Evolutionary Medicine: Part 2 with Dr Mark Donohoe

Evolutionary Medicine: Part 2 with Dr Mark Donohoe

Are the genes that helped us survive in the past now working against our health in the present?

In this second episode of a three-part series, Dr Mark Donohoe and Andrew continue the discussion of evolutionary medicine, exploring the rise of 'diabesity', the nuances of fertility and how the human condition builds resilience .

Covered in this episode

[00:47] Welcoming back Dr Mark Donohoe
[01:28] How the genes that helped us survive in the past are killing us in the present
[07:14] Pharmaceutical longevity and survival of the sickest
[11:44] Humans above all else
[15:02] The accumulating costs of overriding nature
[19:33] Stopping the symptoms but prolonging the disease
[24:53] The downside of convenience
[28:02] The power of herbs, diet and lifestyle medicine
[33:06] Thanking Mark and closing remarks

Andrew: This FX Medicine. I'm Andrew Whitfield-Cook. Joining us again in the studio today for part 2 of evolutionary medicine is Dr Mark Donohue who earned his medical degree from Sydney Uni in 1980.

Mark worked around the Central Coast of New South Wales honing his medical skills. But this is where his interest in integrative medicine sparked because patients just weren't fitting into the boxes of diagnoses and treatments, which were drummed into him in medical school.

Mark is considered one of the fathers of integrative medicine in Australia, and he has been a vanguard for patient health throughout his whole career.

Welcome back to FX Medicine, Mark.

Mark: Always my pleasure, Andrew.

Andrew: Mark, we're going to be delving into some specifics of evolutionary medicine in part 2. So I think to start off with energy, calories, kilojoules, why did it save us and why is it now killing us?

Mark: It's our number one best-seller when it comes to things going wrong with humans is diabesity. We're getting fatter. We're dying of the diseases. And for the first time, we expect the generation ahead to die younger than we did and our parents did.

And so we've reached the tipping point, which is what you do see in evolutionary medicine. You take action in one generation to do one thing, and it percolates through the next two selection processes so that, if you like, the weak, the ones not fitted to supermarkets, not fitted to available food the whole time start to get the diseases of obesity.

So the story is I think a very good one because it's something that we are all aware of in first-world countries. We evolved apparently on the plains, on the savannahs of Africa. And fat and sugars were in pretty tight supply. We were little animals. We didn't have big teeth. We couldn't kill anything, at least in the original stages.

And so we were forever after food. Therefore reproduction...remembering evolution doesn't favour longevity; it favours you having kids. It always favours reproduction over longevity. So the survivors to reproduce were those that could survive the famine, survive shortages of food, and have the genes that allow them to gather and hold as much of the energy that was available in their food supply as possible.

Now it turns out we co-evolved with organisms in our gut that did much the same thing. Their host had to be provided for so the so-called energy harvesting bacteria, the bacteria in our gut for the microbiome that we love to talk about, they were working with us. Everything was about storing for a rainy day sometime in the future. We had famines regularly, and so the survivors of necessity were those that could harvest and store the most available fuel.

Now comes times that are different. Now we have feast without famine. We have supermarkets. We have available food the whole time, and we revert to form. When the food is available and it's high-fat, high-sugar, high-kilojoules, high-energy, there is a natural propensity for the survivors of the evolutionary famines of the past to move forward.

So, we can say when there's feast but not famine, the genes that saved us in the past are the ones that are killing us in the present. And it's a beautiful story.

Andrew: And indeed moving forward, it appears to me that, if you look at intermittent fasting and the longevity research that's going on, the topsy-turvy thing is going to happen where those people that are going to eat less are going to survive longer. Where, in the past it was those people that ate less, they had hunger and they died earlier. Now it's flipped.

Mark: Yes. Yeah, there may be another problem though. What's the evolutionary selection pressure right now? The supermarket.

Those that can adapt to the supermarket with its fats and sugars, those that don't die of the problems that we now have. We now see a reversal of evolution because the evolutionary pressure is that we now have eternal feast. There is no famine.

What happens to a population on those circumstances? You can make a pretty good argument that the most fertile, the most capable of reproduction are the ones that are best adapted to supermarkets. So the minority group from the past that only did well during the feast and not the famine have now caught their time.

It's kind of John Howard's "the time is right for me." And if you've got the right genes at the moment, you can maintain low body fat and low body weight even in a feast, even in the feasting period.

There is also another aspect to eating that is explained by evolutionary medicine, and that is there is something about anorexia and this tendency to gorge and then disgorge that looks to go back into ancient times, that there was always a bit of a problem with feast over famine, and that what we now see as a psychiatric disorder especially among young women, body dysmorphia and anorexia and bulimia, weirdly now is thought to have a survival advantage. It's not pure psychiatric disease.

It's when you overfeast, when the risk starts to rise from the feasting. Those that are capable of eliminating the fats that would otherwise clog their arteries or the fats that would otherwise diminish fertility, those people are capable of surviving longer.

Now it gets to a very strange stage when you are in the position that many young women are today where their body image is defined by magazines, and there is psychological stressors that play a part in that.

Andrew: But they wouldn't cause longevity.

Mark: No, it may not cause longevity but in a feasting environment where obesity is itself a risk factor for fertility, maintaining stable body weight, that there is a level of. . .

Andrew: Oh, I see.

Mark: . . . "Can a woman choose something which maintains stability of body weight?" In the extreme, it's definitely not evolutionary because the women who are underweight fail to reproduce.

But the process of minimising the ability for women probably more than men to minimise excess body fat does paradoxically increase fertility for the middle range. The very obese and the very underweight are both relatively infertile.

So something about voluntary constriction of the kilojoules is an important part of thinking about what is an eating disorder; it's the extreme of something that could be beneficial.

Andrew: More and more we're seeing fertility issues caused by obesity, in the younger age group. So it seems like that. . . I'm going to say the word selection pressure, but I don't know if that's correct.

But it just seems that obesity is being seen at a much earlier age. I think it was 20% of our kids are now overweight or obese. Half of the adult population is overweight or obese.

Mark: Yes.

Andrew: So that's a massive amount of population that may have issues with fertility. Are we now getting to a stage with, let's say the words, pharmaceutical longevity? Because that's a great thing that the pharmaceutical industry is doing, is keeping sick people alive longer.

Mark: And this becomes a problem for evolution, right?

Andrew: And the Earth.

Mark: Well, the basic problem as well for medicine is this. The best model we have of biology, the thing that everybody puts their hand up and says, "Yep, that's right," is evolutionary biology. Natural selection, survival of those fittest to reproduce.

Medicine is antievolutionary. It is anti-Darwinian in the extreme, because it becomes survival of the richest, survival of the most vulnerable, survival of those that would never have had a chance to reproduce before.

Andrew: And survival of the most commercially applicable.

Mark: Yes. If you could afford medicine, you can stay alive longer. And so it becomes a profound philosophical problem that, if the world has progressed along very nicely with evolutionary pressure, yes, tragic. Thirty per cent of all babies never made it to the fifth year of life. So there is wastage and there is all the way through biology in nature. Everybody goes through that.

Every organism goes through that natural selection process except humans. We've now decided by sheer force of will we can make survival of the white, rich, privileged male who's well-educated much longer than it ever could have been.

We in fact waste vast resources, keeping rubbish from evolution. I am one of those pieces of rubbish. You know, once we've passed our reproductive stage, we are just a drain on resources.

Andrew: Putting my hand up here.

Mark: Yes. And so evolution is harsh. It's a harsh parent. It culls and it reduces. And that's not something we as humans like. So we put vast resources into not letting that happen and we end up now with a second, third, and fourth-generation from effectively artificial fertility.

If we are not fertile and able to produce healthy children ourselves, then as each generation passes, we run the risk of genetic resilience being lost and a higher and higher proportion of the children that we love dearly and that we would do anything to preserve, we now have mortality rates well under 1% for those first years of life.

And so what previously was children that were never going to make it now become children that do make it and the second, third, fourth, and fifth generation start to show that up.

Andrew: So survival of the sickest.

Mark: Survival of the sickest.

Andrew: And richest.

Mark: So I remember back in the 1980s, an ad for CT scanners were out, and there was an ad by one of the CT manufacturers of a father sitting next to a very sick child and the title was, "Survival of the weakest."

And it was a profound message that, yes, we can do survival of the weakest. By brute force, we are capable of creating technologies that drag us all through and make us not unhappy about perinatal mortality. But the cost of it just escalates over time, and the unexpected effect is we now have reproduction from children that never would have survived in the past. They're producing their own kids.

And we do see rates of other disorders including obesity which could be relatively quickly selected. We do see that starting to increase because now the rich people are the fat people. We have little concern honestly, with those in greatest need of care so evolutionary medicine and biology is still going on in Africa, still going on in areas of Asia.

And the selection process, while brutal, does mean that obesity and the problems of the first-world have not even visited there yet. Every time we bring the genie out and we say, "Look, Western world, you can live like this. "

Andrew: Strong medicine.

Mark: That's right. The medicines create the ability to survive things that we never could have survived, and the food that we bring with us creates obesity that we can't survive and that's the problem.

Andrew: At the risk of sounding like a dystopian sci-fi movie, it seems that part of the problem that we have is our altruism, our love, our care. . .

Mark: For ourselves.

Andrew: . . . for ourselves, yes, but. . .

Mark: As opposed to all other organisms.

Andrew: . . . for the sick, the weak, the injured, for our families, for those that we love. And it seems like this may be in part the reason that we are heading into this issue.

I mean, obviously partly there's commerce. There's brute commerce. If you can sell something that will keep somebody alive longer, there's a customer for you.

Mark: As long as they can afford it, right?

Andrew: Well, very true. But I think that's half the trick, isn't it?

Mark: It is.

Andrew: You know, drugs that seem to be very expensive until they get onto a government subsidised thing, and then they're good. And then they're a good drug. So they're subsidised and they're cheap.

Mark: So we do create the rod for our own back. The point is, evolution, which we believe to be the kind of identifier of biology across the universe… people talk about this. One thing that we know, on any planet where life exists, evolution will be the process by which life emerges.

Andrew: What you do mean, “on any planet where life exists?”

Mark: That's exactly what they…

Andrew: We don’t know if they have other life yet.

Mark: And that's what the astrobiologists are saying that Darwinian concepts are so deep by definition. In other words, the things that survived had to survive, and you can kind of make evolutionary biology almost trivial by saying the just-so stories of, "Oh, we see people looking like this now. It must have been in the past that they roamed the Savannah," and we have those kind of stories in our mind.

The concept is that the things that survived somehow survived because they survived. And that, in a trivial sense, is almost evolution. If you can reproduce, you make it. If you don't reproduce, by definition, you don't have a next generation.

What we've done in Western medicine is bring medicine in to say, "The survival of one species over all others is critical and that every life is sacred." Whereas evolution never said every life is sacred. It does the experiment. There's a million different variants and the ones that don't make it, tough luck. We move on and we move along a path where the organisms are better adapted to their world and the world around them becomes better adapted to the organism.

And the humans have been the first to break the mould to say, "No, our survival is superior to everything else, and all other forms of life, all other resources will be sacrificed to the life of humans. " And you can make an argument that that's done planetary damage of a huge type. I mean, we face crises with the atmospheric changes, with the sea changes, with the food chain that threaten far more than humans right now.

But one very valuable question is you can defy evolution for maybe 100 years, maybe even 500 years. You cannot do it forever. If we're the only surviving organisms at the end of another thousand years, then we don't survive anyway.

And so there's an important question about, "Do we respect evolution or is it something that we've passed?" And the hard evolutionists say, "No, evolution already set the stage so that, when an organism like us came along, we can win." And the mistaken term that "survival of the fittest" means the fittest to reproduce, not the fittest as in we believe we're the strongest, toughest, nastiest group that ever made it around.

Andrew: You said something earlier. Two things. Firstly, you said “one species over another. The survival of one species over another.” But this seems only applicable in the case of humans. . .

Mark: Yes, it does.

Andrew: . . . and plagues which are often caused by humans. Contrastingly, if we look at wolves, wolves were reintroduced into Yosemite National Park. And rather than decimating - dare I say the word - lower life forms, wolves being at the top of the food chain, the predators, they actually created more balance.

Mark: Yes.

Andrew: They created meadow. They created more growth of trees, less bunging up of waterways. They caused a whole regeneration of an ecosystem. Why don't humans do that?

Mark: Because we're not smart enough. We have... My glib answer is, we have a brain big enough to do damage, but not big enough to be able to conceive the damage that we've caused.

So, we respond late. Go back 25, 30 years, many humans...and I was there with them in the protest. We're talking about the destruction of the atmosphere, the poisoning of the waters. And everybody…

Andrew: This was Silent Spring. This was the era of Silent Spring

Mark: That’s right. Silent Spring. And everybody would say, "No. The science is strongly on us. We can do this. There is no problem. There is no problem. There is no problem." Suddenly, it's a catastrophic problem.

We're good at seeing things late when it should be obvious, but we have not been very good with... The poets and the artists and those that see the problems arising early, the authors, were ridiculed. And then when we run into our problems with climate change, when we run into our problems of pollution, suddenly, it's a catastrophe and we think of an engineering solution. We always think of, "How do we now engineer the atmosphere? How do we now dominate the Earth?"

And it's all about the survival of humans, and we may or may not be reaching the end of our capabilities to do it. This is extending a good deal of a distance from evolutionary medicine, but evolutionary medicine is a part of that framework.

When we override nature time after time after time, then the cost of overriding it accumulate. We don't pay those costs early on. People survive their pneumonia. The, you know, 70-year-old white males that run various countries — I won't even name them — that hold engines of war, those people survive longer than they ever could have before medicine came along to look after them.

So, we have a world which is distorted. We are not focused on the mother, nutrition, development of a healthy baby. We're focused on survival of the crappy, broken humans with their heart attacks, stents, and with multiple operations, running the bloody show. And I have a big problem with that.

I think the world and healthcare will not recover until women, and mothers in particular, take control, those who'd built a baby, they know how to build a baby. A male has never built a baby yet, but we always take over the running of obstetrics, the running of medicine, the running of buildings.

And so, naturally, we have a short-term goal. Males were never meant to live long enough to have a long-term goal. Now, we're making them live too long. I do think, at a deep philosophical level, that too many white males at the top of the food chain are a problem.

Andrew: Yeah, it's a hard line. It's a really hard line when you look at a planetary level as opposed to a community level. It's a really difficult decision.

Mark: However, if you talk to mothers who have raised babies, their ability to know and understand biology is profoundly different to a doctor's. And I was trained in medicine, and I marvel at the good decisions that mothers make time after time, that they know biology, and they know communication, cooperation. They know things that we don't.

We have techniques and tools and categories and diseases and drugs, and we've built a very, very clever system for keeping people alive longer than they actually have the merit points to deserve.

And I'm not suggesting that we go out and cull everybody. I'm saying, doing this with a level of consciousness that we are opposing a biological process that has worked for a couple of billion years, we have to take responsibility for saying, "Maybe we've created a problem. " We very rarely get pure gains in biology. We're forever getting, “You win a bit here and you pay for it later.” You win a bit here and you pay for it later.

Andrew: But an ounce of prevention is worth a pound of cure.

Mark: So, look. Here's another example. People go overseas and they get travel, you know. We are in countries that we were never designed to be in. The bugs in those countries are not our friends.

The bugs in our own countries probably are more our friends. We've co-evolved with them, we've lived them long enough. Those that were never going to survive, didn't. But we travel.

What do we give people when they travel? We give them Imodium. We often give them a couple of antibiotics. We say, "If you get diarrhoea. Get on to the Imodium. Don't dehydrate. This will stop the vomiting. This will stop the diarrhoea. The antibiotic will kill the organism.”

Now, we don't even know that, but what we end up doing is defeating an evolutionary process which is, when a bug like shigella makes its home in you, wash it out quickly, both ends as quickly as you can. I have some form here. In 1977, I visited, on my trip through Europe, a place called Andorra. And there were really cheap baked beans from the supermarket, damaged cans with little dings and cuts and chinks in them, but they tasted fine.

And the next morning, I found myself somewhat drained and about four kilograms lighter. I eventually found out the name of the bug in London a few months later, and it was shigella.

What had I done? I had immediately done exactly what I shouldn't have done. I'd gone on to what was Lomotil at that time. I was a good medical student. I knew how to make sure that I was not going to get sick, and I made myself sicker. And it took two years for that little visitor to leave. So, one bad baked bean choice, I managed to turn into a two-year journey.

Andrew: That actually paints a very brilliant picture of the perfect drug, is a drug which takes away your symptoms and prolongs your disease. I mean, it's the perfect commercial decision, really, isn't it? So, you look at...

Mark: You are such a cynic, Andrew.

Andrew: But look at NSAIDs. Like, beautiful for relieving pain. Unfortunately, they have some side effects with gastric ulcers and things like that. But the big thing is, they also inhibit the recovery of the cartilage, which propagates the disease process which you're treating.

Mark: Yes. Along the way, they also do a bit of damage to the gut which also requires that you be on an acid suppressant. And the acid suppressant then leads to infection. And so, that is a beautiful demonstration that we have something that fixes approximate problem in the short-term. And we mistake it in medicine for something that's useful long-term.

So, the NSAIDs for short-term relief, bloody brilliant. For long-term relief, cause problems. We go on the acid suppression, short-term, relief is brilliant. Long-term, more and more problems. And then as we get those more and more problems, we then have infection with antibiotic. And now, we're using antibiotics on top of it. You could make the cynical judgement that pharma...

Andrew: That's creation of new markets.

Mark: ...has in fact invented the field. There was a well-known manufacturer, I'm not going to say who it was, but as we entered our GPC conferences, it had a very large vertical structure advertising Viagra. On the other side of it, the antidepressants that were going to be needed with the Viagra.

And so, it was basically, they had a group of drugs around here and no matter where your starting point, you would eventually end up on the others. If you took the antidepressants, you lost erectile function. You would need the Viagra.

So, we can construct markets, and you could take the cynical view that this is all pharma does. And I don't think that's true. I think pharma's origins were there are terrible diseases that are tragic and defeatable. And you have to be careful not to throw the baby out with the bath water.

With shigella, no point winning the long battle if you've died of dehydration along the way. So, rehydration is the job, not stopping the diarrhoea. There's two ways to do it, and the medication side versus the sugar, salt, water mixture is not the way to do it.

Andrew: I don't have an issue with stopping symptoms because we need to function 21st century, but...

Mark: There is another way. It's not like if you are drug-free, we all die. Accumulating, aggregating traditional knowledge over the centuries, millennia in some groups, and understanding processes, having a way of dealing with this a different way.

So, it's not, "Do we have medicine or do we die?" It's, "Can we aggregate human knowledge and human experience over millennia, bring it together and use things like colostrum?" Why? It makes more sense. You actually have a way of winning a battle, of bringing an illness or a disease to an end much more quickly and not having the future consequences.

My problem with my own profession is not that it doesn't work, it bloody well does. It works brilliantly and vigorously, and lives are saved that could never have been saved. The problem is, we extend that to say, "And that's healthcare."

It's not. We are really good at disease care, and we are capable of rescuing from the edge, and then we just don't know when to stop. I've just watched the Patton movie, "The trouble, George, is you just don't know where to stop." And medicine does the same thing.

We don't know where to stop. And so, we take something that works beautifully for acid suppression for weeks and turn it into a lifetime story. And then we allow the accumulation of symptoms to invisibly just appear so that we paradoxically don't get vigorous health back. We get acceptable health back. We get enough back that another visit to the doctor can always pull you around a bit more.

Andrew: But another very dangerous word is convenience. We are our own worst enemies. We're too lazy to make our dietary changes. And I don’t want to go for that…

Mark: Well, in evolutionary terms, our diet is separated from our life as well. We have packages of things sitting in supermarkets that people don't even realise, we don't slaughter our chooks, we don't slaughter our cows. We don't do any of that. We don't even milk our cows. We basically expect food to be delivered in a way.

And evolution is not kind to that kind of a response. We are not adapted to that fecundity of a supermarket nor are we adapted to one other thing that humans are very fond of, which is stable environments. We are the products of a biological system that varied over seasons, over famines, over pests, over diseases, over plagues. We are strong because we are tested and we didn't all die out at some stage in the past.

We now think, an air-conditioned home at 22 degrees all year round, that we live almost at our risk and that the outside world is scary. We have playgrounds that are covered with rubberised stuff with stinking phenyls in it. We don't want children to land on grass or ground. We have supermarkets where the food is identical whether you're in June or January.

And when you do those things, what you do is diminish the range that each person is required to go through. What builds resilience is testing the edges. And we've got so used to not testing those edges. In medicine, you can be sued for testing the edges. If you do...

Andrew: And even playgrounds.

Mark: Yes, that's true. The mindset of, “We can make the world safer,” is “Ee can make it more constricted.” We can make it so that it's acceptable for more, that harm never occurs. And when you fear harm, harm happens in a different way. It will never ever leave you alone.

Now, we have the obesity epidemic. We have problems with cardiovascular disease, which we solve, again, by brute force. We don't have concepts of diet, that have made it out except for one group. One group that I have great hope for, and that is mothers and people bringing babies into the world that are educated enough to now know that they don't live just by the grace of medicine.

You don't turn a baby into a medical consumer in their first weeks of life. You birth naturally, you feed naturally. There is a microbiological component to that that produces resilience in the first weeks and months of life. And I watch that now in my practice percolating through to years and decades.

Once the mindset of the mother and the family builds resilience early, then that's a resilient child moving on into the future. And I have great hopes that that takes over from our mindset that all kids are just waiting to break and need antibiotics or need antidepressants or need Ritalin or need something like that.

We need to apply the evolutionary medicine concepts to those kids. "Why are you like that?" not, "What's the diagnosis?” Not “What's the drug?" but, "Why are you going down that path?" Evolutionary psychology is playing a part. Now, people are doing the same thing there of saying, "Why is the child this way?" not, "What is the diagnosis and what's the pills?”

So, I have great hopes. But actually, they come from our area of functional medicine, of evolutionary medicine, of traditional medicines and that thing that I say I want to do every time I see you, herbs. The herbs have...

Andrew: God dang it, Mark.

Mark: I know. I know. I'm a would-be herbalist that never gets started on my path. But the herbs have something different to them that when a good herbalist and a person work together for the health of themselves, their pregnancy, their child, there's a depth to herbs that drugs never have.

Drugs are one item at a time. I'm watching this in the cannabis argument at the moment. What do we want? Medical THC and medical cannabinoids. What does the herb provide? A much broader range of things with terpene variability and the terpenes that have big effects.

The medical model is always, hone it down the active ingredient, the thing that's going to save a life. And I think nutrition and herbs, where diet and herbs almost intermingle, there's a fascinating area there that's from partly by the mothers, partly by the midwifes, partly by the witches. We hate those concepts, but in fact, they kept us here and they made it through the first million years.

Andrew: Old wives' tales and pseudoscience.

Mark: Yes.

Andrew: Despite the carryings on of, you know, let's say, those orthodox people about vitamins and herbs being pseudoscience, I think it's very interesting that every single culture on Earth has used plants, minerals, foods that were available for them as medicine. Now, they weren't strong medicine. They didn't keep you alive necessarily if you had shigella, but they were used as a system of medicine for longevity, for health, for balance, for nourishing.

Mark: Yeah. And we're not against moving from that level of medicine, diet to start with, nutrition in pregnancy, diet, moving to herbs and the things that are found in nature. There's no harm then moving on to medicine when things get really tough.

Andrew: Yeah.

Mark: And medicine is at its finest when you are on the edge, where you may not survive if something is not done. But the further it invades back into our mindset of, "So, if acid suppressants go there and I've got heartburn because I'm stressed and everything in life is going to eh…just pull it out of the cupboard and it will get me through again." I'm against that.

Medicine in its place is bloody brilliant. It's a great scientific venture. I have no problems with it salvaging everything human and sacrificing everything not human in that quest, because I do see the end result is, humans without the rest of biology, we haven't got a planet, we're not humans at all.

Andrew: So, we've spoken about seasonality. We've spoken about the issues of the overabundance of calories, of kilojoules, energy. How do we retain that balance? How do we get back seasonality?

Mark: It's hard work. It's hard work. There are farmers markets and there are organic markets. There's a movement back from the hippies, from the 1960s. You remember the hippies from the 1960s, they’re probably before your time.

Andrew: I saw them in movies.

Mark: Yeah. They became the bastards that now dominate politics all around the world and have become...

Andrew: And commercialism.

Mark: Yes. That's right. The vanguard of commercialism. But there is a return. And I think, partly, it's the internet empowering people to have knowledge that they never actually had access to before. Medicine has always relied on hiving off the knowledge of life and death and making it unavailable to the public.

Give a mother enough information, she doesn't hang herself and her child. She makes good decisions because she's got a feedback unit with that baby that is very, very swift. I do see the future as returning health to the people. This sounds idealistic, I know. But returning health to the people already started.

Twenty years now, we've been getting information online that people have been testing out. It annoys doctors to no end. But doctors are learning to look at the same information and starting to discover new things about holistic healthcare, herbalism, dietary intervention.

Lifestyle medicine is now regarded as probably the most powerful invention of the first 30 years of this century. Why? Because if you do lifestyle medicine right, the rates of reduction of cardiovascular disease, obesity, cancer, are massive compared to whatever we can do in the medical world. Nearly all of the principles by which those are beaten are evolutionary medicine.

So, by its nature, the healthy upbringing of a child, a successful pregnancy, healthy parents going into a pregnancy, that's the tipping point. That's the place that kind of...what we call the “teachable moment.” Why will a mother do almost anything? She's having a baby. If you give her the right information, that's a powerful way of raising a healthy child.

Why do we mess up? We see babies who have not been looked after with mothers that had no information, and we keep giving drugs to them as though that's the treatment. And it just isn't.

Andrew: Mark, I wish we could talk further, but we have run out of time. I would love to get you back for part three to finish off our section here.

Mark: There are so many other areas that we could cover.

Andrew: Well, mood disorders, common symptoms. Because I really want to ask you about, certainly, these other massive areas of health issues in our modern society. Anxiety and depression, for instance, mood disorders, but also allergies and autoimmunity.

Mark: Yes.

Andrew: Would you be available to come back another time?

Mark: Sure, love to. It's too big a topic to just commit to two episodes. I agree.

Andrew: I keep going. And we haven't even gotten onto apples or...

Mark: No. Stewed apples have not made a hit yet. So, yes. Three more episodes should be able to cover that.

Andrew: Mark, as always, I love having you on the show. And you always get me thinking about these controversial, even confronting, issues, particularly with my own dietary and lifestyle issues.

But I hope it gives our listeners some clues as to how they can regain some of that seasonality and that balance back into their lives. So, thank you for joining us once again on FX Medicine.

Mark: Thank you.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.

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