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Evolutionaire geneeskunde

De groei van onze hersenen heeft ons gevoelig gemaakt voor ‘typisch westerse’ ziekten

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Samenvatting

De evolutionaire geneeskunde, ook wel darwinistische geneeskunde, maakt gebruik van kennis van de paleolithische omgeving, genetica, vergelijkende anatomie, bio-geochemie, archeologie, antropologie, (patho)fysiologie en epidemiologie. Het betreft een nog jonge discipline die ziekte en gezondheid tracht te verklaren vanuit onze evolutionaire achtergrond. Deze kennis is belangrijk voor de identificatie van factoren die een rol spelen in onze huidige ongezonde leefstijl. De discipline komt niet zelden in conflict met heersende wetenschappelijke paradigma’s. In de paleolithische tijd (2,5 miljoen tot 10.000 jaar geleden) is ons brein gegroeid van ongeveer 400 naar 1.300–1.400 mL. Deze groei kon slechts plaatsvinden in het land-water ecosysteem, waar overvloedige hoeveelheden ‘hersen-selectieve nutriënten’ samenkomen. Ze omvatten jodium, selenium, ijzer, vitamines A, D en B12, en de visolievetzuren EPA en DHA. Wereldwijd behoren hun tekorten momenteel tot de meest voorkomende deficiënties. Onze uniek grote verhouding tussen hersen- en totaal lichaamsgewicht heeft ons gevoelig gemaakt voor glucosetekorten. Deze dreigen vooral bij hongeren, zwangerschap en infectie. Hiertoe passen we ons energiemetabolisme aan, onder andere door het veroorzaken van insulineresistentie. Onze huidige ongezonde leefstijl wordt gekenmerkt door chronische stress, chronisch slaapgebrek, wanvoeding, onvoldoende fysieke activiteit, abnormale microbiële flora en milieuverontreiniging. Ze brengen ons in een chronische toestand van lage-graad inflammatie, hetgeen leidt tot metabole aanpassingen. Op lange termijn veroorzaken deze aanpassingen het metabool syndroom en de typische welvaartsziekten, zoals diabetes mellitus type 2, hart- en vaatziekten en bepaalde vormen van kanker. Terugkeer naar de paleolithische tijd met behoud van de cultuur van de 21e eeuw is de enige natuurlijke manier om gezond oud te worden.

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Figuur 1

Notes

  1. Allostasis: het proces dat door middel van fysiologische en gedragsveranderingen leidt tot stabiliteit (homeostase). ‘Het behoud van stabiliteit door verandering.’

  2. Hominoïd: lid van de superfamilie Hominoidea, omvattende alle moderne grote mensapen (gorilla’s, chimpansees en orang-oetans) en mensen en een aantal van hun uitgestorven voorouders en verwanten.

  3. Hominid: lid van de familie der Hominidae, omvattende alle moderne en uitgestorven mensen en mensapen en hun directe voorouders.

  4. Homo: lid van het geslacht Homo, omvattende de moderne mensen en enkele van hun uitgestorven vormen.

  5. Homo sapiens: lid van de soort Homo sapiens, waarvan Homo sapiens sapiens de enige nog levende is.

  6. De Na-Cl symporter zorgt in de nieren voor de simultane reabsorptie van Na+ en Cl− in de distale tubuli.

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Muskiet, F.A.J. Evolutionaire geneeskunde. Bijblijven 34, 391–425 (2018). https://doi.org/10.1007/s12414-018-0318-2

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