title: Evolutionary health promotion.
abstract: Health promotion's promise is enormous, but its potential is, as yet, unmatched by accomplishment. Life expectancy increases track more closely with economic prosperity and sanitary engineering than with strictly medical advances. Notable achievements in the past century--the decreased incidences of epidemic infections, dental caries, and stomach cancer--are owed to virologists, dentists, and (probably) refrigeration more than to physicians. Prevention speaks against tobacco abuse with a single voice, but in many other areas contradictory research findings have generated skepticism and even indifference among the general public for whom recommendations are targeted. Health promotion's shortcomings may reflect lack of an overall conceptual framework, a deficiency that might be corrected by adopting evolutionary premises: (1) The human genome was selected in past environments far different from those of the present. (2) Cultural evolution now proceeds too rapidly for genetic accommodation--resulting in dissociation between our genes and our lives. (3) This mismatch between biology and lifestyle fosters development of degenerative diseases. These principles could inform a research agenda and, ultimately, public policy: (1) Better characterize differences between ancient and modern life patterns. (2) Identify which of these affect the development of disease. (3) Integrate epidemiological, mechanistic, and genetic data with evolutionary principles to create an overarching formulation upon which to base persuasive, consistent, and effective recommendations.
authors.affiliation: Department of Anthropology, Emory University, 2887 Howell Mill Road NW, Atlanta, GA 30327, USA. daphne@mindspring.com
authors.forename: S Boyd
authors.initials: SB
authors.lastname: Eaton
authors.forename: Beverly I
authors.initials: BI
authors.lastname: Strassman
authors.forename: Randolph M
authors.initials: RM
authors.lastname: Nesse
authors.forename: James V
authors.initials: JV
authors.lastname: Neel
authors.forename: Paul W
authors.initials: PW
authors.lastname: Ewald
authors.forename: George C
authors.initials: GC
authors.lastname: Williams
authors.forename: Alan B
authors.initials: AB
authors.lastname: Weder
authors.forename: Stanley B
authors.initials: SB
authors.lastname: Eaton
authors.forename: Staffan
authors.initials: S
authors.lastname: Lindeberg
authors.forename: Melvin J
authors.initials: MJ
authors.lastname: Konner
authors.forename: Iver
authors.initials: I
authors.lastname: Mysterud
authors.forename: Loren
authors.initials: L
authors.lastname: Cordain
mesh_terms: D005075:Biological Evolution; D014644:Genetic Variation; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D011315:Preventive Medicine; D011634:Public Health; D014481:United States