Wells, J;
(2019)
The diabesity epidemic in the light of evolution: insights from the capacity–load model.
Diabetologia
, 62
(10)
pp. 1740-1750.
10.1007/s00125-019-4944-8.
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Abstract
The global nutrition transition is associated with rapid increases in the prevalence of obesity, but the implications for diabetes differ between populations. A simple conceptual model treats diabetes risk as the function of two interacting traits: ‘metabolic capacity,’ which promotes glucose homeostasis, and ‘metabolic load’, which challenges glucose homoeostasis. Population variability in diabetes prevalence is consistent with this conceptual model, indicating that the effect of obesity varies by ethnicity. Evolutionary life history theory can help explain why variability in metabolic capacity and metabolic load emerges. At the species level (hominin evolution), across human populations and within individual life courses, phenotypic variability emerges under the selective pressure of maximising reproductive fitness rather than metabolic health. Those exposed to adverse environments may express or develop several metabolic traits that are individually beneficial for reproductive fitness, but which cumulatively increase diabetes risk. Public health interventions can help promote metabolic capacity, but there are limits to the benefits that can emerge within a single generation. This means that efforts to curb metabolic load (obesity, unhealthy lifestyles) must remain at the forefront of diabetes prevention. Such efforts should go beyond individuals and target the broader food system and socioeconomic factors, in order to maximise their efficacy.
| Type: | Article |
|---|---|
| Title: | The diabesity epidemic in the light of evolution: insights from the capacity–load model |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00125-019-4944-8 |
| Publisher version: | https://doi.org/10.1007/s00125-019-4944-8 |
| Language: | English |
| Additional information: | Copyright information © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| Keywords: | Body composition; Capacity-load model; Diabetes; Evolution; Life course delelopment; Public health; Review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10074917 |
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