These perspectives provide a more cohesive framework for gaining insights into the determinants of health and disease. We consider these evolutionary principles in conjunction with population genetics and describe several pathways by which evolutionary processes can affect disease risk. The key principles of evolutionary medicine are that selection acts on fitness, not health or longevity that our evolutionary history does not cause disease, but rather impacts on our risk of disease in particular environments and that we are now living in novel environments compared to those in which we evolved. However, there is a lack of awareness of their importance amongst physicians, medical researchers, and educators, all of whom tend to focus on the mechanistic (proximate) basis for disease, excluding consideration of evolutionary (ultimate) reasons. An appreciation of the fundamental principles of evolutionary biology provides new insights into major diseases and enables an integrated understanding of human biology and medicine.
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