Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
29 Mar

Maybe There is Such a Thing as Too Much Information

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!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. People on SAD often feel fine and wouldn’t change anything if they found out they had an increased chance of diabetes through their diet.

    Knoweledge is power, I would want to know this kind of information, and how and if I chose to act on it.

    A wrote on March 30th, 2012
  2. I agree that there’s often TMI, especially with our 24-hour news cycle that insists on reporting all sorts of ill-conceived ‘studies.’ But I also think we can learn a lot from our family history and be pro-active in our health care.

    For example, I have two siblings who died in early adulthood of blood clots, so the remaining siblings were all tested to see if we had a genetic disorder. None of us did, but my own tests showed a ‘slight’ tendency in the opposite direction. Although it’s not serious, my clotting is slower than normal, and I’ve been advised to inform any doctor of this should surgery be planned.

    In addition, since 3 of my siblings developed Type2, I began eating like a diabetic several years ago–mainly low carb and now primal with no grains, sugars, or dairy. My endo believes that my diet is mainly responsible for the fact that I have NOT developed diabetes. This article shows that I’m not immune, since the clear familial tendency could be triggered by an infection, but I’m taking whatever measures I can to avoid developing diabetes.

    Anita Gandolfo wrote on March 30th, 2012
  3. TMI
    Instincts get buried by it..people assume it..others use it as weapons…some good and some bad is always floating around.

    ….yet for many folks out there….”if it works” all they need to know>>>

    Dave PAPA GROK Parsons wrote on March 30th, 2012
  4. Mark, you are the voice of sanity in a mostly insane world.

    Paul wrote on March 30th, 2012
  5. The basic issue is one of scale. We’re trying to determine “health” and “fitness” and “what prevents diabetes or cancer” or whatever. These are all MACRO scale issue. The extraordinary level of detail at the MICRO level (DNA markers, working of individual cells, etc) may or may not have a direct impact on the macro scale. This is the reason we have so many conflicting “studies” in the world of science, and why things like the China Study can be interpreted in different ways. If you focus on the micro details and extrapolate based on your preconceived ideas, you can lead to whatever MACRO conclusions you like.

    This is one of the reasons I think Primal/LC/Paleo is so effective. It’s focused on macro on a macro problem (overall health and fitness) by looking at the macro level story, which generates macro results.

    Jeff wrote on March 30th, 2012
  6. For most people, there’s no need to know. My mother had early-onset breast cancer and I’ve never felt the need to know if I carry the BRCA gene. It’s like waiting for a shoe to drop — FOR ME. But others may feel differently and that’s okay.

    I have 3 kids and have also had 3 miscarriages. After our second child was born with a rare genetic disorder we decided to pursue some testing. I’m glad we did. We learned this specific genetic disease was a 50/50 chance for any baby we conceived, and 70% of the time it was lethal / fatal before birth. It gave us some answers. Hard decisions had to be made, yes, but I’m glad to know.

    Lindsey wrote on March 31st, 2012
  7. It’s something interesting to keep an eye on, but not worth worrying about yet.

    What might be really interesting is if this research could be bent to the psychology field. These days, the procedure for putting a patient on drugs is to try one after another until you find one that works. What if they could do a test to rule out a couple of duds, or determine if it’s a simple red dye allergy?

    I also hear that Gluten-free and Paleo diets can cure behavioral problems. (Gotta find enough people that already don’t eat Twinkies to do a proper study.) I’ve noticed that I can think clearly for the first time in my life after becoming a foodie and cutting out almost all convenience foods.

    If Gattaca is anything to go on, the main character was tested and supposed to be dead of a faulty heart by the time the movie took place.

    Kelekona wrote on March 31st, 2012
  8. I think the more information the better. But I think most people want simple effective actionable information.

    All of this talk about biomarkers and insulin receptor binding proteins quite honestly make my head spin. And I actually have a decent interest in health related information.

    So I say, when trying to determine the best thing that we should do for our health we always want to have the most accurate information available. The more information we have the better.

    But we need someone knowledgeable to break it down for us. But no the average person doesn’t want to obsess over tons of data.

    They just want to know what they need to do to get the result that they want. And when they have a question about a routine,treatment,diet etc. They will occasionally want to see the data that validates what they are doing.

    Mrfuzzybear wrote on March 31st, 2012
  9. My partner and I both have 23andme accounts. Knowing our genomics has helped improve our health. We are both c677T (one variant of the MTHFR gene) and our ability to metabolise folate from the diet is only about 8% of normal. These genes are present in approximately 10% of the population, and the treatment is relatively straight forward (and FDA reviewed) – take the active form of folate (methylfolate) as a supplement. Methylfolate is not found in food. Having c677T is associated with a wide range of problems, not just pregnancy. Some of the conditions include early heart disease, forms of cancer, and chronic fatigue. Ignore this polymorphism at your peril! More information about MTHFR can be found here

    Other useful information that I was able to glean from my gene profile was in the area of vitamin A. Conversion of beta carotene to retinol is generally low, and I am able to perform this conversion at approximately 69% less than normal. Further reading here
    I now make sure to supplement with A, D and K2.

    I have other genetic markers relating to B12, B6, and sulphur (the CBS polymorphism) which seem to explain lab findings that were not optimal despite a strict paleo diet. In each case there is a specific nutritional work around.

    Lastly, the information provided about responses to drugs might prove useful in the future. No more Floxacillin for me!

    David wrote on March 31st, 2012
    • David, I realize this is an old post, but it always helps with thinking things through to answer them. I’ve been wondering for a year or so if I should do a 23andMe, and your post has decided to do it for the very reasons you have outlined. This might be the missing piece for me. My family is highly prone to migraine, depressive and other mental health disorders, stroke, chronic fatigue, and other conditions that suggest we may have an MTHFR mutation. We don’t get diabetes (only one case in the last three generations) or much heart disease (two cases in the last three generations). I’ve worked so hard and so long on my chronic migraine, chronic fatigue, tendency to eczema, IBS, and gluten sensitivity, and I have made a lot of progress – but just never seem to really get over the hump, and this is 25 years down the line. I read and research, and experiment on myself. I feel like Sisyphus!

      If there is indeed a MTHFR or other mutation, I’ll be able to target my intervention work more precisely. If not, it’s back to the read, research, and experiment mode.

      SuzU wrote on December 5th, 2014
  10. I have to say, I think that whole thing is really smurfing awesome. I love studies that help show the whole big picture volley of a response your body makes as it changes and reacts. Its a living dynamic system, and you actually get to see it act and be alive and respond. I’m only 35, but I remember when I was in college and was studying genetics and we were still working on sequencing the human genome. It was a vast undertaking, requiring thousands of labs of researchers all over the world, working on different parts of it. Researchers spent a decade working on getting the whole thing done, just for one person’s worth of DNA. I never once dreamed I’d have the option to have my own genome sequenced all the way. Nowadays you can spend maybe $10,000 to get it done, and in a few years we might be able to do it for a few hundred dollars. I very much look forward to learning what my own DNA holds, and will day dream of the future when they can check to see my drug tolerances before even trying it.

    Masdevallia wrote on March 31st, 2012
  11. Mark,

    It seems you may have made a typo in your bullet point about hemochromatosis.

    You said “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.”

    As a someone with a family history of hemochromatosis, I can tell you that if you have this disorder taking in too much iron can make you sick. Even the link to the hemochromatosis article on the Pub Med Health website says “If you are diagnosed with hemochromatosis, you should follow a special diet to reduce how much iron is absorbed from your diet. The diet prohibits alcohol, especially for patients who have liver damage. You will also be told to avoid iron pills or vitamins containing iron, vitamin supplements, iron cookware, raw seafood (cooked is fine), or fortified processed foods such as 100% iron breakfast cereals.”

    Is this as it seems, an oversight/typo or is this a CW thing that can be dis-proven to the point that I can inform my mother, uncles, aunt, and cousins about?

    Scott wrote on April 4th, 2012
  12. I am a loyal reader of yours, but I have often commented on my own blog about your frequent and unnecessary use of scientific references to justify primal principles. In fact, that is what my entire blog is about. Authentic health needs no science for justification; we have the world’s longest case study – human history. All primal teachers should embrace this as a tenet of primalism.

    Dave Young wrote on May 21st, 2012

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