A review of The Fetal Matrix: Evolution, Development and Disease, by Peter Gluckman and Mark Hanson

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Many of the readers of Evolution & Development will be aware of evolutionary medicine in the guise of evolutionary psychology. Another revolutionary approach to medicine is underway, however. It is developmental, epigenetic, and evolutionary. Driven by the authors of The Fetal Matrix, its origins lie in (1) the description, 15–20 years ago, of low-birth weight human babies as representing a syndrome rather than the low end of the normal distribution of weight at birth; (2) the perception that many physicians regard all patients as representing a typical (average, mean) condition and pay no heed to variation; (3) the hunt for the geneticFoften single geneForigin of syndromes; and (4) the recognition that analysis of human health and disease has much to learn from the upsurge of knowledge in evo-devo over the past 15 years. ‘‘Developmental Origins of Human Health & Disease’’ is the name for a new society dedicated to investigating just these issues. The Fetal Matrix, the first monograph devoted to this field, is written by two of the prime founders (founding fathers) of DOHHD, Peter Gluckman of Auckland and Mark Hanson of Southampton. Clearly and engagingly written, illustrated with examples from many organ systems and prevailing human conditionsFobesity, diabetes, osteoporosis, cardiovascular disease, decline in cognitive function with ageFThe Fetal Matrix provides an excellent introduction to what could be called evo-devo medicine. The central message, embodied in the term predictive adaptive responses, and made explicit throughout, is ‘‘that crucial interactions that determine our destiny occur before birth, when our genes interact with their environment,’’ that these interactions ‘‘are evolutionary echoes of mechanisms that allowed our hunter-gather ancestors to survive,’’ and that ‘‘the new concepts. . .are crucial to understanding the daunting public health burden in societies undergoing rapid transition from poverty to affluence’’ (back cover). Do Gluckman and Hanson succeed in living up to these ambitious statements? Yes and no. Predictive adaptive responses (PAR)Facknowledged as a short hand for a complex idea with a long historyFare discussed in Chapter 3 in the context of embryo/larval-environment interactions, life history theory, phenotypic plasticity, survival strategies and maternal influences, all of which both echo the Baldwin effect/organic selection, all topics that will be familiar to readers of Evolution & Development. Like organic selection, PARs do not produce short-term physiological adaptations but more permanent changes. The theory of predictive adaptive responses as biological processes is neatly laid out in seven points on page 144: (1) PARs are induced by environmental factors in early life, (2) elicit a permanent physiological or structural change, (3) can be initiated via multiple environmental cues, each acting at a different time during development, (4) are not restricted in direction but are nor random, (5) confer a survival advantage, manifest in increased fitness, (6) define the environmental range in which an organism can thrive optimally, but (7) are can lead to a disadvantageous outcome if the PAR does not match the environment experienced by the adult. With the exception of point 6, these look much like the elements of genetic assimilation as proposed by Conrad Waddington. Genetic assimilation is a reaction to the environment experienced at a specific stage during ontogeny, not a definition of the environment experienced by the adult, although the range of environmental insults to which an EVOLUTION & DEVELOPMENT 8:3, 320–321 (2006)