Genotype, obesity and cardiovascular disease - Has technical and social advancement outstripped evolution?

Paul Zimmet, C. R. Thomas

Research output: Contribution to journalReview ArticleResearchpeer-review

64 Citations (Scopus)


Teleologically, our ancestors were highly adapted hunter-gatherers. In recent history, the environment in which Homo sapiens exists has altered drastically and humans are exposed to environments for which the hunter-gatherer genotype is ill-suited. The adoption of a sedentary Western lifestyle, and the case of obtaining food of a high calorific content imposed upon a thrifty genotype, have resulted in the current global epidemic of obesity, Type 2 diabetes and the Metabolic Syndrome. The ramification of this epidemic is that cardiovascular disease is becoming a global healthcare problem, which will have its greatest impact on the developing nations. A global strategy is required to reduce the impact of the Western lifestyle on the health of developing nations and prevent obesity and Type 2 diabetes. Such an approach needs to be culturally sensitive, integrated, and multidisciplinary and involve a range of interventions that work at the individual and community levels. If lifestyle measures fail, then pharmacological intervention may be necessary. For this, novel agents such as dual PPARα/γ agonists may be the therapy of the future.

Original languageEnglish
Pages (from-to)114-125
Number of pages12
JournalJournal of Internal Medicine
Issue number2
Publication statusPublished - 1 Aug 2003
Externally publishedYes


  • Cardiovascular disease
  • Diabetes
  • Obesity
  • PPAR
  • Thrifty genotype

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