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Evolutionary Medicine

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    Why evolutionary medicine?


    Evolution is the organising principle at all levels of life. It therefore makes sense to approach health and wellbeing from an evolutionary perspective - to gain a valid and useful insight into the causes and remedies of modern illness.

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    "Civilisation"


    Agriculture only started a maximum of 600 generations ago - a blink of an eye in evolutionary timescales.


    Our bodies and minds are still essentially hunter-gatherers
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    Mismatch


    Our genome is adapted to thriving in an environment vastly different from how most people live today. The resulting mismatch is at the root of most modern day chronic diseases.


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    In Practice


    The cornerstone of our practice at Urban Fringe is to examine health problems through the lens of evolutionary physiology and psychology.


600 Generations

No more than 600 generations ago, everybody everywhere was a hunter-gatherer, living in small bands of fewer than 50 people.

This is a blink of an eye in evolutionary terms: people 600 generations ago were more or less exactly the same as us, with a handful of very minor variations.

The preceding two million years of evolution as hunting and foraging bipeds is where we became human.

During the past 150 years we have experienced a massive global population boom. This, combined with great advances in medical science, hygiene and economic prosperity has led to much greater life expectancy. The downside of this is the emergence of widespread chronic diseases, particularly in an ageing population. This has become known as the epidemiological transition

crowded boat

Modern diseases associated with mismatch.

Our genome is adapted to survive and thrive in environments that are vastly different to the way we live today. The resulting mismatch may be at the root of most chronic diseases today.

Not every illness listed is always caused by mismatch (and many are hypothesized mismatches)

Most modern diseases are triggered or intensified by environmental factors that have become common since the advent of agriculture and industrialisation.

They are caused or aggravated by our lifestyles that are out of sync with our body’s ancient biology.

  • Anxiety and Depression
  • Alzheimer's disease
  • Asthma
  • Cancers
  • Chronic Fatigue
  • Coronary Heart Disease
  • Crohn's Disease
  • Diabetes
  • Endometriosis
  • Fibromyalgia
  • Gout
  • Hypertension
  • Chronic insomnia
  • IBS
  • Lower back pain
  • Insulin resistance
  • Multiple Sclerosis
  • Myopia
  • OCD
  • Osteoporosis
  • PCOS
  • Stomach ulcers
  • Fatty liver syndrome
  • Haemorrhoids
  • There is no such thing as Optimum Health

    "adaptations evolved to promote health, longevity, and happiness only insofar as these qualities benefit an individual’s ability to have more surviving offspring" Daniel Lieberman: "The Story of the Human Body" 2013

    Human adaptations did not necessarily occur to promote physical or mental wellbeing. Our evolutionary history is complex: we are not specifically adapted for any single environment, habitat, diet or exercise regime.

    Optimum health is a bit of an illusion. Whilst we can all remember a time when we felt better than now, the reality is that we are who we are in the present moment. If we can adapt our own personal environment - including what we do and what we eat, to support our core state, then we stand a much better chance of avoiding the pitfalls of modern ageing. We can also put right many of the conditions that are exacerbated by environmental mismatch.

    It is helpful to see your health and wellbeing as a journey, rather than a destination.


    Evo Physiology

    Physiology is the study of normal function in a living body. From an evolutionary perspective we look at how and why our bodies function like they do and work forwards from that to see what interventions might help to strengthen the core state. In practice, the following checklist represents our main focus of inquiry:

    The story of the human body

    Energy balance: storage and use of nutrients

    Inputs and Interventions

    Lifestyle factors

    How does knowing all of this help?

    An evolutionary perspective helps us to look at the extent to which diseases are caused by mismatches between the environmental conditions (including diet, physical activity, sleep and other factors) in which we evolved, and the environmental conditions that we now experience. By making this connection and applying some common sense lifestyle changes, alongside some remedial interventions where necessary, it is possible to live a long and healthy life.

    Epidemiological Transition

    As more people live longer, more of them are suffering from chronic illness and disability.