Genotype, obesity and cardiovascular disease--has technical and social advancement outstripped evolution?
Teleologically, our ancestors were highly adapted hunter-gatherers. In recent history, the environment in which Homo sapiens exists has altered drastically and humans are exposed to environments for which the hunter-gatherer genotype is ill-suited. The adoption of a sedentary Western lifestyle, and the case of obtaining food of a high calorific content imposed upon a thrifty genotype, have resulted in the current global epidemic of obesity, Type 2 diabetes and the Metabolic Syndrome. The ramification of this epidemic is that cardiovascular disease is becoming a global healthcare problem, which will have its greatest impact on the developing nations. A global strategy is required to reduce the impact of the Western lifestyle on the health of developing nations and prevent obesity and Type 2 diabetes. Such an approach needs to be culturally sensitive, integrated, and multidisciplinary and involve a range of interventions that work at the individual and community levels. If lifestyle measures fail, then pharmacological intervention may be necessary. For this, novel agents such as dual PPARalpha/gamma agonists may be the therapy of the future.
Zimmet
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International Diabetes Institute, Caulfield, Victoria, Australia. pzimmet@idi.org.au
Thomas
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CR
D000222:Adaptation, Physiological; D000273:Adipose Tissue / Q000503:physiopathology; D000818:Animals; D005075:Biological Evolution; D002318:Cardiovascular Diseases / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology; D004195:Disease Models, Animal; D005838:Genotype; D005849:Gerbillinae; D006801:Humans; D008019:Life Style; D013677:Medical Laboratory Science; D024821:Metabolic Syndrome / Q000208:ethnology / Q000209:etiology / Q000628:therapy; D009765:Obesity / Q000209:etiology* / Q000628:therapy; D051381:Rats; D018160:Receptors, Cytoplasmic and Nuclear / Q000502:physiology; D012931:Social Environment; D014157:Transcription Factors / Q000502:physiology
D018160:Receptors, Cytoplasmic and Nuclear; D014157:Transcription Factors