Evolutionaire geneeskunde U bent wat u eet, maar u moet weer worden wat u at 1
01 Jan 2005-
TL;DR: In this paper, we realiseren ons onvoldoende dat we een product zijn van de natuur, en niet ons genoom per se, is de belangrijkste oorzaak van de huidige chronische (degeneratieve) ziekten.
Abstract: Darwin beschouwde de leefomstandigheden als de belangrijkste drijvende kracht achter de evolutie. Organismen voorzien de natuur van een grote genetische diversiteit en de natuur maakt hieruit een keuze. Ons genoom is gedurende de evolutie dus bij uitstek aangepast aan de omgeving, waaronder klimaat, voeding en pathogenen. Homo sapiens is ongeveer 160.000 jaar oud en ons genoom muteert met een snelheid van ongeveer 0,5% per miljoen jaar. Door de snelle verandering van onze omgeving in de afgelopen 100 jaar hebben we een conflict veroorzaakt tussen ons nog in het paleolithisch tijdperk (2,5*10 6 tot 10 4 jaar geleden) verkerend genoom en deze omgeving. Dit conflict, en niet ons genoom per se, is de belangrijkste oorzaak van de huidige chronische (degeneratieve) ziekten, waaronder diabetes mellitus, hart en vaatziekten, bepaalde vormen van kanker en enkele psychiatrische ziekten. Inzake de voeding begon dit conflict ongeveer 10.000 jaar geleden bij de overgang van ons bestaan als jager-verzamelaars naar een agrarische samenleving die gepaard ging met een hoge consumptie van koolhydraten. Het conflict is geescaleerd vanaf de industriele revolutie, en in een stroomversnelling geraakt vanaf het begin van de vorige eeuw, onder andere door een hoge inname van verzadigd vet en van mono- en disacchariden, een lage inname van vis en een ongunstige balans tussen energie inname en fysieke activiteit. We realiseren ons onvoldoende dat we een product zijn van de natuur. Nabootsing van de paleolithische leefomstandigheden naar moderne inzichten is van belang voor zowel primaire als secundaire preventie. Educatie vanaf de schoolleeftijd, (meer) aandacht voor voeding/leefstijl in de studies geneeskunde en farmacie, en een verplichte productinformatie die (veel) verder gaat dan de huidige summiere aanduidingen kunnen een gunstige rol spelen bij de beslechting van het conflict.
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TL;DR: This review focuses on lifestyle changes, especially dietary habits, that are at the basis of chronic systemic low grade inflammation, insulin resistance and Western diseases, and the disturbance of the authors' inflammatory/anti-inflammatory balance is illustrated by dietary fatty acids and antioxidants.
Abstract: In this review, we focus on lifestyle changes, especially dietary habits, that are at the basis of chronic systemic low grade inflammation, insulin resistance and Western diseases. Our sensitivity to develop insulin resistance traces back to our rapid brain growth in the past 2.5 million years. An inflammatory reaction jeopardizes the high glucose needs of our brain, causing various adaptations, including insulin resistance, functional reallocation of energy-rich nutrients and changing serum lipoprotein composition. The latter aims at redistribution of lipids, modulation of the immune reaction, and active inhibition of reverse cholesterol transport for damage repair. With the advent of the agricultural and industrial revolutions, we have introduced numerous false inflammatory triggers in our lifestyle, driving us to a state of chronic systemic low grade inflammation that eventually leads to typically Western diseases via an evolutionary conserved interaction between our immune system and metabolism. The underlying triggers are an abnormal dietary composition and microbial flora, insufficient physical activity and sleep, chronic stress and environmental pollution. The disturbance of our inflammatory/anti-inflammatory balance is illustrated by dietary fatty acids and antioxidants. The current decrease in years without chronic disease is rather due to "nurture" than "nature," since less than 5% of the typically Western diseases are primary attributable to genetic factors. Resolution of the conflict between environment and our ancient genome might be the only effective manner for "healthy aging," and to achieve this we might have to return to the lifestyle of the Paleolithic era as translated to the 21st century culture.
177 citations
Cites background from "Evolutionaire geneeskunde U bent wa..."
...The ultimate aim of this survival strategy is, however, deeply anchored in our evolution, during which our brain has grown tremendously....
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TL;DR: A study of the effects of food supplements on aggression, rule-breaking, and psychopathology among young Dutch prisoners found the results to be promising, but no significant improvements were found in a number of other outcome measures.
Abstract: In an earlier study, improvement of dietary status with food supplements led to a reduction in antisocial behavior among prisoners. Based on these earlier findings, a study of the effects of food supplements on aggression, rule-breaking, and psychopathology was conducted among young Dutch prisoners. Two hundred and twenty-one young adult prisoners (mean age=21.0, range 18-25 years) received nutritional supplements containing vitamins, minerals, and essential fatty acids or placebos, over a period of 1-3 months. As in the earlier (British) study, reported incidents were significantly reduced (P=.017, one-tailed) in the active condition (n=115), as compared with placebo (n=106). Other assessments, however, revealed no significant reductions in aggressiveness or psychiatric symptoms. As the incidents reported concerned aggressive and rule-breaking behavior as observed by the prison staff, the results are considered to be promising. However, as no significant improvements were found in a number of other (self-reported) outcome measures, the results should be interpreted with caution.
121 citations
Cites background from "Evolutionaire geneeskunde U bent wa..."
...Epidemiological research, for instance, shows that major changes in dietary patterns over time have taken place, especially in industrialized world during the last century [Cordain et al., 2005; Crawford et al., 1999; Muskiet, 2005; Simopoulos, 1999]....
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TL;DR: The evidence for the long-reigning hypothesis of human evolution on the arid savanna is weighed against the hypothesis that man evolved in the proximity of water and the composition and merits of so-called 'Palaeolithic diets' are evaluated.
Abstract: Evolutionary medicine acknowledges that many chronic degenerative diseases result from conflicts between our rapidly changing environment, our dietary habits included, and our genome, which has remained virtually unchanged since the Palaeolithic era Reconstruction of the diet before the Agricultural and Industrial Revolutions is therefore indicated, but hampered by the ongoing debate on our ancestors' ecological niche Arguments and their counterarguments regarding evolutionary medicine are updated and the evidence for the long-reigning hypothesis of human evolution on the arid savanna is weighed against the hypothesis that man evolved in the proximity of water Evidence from various disciplines is discussed, including the study of palaeo-environments, comparative anatomy, biogeochemistry, archaeology, anthropology, (patho)physiology and epidemiology Although our ancestors had much lower life expectancies, the current evidence does neither support the misconception that during the Palaeolithic there were no elderly nor that they had poor health Rather than rejecting the possibility of 'healthy ageing', the default assumption should be that healthy ageing posed an evolutionary advantage for human survival There is ample evidence that our ancestors lived in a land-water ecosystem and extracted a substantial part of their diets from both terrestrial and aquatic resources Rather than rejecting this possibility by lack of evidence, the default assumption should be that hominins, living in coastal ecosystems with catchable aquatic resources, consumed these resources Finally, the composition and merits of so-called 'Palaeolithic diets', based on different hominin niche-reconstructions, are evaluated The benefits of these diets illustrate that it is time to incorporate this knowledge into dietary recommendations
42 citations
TL;DR: It will be argued that, in order to disentangle some of the ambiguities involved, it has to broaden the temporal horizon of the debate, and clarify the concept of nature that emerged in the context of the “Common Human Pattern”.
Abstract: Debates on the role of biotechnology in food production are beset with notorious ambiguities. This already applies to the term “biotechnology” itself. Does it refer to the use and modification of living organisms in general, or rather to a specific set of technologies developed quite recently in the form of bioengineering and genetic modification? No less ambiguous are discussions concerning the question to what extent biotechnology must be regarded as “unnatural.” In this article it will be argued that, in order to disentangle some of the ambiguities involved, we have to broaden the temporal horizon of the debate. Ideas about biotechniques and naturalness have evolved in various socio-historical contexts and their historical origins will determine to a considerable extent their actual meaning and use in contemporary deliberations. For this purpose, a comprehensive timetable is developed, beginning with the Neolithic revolution ~10,000 years ago (resulting in the emergence of agriculture and the Common Human Pattern) up to the biotech revolution as it has evolved from the 1970s onwards—sometimes referred to as a second “Genesis.” The concept of nature that emerged in the context of the “Common Human Pattern” differs considerably from traditional philosophical concepts of nature (such as coined by Aristotle), as well as from the scientific view of nature conveyed by the contemporary life sciences. A clarification of these different historical backdrops will allow us to understand and elucidate the conceptual ambiguities that are at work in contemporary debates on biotechnology and the place of human beings in nature.
29 citations
Cites background from "Evolutionaire geneeskunde U bent wa..."
...The ‘‘estrangement’’ between Neolithic diets and Palaeolithic genomes has been causing an impressive series of so-called ‘‘cultural’’ health problems, ranging from obesity and diabetes to cardiovascular disease (notably Coronary artery disease or CAD) and colon cancer (Eaton and Konner 1983; Cordain 2002; Cordain and Eaton 2005; Muskiet 2005)....
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...…and Palaeolithic genomes has been causing an impressive series of so-called ‘‘cultural health problems, ranging from obesity and diabetes to cardiovascular disease (notably Coronary artery disease or CAD) and colon cancer (Eaton and Konner 1983; Cordain 2002; Cordain and Eaton 2005; Muskiet 2005)....
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TL;DR: The role of genomics is explored with the help of two examples, namely the renaissance of Paleolithic diets and of Pleistocene parks, to argue that an understanding of the world in ecocentric terms requires new partnerships and mutually beneficial forms of collaboration and convergence between life sciences, social sciences, and the humanities.
Abstract: Views of ourselves in relationship to the rest of the biosphere are changing. Theocentric and anthropocentric perspectives are giving way to more ecocentric views on the history, present, and future of humankind. Novel sciences, such as genomics, have deepened and broadened our understanding of the process of anthropogenesis, the coming into being of humans. Genomics suggests that early human history must be regarded as a complex narrative of evolving ecosystems, in which human evolution both influenced and was influenced by the evolution of companion species. During the agricultural revolution, human beings designed small-scale artificial ecosystems or evolutionary "Arks," in which networks of plants, animals, and microorganisms coevolved. Currently, our attitude towards this process seems subject to a paradoxical reversal. The boundaries of the Ark have dramatically broadened, and genomics is not only being used to increase our understanding of our ecological past, but may also help us to conserve, reconstruct, or even revivify species and ecosystems to whose degradation or (near) extinction we have contributed. This article explores the role of genomics in the elaboration of a more ecocentric view of ourselves with the help of two examples, namely the renaissance of Paleolithic diets and of Pleistocene parks. It argues that an understanding of the world in ecocentric terms requires new partnerships and mutually beneficial forms of collaboration and convergence between life sciences, social sciences, and the humanities.
7 citations
Cites background from "Evolutionaire geneeskunde U bent wa..."
...New insights in combination with novel technologies may lead to a ‘renaissance of Paleolithic food’ (Muskiet 2005;Zittermann 2003)....
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References
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TL;DR: Comparative genomic analysis indicates vertebrate expansions of genes associated with neuronal function, with tissue-specific developmental regulation, and with the hemostasis and immune systems are indicated.
Abstract: A 2.91-billion base pair (bp) consensus sequence of the euchromatic portion of the human genome was generated by the whole-genome shotgun sequencing method. The 14.8-billion bp DNA sequence was generated over 9 months from 27,271,853 high-quality sequence reads (5.11-fold coverage of the genome) from both ends of plasmid clones made from the DNA of five individuals. Two assembly strategies-a whole-genome assembly and a regional chromosome assembly-were used, each combining sequence data from Celera and the publicly funded genome effort. The public data were shredded into 550-bp segments to create a 2.9-fold coverage of those genome regions that had been sequenced, without including biases inherent in the cloning and assembly procedure used by the publicly funded group. This brought the effective coverage in the assemblies to eightfold, reducing the number and size of gaps in the final assembly over what would be obtained with 5.11-fold coverage. The two assembly strategies yielded very similar results that largely agree with independent mapping data. The assemblies effectively cover the euchromatic regions of the human chromosomes. More than 90% of the genome is in scaffold assemblies of 100,000 bp or more, and 25% of the genome is in scaffolds of 10 million bp or larger. Analysis of the genome sequence revealed 26,588 protein-encoding transcripts for which there was strong corroborating evidence and an additional approximately 12,000 computationally derived genes with mouse matches or other weak supporting evidence. Although gene-dense clusters are obvious, almost half the genes are dispersed in low G+C sequence separated by large tracts of apparently noncoding sequence. Only 1.1% of the genome is spanned by exons, whereas 24% is in introns, with 75% of the genome being intergenic DNA. Duplications of segmental blocks, ranging in size up to chromosomal lengths, are abundant throughout the genome and reveal a complex evolutionary history. Comparative genomic analysis indicates vertebrate expansions of genes associated with neuronal function, with tissue-specific developmental regulation, and with the hemostasis and immune systems. DNA sequence comparisons between the consensus sequence and publicly funded genome data provided locations of 2.1 million single-nucleotide polymorphisms (SNPs). A random pair of human haploid genomes differed at a rate of 1 bp per 1250 on average, but there was marked heterogeneity in the level of polymorphism across the genome. Less than 1% of all SNPs resulted in variation in proteins, but the task of determining which SNPs have functional consequences remains an open challenge.
12,098 citations
Book•
14 Mar 2000
TL;DR: This chapter discusses how to ask clinical questions you can answer and critically assess the evidence for evidence-based medicine, as well as 7 Rapid Reference Cards used in clinical practice.
Abstract: Introduction: On the Need for Evidence-Based Medicine 1. How to Ask Clinical Questions You Can Answer 2. Searching for the Best Evidence 3. Critically Appraising the Evidence 4. Can You Apply This Valid, Important Evidence in Caring for Your Patient? 5. Evaluation Appendix: Confidence Intervals Also Included Are 7 Rapid Reference Cards
6,019 citations
TL;DR: General agreement of genetic and predefined populations suggests that self-reported ancestry can facilitate assessments of epidemiological risks but does not obviate the need to use genetic information in genetic association studies.
Abstract: We studied human population structure using genotypes at 377 autosomal microsatellite loci in 1056 individuals from 52 populations. Within-population differences among individuals account for 93 to 95% of genetic variation; differences among major groups constitute only 3 to 5%. Nevertheless, without using prior information about the origins of individuals, we identified six main genetic clusters, five of which correspond to major geographic regions, and subclusters that often correspond to individual populations. General agreement of genetic and predefined populations suggests that self-reported ancestry can facilitate assessments of epidemiological risks but does not obviate the need to use genetic information in genetic association studies.
2,661 citations
TL;DR: A modest intake of fatty fish (two or three portions per week) may reduce mortality in men who have recovered from MI.
2,624 citations
TL;DR: The protective effect of the Mediterranean dietary pattern was maintained up to 4 years after the first infarction, confirming previous intermediate analyses and indicating that a comprehensive strategy to decrease cardiovascular morbidity and mortality should include primarily a cardioprotective diet.
Abstract: BACKGROUND--The Lyon Diet Heart Study is a randomized secondary prevention trial aimed at testing whether a Mediterranean-type diet may reduce the rate of recurrence after a first myocardial infarction. An intermediate analysis showed a striking protective effect after 27 months of follow-up. This report presents results of an extended follow-up (with a mean of 46 months per patient) and deals with the relationships of dietary patterns and traditional risk factors with recurrence. METHODS AND RESULTS--Three composite outcomes (COs) combining either cardiac death and nonfatal myocardial infarction (CO 1), or the preceding plus major secondary end points (unstable angina, stroke, heart failure, pulmonary or peripheral embolism) (CO 2), or the preceding plus minor events requiring hospital admission (CO 3) were studied. In the Mediterranean diet group, CO 1 was reduced (14 events versus 44 in the prudent Western-type diet group, P=0.0001), as were CO 2 (27 events versus 90, P=0.0001) and CO 3 (95 events versus 180, P=0. 0002). Adjusted risk ratios ranged from 0.28 to 0.53. Among the traditional risk factors, total cholesterol (1 mmol/L being associated with an increased risk of 18% to 28%), systolic blood pressure (1 mm Hg being associated with an increased risk of 1% to 2%), leukocyte count (adjusted risk ratios ranging from 1.64 to 2.86 with count >9x10(9)/L), female sex (adjusted risk ratios, 0.27 to 0. 46), and aspirin use (adjusted risk ratios, 0.59 to 0.82) were each significantly and independently associated with recurrence. CONCLUSIONS--The protective effect of the Mediterranean dietary pattern was maintained up to 4 years after the first infarction, confirming previous intermediate analyses. Major traditional risk factors, such as high blood cholesterol and blood pressure, were shown to be independent and joint predictors of recurrence, indicating that the Mediterranean dietary pattern did not alter, at least qualitatively, the usual relationships between major risk factors and recurrence. Thus, a comprehensive strategy to decrease cardiovascular morbidity and mortality should include primarily a cardioprotective diet. It should be associated with other (pharmacological?) means aimed at reducing modifiable risk factors. Further trials combining the 2 approaches are warranted.
2,597 citations