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Four Approaches to Health Care

February 12, 2014



Biologically, man hasn’t evolved in 50,000 years.  Culturally we are evolving faster than any other time in the history of the world.  The human masticatory system hasn’t changed.  Our understanding of it may have changed but the biology has remained the same.  What has changed is our culture.

Cultural evolution more than biologic evolution is the dominant and most powerful engine of change.  This is now the most powerful force on the planet… And one that is radically transforming our bodies.

Dental caries and periodontal disease is what the modern biologists call mismatch diseases…like heart disease, diabetes and some forms of cancer.  Our biology is mismatched to our current culture.  In many ways, because of these mismatches, we may be devolving rather than evolving.  This “mismatch hypothesis”applies evolutionary biology to health and disease.

Theodosius Dobzhansky prominent geneticist and evolutionary biologist says, “Nothing in biology makes sense except in the light of evolution.” Now add cultural evolution evolution to that.

The biggest changes from the Agricultural Revolution through the Industrial Revolution and now to the Information Revolution has centered around how people think and behave differently.

We have a unique and totally unprecedented ability to innovate and transmit information and ideas from person to person.  “Greatest cultural advances occurred thanks to more effective methods of transmitting information…language (human speech), writing, printing press, telephone, photography, Internet, downloads etc,” according to Harvard paleoanthropologist, Daniel Lieberman, author of the book The Story of the Human Body.

Cavities and gum disease were not issues for the hunter-gatherers – that picture above just about says it all.

Besides the diet and the overabundance of processed foods available today, the way we provide health care is devolving as well.  Health care sometimes neglects the real science of prevention and uses technology to bail us out of the mess we behaved our way into.  What I mean is that we confuse science with technology.

Today’s technology is amazing…but it’s value lies in helping us to do our tasks better and faster…and sometimes much more expensively.  Culturally we have created problems in such great numbers that we have become dependent on the technology to save us.

How’s that working?

That’s why there is such big interest these days in the Paleo movement.  I’m not arguing for a diet filled with meat and fish but rather for a simpler way of life…a way of life that made more sense for our overall health.  Hunter-gatherers were more in tune with their circadian rhythm and ate, moved and slept so that they didn’t have to adapt to processed foods, driving, and sleep deprivation which leads to the aforementioned mismatch diseases.

Before cooking and food processing… Losing your teeth could be a death sentence.  Today, as we evolve, dentists are more and more concerned about fixing the disasters rather than preventing them.

Lieberman suggests that there are four ways to approach health care...and like him, I don’t judge because we are where we are in time.  But I do have my preference…but that comes with certain responsibilities:

  1. Let natural selection sort the problem out.  Most of dentists know how that works.  Think chronic inflammation and visceral fat.

  2. Invest more in biomedical research and treatment.  Let’s just keep throwing more money at this giant health problem.  How does 58 billion sound on heart patients?

  3. Educate and empower.  The one I rely on—for me and my patients—mostly for me.

  4. Change the environment (Make it law)–Sure…good luck with this—freedom is more precious than good health

I don’t know about you but I vote for number 3.  I have become fanatical about truly understanding the science—and only relying on the technology when necessary.  This works for me at a personal level – but as I attempt to empower my patients n- it works for them too.

I encourage all health care providers to see our health care problems through the lens of evolution – because if cultural evolution got us into this, then shouldn’t cultural evolution be able to get us out?


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