Diapositiva 1

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Malocclusions and Urolithiasis in the Context of
Evolutionary Medicine Libertini G. (M.D.,
Independent Researcher)
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Evolutionary Medicine is not an Alternative
Medicine (like homeopathy, iridology, ayurvedic
medicine, naturopathy, traditional Chinese
medicine, energy medicine, etc.) but a Medicine
that is more thoroughly scientific in that it
involves the concepts of Evolutionism.
Evolutionary Medicine involves many concepts and
applicative consequences. Here, I develop a
practical application of a simple concept, the
mismatch 1,2, to the genesis of malocclusions
and of urolithiasis.
What is Evolutionary Medicine? Evolutionary or
Darwinian Medicine 1-6 comes into being in 1991
1, but there are some known forerunners 7
(e.g. 8) and others not generally cited as
forerunners 9,10.
A medicine that ignored the principles of
chemistry, for example, would be partially
scientific. Similarly, a medicine that ignores
the principles of evolution is partially
scientific.
1 Williams GC, Nesse RM (1991) The dawn of
Darwinian medicine. Quart. Rev. Biol. 66,
1-22. 2 Nesse RM, Williams GC (1994) Why we get
sick. New York (USA), Times Books. 3 Stearns SC
(ed) (1999) Evolution in health and disease (1st
ed.). Oxford (UK), Oxford University Press. 4
Trevathan WR, Smith EO, McKenna JJ (eds) (1999)
Evolutionary Medicine. New York (USA), Oxford
University Press. 5 Trevathan WR, Smith EO,
McKenna JJ (eds) (2008) Evolutionary Medicine
new perspectives. New York (USA), Oxford
University Press. 6 Stearns SC, Koella JC (eds)
(2008) Evolution in health and disease (2nd ed.).
Oxford (UK), Oxford University Press. 7
Trevathan WR, Smith EO, McKenna JJ (2008)
Introduction and overview of Evolutionary
Medicine. In Trevathan WR, Smith EO, McKenna JJ
(eds) Evolutionary Medicine new perspectives.
New York (USA), Oxford University Press. 8
Eaton SB, Shostak M, Konner M (1988) The
paleolithic prescription a program of diet
exercise and a design for living. New York (USA),
Harper Row. 9 Price WA (1939) Nutrition and
Physical Degeneration. New York London, Paul B.
Hoeber. 10 Libertini G (1983) Ragionamenti
Evoluzionistici. Naples (Italy), Società Editrice
Napoletana English Edition (2011) Evolutionary
Arguments. Crownsville (USA), Azinet Press.
The concept of mismatch is simple but with huge
implications
So, the contrast is not between current medicine
and alternative medicines but between current
medicine (which in most cases ignores
Evolutionism) and Evolutionary Medicine (which is
a more thoroughly scientific medicine)
If a species is adapted to a certain range of
conditions (including diet, environmental
conditions, interrelations with other living
beings, etc.), called for brevity ecological
niche, any change in the ecological niche
potentially is a source of disfunctions
(diseases), because there is no adaptation to the
new conditions. This is defined as "mismatch.
1 Eaton SB, Shostak M, Konner M (1988) The
paleolithic prescription a program of diet
exercise and a design for living. New York (USA),
Harper Row. 2 Libertini G (2009) Prospects of
a Longer Life Span beyond the Beneficial Effects
of a Healthy Lifestyle, in Bentely JV, Keller MA
(eds) Handbook on Longevity Genetics, Diet
Disease, New York (USA), Nova Science Publishers
Inc.
Is this difference only a theoretical / verbal
nicety? or Does this difference have strong and
significant implications for the structure of
medical studies and for health organization?
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Malocclusions and Urolithiasis in the Context of
Evolutionary Medicine
A study on Tanzanian children showed that 63.8
per cent of the subjects had at least one type of
anomaly 1. For Urolithiasis The overall
probability of forming stones differs in various
parts of the world 1-5 in Asia, 5-9 in Europe,
13 in North America, 20 in Saudi Arabia.
2 Among 20- to 74-old United States residents
nephrolithiasis incidence increased from 3.8 in
the period 1976-1980 to 5.2 in the period
1988-1994 3. Recent data provide evidence that
the incidence of nephrolithiasis in children is
rising. 4  
Pediatric urolithiasis has increased globally
in the last few decades. 1 There has been
considerable increase in the incidence of
idiopathic renal stone in Europe, North America,
Australasia and Japan within the present century
(Grossmann, 1938 Inada et al., 1958 Andersen,
1969 Fig. 4.1) 2
Step 1 - Epidemiological study of modern
populations For Malocclusions In USA
Noticeable incisor irregularity occurs in the
majority of all racial/ethnic groups, with only
35 of adults having well-aligned mandibular
incisors. Irregularity is severe enough in 15
that both social acceptability and function could
be affected, and major arch expansion or
extraction of some teeth would be required for
correction. 1 In a study on Peruvian children
The prevalence of malocclusions was 85.6
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1 Mtaya M et al. (2009) Prevalence of
malocclusion and its relationship with
socio-demographic factors, dental caries, and
oral hygiene in 12- to 14-year-old Tanzanian
schoolchildren. Eur. J. Orthod. 31, 467-76. 2
Ramello A et al. (2000) Epidemiology of
nephrolithiasis. J. Nephrol. 13, S45-50. 3
Stamatelou KK et al. (2003) Time trends in
reported prevalence of kidney stones in the
United States 1976-1994. Kidney Int. 63,
1817-23. 4 Sas DJ. (2011) An update on the
changing epidemiology and metabolic risk factors
in pediatric kidney stone disease. Clin. J. Am.
Soc. Nephrol. 6, 2062-8.
1 Proffit WR et al. (1998) Prevalence of
malocclusion and orthodontic treatment need in
the United States estimates from the NHANES III
survey. Int. J. Adult Orthodon. Orthognath. Surg.
13, 97-106. 2 Aliaga-Del Castillo A et al.
(2011) Malocclusions in children and adolescents
from villages and native communities in the
Ucayali Amazon region in Peru Article in
Spanish Rev. Peru Med. Exp. Salud Publica 28,
87-91.
1 Sharma AP, Filler G. (2010) Epidemiology of
pediatric urolithiasis. Indian J. Urol. 26,
516-22. 2 Trowell HC, Burkitt DP (eds) (1981).
Western diseases, their emergence and prevention.
Edward Arnold, USA.
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Step 2 - Comparison between the frequency of a
disease in modern populations and the frequency
of the same disease in populations in primitive
conditions
Price, in his irreproducible work 1,
documented in many parts of the world (in people
now completely modernized, but in 1939 divided
into groups living in primitive conditions and
others with more or less advanced degree of
civilization) very different rates of tooth decay
depending on the degree of diet modernization. In
populations living with a natural diet, the set
of teeth was well-formed, the bones of the face
well developed, and the teeth practically free
from caries (fig. 17 from 1). By contrast, in
populations with modernized diets, the set of
teeth was disordered, the face underdeveloped and
tooth decay widespread, and all these alterations
were proportional to the degree of diet
modifications (fig. 19 from 1).
For Malocclusions Although previous studies of
primitive Eskimos have reported practically no
malocclusion, 82 per cent of the children in this
study had malocclusions. 1 It is a matter of
great significance that the Eskimos who are
living in isolated districts and on native foods
have produced uniformly broad dental arches and
typical Eskimo facial patterns. Even the first
generation forsaking that diet and using the
modern diet, presents large numbers of
individuals with marked changes in facial and
dental arch form 2 from 25 to 75 per cent
of individuals in various communities in the
United States have a distinct irregularity in the
development of the dental arches and facial form
In a study of 1,276 skulls of these ancient
Peruvians, I did not find a single skull with
significant deformity of the dental arches. 2
(see fig. on the right)
Another important source of information
regarding the Aborigines of Australia was
provided by a study of the skeletal material and
skulls in the museums at Sydney and Canberra,
particularly the former. I do not know the number
of skulls that are available there for study, but
it is very large. I examined many and found them
remarkably uniform in design and quality. The
dental arches were splendidly formed. 1 Note
the marked difference in facial and dental arch
form of the two Samoan primitives above and the
two modernized below. The face bones are
underdeveloped below causing a marked
constriction of the arches with crowding of the
teeth. Comment to fig. 36 (on the right) from
1.

• 1 Barry FW (1971) Malocclusion in the modern
  Alaskan Eskimo. Amer. J. Orthod. 60, 344-54.
• 2 Price WA (1939) Nutrition and Physical
  Degeneration. New York London, Paul B. Hoeber.

Figures 17 (left) and 19 (right) from 1

• 1 Price WA (1939) Nutrition and Physical
  Degeneration. New York London, Paul B. Hoeber.

• 1 Price WA (1939) Nutrition and Physical
  Degeneration. New York London, Paul B. Hoeber.

Figure 78 from 2