Topical Review Article Diet and Our Genetic Legacy in the Recent Anthropocene: A Darwinian Perspective to Nutritional Health Mark D. Lucock, PhD, CBiol, FSB, FRCPath 1 , Charlotte E. Martin, BFSHN (Hons) 1 , Zoe R. Yates, PhD 1 , and Martin Veysey, MD, MRCP, FRACP 2 Abstract Nutrient–gene research tends to focus on human disease, although such interactions are often a by-product of our evolutionary heritage. This review explores health in this context, reframing genetic variation/epigenetic phenomena linked to diet in the framework of our recent evolutionary past. This ‘‘Darwinian/evolutionary medicine’’ approach examines how diet helped us evolve among primates and to adapt (or fail to adapt) our metabolome to specific environmental conditions leading to major dis- eases of civilization. This review presents updated evidence from a diet–gene perspective, portraying discord that exists with respect to health and our overall nutritional, cultural, and activity patterns. While Darwinian theory goes beyond nutritional con- siderations, a significant component within this concept does relate to nutrition and the mismatch between genes, modern diet, obesogenic lifestyle, and health outcomes. The review argues that nutritional sciences should expand knowledge on the evolutionary connection between food and disease, assimilating it into clinical training with greater prominence. Keywords nutritional anthropology, nutritional genetics, Darwinian medicine, preventative medicine, epigenetics Received July 23, 2013. Accepted for publication August 1, 2013. Introduction The term anthropocene was first introduced in 2000. 1 The neologism refers to a period of rapid innovation beginning in the late 18th century, when industrial enterprise set in motion changes with global impact with respect to Earth’s biology, climate, human culture, and health. However, many anthropol- ogists consider the anthropocene to have originated far earlier, when animal and plant domestication replaced hunter-gatherer lifestyles. 2 Most scientists now concur that this biocultural phenomenon comprises several stages extending back to the Neolithic. 2,3 Its origins may be even more archaic; the discov- ery of fire 0.5 to 1.5 million years ago may be the true start of the anthropocene—a point in time that changed everything that followed. A putative marker of this is the smaller, weaker jaw and more compact dentition of subsequent hominins, indicative of reduced chewing, gnawing, and tearing commensurate with the expansion of cooking. 4 Cooking likely increased meat con- sumption and promoted encephalization along with evolution of a smaller gut, enhanced bipedal agility and anatomical remodeling of the hand for tool use. If the anthropocene is defined by intellectual capability to modify the world, rather than be modified by it—perhaps the pivotal factor—controlling fire—represents its true inception point. This article examines how biocultural adaptations to new foods during the anthropocene influenced human evolution, and why some of these past adaptations to ancestral environ- ments have led to a mismatch between ancient genes and contemporary diet and lifestyle, contributing to the diseases of civilization/affluence. This approach underscores Darwi- nian/evolutionary medicine, which applies modern evolution- ary theory to understanding health and disease. To achieve this, the review follows how recent human dietary transitions have contributed to present-day disease burden, identifying a selection of the increasing number of genes that influence com- mon disease phenotypes. It then examines nutritional health taking account of thrift, the developmental origins of adult dis- ease, ageing and lifecycle complexity, and the extent to which 1 University of Newcastle, Ourimbah, New South Wales, Australia 2 Central Coast Local Health District, Gosford, New South Wales, Australia Corresponding Author: Mark D. Lucock, PhD, CBiol, FSB, FRCPath, School of Environmental & Life Sciences, University of Newcastle, PO Box 127, Brush Rd, Ourimbah, New South Wales 2258, Australia. Email: Mark.Lucock@newcastle.edu.au Journal of Evidence-Based Complementary & Alternative Medicine 2014, Vol 19(1) 68-83 ª The Author(s) 2013 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/2156587213503345 cam.sagepub.com