1
|
Davis CC, Choisy P. Medicinal plants meet modern biodiversity science. Curr Biol 2024; 34:R158-R173. [PMID: 38412829 DOI: 10.1016/j.cub.2023.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Plants have been an essential source of human medicine for millennia. In this review, we argue that a holistic, interdisciplinary approach to the study of medicinal plants that combines methods and insights from three key disciplines - evolutionary ecology, molecular biology/biochemistry, and ethnopharmacology - is poised to facilitate new breakthroughs in science, including pharmacological discoveries and rapid advancements in human health and well-being. Such interdisciplinary research leverages data and methods spanning space, time, and species associated with medicinal plant species evolution, ecology, genomics, and metabolomic trait diversity, all of which build heavily on traditional Indigenous knowledge. Such an interdisciplinary approach contrasts sharply with most well-funded and successful medicinal plant research during the last half-century, which, despite notable advancements, has greatly oversimplified the dynamic relationships between plants and humans, kept hidden the larger human narratives about these relationships, and overlooked potentially important research and discoveries into life-saving medicines. We suggest that medicinal plants and people should be viewed as partners whose relationship involves a complicated and poorly explored set of (socio-)ecological interactions including not only domestication but also commensalisms and mutualisms. In short, medicinal plant species are not just chemical factories for extraction and exploitation. Rather, they may be symbiotic partners that have shaped modern societies, improved human health, and extended human lifespans.
Collapse
Affiliation(s)
- Charles C Davis
- Department of Organismic and Evolutionary Biology, Harvard University Herbaria, 22 Divinity Avenue, Cambridge, MA 02138, USA.
| | - Patrick Choisy
- LVMH Research, 185 Avenue de Verdun, 45804 Saint Jean de Braye CEDEX, France
| |
Collapse
|
2
|
Misheva T, Nesse RM, Grunspan DZ, Brownell SE. The EvMed Assessment: A test for measuring student understanding of core concepts in evolutionary medicine. Evol Med Public Health 2023; 11:353-362. [PMID: 37881688 PMCID: PMC10597536 DOI: 10.1093/emph/eoad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/27/2023] [Indexed: 10/27/2023] Open
Abstract
Background and objectives Universities throughout the USA increasingly offer undergraduate courses in evolutionary medicine (EvMed), which creates a need for pedagogical resources. Several resources offer course content (e.g. textbooks) and a previous study identified EvMed core principles to help instructors set learning goals. However, assessment tools are not yet available. In this study, we address this need by developing an assessment that measures students' ability to apply EvMed core principles to various health-related scenarios. Methodology The EvMed Assessment (EMA) consists of questions containing a short description of a health-related scenario followed by several likely/unlikely items. We evaluated the assessment's validity and reliability using a variety of qualitative (expert reviews and student interviews) and quantitative (Cronbach's α and classical test theory) methods. We iteratively revised the assessment through several rounds of validation. We then administered the assessment to undergraduates in EvMed and Evolution courses at multiple institutions. Results We used results from the pilot to create the EMA final draft. After conducting quantitative validation, we deleted items that failed to meet performance criteria and revised items that exhibited borderline performance. The final version of the EMA consists of six core questions containing 25 items, and five supplemental questions containing 20 items. Conclusions and implications The EMA is a pedagogical tool supported by a wide range of validation evidence. Instructors can use it as a pre/post measure of student learning in an EvMed course to inform curriculum revision, or as a test bank to draw upon when developing in-class assessments, quizzes or exams.
Collapse
Affiliation(s)
- Taya Misheva
- Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Randolph M Nesse
- Center for Evolutionary Medicine, School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Daniel Z Grunspan
- Department of Integrative Biology, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Sara E Brownell
- Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ, USA
| |
Collapse
|
3
|
Leontiadis GI, Longstreth GF. Evolutionary Medicine Perspectives: Helicobacter pylori, Lactose Intolerance, and 3 Hypotheses for Functional and Inflammatory Gastrointestinal and Hepatobiliary Disorders. Am J Gastroenterol 2022; 117:721-728. [PMID: 35169106 DOI: 10.14309/ajg.0000000000001681] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/10/2022] [Indexed: 12/11/2022]
Abstract
Many clinicians have suboptimal knowledge of evolutionary medicine. This discipline integrates social and basic sciences, epidemiology, and clinical medicine, providing explanations, especially ultimate causes, for many conditions. Principles include genetic variation from population bottleneck and founder effects, evolutionary trade-offs, and coevolution. For example, host-microbe coevolution contributes to the inflammatory and carcinogenic variability of Helicobacter pylori. Antibiotic-resistant strains are evolving, but future therapy could target promutagenic proteins. Ancient humans practicing dairying achieved survival and reproduction advantages of postweaning lactase persistence and passed this trait to modern descendants, delegitimizing lactose intolerance as "disease" in people with lactase nonpersistence. Three evolutionary hypotheses are each relevant to multiple diseases: (i) the polyvagal hypothesis posits that prehistoric adaptation of autonomic nervous system reactions to stress is beneficial acutely but, when continued chronically, predisposes individuals to painful functional gastrointestinal disorders, in whom it may be a biomarker; (ii) the thrifty gene hypothesis proposes genetic adaptation to feast-famine cycles among Pleistocene migrants to America, which is mismatched with Indigenous Americans' current diet and physical activity, predisposing them to obesity, nonalcoholic fatty liver disease, and gallstones and their complications; and (iii) the hygiene hypothesis proposes alteration of the gut microbiome, with which humans have coevolved, in allergic and autoimmune disease pathogenesis; for example, association of microbiome-altering proton pump inhibitor use with pediatric eosinophilic esophagitis, early-life gastrointestinal infection with celiac disease, and infant antibiotic use and an economically advanced environment with inflammatory bowel disease. Evolutionary perspectives broaden physicians' understanding of disease processes, improve care, and stimulate research.
Collapse
Affiliation(s)
- Grigorios I Leontiadis
- Division of Gastroenterology and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - George F Longstreth
- Section of Gastroenterology, Veterans Administration San Diego Healthcare System, San Diego, California, USA
| |
Collapse
|
4
|
Moltzau Anderson J, Horn F. (Re-) Defining evolutionary medicine. Ecol Evol 2020; 10:10930-10936. [PMID: 33144938 PMCID: PMC7593192 DOI: 10.1002/ece3.6825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 11/26/2022] Open
Abstract
The applicability of evolutionary biology principles to diseases has been largely questioned by the medical field. While Evolutionary Medicine (EM) developed in part to lessen this gap, EM is an independent field from both evolution and medicine, whose continued narrowing of topics as a consequence of its reductionist approach, in addition to its focus to introduce itself at a late stage in medical education, has led to its continued resistance toward implementation. In turn, this has had a profound and lasting impact on the awareness of evolution in medicine among physicians. For both the evolutionary and medical communities to reach a common perspective and obtain a greater frame-work of medical thought, a comprehensive view of the evolution of the healthy human being needs to be introduced as a starting point during the premedical curriculum. Here, we present our views on the ongoing challenges that have caused the continued division between the evolutionary fields and medicine, and provide solutions to help bridge the gap for an interdisciplinary field of evolution in medicine.
Collapse
|
5
|
Power ML, Snead C, Reed EG, Schulkin J. Integrating evolution into medical education for women's health care practitioners. Evol Med Public Health 2020; 2020:60-67. [PMID: 32382419 PMCID: PMC7196338 DOI: 10.1093/emph/eoaa009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/24/2022] Open
Abstract
Evolution is a fundamental principle in biology; however, it has been neglected in medical education. We argue that an evolutionary perspective is especially important for women's health care providers, as selection will act strongly on reproductive parameters, and the biological costs of female reproduction are generally more resource expensive than for men (e.g. due to gestation and lactation) with greater effects on health and wellbeing. An evolutionary perspective is needed to understand antibiotic resistance, disease and health risks associated with mismatches between our evolved adaptations and current conditions, the importance of the microbiome and the maternal role in how infants acquire and develop their early-life microbiome (vaginal birth, lactation), and the importance of breastmilk as a biochemical signal from mothers to their babies. We present data that obstetrician-gynecologists' views regarding the inclusion of evolution within their training is generally positive, but many barriers are perceived. Requiring coursework in evolutionary biology with an emphasis on evolutionary medicine prior to enrollment in medical school may be a solution.
Collapse
Affiliation(s)
- Michael L Power
- Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC 20013-7012, USA
- American College of Obstetricians and Gynecologists, Washington, DC 20024-2188, USA
| | - Carrie Snead
- American College of Obstetricians and Gynecologists, Washington, DC 20024-2188, USA
| | - Eda G Reed
- Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC 20013-7012, USA
- Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jay Schulkin
- Obstetrics & Gynecology, University of Washington School of Medicine, Seattle, WA 98195, USA
| |
Collapse
|
6
|
Grunspan DZ, Moeller KT, Nesse RM, Brownell SE. The state of evolutionary medicine in undergraduate education. EVOLUTION MEDICINE AND PUBLIC HEALTH 2019; 2019:82-92. [PMID: 31205719 PMCID: PMC6557193 DOI: 10.1093/emph/eoz012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/22/2019] [Indexed: 01/30/2023]
Abstract
Background and objectives Undergraduate courses that include evolutionary medicine (EM) are increasingly available, but quantified data about such courses are lacking. In this article, we describe relevant course offerings by institution and department type, in conjunction with information on the backgrounds and experiences of associated instructors. Methodology We searched course catalogs from 196 American universities to find courses that include EM, and sent a survey to 101 EM instructors to ask about their backgrounds and teaching experiences. Results Research-focused universities (R1) were much more likely to offer at least one course that covers evolutionary applications to health and disease than universities that granted only bachelor's or master's degrees. A survey course on EM was offered in 56% of 116 R1 universities, but only 2% of the 80 non-R1 universities we searched. Most EM instructors have backgrounds in anthropology or biology; each instructor's area of expertise provides clues as to how continued growth of EM may occur differently by discipline. Conclusions and implications Undergraduates are most likely to learn about EM in research-intensive universities from an anthropological or biological perspective. Responses from anthropology and biology instructors, including whom they share course materials with, highlight that courses may differ depending on the discipline in which they are taught. LAY SUMMARY Recognition of evolution's relevance to understanding health and disease is growing, but documentation of coverage in undergraduate education is lacking. This study explores where evolutionary medicine (EM) content is taught across 196 undergraduate institutions and how 53 instructors describe their experiences teaching EM.
Collapse
Affiliation(s)
- Daniel Z Grunspan
- Center for Evolution and Medicine, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA
| | - Karla T Moeller
- School of Life Sciences, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA
| | - Randolph M Nesse
- Center for Evolution and Medicine, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA
| | - Sara E Brownell
- Center for Evolution and Medicine, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA
| |
Collapse
|
7
|
Basile AJ, Schwartz DB, Rigdon J, Stapell H. Status of evolutionary medicine within the field of nutrition and dietetics: A survey of professionals and students. Evol Med Public Health 2018; 2018:201-210. [PMID: 30254747 PMCID: PMC6146772 DOI: 10.1093/emph/eoy022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/01/2018] [Indexed: 01/03/2023] Open
Abstract
LAY SUMMARY Through an online survey of nutrition and dietetic professionals and students, we learned there is interest to incorporate evolutionary medicine into the nutrition and dietetics field and education programs. BACKGROUND AND OBJECTIVES Evolutionary medicine is an emerging field that examines the evolutionary significance of modern disease to develop new preventative strategies or treatments. While many areas of interest in evolutionary medicine and public health involve diet, we currently lack an understanding of whether nutrition and dietetics professionals and students appreciate the potential of evolutionary medicine. METHODOLOGY Cross-sectional online survey to measure the level of appreciation, applicability and knowledge of evolutionary medicine among nutrition and dietetics professionals and students. We then examined the relationships between support of evolutionary medicine and (i) professionals and students, (ii) US region, (iii) religious belief and (iv) existing evolutionary knowledge. RESULTS A total of 2039 people participated: students (n = 893) and professionals (n = 1146). The majority of the participants agree they are knowledgeable on the theory of evolution (59%), an understanding of evolution can aid the nutrition and dietetics field (58%), an evolutionary perspective would be beneficial in dietetics education (51%) and it is equally important to understand both the evolutionary and direct causes of disease (71%). Significant differences in responses between professionals and students suggest students are currently learning more about evolution and are also more supportive of using an evolutionary perspective. Whereas differences in responses by US region were minimal, differences by religious belief and prior evolutionary knowledge were significant; however, all responses were either neutral or supportive at varying strengths. CONCLUSION AND IMPLICATIONS There is interest among professionals and students to incorporate evolutionary medicine into the nutrition and dietetics field and education programs.
Collapse
Affiliation(s)
- Anthony J Basile
- School of Life Sciences, Arizona State University, 427 E Tyler Mall #4601, Tempe, AZ, USA
- Institute of Human Nutrition, Columbia University Medical Center, 630 West 168th Street PH1512, New York, NY, USA
| | - David B Schwartz
- Department of Sociology, Princeton University260 College Ave Apt. E, Palo Alto, CA, USA
| | - Joseph Rigdon
- Quantitative Science Unit, Stanford University School of Medicine, 1070 Arastradero Rd, Palo Alto, Stanford, CA, USA
| | - Hamilton Stapell
- Department of History, State University of New York, 600 Hawk Dr, New Paltz, NY, USA
| |
Collapse
|
8
|
Enam SF, Hashmi S. The importance of Evolutionary Medicine in developing countries: A case for Pakistan's medical schools. EVOLUTION MEDICINE AND PUBLIC HEALTH 2018; 2018:26-33. [PMID: 29492264 PMCID: PMC5822701 DOI: 10.1093/emph/eoy004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/21/2018] [Indexed: 01/16/2023]
Abstract
Evolutionary Medicine (EM) is a fundamental science exploring why our bodies are plagued with disease and hindered by limitations. EM views the body as an assortment of benefits, mistakes, and compromises molded over millennia. It highlights the role of evolution in numerous diseases encountered in community and family medicine clinics of developing countries. It enables us to ask informed questions and develop novel responses to global health problems. An understanding of the field is thus crucial for budding doctors, but its study is currently limited to a handful of medical schools in high-income countries. For the developing world, Pakistan's medical schools may be excellent starting posts as the country is beset with communicable and non-communicable diseases that are shaped by evolution. Remarkably, Pakistani medical students are open to studying and incorporating EM into their training. Understanding the principles of EM could empower them to tackle growing health problems in the country. Additionally, some difficulties that western medical schools face in integrating EM into their curriculum may not be a hindrance in Pakistan. We propose solutions for the remaining challenges, including obstinate religious sentiments. Herein, we make the case that incorporating EM is particularly important in developing countries such as Pakistan and that it is achievable in its medical student body.
Collapse
Affiliation(s)
- Syed Faaiz Enam
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Shumaila Hashmi
- Greater Manchester Mental Health Trust, Manchester M25 3BL, UK
| |
Collapse
|
9
|
Grunspan DZ, Nesse RM, Barnes ME, Brownell SE. Core principles of evolutionary medicine: A Delphi study. Evol Med Public Health 2017; 2018:13-23. [PMID: 29493660 PMCID: PMC5822696 DOI: 10.1093/emph/eox025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/17/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education. METHODOLOGY The Delphi method was used to elicit and validate a list of core principles for evolutionary medicine. The study included four surveys administered in sequence to 56 expert panelists. The initial open-ended survey created a list of possible core principles; the three subsequent surveys winnowed the list and assessed the accuracy and importance of each principle. RESULTS Fourteen core principles elicited at least 80% of the panelists to agree or strongly agree that they were important core principles for evolutionary medicine. These principles over-lapped with concepts discussed in other articles discussing key concepts in evolutionary medicine. CONCLUSIONS AND IMPLICATIONS This set of core principles will be helpful for researchers and instructors in evolutionary medicine. We recommend that evolutionary medicine instructors use the list of core principles to construct learning goals. Evolutionary medicine is a young field, so this list of core principles will likely change as the field develops further.
Collapse
Affiliation(s)
- Daniel Z Grunspan
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ 85287, USA
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA
| | - Randolph M Nesse
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ 85287, USA
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA
| | | | - Sara E Brownell
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ 85287, USA
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA
| |
Collapse
|
10
|
Graves JL, Reiber C, Thanukos A, Hurtado M, Wolpaw T. Evolutionary Science as a Method to Facilitate Higher Level Thinking and Reasoning in Medical Training. EVOLUTION MEDICINE AND PUBLIC HEALTH 2016; 2016:358-368. [PMID: 27744353 PMCID: PMC5101907 DOI: 10.1093/emph/eow029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/29/2016] [Indexed: 12/16/2022]
Abstract
Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula. To illuminate how evolution may be helpful in these areas, examples in which the insights of evolutionary science are already improving medical treatment and ways in which evolutionary reasoning can be practiced in the context of medicine are provided. To facilitate the learning of evolutionary principles, concepts derived from evolutionary science that medical students and professionals should understand are outlined. These concepts are designed to be authoritative and at the same time easily accessible for anyone with the general biological knowledge of a first-year medical student. Thus, we conclude that medical practice informed by evolutionary principles will be more effective and lead to better patient outcomes. Furthermore, it is argued that evolutionary medicine complements general medical training because it provides an additional means by which medical students can practice the critical thinking skills that will be important in their future practice. We argue that core concepts from evolutionary science have the potential to improve critical thinking and facilitate more effective learning in medical training.
Collapse
Affiliation(s)
- Joseph L Graves
- Joint School for Nanoscience & Nanoengineering, North Carolina A&T State University & UNC Greensboro, 2907 E. Gate City Blvd, Greensboro, NC
| | - Chris Reiber
- Department of Anthropology, Binghamton University, PO Box 6000, Binghamton, NY 13902-6000
| | - Anna Thanukos
- University of California Museum of Paleontology, 1101 Valley Sciences Building, Berkeley, CA 94720-4780
| | - Magdalena Hurtado
- Department of Anthropology, Arizona State University, Tempe, AZ 85281
| | - Terry Wolpaw
- Penn State Health, Pennsylvania State University, 500 University Drive, Hershey, PA 17033
| |
Collapse
|