
Evolutionary gene loss may explain why only humans are prone to heart attack - rjzotti
https://www.sciencedaily.com/releases/2019/07/190723182255.htm
======
crabLouse
Since the driver of the selection against the related gene seems to be
malaria, I wonder if this is linked to prevalence of body hair on human
ancestors.

Bug bites on hairless skin probably had something to do with dying of disease,
and the early homonids that had the gene seem to be the ones hit the hardest.

We also see evolutionary markers related to bed bugs, head lice and body lice.
Maybe mosquitos and genes linked to a possible malaria pandemic offer more
clues.

~~~
fragmede
Malaria is a fascinating one, with the prevalence of sickle cell anemia and
G6PD blood deficiency in some populations with high exposure. Both of those
cause health issues but they both confer some level of resistance to malaria.

~~~
baddox
Isn’t the recessive gene for cystic fibrosis also linked to malaria
resistance?

Edit: apparently it might be linked to a resistance to cholera.

~~~
xythum
I was taught (undergraduate genetics) that it was TB, but I see the relevant
Wikipedia page also lists cholera, typhoid and diarrhea _shrug_

------
bitwize
On the other hand, cats -- for example -- are highly prone to kidney failure
in a way that humans are not.

~~~
glastra
Cats, being obligate carnivores and lacking a proper mechanism for extracting
energy out of fatty acids (e.g. ketogenesis in humans), have actually very
efficient kidneys to dispose of all the nitrogen coming from their protein-
exclusive metabolism.

Domestic cats are at risk, but that is more a result of domestication and
improper feeding (carbohydrate) than evolution or genetics. Unless I am
missing something, of course! Care to elaborate?

~~~
johnkpaul
Whenever I see comments blaming carbohydrate intake for large swaths of
problems I find it challenging because I agree and then feel that I am seen as
a heretic or extremely gullible.

Do you ever feel that way?

~~~
glastra
Yes.

I don't usually express my opinions on nutrition, metabolism and/or health in
general in the open, because I know they go against what is currently
mainstream and they would be met (as elsewhere in this submission) with
extreme resistance. I can't blame the others, though, as I once was in their
same position and know how it feels when deeply ingrained ideas are challenged
from the outside.

I have learned to live without the need to be "right", or to educate others
when they don't want to be. It is enough for me to apply what knowledge and
intuition I have gained over the last years for my own health and well-being.
If, at some point, someone wants me to share that knowledge, then I will
gladly do it.

~~~
johnkpaul
Thank you for this. This is very helpful both practically and emotionally.

I also try not to say a word about my beliefs. That was much easier before
having children who are offered carbohydrates constantly.

~~~
glastra
You're very welcome.

Even though I have no children, I can try to imagine what it feels like.

My paternal grandfather died of complications from uncontrolled, insulin-
dependent type 2 diabetes. He spent his last years half-blind, unable to move,
filled with ulcers and missing several toes.

My father has been hovering around the prediabetic range for many years now,
and I live a 5-hour drive away from him. Effectively, he is like a child, with
no knowledge of nutrition or metabolism, trying to find his way in a world
dominated by a food industry that doesn't have public health anywhere in its
objectives.

But it's not just the food industry, although they might have the monopoly of
malice in this context. Guess what the diet prescribed by his primary care
provider looked like once he was deemed prediabetic. Motherfucking biscuits
for breakfast, pasta or rice with lean meat, sugar-laden fruit juice... but
counting calories! Exactly the opposite of what I have finally convinced him
to eat by chipping away on every holiday visit. He's not exactly following a
ketogenic diet, but at least he is starting to figure out what sugar, starch
and seed oils do to people, and how the blame was shifted onto the wrong
substances (saturated fat and salt, basically). He is even giving intermittent
fasting a go!

It's hard when you know that the potential suffering of a loved one is
perfectly avoidable with just the right pieces of information.

As you might have guessed, having type 2 diabetes in my immediate ancestry
(also in my maternal family) was one of the reasons that led me down the
rabbit hole. I now treat nutrition and its effect on health and metabolism
sort of like a hobby. I guess there is a component of biohacking in there as
well.

------
raxxorrax
I have the feeling this has much more to do with our self inflicted lifestyle
than genetic factors.

Maybe no other animal is just that stupid.

~~~
klodolph
> Maybe no other animal is just that stupid.

Have you ever owned a cat or dog? My experience is that a percentage of them
will overeat unless constantly monitored, eat things that are outright
dangerous, etc. What is it that makes humans the stupid ones, here?

~~~
chosenbreed37
I wonder whether or not we should distinguish between domesticated animals and
wild ones

~~~
masklinn
It would be an interesting (if difficult) experiment but from what I know wild
animals will absolutely gorge themselves if they can.

The difference is that in the wild, this is tends to be quickly followed by a
resource crash from a normal cycle (e.g. winter crash after summer glut) and /
or population explosion.

I don't know that any organism has had evolutionary-scale periods over which
to psychologically integrate an access to essentially unlimited (in time and
quantity both) resources.

~~~
humanrebar
I have seen wild geese eat too much seed from bird feeders and practically
lose the ability to fly.

I suspect the correcting mechanism for that is generally predation.

------
dilawar
I wonder if a gone lost hundreds of years ago is somehow _responsible_, then
why heart attack related death mostly occured in last 50 years?

~~~
deanstag
It could be that they were not diagnosed as heart attacks before that.

edit: And also maybe general life style differences regarding availability and
richness of food, exercise, shorter life spans etc.

~~~
svachalek
In the 19th century, a heart attack may have been recorded as "old age",
"sudden death", "apoplexy", "stomach cramps", "spasms", or a lot of other
things. As long there weren't any suspicious circumstances I don't think they
usually looked into it that closely.

~~~
taurath
I mean, this was when amputation and leeches was the pinnacle of medicinal
triage. Life expectancy hit 49 in 1900 - for most of the 1800s it was below
40, a fact that still blows my mind today.

~~~
kqr
...are you aware that most of that low life expectancy was caused by infant
and child mortality? Once you lived past 15, you were expected to stick around
at least to your 60s, if not more.

So yes, modern medicine is a Herculean effort in many ways. One of them is
that it saves so many of our otherwise _very_ frail and helpless children.

~~~
taurath
Thanks for this - I was using life expectancy at birth. Looks like it was
around 55->60 from 1850->1900 if you lived to 5 looking at this chart:
[https://ourworldindata.org/uploads/2013/05/Life-
expectancy-b...](https://ourworldindata.org/uploads/2013/05/Life-expectancy-
by-age-in-the-UK-1700-to-2013.png)

------
cc439
Interesting, I was always under the impression that chipmunks were susceptible
to heart attacks. I can't remember where I read it and I can't find a current
source but you are apparently not supposed to harass chipmunks because they
can experience stress induced heart attacks when threatened/chased. I've also
seen potential evidence for this when my cat chased one around a parking lot
only for it to collapse after sprinting around for a solid minute. It was
immobile, looked short of breath and eventually died at some point between
when I brought my cat in and the next morning.

~~~
CamperBob2
Rabbits, too.

The whole premise behind this headline seems bogus.

~~~
DennisP
The headline seems bogus but the article says that "naturally occurring
coronary heart attacks _due to atherosclerosis_ are virtually non-existent in
other mammals." Atherosclerosis is the cause of only "one-third of deaths
worldwide due to cardiovascular disease" so other causes could still apply to
other mammals. For example, "chimp heart attacks were due to an as-yet
unexplained scarring of the heart muscle."

Of course we can give rabbits atherosclerosis by giving them high cholesterol
from a diet they don't eat in the wild. But in humans, "in roughly 15 percent
of first-time cardiovascular disease events (CVD) due to atherosclerosis, none
of these [risk] factors apply," where risk factors include "blood cholesterol,
physical inactivity, age, hypertension, obesity and smoking."

So the study explores a possible reason for that.

~~~
fpoling
Elephants that live in savannas in Africa are prone to atherosclerosis, while
those living in forest areas are not. [1] discusses that it can be due to
food. In savanna elephants are forced to feed on grains and dry grass, while
in forest they feed on leaves, which is probably more natural.

[1] Staffan Lindeberg. Food and Western Disease: Health and Nutrition from an
Evolutionary Perspective

------
jedberg
If this turns out to be true, I wonder if this is something CRISPR could
fix...

~~~
ordu
I'm not sure that I wish CMAH gene back:

 _> Interestingly, the evolutionary loss of the CMAH gene appears to have
produced other significant changes in human physiology, including reduced
human fertility and enhanced ability to run long distances._

Reduced fertility doesn't seem for me important, we have a contraception for
that. But enhanced ability to run long distances seems very convenient. I can
ride a bicycle or walk for hours just for fun of physical exercise, and I'm
not going to lose that.

~~~
moccachino
I read somewhere that running very long distances is basically the only
physical thing humans can do better than any other animal.

~~~
ordu
Pretty close. I heard that humans are second after dogs.

~~~
barrkel
Per [https://www.quora.com/What-animals-are-better-long-
distance-...](https://www.quora.com/What-animals-are-better-long-distance-
runners-than-humans) humans are best in hot arid places, horses are best in
cooler temperate zones as the only other sweating animal, and dogs are best in
cold climates, where their breathing isn't as badly affected by panting as it
would be in hotter climates.

------
pvaldes
It seems that this guys never tried to catch a shrew.

~~~
akvadrako
I've seen a mouse die in a "humane" trap after being carried a couple blocks –
I always understood that was from a heart attack. It seems to happen with
birds too – stress them out a bit, then dead.

So in what way are "only humans" prone? Are these not heart attacks?

~~~
EdwardDiego
Probably time to agree on what "heart attack" means.

My Dad's heart stopped and he was kept alive by 45 minutes of CPR by burly
firefighters - did he have a heart attack? Nope. His heart's pacemaker cells
went on the fritz, but it wasn't a myocardial infarction.

A "heart attack" is a myocardial infarction, but many other bad things can
happen to your heart.

------
Rickvs
Perhaps we evolved a heart overclocking ability. Sometimes we just push the
heart too hard.

------
glastra
> Atherosclerosis -- the clogging of arteries with fatty deposits

What a way to start an article in a website with "science" in its name.

Atheroma is an accumulation of white blood cells. White. Blood. Cells. Not
fat.

"Meat bad, saturated fat bad, eat your necessarily fortified grains and heart-
healthy industrially extracted seed oils."

~~~
hirenj
-oma is a suffix that means tumour. E.g. lymphoma.

-sclerosis is a hardening. E.g arthrosclerosis for a hardening of joints.

~~~
glastra
I fail to see what this has to do with my comment.

The hardening in atherosclerosis is caused directly and exclusively by
atheroma.

~~~
sambe
Everything I've ever read says fatty deposits. The NHS website calls fatty
deposits "atheroma". You can find multiple definitions of
atherosclerosis/atheroma in other places describing them the same way.
Wikipedia says:

"While the early stages, based on gross appearance, have traditionally been
termed fatty streaks by pathologists, they are not composed of fat cells but
of accumulations of white blood cells, especially macrophages, that have taken
up oxidized low-density lipoprotein (LDL)."

So whilst it may be more accurate to say they are white blood cells that fed
on LDL (and presumably contain fatty substances as a result) there is a long
tradition of calling them fatty substances, and there is at minimum a
connection to fat.

It seems misleading to try to discount the role of the fat to me. They don't
sound like they are just normal white blood cells. Is there any doubt that the
fat plays a causative role? I know a couple of cardiologists who say it is
clear. Do you have some references for the idea that fat is not relevant?

~~~
glastra
What do those cardiologists say? That fat in the blood (triglycerides) causes
atherosclerosis? Or dietary fat? Very different things.

Regarding the mechanism of atheroma formation, I don't have a list of
references handy, but maybe this is a good start:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152836/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152836/)

Also of interest would be the role of high insulin and/or glucose and the
damage they can cause to the arterial walls (inflammation is a necessary
condition in the formation of atheroma).

~~~
sambe
The conventional wisdom: fat in the blood is the main thing to worry about
(along with genetics) and that lifestyle factors have a big influence on that.
So both, really.

Which part of that paper disputes the importance of fat?

------
Pimpus
So now we're including "survival of the unfittest" as part of evolutionary
theory? Sorry, this makes zero sense. If humans really did evolve, then we hit
the lottery - several times.

~~~
ben_w
Fitness doesn’t mean what you think it means. As others have noted on this
post, this mutation confers some resistance to malaria.

When the options are “malaria with high probability from birth onwards” or
“heart attack after multiple decades with high probability if nothing else
kills you first”, this _is_ fitness.

Besides which, if humans _didn’t_ evolve, you need to explain why the creator
didn’t use a better mechanism to prevent us from getting malaria. For example:
not creating malaria when they created us.

------
olliej
I like how the headlines explicitly states _humans_.

For yet another study in ... mice.

There are other options like dogs and pigs which are much better models for
human biology, so if you really want to make a claim about subtle effects of
human genetics you need to be as close to a human model as possible.

This is entirely ignoring the someone generous leap they make that one single
gene mutation is responsible for an increased rate of heart disease. It also
doesn’t touch on what the benefits for that gene were (to spread through the
gene pool completely it must have some benefit that outweighs the cost)

~~~
AlexCoventry
If this withstands scrutiny a chimpanzee study can't be far off, though.

~~~
buntsai
Nah. Primate studies are too expensive, impractical and ethically difficult to
justify. Think about the number of subjects you would need for statistical
significance ...

