If you're a fan of books like The Tipping Point and Freakonomics, I highly recommend Survival of the Sickest. It's full of the same kinds of fascinating insights that make for great cocktail party conversation. As a parent, I was particularly fascinated by the chapter on how what you eat during pregnancy can influence the way your children (and even their children) metabolize their food. And as a health conscious person, you'll get practical, actionable ideas on how to think about personalizing your diet based on your background.
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This book about genetics, evolution and disease is a genuine page turner, that's how deeply interesting it is, and how well it is written. The basic premise runs like this: The environment puts pressure on all living things, including humans, to evolve characteristics that help us survive long enough to reproduce and pass on our genes. Over the millenia, various conditions such as drought, ice ages and other climate changes have sparked genetic mutations that enhance our abilities to survive. These include some biological conditions that are advantageous in the short term, but sometimes detrimental in the long term.
For example, today we consider diabetes mellitus a serious disease because it raises human blood sugars to dangerous levels that can result in loss of limbs and sight, among other problems. However, in an ice age, when temperatures were significantly lower than they are now, having extra sugar in the blood may have enabled our ancestors to survive the cold because sugar lowers the temperature at which we freeze to death. Similarly, Sickle Cell Anemia may have evolved to help people resist malaria.
What's especially interesting is that this theory would explain why ethnic groups that are prone to diabetes -- Scandinavians and people from the British Isles, for instance -- originally came from northern areas that were at one time covered by glaciers. And the ancestors of those groups that tend to carry the genes for Sickle Cell generally originated from climates in which malaria was prevalent.
Another intriguing idea is that some "sicknesses" only become serious problems when an individual is older and past his or her prime reproductive years. So if one of our ancestors had, for instance, a chronic disease like diabetes, it probably wouldn't kill him/her until after the person had children.
There are many such fascinating observations and facts in this relatively short book and I highly recommend it to anyone who wonders how things and people got to be the way they, and we, are today.
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You don't need a degree in evolutionary biology to understand Survival of the Sickest. This book gives you a peak into how evolution can actually select for disease, and makes a compelling case for why and how understanding this can shape the way disease is treated in the future. It also explains some fascinating facts - like how some Americans are immune to HIV because they have a mutation and how a person can rust to death but be saved by giving blood. It'll leave you thinking completely differently about your body, and - in some cases - like when it advises that you should take your sunglasses off for a few minutes when you get into the sun so that your eyes can "tell" your skin to be on guard against it, it'll actually affect the way you act.
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From the second I picked up this book, I realized I was in for a fun ride! A unique look at evolution and genetics is mixed with humor and fun facts. You may never look at The Plague, baby fat,alcohol,vikings,or your very own medical problems in the same way. This book is an entertaining trip into our history and future -- a must read!!!
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I read this book in one sitting - it is fascinating and remarkably accessible. Moalem takes a unique and optimistic approach towards investigating the purpose of disease as a way to really understand its role in evolution. The book is packed with insightful anecdotes and leaves the reader less alarmed by disease, and instead with a deeper understanding of its purpose. Most remarkable, the book takes the reader along a journey that connects us to our ancestors.
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We're used to thinking of disease as the enemy, as a malicious force that makes our lives shorter and more miserable. That may be exactly what "disease" is on an individual basis--but its value to the species as a whole is a different matter.
Dr. Moalem elegantly explains why medical conditions that are deemed to be diseases today often helped our ancestors survive and reproduce in difficult environments. Take hemochromatosis, a hereditary condition that causes iron to accumulate in a person's internal organs, eventually leading to death. Although the gene that causes hemochromatosis was once thought to be rare, research completed in 1996 found that it's actually surprisingly common. Why wouldn't such a terrible disease have been "bred out" of our species long ago? The answer is that hemochromatosis reduces the amount of iron available to iron-loving bacteria, such as the bubonic plague that depopulated Europe in the mid-1300s. A person living in the Middle Ages with the hemochromatosis gene would have eventually died from iron build up, but in the meantime would have have had a smaller chance of dying from the plague and other iron-loving infections--in an age when few people lived past the age of 50, the disease resistance conferred by hemochromatosis far outweighed the disadvantage that would have materialized if the person carrying the gene had lived to old age. People with hemochromatosis reproduced and passed the gene one to their heirs; those without it died of the plague, without children.
"Survival of the Sickest" is filled with similarly surprising observations. Anemia may be the body's way of reducing iron available to bacteria--giving an iron supplement to a malnourished population may be a bad idea and ironically (so to speak) medical bloodletting may not have been such a bad idea. Type II diabetes may have been a condition that conferred an advantage on northern Eurpoeans during the ice age, when an increase in sugar in the bloodstream and frequent urination would have reduced the risk of freezing to death. Similarly, sickle cell anemia offers protection from malaria. In the "good old days," a genetic condition that kept a person from dying before reproducing would have been a boon, even if the condition would have turned killer if the person managed to reach old age.
The book is filled with other "big ideas, briefly discussed." Instead of battling bacteria with antibiotics (which is only making them tougher), perhaps we could manage their evolution so that they thrive by inconveniencing their host (like a cold) instead of by flooring it (like malaria). And, although Dr. Moalem seems to agree that natural selection is the big driver of evolution, he observes that perhaps Lamarck wasn't so far off after all--jumping genes, retroviruses and methylation all suggest that an organism's life experiences can in certain circumstances affect future generations. As for aging--perhaps our bodies are designed by natural selection to limit the number of times a cell can reproduce (thus insuring that we will all die from old age if something else doesn't get us first), the alternative being an excess of cells without such a limit (in other words, cancer).
On the whole, "Survival of the Sickest" is readable, surprising and filled with "ah-ha!" moments. If you enjoyed "The Tipping Point" or "Freakonomics," you'll probably be intrigued by Dr. Maolem's often counter-intuitive observations.
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Survival of the Sickest, by Dr. Sharon Moalem, with Jonathan Prince -- Hardcover 267 pages with Notes and Index
Most of us probably think of evolution in terms of the ancient past when ape-like creatures were morphing into human form or earlier when one-celled animals were gradually changing into the next higher forms of animals, or even when dinosaurs evolved into birds. Some have likely included the domestication of plants and animals as an agricultural arm of evolution, and may have considered the mutating of a retrovirus like HIV/AIDS to be an aspect of evolution.
But if you read Survival of the Sickest, you will likely come away with a very different appreciation of the wonders of evolution. Dr. Moalem takes us on a journey of discovery, a journey that started in his young life as a search for a cause for his grandfather's, and his own, as it turned out, disease of hemochromatosis (dangerous levels of iron in the blood and organs). This quest led to an answer and more questions--many, many more questions--about the true nature of the physical influences in our lives--and why we need diseaase.
Dr. Moalem writes with tongue firmly in cheek as he makes his points with vigor. Survival of the Sickest tells, if not a different story of life, then certainly one that has an uncommon emphasis. He says, "... life is in a constant state of creation. Evolution isn't over--it's all around you, changing as we go. ... nothing in our world exists in isolation. We--meaning humans and animals and plants and microbes and everything else--are all evolving together and our relationship with disease is often much more complex than we may have previously realized."
"So to be crystal clear: everything out there is influencing the evolution of everything else. The bacteria and viruses and parasites that cause disease in us have affected our evolution as we have adapted in ways to cope with their effects. They have evolved in turn, and keep on doing so. All kinds of environmental factors have affected our evolution, from shifting weather patterns to changing food supplies--even dietary preferences that were largely cultural."
Dr. Moalem puts this all into perspective with this poetic summation: "It's as if the whole world is engaged in an intricate, multilevel dance, where we're all partners, sometimes leading, sometimes following, but always affecting one another's movements--a global, evolutionary Macarena."
Much of the book concerns the genetic interaction of the DNA of bacteria and viruses with ours. "DNA is not destiny--it's history. Your genetic code doesn't determine your life. Sure, it shapes it--but exactly how it shapes it will be dramatically different, depending on your parents, your environment, and your choices."
As an illustration of the dynamic nature of the science of evolution, he goes well beyond established DNA understanding with a discussion of the possibility that Lamarkian theory (individual behaviors can result in genetic modification in an individual and that trait be passed on to offspring) could be coming back in vogue.
There is a lengthy discussion of what the young science of epigenetics is discovering about the effects that "methylation" has on our genome. It seems that methylation is some communication media that attaches to particular genes within an individual and modifies the on/off switch and even the strength of its expression without actually modifying the DNA.
I found rather fascinating the claim that the behaviors of a prospective mother can alter the expression of genes in her baby, but she can influence development even before her fertilized egg has implanted in her uterus. Even more amazing, and, I think, not fully substantiated in the book, is the claim that behaviors of the baby's grandmothers, and even of its father and grandfathers can influence gene expression in the developing fetus. He does admit, however, that the jury is still out on some of this research.
I loved this existential summary: "Your genes are the evolutionary legacy of every organism that came before you, beginning with your parents and winding all the way back to the very beginning. Somewhere in your genetic code is the tale of every plague, every predator, every parasite and every planetary upheaval your ancestors managed to survive. And every mutation, every change, that helped them better adapt to their circumstances is written there."
Survival of the Sickest is a fun read. I found myself smiling at the author's use of metaphor and expression, and at a few puns he sprinkled here and there. You'll get a different perspective on the utter pervasiveness of evolution, on how this universe operates at the biologic level, and of how we fit within it. I highly recommend it.
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This is a great little book to tote along wherever you go and have a few minutes to spend on insights into the fascinating and intelligent ways our bodies and, really, Nature, work in our best interests. It leaves the reader in awe of the universe and all its complexities. And because each chapter is a separate topic, it's very easy to pick up and put down and still get a sense of an overall thread. Moalem loves a mystery, a challenge - and has shared his enthusiasm with his readers. His style is engaging, accessible, and fun. As he has a conversation with you, he takes you through the logic of the process with an amusing metaphor (eg: "When you try to move one dancer with a bulldozer, you're pretty darn certain to scoop up more than one Rockette.") You don't become confused because he explains details in an interesting, and totally uncondescending way. The chapter on epigenetics is fascinating: who knew that a woman's lifestyle habits can actually change the fetus' genes? We used to think that her habits could change the baby's health, but the genetic code? That's kind of like saying if you swim a lot when you're pregnant, the baby will show a predisposition to swimming. But it's true in a sense (read the chapter "Methyl Madness" to find out). Moalem is one who would put some credence in old wives' tales because he believes that long-held beliefs can often be accurate in a weird way (bloodletting, for example). This is a must-have book for anyone curious about little known and groundbreaking knowledge of the human body.
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"DNA isn't destiny--it's history. Your genetic code doesn't determine your life. Sure, it shapes it--but exactly how it shapes it will be dramatically different depending on your parents, your environment, and your choices. Your genes are the evolutionary legacy of every organism that came before you, beginning with your parents and winding all the way back to the very beginning. Somewhere in your genetic code is the tale of every plague, every predator, every parasite, and every planetary upheaval your ancestors managed to survive. And every mutation, every change, that helped them better adapt to their circumstances is written there."
So writes Dr. Sharon Moalem, a geneticist and evolutionary biologist in "Survival of the Sickest"--the story of how disease is forever linked to our and the Earth's past through evolution.
Why afterall, is there, and always has been, so much disease afflicting humanity? From numerous plagues to influenza pandemic to AIDS to cancer millions have died of regardless of space or time.
There will always be disease because of the nature of life: all organisms want to live and reproduce, Dr. Moalem explains. Diseases are caused by bacteria, parasites and viruses, some of which survive by harming humans. Bacteria and viruses reproduce and evolve much faster than humans, and a new strain of either can potentially cause harm to a person or population that doesn't have a built-in response to fight it. That is exactly what happened with the bubonic plague in the 14th century in Europe. However, over time, the plague subsided. Fast forward a couple hundred years and the medicinal practice of bloodletting is widespread on the continent. Fast forward to the late 20th and 21st century and scientists discover that hemochromatosis, afflicting a small but not insignificant number of people with European ancestry, is an inherited disease whose victims die prematurely because of excess iron in their blood. What is the connection between these three events?
This is just one amazing story of how evolution plays a role in disease. There are many others discussed by Moalem, including, the reasons why so many northern Europeans inherit a propensity to develop Type 1 diabetes, why malaria victims are bed-ridden, and why mothers affected by malnutrition have babies that can cope better in harsh environments.
The only downside of the book is that the somewhat frequent colloquialisms are unnecessary and written as if the target audience was in middle school. Otherwise, the content of Survival of the Sickest is so engrossing that one is almost guaranteed to pull an all-nighter reading it.
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I am reading this book at this writing and I am thoroughly enjoying it. Where else could you combine Stradivarius violins, ice ages, DNA, and frozen frogs to explain diabetes? This is an excellent read. The connections are amazing. It will have you thinking about evolution in a completely new way and in very clear terms. This book is informative and entertaining.
P.S. Do not be surprised if you end up reading each chapter twice and being entertained both times.
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