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Open Access Commentary

Secular trends in new childhood epidemics: insights from evolutionary medicine

Martin Brüne1* and Ze’ev Hochberg2

Author Affiliations

1 LWL University Hospital, Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Ruhr-University Bochum, Alexandrinenstraße 1, 44791, Bochum, Germany

2 Rappaport Family Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 30196, Israel

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BMC Medicine 2013, 11:226  doi:10.1186/1741-7015-11-226

Published: 21 October 2013

Abstract

In the last few decades, pediatric medicine has observed a dramatic increase in the prevalence of hitherto rare illnesses, among which obesity, diabetes, allergies and other autoimmune diseases stand out. In addition, secular trends towards earlier onset of puberty and sexual activity contribute to the psychological problems of youth and adolescents. All this has occurred in spite of the improved health care provision for children, yet traditional concepts of medicine have failed to explain these new “epidemics”.

A recent conference and science school of the European Society of Paediatric Endocrinology (ESPE) in Acre, Israel, has taken up this challenge. Experts across disciplines including medicine, anthropology and developmental psychology discussed potential causes of childhood ill-health from an evolutionary point-of-view. Seen from an evolutionary vantage point, the “epidemics” of childhood obesity, diabetes and psychological dysfunction appear, in part, to be related to a mismatch between ancestral adaptations and novel environmental contingencies. These include changing exposures to pathogens, which impact on the function of the immune system, as well as changing patterns of parenting, which influence the timing of puberty and the risk for developing psychopathology.

Keywords:
Pediatric endocrinology; Life history; Hygiene; Pathogen exposure; Autoimmune diseases; Evolutionary mismatch; Psycho-biological development; Psychopathology; Obesity; Diabetes