A couple weeks back, the LA Times published a piece on a geneticist’s experience with “personalized medicine.” Based on careful and constant monitoring of his sequenced DNA and around 40,000 health markers – or “omics” – over 14 months by a team of his colleagues, Stanford geneticist Michael Snyder observed in painstaking detail exactly what his body was doing during periods of sickness and health. If and when a viral infection entered the picture, Snyder and his team could watch how thousands of biomarkers responded. He could track its invasion, his body’s battle against it, and its eventual retreat. Although Snyder had no family history of diabetes, his sequenced DNA revealed he was at risk for it, so he began monitoring his blood sugar. Sure enough, a couple weeks after the viral infection, he noticed that his glucose was abnormally elevated. Analysis of his “omics” profile during the infection showed that auto-antibodies, which are often produced by the body in response to infections, had begun targeting an insulin receptor-binding protein which impaired his ability to clear glucose from the blood. Snyder was eventually diagnosed with the disease (but later fought it off with diet and meds), and though it isn’t spelled out clearly in the article, it sounds like the fallout from the viral infection may have precipitated his development of type 2 diabetes.
It’s a good story, but how applicable are its contents to the average person without an armada of geneticists at his or her disposal? I’m dubious, though I can see the argument for finding out where you stand on certain specific genetic predispositions:
- Diabetics should probably learn which “Metformin response” genotype they are before filling a prescription for the drug. If they’re non- or low-responders to the drug, it won’t be as effective.
- Whether or not you have the genes for hereditary hemachromatosis, or excessive iron absorption, can be useful knowledge (especially for men who neither menstruate, pit fight, nor engage in bloodletting). If testing indicates you do have it, you can take simple steps to correct or mitigate the issue, like giving blood and drinking red wine, tea, or coffee with iron-rich meals to lessen iron absorption. But those aren’t bad things to be doing regardless.
- Those with a “malfunctioning” MTHFR gene may have issues producing folate, a crucial fertility and pregnancy nutrient. Women who have the genetic variant should probably supplement with extra folate before and during pregnancy. But that’s something pregnant women should probably already be doing.
But for the most part, there’s just not a whole lot we can do with this information. I guess it could be cool to use your “omics” to “see” a cold or flu coming before it touches down, but is that even very feasible for the average person? Snyder’s team of chemists were analyzing 40,000 variables every time they took an omics measurement (20 times over the course of 14 months), while the average blood test (which we get maybe once a year) looks at around 20 variables. They hope to narrow it down to a “subset of them that will be truly predictive of future health,” but that’s a long ways off. In the meantime, let’s keep in mind that Snyder’s biggest discovery was that he had type 2 diabetes. The genetic test indicated that the blood sugar was worth keeping an eye on, but the smorgasbord of esoteric biomarkers wasn’t required to tell him that he had elevated blood sugar. It was a simple blood sugar test, a basic $10 pin prick that you can pick up at the drug store, the very same test that millions of diabetics and health-conscious consumers use on a daily basis. The omics report revealed the connection between the viral infection and the diabetes, but the real, actionable data – that he had a problem regulating his blood sugar – could be attained quite easily.
Research like this is important. It can show us how our genes interact with our environment, and it can identify which biomarkers should be tracked and which should be discarded as irrelevant. It’s also cool that we could conceivably watch our biomarkers in flux as they respond to viral infections, actually see the cytokine storm that responds to the flu, or watch the inflammatory cycle that occurs after a heavy workout and makes training adaptations possible. I won’t argue against that. I am, however, wary of people rushing out to jump on the latest trend in personalized science, spending a lot of money, getting a product (that may not even be legible to a layman), and trying to base important lifestyle decisions on the information therein. Sometimes, simpler is better. Sometimes, easy is more effective. Sometimes, less is much, much more, while more information is constricting, stress-inducing, and paralyzing. Let the research commence, but I’d refrain from acting on it until you (and the folks doing the research) actually suss out all the implications.
It’s not that I don’t see the merit in this stuff for some people. It’s just that I don’t care. I already have enough to worry about and obsess over. The last thing I need is another set of biomarkers to consider. I’ve been Primal for eleven years now. I’m happy, fit, healthy, with zero complaints. I’m happy and satisfied with my diet. Things are going well. Everything appears to be working, inside and out. I rarely go to the doctor, but when I do go for a checkup, everything checks out. Is there anything I’d drastically change about my lifestyle if presented with a full omics report? Honestly, no.
Say I went through with it and it told me that a huge cytokine storm swells up inside me every weekday around mid afternoon, indicating a stress response. Would that change anything? No! I know I need to relax more and reduce stress in my life (especially my work life), and “seeing it” would be interesting, but I don’t need a printout to tell me I need to work on it.
Say I learned that I carried the mutated ACTN gene for endurance sports (as opposed to the gene for strength or sprint sports). Would I then drop the heavy lifting, the hiking, the Ultimate frisbee, the beach sprints, and go back to running marathons and completing triathlons? No! I know how my body reacts to that type of training. Hell, there’s a very good chance I do have the mutated gene, given my success with endurance sports, but that didn’t make it healthy or even enjoyable. The genetics of it all are immaterial in a sense.
What are you going to do if it’s bad news? Agonize over it? Stew in a pot of your own helplessness? Stay up late scouring blogs and forums and databases for some way to make sense of the information dump? Or are you going to keep living your life, eating right, moving well and often, enjoying the company of friends and loved ones, savoring a good glass of wine (or whatever poison you fancy), getting up early for a crisp weekend hike, and generally doing the things that have already proven to lead you toward good health?
Of course, some people love to know as much as possible (even if they don’t really know what the numbers and configurations of letters they get back from the testing company actually mean). Go for it, then. When the science gets stronger and they narrow those 40,000 variables to a couple hundred really relevant ones, I’ll pay attention too. I’m not promising I’ll micromanage my life because of it, but I’ll be listening with interested ears.
Where do you fall on all this, folks? Do you want to know absolutely all the wrinkles of your genome? Do you want a constant, daily play-by-play on the inner workings of your physiology? Or do you think that would be counterproductive to your goals and your desires? Let me know in the comment section!