The global nutrition transition, which embraces major changes in how food is produced, distributed and consumed, is associated with rapid increases in the prevalence of obesity, but the implications for diabetes differ between populations. A simple conceptual model treats diabetes risk as the function of two interacting traits: ‘metabolic capacity,’ which promotes glucose homeostasis, and ‘metabolic load’, which challenges glucose homoeostasis. Population variability in diabetes prevalence is consistent with this conceptual model, indicating that the effect of obesity varies by ethnicity. Evolutionary life history theory can help explain why variability in metabolic capacity and metabolic load emerges. At the species level (hominin evolution), across human populations and within individual life courses, phenotypic variability emerges under selective pressure to maximise reproductive fitness rather than metabolic health. Those exposed to adverse environments may express or develop several metabolic traits that are individually beneficial for reproductive fitness, but which cumulatively increase diabetes risk. Public health interventions can help promote metabolic capacity, but there are limits to the benefits that can emerge within a single generation. This means that efforts to curb metabolic load (obesity, unhealthy lifestyles) must remain at the forefront of diabetes prevention. Such efforts should go beyond individuals and target the broader food system and socioeconomic factors, in order to maximise their efficacy.
Table of Contents
What you do with your fork impacts everything | Mark Hyman | TEDxChicago
What is the best diet for humans? | Eran Segal | TEDxRuppin
Microbiome: Gut Bugs and You | Warren Peters | TEDxLaSierraUniversity
Why is the Science of Nutrition Ignored in Medicine? | T. Colin Campbell | TEDxCornellUniversity
The food we were born to eat: John McDougall at TEDxFremont
Debunking the paleo diet | Christina Warinner | TEDxOU
Sugar — the elephant in the kitchen: Robert Lustig at TEDxBermuda 2013 Read More
Adjaye-Gbewonyo, K., & Vaughan, M. (2019). Reframing NCDs? An analysis of current debates. Global health action, 12(1), 1641043. doi:10.1080/16549716.2019.1641043
There have been many debates in recent years as to whether the communicable disease versus non-communicable disease (NCD) division is a meaningful one in disease classification. Several critiques have been raised about the framing of NCDs, regarding not only the prominent role that infections play in the aetiology of NCDs, but also the communicability of many social determinants of NCDs and the individualistic, ‘lifestyle’ framing of NCDs that tends to focus on health behaviours to the neglect of socio-political, environmental, and structural determinants of health. In this paper, we give a historical overview of the usage of the NCD terminology and analyse some of the recent debates regarding the naming and framing of NCDs. We argue that a lack of reflection on the assumptions underlying the naming and framing of NCDs may lead to the collection of insufficient epidemiological data, the development of inappropriate interventions and the provision of inadequate care. Work in social epidemiology, health promotion, medical anthropology, demography, and other fields may provide insights into the ways in which efforts targeting NCDs may be reframed to improve impact and efficacy. In addition, concepts such as multimorbidity and syndemics, frameworks such as ecosocial theory and approaches based in the social sciences may provide a way forward in the conceptualization of disease.
Atzil, S., Gao, W., Fradkin, I., & Barrett, L. F. (2018). Growing a social brain. Nature Human Behaviour, 2(9), 624-636. doi:10.1038/s41562-018-0384-6
It has long been assumed that social animals, such as humans, are born with a brain system that has evolved to support social affiliation. However, the evidence does not necessarily support this assumption. Alternatively, social animals can be defined as those who cannot survive alone and rely on members from their group to regulate their ongoing physiology (or allostasis). The rather simple evolutionary constraint of social dependency for survival can be sufficient to make the social environment vitally salient, and to provide the ultimate driving force for socially crafted brain development and learning. In this Perspective, we propose a framework for sociality and specify a set of hypotheses on the mechanisms of social development and underlying neural systems. The theoretical shift proposed here implies that profound human characteristics, including but not limited to sociality, are acquired at an early age, while social interactions provide key wiring instructions that determine brain development.
Kirmayer, L. J., & Gomez-Carrillo, A. (2019). Agency, embodiment and enactment in psychosomatic theory and practice. Med Humanit, 45(2), 169-182. doi:10.1136/medhum-2018-011618
In this paper, we examine some of the conceptual, pragmatic and moral dilemmas intrinsic to psychosomatic explanation in medicine, psychiatry and psychology. Psychosomatic explanation invokes a social grey zone in which ambiguities and conflicts about agency, causality and moral responsibility abound. This conflict reflects the deep-seated dualism in Western ontology and concepts of personhood that plays out in psychosomatic research, theory and practice. Illnesses that are seen as psychologically mediated tend also to be viewed as less real or legitimate. New forms of this dualism are evident in philosophical attacks on Engel’s biopsychosocial approach, which was a mainstay of earlier psychosomatic theory, and in the recent Research Domain Criteria research programme of the US National institute of Mental Health which opts for exclusively biological modes of explanation of illness. We use the example of resignation syndrome among refugee children in Sweden to show how efforts to account for such medically unexplained symptoms raise problems of the ascription of agency. We argue for an integrative multilevel approach that builds on recent work in embodied and enactive cognitive science. On this view, agency can have many fine gradations that emerge through looping effects that link neurophenomenology, narrative practices and cultural affordances in particular social contexts. This multilevel ecosocial view points the way towards a renewed biopsychosocial approach in training and clinical practice that can advance person-centred medicine and psychiatry.
Obesity is still increasing in prevalence in almost all countries and is an important risk factor for poor health and mortality. The current approach to obesity prevention is failing despite many piecemeal efforts, recommendations, and calls to action. This Commission following on from two Lancet Series on obesity looks at obesity in a much wider context of common underlying societal and political drivers for malnutrition in all its forms and climate change. The Commission urges a radical rethink of business models, food systems, civil society involvement, and national and international governance to address The Global Syndemic of Obesity, Undernutrition, and Climate Change. A holistic effort to reorient human systems to achieve better human and planetary health is our most important and urgent challenge.
Purpose of the review Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues.
Recent findings Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior.
Summary The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
Keywords Total environment . Social determinants . Cumulative exposures . Life course . Health disparities
Discover how we can restore our health by restoring our soil. Zach Bush, triple-board certified MD, makes brilliant big picture connections between current commercial farming practices, gut health, and the meteoric rise of disease since the introduction of glyphosate—a powerful herbicide and antibiotic used in big agriculture.
“Evolutionary research has confirmed that all complex organisms emanate from cellular roots. Further, too, all reiterate through a single cell stage for reproduction. Despite outward appearances, every complex organism remains perpetually attached to an inherent cellular narrative as an intimate co-alignment of mixed cellular ecological units. We are cellular beings, and ever remain thus. Our range of unique human behaviors are therefore derivative, whether manifested as impulsive risk taking or artistic expression. All such human endeavors are our means of exploring a catalogue of necessary information within an obligatory circumstance in which the information upon which we must rely is always equivocal.
Yet, within this complexity, there is hidden unity. Our illusion of singularity depends on the transitory but inseparable conjoining cohesion of all our linked cellular ecologies. And from this emanates the largest Truth: we and the environment are entwined self-similarities. The environment that matters most is not without, it is embedded within our own natural being. And our only sure Truth is our own impermanent and ambiguous transit through this intimate and reciprocating dimension.
Why then is life full of deceptions? At all points in time and for every organism within the informational system that biology represents, the predominating driver is not just access to information, but an active assessment of its inherently equivocal context and quality. Biology’s continuous drama is the struggle to settle a range of unknowns into forms of information that are discretely recognizable as secure. Those actions that sustain us must always travel along that path. It is our simple plight that nothing need be as it seems and, in consequence, our survival is an unceasing battle to overcome inherent untruth.”
Zach Bush, MD is a triple board certified physician specializing in Internal Medicine, Endocrinology and Metabolism, as well as in Hospice and Palliative care. The director of M Clinic in Virginia, Dr. Bush has published peer-reviewed articles and book chapters in the areas of infectious disease, endocrinology, and cancer.
This is a mind-blowing conversation that explores new insights into the mechanisms behind human health and longevity. It’s about the massive and misunderstood impact of industrial farming, chemical pesticides, the pharmaceutical industry and even errant Western medical practices have on both human and planetary health.
It’s a conversation about the difference between the science of disease and the science of health. It’s about the microbiome as a critical predictor of and protector against illness. And it’s an exploration of autism, epigenetics and the mechanics of intercellular communication..
This new edition of the iconic IUBMB-Nicholson Metabolic Pathways Chart brings increased functionality to a canonical tool. Now, all metabolites, enzymes, and selected pathways are searchable and interactive. The “backbone” of the map is the Glycolytic Pathway followed by the TCA (Krebs) Cycle and the Respiratory Chain which together lead to the synthesis of ATP by ATP Synthase. ATP is the source of most of the energy required for all life. Many biosynthetic and breakdown pathways of metabolism such as carbohydrates, amino acids, lipids are associated with this backbone and are differentiated by the use of color. Human metabolism is distiguished where possible by the use of black arrows. Some 550 reactions are identified by their IUBMB Enzyme Commission (EC) numbers which are then indexed.