Too Much of a Good Thing

Introduction

In "Too Much of a Good Thing," Dr. Lee Goldman explores the fascinating disconnect between our ancient bodies and the rapidly changing modern world. The book delves into how our genetic makeup, shaped by millions of years of evolution, is struggling to keep up with the drastic changes brought about by the Industrial Revolution and subsequent technological advancements.

Goldman argues that many of the chronic diseases plaguing modern society are a result of this mismatch between our Stone Age bodies and our 21st-century lifestyles. From obesity and heart disease to anxiety and depression, the author examines how our once-beneficial adaptations are now working against us in unexpected ways.

The Slow Pace of Human Adaptation

Our Bodies: Stuck in the Stone Age

The human body is remarkably slow to adapt to changes in the environment. Goldman illustrates this point with the example of skin color adaptation. It took thousands of generations for humans who migrated out of Africa to develop lighter skin in response to less sunny environments. This gradual change allowed for better vitamin D production, which is crucial for bone health.

However, the pace of environmental change since the Industrial Revolution has far outstripped our body's ability to adapt. In just a few centuries, we've transformed our world in ways that our Stone Age bodies simply weren't designed for:

1. Food abundance instead of scarcity
2. Sedentary lifestyles instead of constant physical activity
3. Information overload instead of limited stimuli
4. Safety and comfort instead of constant threats

These rapid changes have left our bodies confused and struggling to cope, leading to a host of modern health problems.

The Food Paradox: From Scarcity to Abundance

Evolutionary Eating Habits

Our ancestors lived in a world where food was scarce and unpredictable. As a result, our bodies evolved to take full advantage of any available food sources. Goldman shares a striking example of this adaptation: early pioneers observed Native American tribes consuming up to nine pounds of meat – roughly 12,000 calories – in a single day when food was plentiful.

This ability to feast and store excess energy as fat was a crucial survival mechanism in times of scarcity. Our bodies are programmed to create energy reserves in the form of fat deposits in our hips, bellies, and thighs. These fat reserves served two important purposes:

1. Energy storage for times of food scarcity
2. Insulation against cold temperatures

The Modern Obesity Epidemic

In today's world of food abundance, our bodies' efficient fat-storage mechanisms have become a liability. We no longer need to prepare for long periods without food, nor do we require as much insulation thanks to modern clothing and housing. Yet our bodies continue to operate as if famine is just around the corner.

This mismatch between our evolutionary programming and our current environment has contributed significantly to the modern obesity epidemic. Goldman highlights several factors that make weight loss particularly challenging:

1. Metabolic adaptation: As we lose weight, our bodies require fewer calories to maintain the new, lower weight. For every percent of body mass lost, we need about 20 fewer calories per day.

2. Hormonal changes: Dr. Priya Sumithran's research in 2012 revealed that weight loss triggers hormonal changes that increase appetite, regardless of the person's current size. This was beneficial when food was scarce but now contributes to weight regain.

3. Genetic predisposition: Our genes still favor individuals who can efficiently store fat, making it difficult for many people to maintain a healthy weight in an environment of abundance.

Water and Sodium: A Delicate Balance

The Dangers of Dehydration in Ancient Times

Goldman uses the legendary story of Pheidippides, the Greek messenger who ran from Marathon to Athens, to illustrate the historical dangers of dehydration. In arid environments with limited access to clean water, extreme physical exertion could be fatal. Pheidippides reportedly died of heatstroke immediately after delivering his message, having lost up to two liters of sweat per hour during his run.

Our bodies developed powerful mechanisms to conserve water and sodium in response to these threats. These adaptations included:

1. Reduced sweating to conserve water
2. Hormones that help maintain high levels of sodium in the blood
3. Strong thirst and salt cravings

Modern Consequences of Ancient Adaptations

While these mechanisms were crucial for survival in water-scarce environments, they pose significant health risks in our modern world of abundant water and high-sodium diets. Goldman explains how our bodies' sodium-retention abilities now contribute to widespread hypertension:

1. Excess sodium intake leads to increased blood volume
2. Higher blood volume results in elevated blood pressure
3. Chronic high blood pressure damages blood vessels and organs

The author notes that in the United States, a staggering 15 percent of all deaths are caused by high blood pressure – a direct consequence of our bodies' outdated sodium-retention mechanisms.

The Price of Panic: Anxiety and Depression in the Modern World

Evolution of the Fight-or-Flight Response

Our ancestors faced constant threats from predators, rival tribes, and harsh environments. In this context, a heightened state of alertness and a quick stress response were essential for survival. Goldman explains how natural selection favored individuals who were more easily frightened and quick to react:

1. Faster reaction times increased chances of survival
2. The ability to anticipate threats helped avoid dangerous situations
3. A strong stress response provided the energy needed to flee or fight

The Cost of Injuries

To underscore the importance of avoiding injuries in prehistoric times, Goldman cites research by psychiatrist Randolph Nesse. Nesse calculated that while fleeing from a predator might cost about 200 calories, an injury could result in a loss of over 20,000 calories in the following week due to inability to hunt or gather food. This high cost of injury reinforced the value of a robust panic response.

Modern Manifestations of Ancient Fears

In today's relatively safe environment, our hair-trigger stress response has become maladaptive. Goldman argues that this mismatch contributes significantly to the prevalence of anxiety and depression in modern society:

1. Minor stressors trigger disproportionate panic responses
2. Constant exposure to negative news and information keeps us in a state of heightened alert
3. Work-related stress activates the same physiological responses as life-threatening situations

Our bodies struggle to distinguish between genuine threats and the numerous non-life-threatening stressors we encounter daily. This results in chronic activation of our stress response, leading to a host of mental and physical health problems.

Blood Clotting: A Double-Edged Sword

The Evolution of Rapid Clotting

Goldman explains how our bodies' ability to quickly form blood clots was a crucial adaptation for survival in prehistoric times. Before the advent of modern medicine, even minor wounds could lead to fatal blood loss. Natural selection favored individuals whose blood clotted rapidly, as they were more likely to survive injuries and pass on their genes.

The author describes the intricate clotting mechanism our bodies have developed:

1. High concentration of platelets in the blood
2. Platelets quickly attach to wound sites, forming a seal
3. Chemical signals attract more platelets to the injury

This efficient clotting system was vital in a world where childbirth, hunting accidents, and violent conflicts posed constant threats.

The Modern Threat of Blood Clots

While our blood's eagerness to clot once saved lives, it now poses a significant health risk when combined with modern dietary habits and sedentary lifestyles. Goldman outlines how this ancient adaptation contributes to heart attacks and strokes:

1. Unhealthy diets high in saturated and trans fats lead to cholesterol buildup in arteries
2. Cholesterol deposits can tear, creating small wounds in artery walls
3. Platelets rush to repair these tears, forming clots
4. Clots can block blood flow, causing heart attacks or strokes

This example vividly illustrates how a once-beneficial trait can become detrimental in a changed environment.

The Limits of Genetic Adaptation

Why Natural Selection Won't Solve Modern Health Problems

Goldman argues that we shouldn't expect our genes to evolve quickly enough to address modern chronic diseases on their own. He presents several reasons why natural selection is unlikely to weed out genes that contribute to conditions like obesity, diabetes, and heart disease:

1. These diseases typically don't affect reproductive success
2. Modern medical interventions allow individuals with these conditions to survive and reproduce
3. The global population is too large and dispersed for beneficial mutations to spread quickly

The Challenge of Rapid Environmental Changes

The author emphasizes that our current environment is changing much faster than our bodies can adapt through genetic evolution. While some minor adaptations might occur over generations (such as increased prevalence of nearsightedness due to indoor lifestyles), these changes are unlikely to significantly impact our susceptibility to chronic diseases.

Goldman suggests that instead of relying on natural selection, we need to find other ways to address the mismatch between our Stone Age bodies and our modern environment.

Collective Action: A Powerful Tool for Change

The Limitations of Individual Willpower

To illustrate the challenges of relying solely on individual willpower to combat health issues, Goldman uses the example of Oprah Winfrey's well-publicized weight loss struggles. Despite her tremendous success and determination in other areas of life, Oprah has faced ongoing difficulties maintaining a healthy weight.

The author argues that this is not due to a lack of willpower but rather a result of our bodies' deeply ingrained evolutionary programming. Even highly motivated individuals like Oprah or former U.S. President William Howard Taft (who weighed 354 pounds when he took office) struggle to overcome these biological imperatives.

The Power of Government Intervention

Goldman advocates for collective action, particularly through government policies, as a more effective approach to addressing modern health challenges. He provides several examples of successful interventions:

1. United Kingdom: The government convinced food companies to reduce salt content in processed foods by 20-30%, leading to improved cardiovascular health outcomes.

2. Finland: Through a combination of health campaigns and mandatory salt content limits, the country reduced sodium consumption by 25%, resulting in fewer high-blood-pressure-related complications.

3. Japan: The government implemented a law requiring annual waistline measurements for adults aged 40-70, with mandatory dietary counseling for those exceeding certain limits. This policy has contributed to Japan's low obesity rate of just 5%.

These examples demonstrate how collective action can create environments that support healthier choices, making it easier for individuals to overcome their evolutionary predispositions.

The Promise of Medical Research

Pharmaceutical Innovations

While much of the book focuses on the challenges posed by our outdated bodies, Goldman also highlights the potential of modern medical research to address these issues. He points to several promising areas of research:

1. HIV treatment: The discovery of HIV-resistant gene mutations in a small percentage of the population has led to groundbreaking treatments, such as the case of Timothy Ray Brown, who was cured of both AIDS and leukemia through a bone marrow transplant.

2. Targeted cell therapies: Scientists are developing methods to target specific cells in the body, potentially allowing for more precise treatments with fewer side effects.

3. Memory manipulation: Research on mice has shown the potential to erase anxiety and depression-inducing memories using optogenetics, a technique that uses light to control cells.

The Role of Pharmaceutical Companies

Goldman acknowledges the criticisms often leveled at pharmaceutical companies but emphasizes their crucial role in advancing medical research. He argues that despite past failures (such as the initial response to the AIDS epidemic), these companies have the resources and expertise necessary to develop innovative treatments for modern health challenges.

Practical Implications and Advice

Understanding Our Bodies' Limitations

One of the key takeaways from Goldman's book is the importance of recognizing our bodies' evolutionary limitations. By understanding that our instincts and cravings are often at odds with our modern environment, we can make more informed decisions about our health and lifestyle choices.

Creating Supportive Environments

Given the power of our genetic programming, Goldman suggests that creating environments that support healthy choices is crucial. This can involve:

1. Designing cities to encourage physical activity
2. Implementing policies that make healthy food more accessible and affordable
3. Educating people about the mismatch between our bodies and our environment

Embracing a "Hunter-Gatherer" Mindset

As actionable advice, Goldman recommends adopting a diet and lifestyle that more closely resembles that of our ancestors:

1. Eat foods that would be available in the wild: vegetables, fruits, lean meats, and nuts
2. Engage in regular physical activity throughout the day
3. Limit exposure to chronic stressors and information overload

By aligning our modern lives more closely with our evolutionary heritage, we may be able to mitigate some of the health challenges posed by our outdated bodies.

Conclusion: Bridging the Gap Between Past and Present

"Too Much of a Good Thing" offers a compelling exploration of the complex relationship between our evolutionary past and our modern health challenges. Dr. Lee Goldman's work illuminates the ways in which our bodies' once-beneficial adaptations have become liabilities in today's world of abundance, comfort, and rapid change.

The book's key messages include:

1. Our bodies are still adapted for a world of scarcity and constant threats, leading to problems with obesity, anxiety, and chronic diseases.

2. Individual willpower alone is often insufficient to overcome our deeply ingrained genetic programming.

3. Collective action, particularly through government policies, can be highly effective in creating healthier environments.

4. Medical research and technological innovations offer hope for addressing the mismatch between our Stone Age bodies and our modern world.

By understanding the evolutionary roots of our health challenges, we can develop more effective strategies for improving public health and individual well-being. Goldman's work encourages us to rethink our approach to health and lifestyle, considering both our biological heritage and the unique demands of our modern environment.

Ultimately, "Too Much of a Good Thing" serves as a call to action, urging us to find innovative ways to bridge the gap between our Stone Age bodies and our 21st-century lives. By combining insights from evolutionary biology, public health policy, and cutting-edge medical research, we can work towards a future where our ancient genes and modern lifestyles exist in greater harmony.