Genetic predisposition to obesity presents a paradox: how do genetic variants with such a detrimental impact on human health persist through evolutionary time? Numerous hypotheses, for instance the thrifty genotype hypothesis, attempt to explain this phenomenon, yet fail to provide a satisfying answer to the modern obesity epidemic. In this critical review, I appraise existing theories explaining the evolutionary origins of obesity and explore novel biological and sociocultural agents of evolutionary change that may help explain the distribution of obesity and leanness predisposing variants in modern human populations. Gene pleiotropy and adaptations to diverse environmental niches may explain the rise and subsequent selection of obesity risk alleles. The regulation of gene expression by epigenetic mechanisms may serve as a stochastic factor affecting the manifestation of obesity phenotypes. Finally, exposure to malnutrition and disease epidemics in the wake of colonialism, culturally mediated notions of attractiveness and desirability, and diverse mating systems – including forced copulation, consanguinity and polygamy – may play a role in shaping the human genome. In short, I posit that in order to explain ethnic variation in obesity susceptibility, we must examine the origin of physiological adaptations and understand the sociocultural experiences of individuals and populations. As an imperative first step towards the identification of important drivers of obesity gene evolution, this review will inform empirical research focused on testing evolutionary theories by way of population genetics and mathematical modelling. Ultimately, these data will promote a better understanding of the aetiology of obesity and are expected to guide the development of targeted management, treatment, and prevention strategies. / Thesis / Master of Science (MSc)

Die hier vorliegende Arbeit zeigt die molekulare Evolution des Melatoninrezeptor 1 B-Gens (MTNR1B) und des Fat Mass and Obesity Associated-Gens (FTO). Für beide Gene wurden in genomweiten Assoziationsstudien (GWAS) Varianten entdeckt, welche zu der Entwicklung einer Adipositas bzw. deren Folgeerkrankungen beitragen können. So wurde für Einzelbasenaustausche (SNPs) im MTNR1B (rs10830963, rs4753426) eine Verschlechterung der Nüchternglukose sowie der Insulinausschüttung gezeigt. Zudem wurde für die Allelfrequenz des rs4753426 C-Allels ein Zusammenhang mit der täglichen Sonnenscheindauer beschrieben. Im FTO wurde eine (tagging) Variante im ersten Intron identifiziert (rs9939609), welche einen erhöhten Körpermasseindex (BMI) zu vermitteln scheint und robust repliziert werden konnte. Zusätzlich konnte in den Sorben, einer in der Lausitz ansässigen Volksgruppe, eine Variante im dritten Intron (rs17818902) beschrieben werden, die ein zusätzliches, stärkeres Assoziationssignal mit einem erhöhten BMI zeigte. Dies führte zu der Fragestellung, ob MTNR1B und FTO einer Konservierung unterlegen sind. Zudem interessierten populationsspezifische Unterschiede, um die Untersuchungen in den Kontext der Hypothese des sparsamen Genotyps stellen zu können. Demnach haben Individuen mit einer genetischen Veranlagung, die ihnen eine effizientere Energiespeicherung ermöglicht, zu Zeiten von Nahrungsmangel einen Fitness-Vorteil gegenüber Nicht-Trägern. Die Konservierung zwischen den Spezies wurde mit Phylogenetic Analysis by Maximum Likelihood (PAML) betrachtet, eine Analyse die auf dem Verhältnis von nichtsynonymen zu synonymen Basenaustauschen innerhalb einer kodierenden Sequenz beruht. Die Selektion innerhalb bzw. zwischen menschlichen Populationen wurde anhand verschiedener populationsgenetischer Variablen näher beleuchtet. Sowohl für MTNR1B als auch für FTO konnte gezeigt werden, dass sie über die betrachteten Spezies im Durchschnitt stark oder sehr stark konserviert sind, was die physiologische Relevanz dieser Gene untermauert. Für MTNR1B zeigte sich zudem, dass es auf dem Ast zum Menschen nicht konserviert, sondern positiv selektioniert ist. Dies kann als Anzeichen für durch die Umwelt bedingte Einflüsse gedeutet werden. Essentielle Residuen des Rezeptors sind jedoch auch hier hochgradig konserviert. Die populationsgenetischen Variablen implizieren bei beiden Genen eine nicht-neutrale Selektion. Während sich beim MTNR1B insbesondere populationsspezifische Unterschiede anhand des Fixierungsindex Fst zeigten, konnten für FTO marginal signifikante Korrelationen zwischen der Konservierung der Haplotypen und der Stärke der Assoziation mit BMI in den Sorben gezeigt werden. Für beide Gene kann die Hypothese des sparsamen Genotyps nicht prinzipiell ausgeschlossen werden, allerdings sind weitere Untersuchungen diesbezüglich von Nöten.

Die hier vorliegende Arbeit zeigt die molekulare Evolution des Melatoninrezeptor 1 B-Gens (MTNR1B) und des Fat Mass and Obesity Associated-Gens (FTO). Für beide Gene wurden in genomweiten Assoziationsstudien (GWAS) Varianten entdeckt, welche zu der Entwicklung einer Adipositas bzw. deren Folgeerkrankungen beitragen können. So wurde für Einzelbasenaustausche (SNPs) im MTNR1B (rs10830963, rs4753426) eine Verschlechterung der Nüchternglukose sowie der Insulinausschüttung gezeigt. Zudem wurde für die Allelfrequenz des rs4753426 C-Allels ein Zusammenhang mit der täglichen Sonnenscheindauer beschrieben. Im FTO wurde eine (tagging) Variante im ersten Intron identifiziert (rs9939609), welche einen erhöhten Körpermasseindex (BMI) zu vermitteln scheint und robust repliziert werden konnte. Zusätzlich konnte in den Sorben, einer in der Lausitz ansässigen Volksgruppe, eine Variante im dritten Intron (rs17818902) beschrieben werden, die ein zusätzliches, stärkeres Assoziationssignal mit einem erhöhten BMI zeigte. Dies führte zu der Fragestellung, ob MTNR1B und FTO einer Konservierung unterlegen sind. Zudem interessierten populationsspezifische Unterschiede, um die Untersuchungen in den Kontext der Hypothese des sparsamen Genotyps stellen zu können. Demnach haben Individuen mit einer genetischen Veranlagung, die ihnen eine effizientere Energiespeicherung ermöglicht, zu Zeiten von Nahrungsmangel einen Fitness-Vorteil gegenüber Nicht-Trägern. Die Konservierung zwischen den Spezies wurde mit Phylogenetic Analysis by Maximum Likelihood (PAML) betrachtet, eine Analyse die auf dem Verhältnis von nichtsynonymen zu synonymen Basenaustauschen innerhalb einer kodierenden Sequenz beruht. Die Selektion innerhalb bzw. zwischen menschlichen Populationen wurde anhand verschiedener populationsgenetischer Variablen näher beleuchtet. Sowohl für MTNR1B als auch für FTO konnte gezeigt werden, dass sie über die betrachteten Spezies im Durchschnitt stark oder sehr stark konserviert sind, was die physiologische Relevanz dieser Gene untermauert. Für MTNR1B zeigte sich zudem, dass es auf dem Ast zum Menschen nicht konserviert, sondern positiv selektioniert ist. Dies kann als Anzeichen für durch die Umwelt bedingte Einflüsse gedeutet werden. Essentielle Residuen des Rezeptors sind jedoch auch hier hochgradig konserviert. Die populationsgenetischen Variablen implizieren bei beiden Genen eine nicht-neutrale Selektion. Während sich beim MTNR1B insbesondere populationsspezifische Unterschiede anhand des Fixierungsindex Fst zeigten, konnten für FTO marginal signifikante Korrelationen zwischen der Konservierung der Haplotypen und der Stärke der Assoziation mit BMI in den Sorben gezeigt werden. Für beide Gene kann die Hypothese des sparsamen Genotyps nicht prinzipiell ausgeschlossen werden, allerdings sind weitere Untersuchungen diesbezüglich von Nöten.

Globally, the prevalence of Type 2 diabetes is rising. The most affected populations are those that have undergone recent and rapid transition towards a Western lifestyle, characterised by energy-dense diets and physical inactivity.¶ Two major hypotheses have attempted to explain the variation in diabetes prevalence, both between and within populations, beyond the contributions made by adult lifestyle. The thrifty genotype hypothesis proposes that some populations are genetically well adapted to surviving in a subsistence environment, and are predisposed to develop diabetes when the dietary environment changes to one that is fat and carbohydrate rich. The programming hypothesis focuses on the developmental environment, particularly on prenatal and early postnatal conditions: nutritional deprivation in utero and early postnatal life, measured by low birthweight and disrupted child growth, is proposed to alter metabolism permanently so that risk of diabetes is increased with subsequent exposure to an energy-dense diet. Both hypotheses emphasise discord between adaptation (genetic or developmental) and current environment, and both now put forward insulin resistance as a likely mechanism for predisposition.¶ Diabetes contributes significantly to morbidity and mortality among Australia’s Indigenous population. Indigenous babies are more likely to be low birthweight, and typical patterns of child growth include periods of faltering and rapid catch-up. Although there have been numerous studies in other populations, the programming hypothesis has not previously been tested in an Australian Indigenous community. The framework of the programming hypothesis is thus expanded to consider exposure of whole populations to adverse prenatal and postnatal environments, and the influence this may have on diabetes prevalence.¶ The present study took place in Cherbourg, a large Aboriginal community in southeast Queensland with a high prevalence of diabetes. Study participants were adults with diagnosed diabetes and a random sample of adults who had never been diagnosed with diabetes. Data were collected on five current risk factors for diabetes (general and central obesity, blood pressure, age and family history), in addition to fasting blood glucose levels. A lifestyle survey was also conducted. Participants’ medical records detailing weight growth from birth to five years were analysed with regard to adult diabetes risk to determine whether childhood weight and rate of weight gain were associated with subsequent diabetes. Adult lifestyle factors were xiialso explored to determine whether variation in nutrition and physical activity was related to level of diabetes risk.¶ Approximately 20% of adults in Cherbourg have diagnosed diabetes. Prevalence may be as high as 38.5% in females and 42% in males if those who are high-risk (abnormal fasting glucose and three additional factors) are included. Among those over 40 years, total prevalence is estimated to be 51% for females and 59% for males.¶ Patterns of early childhood growth may contribute to risk of diabetes among adults. In particular, relatively rapid weight growth to five years is associated with both general and central obesity among adult women. This lends some qualified support to the programming hypothesis as catch-up growth has previously been incorporated into the model; however, although the most consistent association was found among those who gained weight more rapidly, it was also found that risk is increased among children who are heavier at any age.¶ No consistent associations were found between intrauterine growth retardation (as determined by lower than median birthweight and higher than median weight growth velocity to one and three months) and diabetes risk among women or men. A larger study sample with greater statistical power may have yielded less ambiguous results.¶ Among adults, levels of physical activity may be more important than nutritional intake in moderating diabetes risk, although features of diet, such as high intake of simple carbohydrates, may contribute to risk in the community overall, especially in the context of physical inactivity. A genetic component is not ruled out. Two additional areas which require further investigation include stress and high rates of infection, both of which are highly relevant to the study community, and may contribute to the insulin resistance syndrome.¶ Some accepted thresholds indicating increased diabetes risk may not be appropriate in this population. Given the relationship between waist circumference and other diabetes risk factors and the propensity for central fat deposition among women even with low body mass index (BMI), it is recommended that the threshold where BMI is considered a risk be lowered by 5kg/m2 for women, while no such recommendation is made for men.¶ There are a number of social barriers to better community health, including attitudes to exercise and obesity, patterns of alcohol and tobacco use and consumption of fresh foods. Some of these barriers are exacerbated by gender roles and expectations.¶

Obesity prevalence continues to increase worldwide, yet few safe and effective treatment options are available suggesting there needs to be a greater emphasis on preventing rather than treating obesity. This research investigated the association of obesity predisposing SNPs and a gene score with nutrient consumption patterns including total energy intake and macronutrient distribution in a European ancestry population as well as discussing an evolutionary perspective on eating disorders using current epidemiological evidence to identify genes which may be involved. The association of two of the 14 obesity predisposing SNPs and the gene score with BMI was confirmed in the EpiDREAM population. Novel associations between two SNPs located in or near BDNF (rs6265 and rs1401635) were found with total fat, MUFA, and PUFA intake. Rs1401635 was also associated with total energy and trans fat intake. Novel associations of rs6235 (PCSK1) and the gene score were found with total energy intake. The novel associations found indicate that food related behaviours are one of the mechanisms of action through which obesity predisposing SNPs cause obesity and therefore warrant further investigation. The lack of association among all genes and the modest association of the gene score show that mechanisms other than food consumption are important. The investigation of the evolutionary history of eating disorders revealed that the adapted to flee famine hypothesis is a plausible theory explaining anorexia nervosa while the thrifty genotype hypothesis provides a possible explanation for bulimia nervosa and binge eating disorder. These evolutionary theories can be applied to identify new candidate genes as well as phenotypic traits to investigate to better understand the genetic architecture of eating disorders. Understanding genes associated with disordered eating patterns may highlight future areas for obesity prevention. / Thesis / Master of Science (MSc) / A large percentage of the risk of developing obesity or an eating disorder (anorexia nervosa, bulimia nervosa, and binge eating disorder) is determined by genetics. For obesity, many genes have been identified as influencing risk, but the mechanisms through which the genes work are largely unknown. For eating disorders, gene identification efforts have been mostly unsuccessful and no mechanisms of action have been determined. In the first component of this thesis we found an association between previously identified obesity risk genes and food intake, specifically the total number of calories consumed per day and the percentage of calories from total fat and fat subtypes. These results support that food related behaviours are possible mechanisms of action which need to be further investigated. In the second half of the thesis we viewed eating disorder behaviours from an evolutionary perspective. We concluded that there are theories that possibly explain eating disorder behaviours including being able to live off of small quantities of food as well as binging. These evolutionary theories can be applied to identify new genes to study in the context of eating disorders as well as different definitions of eating disorders.