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The Evolution of Human Adiposity and Obesity: Where Did It All Go Wrong?
The Evolution of Human Adiposity and Obesity: Where Did It All Go Wrong?
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The evolution of human adiposity and obesity: Where did it all go wrong?
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Because obesity is associated with diverse chronic diseases, little attention has been directed to the multiple beneficial
functions of adipose tissue. Adipose tissue not only provides energy for growth, reproduction and immune function,
but also secretes and receives diverse signaling molecules that coordinate energy allocation between these functions
in response to ecological conditions. Importantly, many relevant ecological cues act on growth and physique, with
adiposity responding as a counterbalancing risk management strategy. The large number of individual alleles
associated with adipose tissue illustrates its integration with diverse metabolic pathways. However, phenotypic
variation in age, sex, ethnicity and social status is further associated with different strategies for storing and using
energy. Adiposity therefore represents a key means of phenotypic flexibility within and across generations, enabling a
coherent life-history strategy in the face of ecological stochasticity. The sensitivity of numerous metabolic pathways to
ecological cues makes our species vulnerable to manipulative globalized economic forces. The aim of this article is to
Disease Models & Mechanisms DMM
understand how human adipose tissue biology interacts with modern environmental pressures to generate excess
weight gain and obesity. The disease component of obesity might lie not in adipose tissue itself, but in its perturbation
by our modern industrialized niche. Efforts to combat obesity could be more effective if they prioritized ‘external’
environmental change rather than attempting to manipulate ‘internal’ biology through pharmaceutical or behavioral
means.
this ‘thrifty phenotype’ hypothesis, an increased risk of diabetes metabolism as a generic metabolic form of risk management,
following low birth weight could be attributed to poor pancreatic contrasting with behavioral risk management by the brain (Fig. 1).
development interacting with excess body weight in later life. Again, It is well established that adiposity can fluctuate within individuals
this hypothesis has been extremely influential; however, although in response to a variety of life-course or ecological factors, in
low birth weight babies are widely assumed to have an increased addition to accommodating genetic influences. Such fluctuations
risk of adult obesity, a recent meta-analysis failed to support this represent the balance of two competing strategies: on the one hand,
assumption (Yu et al., 2011). individuals have a tendency to maintain a broad profile of adiposity
In both of these hypotheses, fat and thrift were considered two over time, reflecting genetic, developmental and environmental
sides of the same coin. Thrift remains a very useful concept in influences; on the other hand, individuals have the capacity to gain
evolutionary approaches to human adiposity and metabolism; or lose fat over short time periods in order to buffer other
however, it is essential to emphasize from the outset that there is components of phenotype, and hence manage perturbations in
much more to thrift than fat, and much more to fat than thrift energy balance. Genetic variability in adiposity might likewise be
(Wells, 2011). considered to represent ancestral influence on the overall risk
Thrift implies a degree of prosperity deriving from earlier management strategy.
frugality and careful management of resources (Wells, 2009b). It Until recently, there was a widespread tendency to consider
refers generically to the efficiency with which energy is used, and adipose tissue an inert fuel dump, simply storing energy for it to
can derive either from reducing energy expenditure, or storing be drawn upon by other tissues as required. It is now recognized
energy. Fat is only one strategy for storing energy, and organisms that adipose tissue secretes and responds to a wide variety of
show a wide variety of other forms of thrift, including hibernation, signaling molecules (Ahima, 2006). Rather than being supplied by
torpor and a reduced activity level, along with manipulations of large arteries, adipose tissue depots are maintained by many
growth rate, body size and relative investment in expensive organs smaller blood vessels from adjacent tissues, which generate close
such as brains or secondary sexual characteristics (Wells, 2009b). connections with these tissues (Pond, 1998). Various receptors for
Storing energy as fat allows some organisms to tolerate ecological the molecular signals that control uptake and discharge of
uncertainty; however, many organisms respond to such uncertainty triglycerides, located on the cell membrane and in the internal
in a rather different way – for example, through variation in cytoplasm, provide integration with several regulatory systems
reproductive success. Boom-bust population dynamics characterize (Pond, 1998). Through these complex and multiple signaling
species such as rabbits, which respond to increased energy supply systems, adipose tissue is intricately involved in a wide variety of
by increasing reproductive rate rather than depositing fat (Wells, metabolic pathways. Far from being inert, therefore, the risk
2009b). management strategy represented by adipose tissue plays a
For species with energy stores, the allocation of energy between proactive role in allocating energy between competing functions
competing functions is potentially subject to greater control, (Wells, 2009c), thereby contributing to life-history strategy and
allowing more complex life-history strategies (see Box 1) (Pond, promoting reproductive fitness (Hill, 1993).
2003). Indeed, a recent study found that adipose tissue is negatively
associated with brain size across mammals (Navarrete et al., 2011), The genetics of adiposity
highlighting that storing energy and processing information are Recent studies have emphasized a strong heritable component of
alternative ways of dealing with ecological uncertainty. Humans, variability in adiposity. Heritability estimates from a selection of large
however, have both large brains and high adiposity (Wells, 2009b), classical twin studies from industrialized populations, comparing
making both strategies possible. monozygous and dizygous twins, are provided in Table 1;
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Social
stress
Single acute Multiple integrated
signal metabolic signals
Disease Models & Mechanisms DMM
adoption studies have also suggested high heritability (Sorensen et experience in utero is associated with various subsequent
al., 1989; Stunkard et al., 1986b). However, these studies have been components of phenotype that are relevant to adiposity.
conducted largely in industrialized populations, where favorable However, genetic variability within populations is not the only
environmental conditions might maximize the contribution of important comparison. Humans also appear systematically fatter
genetic factors to phenotypic variability. Equivalent data from other than other primates (Altmann et al., 1993), although few data are
ecological settings are lacking and, under greater ecological available except from captive primates, themselves likely to be
constraint, heritability might well be lower. Genome-wide overweight. Even women with a low body mass index (BMI) in
association studies report an increasing number of individual alleles foraging populations have ~20% of weight as fat (Wells, 2012c). A
that are associated with adiposity, although findings often fail to genetic perspective on human adiposity therefore emphasizes two
be replicated across populations, a scenario that might be due to key issues: first, that ‘pan-human’ thrift manifests as a continuous
variability in study design and sample size as well as in population trait with substantial plasticity (discussed in the following section),
ethnicity (Elks et al., 2010a; Heid et al., 2010; Speliotes et al., 2010; and, second, that it is subject to within- and between-population
Willer et al., 2009; Yajnik et al., 2009). Adiposity therefore seems variability.
to have the genetic profile of a continuous trait that is affected by Several evolutionary approaches to contemporary genetic
numerous different genes, whose number and variability across variability in adiposity have been proposed. In his classic paper,
populations remain to be established. Neel emphasized differential exposure to ancestral famine (Neel,
The reported high heritability values are currently being re- 1962). Over the last decade, some have argued that there is no
evaluated, following recent developments in our understanding of evidence for such thrifty genes (Speakman, 2006; Speakman, 2008).
the biology of phenotypic variability. For example, monozygous Because starvation is rarely the primary cause of death in famines
twins are not only more similar genetically than dizygous twins, (Mokyr and O Grada, 2002), Speakman argued that famine could
but are also more similar epigenetically (Fraga et al., 2005). This not have been sufficiently powerful as a source of selection to
means that the greater similarity of monozygous twins might not generate variability in thrifty genes. Instead, he proposed the ‘drifty
be due entirely to genetic factors, and might also reflect a similar genotype’ hypothesis, arguing that multiple alleles impacting
environmental experience, especially in early life (Armitage et al., adiposity accumulated below the threshold for phenotypic
2008; Yajnik, 2004). This is an extremely important point, because detection over millions of years through genetic drift, and have only
Table 1. Heritability coefficients from a selection of large twin studies for anthropometric indices of adiposity
Population Age n Outcome Heritability (%) Reference
China Adults 1260 twin pairs BMI 61 Lee et al., 2010
Waist 75
Finland Adults ~5278 twin pairs BMI 80 Hjelmborg et al., 2008
United Kingdom 4 years 3582 twin pairs BMI 48 Haworth et al., 2008
11 years 4251 twin pairs BMI 78
United States 20 years 4071 twin pairs BMI 77 Stunkard et al., 1986a
Adults 1224 twin pairs BMI 76 Watson et al., 2010
–4.5
–5.5
0 1000 2000 3000 4000 5000
Disease Models & Mechanisms DMM
recently been exposed in the modern obesogenic environment When a new mutation occurs, it can increase in frequency in
(Speakman, 2008). the gene pool if it is beneficial, through a ‘selective sweep’. Recent
However, other life-history functions (growth, maintenance of the evidence suggests that many local selective sweeps of genes
large Homo brain, reproduction and immune function) might have influencing metabolism and adiposity only began relatively recently,
been very important traits exposed to selection on energetics, and and are still continuing (Bender et al., 2011; Pickrell et al., 2009).
this perspective becomes more valuable if the definition of thrifty The specific functions of these genes converge on several important
genes is expanded to those associated with any aspect of adipose components of biology, including metabolism and digestion,
tissue biology, rather than those associated with energy stores only. immune defense, reproduction, and cognition (Cochran and
Bouchard suggested five broad types of thrifty gene: those associated Harpending, 2009; Voight et al., 2006).
with appetite; metabolism or thermogenesis; predisposition for Genetic evidence indicates that adiposity is a continuous trait,
physical activity; adipocyte lipid storage capacity; and lipid oxidation much like other life-history traits such as stature and the timing of
rate (Bouchard, 2007). This list can now be lengthened because genes puberty (Elks et al., 2010b; Lango Allen et al., 2010). Continuous traits
that are associated with adult BMI have been linked with infant tend to have a polygenic architecture, with each associated gene
growth, pubertal timing and insulin metabolism (Elks et al., 2010a; contributing a small magnitude of effect. The polygenic basis of
Elks et al., 2010b; Hattersley et al., 1998). adiposity maintains numerous small sensitivities to diverse ecological
Contemporary human genetic variability can be attributed to stresses that are relevant to life-history strategy, integrating them into
several different sources. First, some variability has persisted from a single phenotype (Wells, 2009b). In this way, it might represent a
Homo erectus, passing through the population bottleneck that moderate form of bet-hedging – i.e. increasing variance in offspring
characterized the origin of our own species (Garrigan and Hammer, to reduce variance in fitness (Wells, 2009b). Perhaps more
2006). Second, there is evidence that the gene pool of Homo sapiens importantly, the same polygenic architecture further offers a stable
received contributions through interbreeding with other hominin platform on which mechanisms of plasticity can function, because
species, such as Neanderthals (Green et al., 2010) and a recently the trait becomes robust to individual mutations by constraining their
discovered type from Siberia (Abi-Rached et al., 2011). Because magnitude of effect (Wagner, 2005).
Neanderthals were well adapted to cold environments and a diet Crucially, this perspective also suggests substantial common
rich in protein, these genes might be very relevant to contemporary ground between the genetic and plastic components of adiposity
adiposity variability (Cochran and Harpending, 2009). Third, the variability. The genetic component integrates multiple ancestral
main proportion of global human genetic variability is assumed to influences on life-history traits such as growth, pubertal
have occurred following the exodus from Africa around 60,000 development, metabolism, adipocyte biology, etc., whereas the
years ago, when populations migrated to most continents and plastic component allows greater life-course flexibility in the same
adapted to a wide range of thermal environments, ecosystems, traits. Next, I consider the long-term evolutionary environment that
dietary niches and disease loads (Garrigan and Hammer, 2006). shaped this overall profile.
Fourth, the rapid expanse in global population size following the
emergence of agriculture is predicted to have substantially increased What environment shaped human adiposity?
the absolute number of new mutations in the last 10,000 years The pan-human profile of adiposity was shaped over our
(Cochran and Harpending, 2009). evolutionary past, reflecting ecological pressures that favored a
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The evolution of human obesity SPECIAL ARTICLE
number of unusual traits that are characteristic of our species during the non-feeding period. Other ecological stresses favoring
(Wells, 2009b). These traits include large brains and fully bipedal fat stores include migration, breeding and hibernation, each of
locomotion, but also key social and behavioral capacities, and they which temporarily overloads energy demand relative to intake
have been widely assumed to have been favored by the emerging (Pond, 1998). Adipose tissue stores are particularly valuable in cold
‘savannah’ environment in east and southern Africa. environments, which are more vulnerable to fluctuations in energy
There is a tendency to consider the savannah a relatively stable supply (Pond, 1998). So important is fat to some hibernating
environment, with our modern fast-changing urban environment animals that if they are starved as winter approaches, they
generating a stark sudden contrast. An increasing volume of preferentially preserve adipose tissue, and oxidize lean tissue
palaeoenvironmental data suggests that this view of past stability instead (Dark, 2005).
is very misleading (Potts, 1996; Potts, 2011). Isotopic data indicating We can therefore consider adipose tissue as a strategy for energy
trends in global temperature indicate that, as the world became storage that responds to multiple ecological stresses, interacting
cooler over the last few million years, this was accompanied by with the characteristics of the animal. As body size increases, the
another trend towards increasing climatic volatility (Fig. 2) (Lisiecki energy expenditure per kg body weight decreases (Oftedal, 2000).
and Raymo, 2005). This volatility in turn is assumed to equate to Metabolic processes therefore become more efficient as body size
continual ecosystem change, because rises and falls in temperature increases. In this way, larger body size per se, along with both
and precipitation alter patterns of vegetation and associated absolutely and relatively greater energy stores, increases the period
communities of organisms (Potts, 1996). The last 10,000-year of time over which adipose tissue stores can fund energy
period has paradoxically been relatively stable climatically requirements.
(Richerson et al., 2001), but has instead been increasingly perturbed Storing energy as fat is by no means the only strategy for
by the niche-constructing activities of humans themselves (Wells managing the risk of uncertainty in energy supply. A highly social
Disease Models & Mechanisms DMM
and Stock, 2007). There has arguably never been a lengthy period organism such as humans can store energy not only in the body
of environmental stability during the evolution of the Homo genus. but also extra-corporally (in food hoards) or in social relationships.
Although outright famines might have been rare in pre- This ‘redundancy’ of multiple mechanisms suggests that energy risk
agricultural populations, and severe food shortages could be management was crucial in the evolution of our species; however,
addressed by nomadism, hominin populations can be assumed to although the different approaches have much in common, they also
have experienced energy stress repeatedly across and within address different situations. Storing energy in social relationships
generations, resulting from various cycles of uncertainty. These or food hoards buffers against individual uncertainty and
include seasonality, longer-term systematic climate shifts, and misfortune, such that other group members alleviate the risk. This
extreme events such as volcanic eruptions and climatic cycles (Potts, scenario gives control over the social distribution of energy stores.
1996), an example in the contemporary world being El Niño effects. Storing energy in the body buffers against situations that affect all
More recently, human activities such as over-hunting and individuals in the social group, such as major ecological stress. This
unsustainable agricultural strategies have maintained ecological scenario increases control over the internal distribution of energy,
perturbations (Diamond, 1998; Fagan, 1999). The ability to as discussed below. However, storing energy in the body also carries
withstand ecological volatility would furthermore have improved its own risks – the historical record has repeatedly documented
the capacity to probe new habitats and niches, and hence colonize widespread cannibalism during severe famine, with some
new territories, a process that could have ramped up through individuals plundering the somatic energy stores of others (Keys,
positive feedback effects (Wells and Stock, 2007). This issue is of 1999).
particular interest given the role of energy stores both in promoting
reproduction, and in withstanding energy stress, as discussed
below.
Although further details of this ecological volatility remain to Adipose tissue
be established, there is already sufficient evidence to assume that
Skeletal muscle
hominin evolution has been strongly shaped by stochastic
environments, with regular exposure to energy stress; this Gut
Heart
Adipose tissue as a strategy
Brain
The notion that adiposity functions as a complex risk management
system is supported by previous evaluations of how the tissue 0 20 40 60 80 100
% reduction following starvation
evolved in vertebrates. Early mammals, for example, were small
and nocturnal. Lactating mice lay down fat by night in order to Fig. 3. Percentage reduction in the mass of various organs and tissues
fund lactation by day (Pond, 1984). In such small species, lactation during starvation. During starvation, the amount of adipose tissue decreases
is too expensive to fund directly from energy intake, hence storing substantially, but most other tissues also decline. Based on published data
energy during the period of feeding makes high energy output viable (Rivers, 1988).
females than males due to their higher average body fat content 6
(Norgan, 1997). However, Fig. 3 illustrates that adipose tissue is by
4
no means the only tissue that is broken down during starvation,
and that, although it is the most plastic tissue, skeletal muscle, gut, 2
The sections above have briefly demonstrated that adipose tissue Risk management in operation: the long view
is associated with numerous different biological functions. Although humans have a common risk management strategy in
Importantly, they can all be integrated within the theoretical model their adipose tissue, its characteristics also differ between
of life-history. Adipose tissue can provide energy for each of these populations, and between individuals within populations. Unlike
Disease Models & Mechanisms 601
SPECIAL ARTICLE The evolution of human obesity
Fuel depot
Insulin suggested that intramuscular adipose tissue in African populations
Peripheral Leptin
might have been favored as an adaptation to malaria, providing
Adipose local fuel for muscle tissue in this disease, for which fever is a key
Deep Resistin component of immune defense, whereas visceral adiposity might
Energy have been favored in south Asian populations as an adaptation to
intake Expend Adiponectin
Maintenance
gut-borne infections, which can be promoted by regular monsoon
Synthesis Growth factors rainfall (Wells, 2009a).
Functions
Activity Interleukins
This hypothesis can be placed alongside other hypotheses for
Reproduction ethnic genetic variability in traits relevant to adiposity, such as
dietary ecology (Kagawa et al., 2002) and thermal stress (Hancock
Losses et al., 2008). However, the reason why the variable disease selection
hypothesis merits particular attention is that it offers an explanation
Fig. 5. Energy metabolism as an ‘allocation game’, with incoming energy for variability in cytokine biology – and it is the cytokine load
allocated to ongoing biological functions (energy expenditure) or a range
imposed by obesity that seems to be particularly detrimental in
of energy stores. The allocation ‘decisions’ are assumed to be orchestrated by
terms of chronic degenerative disease risk (Alvehus et al., 2010;
Disease Models & Mechanisms DMM
adaptations might interact with the subsequent environment to behavior might therefore seem the obvious target for both
moderate obesity risk (Wells, 2012a). Importantly, however, the treatment and prevention. Nonetheless, weight management
mechanisms underlying such physiological plasticity seem to differ programs typically achieve only modest weight loss on average
between populations, such that both early-life and subsequent risk (although some individuals perform better) and many who initially
factors can vary (Wells, 2012a). lose weight subsequently regain it (Taubes, 2008). The lack of
success in behavioral prevention programs is indicated by upward
Where is the disease of obesity located? trends in obesity prevalence in many industrialized countries, and
So far, this article has described adipose tissue as a flexible risk even more so in countries undergoing rapid economic development
management strategy for allocating energy across competing life- (Misra and Khurana, 2008; Popkin, 2007).
history functions under stochastic conditions. This system is Because obesity is rare in traditional societies, it is clear that
assumed to have evolved under conditions of regular energy stress, environmental factors are essential for its occurrence in the vast
and indicates that adipose tissue biology in humans is fundamental majority of individuals, and that these factors drive behavioral
to our species’ persistence (Wells, 2009c). In modern environments, change at the level of the individual (Poston and Foreyt, 1999).
this adaptive system is paradoxically associated with ill health, Molecular variability might account for differential susceptibility
through chronic excess weight gain and the metabolic co- to the obesogenic niche, but the niche itself is a prerequisite for
morbidities of obesity (Hankey, 2012; Lustig, 2008; Prasad et al., obesity except in the case of very rare genetic disorders (O’Rahilly
2011). et al., 2003). Significantly, evidence increasingly suggests that many
This scenario can be attributed to the way in which multiple non-human species become overweight if subjected to the human
components of modern urban environments interact with the industrialized niche. Many primate species become obese in
sensitive physiological pathways that confer adaptive plasticity. captivity (Kemnitz and Francken, 1986), and diverse species of pet
animals also gain excess weight (German, 2006). These findings
Disease Models & Mechanisms DMM
global supply of food, but socialize the health costs (Albritton, 2009). economy. As capitalism draws ever more of the global population
into its multinational marketplace, the prevalence of obesity rises
in concert. A major shift in strategy, from individual-based science
nourished, often as a direct consequence of exploitation as cheap to population-based economics, will probably be required to
labor in agricultural production, industry or new urban economies. reduce the global health burden of excessive energy intake and
Another large and increasing proportion of the population has obesity. If the disease component of obesity lies not in adipose tissue
become overweight, owing to various manipulations that maximize itself, but in the interaction between adipose tissue biology and our
profit for the food retail and associated industries (Albritton, 2009). modern industrialized environment, efforts to combat obesity
Recent work on the role of refined-carbohydrate diets in perturbing would be much more effective if they prioritized ‘external’
insulin metabolism highlights how the content of foods might drive environmental change rather than attempting to manipulate
changes in human behavior, rather than vice versa (Taubes, 2008; ‘internal’ biology through pharmaceutical or behavioral means.
Wells and Siervo, 2011).
Capitalism therefore drives both under-nutrition and excessive Conclusion
energy intake. However, in recent decades, a further effect is for
Adipose tissue is found in many vertebrates, where it represents a
capitalism to drive the transition from one nutritional state to the
sophisticated means of accommodating uncertainty in energy
other (Fig. 6). In ‘emerging market’ modernizing countries such as
supply. The fact that adipose tissue is the source of numerous
India, obesogenic food products interact with metabolic
signaling molecules highlights its role in orchestrating life-history
adaptations to chronic malnutrition to produce a high prevalence
decisions. This risk management system is, however, increasingly
of obesity that can approach 50% in urban populations (Pandey et
destabilized in many human populations. Prevailing economic
al., 2011). A recent study showed, for example, that the transmission
policies cause individuals to be subjected to a range of ‘invasive’
of obesity from mother to offspring is much more likely if the
cues favoring fat accumulation, in environments in which actual
mother was herself born small (Cnattingius et al., 2011),
energy availability has high stability. The combination of
demonstrating the impact of prior under-nutrition on susceptibility
insulinogenic diets and psychosocial stress on the one hand, and
to the obesogenic niche. These rapid secular trends are driven by
low energy demand for physical exertion, reproduction and
the aim of the food industry to target new markets (Stuckler et al.,
immune function on the other, stimulates chronic lipogenesis but
2012), in the absence of any efforts to address persisting under-
nutrition. This is illustrated by a persisting high prevalence of reduces lipolysis. At this point, high levels of adiposity become toxic
under-nutrition in the same populations in which obesity is rapidly and harmful to health. It is these socio-environmental cues,
escalating, a situation known as the dual burden (Doak et al., 2000; collectively orchestrated by our capitalist economic system, that
Doak et al., 2005). are the optimal target for obesity prevention.
Capitalism therefore stands out from other politico-economic This article is part of a special issue on obesity: see related
systems in its capacity to drive both under-nutrition, through the articles in Vol. 5, issue 5 of Dis. Model. Mech. at
demand for cheap labor, and excessive energy intake, through the http://dmm.biologists.org/content/5/5.toc.
demand for ever-increasing levels of consumption to boost COMPETING INTERESTS
profits. In the midst of this economic environment, the risk The author declares that he does not have any competing or financial interests.
management system represented by adipose tissue swings
FUNDING
between extremes of chronic energy deficiency in some, and This research received no specific grant from any funding agency in the public,
obesity in others. Chronic psychosocial stress is no longer a signal commercial, or not-for-profit sectors.
604 dmm.biologists.org
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