Abstract Background Evolutionary psychiatry applies principles of evolutionary biology to explain vulnerability to mental disorders and has been proposed as a valuable addition to psychiatric training. Despite increasing interest, little is known about how clinicians understand and apply evolutionary perspectives in practice. Aims To explore psychiatric trainees’ and consultants’ experiences of evolutionary psychiatry teaching and to examine its perceived relevance to clinical practice and training. Methods A qualitative study was conducted using semi-structured focus groups with psychiatric trainees and consultant psychiatrists attending workshop-based teaching sessions. Three focus groups (N = 18) were conducted. Discussions were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Results Four overarching themes were identified: (1) Conceptual Reframing of Psychiatry, (2) Conceptual Value, Curricular Absence, (3) Tension Between Explanatory Insight and Clinical Utility, and (4) Barriers to Integration Within Training and Practice. Participants described evolutionary psychiatry as providing a coherent explanatory framework that enhanced understanding and formulation, particularly through concepts such as adaptation, trade-offs, and mismatch. However, exposure during training was limited, and participants reported uncertainty regarding its application in day-to-day clinical decision-making. Structural barriers, including curriculum constraints and limited faculty expertise, were compounded by concerns regarding abstraction and potential misapplication. Conclusions Evolutionary psychiatry is experienced by clinicians as conceptually valuable but insufficiently integrated into training and practice. Bridging the gap between explanatory insight and clinical utility will require embedding evolutionary perspectives within existing curricula, linking theory to clinically relevant applications, and supporting faculty development.
Abstract Background and Objectives Evolutionary theory and research suggest that spontaneous abortion of male twins varies over time with adversity in the population. This “selection in utero” has attracted little attention from clinical researchers. We attribute this to failure of basic literature to connect selection in utero to clinically important problems. We hypothesize a connection to racial disparities in infant mortality. Invoking relaxed selection in utero, prior research reports that Non-Hispanic Black women pregnant at the election of Barrack Obama as President, birthed more male twins than expected. We reason that if relaxed selection in utero accounted for the “excess” male twins, a disproportionate fraction would be frail and die in infancy. Methodology We test our reasoning with time-series methods that control confounders affecting infant mortality among female twins born to non-Hispanic Black women and among male twins born to non-Hispanic white women. Results As hypothesized, the ratio of Black to white infant mortality rates among twin males born from the “Obama cohorts” appears 40% greater than statistically expected. Conclusion and Implications The National Academy of Medicine has characterized racial disparities in health as “inexcusable” and ranked them 3rd among targets for biomedical research in the United States. We show that evolutionary theory provides an explanation of why an event desired by a majority of American voters appeared followed by an increase in an undesired disparity in infant mortality. Our findings, combined with the National Academy’s ranking, therefore suggest that biomedical researchers should pay greater attention to evolutionary explanations of health disparities.
Abstract The evolution of resistance to chemical interventions is a widespread challenge in medicine and agriculture, affecting bacteria, viruses, parasites, cancer, pests, and weeds. Many resistance management strategies have been proposed, but empirical comparisons are rare, especially in large-scale systems like agriculture and public health, where populations are difficult to replicate, and interventions cannot easily be tested experimentally. Cancer offers a unique opportunity to study resistance evolution. Because evolution occurs within individual patients, resistance strategies can be tested directly in clinical trials, with each patient serving as an independent replicate. Combined with diverse therapies and experimental models, this makes oncology a powerful system for studying therapeutic resistance. Whether insights from cancer apply to other systems remains an open but testable question. Addressing this could reveal general principles of resistance evolution and help unify currently fragmented approaches to resistance management across disciplines.
Abstract Background and objectives Pigmentary traits (skin, hair, eye colour, tanning response) are epidemiologically linked to skin and ocular cancers, but the extent and nature of shared genetic architecture remain incompletely defined. In this study we explored to what extent pigmentation- and cancer-associated variants exhibit pleiotropy. Methodology We analyzed genome-wide association studies summary statistics from European populations for skin colour; hair colour (blonde, light brown, red, dark brown, black); eye colour; tanning response; and four cancers: cutaneous malignant melanoma (CMM), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and uveal melanoma (UM). Genetic correlations were estimated with LD score regression. Multi-trait and pairwise pleiotropy were tested with Cross-Phenotype Association. We reviewed available colocalization data (COLOC framework) and post-association functional annotation/mapping (e.g. FUMA) to interpret shared signals. Results Significant genetic correlations were observed between multiple pigmentary traits and each cancer. Multi-trait and pairwise analyses identified numerous shared regions, including canonical pigmentation loci (MC1R, ASIP, TYR, BNC2, IRF4, OCA2/HERC2, SLC24A4, DCT, TYRP1). Directions of effect indicated that lighter skin, hair and iris pigmentation and poor tanning were associated with increased risk across cancers. Colocalization data supported shared causal variants at several loci; for UM, variants driving light eye colour at IRF4 and HERC2 were linked to higher risk. Conclusions and implications Skin and ocular melanomas illustrate evolutionary mismatch: variants favoured at high latitudes for lighter pigmentation now elevate cancer risk under modern UV exposure. Mapping shared architecture highlights biological pathways that may refine risk prediction, motivate functional studies, and inform prevention strategies. Lay summary Using genome-wide data, we examined how genes shaping human pigmentation relate to risk of skin and eye melanomas. Multi-trait analyses revealed shared genetics: lighter skin, hair and eye colour, and poor tanning, increased cancer risk. Findings illustrate evolutionary mismatch and highlight pathways that guide prevention, risk prediction, and future research.
Abstract Human gastrointestinal anatomy evolved under conditions of food scarcity, low–caloric-density diets, and high physical activity. In this context, a relatively gastric-accommodation stomach capacity conferred a survival advantage by allowing consumption of large volumes of fibrous, low-energy foods, buffering seasonal shortages, and maximizing intake during rare periods of abundance. Modern food environments, characterized by constant access to energy-dense foods and sedentary lifestyles, have reversed these selective pressures, creating an evolutionary mismatch between ancestral digestive physiology and contemporary diets. This narrative review explores how a digestive architecture shaped by scarcity may become maladaptive in modern high-calorie conditions and examines stomach capacity as an under-recognized contributor to obesity and metabolic disease. Evidence was synthesized from evolutionary biology, anthropology, gastroenterology, and metabolic medicine using literature identified in PubMed, Scopus, and Web of Science (1990–2024). Evolutionary and anthropological evidence suggests that increased gastric volume was advantageous in both pre-agrarian and agrarian societies. In contrast, in modern environments this trait may promote excessive energy intake, delayed satiety, and metabolic dysfunction, particularly in the presence of ultra-processed foods. Clinical observations from bariatric surgery support this framework, as surgical reduction of gastric volume induces rapid metabolic improvements, often preceding significant weight loss. Gastric accommodation capacity, once adaptive, may now contribute to metabolic disease in obesogenic environments, reframing obesity as a predictable consequence of evolutionary mismatch.
