 major and 37 secondary categories of death causes. By means of 12 diagrams the mortality trends of new and old diseases are discussed. The author classifies as a 'new' disease one that was formerly either unknown or rare but became common, was formerly mild but became severe, or one that developed important new features. Based on these facts the new diseases under discussion are, for instance: ischemic heart disease, lung and bronchial carcinoma, high speed transport accidents, and adverse reactions to therapeutic and diagnostic agents (150 are listed in a table). An 'old' disease is defined as one that was formerly common but became rare, or was formerly severe but became mild; e.g. infectious diseases such as tuberculosis, diphtheria measles, meningitis, and intestinal infections. Artifacts in mortality classification that may cause false variations in the recorded death rates are listed. In this address, mortality data derived from official tabulations are checked against the personal autopsy experience of the author, which extends over a period of 40 yr. Recommendations for the future of mortality statistics are given. (37 references).
The Yanomamo Indians are an unacculturated tribe inhabiting the tropical equatorial rain forest of northern Brazil and southern Venezuela who do not use salt in their diet. The group therefore presented an unusual opportunity to study the hormonal regulation of sodium metabolism in a culture with life-long extreme restriction of dietary sodium, with parallel observations on blood pressure. Blood pressures increased from the first to second decade but, in constrast to civilized populations, do not systematically increase during subsequent years of life. In twenty-four hour urine collections on adult male Indians, excretion of sodium averaged only 1 plus or minus 1.5 (SD) mEq. Simultaneous plasma renin activities were elevated and comparable to those of civilized subjects placed for brief periods on 10 mEq sodium diets. Similarly, excretion rates of aldosterone equaled those of acculturated subjects on low sodium diets. The findings suggest that the hormonal adjustments to life-long low sodium intakes are similar to those achieved in acute sodium restriction of civilized man. Parenthetically, these elevated levels of aldosterone and renin were probably the norm for man during much of human evolution and suggest that the values observed in civilized controls are depressed by an excessive salt intake in contemporary diets.
Fibrinolytic activity and platelet adhesiveness are normal in cases of angina pectoris and healed myocardial infarction, whereas fibrinolytic activity is diminished in acute myocardial infarction. Exercise increases fibrinolytic activity in normal people but the effect on it of submaximal exercise in patients with ischaemic heart disease is not known. Resting platelet adhesiveness and fibrinolytic activity were determined in 20 patients suffering from ischaemic heart disease and eight healthy controls. Both groups were then subjected to submaximal exercise on a motor-driven treadmill. The ST segment of the electrocardiogram and the heart rate were monitored during exercise by an on-line digital computer. Fibrinolytic activity determinations were repeated immediately after exercise. There was a significant increase in fibrinolytic response in both groups but it was significantly less in the ischaemic groups (36-2%) compared with the controls (55-9%) (P less than 0-01). The ST segment depression was 2-3 mm in the ischaemic group and 0-52 mm in controls--also a significant difference (P less than 0-01). There was no correlation, however, between the ST change and the fibrinolytic response. A diminished response in the ischaemic group may favour their predisposition to thrombotic episodes.
The long-term effect of exercise on blood-pressure (BP) was assessed in 13 untreated patients with essential hypertension. After a 6-week run-in period the levels of activity studied were sedentary, 45 min bicycling at 60-70% of maximum work capacity (Wmax) three times per week (3/week), and 45 min bicycling seven times per week (7/week), each for 4 weeks. The order differed between subjects in accordance with a Latin square. Supine BP, 48 h after each phase, averaged 148/99 mm Hg in the run-in and 143/96 mm Hg in the sedentary phase; it fell below values in the sedentary phase by 11/9 mm Hg with 3/week exercise, and by 16/11 mm Hg with 7/week exercise (both p less than 0.01). With increasing activity total peripheral resistance fell and the cardiac index rose. Plasma noradrenaline concentration fell below values in the sedentary phase by 21% and 33% after 3/week and 7/week exercise. Bodyweight and 24 h sodium excretion remained constant. Moderate regular exercise lowers BP and seems to be an important non-pharmacological method of treating hypertension.