Gurven Michael D, Lieberman Daniel E
Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA.
Department of Human Evolutionary Biology, Harvard University, Cambridge, MA.
Evol Hum Behav. 2020 Sep;41(5):330-340. doi: 10.1016/j.evolhumbehav.2020.04.001. Epub 2020 Apr 14.
Despite recent rapid advances in medical knowledge that have improved survival, conventional medical science's understanding of human health and disease relies heavily on people of European descent living in contemporary urban industrialized environments. Given that modern conditions in high-income countries differ widely in terms of lifestyle and exposures compared to those experienced by billions of people and all our ancestors over several hundred thousand years, this narrow approach to the human body and health is very limiting. We argue that preventing and treating chronic diseases of aging and other mismatch diseases will require both expanding study design to sample diverse populations and contexts, and fully incorporating evolutionary perspectives. In this paper, we first assess the extent of biased representation of industrialized populations in high profile, international biomedical journals, then compare patterns of morbidity and health across world regions. We also compare demographic rates and the force of selection between subsistence and industrialized populations to reflect on the changes in how selection operates on fertility and survivorship across the lifespan. We argue that, contrary to simplistic misguided solutions like the PaleoDiet, the hypothesis of evolutionary mismatch needs critical consideration of population history, evolutionary biology and evolved reaction norms to prevent and treat diseases. We highlight the critical value of broader sampling by considering the effects of three key exposures that have radically changed over the past century in many parts of the world-pathogen burden, reproductive effort and physical activity-on autoimmune, cardiometabolic and other mismatch diseases.
尽管最近医学知识的迅速进步提高了生存率，但传统医学对人类健康和疾病的理解在很大程度上依赖于生活在当代城市工业化环境中的欧洲血统人群。鉴于高收入国家的现代生活条件与数十亿人和我们所有祖先在几十万年间所经历的生活方式和接触情况差异巨大，这种对人体和健康的狭隘研究方法非常有限。我们认为，预防和治疗衰老相关的慢性疾病及其他错配疾病既需要扩大研究设计以涵盖不同人群和环境，也需要充分纳入进化视角。在本文中，我们首先评估高知名度国际生物医学期刊中工业化人群的偏差代表性程度，然后比较世界各地区的发病率和健康模式。我们还比较了生存型人群和工业化人群的人口统计学比率及选择压力，以思考在整个生命周期中选择对生育力和存活率作用方式的变化。我们认为，与像旧石器时代饮食法这种简单化的错误解决方案相反，进化错配假说需要对人口历史、进化生物学和进化反应规范进行批判性思考，以预防和治疗疾病。我们通过考虑在过去一个世纪里世界许多地区发生了根本性变化的三种关键接触因素——病原体负担、生殖投入和身体活动——对自身免疫性疾病、心脏代谢疾病及其他错配疾病的影响，强调了更广泛抽样的关键价值。
