ABOUT THIS BOOK
So many women who do everything right to stay healthy still wind up with breast cancer, heart disease, or osteoporosis. In The Fragile Wisdom, Grazyna Jasienska provides an evolutionary perspective on the puzzle of why disease prevention among women is so frustratingly difficult. Modern women, she shows, are the unlucky victims of their own bodies’ conflict of interest between reproductive fitness and life-long health.
The crux of the problem is that women’s physiology has evolved to facilitate reproduction, not to reduce disease risk. Any trait—no matter how detrimental to health in the post-reproductive period—is more likely to be preserved in the next generation if it increases the chance of giving birth to offspring who will themselves survive to reproductive age. To take just one example, genes that produce high levels of estrogen are a boon to fertility, even as they raise the risk of breast cancer in mothers and their daughters.
Jasienska argues that a mismatch between modern lifestyles and the Stone Age physiology that evolution has bequeathed to every woman exacerbates health problems. She looks at women’s mechanisms for coping with genetic inheritance and at the impact of environment on health. Warning against the false hope gene therapy inspires, Jasienska makes a compelling case that our only avenue to a healthy life is prevention programs informed by evolutionary understanding and custom-fitted to each woman’s developmental and reproductive history.
Jasienska [is]…uniquely qualified to explore women’s reproductive health from a perspective that is not only cross-cultural but also infused with evolutionary wisdom. Her book is a revelation… Intellectually invigorating.
-- David P. Barash Chronicle of Higher Education
Women may aim for perfect health through diet, exercise and close attention to medical advice, but still develop breast cancer or osteoporosis. Reproductive fitness often wars with general physical fitness over a woman's lifetime, argues public-health specialist Grazyna Jasienska. Drawing on a raft of research in evolutionary biology and beyond, she points to factors such as the disjunction between 'palaeo' and current lifestyles, hormonal disparities and longer lifespans as key to informing disease-prevention strategies.
The antithesis of the diet and get-fit-quick books we're bombarded with at this time of year, The Fragile Wisdom: An Evolutionary View on Women's Biology and Health by Grazyna Jasienska is an engaging examination of how our hormonal and reproductive systems are attuned to our evolving circumstances. Don't expect instant solutions--Jasienska suggests our bodies are not so much 'wise' but 'confused' as they adapt to whatever life has thrown at us over the generations. Fascinating stuff.
In The Fragile Wisdom, Jasienska offers new insights into evolutionary trade-offs between reproductive viability and other aspects of a woman's health. The book includes well-researched (48 pages of references) analyses of Paleolithic dietary patterns as well as hormonal fluctuations that support fertility of younger women and place these same women at risk for postmenopausal cancers of their reproductive organs. One of many strengths of the book is the author's refusal to settle for easy answers or to offer advice. Rather, she raises questions and argues persuasively that human evolutionary heritage is far more complex, more interesting, and more challenging than most readers may have imagined. Although the emphasis is on women's health, this thought-provoking, well-reasoned work is relevant for anyone seeking a better understanding of humanity's collective history and its implications for today.
-- M. D. Lagerwey Choice
A great read for those interested in women's health and evolutionary biology.
-- Susanne Caro Library Journal
Jasienska explores the ways in which modern changes in attitude (and medicine) with respect to the evolutionary role of women to reproduce might be contributing to rising female health problems. Jasienska demonstrates that long ago, estrogen levels were kept in check by the frequency with which women, lacking any suitable form of birth control, became pregnant; today, on the other hand, women--abetted by social and technological advances--can choose a life for themselves other than motherhood. However, this means that women are pregnant fewer times during their lifespan, therefore they cycle more frequently and thus produce more estrogen--a hormone which, at high levels, shows a high correlation with the incidence of breast cancer. Despite huge steps made in the last 100 years toward gender equality, Jasienska compellingly shows that the impact of millennia of biological evolution continues to assert itself.
-- Publishers Weekly
Far and away the best book I've read in the field of evolutionary medicine since Nesse and Williams' Why We Get Sick. The most sophisticated understanding of evolution combined with the best original empirical science and the most creative theoretical thinking.
-- Peter T. Ellison, author of On Fertile Ground
Jasienska refuses to present a model of how modern women should lead their lives; rather she insists that each woman is an individual in her own circumstances and must make decisions about the trade-offs inherent to her personal life history.
-- Jane B. Lancaster, Distinguished Professor of Anthropology, University of New Mexico, and editor, Human Nature
Jasienska offers readers an engaging discourse on a critical part of the modern human condition, and the evolutionary and biocultural processes responsible for its development.
-- Michael P. Muehlenbein, Associate Professor of Anthropology, Indiana University, Bloomington
TABLE OF CONTENTS
Introduction: Why It Is So Difficult to Be Perfectly Healthy
1. If Reproductive Hormones Are So Important, Why Is There So Much Variation?
2. Coevolution of Biology and Culture: Agriculture and Selection for High Levels of Estrogen
3. You Are What You Eat . . . as a Fetus
4. The French Paradox: Did Child Welfare Reduce the Risk of Heart Disease?
5. Intergenerational Echoes of Slavery
6. The Price of Reproduction
7. The Ultimate Test of the Costs of Reproduction: Life Span
8. Evolutionary Past and Modern Diet
9. Evolution and Physical Activity
10. Evolutionary Trade - Offs and Culture
11. Fallacies of Philanthropy
12. Fixing Genes versus Fixing Lifestyles
Conclusion: Is Our Physiology Obsolete?