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Evolutionary Medicine

I have been asked to review a pre-publication proof of a book that will be published in May 2009: Evolution Rx: A Physician’s Guide to Harnessing Our Innate Capacity for Health and Healing by William Meller, MD. It offers “a primal yet radical new view of why we act and feel the way we do, why we get sick and how we heal. This new perspective, known as evolutionary medicine, looks at how our Stone Age ancestors lived, loved, got sick and got well over millions of years, which leads to guidelines for living longer healthier and happier lives today.”

He says we are the way we are because that’s what it took to adapt and survive throughout our evolutionary history. To some extent, that’s true, but that’s not the whole story. Sometimes we are the way we are because of an accident of evolutionary history that had no bearing on survival. Sometimes we are the way we are because a useless trait was linked to a useful one and came along for the ride – what Stephen Jay Gould referred to as “spandrels.”

The problem with evolutionary explanations is that we can never know for sure if they are true. We may be inventing “Just So Stories” like Rudyard Kipling’s “How the Camel Got His Hump.” Our explanation may seem perfectly reasonable but we may not have all the information and there may be a better explanation that simply doesn’t occur to us.

There are also pitfalls in trying to determine how our Stone Age ancestors lived. The evidence is spotty. It is tempting to think we should try to live more like they did, but that doesn’t necessarily follow. Stone Age women had fewer menstrual cycles during their lifetime because of constant pregnancies and breastfeeding – does that really mean that we should suppress menstruation in women today? Maybe, maybe not.

Meller offers reassuring explanations for various diseases and conditions, trying to show that they are good, not bad. Morning sickness protected the fetus from toxins in foods. Prematurely bald men looked wiser so were more likely to mate. Sickle cell trait protects from malaria. Pain helps prevent further injury. Injuries may be good for us by stimulating repair mechanisms that may also weed out cancer. ADHD evolved as a survival trait – people who weren’t focusing on one thing were more likely to notice a new thing like the tiger behind the bush.

He sees the consequences of evolution in his patients and he shares his insights with them.

I wanted to see if understanding their deep evolutionary past would help them when they sprained an ankle or struggled with diabetes. It didn’t take long to see the effect… patients develop[ed] an entirely new outlook… followed by positive and dramatic changes.

So he says. But he offers no evidence.

Do we really need to explain the evolutionary history of obesity, or is it enough to tell obese patients what I used to tell them: “There’s nothing wrong with you; in fact there’s something very right. If you and I were in a famine situation, you would be more likely to survive. Unfortunately when food is abundant, your calorie-conserving abilities become a detriment.”

I really can’t see a need for a separate “evolutionary medicine” since evolutionary knowledge and concepts are already an integral part of scientific medicine. Evolution helps us understand why we have a blind spot in the eye and how bacteria develop antibiotic resistance.

Much of Meller’s advice is refreshing. He rejects common myths like the need to drink 8 glasses of water a day, the need for detoxification, and the need to stretch before exercise. He shows that taking vitamins and antioxidants is likely to do more harm than good. He rejects alternative medicine’s unproven treatments. He says there is “no evidence that eating organic foods or using any detoxifying products actually improves health or prevents cancer.” He says “We play fast and loose with massive amounts of known toxins [cigarettes, alcohol], yet fret over compounds measured in parts per billion with little measurable effect.” He says so much that is in line with good science-based medicine that it makes it just that more disappointing when he slips.

He says some things that are questionable and some that are simply wrong. He says you can reduce your children’s risk of nearsightedness by encouraging a low carbohydrate diet, playing outdoors and holding books at least 18 inches away from their eyes. I could find no evidence to support any of those claims. He says the Women’s Health Initiative showed that the total death rate among women taking hormones was lower than those who didn’t. That’s just wrong: the study showed no difference in mortality between the two groups. He says the best treatment for lactose intolerance is to drink small amounts of milk regularly because this will increase your production of lactase. I couldn’t find any evidence to support that claim. He says the McKenzie back exercises are the best treatment for low back pain: most doctors disagree. I don’t even know what to make of his statement that “tuberculosis was in rapid decline, even before antibiotics, largely due to the immune-stimulating effects of sunlight.” Or “two genders exist because juggling our genes doubles our resistance to infection.” There are many other statements in the book that bother me.

The text is interspersed with boxes giving “Evolutionary Prescriptions” for various conditions. I don’t see how he can justify calling them “evolutionary” since they are mostly the conventional medical advice that everyone already follows. What is “evolutionary” about preventing cancer by not smoking, by getting a colonoscopy after age 50, by taking HPV vaccine, etc.? Other parts of his evolutionary prescriptions are fanciful, like a low carbohydrate diet and playing outdoors to reduce the risk of myopia. What is evolutionary about his advice to nap for 90 minutes after lunch, and where is the evidence that such advice improves patient outcomes?

The author is skeptical about many of the things I’m skeptical about, but I’m skeptical of some of the other claims that he accepts. Seeing everything in medicine through evolutionary glasses impresses me as more of a gimmick than as a clinically useful approach. Evolution clearly informs medical practice, but I can’t see the value of “evolutionary medicine” as a separate discipline and I can’t recommend this book.

Posted in: Book & movie reviews, Evolution

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23 thoughts on “Evolutionary Medicine

  1. Norman says:

    “He says the McKenzie back exercises are the best treatment for low back pain: most doctors disagree.”

    Could you say some more about this? I was recommended “Treat Your Own Back” (ISBN 0959804927 ) by my physiotherapist a few years ago and have found it invaluable – it gives me the tools to prevent or cure back pain all by myself. Checking out Amazon, it has 24 reviews of which 22 are 5-star.

    OK, now I answer my own question. A quick google session suggests that the evidence is not there. Examples:

    http://clinicalevidence.bmj.com/ceweb/conditions/msd/1116/1116_I16.jsp

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1421491

    “To date [ie 2006], no authors have compared McKenzie therapy with placebo or no treatment.”

    So, there’s a research topic waiting for a keen PhD student.

  2. David Gorski says:

    There are also pitfalls in trying to determine how our Stone Age ancestors lived. The evidence is spotty. It is tempting to think we should try to live more like they did, but that doesn’t necessarily follow. Stone Age women had fewer menstrual cycles during their lifetime because of constant pregnancies and breastfeeding – does that really mean that we should suppress menstruation in women today? Maybe, maybe not.

    Well, there’s no doubt that more pregnancies and fewer menstrual cycles are protective against breast cancer, but it’s doubtful that in Stone Age times most women lived long enough to experience the benefit of decreased rates of breast cancer. Also, in Stone Age times, more pregnancies were dangerous, as without modern medical interventions there was a much higher risk of dying in childbirth than there is today, which would raise the risk of death from childbirth complications far more than multiple pregnancies lower the risk of death from breast cancer.

    In any case, this book sounds a lot like Sharon Moalem’s Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease. Yes, it’s a lot of the same, a mix of science-based conclusions and science-informed speculation with stuff that’s just off the plantation. I suppose I should have taken a hint: When the author refers to himself as a “medical maverick” in the title of a book, chances are that the book’s full of what I like to call “dubiosity.”

  3. Harry says:

    @ David
    In any case, this book sounds a lot like Sharon Moalem’s Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease. Yes, it’s a lot of the same, a mix of science-based conclusions and science-informed speculation with stuff that’s just off the plantation. I suppose I should have taken a hint: When the author refers to himself as a “medical maverick” in the title of a book, chances are that the book’s full of what I like to call “dubiosity.”

    I hated Moalem’s book, I couldn’t even finish it. That and I love Evolutionary Medicine. I would recommend Randolph Nesse’s website and The Evolution & Medicince Review. There recently was a Colloquium at the National Academy of Science on the topic that got a nice write up in Science Magazine.

    My personal interest in Evolutionary Medicine is using parasite hacks to explore diseases of immunodysregulation such as Allergies and Autoimmunity. Alas, I’m still in search of a lab to work in. Stupid medical school, always cutting into my research time…

    My apologies in advance if my html gets screwed up, my Code Kung Fu is weak before coffee.

  4. TsuDhoNimh says:

    I don’t even know what to make of his statement that “tuberculosis was in rapid decline, even before antibiotics, largely due to the immune-stimulating effects of sunlight.”

    Let me dig out my old (older than either of us) med books: Ahah! Tuberculosis was in decline mostly because of required pasteurization of milk, and testing cows for M. bovis.

    Add in screening tests for humans, strict forced quarantine, public funds for sanitariums, and public awareness campaigns … it all added up.

    UV light kills the TB bacteria directly, minimizing the chances of spread. Hence, the “open air” sanatariums and high-altitude sanitariums were quite effective because of the UV from the sun minimized spread to staff and visitors. Testing staff and only using staff who were already positive helped – no sick staff going home and spreading it.

    Nothing about the immune system was being “enhanced” by sunlight, transmission was being reduced.

    Betty McDonald’s “The Plague and I” about undergoing treatment at Firland Tuberculosis Sanatorium is the best I’ve seen on what it was like. Collapsing lungs, enforced fresh air, the whole pre-antibiotic ritual.

  5. David Gorski says:

    I hated Moalem’s book, I couldn’t even finish it. That and I love Evolutionary Medicine. I would recommend Randolph Nesse’s website and The Evolution & Medicince Review.

    I got Moalem’s book as a review copy, and I only got halfway through it. I have much better things to do with my precious free non-work, non-blogging time than to waste it reading dubiosity like that. Way too much time just to get a single book review post out of.

    I love evolutionary medicine too, and I’ve written about it in the context of understanding cancer. Maybe I should dig out and dust off some of those old articles and update them for SBM. After all, if Kim can do it, so can I. :-)

  6. My personal physician (temporarily) was also lecturer on evolutionary medicine at one of the University of California campuses. He tried to convince me that we evolved without access to high carbohydrate diets, and he concluded that the Atkins Diet was “evolutionarily correct”. Being the type of person who always thinks he knows more than his physician (usually finding out that I don’t), I did both University of Google and peer-reviewed article research on the topic . The former made me feel that my physician was trained there and the latter seemed to indicate that one of the key steps in human evolution was a move to a pastoral lifestyle that included farming, and I presume eating grains and fruits.

    So I read the review above, thinking to myself that I’ve heard these things before. I wonder where. Going back to the beginning of the article, I noticed that William Meller authored it, I find it ironic that my former personal physician now has a book out. ;)

  7. Calli Arcale says:

    Sounds like it falls into the main pitfall of misunderstanding evolution — the assumption that evolution produces “better” organisms. It doesn’t. It produces different organisms. If they survive, it’s because they either got lucky or were better able at surviving long enough to successfully reproduce. Related to it is the assumption that species are discrete entities, and that evolution can “complete”. There seems to often be an assumption that humans are in some kind of final state (or that any deficiencies we have are in the process of evolving out, so that we can achieve our final state), but evolution really has no end point.

    I think these two misunderstandings are what lead people to the assumption that if a trait exists, it must confer either a survival or reproductive advantage. But this is not the case. Many traits survive simply because they do not confer enough of a *disadvantage* for them to go away.

    Evolution can be a real b1tch, quite frankly. The outcome is not always better for the individual, and often is only barely beneficial even to the species as a whole. Just look at reproduction. In humans, it’s dangerous, but involves some very fun activities that solidify pair-bonds. In many species, it’s lethal. I’m not just talking about female mantises and spiders eating their mates. Many species’ mating and reproduction techniques put most horror movies to shame. The behavior of male ducks can be shocking. And that’s something selected by evolution.

    Just because it evolved doesn’t mean it’s beneficial. And even if its beneficial it doesn’t mean its something we want. Maybe the high death rate in Stone Age times was helpful for preventing overpopulation. There’s a can of worms that I bet Dr Meller didn’t open, yet it’s every bit as legit as claiming that reduced menstruation may be beneficial because Stone Age women were always pregnant or nursing. If we take his logic, we should believe that we’re supposed to be dead by what is now considered middle age, and yet I really doubt he was going to go that route.

  8. I’ve got the Sears books. Not the latest one– that came out after I got un-brainwashed. ;) But if anyone on the SBM blog would like to review them to help un-brainwash other vulnerable new parents, I’d love to ship them to you. Just shoot me an email.

  9. To Joe…hysterically funny!

    To Calli…if I may beg to differ, but each individual in a population is the “endpoint” of evolution, since an individual cannot evolve any further. In addition, evolution occurs through two main mechanism: natural selection and genetic drift.

    Natural selection is, in fact, the process whereby traits in individuals that allow for greater survivability and reproduction become more common in a given population over time. It is the more powerful of the forces in evolution.

    Genetic drift is the random changes in traits, some of which are negative, some neutral and some positive. Without genetic drift, I suppose, natural selection cannot occur, because a population would have no variability.

    You seem to be indicating that evolution = genetic drift, or just a random assortment of genes. Natural selection is what gives individuals, and eventually a population, an advantage over another individual or population.

    Since an individual cannot evolved, and is the endpoint of its own evolutionary tree, one cannot make any value judgement on whether it’s better or worse.

  10. Calli Arcale says:

    To Calli…if I may beg to differ, but each individual in a population is the “endpoint” of evolution, since an individual cannot evolve any further. In addition, evolution occurs through two main mechanism: natural selection and genetic drift.

    Evolution isn’t about the individual. It’s about changes over time. True, you could indeed say that each individual is the endpoint, but that’s meaningless. What I was trying to get across is that many people get confused and think that each *species* has an endpoint, and that there is some sort of perfectly evolved state. (Going along with this is the confusion many Creationists have regarding transitional species. They point to the lack of transitional species, unaware that all species are transitional.)

    So, each individual is an endpoint — and also a starting point, and also a midpoint. Of course individuals can’t evolve further* — evolution is about their descendants evolving.

    I suppose you could argue that a celibate person is an evolutionary endpoint, but that’s also not what people mean when they are misconstruing evolution to suggest that evolution works towards some final state. It doesn’t. It doesn’t ever end, except in the case of extinction. If a species is alive, it’s not done evolving.

    *Sort of. Tissues inside a person can still evolve. This is an issue in cancer treatment, where tumor cells can evolve resistance to certain chemo agents.

  11. playing outdoors to reduce the risk of myopia.

    Wouldn’t additional time in UV radiation actually lead to more eye damage?

  12. Calli Arcale says:

    Addendum:

    I did not mean to imply that natural selection isn’t a major force. It definitely is. It just doesn’t make value distinctions like “better”. There’s no such thing as “highly evolved”, for instance. There’s just “survives and/or reproduces better under the current conditions than whatever it’s competing against”. This doesn’t mean it’s an ideal state. If it were, purple loosestrife wouldn’t be wiping out the cattails in my neck of the woods, because the cattails would be perfectly evolved already.

    Oh, and in addition to natural selection, don’t forget sexual selection. ;-)

    One other thing that gets forgotten is that evolution doesn’t stop. We are not the same people we were a million years ago. And we probably don’t know as much about our ancestors’ lives as folks espousing a Stone Age lifestyle seem to believe.

  13. Calli Arcale says:

    Argh. Still not clear enough. I seem to contradict myself above. I guess what I’m trying to say is that there is no universally best species, and no species will ever achieve an ideal state. The best they can hope for is to be better at surviving and reproducing than their ecological roommates.

  14. The Blind Watchmaker says:

    I like to ponder the evolutionary reasons for many of the issues that we deal with today. One can speculate, but one cannot make claims as if they are fact. At best, most evolutionary health claims can be listed as hypothesis.

    This sounds just like the tactics of many pseudoscientists. Use “sciency” (is that a word?) sounding themes to justify your brand of woo. He knows that skeptics tend to like evolution and tend to question alternative medicine. He uses these as the common ground from which to launch his woo-woo.

    It’s bait and switch.

  15. Prometheus says:

    “tuberculosis was in rapid decline, even before antibiotics, largely due to the immune-stimulating effects of sunlight.”

    This is the exact opposite of the effect sunlight has on the immune system. If I may refer you to a recent review:

    Norval et al. The effect of chronic ultraviolet radiation on the human immune system. Photochem Photobiol. 2008 Jan-Feb;84(1):19-28.

    http://www3.interscience.wiley.com/journal/119395269/abstract?CRETRY=1&SRETRY=0

    Ultraviolet light – a key part of sunlight and what makes it most different from artificial light – actually impairs the immune system. This, by the way, is not “cutting edge science” – it has been known for thiry years.

    This sounds more and more like Dr. Meller simply writing down his thoughts and beliefs without doing much “fact-checking”.

    Too bad.

    Prometheus

  16. James Fox says:

    Gorski wrote, ” I have much better things to do with my precious free non-work, non-blogging time than to waste it reading dubiosity like that.”

    Now which 1980’s teen B horror movie heroine based on a literary archetype are you???

  17. khan says:

    Another thing people forget is that a lot of really nasty inherited crap is not weeded out by evolution because it doesn’t manifest until after successful reproduction.

  18. wmeller says:

    Dr Meller replies:
    I want to thank Dr Hall for her thoughtful review of the galley proof of my forthcoming book, Evolution Rx. You will be happy to know that an appendix which provides much of the evidentiary support of the material has been included in the final version, as well as revisions which make it even more readable.
    My aim in writing this book is to offer a general introduction to an evolutionary approach to medicine and its impact on our lives today.
    The main distinction between Evolution Rx and more scholarly works such as Why We Get Sick by Nesse and Williams and Evolution in Health and
    Disease by Stearns et al, is that I am a practicing physician who has found that an evolutionary approach can be helpful to patients with a wide range of common illnesses.
    I could not agree with you, and with the commenter Khan, more when you say that we are not only the product of all our past adaptations but also a collection of prehistoric accidents and once, but now no longer, useful abilities. Chapter 8, Flawed Heritage, addresses diseases such as sickle cell anemia and cystic fibrosis which are legacies of such past environments.
    It was not my intention to provide full documentation of the evidence for this material in this book. Those who are familiar with the literature don’t need it and the reader for whom the book is intended would only be bogged down by it. I struggled during the writing with how much evidence to include in the text, as footnotes, in appendices and bibliography. In the end, with the goal of appealing to the broadest new audience and the limitations of the length of the book, we left much of it out. Think of it as the comic book or “ “lite” version without pictures. No less accurate simply reaching out to a different group.
    This book is designed to capture the attention and imagination of those who have never considered the import of evolution in their daily lives not so much the well-educated readers of this sophisticated blog.
    But as the comments show, even in this community there can be misunderstandings.
    I carefully avoid suggesting that we should live as our stone age ancestors did, merely that we should be informed and cautioned by the primal conditions to which we are best adapted. As Dr. Hall so rightly states “evolutionary concepts are already an integral part of scientific medicine,” but as her daily work on behalf of science-based medicine shows, not all of us doctors practice it yet. Nor do those innumerable patients who seek out “alternatives” always know what they are getting themselves in to. My book was written for them.
    As to specific findings in the book such as the causes of myopia, the conclusions of the WHI HRT study, the effect of drinking milk in the lactose intolerant, and the benefits of postural (McKenzie) treatment of back pain [I am glad the commenter Norman has found it to be of such relief as have hundreds of my patients], I will be happy to share the published research (not my own) on which these observations are based with all who are interested.
    David Gorski’s point that stone age women were not troubled by breast and uterine cancer is well taken, and addressed in the book. As he says the protective effect of having fewer periods is firmly established, so the take home message is that women today should consider the benefit it may bring to them to have fewer cycles. This is typical of the kind of recommendation that an evolutionary approach can bring to modern medicine.
    I also found Dr. Moalems book rough going. It discusses some rather obscure conditions and espouses some pretty far out hypotheses. My book deals with everyday diseases for the most part.
    Harry- you will enjoy the chapter on allergies and immune regulation by parasites and I wish you the best in med school. You are way ahead of your peer group if you are already reading this blog.
    As TsuDhoNimh states the waning of TB prior to the advent of antibiotics has been well established. The traditional explanations of improved hygiene as a result of the novel germ theory of disease go a long way towards explaining it. My suggestion that the effects of sunlight in stimulating increased Vitamin D come as result of the latest research into the vital part this vitamin plays in immune function and the relative lack of sun exposure in some social classes in the 19th century. A lack which we are seeing repeated today as a result of a misplaced fear of skin cancer. Michael Simpson (Hello again, Michael) is right that direct UV has a negative effect on immune cells, in fact it is lethal to many types of cells which is why we have such a well adapted melanin producing organ as our skin to protect us from overdose. The immune stimulation is mediated by Vitamin D.
    The hypothesis that two sexes exist because it confers a selective advantage against infections is Marlene Zuk’s. I simply refer to it to show how far back and how deep in our nature a need to resist infections goes. This is a typical example of the sort of speculation that is common and necessary in science. There is a place for it in any scientific endeavor as it is this kind of generative thinking that moves research forward.
    I hope that when the very interested commenters have a chance to read the book itself they will find it lucid and illuminating rather than ironclad and exhaustive.
    I look forward to continuing this dialogue and all of our efforts to bring scientific and effective medicine to a greater number of people.
    Thank you,
    William Meller

  19. Harry says:

    @David

    I love evolutionary medicine too, and I’ve written about it in the context of understanding cancer. Maybe I should dig out and dust off some of those old articles and update them for SBM. After all, if Kim can do it, so can I.

    Are you familiar with Steven Frank? He has written several books on Evolutionary Medicine. One is titled “Dynamics of Cancer; Incidence, Inheritance, and Evolution” You can find the whole book, free, at the NCBI Bookshelf. I haven’t had the time to read it but I did get through most of his book on Evolution and Infectious Human Diseases.

    From the Dynamics of Cancer introduction:
    Through failure we understand biological design. Geneticists discover the role of a gene by studying how a mutation causes a system to fail. Neuroscientists discover mental modules for face recognition or language by observing how particular brain lesions cause cognitive failure.

    Cancer is the failure of controls over cellular birth and death. Through cancer, we discover the design of cellular controls that protect against tumors and the architecture of tissue restraints that slow the progress of disease.

    Given a particular set of genes and a particular environment, one cannot say that cancer will develop at a certain age. Rather, failure happens at different rates at different ages, according to the age-specific incidence curve that defines failure.

    To understand cancer means to understand the genetic and environmental factors that determine the incidence curve. To learn about cancer, we study how genetic and environmental changes shift the incidence curve toward earlier or later ages.

    The study of incidence means the study of rates. How does a molecular change alter the rate at which individuals progress to cancer? How does an inherited genetic change alter the rate of progression? How does natural selection shape the design of regulatory processes that govern rates of failure?

  20. Harry says:

    @William Meller
    Harry- you will enjoy the chapter on allergies and immune regulation by parasites and I wish you the best in med school. You are way ahead of your peer group if you are already reading this blog.

    I will make it a point to read that chapter this summer. By any chance did you make it to the recent symposium in D.C.? Also, you may find Randolph Nesse’s The Evolution and Medicine Review website useful and sign up there.

  21. yeahsurewhatever says:

    “The problem with evolutionary explanations is that we can never know for sure if they are true. We may be inventing “Just So Stories” like Rudyard Kipling’s “How the Camel Got His Hump.” Our explanation may seem perfectly reasonable but we may not have all the information and there may be a better explanation that simply doesn’t occur to us.”

    Why, for example, cannot humans endogenously produce ascorbic acid from glucose? Most animals can. The just-so story created for this was that presumably there was a long period of abundance of ascorbic acid in the primate/guinea pig/fruit bat/etc diet, so the gene no longer had any pressure to code correctly, and became an intron.

    Is there any particular reason to suppose there was such an exogenous abundance of ascorbic acid for our ancestors several dozen million years ago? No. Is there some good way to corroborate this explanation? No.

    “Stone Age women had fewer menstrual cycles during their lifetime because of constant pregnancies and breastfeeding – does that really mean that we should suppress menstruation in women today? Maybe, maybe not.”

    Neolithic women had fewer menstrual cycles during their lifetime due to having a shorter lifetime, if for no better reason. People tended to die before 30 at that time, usually of a mouth disease. It doesn’t mean that we “should” suppress menstruation today, though. Such an is-ought distinction can’t be crossed by that line of reasoning.

    “Meller offers reassuring explanations for various diseases and conditions, trying to show that they are good, not bad. Morning sickness protected the fetus from toxins in foods. Prematurely bald men looked wiser so were more likely to mate. Sickle cell trait protects from malaria. Pain helps prevent further injury. Injuries may be good for us by stimulating repair mechanisms that may also weed out cancer. ADHD evolved as a survival trait – people who weren’t focusing on one thing were more likely to notice a new thing like the tiger behind the bush.”

    Given that malaria is older than the human species itself, it is actually conceivable that sickle cell trait evolved in its current form primarily as a strategy against malaria. But it’s only a benefit where malaria is epidemic, and even then only a mixed benefit. I’d rather have a stockpile of quinine than have sickle cell trait, but maybe that’s just me.

    The other points raised here by Meller are kind of a stretch, particularly the ADHD one, since there’s no particular reason to believe it’s hereditary even if it were conclusively shown to be a real condition, which it hasn’t been.

    “Evolution helps us understand why we have a blind spot in the eye”

    Squids still mock us for this.

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