[1] Wiki, 12/18 Ache https://en.wikipedia.org/wiki/Ach%C3%A9. The article’s discussion of their diet puzzles on why the men prefer to hunt rather than gather food for which coconuts are plentiful and supplies 25% more energy per hour of labor than hunting. I aver that hunting reduces boredom more than gathering foods such as coconuts. Given this it explains why another article finds that the average for hunter-gatherers is 60% of calories from animals and insects.

[2] Kelley, David, Jing He, et al Oct 2002, Dysfunction of Mitochondria in Human Skeletal Muscle in Type 2 Diabetes

[3] Kevin Short, Maureen Bigelow, et al, April 2005, Decline in skeletal muscle mitochondrial function with aging humans

Review of Burkett & Trowell -- include WESTERN DISEASES: THEIR EMERGENCE AND PREVENTION. By H.C. Trowell and D.P. Burkett

Burkitt. Cambridge, MA, Harvard University Press, 1981. 456 pp. $40.00.

During travels through developing and industrialized countries in the West Pacific, Far East, and Central America, I often wondered about the state of health of these peoples and those in similar countries around the world. I was especially curious about the prevalence of chronic non-infectious diseases and how these were related to culture, environment, diet, and personal health practices. Furthermore, I was intrigued about the extent to which Western acculturation directly or indirectly

affected health. These questions are now answered on a global basis in this book edited by two eminent physicians, H.C. Trowell and D.P. Burkitt. I applaud their efforts and those of the contributors in presenting current information on this timely and significant aspect of international health and epidemiology. As is succinctly stated in their preface, "this book attempts to discuss the commoner diseases of civilization." In essence, these diseases are ones felt by the editors

to be characteristic of modern Western industrialized societies: metabolic and cardiovascular diseases (e.g., coronary artery disease, hypertension, diabetes mellitus, cerebrovascular disorders); intestinal diseases (e.g., appendicitis, diverticular disease, cancer, hemorrhoids, polyps, constipation); and a variety of others, including

nephrolithiasis, gout, pernicious anemia, thyrotoxicosis, and breast and lung cancer.

The major chapters in the book study several specific populations from all corners of the earth. They are collected in sections under the concepts of hunter-gatherers, peasant-agriculturists, migrants and mixed ethnic groups, and the Far East. The people described include Inuit Eskimos, Australian aborigines, Pacific Island groups, South African populations, Hawaiian ethnic groups, and the population of Taiwan and China. The chapters are thorough and well-written, with numerous and current references. The 34 contributors, of whom the majority are physicians, have had extensive experience living and working with these populations. In each chapter, discussions cover population demographics, cultural aspects of the diet, and important studies on disease-specific morbidity and mortality data. A common thread running through all of the chapters is the role of diet (carbohydrate, fat, fiber, and protein components) and known health risk factors (smoking, sedentary living, alcohol consumption,

stress concomitants, and individual susceptibility) as associated factors in the epidemiology of these diseases. Topics are presented in an informative manner for the reader to consider, without biased "breast-beating" over conjectured dogmas. Another section of chapters is concerned with the international epidemiology and environmental aspects of certain important diseases, including multiple sclerosis,

cancer, and the arthritides. The current state of the art in the treatment and prevention of cardiovascular diseases, intestinal disorders, and diabetes mellitus is also examined. There are only two shortcomings of this book, but they are inherent in its design and do not detract from its purpose. In some instances, the available orbidity and data are limited and are not able to be broken down into specific rates, i.e., by age group. Second, the subject of psychiatric diseases is not covered; however, this would entail a separate text.

Western Diseases: Their Emergence and Prevention stands on its own merits as a welcomed and necessary reference for those involved in the fields of international health and epidemiology. I also highly recommend this book to anyone who anticipates working in the fields of overseas health care or exploration medicine.

MARK L. DEMBERT

Department of Epidemiology and Public Health

Yale University School of Medicine

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
https://www.lrb.co.uk/v03/n24/thomas-mckeown/the-burden-of-prudence-industrialisation-and-disease

The Burden of Prudence – Industrialisation and Disease

Thomas McKeown

Hugh Trowell and Denis Burkitt are a distinguished physician and surgeon who have spent most of their professional lives in Africa; with T.L. Cleave and G.D. Campbell, they have probably contributed more than anyone else to our understanding of the relation between the health problems of developed and developing countries. In Western Diseases they bring together reports by 34 contributors, who describe their experience of changes in the pattern of disease in several countries as Westernisation occurs. There are four main lines of evidence, which the editors admit are not all equally secure. 1. Until recently many of the non-communicable diseases now predominant in the West were uncommon or absent in hunter-gatherers and peasant agriculturists. 2. When these populations change from their traditional ways of life to those of the developed countries, they begin to exhibit the Western pattern of disease. 3. The incidence of some of the diseases has declined in Western populations which have reversed certain features of their lifestyle to bring it closer to that of peasant agriculturists. 4. Of the multiple influences responsible for the Western pattern of disease, dietary changes are probably the most important.

The full text of this book review is only available to subscribers of the London Review of Books.

Figure 3, Fasting plasma leptin (ng/mL) in Kitava horticulturalists versus healthy Swedes. ⁹²

Figure 4 Fasting plasma leptin (ng/mL) in Ache Indians versus American marathon runners.⁸³ Ache (Axe people) are indigenous hunter-gatherers of eastern Paraguay.

Figure 7, Maximum oxygen consumption in various populations (mL/kg/min). ⁶⁷

The Burden of Prudence – Industrialisation and Disease

Thomas McKeown

Figure 3, Fasting plasma leptin (ng/mL) in Kitava horticulturalists versus healthy Swedes. 92

Figure 4 Fasting plasma leptin (ng/mL) in Ache Indians versus American marathon runners.83 Ache (Axe people) are indigenous hunter-gatherers of eastern Paraguay.

Figure 7, Maximum oxygen consumption in various populations (mL/kg/min). 67

The Burden of Prudence – Industrialisation and Disease

Thomas McKeown

Figure 3, Fasting plasma leptin (ng/mL) in Kitava horticulturalists versus healthy Swedes. ⁹²

Figure 4 Fasting plasma leptin (ng/mL) in Ache Indians versus American marathon runners.⁸³ Ache (Axe people) are indigenous hunter-gatherers of eastern Paraguay.

Figure 7, Maximum oxygen consumption in various populations (mL/kg/min). ⁶⁷