{"id":32555,"date":"2021-04-16T20:55:31","date_gmt":"2021-04-17T00:55:31","guid":{"rendered":"https:\/\/www.shortform.com\/blog\/?p=32555"},"modified":"2021-04-23T14:20:23","modified_gmt":"2021-04-23T18:20:23","slug":"why-do-we-get-sick","status":"publish","type":"post","link":"https:\/\/www.shortform.com\/blog\/why-do-we-get-sick\/","title":{"rendered":"Why Do We Get Sick? Our Bodies Make Compromises"},"content":{"rendered":"\n

Why hasn’t evolution prevented sickness and disease? How can Darwinian medicine explain why we get sick?<\/p>\n\n\n\n

The reason we still get sickness and disease despite evolution is that the body must make careful compromises. Sometimes, the thing that causes a disease is or was helpful to us at some point in time. <\/p>\n\n\n\n

Continue reading to learn why we get sick despite evolutionary advances. <\/p>\n\n\n\n\n\n\n\n

Why Haven\u2019t We Evolved Disease Away?<\/strong><\/h2>\n\n\n\n

After millions of years of evolution, why do our bodies still seem so flawed? Why do we get sick<\/a> at all? Why hasn\u2019t natural selection<\/a> prevented heart attacks, nearsightedness, and Alzheimer\u2019s disease?<\/p>\n\n\n\n

The common answer is that \u201cnatural selection isn\u2019t powerful enough to get rid of disease.\u201d This is usually the wrong idea. <\/p>\n\n\n\n

Instead, it\u2019s important to realize that the body is a bundle of careful compromises<\/strong>. The reason we have diseases today is that the very things that cause disease were helpful for us at one point, or are still helpful for us in certain situations. In this way, evolutionary medicine<\/a> seeks to understand why<\/em> we have disease.<\/p>\n\n\n\n

In thinking about disease, it\u2019s important to distinguish between proximate causes <\/strong>and evolutionary causes<\/strong> of disease. <\/p>\n\n\n\n

Proximate and Evolutionary Causes of Sickness<\/h3>\n\n\n\n
  • Proximate questions ask \u201cwhat caused the disease? How did the disease start and progress?\u201d For heart attacks, the proximate cause is atherosclerosis, and its associated causes like high blood pressure and cholesterol. <\/li>
  • Evolutionary questions ask, \u201cwhy <\/em>hasn\u2019t natural selection eliminated the genes that lead to heart disease? Why hasn\u2019t it eliminated our craving for fatty foods and for overeating?\u201d<\/li><\/ul>\n\n\n\n

    In Darwinian medicine, evolutionary explanations of disease require explaining more than just the current function – they should explain aspects of the evolutionary adaptation that leads to the disease:<\/p>\n\n\n\n

    1. how the adaptation gives an advantage<\/li>
    2. why lacking this adaptation causes a disadvantage<\/li>
    3. what was gradually shaped by natural selection to arrive at the current form<\/li><\/ol>\n\n\n\n

      Evolutionary medicine is not just philosophizing. It\u2019s also useful in predicting what to expect  when treating disease. For example, infections usually cause low iron levels. The proximate viewpoint would suggest that giving iron as a treatment is an obvious choice. However, the evolutionary viewpoint would question, \u201cis lower iron perhaps a defense against infection? Perhaps the body has adapted to lower iron during an infection, because it helps fight the infection? If this is true, wouldn\u2019t giving iron actually worsen<\/em> the infection?\u201d<\/p>\n\n\n\n

      Reasons We Get Sick<\/h3>\n\n\n\n

      This still doesn\u2019t completely answer the question. If natural selection is so powerful, then why do we still<\/em> get sick?<\/strong> There are a range of causes:<\/p>\n\n\n\n

      • Defenses confused as disease<\/strong>
        • Many defenses during disease seem like diseases themselves. A common one is a cough, which is often confused as a cause of disease, when it\u2019s actually a defense mechanism.<\/li>
        • If you incorrectly believe a defense is a disease and you treat it, you can cause catastrophic damage.<\/li><\/ul><\/li>
        • Infection<\/strong>
          • These are external agents like bacteria and viruses that cause disease. We\u2019ve adapted defenses to them, but they continuously adapt to our defenses. It\u2019s an ever-lasting arms race.<\/li><\/ul><\/li>
          • Novel environments<\/strong>
            • We evolved over millions of years living in small hunter-gatherer tribes on the plains of Africa. Today, we live in a world of constantly available food, cars, dense cities, and artificial lights. Our bodies did not evolve for this environment, and these new environments can cause diseases that were uncommon in our prehistoric past.<\/li><\/ul><\/li>
            • Genes<\/strong>
              • Genes that cause severe damage are selected against by natural selection. Therefore, defective genes with no compensating benefit are usually not a common cause of disease.<\/li>
              • Many genes confer a benefit in a more natural environment but now cause disease in today\u2019s modern novel environment. For example, genes that predispose to heart disease were likely once useful when humans could barely scavenge enough to eat, but they\u2019re harmful in today\u2019s age.<\/li><\/ul><\/li>
              • Design compromises<\/strong>
                • A disease-causing gene viewed in isolation may seem like an odd weakness, but this ignores the bigger picture of how there might be coinciding benefits. Walking upright tends to cause back problems, but it allowed humans to carry food and babies.<\/li><\/ul><\/li>
                • Evolutionary legacies<\/strong>
                  • Evolution is incremental and path-dependent, meaning some setups are legacies from previous evolution. For example, the esophagus and trachea have the same orifice input, which predisposes people to choking.<\/li><\/ul><\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"

                    Why hasn’t evolution prevented sickness and disease? How can Darwinian medicine explain why we get sick? The reason we still get sickness and disease despite evolution is that the body must make careful compromises. Sometimes, the thing that causes a disease is or was helpful to us at some point in time. Continue reading to learn why we get sick despite evolutionary advances.<\/p>\n","protected":false},"author":8,"featured_media":32562,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[16,160],"tags":[265],"class_list":["post-32555","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-science","tag-why-we-get-sick","","tg-column-two"],"yoast_head":"\nWhy Do We Get Sick? 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