Evolutionary Medicine

Abstract Evolutionary medicine is a fast‐growing research field providing biomedical scientists with evolutionary perspective for the comprehension of the human health and disease as a result of evolutionary processes, such as selective constraints, trade‐offs, conflicts between different systems within the same organism and mismatches between our modern lives and the environment where human beings evolve. The present human genome and phenotypes are essentially Palaeolithic: they are not adapted to the modern lifestyle, thus favouring the so‐called diseases of civilization. Molecular evolution has helped to revolutionise our understanding of cancer, of autoimmune disease, and of the origin, spread, and pathogenesis of emerging diseases, emotional disruptive behaviour and mental diseases, where it has revealed historical processes and suggested new therapies. An evolutionary perspective of medicine works as a comprehensive scaffolding for organising medical principles and ideas (as it does in biology in general) that otherwise would remain unconnected. Key Concepts Evolutionary medicine studies the dynamic consequences of natural selection acting on the human lineage and underlying human health and disease. Originated from Darwinian Evolutionary Theory, Evolutionary medicine has undergone an exponential growth since the early 1990s providing a comprehensive framework, which places medical principles and ideas within evolutionary context. The complex genetic diseases within evolutionary perspective can be explained by evolutionary conflicts, mismatches between genotypes and modern environment, trade‐offs as a result of evolutionary innovations and selective constraints. Evolutionary perspective can provide us with therapeutic targets for exclusively human diseases, especially for diseases in which evolutionary mechanisms act over short time periods. Evolutionary framework needs to be integrated into the precision medicine to complex pathologies, accounting for the life history of human populations.