Control theory for Evolutionary Medicine

Control theory for Evolutionary Medicine

“Evolutionary Medicine Needs Engineering Expertise”
by Randolph M Nesse,
The National Academy of Engineering “Perspectives.”

“Engineering has made vast contributions to health and medicine, from designing water and sewer systems that have saved millions of lives to optimizing healthcare delivery systems and creating ever more sophisticated medical devices. New applications of evolutionary biology to medicine are now giving rise to new opportunities for engineering to enhance understanding of disease. Projects that bring engineering expertise to bear on the questions addressed by evolutionary medicine promise major advances.

What Is Evolutionary Medicine?

Evolutionary medicine is the field that uses the principles of evolutionary biology to better understand, prevent, and treat disease. Medicine has made great progress by viewing the body from a mechanic’s point of view—asking how it works, what has gone wrong, and how to fix it. Evolutionary medicine adds an engineer’s point of view by also asking why natural selection left so many aspects of the body vulnerable to disease.

Naïve attempts to answer such questions sometimes suggest that diseases like cancer, schizophrenia, and diabetes somehow give advantages, but such explanations are almost always wrong. Diseases are not adaptations shaped by natural selection, so they do not have direct evolutionary explanations.

The correct objects of evolutionary explanation are traits that leave humans vulnerable to diseases and problems. Why is the windpipe located where food can block it? Why is the birth passage obstructed by a narrow ring of bone? Why hasn’t natural selection provided better protection against infection? Can an answer to that question help to explain the prevalence of excessive inflammation that causes autoimmune diseases, atherosclerosis, and Alzheimer’s disease? Why are pain, anxiety, and depression often excessive? Why are people vulnerable to obesity, eating disorders, and addiction? And why hasn’t natural selection provided better protection against cancer?

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New commentaries in EMPH

New commentaries in EMPH


Five reasons COVID-19 is less severe in younger age-groups 

Paul W TurkeEvolution, Medicine, and Public Health, Volume 9, Issue 1, 2021, Pages 113–117,

Conflicts over calcium and the treatment of COVID-19 

Bernard CrespiJoe AlcockEvolution, Medicine, and Public Health, Volume 9, Issue 1, 2021, Pages 149–156,

An evolutionary mismatch narrative to improve lifestyle medicine: a patient education hypothesis 

Anthony J BasileMichael W RennerBrandon H HidakaKaren L SweazeaEvolution, Medicine, and Public Health, Volume 9, Issue 1, 2021, eoab010,

Did giraffe cardiovascular evolution solve the problem of heart failure with preserved ejection fraction? 

Barbara Natterson-HorowitzBasil M BaccoucheJennifer Mary HeadTejas ShivkumarMads Frost Bertelsen …Evolution, Medicine, and Public Health, Volume 9, Issue 1, 2021, Pages 248–255,

Club EvMed for October

Club EvMed for October

Club EvMed: How evolutionary behavioural sciences can help us understand behaviour in a pandemic

Thursday, October 14th at 11am EDT/17:00 CEST

Join us for a conversation with Ruth Mace, Professor of Evolutionary Anthropology at University College London, Emily Emmott, Lecturer in Anthropology at University College London, and Gul Deniz Salali, Lecturer in Evolutionary Anthropology at University College London. Prof. Mace will outline the main conclusions from taking a behavioural ecological approach to understanding the diversity of responses to behavioural responses to the COVID-19 pandemic. Dr. Emmott will outline her research on how the pandemic disrupted social networks, focusing on mothers of young babies and the risk of depression. Dr. Salali will present the findings from her ongoing project that tackles vaccine hesitancy (a delay in acceptance or refusal of vaccines) using predictions from cultural evolution theory.

Attendees are encouraged to read Arnot et al. 2020, “How evolutionary behavioural sciences can help us understand behaviour in a pandemic,” Myers and Emmott 2021, “Communication across maternal social networks during England’s first national lockdown and its association with postnatal depressive symptoms,” and Salali and Uysal 2021, “Effective incentives for increasing COVID-19 vaccine uptake.” Sign up here for the meeting link:

Club EvMed: Evolutionary demography sheds light on the allelic spectrum of late-onset diseases

Thursday, October 21st at 1pm EDT/19:00 CEST

Join us for a conversation with Samuel Pavard, Associate Professor at the National Museum of Natural History in Paris, France, and Christophe Coste, Researcher at the Norwegian University of Science and Technology. Geneticists have long considered alleles involved in post-menopause mortality to be neutral as no reproduction occurs anymore. Population genetics models have predicted that genetic drift rather than purifying selection was shaping the allelic spectrum of late-onset diseases, leading to a few common variants explaining most of the diseases’ prevalences. However, recent association studies show that most susceptibility alleles to late onset diseases have low frequencies: a characteristic of alleles under negative selection. We show that susceptibility alleles to late onset diseases are under purifying selection for most known age-at-onset distributions of late-onset genetic diseases. We conclude that neutrality is probably the exception among alleles that have a deleterious effect in old age and that accounting for sociocultural factors is required to understand the full extent of the force of selection shaping senescence in humans.

Attendees are encouraged to read Pavard and Coste 2021, “Evolutionary demographic models reveal the strength of purifying selection on susceptibility alleles to late-onset diseases.” Sign up here for the meeting link:

New commentaries in EMPH

EMPH Emphasis: Williams Prize, 48 Clinical Briefs, and higher impact factor

Evolution Medicine and Public Health has now published 48 Clinical Briefs, now all conveniently listed together for easy access. Each one provides a single page about how an evolutionary view illuminates a clinical condition.

Renee Hagen

The best article in the journal each year receives the $5000 Williams Prize. This year’s prize is for an article by Renee Hagen and Brooke Scelza “Adoption of outgroup norms provides evidence for social transmission in perinatal care practices among rural Namibian women” 

Submit your article now!

EMPH is an open access journal published by Oxford University Press that is edited by Charles Nunn. Under his editorship the journal impact factor has just increased to 5.425.

Club EvMed June 29

Club EvMed: Of Mice and Elephants: Trade-Offs of Tumor Suppressor Duplication and Body Size Evolution in Afrotheria

Tuesday, June 29th at 12pm EDT/18:00 CEST

Join us for a conversation with Juan Manuel Vazquez, Postdoctoral Scholar at the University of California-Berkeley. Peto’s Paradox describes the observation that while cancer risk is correlated with body size and lifespan within species, no such correlation holds between species. This indicates that large, long-lived species have evolved enhanced cancer protection mechanisms, and that these mechanisms may be used to treat and even prevent human cancers, and extend the human healthspan. The recent expansion of body size in elephants relative to other members of their resident clade of Afrotheria led us to explore how both body size and lifespan evolved in this group. Unexpectedly, we found that tumor suppressor duplication was pervasive in Afrotherian genomes, rather than restricted to Proboscideans. Proboscideans, however, have duplicates in unique pathways that may underlie some aspects of their remarkable anti-cancer cell biology. These data suggest that duplication of tumor suppressor genes facilitated the evolution of increased body size by compensating for decreasing intrinsic cancer risk. In our talk, we will begin with a summary of these findings, then move on to a discussion of the implications of tumor suppressor duplicates in the development and fitness of various animals, and of a new paradox: how can an organism’s body size expand given enhanced genetic shackles on growth?

Attendees are encouraged to read Vazquez and Lynch 2021, “Pervasive duplication of tumor suppressors in Afrotherians during the evolution of large bodies and reduced cancer risk” and García-Cao et al. 2002, “‘Super p53’ mice exhibit enhanced DNA damage response, are tumor resistant and age normally.” Sign up here for the meeting link:

The Price of Optimism

The Price of Optimism

Gassen, J., Nowak, T. J., Henderson, A. D., Weaver, S. P., Baker, E. J., & Muehlenbein, M. P. (2021). Unrealistic Optimism and Risk for COVID-19 Disease. Frontiers in Psychology, 12, 647461.

Risk perception and consequently engagement in behaviors to avoid illness often do not match actual risk of infection, morbidity, and mortality. Unrealistic optimism occurs when individuals falsely believe that their personal outcomes will be more favorable than others’ in the same risk category. Natural selection could favor overconfidence if its benefits, such as psychological resilience, outweigh its costs. However, just because optimism biases may have offered fitness advantages in our evolutionary past does not mean that they are always optimal. The current project examined relationships among personal risk for severe COVID-19, risk perceptions, and preventative behaviors. We predicted that those with higher risk of severe COVID-19 would exhibit unrealistic optimism and behave in ways inconsistent with their elevated risk of morbidity and mortality. See link for full article