What is Evolutionary Medicine?

“Nothing in Biology makes sense except in the light of evolution”, Theodosius Dobzhansky said in his famous 1973 essay. Applying this principle to medical research suggests that studying the proximal causes of health and disease is limited, and to be better understood, such research should be fit within a more dynamic evolutionary framework. While traditional biomedical research is often concerned with pathophysiology, it is the relatively novel science of evolutionary medicine that seeks to link human pathology with our past, present, and future evolutionary trajectories. Combining the study of proximal and distal reasons underpinning medical disorders yields a deeper understanding that may help to improve the ways diseases are screened for, treated, or prevented.  

The modern application of evolutionary theory on medical issues began in the 1980s, with contributions among others from Stanley Boyd Eaton and Melvin Konner on paleolithic nutrition, and then in the 1990s from Randolph Nesse and George Williams on the new science of Darwinian medicine. Today, the interdisciplinary and international members of this growing community of researchers are organized in a society, the International Society of Evolution Medicine and Public Health. See also the Evolution and Medicine Review website.

1. Antibiotic resistance is the result of selection for bacterial strains that carry resistance mutations by the antibiotics we use to eradicate them. By taking this evolutionary principle into consideration, we can design treatment protocols that minimize the chance of resistance emergence and even reverse it when it occurs.
    
2. Many metabolic disorders including hypercholesterinemia and diabetes are affected by the mismatch between our modern-life environment, characterized by a Western diet and poor physical activity, and the environment in which our hunter-gatherer ancestors evolved for hundreds of thousands of years. This should be considered when designing diet and exercise regimes to prevent and treat these disorders.
    
3. Evolution works by selecting favorable variants in the genome, leaving us slightly different from each other. An individualized approach is currently gaining more awareness with the rise of personalized medicine. As opposed to the traditional “one treatment fits all” approach, personalized medicine advances treatments that are tailored to the specific needs of each patient. This requires a deeper understanding of the biological processes that can differ between indivuduals based on sex, age, ethnicity, genetics, environment, etc. Today, such an approach is still in its preliminary stages, but is expected to rise in popularity with the advent of wearable devices that track various physiological parameters in real time as well as further understanding of subtle differences in these parameters that may be determined by our evolution to a significant extent.

F Rühli, M Henneberg (2017). Biological Future of Humankind: Ongoing Evolution and the Impact of Recognition of Human Biological Variation. On Human Nature, 263-275.

F Rühli, M Haeusler, A Saniotis, M Henneberg (2016). Novel modules to teach evolutionary medicine: an Australian and a Swiss experience. Medical Science Educator 26 (3), 375-381.

F Rühli, K van Schaik, M Henneberg (2016). Evolutionary medicine: the ongoing evolution of human physiology and metabolism. Physiology 31 (6), 392-397.

F Rühli, M. Henneberg (2013). New perspectives on evolutionary medicine: the relevance of microevolution for human health and disease. BMC medicine 11 (1), 115.