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The PO challenge

While I worked a busy shift in the ER today I saw more than a dozen patients with flu symptoms. They complained of cough, congestion, headache, muscle pain, and often, stomach upset. It reinforced the idea that infection and fever are almost always accompanied by a loss of appetite, if […]

Killer vitamins

In 2008 the New York Times published an article, News keeps getting worse for vitamins. Since then, additional trials of vitamins have also spectacularly failed. The Cochrane review, a well-known publisher of meta-analyses, reviewed anti-oxidant vitamins, Vitamin C, Vitamin A, Vitamin E, and selenium, and concluded that while these compounds […]

Shock as a host defense

This is one of the most interesting ideas in (evolutionary) medicine. Is shock itself a host defense? Kathryn Maitland conducted the FEAST trial, a landmark study of fluid resuscitation in children with septic shock published in the New England Journal of Medicine, that we have discussed in a previous podcast […]

Do big eggs = sick chicks?

Veterinary medicine and agricultural biology have a lot to offer the field of evolutionary medicine. (See, for instance, Zoobiquity by Barbara Natterson-Horowitz.) Recently, Fred Madsen sent me a link describing research by Kirk Klasing of UC Davis that highlights those connections. Here is an excerpt: “The quantitative investment in immune […]

Evolutionary Medicine TV

Starting this Friday, I am teaming up with Kate Rusk on Inertia TV for a live discussion on my favorite topic: evolutionary medicine. Inertia TV describes itself as a new educational live-streaming network on @Twitch made by a bunch of fun-loving nerds. Sounds about right! I joined Kate previously on […]

Food, yogurt and the microbiome

Not too long ago, we thought we understood nutrition. Food could be broken down to its component parts: carbohydrates, protein, and fat along with micronutrients such as iron and vitamins. Dietary advice was based on calculations of our body’s needs for these nutrients. Malnutrition could be eliminated by meeting recommended […]

Revisiting evolutionary mistakes physicians make

Evolutionary mistakes physicians make fall in three main categories I. Misunderstanding of adaptation in human biology II. Acting as an agent of selection III. Failure to recognize how competition between genomes causes disease. These mistakes occur because most physicians are not taught to think (or communicate) in terms of natural […]

Anorexia and the Acute Phase Response

During sickness it is very common to lose one’s appetite (anorexia) and reduce energy intake. The anorexia during illness is one of a group of symptoms collectively known as sickness behaviors. Whether anorexia and other sickness behaviors are adaptive is uncertain and the optimal amount of nutrition to provide during illness […]

Do we never learn?

In 2001, a paper by van den Berghe and colleagues was published in the New England Journal of Medicine. It described a trial of intensive blood sugar control in critically ill patients and reported improved survival with intensive glucose treatment using insulin. This study led to a substantial increase in […]