Human foragers avoid noncommunicable diseases that are leading causes of mortality, partly because physically active lifestyles promote healthy aging. High activity levels also promote tissue damage accumulation from wear-and-tear, increase risk of injury and disability which compromise productivity, and reduce energetic investments in somatic maintenance given constrained energy expenditure. Constraints intensify when nutrient supply is limited and surplus energy is directed toward pathogen defense and reproduction, as occurred throughout hominin evolution. This paper reviews evidence linking exposomes to musculoskeletal health in subsistence populations, focusing on effects of physical activity, pathogens, diet, and reproduction. Chronic musculoskeletal conditions are common for humans and possibly prehistoric hominins but rarer in quadrupedal apes. We propose that transition to bipedalism ~6 to 8 million years ago constituted an early “mismatch scenario," increasing hominin susceptibility to musculoskeletal conditions vis-à-vis quadrupedal apes due to changes in mechanical loading environments. Mismatched musculoskeletal traits were not targets of selection because of trade-offs favoring bipedal extractive foraging and higher fertility.

中文翻译：

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当代小规模自给人口为人类肌肉骨骼健康和老龄化提供了独特的见解


人类觅食者避免非传染性疾病，这些疾病是导致死亡的主要原因，部分原因是积极锻炼的生活方式促进了健康老龄化。高活动水平还会促进磨损造成的组织损伤积累，增加受伤和残疾的风险，从而损害生产力，并在能量消耗受限的情况下减少对体细胞维持的精力投资。当营养供应有限并且多余的能量被用于病原体防御和繁殖时，限制会加剧，就像在整个人进化过程中发生的那样。本文回顾了暴露组学与自给人口肌肉骨骼健康相关的证据，重点关注身体活动、病原体、饮食和生殖的影响。慢性肌肉骨骼疾病在人类和可能的史前古人类中很常见，但在四足类人猿中更为罕见。我们提出 ~6 到 800 万年前向双足行走的过渡构成了早期的“不匹配情景”，由于机械负载环境的变化，相对于四足类人猿，古人类对肌肉骨骼条件的易感性增加。不匹配的肌肉骨骼特征不是选择的目标，因为权衡有利于双足提取觅食和更高的生育能力。