Curmudgeonalia
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June 7, 2008

Survival of the Sickest

The Surprising Connections Between Disease and Longevity
Dr. Sharon Moalem – ISBN – 9780060889661

Talk about fascinating! This work is at once deeply enlightening and a pleasure to read. He has a wholly unique manner of writing: refreshing, almost lilting, and in some ways similar to Bill Bryson in that it is entertaining while immensely informative. His creative metaphors clearly stem from a vast knowledge base outside of medicine. He makes clear—that is: MAKES CLEAR—that which he is explaining with a wry, inviting humor.

He begins by noting several well known and common genetic aberrations which, while they may kill, are proven to assist in survival. Examples are Hemochromatosis (an iron storage disease) common in European peoples, which provides protection against Plague, and Sickle Cell Anemia in blacks from Africa, as well as Thallasemia, a variant found in Mediterranean Europe, both of which protect against Malaria. Diabetes itself is demonstrably protective against cold (read ice-age.)

One might wonder why diseases which kill are so common. The answer: for the most part they do not kill the young. Rather, they defer their complications until individuals are past the reproductive period of early adulthood, thus assisting in the survival of the race.

When he has your undivided attention he proceeds to cholesterol, and its provision of the substrate for Vitamin D, noting (not so) humorously that when the Australians began a campaign to slather themselves with UV sun blocking creams, the incidence of Avitaminosis D skyrocketed. Less skin cancer, more rickets anyone? As well, he emphasizes that one’s ancestral climate is paramount. African Americans, for instance, are twenty to forty times less likely to develop melanomas. Where our ancestors came from, and how they adapted, is important to us; many of the current problems are related to the incredible mobility of moderns, appearing all over the planet in environments for which they are unsuited by genetics.

Further, regarding cholesterol, he observes that one might be able to reduce cholesterol by getting sufficient sunlight to covert the excess to Vitamin D. “Wouldn’t you rather hit the tanning salon before starting a lifetime of Lipitor? That’s food for thought.”

Researchers observe that we consume 5-10,000 natural toxins annually, and that 20 percent of cancer-related deaths are caused by ingredients commonly in our diet. So . . . why don’t we evolve mechanisms to ablate these toxins? The short answer is that we have, we do, and we will continue. He then explains.

He advances varietal discussions of infectious agents, embellishing some of the observations in Good Germs, Bad Germs, just reviewed. He concludes that if we worked at it we might just find ways for the good germs to survive in healthy individuals, protecting them against the bad guys.

The discussion of host/parasite relationships is expository and well done, emphasizing for instance, that malaria keeps one bedridden so that mosquitoes are able to feed easily, while the common cold permits you to go to work where you can more easily spread the goodies.

Finally, in later chapters, he notes that the genetic makeup affects an individual’s response to “a given drug” is now being recognized as demanding of “personalized medicine,” tailored to need and genome. He also emphasizes the “dangerous antibiotic arms race,” suggesting that, instead we should be looking at vectors which bring diseases and see how we can either avoid them or alter their behavior. While we may be outmatched by their ability to respond to varietal conditions, we are smarter.

I was especially fascinated by his discussion of DNA/RNA. For years we have “known” that only about 3% of our DNA matters, the rest is “junk stuff” carried over from the evolutionary process. Not so, it is now realized. Much of is not junk, but critical to our health, and much of it is now presumed to be viral materials incorporated in the evolutionary process millions of years ago, without which we could not survive. As well he delves into generational genomic discoveries which stand the world of genetics on its ear. The genome is not just passed along with rare change, but is dynamic, ongoing, and is even influenced by nurture.

He concludes: “I hope that you’ll come away from this book with an appreciation of three things. First, that life is in a constant state of creation. Evolution isn’t over—it’s all around you, changing as we go. Second, that nothing in our world exists in isolation. We—meaning humans and animals and plants and microbes and everything else—are all evolving together. Third, that our relationship with disease is often much more complex than we have previously realized.

Great Read!

Posted by respeto at June 7, 2008 11:55 AM