Darwinian Medicine

Evolution
The idea of evolution is not new

and it did not start with Charles Darwin

Anaximander (520BCE)

Georges de Cuvier (1790s) Jean de Lamarck (1809)

Few people would argue that life

on earth has changed for better or worse over time

We cannot view these changes

since they occur over thousands or millions of years

Evolution
Evolution is a process of gradual

change in the characteristics of species

Individuals differ in heritable

traits and only a subset of each generation reproduces

Adaptations (physical features

and behaviour) evolve over generations in conformation with features in the natural environment

Survival of the Fittest

The term survival of the fittest does not mean

physically fit
This term is often misunderstood

It means those that fit into the environment

One could say survival of the survivors

Population Control and Natural Selection

As the population grows, there is

a scarcity of valued resources such as food and shelter. As a consequence of this, things such as predation, disease, and starvation work to keep the population in check (ie. Only the most fit survive)
Darwin was influenced by the

work of Thomas Malthus (An Essay on the Principle of Population, 1798)

Populations grow at an exponential rate if left unchecked However, the environment has a resource maximum capacity

Survival and Reproduction

Natural selection is the mechanism of evolution
Natural selection entails 2 major themes: survival and

reproduction
There are strong and direct selective pressures

favouring 1) Survival at least until reproductive age 2) Reproduction itself

Survival and Reproduction

All organisms have mechanisms of self

preservation and reproduction

Hunger and thirst We seek food and water in many ways hunting,

agriculture to working for money to exchange for food

We avoid harm that may cause pain and we seek

shelter and comfort

These are self preserving motivations We also have reproductive motivations

Survival and Reproduction

Mature individuals will seek affiliation with the

opposite sex and be gratified with sexual activity

Organisms that fail to survive and reproduce will

not pass on their heritable characteristics

There are actually circumstances that favour dying

and not reproducing

Competition
and among species

Given that most species over-produce there is usually

not enough resources to go around

Accordingly there is competition both within species
Those that compete most effectively survive and may

reproduce
There are different strategies and selections for dealing with competition for resources

Cost-Benefit Analysis
Competition can be very costly for animals Animals have developed other means of settlings conflicts that tend to favor peace instead of aggression The benefits of aggressive behaviour must outweigh

the potential costs of such energetically costly behaviours.

Facial Expressions and other Status Signs

Types of Selection
Natural Selection (nature selects as mentioned

above) Sexual selection (the opposite sex decides what is sexy and who will reproduce) Kin Selection (your parents and genetically related individuals will help you survive) Artificial Selection (Man can selectively breed animals for traits e.g. a fierce guard dog)

Natural Selection
Not all individuals make it to reproductive age and not

all who do, reproduce

Moth example: Industrialized England Rapid environmental change

Pre-industry white moths had a slight advantage (predation from birds)

Post black ones did

During the industrial revolution, trees became blackened with soot from all the coal that was used as fuel in factories This created a rapid selective pressure for black moths and against white ones

Genetic influences and environmental changes an artificial analogy

The Importance of Reproduction

Any heritable trait which fosters reproduction will

make copies of itself for the future

Survival is a necessary condition for this but is not

sufficient
Traits within a species can change over generations

with environmental pressures

Example of moths seen earlier

The Importance of Reproduction

Within any species some individuals reproduce

more than others (this trait may be heritable)

It is this differential reproduction that is the

essence of natural selection

Sexual Selection
Within most species there is competition for mates

Mate choices of one sex help to determine which

members of the opposite sex reproduce

This influences which traits get passed on to future

generations

Sexual Selection
The sex that invests more in raising the offspring is

generally more choosy when it comes to selecting a mate advantage

Those judged attractive have a reproductive

Womens preferences for dominant vs. non-dominant looking faces changes across the menstrual cycle

 Selfish behaviour can be understood as protection of

Selfishness
succeed instead

ones own prospects of survival and reproduction

The alternative is that competing individuals will

Sometimes competing individuals are relatives who

share interests in replication of their common genetic material

Inclusive Fitness Maximization

It has been suggested that individuals strive to maximize the representation of their genes in future generations Direct reproduction is not the only way to bring ones genes into future generations (nepotism)
W.D. Hamilton (1964)

Inclusive Fitness Maximization

This type of behaviour (increasing individuals genes

in future generations) should be selected for

This also applies obviously to nurturance of young

However, survival can impede inclusive fitness(if you

are a burden toward your kin)

Kin Selection
Kin selection A gene that prompts behaviour which enhances the fitness of relatives but

lowers that of the individual displaying the behavior, may increase in frequency, because relatives often carry the same genes.
Individuals who do not reproduce can gain inclusive fitness by helping their relatives
this is known as nepotism or nepotistic behaviour as

long as the benefits of nepotism (helping kin) outweigh the loss in reproductive success of the nepotist

Nepotism
Parental behaviour serves to propagate genes so it should be

selected for if it has a genetic basis

Nepotism is behaviour favouring kin
E.g. - grandparent or aunt or uncle

being nice

Coefficient of relatedness
Coefficient of relatedness: r Between you and: parent 0.5 full sib 0.5 half sib 0.25 grandparent 0.25 aunt/uncle 0.25 nephew 0.25 first cousin 0.125

Genetic Relatedness

Euler and Weitzel (1996)

 From hunting/gathering in small groups to

Altruism

cooperative role specializations in large communities Unprecedented in evolution for such intricate group dynamics This is a far cry from the hunting/gathering village where an individual may spend an entire lifetime among kin Reciprocal altruism in modern society

 This describes cases where the rate at which an organism adapts to its environment is slower than the rate of environmental change This leads to a mismatch of adaptations selected for over millions of years and the current

Evolutionary lag

environment
Evolutionary Psychology suggests that human

psychological mechanisms are largely evolved solutions to adaptive problems in the remote past

Evolutionary lag
Sexual maturity at young ages

(too young to bring up kids on your own in todays society)

Fears and phobias (why are we

afraid of spiders and snakes but not cars and electricity)

Sex for pleasure instead of

reproduction (birth control)

Evolutionary lag
Altruism (helping someone who does not share your

genes, how does this benefit you?)

Modern medicine (medical science tends to ignore the

bodys natural responses to injury and illness)

Evolutionary Lag

High caloric intake

Sedentary lifestyle Food additives and

toxins Saturated and trans fats Highly processed carbs (high glycemic index)

Darwinian Medicine
Descriptions of disease in current medical textbooks omit

a crucial section - an evolutionary explanation for why humans are vulnerable to disease
Some of these explanations will have immediate practical

benefits for medical practice

Darwinian Medicine
Current medical sciences focuses on a

straightforward study of the body's anatomic and physiological mechanisms as they currently exist
Darwinian medicine asks why the body is designed

in a way that makes us all vulnerable to problems like cancer, atherosclerosis or depression

Facts about biology and Evolution

Discomforting conditions, such as pain, fever,

cough, vomiting and anxiety, are actually neither diseases nor design defects but rather are evolved defences
Conflicts with other organisms--Escherichia coli or

crocodiles, for instance--are a fact of life (interspecies competition)

Ebola virus as deadly and unstoppable as it was eventually it killed itself

Facts about biology and Evolution

Availability of dietary fats, sugars and salt are so recent that natural selection has not yet had a chance to deal with them The body may fall victim to trade-offs between a trait's benefits and its costs;
Example: the sickle cell gene, which also protects

against malaria (only when heterozygous)

Sickle cell anemia can be fatal but protects against malaria

Examples of mistakes made in modern medicine

Medical science is focused so deeply in biology,

biochemistry and molecular biology

Broader perspectives of disease and injury are often

overlooked

Fever
The body functions best at a constant

temperature
It may not function too well if that

temperature increases
BUT fever makes the body an

inhospitable place for pathogens to thrive

Iron supplements
When the body is infected, it usually sequesters

iron in the liver

This makes the body not function well due to the

lack of iron in circulation

Pathogens cannot access it if it is put away in the

liver (iron is crucial for all forms of life)

Anxiety, sadness, and jealousy

These traits have been known to

promote ones survival

Anxiety forces us to deal with

things that need dealing with social situations and reassess our goals and our life

Sadness allows us to withdraw from

Jealousy is often a way to guard a

mate, to protect ones interests or to generate motivations

Morning sickness during pregnancy

This nausea occurs during a time of rapid tissue

development in the fetus

Obstetricians have not considered the possibility that

nausea of pregnancy may be a defence against toxins

Morning sickness during pregnancy

Morning sickness during pregnancy

Flaxman & Sherman, 2000

Coughing
People who cannot clear foreign matter from their

lungs are likely to die from pneumonia

Should not take a cough suppressant when you have a

productive cough (phlegm)

Antibiotic resistance
This is a classic demonstration of natural selection Bacteria are individuals whos gene vary like any other

organism
A few bacteria may be resistant to a particular

antibiotic

Antibiotic resistance
When antibiotics are used, these few bacteria may

survive Their environment now has no competing bacteria (they all died) This sets the stage for these resistant bacteria to thrive