The development of civilization has been generally interpreted as a positive step for the wellness of the human species, which has led to an increase in lifespan and quality of life. On the other hand, this accelerated progress, which began with the agricultural revolution and grew exponentially with the industrial revolution, has opened the door to new dangers to human health.
Modern science, through the improvement of health services, as well as social and economic conditions, has eliminated the death threat of most infectious diseases but over the last two centuries of history in human civilization, threats have shifted towards chronic degenerative diseases (or non-communicable diseases NCDs) such as cardio-vascular, metabolic, autoimmune and neurodegenerative diseases, cancer, diabetes and other medical conditions such as obesity .
In 1995, there were an estimated 200 million obese adults worldwide and an additional 18 million children under five years of age classified as overweight. In the 2000s, the number of obese adults rose to over 300 million. “In every region of the world, obesity doubled between 1980 and 2008”, says Dr. Ties Boerma, Director of the WHO Department of Health Statistics and Information Systems.
“Today half a billion people (12% of the world population) are considered obese. The obesity epidemic is also spreading in developing countries, where it is estimated that more than 115 million people suffer from obesity-related problems.
One in three adults worldwide suffer from high blood pressure, a condition that causes about half of all stroke and heart disease deaths. 347 million people worldwide suffer from diabetes, with 80% of them living in low and middle-income countries. The World Health Organization (WHO) says that deaths from diabetes will double again by 2030 [2.3].
Recognising the devastating social, economic and health impacts of NCDs, world leaders adopted a strong political strategy in September 2011 to address this issue and assigned several tasks to WHO to help support individual countries’ efforts. Despite these recommendations, the number of people affected by obesity and NCDs continues to expand like wild fire [3,4].
UNSUCCESFUL AND CONFUSING PREVENTIVE MEDICINE
The promises of medicine regarding health promotion are enormous but the results obtained do not reflect the word given. Medicine has made giant leaps in recent times and what seemed like science fiction decades ago is now reality. We are able to transplant internal organs and almost renovate people after a terrible car accident, but in terms of prevention, traditional medicine has miserably failed its mission and in addition seems to be in total confusion .
…[people] increasingly find themselves beset with contradictory advice. No sooner do they learn the results of one research study development, they hear of one with the opposite message. (N Engl J Med 1994; 331:189-900).
The news about health risks comes thick and fast these days and it seems almost constitutionally contradictory. (Science 1995; 269:164-9).
Advice to the public about what to eat…and basically how to live, seems to do an about-face every time a new study is published in a medical journal. (New York Times 1998 Mar 22: 4 WK)
These statements from 20 years ago are still relevant today, given the slow progress of science step by step. The American Heart Association (AHA) inspects its dietary guidelines according to the latest scientific research every two years [6-9]. For example, from the recommended daily salt dose of 6000 mg/d in 1996, today the recommendations speak of < 1500 mg/d in order to prevent cardiovascular disease .
Although substantially unchanged from the 1995 Recommendation, the updated recommendation on physical activity and public health has “improved” in several ways. Since 2007, more information about the intensity, frequency and volume has been available .
Although in 1996 the recommendations to reduce the risk of developing cardiovascular disease were, in general, to replace saturated fats with carbohydrates, protein and mono or polyunsaturated fatty acids , today the recommendations suggest that the daily intake of saturated fatty acids should be less than 10% of the total energy intake, through the only substitution by mono and polyunsaturated fatty acids [12,13].
These and many other examples such as “maximum two eggs a week otherwise cholesterol clogs the arteries”, whose today are no longer held responsible for the increase in cholesterol. Studies that previously claimed that pasta makes you fatten and after a week studies that claimed the opposite come out.
Other studies claim that calcium in milk and cheese is necessary for building strong bones but today the issue is very controversial and many studies have found no correlation between low calcium consumption and risk of bone fractures [14,15].
How many times have we heard news of this kind? Before, what was good for health today is harmful or vice versa.
Such confusion and failure of the health prevention guidelines can be explained by the lack of a comprehensive conceptual framework, a shortcoming that could be corrected by adopting evolutionary premises .
THE EVOLUTIONARY MISCMATCH THEORY
A more complex and comprehensive approach to health promotion is necessary, and a general framework, which takes account of the intrinsic nature of the human being, needs to be developed.
To this aim, it is suggested that the study and understanding of human evolution could be the starting point from which scientific research could be directed in order to prevent the spreading of NCDs and promote a truly healthy lifestyle. Therefore, the shortcomings and failures of preventive medicine could be corrected by adopting the evolutionary mismatch theory, which provides three simple logical principles [16,17]:
The human genome has been forged and selected in past environments very different from those of the present [18,19];
Cultural evolution proceeds too fast for the human genome to adapt successfully, resulting in the dissociation of our genes and the environment in which we
This dissociation between genome and lifestyle promotes the development of NCDs .
The human genome would be substantially unchanged from the late Paleolithic period (50,000-10,000 B.C.), set to express itself at its best according to a hunter-gatherer lifestyle . Physical activity, sleep, sun exposure and the dietary needs of any living organism (including humans) are genetically determined.
After the publication of Eaton and Konner in 1985 , the role of the evolutionary mismatch theory has been increasingly recognized in scientific literature. The drastic changes in diet and lifestyle that have taken place since the Neolithic Revolution (and more radically since the Industrial Revolution and the Modern Age) are too recent on an evolutionary time scale in order to allow the human genome to fully adapt [16-22].
Already in Ancient Greece, the philosopher Socrates drew a hint of such theory by stating that the diseases of the humankind of that time derive from idleness, luxury and the food we use to eat . Since the agricultural revolution of about 10,000 years ago, which started in the Middle East and then spread to the rest of the globe [24-28], humans met for the first time during his evolutionary history the NCDs.
When cereal diets were first adopted to replace the meat-based diet of hunter-gatherers, a characteristic reduction in stature was observed, an increase in infant mortality, a reduction in life span, an increase in the incidence of infectious diseases, diabetes, iron deficiency anaemia and the incidence of osteomalacia, osteoporosis and other bone mineral disorders, as well as an increase in the number of dental caries and enamel defects [28-35].
According to the evolutionary mismatch theory, it is generally accepted that not enough time has elapsed since the invention of agriculture for significant adaptations to occur in the human’s DNA. It can therefore be said that human beings are genetically predisposed to live according to the hunting and harvesting style that accompanied us for millions of years . From the social point of view, we are people of the XXI century, but genetically we have remained citizens of the Paleolithic era .
NOT JUST THEORIES
It is interesting to observe that MCDs were unknown to hunter-gatherers and that the 229 still living populations [37,38], who still live according to this lifestyle, do not show any apparent signs of such diseases [39-47].
The most striking example is represented by the Pima Indians, a population descended from the Paleoindians whose ancestors migrated from Asia to North America through the frozen Bering Strait during the first of the three glaciations [48-50].
Therefore, the genome of the Paleodians has most probably been shaped during these migrations, which lasted thousands of years, and set in accordance with the lifestyle of the nomadic hunter-gatherers according to their cycles of physical activity (represented by hunting) and fast/famine .
However, when they settled in Central America, these communities successfully adapted to the desert environment by developing primitive agriculture that was always supported by hunting and harvesting.
The successful adaptation of the Pima to life in the desert continued until the end of the 19th century, when the area was invaded and occupied by European immigrants who destroyed their culture and influenced their way of life, especially by introducing foods previously unknown to the Pima Indians, such as refined cereals and sugar.
The Pima Indians of Arizona now have the highest reported prevalence of obesity and diabetes compared to all other populations in the world [52-54], so much so that they have become an object of study and scientific research.
Although type 2 diabetes and obesity have genetic factors [52,55], the interaction of the genotype with adverse environments plays the most important role in the development of a given disease (sick phenotype).
To confirm this statement, in 2006 Schulz and his collaborators studied the effects of different lifestyles on obesity and diabetes in Pima Indians living in Mexico and the United States.
Despite geographical separation, linguistic and genetic studies indicate that they share a very similar genetic background. Both populations of Pima have been classified according to DNA polymorphisms to establish their genetic similarity and, as well known, their genes have been classified as highly susceptible to develop type 2 obesity and diabetes [56,57].
In order To clarify the contribution of environmental influences to type 2 diabetes, they studied two groups of Pima Indians in Mexico and the United States.
The Pima Indians in the United States live mainly in the desert regions of Arizona while the Pima Indians in Mexico live in a remote region of the Sierra Madre Mountains, in an area that is only recently accessible through the road network. The Mexico Pima, in contrast to the United States Pima, have undergone a relatively minor change in their original lifestyle [58,59].
Schulz and his collaborators compared the Mexican group with the American Pima group, examining the prevalence of diabetes and glucose tolerance with the aim of understanding the extent to which genetic and environmental factors influence diabetes and obesity in these two populations.
Results showed that among the Mexican Pima Indians, 5.6% of men and 8.5% of women had diabetes, prevalence significantly lower than the U.S. Pima Indians, of which 34.2% of men and 40.8% of women had the disease [56,57].
The much lower prevalence of type 2 diabetes and obesity in the Pima Indians in Mexico compared to the United States indicates that even in populations genetically prone to these conditions, their development is mainly determined by environmental circumstances or their lifestyle. However, since this population has been displaced from its original lifestyle followed for thousands of years, there has been a mismatch between their genes and their environment, inevitably causing type 2 diabetes and other metabolic disorders.
The example of the Pima Indians is just one of many to verify the evolutionary mismatch theory. In 1991, Dr. Kieran O’Dea studied the effect of Western lifestyle on Australian aborigines. When the transition from their traditional hunter-gatherer lifestyle to sedentary-westernised life occurred, we observe high rates of obesity, type 2 diabetes, reduced glucose tolerance, hypertriglyceridemia, hypertension and hyperinsulinemia. Insulin resistance may be the common pathogenic characteristic of this group of conditions associated with increased risk of cardiovascular disease.
The traditional lifestyle of hunter-gatherers, characterized by high physical activity and a diet with low energy density (low glycemic index and load, high content of monounsaturated fats, fiber, protein, vitamins and minerals), promotes fat mass reduction and increase of lean mass by minimizing insulin resistance.
For most Aboriginal people, however, the Western lifestyle, characterized by reduced physical activity and an energy rich diet (rich in refined carbohydrates along with saturated fats), promotes obesity and maximizes insulin resistance .
Furthermore, observational studies on the current populations of hunter-gatherers, including the Hazda of Tanzania, the Hiwi in Venezuela and the Ache in Paraguay, still show that MCDs seem to be unknown in these tribes and communities [39-47].
CRITICISM OF THE EVOLUTIONARY MISMATCH THEORY
Obviously, like any concept that diverges from the “normality” and threatens our comfort zone by creating cognitive dissonances, criticism could not be lacking.
WHAT WOULD BE THE POINT OF ADOPTING THE EVOLUTIONARY MISMATCH THEORY FOR HEALTH PREVENTION PURPOSES, IF THE HUNTER-GATHERER MAN DIED AT THE AGE OF 30?
That is not true! The famous 30 years for men and 35 for women refer to the average age of that time. For obvious reasons of precarious hygiene conditions, battles between rival tribes, attacks by wild animals, injuries by bruising or cutting, etc., infant mortality and premature deaths were high and if we add them to the few deaths in old age, we will have a very low value. In addition, we have relatively few human bones from the pre-farming period, because it takes some very unusual conditions to preserve human remains for more than 10,000 years.
Therefore, it is very approximate to suggest that these remains are representative of the entire human population at that time. The examination of these pre-agricultural bones is further obscured by the comparison made with contemporary bones, where the age of death of the individual is more easily ascertainable . The only credible data are those from observational studies on the populations of hunter-gatherers today, whose members can easily reach the age of 70 [39-47].
WE WOULD HAVE ADAPTED IN 10,000 YEARS, WOULDN’T WE?
For over 99% of our evolutionary history, humans have lived in small nomadic groups without domesticating plants or animals. This hunting and gathering lifestyle is the only stable and persistent adaptation that man has ever achieved. It is generally recognised that not enough time has elapsed since the invention of agriculture 10,000 years ago for significant changes in human genome to have occurred [61-77].
However, only 12 alleles have been selected in the last 10,000 years in the human genome, a relatively insignificant amount. These include alleles responsible for skin pigmentation, eye colour, immune system, fatty acid and vitamin D metabolism .
But the greatest criticism comes from the persistence of the enzyme lactase, the object of strong selection in the human genome in the post-agricultural period [79,80]. According to a genetic study carried out on the remains of 230 ancient individuals in the Eurasian region, the first appearance of the allele for lactase is present in an individual who lived between 2300 and 2200 BC in Central Europe .
That is true! Someone a minimum has adapted. But the paradox is that the selection of these alleles has been shown to have a potential link with celiac disease, ulcerative colitis, irritable bowel syndrome and most likely all autoimmune diseases . Few of us have adapted to agricultural diets based on dairy products and cereals and the few could pay the price with autoimmune diseases. And this is another confirmation of the evolutionary mismatch theory!
Further confirmation, and not by a strange coincidence, is given by the fact that the two most famous intolerances in the world are gluten and lactose, contained in cereals and dairy products, two types of food recently introduced in human evolutionary history.
Not to mention that we are all most probably sensitive to gluten, who more and who less. After eating gluten-containing cereals, such as a dish of pasta, you often end up collapsing on the tired sofa, with abdominal pain and swelling, blurred mind, flatulence and all the other symptoms of non-celiac gluten sensitivity (NCGS), symptoms that we believe to be normal because we have always had them.
Recent studies suggest that currently, at least 6% of the American population suffers from this disorder [81-84] and all of us at least once in our lives have had symptoms of non-celiac gluten sensitivity, a condition that may be transient and due to intestinal permeability (read more abouti it here).
Obviously, the subject is very complex and the data on people suffering from this gluten disorder are very reductive given the extreme difficulty in diagnosing this condition.
Meanwhile, no one is allergic to meat. We have been eating it for millions of years.
For the time being, we will only be looking at these two criticisms, the most important ones. In another article we will analyse the eating habits of hunter-gatherers and respond to the relative criticisms.
CONCLUSION: LET’S GO BACK TO OUR ORIGINS!
MCDs and obesity are becoming increasingly common despite the recommendations of preventive medicine, which seems to be in total confusion and unable to fulfil the promises made for health prevention. It is still unclear what should be eaten and what lifestyle should be adopted to maintain health and prevent health problems from arising.
These shortcomings and gaps can be filled by adopting evolutionary premises such as the evolutionary mismatch theory.
The human body, which reflects adaptations established in the late Palaeolithic (50,000-10,000 BC), is not suitable for today’s lifestyle, but for that of the hunter-gatherer as the evolutionary mismatch theory explains .
This does not mean that we have to sling bows and arrows and arm ourselves with a club to go and shoot down some wild animals in the nearest forest, as the stupidity and ignorance of many people just suggests as soon as they hear about evolutionary theories and health promotion.
The aim is to adapt our original lifestyle, in terms of physical activity, nutrition, nutritional supplementation, rest and control of stressful agents, to everyday modern life. We at EVOplus are masters in this and we have been adopting this strategy for years, achieving incredible results.
Logic and simplicity are the basis of health promotion and we should return to living as naturally as possible. This is our uniqueness and our method. Come and discover it with us. Let your genes express themselves in the best possible way and you will get results you never thought possible.
EVOplus - Lifestyle Revolution
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