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Evolutionary Biology and Health - Part Two: an Interview With James Evans, M.D., Ph.D.
In this episode of Fitness Rocks I talk to Dr. James Evans from the University of North Carolina School of Medicine. Dr. Evans is a molecular biologist and one of the few people involved with teaching evolutionary biology to medical students.
 Play Podcast 150 It is my contention that we will not be able to solve the epidemics of obesity and obesity-related chronic diseases until we recognize the central role of evolution in our modern health problems. Our biology is unsuited for the modern environment that we have created. An over-abundance of unhealthy food and a lifestyle in which physical activity is optional are the root causes of chronic diseases. In addition to pursuing new “miracle drugs” to “cure” lifestyle-related illnesses, we should also be addressing the elements of our modern environment and our modern lifestyles that are out of sync with our evolution and are causing these chronic illnesses in the first place.
More than half of the United States population refuses to accept the science of evolution, which leaves me wondering if we will ever be able to stop the steady increase in the percentage of Americans who are becoming obese and developing chronic diseases? The very fact that people of normal weight today are statistically abnormal should be a huge signal that something is fundamentally wrong with our modern lifestyle. It appears to me that our society is accepting the fate of escalating medical disabilities from chronic diseases as if these diseases are inevitable. They aren’t.
People will counter me by claiming their right to a different opinion. I respect that, but an opinion is what you have when you decide whether you think you look better in a blue shirt or a white shirt. Evolution is science. Science is the field of human endeavor that brought you cell phone technology, the internet, coronary artery bypass grafting, antibiotics, the small pox vaccination, space flight, satellites, air planes, automobiles, etc. Evolution is a concept that you either understand or you don’t. Understanding our biology, our evolution, is the key to solving our epidemic of chronic diseases.
Monte Ladner, M.D.
References:
The Voyage Continues: Darwin and Medicine at 200 Years
Dr. Evans’ Power Point Slide Show on Evolutionary Medicine
Video Lecture on Evolution at FORA.TV by Dr. Kenneth Miller
Related posts: - Evolutionary Biology and Health – Part One: an Interview with Neil Shubin, Ph.D.
- The Environment and Your Health: an Interview with Paul Auerbach, M.D.
- Knowledge Is Not Always Power: An Interview with David Katz, M.D.
- What is the Optimal Exercise Strategy?
- Alternate Day Fasting – An Interview with Dr. Krista Varady
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I don’t believe in evolution, at least not human evolution. Statistically speaking our bodies haven’t changed in millions of years. Beyond that, comparing the brains and digestive systems of primates and humans leads one to realize there is no way we descended from them. See ETH (expensive tissue hypothesis). With that being said, I agree with you on food, science and our health. The wonderful world of health care has evolved into a flow chart of conditions and pharmaceutical fixes. If a drug can’t fix it then we don’t know what’s wrong. Lipitor is a wonderful example of this. Top-selling prescribed drug, yet outside of hyperbole and cognitive dissonance there is no scientific evidence for its existence. The foods we eat, lifestyles we live and over-reliance on prescription medication is an evolutionary nightmare.
Brian
Brian,
1. Humans are primates.
2. Your statement “I don’t believe in evolution, at least not human evolution.” reflects a widely held misconception that humans are not part of the natural world, that we are somehow different from, and better than, every other living thing. This misunderstanding has allowed humans to treat the natural world with an appalling arrogance that has led to the extinction of countless species and threatens to one day make the Earth uninhabitable for ourselves.
3. I’m not sure what you mean by the lack of scientific evidence for the existence of lipitor. It definitely exists.
4. If you don’t “believe” in evolution, then what is an “evolutionary nightmare?”
5. Comparing the brains and digestive systems of other primates and ourselves may lead
YOU to realize that there is no shared ancestor for all of us, but that would leave you clearly outside the circle of a very large group of world-class scientists and comparative anatomists. The heart valves of humans and pigs are so similar that surgeons have been replacing defective human heart valves with those of pigs for decades. How does that square with the belief that humans are different in every way from all other living creatures?
6. The statement “Statistically speaking, our bodies haven’t changed in millions of years” is simply wrong. What is your reference for this assertion?
7. You should consider listening to Fitness Rocks podcast 149 – an interview with Dr. Neil Shubin. You should also read his book “Your Inner Fish” – You’ll be fascinated by his work on the comparative anatomy and genetics between species.
Monte
Thanks again for a wonderful podcast. I wanted to share with you the fact that the Houston Chronicle just published an op ed piece by doctors which outlined the importance of lifestyle in the prevention of cancer.(see http://www.chron.com/disp/story.mpl/editorial/outlook/6755592.html) The fact that one of the doctors is from the MD Anderson Cancer Center is good news indeed. The Houston Medical Center, while providing outstanding medical treatment for many individuals (my son included) threatens to take over the entire city. Neighborhoods are being bulldozed for more and bigger medical office buildings. I’m hopeful that as you and other physicians keep bringing home the point that lifestyle is so important for health that the medical complexes will no longer need to expand at such an alarming rate.
Hi Dr.Monte,
Thanks for a very interesting podcast again.
I have no qualms about the Theory of Evolution, but I think it was worthwhile your outlining your stance on it.
One thing that occurred to me as a result of your podcast was that we may be seeing an example of natural selection in the context of personal health. It would seem probable that those who do not/are unable to follow the tenets of a healthy lifestyle (despite those being well-known) are more likely to suffer from chronic diseases and early death – as opposed to those who do follow a healthy lifestyle.
So, in this sense is there not a natural selection occurring that will favour those in the latter category? I have to admit I am a little uncomfortable with that thought – it strikes me as a little fascist in a way. And I would quickly add that work such as yours that tries to educate the population to a more healthful life is admirable. I guess the costly interventions that you mentioned are the cost we bear in trying to fight this process of natural selection. Nor am I suggesting we should somehow limit that help.
But perhaps it alludes to Dr.Evans’s comments on personal responsibility?
In any case, thanks for a thought-provoking piece.
Thanks for the questions. Let me clarify my statement re human evolution. There are too many gaps in the fossil records to say we evolved from anything. The digestive systems of primates (specifically gorillas) are wholly different from ours, which I referred to the expensive tissue hypothesis. Neat comparisons are exactly that, neat. They aren’t hard evidence. You say we are primates. I say look at size and metabolic differences between the brains and digestive systems of primates and humans. Read the expensive tissue hypothesis. Wholly different.
All of this does not mean I don’t think we’re not part of the natural world. I do and we have a role in the extinction of life forms. But that is completely different from saying we came from primates.
What I meant by evolutionary nightmare regarding statins (and big pharma in general) is human involvement. Find one study showing statins prevent heart attacks or plaque build up or even death. There isn’t one. They are all carefully written and biased, when you look with an objective eye, things are different. Statins effectively reduce LDL. But that has not led to a decrease in the incidence of heart disease, heart attack, or even death. You said there is evidence for its existence. Where is it? I hear a lot of people talking about it. But I don’t see any evidence that reducing LDL improves health.
I know too many doctors, taught too many medical school classes and work with too many people that have metabolic disorders to say that a majority of doctors are able to work off a flow chart. It seems if a prescription can’t fix it, then, sorry, we don’t know how to fix it. That, too, is what I meant by an evolutionary nightmare. We’ve evolved from a doctor-patient relationship focused on health to an over-reliance on medication, when making a few small behavioral changes would fix a lot of things.
That was the point of my comment. I hope this clears some things.
Brian
Brian,
I do appreciate that you are at least aware of the Fitness Rocks podcast. And, I do appreciate your taking the time to share your thoughts in the comments section.
However, I would like to suggest, respectfully, that you at least listen to the podcasts before writing comments. The things you are writing make it clear that you have not listened to what Dr. Shubin and Dr. Evans discussed.
On the subject of evolution your comments are, frankly, confused and misinformed. I don’t intend that as a personal insult.
When I was a resident in Anesthesiology I was taking care of a very sick patient in the intensive care unit (ICU). I reviewed the treatment of the patient in the previous days and I completely disagreed with the treatment plan. I wrote a long and detailed note in the chart about what I thought the other doctors were doing wrong. I did not realize that the treatment plan had been orchestrated by the chief of the ICU for whom I had a great deal of respect. When he read my note he responded by writing a note of his own. It went like this: “The comments in the previous note are uninformed, uninvited, and should be ignored.” I later was “invited” to speak with him in his office. He was very polite and instead of yelling at me, he handed me several scientific articles that made it clear what his medical plan was all about. He was right, I had formulated my opinions and comments and written my note BEFORE I took the time to read appropriate, peer-reviewed, scientific articles about the subject. Lesson learned.
I am not the person who classified humans as primates. That person, according to a lecture by Dr. Kenneth Miller, was Carl Linnaeus who was, oddly enough, a creationist. You can find this out by watching the video of Dr. Kenneth Miller that I referenced in the footnotes of Fitness Rocks podcast 150.
The fossil record is remarkable, and remarkably rich. I recommend you read Richard Dawkins’ latest book: “The Greatest Show on Earth.”
Had you listened to podcast 149 with Dr. Shubin you would have been impressed with how complete the fossil record is and how he was able to use data from the fossil record to predict the existence of a “missing link.” He was not only able to predict the existence of this missing link, but he was able to predict how old it would be and where he should look for it. He made these predictions by reviewing the existing fossil record. THEN, he went to the Arctic circle and FOUND the fossil, exactly where the fossil record suggested it should be!
I discussed some recent papers on Statin drugs (drugs like lipitor) in Fitness Rocks podcasts 121 and 105. I’m not going to get into a detailed discussion of the use of statin drugs because I try very hard to stay out of those sorts of discussions on this podcast. I think that discussion needs to stay between patients and their doctors. People who listen to this podcast know how I feel about preventing coronary heart disease.
Thank you for sharing your thoughts here on Fitness Rocks. As promised, I will allow everybody to post their comments as long as they avoid profanity.
I am respectfully in total disagreement with you on the subject of evolution, and I know I will never change your mind. This podcast simply strives to provide information based on peer-reviewed scientific papers and interviews with the scientists who write those papers.
Monte
Monty – I have been enjoying your podcasts for over a year now. Thanks for another great interview and discussion with Dr. Evans.
If you use the first law of thermodynamics, aka Conservation of Energy, it is pretty easy to determine how much food and exercise a person needs. As long as we expend the same amount of energy we take in, our weight will remain about the same, neglecting small changes in bodily fluids. When I want to lose a few pounds, I can reduce my caloric intake by an average of about 250 calories per day and exercise an average of 250 calories more per day to create an energy deficit of 500 calories per day. Doing that on the average for a week will result in a loss of 3500 calories which is a pound.
You mentioned at the beginning of the podcast that our lifestyles have changed alot in the past 100 years or so. (I was enjoying listening to this podcast this afternoon while XC skiing.)
A major reason our lifestyles have changed so much is because we have had access to cheap fossil fuels for about the same amount of time, and they have allowed us to create and power machines that do the heavy lifting that our bodies used to do. These machines have become in effect our “energy slaves.”
Consider the fact that the amount of energy contained in just one barrel of oil is equal to the energy a person expends doing hard labor for more than 8 years! The US uses about 20 million barrels of oil per day, so it is easy to see we have handed over a lot of work to our many energy slaves during the past 100+ years.
Unfortunately, this has also allowed some of us to spend more time on the couch watching TV while consuming empty calories.
Since our food also contains so much cheap embedded fossil energy (pesticides, fertilizer, transport oil, etc.) this has also allowed us to produce so much more cheap food than we were able to before.
It is too bad we have used all of this energy to produce and consume the wrong kind of food….that is so detrimental to our bodies.
In time and due to the eventual depletion fossil fuel reserves, this all will likely change and perhaps we will return to using our bodies more for some of these tasks.
Thanks for all of your good work and I look forward to hearing your next podcast!
Jim
On the subject of Evolutionary Biology, I thought this interview posted on the Scientific American website was very insightful.
“Darwin’s Influence on Modern Thought” by Ernst Mayr
http://www.scientificamerican.com/article.cfm?id=darwins-influence-on-modern-thought
I was listening to the last part of your podcast on the way home tonight and it made me think about a the book “How We Decide” by Johah Lehrer. This book addresses how some of the hard wiring in our brain leads us to valuing the short term much more than the long term (a high discount rate as they say in finance) Here is a book review. http://www.nytimes.com/2009/03/22/books/review/Johnson-t.html
If you have not read this book already, perhaps you would enjoy it. It is right on topic for your current podcast.
Email from a listener:
I’ve just listened to episode 150 and was interested in your story of the
meeting at Harvard where it was being arguedquietly that type 2 diabetes was
genetically determined and genetics would find a way to cure it. It brought to
mind a similar experience I had at a presentation made by the Director of a
major nutrition research unit at Cambridge University. He made the argument that
“the vast majority of cases of obesity were genetically determined” The audience
argued strongly with him. The argument was concluded when a paediatrician
pointed out to him that if everyone smoked, we would view lung cancer as a
genetically determined disease.
Try that one on him the next time!
Harry