Last night I was attending a social event. A couple of hours after I had arrived at the scene of the event, I got to talking with a friend of mine about Darwinian/evolutionary medicine. Just like so many others, she knows little to nothing about Darwin, the evolution of the human diet, or evolutionary science and doesn’t – or at least didn’t, until our talk – have a good understanding of how Darwinian medicine differs from conventional medicine. She had accumulated or created some mental conceptions of what Darwinian/evolutionary medicine is though, some of which she shared with me. Not surprisingly, I found that some of the conceptions were misconceptions, as opposed to ideas that are rooted in reality. I told her so and we ended up having an interesting talk in which I got to debunk some myths.
A lot of people have never heard about Darwinian medicine; hence, there aren’t that many misconceptions about this emerging medical discipline floating around. There are some though. In today’s article I thought I’d talk about 6 misconceptions that I’ve gotten the impression are fairly common, so as to clear up some confusion and set the record straight.
1. Darwinian medicine is exclusively a theoretical discipline. It’s of little practical value in clinical settings
My impression is that pretty much everyone who’s involved in the emerging field of Darwinian medicine acknowledges that evolutionary theory can help us make sense of why diseases exist. Not everyone recognizes the full potential of Darwinian medicine though. Some people seem to hold the belief that practicing physicians have little to gain from incorporating Darwinian concepts and theories into their clinical practice. I’m definitely not one of those people. I think Darwinian medicine has a lot to offer practicing health professionals. I would go as far as to say that Darwinian medicine has the power to completely revolutionize the way we practice medicine.
It’s certainly true that Darwinian medicine is heavy on theory; however, it’s important to note that much of this theory can be translated into practical applications. By understanding why organisms are designed the way they are and why diseases exist, we can put two and two together and make sense of what it takes to build a healthy, robust human and how to best go about preventing and treating disease. Evolutionary science doesn’t necessarily provide us with clear-cut, definite answers to all of the medical questions we’re looking to answer; however, it does provide us with a framework that we can use to make sense of health and medicine.
2. Darwinian medicine bears a lot of resemblance to functional medicine
I’ve gotten the impression that some people think that Darwinian medicine and functional medicine are joined at the hip and are very similar disciplines. That’s not true. The fact is that Darwinian medicine doesn’t have that much in common with functional medicine. The two differ markedly in the way they approach health and disease. Whereas the primary focus in Darwinian medicine is on elucidating the underlying reasons as to why organisms are vulnerable to disease and understanding, preventing, and treating disease via the use of evolutionary principles, much of the focus in functional medicine is on customizing medical treatments to each individual patient.
Many functional medicine practitioners carry out a range of tests – food sensitivity tests, fecal microbiome analyses, and so forth – in order to elucidate what’s wrong with their patients. Some also seem to operate under the belief that each patient case is completely unique with respects to its etiological and pathological features. Darwinian medicine practitioners view health and medicine somewhat differently. They tend not to focus so much on what makes X patient unique (this is not to say that they don’t care about their patients or customize treatment plans), but rather look for the commonalities that exist between organisms – whether it be single organisms, populations, species, or all organisms – with respects to their compositional structures and disease vulnerabilities and address the evolutionary causes that underlie the development of disease.
It’s certainly possible for a health practitioner to employ principles of both Darwinian and functional medicine in his or her work; however, it’s important to be aware of the fact that the two disciplines differ markedly from each other. Actually, many of the fundamental principles of Darwinian medicine conflict with principles of functional medicine.
3. Darwinian medicine is unforgiving and brutal. Only organisms that are “fit” should be allowed to survive and reproduce
I don’t know if this is a common misconception about Darwinian medicine; however, I chose to include it in the list nonetheless, as the friend of mine I talked about at the beginning of the article seemed to be under the belief that Darwin brings a lot of brutality and ruthlessness to medicine. Moreover, I know a lot of people associate Darwin with the term “survival of the fittest”, despite the fact that it wasn’t actually Darwin who coined that term, but rather the British philosopher Herbert Spencer. Darwin did include the phrase in some of his books though. Moreover, he did come up with the idea of natural selection; hence, it’s not surprising that a lot of people associate the phrase with him.
What’s important to say is that the fact that fitness is integral to evolution doesn’t by any means mean that Darwinian physicians operate under the belief that we should just let nature run its course and not intervene and help sick organisms get better. Those ideas conflict with many of the most fundamental tenets of medicine. Medicine would be a redundant discipline if “survival of the fittest” was a principle everyone lived by.
The purpose of Darwinian medicine is obviously not to “trim” the human gene pool. Rather, the purpose is to elucidate the causes of disease, as well as prevent and treat disease, via the use of evolutionary science. The fact that Darwinian selection favors organisms that are well-adapted to their environment over those that aren’t is a very powerful piece of information, in the sense that it can help us make sense of why the world looks as it does and why organisms behave the way they do. It does not, however, imply that we shouldn’t intervene when organisms get sick.
4. Health doesn’t matter in evolution; hence, we can’t learn much about health or disease from looking back at the billions of years of evolution that sculpted the organisms that live on this planet
Some people seem to be under the belief that health is inconsequential in evolutionary processes. Nothing could be further from the truth. It’s certainly correct that fitness, not health, is what natural selection is concerned about; however, as I’ve pointed out before on the site, organismal fitness is closely linked with organismal health. Sick, weak, and/or fragile organisms obviously tend to be less fit than organisms that are robust and healthy. This is particularly true when talking about organisms that live in natural environments.
With that said, one shouldn’t automatically assume that health and fitness goes hand in hand. Natural selection will favor alleles that are beneficial fitness wise even if they are detrimental health wise. Also, it’s important to remember to consider life history theory when examining why organisms function the way they do and are susceptible to different diseases at different life stages.
5. Darwinian medicine is an “alternative” form of medicine that can be grouped together with Ayurveda, aromatherapy, acupuncture, and other similar disciplines
I don’t claim to know a lot about alternative forms of medicine such as homeopathy or acupuncture. I have some preconceived ideas about such disciplines, but seeing as I don’t know a lot about them, I will refrain from speaking my mind. With that said, I would like to point out that Darwinian/evolutionary medicine has absolutely nothing in common with herbal medicine, homeopathy, or other similar forms of alternative medicine. I don’t have the impression that a lot of people think it does; however, I feel it’s important to point out nonetheless, as I know some close-minded people are prone to lump everything that isn’t 100% mainstream into the “alternative” category.
The thing that most clearly separates Darwinian medicine from other medical disciplines is its unique and diverse scientific infrastructure. A wealth of scientific evidence supports the fundamental principles of Darwinian medicine. Not only have the basic tenets of this emerging medical discipline been validated by experimental studies, but they are also supported by well-established principles of evolutionary biology and ecology. If you disagree with the basic principles of Darwinian medicine, you’re basically saying that you don’t believe that organisms evolve over time in response to environmental pressures or that humans are a part of a larger biotic ecosystem, which is completely ludicrous to think in this day and age, given that numerous studies have validated the fundamental principles upon which the field of biology is built.
I would argue that the scientific backbone of Darwinian medicine is a lot stronger and more robust than the scientific backbone of not only alternative medical disciplines such as osteopathy, but also that of conventional medicine. If you read through my articles here on the site, I think you may find that you come to the same conclusion. This is not to say that no other medical principles beside those that are a part of Darwinian medicine are supported by good science. All I’m saying is that Darwinian medicine differs markedly from other medical disciplines with respects to its scientific basis.
6. Diet and lifestyle interventions are the sole focus of Darwinian medicine in the context of clinical practice
There’s no doubt that one can prevent and treat a lot of disease by bringing evolution-based diet and lifestyle interventions into clinical medicine. With that said, the practical applications of Darwinian theories to clinical medicine don’t stop there. Far from it. Evolutionary theories and concepts are useful in many medical settings and in the treatment of many different types of medical disorders, including conditions that manifest themselves physically in the form of for example diarrhea, depression, or nausea.
Moreover, evolutionary theory can help us answer a wide range of medical-related health problems. For example, evolutionary science can help us make sense of why and how antibiotic resistance develops and what we can do to combat the superbugs that we have created via our indiscriminate use of antimicrobial substances in clinical medicine and agriculture.