Diapositiva 1

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Step 3 - Hypotheses on the possible changes in
the ecological niche underlying the disease and
on possible pathogenetical mechanisms
But if malocclusions are largely caused by
reduced intake of dietary calcium and by reduced
intake and production of vitamin D, these factors
could seem to cause a reduced frequency of
urolithiasis, a thing that is clearly
contradicted by data from modernized population.
Step 2 - (CONTINUED) ... For Urolithiasis Renal
stone is rare among persons living in poor or
primitive socio-economic circumstances and is
very rare in African Bantu living under tribal
conditions (Modlin, 1969) 1 To summarize,
from being virtually unknown in historical times,
renal stone has become significant as a common
morbid condition in the affluent, westernized
countries within the last 80 years whilst
remaining rare in communities where the people
live in primitive and poor conditions. 1
Price, in his fundamental work 1, not
surprisingly called Nutrition and Physical
Degeneration, attributes the high frequency of
malocclusions (and of other dental diseases) to
changes in diet and lifestyle compared with the
habits of primitive societies. A critical factor
emphasized by Price is the amount of dietary
vitamin D and of sun exposure for the formation
of additional vitamin D. According to Price, an
insufficient intake and absorption of dietary
calcium in the early years of life determines,
among other things, insufficient development of
facial bones and an improper development of the
set of teeth. Konner and Eaton 2 reported that
prior to 1990 the recommended daily intake of
vitamin D was 400 IU and that of calcium 800 mg.
In 2010, this advice had become 1000 IU of
vitamin D and 1000 mg of calcium. But the
estimate for the ancestral population was over
4000 IU of vitamin D (also by sunlight) and 1500
mg of calcium. It is clear that with regard to
ancestral conditions there is a strongly reduced
intake of dietary calcium and a considerable
deficiency of vitamin D, a poorly understood
problem even in scientific circles.
However, it has been shown that urolithiasis
frequency is inversely related to dietary calcium
intake 1-3, even though supplemental calcium
may increase the risk 2. Dietary calcium
reduces oxalate absorption and the urinary
excretion of oxalate and this lowers the risk of
kidney stones of calcium oxalate, the prevalent
type of stones 1. This may be due to increased
binding of oxalate by calcium in the
gastrointestinal tract 1. Other factors
correlated with a lower frequency of urolithiasis
are potassium intake 1 and fluid intake 1.
The intake of fiber and plant foods reduces
urinary calcium excretion and thus the frequency
of the stones, while carbohydrate intake has the
opposite effect 3. A higher protein intake is
associated with a moderate increase of
urolithiasis risk 1.
Epidemiological data strongly contrast the
possible hypothesis that the high frequencies of
malocclusions and urolithiasis suffered by modern
populations are caused by a recent (in
evolutionary terms) relaxation of natural
selection pressures. On the contrary, they
indicate that these diseases are largely due to
alterations of the ecological niche to which our
species is adapted, that is presumable phenomena
of mismatch.
1 Curhan GC et al. (1993) A Prospective Study
of Dietary Calcium and Other Nutrients and the
Risk of Symptomatic Kidney Stones. New Engl. J.
Medic. 328, 833-8. 2 Curhan GC et al. (1997)
Comparison of dietary calcium with supplemental
calcium and other nutrients as factors affecting
the risk for kidney stones in women. Ann.
Intern. Med. 126, 497-504. 3 Heller, HJ (1999)
The role of calcium in the prevention of kidney
stones. J. Am. Coll. Nutr. 18, 373S-378S.
1 Price WA (1939) Nutrition and Physical
Degeneration. New York London, Paul B.
Hoeber. 2 Konner M, Eaton SB (2010) Paleolithic
Nutrition Twenty-Five Years Later. Nutr. Clin.
Pract. 25, 594-602.

• 1 Trowell HC, Burkitt DP (eds) (1981). Western
  diseases, their emergence and prevention. Edward
  Arnold, USA.

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It is essential to compare the ancestral diet
with that of contemporary Western populations
1. In the table, the factors in the modern diet
that increase urolithiasis risk are highlighted
in pink, while those having the opposite effect
are highlighted in green. It is not shown in the
table the reduced intake of calcium in modern
diets that is strongly correlated with
urolithiasis frequency.
Step 4 - Study of the mechanisms linking the
alteration of the ecological niche to the
pathogenesis of the disease
For urolithiasis There is hypercalciuria in 95
of patients with nephrolithiasis 1. The
mechanism by which hypercalciuria causes an
increased risk of renal stones is known
2. There are foods that reduce calcium
absorption, and therefore the urinary calcium -
K, PO4, fiber, Alkali Load alias fruits and
vegetables - and others that have the opposite
effect supplemental Ca, Na, Mg, Carbohydrates,
Acid Load alias animal flesh - and the mechanisms
that cause these effects are quite known 2. But
an increase in dietary calcium reduces oxalate
absorption and oxalate excretion in the urine and
thus reduces the frequency with which they form
calcium oxalate stones, the most common type of
calculations 3.
Ancestral (Hunter-Gatherer) Contemporary Western
Total energy intake More Less
Caloric density Very low High
Dietary bulk More Less
Total carbohydrate intake Less More
Added sugars/refined carbohydrates Very little Much more
Glycemic load Relatively low High
Fruits and vegetables Twice as much Half as much
Antioxidant capacity Higher Lower
Fiber More Less
Solubleinsoluble Roughly 11 lt1 insoluble
Protein intake More Less
Total fat intake Roughly equal
Serum cholesterol-raising fat Less More
Total polyunsaturated fat More Less
?-6?-3 Roughly equal Far more ?-6
Long-chain essential fatty acids More Less
Cholesterol intake Equal or more Equal or less
Micronutrient intake More Less
Sodiumpotassium lt 1 gt1
Acid base impact Alkaline or acidic Acidic
Milk products Mothers milk only High, lifelong
Cereal grains Minimal Substantial
Free water intake More Less
For malocclusions The proper development of
facial bones and set of teeth is optimal when the
values ??of dietary calcium and of vitamin D
absorption and production are those to which our
species is adapted. Modernized alimentation has
severely altered these factors, and perhaps
others that are more or less important to a
correct development. The details of these
alterations and the mechanisms by which the
correct development is compromised require
further information and explanations, but the
correlation between alterations in diet and
lifestyle and the correct development of facial
bones and set of teeth are clear and well
documented for a long time past 1.
1 Levy FL et al. (1995) Ambulatory evaluation
of nephrolithiasis an update of a 1980 protocol.
Am. J. Med. 98, 50-9. 2 Heller, HJ (1999) The
role of calcium in the prevention of kidney
stones. J. Am. Coll. Nutr. 18, 373S-378S. 3
Curhan GC et al. (1993) A Prospective Study of
Dietary Calcium and Other Nutrients and the Risk
of Symptomatic Kidney Stones. New Engl. J. Medic.
328, 833-8.
But, meat from game is lean (wild condition),
while meat from breeding is fat (modern
conditions). By considering this, perhaps
proteins were not a risk factor in the wild.
1 Price WA (1939) Nutrition and Physical
Degeneration. New York London, Paul B. Hoeber.
1 Konner M, Eaton SB (2010) Paleolithic
Nutrition Twenty-Five Years Later. Nutr. Clin.
Pract. 25, 594-602.
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First Objection Before applying these measures of
prevention on a large scale, observation of
controlled groups in order to confirm their
validity is necessary.
Step 6 - Analysis of the results achieved and
ideation and proposal of further improvements
Step 5 - Possible restoration of the normal,
alias primeval, conditions or possible compensator
y conditions
Afterwards, it will be indispensable to evaluate
the results obtained with different types of diet
more or less suited to these principles. Useful
indications will be obtained from these results,
which obviously in their application will be
influenced by economic factors, dietary customs,
and individual choices. At the same time, it is
essential to continue the deepening of the study
of ancestral conditions of life to which our body
is better adapted.
But this objection would be generated by a
contradiction of current Medicine. In fact, when
a new drug is proposed, we rightly expect a
series of experiments, in several stages, before
its use is authorized. Meanwhile, the NON-use of
the drug is considered to be due and NOT subject
to preventive experimentation.

• It is clear that Paleolithic diet and lifestyle
  are optimal to prevent malocclusions and
  urolithiasis, but it is also true that the return
  to ancestral conditions of life is not feasible.
• More realistically, it is certainly useful to
  correct as much as possible those changes in diet
  and lifestyle that to a greater extent show to
  increase disease frequencies.
• Available data suggest the following indications
• - to increase the intake of dietary calcium,
  potassium and vitamin D to the levels estimated
  for the Paleolithic
• to increase the exposure to sunlight, so as to
  increase the production of vitamin D
• to increase the intake of foods and elements
  that reduce oxalate absorption and calcium
  absorption (and therefore urinary calcium K,
  PO4, fiber, Alkali Load alias fruits and
  vegetables)
• - to increase the intake of plain water
• to reduce the intake of the foods and elements
  that increase oxalate absorption and calcium
  absorption (and therefore urinary calcium
  supplemental Ca, Na, Mg, Carbohydrates, Acid Load
  alias animal flesh).

On the contrary, in the case of a new habit of
life, alias a change of the ecological niche, the
new habit is introduced and accepted WITHOUT any
trial that demonstrates its safety. Now, If a new
NOT tested habit of life is suspected of causing
illness, the indication to stop this habit of
life is rightful and proper. Why, before its
suspension, should we demonstrate its harmfulness
and the benefits resulting from its suspension?
If these guidelines were not followed, the
populations will gradually adapt to the new
conditions of life with known evolutionary
mechanisms, but it is good to point out that this
choice is ethically unacceptable as it would
result in countless cases of illness and death
before, over many generations, a good adaptation
will be reached.
Such an absurd principle has been used for
decades to extend the use of smoke without that
smokers were at least warned of the deadly risks
they were running. Again, a new habit (smoking)
was introduced without any evidence that proved
its safety and for decades it was claimed that
its harm should be proved before taking action
against it.
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Second Objection Malocclusions and urolithiasis
should be attributed to the combination of
environmental and genetic factors.
Conclusion
Any change of the ecological niche to which a
species is adapted must be considered potentially
harmful until the contrary is proved. In the
case of a new drug, this principle is
observed! Precautionary principle
Malocclusions and urolithiasis involve
significant costs and causes sufferings, reduced
quality of life and even death. Current Medicine
is directed to pursue means of correction that
are increasingly sophisticated and refined. But
the best goal would certainly be to minimize new
cases of malocclusions and urolithiasis,
reserving the cures to exceptional cases. This
would limit the degradation of quality of life, a
lot of suffering, and - last but something to be
reckoned with - rising costs. This is possible
with the correct application of trivial
principles of Evolutionary Medicine.
This is a misleading way of describing the
case. Certainly, when an individual is exposed to
an ecological niche to which its genes are not
adapted, in the diseases that are caused by the
altered ecological niche, his genes, which are
more or less resistant to the onset of diseases,
come into play. But, we cannot and should not
consider the genes that are less resistant to the
diseases as pathological they are entirely
normal genes that in new conditions, to which the
species is not adapted, have responses that are
more or less effective against the onset of
pathological changes. For example, our species is
certainly not adapted to smoking. If, in smokers,
some suffer respiratory failure, others chronic
bronchitis and others cancer, it is not correct
to say that those who develop these diseases have
bad genes that somehow must be corrected, or for
which it is necessary to develop opportune
treatments. The logic says that we must avoid the
alteration of the ecological niche and thus
prevent the development of diseases that result
from it. It should be noted that in some cases
malocclusions or urolithiasis are actually due to
genetic alterations. In these cases any
preventive measure is not able to prevent the
diseases. But, if we refer to data from the study
of populations living under primitive conditions,
the incidence of such cases is rare. Therefore,
the attribution of responsibility to genetic
factors should not be an excuse to diminish or
avoid to address the most attention and efforts
on prevention.
But for other modifications of the ecological
niche, no precaution is taken. It is presumed
irrationally and stupidly, because of
non-scientific evaluations that a modification
must not be considered harmful until the
experience proves the contrary! Imprudence
Principle

Modern doctors, largely unaware even of the most
basic principles of Evolutionism, do not know
these possibilities. At the same time,
evolutionary biologists are unaware of the
extreme importance of these possibilities for a
rational organization of a health system that
should primarily prevent diseases. It is
therefore essential the integration of the
knowledge of Evolutionism in the active body of
current Medicine, transforming it in Evolutionary
Medicine.
The correct scientific logic would be to take
steps against a change in the ecological niche on
the sole grounds of the suspicion that this
change is bad and BEFORE the sure demonstration
in irreproachable scientific terms.
Afterwards, the results in populations (or
fractions of populations), which pursue - to a
greater or lesser extent - the restoration of
more physiological (alias natural) conditions
must be compared both to confirm the expected
results and for evaluating other possible
measures. But one should not expect the results
of test samples before applying the aforesaid
preventive actions on a large scale.
This poster is on my personal pages too
www.r-site.org/ageing (e-mail giacinto.libertini_at_
tin.it)