Evolution has left us pluses and minuses in our health; here's a convoluted tour
Why do many of us humans have debilitating genetic diseases, including sickle cell anemia, excess blood iron (hemochromatosis), and a susceptibility to paralysis from eating common fava beans? Author Moalem, a physiologist and soon-to-be physican, recounts the protective role that these conditions have afforded against other hazards, such as hemochromatosis helping against bloodborne bacterial infections. The stories are complex, and he tells them in even more complex fashion, with many digressions. This can be maddening at times, but the topics introduced along the way have some interest in themselves.
Each genetic disease - or disease susceptibility, in some cases - is introduced with a story of an individual, to add personal interest. By the way, my first sentence is misleading. He does not discuss sickle cell anemia, for which the full condition is lethal, while the heterozygous condition protects against malaria (that's the case when only one of our two genes coding for hemoglobin has the variant form). Moalem goes into some deep and interesting genetics. The most novel part of the book for most readers is probably the story of DNA methylation. This is the modification of our DNA post-facto to make some of it less readable than the rest. It acts as a second level of genetics and is linked to trends in obesity, brain development, and hypertension...and it's something that we can affect ourselves, for better or worse.
Moalem's chapter, "That's Life: Why You and Your iPod Must Die," synthesizes facts that have been known for some years, while being an eye-opener for most people. A bit of larger context is missing, which other writers have termed something like "death is the price of sex." Sexually-reproducing organisms, like humans and unlike, say, bacteria, have lots of built-in protections against changes in environmental conditions, from having two copies of each gene (a bit more complex, but it's a good summary). We avoid the accumulation of bad mutations, and we can grow into complex organisms with diverse capabilities...but we can't reproduce by fission as do bacteria. We have to mate and die. Would you want to last that much longer, anyway? Moalem details why we do "run down" and wear out, to the cellular level. The story is incomplete, at least, from my perspective, in that it doesn't cover non-genetic damage (e.g., progressive loss of our ability to handle oxygen safely in our cellular metabolism) as contributory to the finitude of our lifespan. Moalem does cover the "nicety" that a limit on reproduction by our individual cells is a potent, if incomplete, protection against cancer.
Overall, the book is a good read, a page turner. It may lead you to a healthier lifestyle, and certainly to several hours of high-level amusement.
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Overview
Was diabetes evolution's response to the last Ice Age? Did a deadly genetic disease help our ancestors survive the bubonic plagues of Europe? Will a visit to the tanning salon help lower your cholesterol? Why do we age? Why are some people immune to HIV? Can your genes be turned on—or off?
Survival of the Sickest is fi lled with fascinating insights and cutting-edge research, presented in a way that is both accessible and utterly absorbing. This is a book about the interconnectedness of all life on earth—and especially what that means for us. Read it. You're already living it.