tag:blogger.com,1999:blog-1812431336777691886.post896649067525353025..comments2024-02-29T03:57:00.088-05:00Comments on The Mermaid's Tale: Fairy stories and evolutionary medicineAnne Buchananhttp://www.blogger.com/profile/09212151396672651221noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-1812431336777691886.post-16540277674849978242013-06-27T19:55:47.316-04:002013-06-27T19:55:47.316-04:00I in turn thank Michael Cournoyea for his excellen...I in turn thank Michael Cournoyea for his excellent Perspectives paper. Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-12327662137341047692013-06-27T19:42:45.538-04:002013-06-27T19:42:45.538-04:00Thank you so so much for this post. Thank you so so much for this post. Holly Dunsworthhttps://www.blogger.com/profile/05260104967932801186noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-30230546461080146972013-06-27T10:17:31.567-04:002013-06-27T10:17:31.567-04:00The problem to me is the plethora of, I'm sorr...The problem to me is the plethora of, I'm sorry to say, simplistic panselectionist stuff being published under this catch-phrase, as if it in some way specifically relates to adaptative evolution. <br /><br />The issue is that causation today is so often so genomically complex that referring it to evolution or Darwin or adaptation adds little to our understanding of the biology. It is far too deterministic relative to what we actually know about life.<br /><br />Of course our traits evolved, but we rarely have any way to know why or how (or, often, even when). Many of our traits long antedate humans, of course. Extrapolating from today's experience is generally groundless.<br /><br />I don't practice medicine, of course, but understanding the biology of the effects of variation today is difficult enough without trying to relate it to any serious level patterns of past fitness, etc.<br /><br />To relate genomic variation among people and continents (and species) to variation in outcomes (like diabetes or menopause or fever) rarely requires explicit invocations of past selection.<br /><br />It may be true that examples like lactase persistence and malaria resistance evolved by some plausible (and, on rare occasions, actually demonstrable) selective mechanism. But it gains virtually nothing to know that in terms of therapy. Evolution involved past environments and so on, but health issues relate to present ones.<br /><br />The major exception is history and evolutionary concepts in the sense of their role in generating the amount and general pattern of variation that may (or may not) be functional. Or whether or not meta-analysis is likely to be useful if the samples are from different populations, and things like that.<br /><br />Knowing the role of variation is different from evolutionary reconstructions, except in terms of reconstructing history to understand geographic variation (and why some thalassemia genes are found in Asia, others in Africa, etc.).<br /><br />For short-term evolution, such as strategies to combat parasites and infectio, antibiotic and pesticide resistance and the like, evolution may really be relevant in every respect. There, selection is strong, movement of people and pathogens rapid and on a large scale, etc. We can see it in action on a relevant scale.<br /><br />But this doesn't take away from what I believe is a large, facile amount of untrammeled speculation in the name of Darwin as if it was actually explanatory and relevant to medicine or epidemiology.<br /><br />For example, there is a plethora of studies purporting to relate to reproductive fitness, in the 'evolutionary' context, by analyzing determinants of lifespan and reproduction and grandparenting and so on, in 21st century America. This implied extrapolation really has only to do with family and health structures today, that are demonstrably ephemeral, and has essentially zero relevance to future genomic variation or how today's variation got here. But examples are all over the journal and blogosphere.<br /><br />We have had direct personal experience of blatant censorship in evolutionary medicine, when even responsibly trying to challenge the widespread simplism, as we see it, of this area.<br /><br />Evolution is important in understanding variation, and was important in molding what's here to day. But from a functional point of view, we rarely can know the responsible forces or processes. We may need evolutionary awareness but we don't need a catch-phrase that to me is more about marketing than substance, as it is widely used.<br /><br />But circumspection and tempering of speculation are not good for business these days, and I think we're unlikely to agree on what's simplistic, ideological, or excessive in this area, or what is responsible and cogent. Ken Weisshttps://www.blogger.com/profile/02049713123559138421noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-76339732581845318202013-06-27T10:04:11.866-04:002013-06-27T10:04:11.866-04:00As we say in the post, much biomedical research ha...As we say in the post, much biomedical research has nothing to do with evolution. Which doesn't mean that evolution has nothing to do with biomedicine but that evolutionary theory usually isn't much help. I don't presume to speak for him, but based on his article, it seems that Cournoyea would concur.Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-47907312450484236432013-06-27T09:39:27.760-04:002013-06-27T09:39:27.760-04:00How odd. I have been using Ken's article on Q...How odd. I have been using Ken's article on Quixotic trait loci as one of the best examples of the utility of applying evolution in medicine. If more geneticists took this kind of evolutionary sophisticated view, genomic medicine would be much further along now. Providing physicians with education about evolution is a goal I hope we share. If you see a better way to do it, please share your suggestions so we can learn from you. Anonymoushttps://www.blogger.com/profile/02383002966349671336noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-24626427081987021382013-06-27T08:47:07.816-04:002013-06-27T08:47:07.816-04:00Thanks for weighing in. Perhaps it's a gestal...Thanks for weighing in. Perhaps it's a gestalt thing, but after reviewing the publications you point to in your comment, I stand by our post. Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-4218542708365029072013-06-27T08:01:18.052-04:002013-06-27T08:01:18.052-04:00We'll stick with our original post.
Readers...We'll stick with our original post. <br /><br />Readers who want to see the marketing propaganda for evolutionary medicine can find it all over the web, including the site provided in the foregoing comment.<br /><br />There are also countless articles and a few recent books that provide a responsible, properly circumspect understanding of is known about how evolution actually works. They, however, are not as simplistic, and require more careful attention.<br /><br />Ken Weisshttps://www.blogger.com/profile/02049713123559138421noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-40333660667772962922013-06-26T22:21:59.801-04:002013-06-26T22:21:59.801-04:00Those of us who are working to bring evolutionary ...Those of us who are working to bring evolutionary biology to bear on problems in medicine and public health are unanimous in recognizing that efforts to understand evolutionary reasons for vulnerability to disease are just one of many applications; see my article with Stearns to see where this fits in all 10 categories of applications. Evolutionary medicine is the application of a basic science to medicine in the same way that genetic medicine applies the basic science of genetics. Most of us in evolutionary medicine are all too aware that testing hypotheses about why natural selection has left bodies with traits that make them vulnerable to disease is especially difficult; see my article "Ten Questions for Evolutionary Studies of Disease Vulnerability" for my attempt to help students and others avoid elementary mistakes. Cournoyea ignores this entire literature. He also seems to think that evolutionary medicine claims to offer specific direct clinical recommendations, when most of us in the field have repeatedly emphasized that evolution does not make direct clinical recommendations. It is useful the way other basic sciences are useful...as a foundation for understanding the body and for deriving hypotheses whose testing provides the evidence for making clinical decisions. Of course, there are people who advocate for unsubstantiated ideas, and some who try to derive clinical recommendations directly from theory, but such problems are unfortunately common in many areas of medicine. Examples from evolutionary medicine do not make an argument that evolutionary biology should not be applied to medicine. Instead, they suggest the need for better evolution education for physicians, medical researchers, and philosophers. <br /><br />Global generalizations about evolutionary medicine are not very useful. What is needed, as in all science, is the hard work of considering specific questions and hypotheses, one by one. As for the generalization that evolutionary medicine assumes all traits are adaptations, the very opposite is closer to the truth; an evolutionary view explains why nothing in the body can be perfect and why bodies have plenty of maladaptations (see "Maladaptation and Natural Selection" for details).<br /><br />Those interested in learning more about evolutionary medicine will want to read more at The Evolution and Medicine Review http://evmedreview.com<br />Randolph Nessehttp://randolphnesse.comnoreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-51354516957478894922013-06-15T16:24:08.912-04:002013-06-15T16:24:08.912-04:00Thanks, Michael. It's so nice to have your com...Thanks, Michael. It's so nice to have your comments. I haven't seen the BMC Medicine pieces. Like most adaptationist Just-So stories, belief that we know what explains traits is akin to religion. Funny that we need to follow a paleo-diet and paleo-exercises, but it's okay to fly in planes. Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-15281264645103377672013-06-14T13:38:39.505-04:002013-06-14T13:38:39.505-04:00Anne, thank you for your thoughtful commentary on ...Anne, thank you for your thoughtful commentary on Evolutionary Medicine. It's not easy being critical when there continues to be such enthusiasm for EM. Just yesterday, I was reading an editorial in BMC Medicine about why the time is ripe for translational EM research. In the article, Brüne and Hochberg contend that<br /><br />"questions concerning the causes of sickness and disease cannot be answered without an evolutionary approach. Nor can medicine promote preventive action to help people maintain health without a profound knowledge of gene-environment interactions that were shaped in our distant past." (April 2013, p.1)<br /><br />The editorial serves to preface a small series of articles on EM that "demonstrate how insights from evolutionary theory not only improve our understanding of disease, but offer new ways to diagnose, manage and prevent human ailment." (p.2) After reading these articles, I remain a skeptic about the real value of EM.<br /><br />(You might be interested that a couple of these authors suggest that EvoDevo might influence medicine.)<br /><br />My interest in EM began a few years ago when I overheard a CBC radio program discussing evolutionary exercise (or CrossFit, side dish to the paleo-diet) wherein participants aim to replicate exercises from the Pleistocene. Such models rely on notions of a static or minimally dynamic EEA, emphasizing the mismatch to current lifestyles. Listening to that radio snippet, I couldn't help but think about Buller's critique of EEA (which you mention). It is a critique that I now take for granted. Little did I know that those cursory thoughts about caveman exercise would lead me down a rabbit hole of research.<br /><br />Michaelmichael.cournoyeahttps://www.blogger.com/profile/12422348669457549594noreply@blogger.com