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Survival of the Sickest: The Surprising Connections Between Disease and Longevity

Survival of the Sickest: The Surprising Connections Between Disease and Longevity

4.4 53
by Sharon Moalem, Jonathan Prince

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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?

Joining the ranks


Read it.

You're already living it.

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?

Joining the ranks of modern myth busters, Dr. Sharon Moalem turns our current understanding of illness on its head and challenges us to fundamentally change the way we think about our bodies, our health, and our relationship to just about every other living thing on earth, from plants and animals to insects and bacteria.

Through a fresh and engaging examination of our evolutionary history, Dr. Moalem reveals how many of the conditions that are diseases today actually gave our ancestors a leg up in the survival sweepstakes. When the option is a long life with a disease or a short one without it, evolution opts for disease almost every time.

Everything from the climate our ancestors lived in to the crops they planted and ate to their beverage of choice can be seen in our genetic inheritance. But Survival of the Sickest doesn't stop there. It goes on to demonstrate just how little modern medicine really understands about human health, and offers a new way of thinking that can help all of us live longer, healthier lives.

Survival of the Sickest is filled 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.

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Survival of the Sickest
The Surprising Connections Between Disease and Longevity

By Sharon Moalem HarperCollins Publishers, Inc.
Copyright © 2008
Sharon Moalem
All right reserved.

ISBN: 9780060889661

Chapter One

Ironing it Out

Aran Gordon is a born competitor. He's a top financial executive, a competitive swimmer since he was six years old, and a natural long-distance runner. A little more than a dozen years after he ran his first marathon in 1984 he set his sights on the Mount Everest of marathons—the Marathon des Sables, a 150-mile race across the Sahara Desert, all brutal heat and endless sand that test endurance runners like nothing else.

As he began to train he experienced something he'd never really had to deal with before—physical difficulty. He was tired all the time. His joints hurt. His heart seemed to skip a funny beat. He told his running partner he wasn't sure he could go on with training, with running at all. And he went to the doctor.

Actually, he went to doctors. Doctor after doctor—they couldn't account for his symptoms, or they drew the wrong conclusion. When his illness left him depressed, they told him it was stress and recommended he talk to a therapist. When blood tests revealed a liver problem, they told him he was drinking too much. Finally, after three years, his doctors uncovered the real problem. New tests revealed massive amounts of iron in his blood and liver—off-the-charts amounts of iron.

Aran Gordon was rusting to death.

Hemochromatosis is a hereditary disease that disrupts the waythe body metabolizes iron. Normally, when your body detects that it has sufficient iron in the blood, it reduces the amount of iron absorbed by your intestines from the food you eat. So even if you stuffed yourself with iron supplements you wouldn't load up with excess iron. Once your body is satisfied with the amount of iron it has, the excess will pass through you instead of being absorbed. But in a person who has hemochromatosis, the body always thinks that it doesn't have enough iron and continues to absorb iron unabated. This iron loading has deadly consequences over time. The excess iron is deposited throughout the body, ultimately damaging the joints, the major organs, and overall body chemistry. Unchecked, hemochromatosis can lead to liver failure, heart failure, diabetes, arthritis, infertility, psychiatric disorders, and even cancer. Unchecked, hemochromatosis will lead to death.

For more than 125 years after Armand Trousseau first described it in 1865, hemochromatosis was thought to be extremely rare. Then, in 1996, the primary gene that causes the condition was isolated for the first time. Since then, we've discovered that the gene for hemochromatosis is the most common genetic variant in people of Western European descent. If your ancestors are Western European, the odds are about one in three, or one in four, that you carry at least one copy of the hemochromatosis gene. Yet only one in two hundred people of Western European ancestry actually have hemochromatosis disease with all of its assorted symptoms. In genetics parlance, the degree that a given gene manifests itself in an individual is called penetrance. If a single gene means everyone who carries it will have dimples, that gene has very high or complete penetrance. On the other hand, a gene that requires a host of other circumstances to really manifest, like the gene for hemochromatosis, is considered to have low penetrance.

Aran Gordon had hemochromatosis. His body had been accumulating iron for more than thirty years. If it were untreated, doctors told him, it would kill him in another five. Fortunately for Aran, one of the oldest medical therapies known to man would soon enter his life and help him manage his iron-loading problem. But to get there, we have to go back.

Why would a disease so deadly be bred into our genetic code? You see, hemochromatosis isn't an infectious disease like malaria, related to bad habits like lung cancer caused by smoking, or a viral invader like smallpox. Hemochromatosis is inherited—and the gene for it is very common in certain populations. In evolutionary terms, that means we asked for it.

Remember how natural selection works. If a given genetic trait makes you stronger—especially if it makes you stronger before you have children—then you're more likely to survive, reproduce, and pass that trait on. If a given trait makes you weaker, you're less likely to survive, reproduce, and pass that trait on. Over time, species "select" those traits that make them stronger and eliminate those traits that make them weaker.

So why is a natural-born killer like hemochromatosis swimming in our gene pool? To answer that, we have to examine the relationship between life—not just human life, but pretty much all life—and iron. But before we do, think about this—why would you take a drug that is guaranteed to kill you in forty years? One reason, right? It's the only thing that will stop you from dying tomorrow.

Just about every form of life has a thing for iron. Humans need iron for nearly every function of our metabolism. Iron carries oxygen from our lungs through the bloodstream and releases it in the body where it's needed. Iron is built into the enzymes that do most of the chemical heavy lifting in our bodies, where it helps us to detoxify poisons and to convert sugars into energy. Iron-poor diets and other iron deficiencies are the most common cause of anemia, a lack of red blood cells that can cause fatigue, shortness of breath, and even heart failure. (As many as 20 percent of menstruating women may have iron-related anemia because their monthly blood loss produces an iron deficiency. That may be the case in as much as half of all pregnant women as well—they're not menstruating, but the passenger they're carrying is hungry for iron too!) Without enough iron our immune system functions poorly, the skin gets pale, and people can feel confused, dizzy, cold, and extremely fatigued.

Iron even explains why some areas of the world's ocean are crystal clear blue and almost devoid of life, while others are bright green . . .


Excerpted from Survival of the Sickest by Sharon Moalem Copyright © 2008 by Sharon Moalem. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Meet the Author

Dr. Sharon Moalem is an award-winning neurologist and evolutionary biologist, with a PhD in human physiology. His research brings evolution, genetics, biology, and medicine together to explain how the body works in new and fascinating ways. He and his work have been featured on CNN, in the New York Times, on The Daily Show with Jon Stewart, on Today, and in magazines such as New Scientist, Elle, and Martha Stewart's Body + Soul. Dr. Moalem's first book was the New York Times bestseller Survival of the Sickest. He lives in New York City.

Jonathan Prince was a senior adviser and speechwriter in the Clinton White House and oversaw communications strategy at NATO during the war in Kosovo. He was named one of America's Best and Brightest by Esquire in 2005 for his work to improve political advertising. With former U.S. senator John Edwards and Edwards's daughter Cate, Prince edited Home: The Blueprints of Our Lives.

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Survival of the Sickest 4.4 out of 5 based on 0 ratings. 53 reviews.
Anonymous More than 1 year ago
I was forced to read this book by my AP Biology teacher, but I'm glad she did! Moalem has a funny, sarcastic tone and a diction that is unlike a science journal, which has the boring fancy writing. This book gets straight to the point about diseases and genetics. And I actually want to read it again, as do other people in my class!
nattylight More than 1 year ago
This book is without a doubt amazing. It brings science into our everyday world and more importantly it makes science easy to understand. With every scientific explanation goes an interesting example in our lives today. One that I found incredible was our evolutionary need for diabetes. The author goes into the science of it and how our ancestors lived in an ice age and how to help keep their tissues and organs from freezing they developed diabetes. The sugar in our blood helps prevent our cells from freezing. Pay attention this is my favorite part! After explaining this, much better might I add, the author talks about the whole idea of sugar preventing freezing can be seen in our everyday slurpees that you get at a gas station! If you removed the sugar from a slurpee you would just have a block of ice! AMAZING!
songcatchers More than 1 year ago
Survival of the Sickest is an interesting and thought provoking book about disease. The author takes a handful of diseases, for example diabetes and favism, and looks at them from an evolutionary perspective. She shows how some of the diseases we have today might have actually been a good thing for our ancestors. "Evolution likes genetic traits that help us survive and reproduce-it doesn't like traits that weaken us or threaten our health (especially when they threaten it before we can reproduce)." If diabetes helped our ancestors survive the last ice age, those genes would have been passed on in reproduction. Dr. Moalem definitely makes sense in Survival of the Sickest. It gets a bit scientific in parts though and a little hard to digest. After reading this book I won't look at hereditary disease in quite the same way.
Guest More than 1 year ago
As a genealogist, and an armchair geneticist, this was a fascinating read. It's data was entertaining and easily accessible. A rare find.
Dashiell3 More than 1 year ago
Wow, what a wonderful book. It makes you rethink every genetic trait and disease that ever plagued the human race in recent memory, in an evolutionary context. I read this for my Advanced Biology class and it still stands out as one of my all-time favorites.
OKWANYVA More than 1 year ago
I loaned my copy to a friend and as usually, you don't often get loaned copies back. I now have a Nook and am thinking of buying this book again as a Nookbook. One great thing about this book is its index. As a person with Hemochromatosis, the book is greatly appreciated. But even if you don't have this genetic disorder, it is still worth reading since it talks about such things as Vitamin D and its relation to cholesterol and brown fat which helps Eskimos keep warm in a frozen climate. Then there are chapters that deal with reptiles that have different tails if certain predators such as snakes are in the vicinity. Again, a great book.
Anonymous More than 1 year ago
It was hard to put this book down, it covers topics of diabetes, malaria, and more. It includes why diseases are still in the gene pool and how they can be helpful for our survival.
Anonymous More than 1 year ago
Dr. Moalem does very well in explaining scientific concepts in layman's terms. I do admit that he tends to jump around a bit; however, he also does very well at tying all of his seemingly random tangents together. I'm pretty sure that I'd enjoy this book even if I did not have the background in the study of biology and genetics that I do. Definitely recommend it for anyone curious about disease and its evolution.
dsledoux08 More than 1 year ago
Survival of the Sickest by Dr. Sharon Moalem takes the reader through a different point of view on disease and life as we know it.  It answers questions one didn’t even know they had when talking about evolution and disease.  It is very well written and easy to follow.  The purpose of the book is to explain why diseases are vital to our specie’s evolution, why some diseases are still around today, and why some diseases died out with our ancestors.  It starts of telling the story of an ill grandfather and a very intrigued and determined young grandson who spent countless hours at the library looking through medical research books for an answer.  Once he reaches a conclusion on that quest, another illness pops up in his grandfather so his grandson begins searching for a connection between the two.  This lead to his choice to study biology in college and eventually earn a Ph.D..  By analyzing and comparing complex and intricate gene sequences, he figured out a connection.  He also traces the roots of many types of diseases such as diabetes, hemochromatosis, and STDs.  He also conducted research on genetic diseases, cholesterol, and gene expression.  A quote to sum up the book would be found in the conclusion stating, “I hope that you’ll come away from this book with an appreciation of three things.  First, that life is in a constant state of creation.  Evolution isn’t over- it’s all around you, changing as we go. Second, that nothing in our world exists in isolation.  We- meaning humans and animals and plants and microbes and everything else- are all evolving together.  And third, that our relationship with diseases is often much more complex than we may have previously realized.”
Frank Wahl More than 1 year ago
As a biology teacher, this book gave me more insight into genetic disorders and adds to your arsenal of responses for the never ending "why's?" It even answered many of my own.
Anonymous More than 1 year ago
It is facinating to find out how some of the health problems that plague us today may have evolved within us. She explains where high blood pressure came from, why some people are lighter then others, etc. If you interested in the evolution of genetic diseases then this is the perfact book!
GulliverJF More than 1 year ago
I have a limited background in science, but this book was very clear and easy to understand. I particularly enjoyed his discussion of epigenetics. I recommend this book for just about anyone, no matter what field they are in. I give it five stars, its an excellent book. I also plan to read Dr. Moalem's next book that is coming out soon.
KathleenBur More than 1 year ago
Survival of the Sickest is one of the most interesting and intriguing scientific books I have ever read. Its full of insightful ideas and theories as well as facts I never new before. This book explains why diseases are vital to our evolution, why some diseases are still around today, and why some diseases died out with our ancestors. It was very interesting to see how certain diseases are what make us who we are today and how essential these diseases and genetic disorders were essential to our evolutionary development. I would definitely recommend this book to anyone who is interested in genetics and diseases. It is very well written and is backed up with research and facts. Overall this is a very good book and I would highly recommend it.
VirziManSkells More than 1 year ago
Survival of the Sickest was an amazing book filled with interesting facts that was actually able to keep my attention.  Normal science books leave me day dreaming and skipping pages, this book however did not.  Every chapter reveals a new interesting topic of why humans have evolved the way we have. My favorite chapter was the final chapter. It addresses the human ape theory which really leaves you thinking.  He wrote a very persuading argument about the reasons the theory could actually be true.  Overall however, this book is the only science book I have ever read that I can honestly say I will read again.  
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