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Evolutionary Medicine

Diseases of Civilization

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Traditionally, the relation of medicine to biology had to do with human physiology and microbiology, focusing on immediate and proximal causes and explanations of disease (Nesse, 2001). of evolutionary
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Application

Disease is not a product of NS; multiple adaptations or maladaptations accumulate, due to evolutionary causes, leading to, allowing or facilitating the appearence of a disease (Nesse & Williams, 1994). In this context, the continuously growing insynchronisation between the rapid development the human lifestyle and environment, on one hand, and the rythms of human adaptation, on the other, results in the so-called diseases of civilization, i.e. non-infectuous diseases usually induced by an originally adaptive feature that turns harmful by its exaggeration under modern conditions.
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Human genome has been adapting for hundrends of generations to best fit into paleaolothic and neolithic environments and would probably need many more to adapt to current lifestyles.

Human appetite, taste, metabolism and dentition have been genetically designed to help us survive through long famines, leading us to consume large quantities of sugars, salts and fats whenever available. Wild plant fruits and vegetables proportion of the Stone Age diet. consisted a large

Cultivated plants or dairy products were not included in the diet Every-day physical activity was essential to survival (protection, nutrition search, nomadic lifestyle) People would rarely survive over their forties.
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(Spotorno, 2005)

Nesse & Williams classified them in 5 categories:

Modern scurvey)

dietary

inadequacies

(e.g.

Modern nutritional excesses (e.g. obesity, caries, high-blood pressure, coronary disease) Addictions (e.g. alcoholism, tobacco use) Developmental problems (e.g. scoliosis) Others (e.g depression, metabolism abnormalities)
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calcium

As few would think, diseases of civilization are not only affecting high-developed countries, but also those where the majority of the population lives on low incomes. It is remarkable that many less developed countries have significant fatal health risks due to high blood pressure or glucose concentration.
Cause Population (000) WORLD 6 436 826 PAF (%) High blood 7.511.621 pressure Tobacco use 5.109.562 12,8 8,7 5,8 1.370.923 1.458.457 568.948 HIGH INCOME 977 189 PAF (%) 16,8 17,9 7 1.267.145 744.635 448.597 UPPER MIDDLE INCOME 579 658 PAF (%) 22,8 13,4 8,1 2.911.030 1.878.985 1.085.203 LOWER MIDDLE INCOME 2 464 976 PAF (%) 15,5 10 5,8 1.958.840 1.026.140 1.282.699 LOW INCOME 2 412 669 PAF (%) 7,5 3,9 4,9

High blood 3.387.053 glucose Physical 3.218.535 inactivity Overweigh t and 2.824.996 obesity 22.051.76 Total 7

5,5

625.127

7,7

525.896

9,5

1.073.830

5,7

992.269

3,8

4,8 38

680.131 4.703.586

8,4 58

648.462 3.634.735

11,7 66

989.142 7.938.190

5,3 42

505.622 5.765.570

1,9 22

source: WHO, 2009

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References

Nesse RM, Williams GC. 1994.Why We Get Sick: the New Science of Darwinian Medicine.Times Books, New York. Nesse RM. 2001. Medicines missing basic science. 'The New Physician pp. 8-10. Spotorno, A.E. 2005. Medicina evolucionaria: una ciencia bsica emergente. Rev. Md. Chile, 133: 231-240. WHO, 2009. Health statistics department, Geneve, [http//:www.who.int/evidence/bod] and informatics Switzerland.

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