Evolutionary Insights into the Social and Environmental Drivers of Health Inequality: The Example of the Global Epidemic of Overweight and Cardiovascular Diseases

Cardiovascular diseases (CVDs) like hypertension, diabetes, heart attack, and stroke are now the leading causes of premature death globally, which has been tied to the rapid global rise of overweight and obesity as major public health issues. This chapter reviews current research that is helping revise understandings of the evolutionary forces and processes that are contributing to the rise of overweight and metabolic disease. It details recent updates to people's understanding of the role of diet and activity – reflecting the major influences on energy intake and expenditure – to these conditions, with work increasingly pointing to the primacy of diet and diet composition as major influences on weight gain. The chapter focuses on the common tendency for lower- and middle-income countries to be particularly hard hit with a rapid increase in CVD in the span of a mere generation or two in response to lifestyle and diet transition.