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What was school like in the ancient world? In the pre-covid-age, the enduring general image of attending school for most pupils is one of learning in a classroom with a group of fellow students with a teacher in the front of the classroom teaching subjects such as mathematics, science, history and so on. A year of schooling would be punctuated by examinations where one’s ability to retain their education is tested. Evidently, this is does not necessarily work for everyone as the mere idea of school and academic examinations may sometimes be unpleasant to some people. Philosopher Jiddu Krishnamurti (1895 – 1986), for example, condemned competitive education as destructive and absurd. However, the concept of putting students together in one location for learning purposes existed in the ancient world.
Ancient school built according to the Egyptian and Greek manners by Giovanni Battista Piranesi (1750) Metropolitan Museum of Art
Ancient Egyptian Scribe Schools
Perhaps the earliest form of formal schooling was developed in Egypt's Middle Kingdom under the direction of Kheti, treasurer to 11th Dynasty’s King Menthuhotep II (2061-2010 BC), to educate future scribes. Boys from scribal families and families of the upper classes started early with their schooling. An ancient Egyptian boy’s education commenced between the ages of five and ten years and lasted until he was between 12 and 16 years of age, which would also have been the time of circumcision as transition to adulthood. Although female scribes existed in the entourage of a queen of the 13th Dynasty, the girls did not seem to follow the same method of schooling as the boys. In elite families, girls may have been taught by special tutors such as the example of the tutor Senenmut who was very likely appointed by Thutmose II to teach the princess Nefrure, the daughter of Hatshepsut. Apart from teaching the children themselves, tutors also acted as guardians to the children.
The Seated Scribe: painted limestone and inlaid quartz. Louvre( CC BY-SA 3.0 )
A work of didactic ancient Egyptian literature named The Satire of the Trades , compiled in the Middle Kingdom, extolled the virtues of the professions of the scribe and named it as superior to all other professions. Although the work is a satire, the profession of a tutor was an attractive option to boys and their parents as it provided a relatively easy access to the career path of the high-status position of a scribe.
Agoge: The Rigorous Education and Training System of Spartans
The famous education and training system of the Spartans, the agoge, was a subject of controversy even back in the ancient world. Mystifying and rigorous, this system strove hard to produce citizens who were worthy of Spartan citizenship.
The famous education and training system of the Spartans, the agoge, was a subject of controversy even back in the ancient world. Mystifying and rigorous, this system strove hard to produce citizens who were worthy of Spartan citizenship.
Did You Know?
The word ‘agoge‘ actually means ‘rearing’ in Greek. In the context of the education system, it was taken to mean guidance or training.
In ancient times, it was very rare that public education was a responsibility taken by the State, and in Sparta, both boys and girls were imparted education, albeit in different manners. Not only was the agoge deemed extremely necessary, but the successful completion of the training regime was a prerequisite in order to receive Spartan citizenship.
The objective behind the intensive education and training regime was to produce strong, brave Spartans who would protect the city come what may. All the children of Spartans were expected to undergo the agoge, except the heirs of the royal houses. In fact, the agoge system was so renowned in the ancient world that the elite from other parts of Greece vied to send their sons to Sparta to undergo this training.
A popular legend tells us that the city of Sparta had no strong walls protecting it from outside interference, and when the king was asked why, he simply pointed to his soldiers and said that they were the walls of the city.
The following sections of this article will cover all about the structure and rules of the agoge.
Ubiquitous Ancient Education: Training Young Minds And Bodies - History
Funding This research was supported by a Harry Ransom Center Research Fellowship in the Humanities and a Mellon Dissertation Completion Fellowship at New York University.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned externally peer reviewed.
Data availability statement Data sharing not applicable as no data sets generated and/or analysed for this study. Details of archives used can be obtained from the author.
50 Educational Video Games That Homeschoolers Love
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Video games often get a bad rap. Some of that criticism may be deserved (many don't exactly encourage kids to get active), but video games aren't all bad. In fact, there are a number that are pretty darn educational and can help students young and old learn new things, develop problem-solving skills, and get creative, all while having a really great time. Many schools have already gotten on board with educational video games and homeschoolers can do the same. Here are some great games to try out that present quality educational content in a fun format that students from kindergarten to high school will love.
These video games for Wii, Xbox, and Playstation will get your kids loving the learning process.
- My Word Coach: Available for both Wii and Nintendo DS, this linguist-developed game will help students improve their verbal communication skills through six different fun, word-related games. Even better, the game comes complete with a built-in dictionary loaded with over 17,000 words.
- uDraw Studio: Instant Artist: Help your young learner embrace his or her creative size with this game and drawing device. Players can engage with built in games (using custom-designed avatars and settings) or just get busy creating their own masterpieces.
- Sesame Street: Once Upon a Monster: Geared toward younger learners, this video game brings Sesame Street favorites like Elmo and Cookie Monster together to read kids stories and get them engaged and moving through a series of fun and physical games.
- Smarty Pants: Even parents will enjoy playing this trivia game from Electronic Arts. Similar to Trivial Pursuit, the game quizzes players on a variety of topics from history, to science, to sports, challenging players to come up with right answers and to show off their skills.
- Reader Rabbit: The Reader Rabbit series has reading-related educational games that touch a variety of learning levels and topics. The one we've linked to here is for second graders, but there are others for lower and higher grades. All get kids involved in reading through a series of fun mini-games.
- National Geographic Challenge: Bolster your kids' geographic knowledge with the help of this fun Xbox game, which allows players to quiz themselves, complete puzzles, or explore the world.
- Escape Adventure Island: This Jump Start title is one of many the company offers on the Wii platform. Through it, young learners engage with a 3D environment that helps them to practice math, reading, and critical thinking skills, earning virtual rewards as they go.
- Storybook Workshop: This bargain-priced Wii game is perfect for youngsters who are just learning how to read. It features 16 different fairy tales that kids can listen to or perform, songs you can sing, and even the capability to record your little ones reading the stories.
- LittleBIGPlanet 2: LittleBIGPlanet not only boasts some amazing graphics, but it is also a great game for getting kids to develop problem solving skills. Players navigate through a rich landscape, finding objects along the way, many of which can be used to solve puzzles that will challenge young minds.
- Portal 2: Instead of having players shoot their way to victory like many games do, in Portal 2 players have to use their wits to escape Aperture Laboratories and challenge the power-mad robot at the heart of the story. Ranked as one of the best games of all time, it's a memorable and mentally challenging experience that players won't soon forget.
- Brain and Body Connection: Encourage students to push not only their minds but also their bodies in this game that pushes them to excel in both areas. Kids can play individually or you can all play together as a family.
Nintendo and Playstation handheld devices get an educational upgrade with these games.
- Big Brain Academy: Big Brain Academy, a Nintendo DS game, asks players to take on a number of different kinds of challenges which are timed. Essentially, it's a workout for the brain, designed to challenge players of all ages.
- Magic School Bus Oceans: This is just one of many Magic School Bus games out there, all of which can be amazing ways for young learners to have fun while surreptitiously being educated. In this game, kids will explore the ocean through a series of lessons and seven different educational games.
- BrainQuest: Geared towards grades three and four, this game poses more than 6,000 questions to players. There's action as well as puzzles, and the two are combined in a way that will make kids reluctant to put down the game.
- Spelling Challenges: If your students are in need of some help with spelling, this game could be a fun way to get them to practice. It contains more than 25,000 words at 100 different levels and engages players through 11 different games.
- Book Worm: Reading, spelling, and other language skills are tested in this fun Nintendo DS game. A wealth of word puzzle games will keep kids smiling as they build their own virtual libraries within the game.
- Animal Genius: Animals are fascinating to young learners and this game capitalizes on that. There are five mini-games to play, each focusing on a different habitat, that will quiz kids on their knowledge of all things animal-related.
- Learn Science: Filled with fun mini-games, this title for the Nintendo DS is a great way to help kids practice their science knowledge. There are different game modes and difficulty levels that will extend play to a wide range of learners.
- Brain Age: Parents and kids alike will love using this application to train their brains and become a mental athlete. From math to logic to word problems, there are numerous challenges that will help learners in every aspect of their education. A series of games and tests will help students build the knowledge they need to ace the test, and it just might even be fun to do.
- futureU: Homeschooled kids getting ready to head to college? You may want to invest in this game (it's relatively cheap, so it's not really much of an investment), which helps prep students for the SAT.
- Drawn to Life: Want to help your budding young artist, animator, or creative type embrace his or her talents? This game can be a great way to do so. It allows players to make a drawing which will be brought to life and used to play a series of fun and entertaining games as they fight to bring back an imperiled village.
Power up your PC or Mac for some learning fun when you invest in these amazing educational games.
- SimCity: This classic game isn't just fun. It also teaches invaluable lessons about city planning, environmental impact, and even natural disasters.
- Spore: Your homeschool students can get excited about evolution by playing this game that takes them through single-celled organisms all the way up to space exploration and colonization. Players slowly design their own creatures, adding traits and behaviors along the way that will help or hinder their survival as they evolve. It's fun, addictive, and sneakily educational.
- Nancy Drew: Encourage your kids to hone their critical thinking and problem-solving skills by playing this fun PC game that challenges them to solve a mystery as girl detective Nancy Drew.
- ItzaBitza: In ItzaBitza, drawings come to life. Not only that, but it's also designed to help early readers boost their skills, offering both amazing creativity, confidence building, and language skills.
- Crazy Machines: The Wacky Contraptions Game: Build creative machines, test your contraptions, and put them to work in this imaginative game that teaches the basics of physics, electricity, gravity, and particle effects.
- Brainiversity: This Windows-based game will help you and your kids keep your brains fit and healthy by testing them through mental training sessions. Mini-games cover language, memory, math, and analysis all valuable skills to have in any academic endeavor.
- Civilization: What makes one civilization thrive while another dies? Players will learn just that as they build their own empires in this classic game. The game offers lessons in strategy, ancient and modern cultures, and the fundamentals of human society a great accompaniment to history lessons.
- Hearing Music: Give students ages 5-11 a fun way to boost hearing skills and learn more about music by supplying them with this fun game-based learning method.
These online educational games and resources are making a splash with parents and school districts alike.
- Gamestar Mechanic: You can help your video game-loving kid to embrace tech skills through this game, which allows young players to design and build their own video games.
- Math Blaster: One of the most widely used math games out there, this free game will make learning math more fun than ever for your young learners.
- Quest Atlantis: A popular choice at schools across the country, this educational gaming environment immerses upper elementary and middle school kids in lessons on everything from science to social issues.
- Whyville: Through Whyville, kids can create an avatar, play educational games, hang out with friends, and have fun while doing it!
- Minecraft: Minecraft isn't just an educational game, it's become a nationwide phenomenon. As this Slate piece discusses, the addictive game has captivated students and parents alike. Why? It inspires creativity and problem solving while also being just, well, fun.
- Manga High: Math gets a fun makeover on this site, focusing on game-based learning for students at a wide range of levels. Basic games are free, but the full suite will cost you.
- 20Q: The online version of 20 Questions, this site can be used to help students think and reason.
- Ology: Created by the Museum of Natural History, this game-filled site is an excellent resource for lessons in astronomy, biodiversity, genetics, paleontology, and more.
- Gamequarium: This site is full of learning-based games that focus on a wide range of skills and topics. From number games for kindergartners to Spanish help for middle schoolers, and even a special section for homeschoolers.
- FunBrain: There are dozens of learning games on this site that kids will love to play and you'll love for them to learn from. Reading Arcade, Math Baseball, and Grammar Gorillas are just a few that will become instant classics in your home.
If you're lucky enough to have a tablet, maximize its potential in the classroom by downloading a few (or all) of these great educational games.
Giambattista Vico, critic of Cartesianism
Like Locke, the Italian philosopher Giambattista Vico believed that human beings are not innately rational he argued, however, that understanding results not through sense perception but through imaginative reconstruction. Although Vico’s ideas were not widely known in the 18th century, the importance of his work for the history of philosophy and education has been increasingly recognized since the late 1960s. Vico was professor of rhetoric at the University of Naples from 1699 to 1741. His best-known work is New Science (1725), in which he advanced the idea that human beings in their origins are not rational, like philosophers, but imaginative, like poets. The relation between imagination and reason in New Science is suggestive for educational theory: civilized human beings are rational, yet they came to be that way without knowing what they were doing the first humans created institutions literally without reason, as poets do who follow their imagination rather than their reason. Only later, after they have become rational, can human beings understand what they are and what they have made. Vico’s idea that early humans were nonrational and childlike prefigured Rousseau’s primitivism and his conception of human development (see below The background and influence of naturalism) and the importance Vico accorded to imagination foreshadowed the place that feeling was to have in 19th-century Romantic thought.
De Nostri Temporis Studiorum Ratione (1709 “On the Study Methods of Our Time”) defended the humanistic program of studies against what Vico took to be an encroachment by the rationalistic system of Descartes on the educational methods proper for youth. Vico asserted that the influential Cartesian treatise The Port-Royal Logic, by the Jansenists Antoine Arnauld and Pierre Nicole, inverted the natural course by which children learn by insisting on a training in logic at the beginning of the educational process. He argued instead that young people need to have their mental powers developed and nourished by promoting their memories through the study of languages and enhancing their imaginations through reading poets, historians, and orators. Young minds first need the kind of reasoning that common sense provides. Common sense, acquired through the experience of poets, orators, and people of prudence, teaches the young the importance of working with probabilities prior to an education in logic. To train youth first in logic in the absence of common sense is to teach them to make judgments before they have the knowledge necessary to do so. Vico’s aim was to emphasize the importance of practical judgment in education, an echo of the ideals of Locke and a prefiguring of Rousseau and the 19th-century reformer Johann Heinrich Pestalozzi. Outside Italy, among those who were most influenced by New Science were Joseph de Maistre in the late 18th century and Victor Cousin and Jules Michelet in the 19th century.
The welcome emphasis on First Nations history
The sheer volume of content and foci on Indigenous histories, cultures, and peoples is amazing, and most welcome. I coordinate the Indigenous perspectives in our teacher training programmes at Alphacrucis College, have written formal policy submissions on behalf of professional associations to governing Teacher-Education bodies, and have lived and worked among the active cultures of eight different Indigenous nations. Indigenous history and archaeology have been a passion of mine since I was a teenager tramping through the national parks looking for lost art sites. The Consultation Curriculum contains brilliant material — exactly the kind of fascinating detail that has been absent in conventional teacher training, and definitely lacking in schools.
Previously, “deep time” Indigenous history was exclusively relegated to the primary and infants’ school. In far too many instances, this boiled down to doing occasional dot painting and watching crumby cartoon YouTube clips of de-contextualised dreaming stories, followed by twee activities such as “now write your own dreaming story”. Both approaches tend to make Indigenous history — and their extremely complex, poetic, and diverse spiritualities — look silly. By the time students reach abstract thinking in secondary school, the Indigenous account in the current curricula has tended to become exclusively connected to protest, loss, and trauma, with little sense of celebrating the cultural richness and complexity of pre-, and post-, 1788.
As historian Grace Karskens recently observed in People of the River, a perpetual narrative of massacre and invasion is historically incomplete: almost wherever violent dispossession first occurred, Indigenous people actually fought back with a vengeance, with military strategy and often terrible retributive violence. There was a series of hundreds of small wars of territorial conquest between colonists and local indigenous people. It was an invasion, only less General Patton-style, and more your Roman-Empire style: set up hard scrabble colonists on the frontiers, and they will do your fighting for you, furiously defending their first little patch of dirt. It was a hundred-year-war that Indigenous peoples ultimately lost.
However, Indigenous people also shrewdly adapted themselves to the new social order while maintaining culture and law. Unlike the closed narrative of massacre and annihilation, traditional life was not completely destroyed in many places, but endured for over a century, even in frontiers as violent as the Hawksbury. It endures to this day, in places where we had been taught it had entirely disappeared. This was never, and never would be, a “dying race”.
As a teacher, and now as an education academic, I have been trying to plug up these gaps for decades. And the whole K-10 History Consultation Curriculum is, in fact, actually great content. Nevertheless, I worry about the proposed Curriculum. My worry stems from a simple reality in schools: lack of time.
To put it simply, the inclusion of one topic always means excluding something else. This process of selection and exclusion in education has the real effect of valorising one voice, and silencing another. Up until quite recently, the silencing went the other way — neglecting Indigenous Australia, with nakedly brutal intent and outcome. I lived through this, in my feral upbringing in rural New South Wales in the 1970s. History lessons were simple back then: the mighty explorers, the vile convicts, the wily bushrangers, the wild gold rush days, the Wars. I loved it: my hoary ancestors had inhabited all of these iconic moments. And yet in the class all around me, with quiet, downcast eyes, were children of a far older culture, whose history was entirely absent.
In education we speak of “the hidden curriculum”: what we are meant to learn, what we don’t learn, and what we actually learn. We all learned something about the Indigenous kids in those days, including the kids themselves. I learned that I was top of the heap, and these kids were at the bottom. And then, terribly, I believed it, and often lived it. When the adult world teaches you to be racist when you are eight-years-old, it is hard not to be racist when you are twenty-years-old. Some never grow out of it. Perhaps if I had not become a Christian at age sixteen, and learned of Christ’s love for love and justice, I might be racist still.
However, in a noble effort to give voice to the hitherto voiceless, the Consultation Curriculum has overreached, and has thereby jeopardised the cause of the Indigenous focus by providing a platform of complaint for more unsavoury voices in the public forum. First, because the sheer volume of the suggested First Nations curriculum is unrealistic, and so silencing other voices in the Consultation Curriculum becomes inevitable. The material suggested to be covered in years 7-10 Consultation Curriculum, I could not hope to cover in a semester with highly literate adult trainee teachers. It more resembles what a teacher would deliver in an entire Indigenous perspectives major in a Bachelor degree.
Second, by such a high-volume inclusion, much is lost that should not be lost. In year 7, for example, students are expected to study: “Egypt, Greece, Rome, India and China … it is expected that students will study at least two societies, with one of those being early First Nations Peoples of Australia.” And so it appears that Indigenous history — indeed, only pre-1788 Indigenous history — has taken on a significance equal to the entirety of the rest of Ancient history around the world put together.
It thus becomes easy for the anti-PC brigade to say that Indigenous history is displacing essential cultural knowledge in schooling. The year 8 Consultation Curriculum misses key moments in medieval and Renaissance history — such as the Norman Invasion, the War of the Roses, the Tudors, the English Civil War, the Thirty Years War, the Hapsburg Holy Roman Empire, Magellan, Vasco Da Gama. The entirety of pre-twentieth-century Russian History is absent. The only mention of Chinese Dynasties are single mentions of the Ancient Han and Zou periods, the latter incorrectly categorised under “India”. And yet there are ten references to Renaissance Italy, and over ten to the Ottoman Empire. Absent from the year 9 History Consultation Curriculum are the Austro-Hungarian Empire, the rise of Prussia, any mention of German Europe prior to the twentieth century, and only one mention of the American Revolution. In 7-10 there is no mention whatsoever of Captain James Cook and the arrival of the first fleet: this material is covered briefly in primary at year 4, with ten-year-olds.
Year 10 History is the most thorough in the Consultation Curriculum when it comes to covering the key events — although Mao is not mentioned, nor his atrocities, nor the atrocities of the Soviet Union both at home and in its satellite states. The history of Africa is only mentioned once in the context of Apartheid. South and Central America are not mentioned at all.
But this is all gap chasing. It is far easier to complain about what is missing, than to praise what is there: the remaining material in the existing Consultation Curriculum is excellent stuff. What to include, and what to exclude, is contestable, and will ultimately be settle by committee — which is to say, it will satisfy no one, but such is always the way with a centrally mandated curriculum.
From heroes to thinkers
The notion of paideia did not suddenly emerge in the time of Isocrates, but developed slowly over time. Child-rearing customs that developed in Greece’s Archaic period, from the eighth century B.C. onward, were restricted to a tiny elite of young male aristocrats. They centered on rules and moral dictums—the respect that one owed to parents, the gods, and strangers, for example.
As the literature of Homer spread through the Greek world, the heroes of the Odyssey and the Iliad were held up as examples to inspire young men. A prized quality in the Homeric hero was arete, a blend of military skill and moral integrity.
With the Homeric foundation, scholars began to develop more complex ideas around education. In the fifth century B.C., around the time of Socrates, a new kind of professional teacher, the Sophist, became popular in Athens. Teaching their students rhetoric and philosophy, Sophists infused the traditional values of arete with a new spirit of intellectual inquiry. It is during this period that the word paideia is first found. The movement advocated higher education for young Athenian men starting around the age of 16.
There were notable exceptions to this new emphasis on the life of the mind. In neighboring Sparta, harsh child-rearing customs placed an almost exclusive emphasis on physical prowess to prepare for a soldier’s life. Even so, the development of paideia was not restricted to Athens, and formed part of a pan-Greek culture. (See also: Ancient Spartans were bred for battle.)
Shaped by the slaveholding culture of the Roman Empire, early Christian ethics reflected the moral perspectives of ancient slaveholders, a slaveholder morality. The Christian body matured in a context in which the ubiquitous availability and vulnerabilities of slave bodies distorted the emotional and ethical development of freeborn persons. The household codes (haustafeln) of New Testament epistles (including Colossians, Ephesians, the Pastoral Epistles, and 1 Peter) and selected extracanonical sources provided a new and powerful ideological tool for slaveholders who sought to create compliant bodies. In a world in which slaves were designated and treated as bodies, perhaps it is not surprising that ascetic Christians came to discipline their bodies as slaves.
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“Mens Sana in Corpore Sano”: Cartesian dualism and the marginalisation of sex education
Cartesian dualism has left a heavy legacy in terms of how we think about ourselves, so that we treat humans as minds within bodies rather than mind/body unities. This has far‐reaching effects on our conceptualisation of the sex/gender distinction and on the relationship between bodies and identities. Related to this is a dualism that is embedded in how we think of children in schools we focus on the soundness of the mind, with the sound body treated as an afterthought. This paper considers the effects of this dualism on the position of sex education both in the formal curriculum and in the physical and metaphorical fabric of schooling, considering how the body and its sexuality are both ubiquitous and marginalised within schools. I examine how schools discipline both children's bodies in general and their sexuality and sexual expression in particular, and contrast this with the sidelining of education through and about bodies, and the positioning of these aspects of education as potentially polluting.
Educational Studies, Goldsmiths University of London, New Cross, London SE14 6NW, UK. Email: [email protected]
Laqueur ( 1990 Laqueur T 1990 Making sex: Body and gender from the Greeks to Freud Cambridge, MA: Harvard University Press [Google Scholar] ) notes that this is largely itself a post‐Enlightenment approach in ancient times the body was seen as being suffused with and changed by culture. Male and female bodies were seen as essentially the same, with some organs just located in different places in the female. Gendered behaviours and roles were “real”, part of the order of things, while what we would see as physical sex differences were treated as matters of convention.
Of course there is also an informal curriculum of sex education that mainly takes place between students (Epstein & Johnson, 1998 Epstein D Johnson R 1998 Schooling sexualities Buckingham: Open University Press [Google Scholar] ), but I do not propose to discuss that here.
Evolution Gave Us Heart Disease. We’re Not Stuck With It.
Heart disease is still a new disease, and we can adapt accordingly.
Dr. Warraich is a cardiologist.
For much of history, there were three great threats to human survival: infections, injuries and starvation. By striking early and often, all three prevented us from fulfilling the most important reason for our existence: reproduction. Humans, therefore, evolved mechanisms to stave off these life-limiters.
These days most of us die of heart disease. The reason our species finds itself in the ever-constricting clutches of atherosclerosis — the insidious buildup of cholesterol-filled plaques in blood vessels leading to heart attacks and stroke — might be that human evolution inadvertently led us into its labyrinthine lair. If that is true, is it possible for us find our way out?
While it’s hard to recreate ancient human life and find a causative link, the Tsimane, a remote people living in the Bolivian rain forest, provide a sneak peek. The Tsimane, who have minimal atherosclerosis, are under relentless assault by infectious organisms. Ancient humans predating the Tsimane were under even greater siege. The only human beings who could survive were those with a vigilant immune system, always on the lookout for foreign invaders.
In response to infections, the immune system unleashes a powerful response called inflammation. In extreme forms, such as after catching the flu, inflammation can set the body ablaze and is our best means to keep us sterile and free of infection. Inflammation also plays an important role when someone gets hurt and the barrier between the body and the world outside is breached. Inflammatory cells unleash a cascade that results in blood clots forming to quickly plug nicks and cuts. As species have evolved, they have also developed stronger mechanisms of clot formation.
After the institution of better public hygiene, our great guardian, inflammation, no longer busy with outsiders, turned its menacing guns inward. Inflammation is responsible for every important step in the story of atherosclerosis, from its birth as fatty streaks in the lining of the blood vessels, to the dramatic eruption of cholesterol-laden plaques in blood vessels supplying the heart, brain and legs, that activate our clotting cascade, leading to blockages that cause heart attacks, strokes and blood-choked limbs needing amputation.
The third threat to ancient human survival, starvation, existed because of the long intervals that could occur between generous meals. The brain only feeds on sugar, specifically glucose, and therefore it was necessary to maintain glucose in the blood to nourish the brain during thrifty times. And what hormone lowers glucose levels in the blood? Insulin. Therefore, it is hypothesized inconclusively that genes that reduced the effectiveness of insulin were positively selected, raising the glucose levels in the body and now contributing to the pandemic of diabetes. It is also controversially theorized that high cholesterol levels, one of the most important risk factors for atherosclerosis, could have conferred a longer life in prior generations because of a theoretical protective function against infections. These days, however, the lower the cholesterol, the better.
Evolution has a hand in another important driver of heart disease — obesity. Not only did we develop mechanisms to store nutrition to prepare for the inevitable famine around the corner, obesity actually conferred another advantage — it overcharged inflammation. Not only does inflammation cause atherosclerosis, it also accelerates the development of other risk factors for heart disease such as diabetes and high blood pressure.
Evolution may have affected African-Americans even more adversely, as they are very prone to high blood pressure from salt consumption. Natives of Africa had very little salt in their diets and risked losing most of it in their sweat. There is evidence that those that held onto salt in the body were positively selected through evolution. Salt intake in modern societies is several-fold that of what we had consumed for thousands of years. Mechanisms developed to hold onto a previously rare nutrient might be contributing to high blood pressure at a time when salt is ubiquitous. Hypertension, in fact, is much more common in black Americans compared to both white Americans and foreign-born blacks in the United States.
How can we have a chance at reversing these evolutionary mechanisms? Anti-inflammatory drugs repurposed from other conditions such as rheumatoid arthritis have shown mixed results in treating atherosclerosis. Greater benefits could be achieved from anti-inflammatory therapies specifically designed to treat atherosclerosis.
Perhaps the most important evolutionary mechanisms behind the emergence of atherosclerosis is that protection from our ancient adversaries — infection, injury and starvation — now allows us to live long enough to gain prolonged deadly exposure from our modern lifestyles. “ Because we adapted so well to these other threats, we now live long enough to be exposed to risk that we haven’t had time to genetically accommodate to ,” said Dr. Clyde Yancy, a professor at Northwestern University and Chief of Cardiology at Northwestern Memorial Hospital in Chicago. “ Is it possible that lifestyle changes can overcome the inclinations we have developed ?”
We need to stop testing ourselves with lifestyles and diets that put our body’s defenses at odds with our well-being. Atherosclerosis has always been around, even in the blood vessels of one of the oldest mummified humans, Ötzi the Iceman, who was found in a block of ice from 5,300 years ago. Yet, the reason atherosclerosis rarely killed was because our lifestyles were not at odds with our biology. Recent dramatic reductions in heart disease are proof that through lifestyle improvements and medical therapy, we can exert real agency over our fitness, and that we are not beholden to our genetic biology. While the DASH and Mediterranean diets have the best evidence for heart health, the problem seems to be not too much of either fat, salt, sugar or meat in our diets, but too much of everything. The density of calories available to us coupled with the minimal effort required to obtain them is a toxic recipe.
The solution is not to live like the Tsimane or crumble in nihilism. The solution is to transform our lifestyles so that we can come up to speed with evolutionary mechanisms set in motion millenniums ago. Heart disease is still a new disease, and if we respect our evolution, adapt accordingly and follow evidence-based medical advice, we can revert it to a speck in the history of mankind.
Haider Warraich (@haiderwarraich) is joining the faculty of Brigham and Women’s Hospital, the Boston VA and Harvard Medical School in the fall. He is the author of the new book: “State of the Heart: Exploring the History, Science and Future of Cardiac Disease.”