Evolutionary health promotion

S. Boyd Eaton, Beverly I. Strassman, Randolph M. Nesse, James V. Neel, Paul W. Ewald, George C. Williams, Alan B. Weder, Stanley B. Eaton, Staffan Lindeberg, Melvin J. Konner, Iver Mysterud, Loren Cordain

Research output: Contribution to journalReview articlepeer-review

163 Scopus citations


Health promotion's promise is enormous, but its potential is, as yet, unmatched by accomplishment. Life expectancy increases track more closely with economic prosperity and sanitary engineering than with strictly medical advances. Notable achievements in the past century - the decreased incidences of epidemic infections, dental caries, and stomach cancer - are owed to virologists, dentists, and (probably) refrigeration more than to physicians. Prevention speaks against tobacco abuse with a single voice, but in many other areas contradictory research findings have generated skepticism and even indifference among the general public for whom recommendations are targeted. Health promotion's shortcomings may reflect lack of an overall conceptual framework, a deficiency that might be corrected by adopting evolutionary premises: (1) The human genome was selected in past environments far different from those of the present. (2) Cultural evolution now proceeds too rapidly for genetic accommodation - resulting in dissociation between our genes and our lives. (3) This mismatch between biology and lifestyle fosters development of degenerative diseases. These principles could inform a research agenda and, ultimately, public policy: (1) Better characterize differences between ancient and modern life patterns. (2) Identify which of these affect the development of disease. (3) Integrate epidemiological, mechanistic, and genetic data with evolutionary principles to create an overarching formulation upon which to base persuasive, consistent, and effective recommendations.

Original languageEnglish (US)
Pages (from-to)109-118
Number of pages10
JournalPreventive Medicine
Issue number2
StatePublished - 2002
Externally publishedYes


  • Darwinian medicine
  • Disease prevention
  • Evolutionary medicine
  • Health promotion
  • Human evolution

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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