Evolutionary tips to combat low-grade inflammation - guest blog Remko Kuipers

Over the past century, our life expectancy has increased enormously. The average life expectancy of both men and women in the Netherlands is now around eighty years. What is much less known is that although our life expectancy is increasing, our healthy life expectancy has been declining for decades. In this blog by cardiologist Remko Kuipers you can read about the changes in human living conditions and nutrition over the last 10,000 years, the stress this places on our body and the effect it has on our health. And of course what you can do to adjust your behavior with this knowledge.

About Remko Kuipers

This blog was written by Remko Kuipers . Remko is a health coach, cardiologist and researcher.

After almost ten years of research, he obtained his PhD in evolutionary medicine on the subject of nutrition in 2012. Due to his extensive prior training and his long-term research project, he is better than anyone else aware of the scientific truths and myths that exist surrounding nutrition. During his research he lived for several years among the primitive hunter-gatherers of Africa.

Remko is a bestselling author, known for his books “The Primal Diet” and “Oergezond”.

Although we are getting older, we are also getting sick at younger ages

Over the past century, our life expectancy has increased enormously. The average life expectancy of both men and women in the Netherlands is now around eighty years. What is much less known is that although our life expectancy is increasing, our healthy life expectancy has been declining for decades ( source: CBS ).

Since the 1980s, life expectancy without chronic disease has fallen from 55 to 47 years for men and from 54 to 40 years for women.

It is striking that despite their higher life expectancy, women have a shorter healthy life expectancy than men.

This declining healthy life expectancy is partly explained by better screening methods and changing reference values ​​and definitions of disease. Unfortunately, this seems to be the prevailing image among doctors and policymakers and therefore in the media and among the Dutch population.

However, another explanation is that we are simply becoming ill at an increasingly younger age . However, this simple explanation, in which the cause is just as simple to pinpoint, is preferred to be dismissed by certain stakeholders with the above arguments.

Evolutionary Medicine

The alternative explanation for better screening methods and changing reference values ​​and definitions of disease comes from a relatively young scientific discipline called “Evolutionary Medicine”.

In contrast to “modern” medicine, as taught during the current university course 'Medicine or Medicine', Evolutionary Medicine does not primarily focus on treating, but on preventing diseases.

An Evolutionary Physician tries to prevent diseases by looking at a disease through an evolutionary lens. This means that a disease is viewed from the perspective that evolution is aimed at the survival or reproduction of an individual or a species. In other words, diseases are actually an illogical 'process' from an evolutionary point of view, since diseases do not appear to contribute to survival or reproduction.

An evolutionary physician therefore tries to find (evolutionary) explanations for the disease. These explanations can be many, for example it may be the case that a certain 'disease' has a (yet unrecognized) evolutionary advantage.

For example, we know that people with the disease 'sickle cell anemia' are less susceptible to contracting malaria. That observation fits exactly with the frequent occurrence of sickle cell anemia in places where malaria occurs. In those places, through 'survival of the fittest', evolution has ensured the survival of the people who were best adapted to the prevailing 'conditions of existence' in that place. In other words: where there is a lot of malaria, people with sickle cell anemia survive better than people without the disease ( source: Kuipers, 2012 ).

The Evolutionary Mismatch

Another common evolutionary explanation for diseases is a sudden change in the living conditions of an individual or species.

After all, evolution is a very gradual process that cannot take place within a single generation, but is a process that takes many thousands, if not tens of thousands or even hundreds of thousands of years. Remember that the spread of genes that confer a survival advantage, or a favorable genotype, will take many generations.

Imagine that a new, very beneficial mutation occurs in one individual in a certain species of which there are only a hundred in total. If that mutation allows that individual to have four offspring and his peers only have three, then it will take another 14 generations before there are more people with the favorable genotype. Even if the favorable genotype 5 and the unfavorable genotype 2 had children, it would still take 5 generations for a small population of a hundred people to have more people who possess that favorable genotype.

Evolution is a slow process in species that reproduce only slowly, such as humans, so that sudden changes in the living environment (conditions of existence) can cause health problems.

After all, most animal species – including humans – have slowly but surely adapted to the environment in which they live over millions of years of evolution, over thousands of generations.

If we reconstruct the history of our distant ancestors, we come to the conclusion that they originated in Africa about 6 million years ago. From that moment on, our paths parted from those of our last ape-like relatives and we moved from the jungle into the savannah and settled along the waterfront, where we enjoyed all the food that this rich biotope offered to us.

For almost 6 million years, we have been able to adapt perfectly to life on and partly in water for many generations.

Since about 10,000 years ago, we have been changing our living environment with increasing speed.

The first change was the Agricultural Revolution , or the introduction of agriculture and livestock farming, from the Middle East. Fossil remains of the last hunter-gatherers and the first farmers show that this sudden adjustment in “conditions of existence” was at the expense of our health.

The fact that the vast majority of people living in Western Europe can now digest the milk sugar lactose shows that evolution has not stood still over the past 10,000 years and that certain members of our species have to some extent adapted to this have been able to adapt to the new living environment.

However, just 200 years ago the... Industrial Revolution and only 50 years ago the Fast Food Revolution .

Many, if not all, of our typical Western lifestyle diseases can be attributed to the fact that our genes have not been able to adapt to these very recent changes in our lifestyle, because since the introduction of fast food it has not even been time for a generation passed.

Evolutionary physicians therefore see lifestyle diseases as a conflict or mismatch between our 'Stone Age genes' and our modern living environment. Take into account that current medicine manages to keep us alive for a long time despite all our lifestyle diseases and it is clear that evolution no longer has any influence on our health.

Approaching diseases from an evolutionary perspective

Anyone who is ill can be treated with all kinds of medications and operations in classical medicine to become healthy again. In the case of medicines, someone often never becomes truly healthy again, but often remains chronically ill.

Within Evolutionary Medicine, the preference is to prevent, rather than treat, diseases. From that perspective, the idea is that imitating our lifestyle before the Agricultural Revolution could restore the balance or 'match' between our 'Stone Age genes' and our living environment.

Anyone who wants to be and remain healthy in our Western society should firstly know what our “primeval environment” was and secondly what the most unhealthy modern influences are.

With regard to our primeval environment, it is now clear that our parents evolved in South East Africa over millions of years. They were physically active, living in relatively small groups of up to 300 people on the waterfront. At that time, the environment changed from jungle to savannah and steppe and our ancestor developed from vegetarian to omnivore.

Important ingredients of the diet that our ancestors enjoyed there include iodine, selenium, zinc, magnesium, the omega-3 fish fatty acids EPA and DHA and vitamins A and D ( Source: Kuipers et al, 2013 ).

Consequences of the mismatch

An ever-increasing amount of scientific research shows that the recent changes in our environment since the Agricultural Revolution all lead to 'unhealthy reactions' in the human body. Collectively, these reactions are often referred to as a so-called low grade inflammation .

For example, not everyone digests agricultural products such as grains or livestock products such as dairy equally well. In some individuals, the ingestion of grains or dairy products leads to irritation of the intestinal mucosa, causing damage to the intestine and as a result, certain intestinal bacteria can move from the intestine into the bloodstream, where they do not belong. Once these bacteria are detected in the bloodstream, our body activates the immune system to repel these harmful invaders.

This activation of the immune system and all the associated reactions in the body that result from it are known as low-grade inflammation. This low level of inflammation is in turn associated with the occurrence of lifestyle diseases ranging from cancer to cardiovascular disease, rheumatism to diabetes and from autoimmune diseases to certain psychological disorders.

Back to our primal diet

To remain or become healthy, returning to our primal lifestyle, including our primal diet, seems a much more logical choice. For some people, this will also be a much easier choice than being on medication for life or ending up under the surgeon's knife. Although as a cardiologist I have now discovered that some people find this a very acceptable sacrifice, if it means they can continue to follow a kind of anti-primal lifestyle for life, which involves sitting in front of the TV or computer, smoking and consuming alcohol, chips and fast food are the regular ingredients.

Fortunately, there is also an increasing group of consumers as well as politicians, employers and entrepreneurs who realize that a healthy lifestyle is a cheaper way to maintain good health than a lifetime of chronic illness treated with medication. Moreover, good health is associated with more productivity and lower costs, therefore with more economic prosperity, but also, and perhaps most importantly, with more happiness in life.

What can you do yourself?

To prevent low-level inflammation in your body, it is important to live a healthy life. This initially means sufficient exercise and sufficient relaxation, or the other way around: less sitting and less stress.

Furthermore, our bodies appear to be particularly poorly adapted to so-called ultra-processed food or fast food. Soft drinks are also in fact a form of fast food, because our distant ancestors drank only water when they were thirsty. The fact that our bodies seem least adapted to fast food is exactly consistent with the idea from Evolutionary Medicine that our bodies have had the least time to adapt to this most recent change in environment.

The previous major environmental change was the Industrial Revolution. With regard to our food, it was 'discovered' during that period that food has a longer shelf life if, for example, salt is added to it, if it is canned or freeze-dried, or if certain substances are added for life (of micro-organisms - but also for humans). essential nutrients such as vitamins and minerals are removed from the food.

Consider, for example, making white rice and white bread instead of brown rice and whole wheat bread. Or eating ketchup instead of tomatoes, etc. The most important consequence of this revolution was the shift in the balance from feeding (with the nutrients necessary for our health such as fiber, vitamins and minerals) to filling (with calories). This revolution was accompanied by renowned diseases such as beriberi (a lack of vitamin B), scurvy (a lack of vitamin C) and rickets (a lack of vitamin D).

Almost 10,000 years earlier, the Agricultural Revolution had taken place and even today certain diseases can still be linked to this change in living environment, such as celiac disease (an allergy to gluten from grains) and lactose intolerance (an allergy to dairy). .

Returning to the diet of our hunting and gathering ancestors seems to be the easiest way to grow old healthily.

The life of our ancestors, who, as described earlier, evolved along the waterfront for millions of years, consisted of a richly varied palette of vegetables, fruit, tubers, seeds, nuts, poultry, meat and fish. In particular, the amount of vegetables, fruit and fish in the average Western diet is far below par. The National Institute for Public Health and the Environment (RIVM) calculated a few years ago that the Netherlands is losing 245,000 healthy years of life every year due to unhealthy nutrition, mainly due to a shortage of fish, fruit and vegetables ( Source: RIVM – Our food measured, 2004 ).

Vegetables, fruits and fish

The health of fruits and vegetables can be traced back to the large amount of healthy nutrients in these foods, such as the well-known fibers, vitamins and minerals.

Fruit and vegetables have relatively fewer calories on average than grains, dairy, tubers and fast food respectively, so you can eat more of them without consuming too many calories. Knowing that obesity is one of the main causes of the increasing number of lifestyle diseases in our Western society, consuming fewer calories can certainly be seen as a health advantage.

Fish is one of humanity's most underestimated and underappreciated evolutionary sources of nutrition.

Compared to our closest relatives, the chimpanzee and the bonobo, we distinguish ourselves by our intelligence, which is a result of a three times larger brain volume.

Our brains are made up of building materials from fish, shellfish and aquatic plants that, unlike the chimpanzee and bonobo, we ingest in very large quantities at the water's edge. These omega-3 fatty acids may have been the most important drivers of our brain growth and also fulfill many other essential functions in our body.

Fish fatty acids or omega-3 fatty acids

Omega-3 fats are long, flexible molecules that play an important role in various places in our body. First of all, they are involved in our immune system. In other words, they play a role in low-grade inflammation.

With healthy intake, omega-3 fatty acids can play a role in suppressing low-level inflammation. A deficiency of omega-3 fats in the diet can actually lead to low-grade inflammation being insufficiently suppressed.

In our ancient diet there was always a certain balance between pro-inflammatory omega-6 and anti-inflammatory omega-3 fatty acids.

A shift in our current diet to less fish and more fast food has created an unhealthy balance with a surplus of omega-6 and a shortage of omega-3 fats, resulting in an overactive immune system and low levels of inflammation ( Source: Kuipers, 2012 ).

Omega-3 fats have now largely proven their effectiveness in cardiovascular disease.

Several large observational and (double-blind randomized) intervention studies have now shown that people with the most omega-3 fats in their tissues (also called the omega-3 index) had the smallest chance of having a heart attack and, more importantly, the smallest chance of dying from it ( Source: Bhatt, 2019 ). An omega-3 index of 8% or higher is now considered a target value for optimal cardiovascular health ( Source: Von Schacky, 2014 ).

Finally, omega-3 fats have been extensively examined in the context of our brain and therefore our psyche. Fortunately, after decades of research, it seems difficult to demonstrate differences in health or intelligence between children of mothers who consumed a lot or little (extra) omega-3 fat before or during childbirth.

In the case of a low dietary omega-3 intake, it appears that a pregnant woman compensates for this impending deficiency for the child developing in her womb by releasing omega-3 fats from her own body ( Source: Kuipers et al , 2011 ). As a result, scientific research has not been able to demonstrate a difference in the health of the child, but has been able to demonstrate a difference in the health of the mothers.

For example, women appeared to have less chance of developing diabetes pre-eclampsia (or preeclampsia) and peripartum depression if there was sufficient omega-3 fats in their body.

So make sure that oily fish becomes an important part of your diet (register below and receive the free recipe book from Care by Nature) and preferably eat it 2 to 3 times a week, possibly supplemented with a high-quality supplement ( click here for an overview of supplements on the Dutch market).

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Conclusion

In summary, a person is “like a fish in water” in his own “conditions of existence” and that is living according to the lifestyle of our distant ancestors in the Stone Age.

Of course, we don't have to go back to the Stone Age and we don't have to run after wild animals dressed in animal fur, barefoot, with homemade axes, but that primeval lifestyle can also be given a modern twist. That is, we look for the most important components of that ancient lifestyle and incorporate them into our modern lifestyle.

Important parts of this are sufficient exercise, sitting less, relaxing enough, avoiding stress and eating healthier, in which fast food and soft drinks should be avoided and more vegetables, fruit and oily fish should be eaten.