Abstract

The West is affected by a wide variety of diseases that continue to grow and spread across the world. Western diseases were first recognized in 1973 when D. P. Burkitt observed their consistent emergence in populations that adopted a Western lifestyle.

The spatiotemporal dynamics of Western diseases may suggest a common etiological background. Despite decades of intensive research, no satisfactory explanatory model has ever been proposed. Any overarching theory must consider and explain why:

  • Western diseases generally show different prevalence rates between men and women.  The substantial sex differences in cancer are associated with epigenetic mechanisms, and over 50% of clinically actionable oncogenes are sex-biased.
  • Western diseases tend to affect the entire body.
  • Some Western diseases manifest differently across age groups.
  • Some Western diseases interact with the nervous system.
  • Western diseases are closely associated with reproductive resources,  oxytocin, and olfactory functions.
  • Western diseases have both physical and psychological dimensions.
  • Western diseases spread through cultural Westernization.

These findings show that, while nutritional, genetic, environmental, and several other conditions contribute to Western diseases, they play a secondary, but not insignificant, role.

The present analysis of the origin of Western diseases is based on insights from a broad nomological network in the disciplines of medical science, evolutionary psychology, social sciences, genetics, relationship science, cultural history, demography, reproductive biology, veterinary science, primatology, and beyond.

Prostate cancer (PCa) was chosen as the primary subject of study due to the vast amount of unexplored data and its relations with reproduction, culture, and sexual selection. A similar study of breast cancer and other Western diseases would likely yield comparable results.

Part I of this book reinterprets the results of the primary research. Information hidden among these studies was instrumental in developing game-changing ideas and theories, which are organized around interrelated themes:

  • Western diseases are characterized by spatiotemporal patterns reflecting the level of sexual selection, sexual conflict, and social dysfunction.
  • The incidence of Western diseases is widely related to psychobiological processes associated with sexual selection and reproduction. Two examples follow: A higher presence of women increases the incidence of PCa due to higher sexual selection but decreases the mortality bue to better health care. Height is both a marker of sexual selection and a risk factor for cancer.
  •  Western diseases show different prevalence rates between men and women and can manifest differently across age groups.
  • Oxytocin (OXT) and its receptor are central to the prevalence of Western diseases. The underlying reason is straightforward: Western societies exhibit high levels of social dysfunction, which disrupt hormonal balance, particularly OXT’s critical function as a key social hormone.
  • The imbalance between social hormones and their receptors is characterized by receptor overexpression, which is a known risk factor for cancer.
  • The imbalance in sex hormones is related to changes in the prenatal hormonal environment. This phenomenon originates from strong sexual selection and is responsible for many prevailing diseases and growing identity challenges.
  • The psychobiological design of humans is not in harmony with the current Western lifestyle. This evolutionary mismatch is a root cause of Western diseases.
  • Western diseases stem from an evolutionary conflict, and power structures therefore play an important role in disease etiology.
  • This conflict is also a likely contributor to infertility and population decline.
  • PCa is related to the general evolutionary trade-off between survival and reproduction and likely mediated by strong sexual selection. The Western lifestyle may have reached, and even transcended, the biological and psychological limits of Homo sapiens.
  • Sexual selection and reproductive trade-offs can impact the development of cancer in animals. Humans are unique among species in that sexual selection varies significantly across time and space. This variation may explain the link between cancer and culture.
  • Living in or being exposed to modern Western culture can result in the accumulation of psychological and biological instability throughout the brain and body due to evolutionary maladaptation and associated behavioral and social consequences.

Darwin’s theory of sexual selection exposes the root cause of the deep differences between men and women and challenges central dogmas in Western culture. Studies on sexual selection and sexual conflict are therefore particularly vulnerable to ideological subversion and segregation. The present analysis of human sexual selection as defined by Darwin recognizes that:

  • The definition applies to everything related to fecundity.
  • The definition applies equally for both sexes.
  • The definition allows for influences of social, political, and cultural factors.
  • The definition allows for both competition and cooperation.
  • The definition applies equally for humans, animals, and plants.
  • The definition extends beyond visible traits.
  • The definition extends beyond mating and fertilization.
  • Sexual selection is driven by both conscious and unconscious processes.
  • Sexual selection patterns modulate ever-present biological processes.
  • Sexual selection can be disturbed by man-made biological interference

Due to scientific and economic developments, natural selection has almost been eradicated in the Western world, and sexual selection has become the dominant form of selection, providing a distinct opportunity to study these evolutionary processes. The CCSS matrix model of sexual selection defined here expand the original framework of sexual selection, building on the most basic dichotomies: reproduction vs survival, male vs female, and competition vs cooperation. This limited focus facilitates the investigation of key trade-offs and phenomena that transcend human language, thoughts, imagination, and assumptions.

 CompetitionCooperation
Male-female interactionsMFCOMMFCOOP
Male-male interactionsMMCOMMMCOOP
Female-female interactionsFFCOMFFCOOP

The application of this model provides a surprising and revealing picture of the cultural, social, and political conditions in the West, leading to a better understanding of its problems and diseases.

The review of medical literature led to the development of a the MICUL theory, which is both a synthesis and grand theory, offering a fundamental understanding of the cause of the origin and spread of Western diseases.

MICUL theory posits that the origin and spread of Western diseases derive from psychobiological reactions to an evolutionary discrepancy in the context of sexual selection and its interplay with the cultural, social, and political environment.

The framework introduces a catalog of definitions and ideas with simple and precise definitions. The MICUL model of Western diseases is structured around the interplay between the unconscious mind, the conscious mind, and culture.

The human mind and biology are developed to support the lifestyle of Paleolithic hunter-gatherer societies, which have little in common with the contemporary, Western way of living. The absence of biological and psychological adaptation to modern culture and behavior is a known cause of disease. The MICUL theory adds new layers to the understanding of this threat, focusing on its effects on unconscious processes related to reproduction, competition, social fitness, and hormonal function.

The study identifies, explores, and explains the linkages between Western diseases and the deepest levels of human motivation. The themes presented here are entirely novel and have not previously been described or discussed.

The cultural and political development in the Western world is analyzed and exposed in Part II using a model of a utopian society called FemUtoLand that is regulated by power dynamics rooted in sexual selection. This method of analysis has demonstrated high accuracy in predicting Western politics and culture between 1993 and 2024. The deteriorating health situation in the West is evidence of social stress and a sexual conflict of interest with global implications.

The MICUL theory identifies, analyzes, and presents a new approach to understanding PCa and its etiology by exploring the function of the prostate as a semen-producing gland. Semen production plays a central role in sexual conflict dynamics which are regulated by both evolutionary, cultural, social, and political mechanisms. This perspective adds a new dimension to the study of PCa.

The survey of medical literature on PCa is focused on tracing the connections between markers of PCa, the biochemical composition of seminal plasma, female reproductive processes, and early development. The material shows consistent correlations, suggesting that both normal and cancer-related processes in the prostate share a common biological and evolutionary purpose. The biological processes underlying PCa are designed to increase the reproductive fitness of men, but also reduce their survival. The present framework shows that these processes evolved to benefit women and offspring.

The functioning of the male reproductive system is regulated by biological, evolutionary, cultural, and psychological factors that can be divided into three layers defined in the MICUL model. Each has a distinct role in understanding the pathogenesis of PCa and other Western diseases.

Bottom tier, ultimate causation. Reproductive stress is a psychobiological status resulting in overallocation or lack of reproductive resources to fully respond to the demands of the evolutionary strategy that regulates and balances the male reproductive system. This mechanism (dubbed the EPHOR force) is an unconscious source of motivation dedicated to enhancing the male reproductive success and protecting the developing embryo or fetus. It enables women to exert psychosexual and biological effects on men through their mere presence and likely also through the cultural atmosphere. The psychosexual environment is an important key to understand Western diseases.

The prostate is evolutionarily designed to affect biological processes beyond the male body. It is involved in fertilization and offspring viability and may therefore be more sensitive to outside influence. The male reproductive functions, and thereby the risk of PCa, is unconsciously modulated by:

  • Perceived competition with other men
  • The need to optimize fertilization and prenatal development
  • The need to counteract ovarian aging.
  • The need to co-regulate the female reproductive system
  • Processes involved in transgenerational epigenetic inheritance. All known mechanisms in transgenerational inheritance are associated with PCa.

The comprehensive knowledge of PCa enables a mapping between disease and aspects of female reproduction. The relations between markers of PCa and reproduction include:

  • ovulation, follicular growth, menstrual cycle
  • mitosis, meiosis
  • immune functions, anticoagulants
  • immunosuppression during pregnancy
  • mitigation of ovarian aging
  • regulation of Ph value in the female reproductive tract
  • embryonic and fetal development and growth
  • transfer of resources from the mother to the fetus
  • ovarian, placental, and uterine functions
  • epigenetic functions
  • embryonic stem cell self-renewal, pluripotency, and differentiation
  • potential impact on fetal microchimeric cells
  • modulation of maternal stress, anxiety, and depression
  • lactation

The etiology and pathogenesis of PCa is linked both to cultural and social factors and their impact on sexual selection. Stable conditions require fewer adjustments of reproductive resources and may lead to reduction of disease risk.

Similar principles are believed to apply to other diseases. Every animal and human being has a finite amount of energy and resources to devote to survival and reproduction, and it is a well established concept that trade-offs are a leading cause of human diseases.

Reproductive stress is more likely to occur during sexual activity when the demand for resources devoted to reproduction is elevated. Increased, altered, prolonged, or disrupted activity in the prostate may change the trade-off between reproduction and other competing needs. These processes are complicated, vulnerable, and modulated by psychological, emotional, social, cultural, political, and sexual factors. They interact with many biological phenomena and processes in the prostate that may increase the likelihood, extent or severity of reproductive stress.

Several adverse effects can disturb biological processes in the prostate. Examples of such effects include:

  • Reduced secretory capacity associated with either young or old age.
  • Reduced secretory capacity due to gland size or other biological variables.
  • Deficiency or malfunction of a critical molecule (e.g. the BALOX effect).
  • Sexual problems associated with infertility.
  • Sexual dysfunction.
  • Impacts of social, cultural, and psychological factors on male sexuality.
  • Prostatic diseases (e.g. prostatitis and BPH).
  • Psychosexual factors (e.g. the PEROX effect).
  • Stress and cellular allostatic overload.
  • Exposure to particulate matter, quantum dots, microplastics, and other types of particles.
  • Prostatic calculi.
  • Exposure to endocrine disruptors.
  • The reproductive microbiota.
  • Genetic factors.

Such conditions can aggravate the disease or modify its trajectory. However, only the MICUL theory can explain the spatiotemporal distribution of PCa and other specific characteristics.

Middle tier, proximate causation. Toxic sexual selection is defined as a state of elevated sexual selection pressure that leads to reproductive stress. Processes and outcomes of sexual selection leading to aberrant activity in the prostate increases the risk of reproductive stress and PCa. Conditions and dynamics that may influence such developments include:

  • Sexualization of culture and unconscious reactions to stimuli.
  • Toxic sexual relationships.
  • High quantity and low quality of sexual activity.
  • Likelihood of reproductive success in a specific spatiotemporal context.
  • Level of competition in a specific spatiotemporal context
  • Level of social stress in a specific spatiotemporal context.

The widely quoted Health Professionals Follow-up Study (HPFS) claiming that an ejaculation frequency of 21 or more times per month reduces the risk of PCa is reinterpreted in the light of new studies of hypersexual disorder. There is no reason to believe that more frequent ejaculation can reduce the risk of PCa.

The HPFS study also shows that ejaculation leads to changes in gene expression in the prostate. There is evidence to suggest that any sexual encounter is unique and that every new sexual partner will impact the prostate differently. The more molecular changes in the prostate, the higher the risk of PCa.

Promiscuity increases when women seek power. Proxy indicators of exposure to toxic sexual selection include:

  • The amount of contact with women.
  • Male attractiveness to women.
  • Religion, SES, and political phenomena.
  • Female decision power.
  • Medical conditions that modulate the frequency of sexual interactions.
  • The level of sexualization in a culture.

All data support this interpretation.

The MICUL model shows that several surprising proxy indicators can exist, e.g.:

  • Circumcision can serve as a proxy for religion.
  • HIV can serve as a proxy for homosexuality.
  • Contraceptive methods can serve as a proxy for female decision power.
  • Nutrition can serve as a proxy for SES.

Top tier, distal causation. Toxic culture is defined as a cultural lifestyle that creates disease through mental, biological, and evolutionary pathways. The stronger the sexual selection in a culture, the more it becomes sexualized, the higher the level of prostatic activity, the higher the risk of reproductive stress, and the higher the incidence of PCa.

MICUL theory is grounded on the premise that Western culture is associated with sexualization and changing sexual behavior. As a consequence, more male resources must be devoted to reproduction.

This is confirmed by a comprehensive review of PCa in cultural, religious, and political contexts. Studies on migration show that the disease appears very quickly after a cultural shift. The epidemiological data suggest that:

  • A higher presence of women in a geographical area is positively correlated with the PCa incidence risk. The more women, the higher the risk.
  • A higher presence of women in an area is negatively correlated with PCa mortality. The more women, the better the survival. This pattern is observed in other diseases as well.
  • The more women the better the healthcare (larger cities).
  • The poorer and more remote a geographical area, the fewer women there will be and the lower the incidence rate.
  • The richer a geographical area, the more power women will have and the higher the PCa incidence.
  • Men who live in neighborhoods with social deprivation (loneliness, higher proportions of separated/divorced or widowed individuals) have a higher risk of developing PCa.
  • Men who are in occupations with higher income and prestige have a higher risk of developing PCa.
  • A stronger motivation to adopt a Western lifestyle leads to increased sexual selection and a higher susceptibility to Western diseases.

PCa can be analyzed as the result of a behavioral epidemic. The study aims to identify the key spreading mechanism via cultural transmission, political expansion, wars, sexual revolutions, and economic developments. Spatial and chronological patterns in the incidence rates of PCa and other Western diseases align with a cultural epidemic originating in the U.S. back in the 1920s or earlier. The psychobiological, cultural, and political effects of contraception, abortion, and reproductive technology plays a key role in this development.

The recognition of the connection between diseases, behavior, and motivation meant that everything fell into place, and many deep enigmas could be solved. Twelve distinct pathways through which culture and practices can affect and disrupt  the functions of the prostate have been identified:

1. Body Count (BODCO) Theory. The more sexual partners a man has had, the more molecular changes in the prostate and the higher his risk of PCa.

2. Uterus Power (UTEPO) Theory. Studies of several mammalian species have reported that higher levels of prenatal testosterone is associated with sexual selection and competition for the transmission of female dominance rank across generations. Among humans, this phenomenon has reached a scale that increases the incidence of PCa and many other serious diseases.

3. Receptor Augmentation (RECAU) Theory. Decreased availability of a social hormone can lead to augmented expression of its receptors, thereby increasing the risk of reproductive stress.

4. Sperm Competition (SPECOM) Theory. The male reproductive system is affected by real or perceived competition with other men and by the increasing sexualization of society. Sperm competition plays an important role in PCa and was found to be associated with levels of PSA, PAP, and other proteins. Primate studies support this interpretation.

  • PSA is shaped by evolution as a means to combat sperm competition.
  • PSA has aggressive features and could be a risk factor for PCa on its own.
  • PSA levels can be moderated by the perceived risk of sperm competition and is related to culture and religion.
  • PAP (also known as ACPP) – another key biomarker of PCa – is also shaped by evolution as a means to combat sperm competition

5. Semen Committment (SECOM) Theory. The prostate is affected by the need to optimize fertilization and prenatal development. The study identifies a vast number of connections between markers of PCa and reproduction.

6. Fertility Compensation (FECOM) theory. The prostate is affected by the need to counteract female infertility and ovarian aging. This study identified a high number of connections between markers of PCa and ovarian aging.

7. Seminal Bonding (SEBON) Theory. The evolution of the human reproductive strategy is associated with repeated semen exposure, especially during pregnancy. Seminal bonding explains many commonly known human traits.

8. Seminal Regulation (SEREG) Theory. Human seminal plasma is a major exogenous co-regulator of the female reproductive system. Lack of semen exposure increases the risk of ovarian cancer, preeclampsia, venous thromboembolism, and depressive symptoms.

9. Peripheral Oxytocin (PEROX) Theory. Lack of harmony in sexual relations leads to peripheralization of oxytocin (OXT) reactivity during male sexual activity, increasing the risk of reproductive stress and the long-term risk of PCa.

10. Balance of Oxytocin (BALOX) Theory. The availability of OXT modulates the level of reproductive stress and the long-term risk of PCa.OXT is a limited key resource used for regulating biological and psychological processes, and many different conditions can lead to OXT deficiency. The BALOXT theory is based on a comprehensive survey of correlations between PCa and OXT-related phenomena. The BALOX theory predicts that study outcomes can depend on the level of OXT deficiency in a given culture.

11. Prostatic microchimerism (PMC). The prostate is involved instimulation, activation, and transport of stem cells and microbes. Circulating  PCa cells (CTCs) are present in seminal plasma and could play a role as microchimeric cells in women. This is a speculative but testable idea. Prostatic diseases might be driven by evolutionary demands for stem cells and associated molecular mechanisms outside the male body. It seems logical that microchimeric cells can be of fetal origin (FMC), maternal origin (MMC), or paternal origin (PMC). Several kinds of stem cells have been used for the treatment of premature ovarian insufficiency (POI). The discovery of the effects described by the FECOM theory makes it more likely that PMCs can optimize functions in the ovary or other parts of the female reproductive system.

12. Chemical communication. Pheromones play a clear role in PCa. Overexpression of olfactory receptors is known in several cancer types. Abnormalities in olfactory function have been identified in a high number af medical conditions and Western diseases, suggesting a close association between disease, culture, and social dysfunction.

Many studies shed new light to the nature and effects of elevated testosterone levels during development. Elevated testosterone levels in females suppress reproductive activity in subordinate females. High levels of prenatal androgens enhance competitive behaviors in female primates that live in large groups. A similar mechanism may also exist in humans, as a 2015 U.S. study found that wielding power increases testosterone levels in women.

Increasing testosterone levels among women have significant implications for health and identity issues in the Western world. Higher levels of prenatal testosterone are associated with an increased risk of autism spectrum disorder, PCa, gastric cancer, brain tumors, and polycystic ovarian syndrome (PCOS).

Sons born to mothers with PCOS tend to have increased BMI, abnormal glucose and lipid metabolism, elevated AMH levels, and smaller testicular volume. Some of these traits are transgenerational and persist in future generations. Daughters of PCOS women are exposed to prenatal and pubertal hyperandrogenism and develop PCOS after puberty. Sexual selection and polycystic ovarian syndrome (PCOS) may help explain why obesity is more prevalent in Western populations.

Prenatal testosterone contributes to shaping human sexuality, sexual orientation, personality traits, and phenotypes. Several studies indicate that prenatal testosterone levels are associated with gender dysphoria.

The UTEPO effect has political implications as sexual orientation and political views are strongly correlated. A 2022 Gallup study from the U.S. found significant changes in sexual orientation. Transgender identification is surging throughout the Western world.

The risk of endometriosis is associated with low prenatal and postnatal testosterone. A 2023 study suggests that endometriosis evolved through sexual selection due to men’s attraction to women with feminine traits.

Maternal stress during pregnancy increases boys’ risk of developing intellectual impairment and childhood behavioral disorders and girls’ risk of anxiety and affective disorders. Higher cortisol levels during the third trimester of pregnancy are associated with lower IQ scores in boys, but not in girls

It is generally overlooked or ignored that the development of Western diseases is strongly associated with the OXT system. The underlying cause is clear: OXT is the key social hormone, and Western culture is marked by a decline in both the quantity and quality of social relationships. The misconception of OXT as a “female” hormone may have contributed to collective ignorance regarding the nature and origin of Western diseases. Children born via C-section have lower levels of OXT and other hormones and an increased risk of developing asthma, allergic rhinitis, atopic dermatitis, and obesity.

The OXT problem in Western culture may have political reasons: The more social stress and the more intense the conflict between the sexes, the more frequently OXT will be activated, the less OXT will be available for other purposes, and the more OXT-related diseases and disorders will occur. The OXT system may reveal its ”dark side” during the political mobilization of larger groups, and the OXT system seems unable to identify with multiple in-groups. Stress and conflict can influence all the biological and psychological processes in which OXT is involved.

A large amount of studies have shown that the Western OXT problem is harmful to children. The greater the conflict between the sexes, the less quality time parents spend with their children, potentially causing damage to the developing brain, especially in the oxytocin-vasopressin system.

The decline in T levels among Western men since the 1970s may be sign of a ”loser effect” in the competition between the sexes. A theory of general principles of power dynamics between the sexes is presented in Part II.

A hidden conflict of evolutionary interests in the West is harming social and personal relationships, human health, and basic biological functions. This Western predicament can be observed and analyzed by studying the resulting diseases. A cure might be within reach. A prescription should include a shift in focus toward children, engagement in critical thinking and reasoned dialogue, and the revitalization of cultural heritages and diversity in the West.