UNDERSTANDING CONTEMPORARY DISEASES UNDER EVOLUTIONARY MEDICINE VIEW
Sob a optica da Evolucao o corpo humano nao tem formatacao pre-delineada mas sim eh moldado pela selecao natural resultante da interacao positiva da carga genetica com o meio ambiente. Nesta conjectura, a meta eh maximizar a perpetuacao da especie(reproducao) e nao a saude ! Para tanto, as principais restricoes ambientais tem sido a fome e os agentes infecciosos, cujas respostas de superacao envolvem o uso apropriado da energia endogena. Surge, entao, o padrao genetico eficiente(thrifty) para aproveitamento, estocagem, economia e priorizacao do uso energetico na funcao seletiva de orgaos, defesa imunologica e reparo tecidual. Com essa priorizacao biologica, em presenca de infeccao nao ha crescimento somatico e sem esse, a reproducao pode ser antecipada e a longevidade abreviada. Consequentemente ao padrao genetico “eficiente” frente as situacoes ambientais desfavoraveis, podem ser vistas como respostas fisiologicas, as situacoes de resistencia insulinica, expansao adiposa, hidratacao pos ingestao de sodio e a inflamacao. Se essa heranca filogenetica permitiu a sobrevivencia ancestral em ambiente desfavoravel, o ambiente contemporaneo de fartura energetica, ausencia de predadores classicos e sedentarismo, resulta em confronto(mismatch) com o nosso genoma, ancestralmente moldado. Assim, doencas cronicas como obesidade, diabetes melito insulin dependente, hipertensao arterial, dyslipidemia e syndrome metabolica surgem como resultants desse confront genetico(ancestral)-ambiente(modern). O crescimento universal destas doencas paralelamente ao custo crescent das mesmas, aos cofres da Saude Publica, apontam para a busca de alternativas nao farmacologicas para as mesmas, nos moldes preconizados pela Medicina Comportamental. Como modelo, propomos o estudo “Mexa-se pro-saude, programa de mudanca do estilo de vida com re-educacao comportamental, envolvendo adequacao alimentar e exercicios fisicos supervisionados. Remedio natural, de baixo custo, sem efeitos colaterais e pouquissimas contra indicacao a atencao primaria e secundaria as doencas cronicas nao infecciosas.
UNDERSTANDING CONTEMPORARY DISEASES UNDER EVOLUTIONARY MEDICINE VIEW
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DOI: 10.22533/at.ed.928232106
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Palavras-chave: Medicina e Biologia Evolutiva; Epigenética das Doenças Crônicas Não-Transmissíveis; Medicina Comportamental
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Keywords: Evolutionary Biology and Medicine; Epigenetics of Non-communicable Chronic Diseases; Behavioral Medicine
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Abstract:
From the evolutionary theory, the body is not a product of design but a bundle of compromises shaped by natural selection to maximize reproduction or genetic fitness, not health. Hence, life history theory predicts the coordinated evolution of the traits contributing directly to fitness: age and size at maturation, number and size of offspring, number of reproductive events, and ageing and lifespan. Major constraints were famine and infection with the trade-offs of encephalization-gut size; growth-immunological defense and longevity-reproduction. The major functions involved in lifespan are maintenance, growth, reproduction, and defense, in which energy can be invested. For those, insulin resistance, sodium preservation and inflammation are seen as thriftiness in situations such as famine, water privation and infection. For then, emerged the thrifty genotype. An evolutionary view suggests that many genetic variants interact with environments and other genes during development to influence disease phenotypes. Therefore, it is possible to analyze a great number of diseases in terms of adaptive vulnerabilities connected to our phylogenetic inheritance, such as human bodily inadequacies in relation to the modern environment. This means that current diseases such as obesity, T2D, essential hypertension, dyslipidemia and metabolic syndrome may result from the mismatch of our ancestral thrifty genotype with the contemporary way of life through epigenetic modification of the gene expression. Additionally, the worldwide burden of NCDs demands the implementation of effective population-based strategies. This is the basis of the Behavioral Medicine whose major principles are dietary adequacy and physical activity. As a model, we propose an ongoing epidemiological experience (“Moving for Health Program”), described as a costless lifestyle -modification procedure, alternatively to the current homeostatic model adopted by the Public Service. It could be a natural remedy for recovering part of the imbalance caused by modern life-styles, costless and without the side effects of many pharmacological treatments.
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Número de páginas: 82
- Roberto Carlos Burini
