There are numerous and opinion pieces online on why you shouldn't get your gene's analyzed, and some of the points are valid if the purpose of the tests is what the authors presuppose for each individual. Criticisms tend to be that the tests aren't perfect and account for only a fraction of your genome and as such may miss critical data, that individuals would be better served by a full DNA analysis ordered by their Physician, and that incomplete data, or data associated with a decreased risk, could sway individuals to falsely believing they have no risk and such not getting routing check ups. Some particularly cynical rigid in thought have states that these DNA tests do nothing by enrich shareholders.
While much of the above is true, taken for what the DNA analysis kits are while acknowledging their shortcomings, I do not see any reason why individuals should not have their DNA analyzed if the cost is not burdensome or prohibitive for their situation.
As discussed in last weeks post on my own DNA analysis, likely the biggest immediate takeaway I had was the information on how I respond to high-fat and high-carbohydrates diets. The report was in no way surprising, as my personal experience has been completely in line with what was stated. In the past I have ignored my past personal experiences to try new protocols that had even a modicum of evidence on effectiveness to see how my body responds. Overwhelmingly, these dietary experiments have been massive failures for my own health. Armed with this new knowledge, I believe I will be far less likely to try new dietary protocols which are similar to those that have failed for me in the past.
Data on the best dietary protocol is conflicting, experts rarely agree with each other and systematic reviews on the best dietary protocols yield inconclusive findings on any being advantageous over another¹²³. Likely, different people will respond differently to different diets. Much of it may come down to our genetics, with an individual's microbiota also likely playing a major role⁴. The role both our microbiota and genetics play in dietary protocol is still far too complex, with research in its infancy, for completely accurate predictions to be made.
What does this mean? We're all stuck being our own n=1, for now. Even if a dietary protocol shows to work better than another after a high quality systematic review and meta analysis, that does not mean it will work better for you. The best diet is the diet that you can follow and adhere to, and more often than not that comes down to how you feel when on the diet. If a diet makes you miserable, causes serious cravings and saps your energy you likely won't continue with it, so all the peer-reviewed evidence in the world on how it affects the majority of people becomes irrelevant. Gaining more information from analyzing your DNA arms you with that information to continue adjusting your diet to find what works for you, and what you can maintain as a lifestyle.
What can also come in handy is analysis on likelihood for developing different deficiencies in various vitamins and minerals. We know vitamins and minerals are important and we know deficiencies can come with serious health consequences. For more people, most of the time, broad supplementation of excess vitamins and minerals comes with no benefit. For some, targeted supplementation of what they are lacking can improve health. Knowing what you may be predisposed to lack could be a powerful tool in your personal health regime.
The big criticism in knowing your risk factors is that some who learn them may disregard risks if they are not at an elevated risk. Just because you are not genetically predisposed to a certain type of cancer, for instance, does not mean you cannot develop that cancer. These results need to be taken with a grain of salt, and the same type of caution for developing certain diseases you would have already been cautious of needs to be considered even if your risk is low. Do not allow yourself to gain a false sense of confidence from your DNA analysis.
With the above in mind, your results can alert you to potential risks you had never considered, allowing you to be more proactive with your health. For those carrying particularly risky genotypes, such as I do with one APOE4 allele, there are protocols in place to reduce risk factor. This has some merit when considering the Nigerian Paradox. Despite having a high frequency of individuals carrying two APOE4 alleles, and those carrying 2 APOE4 alleles being 9 to 30x more likely to develop Alzheimer's, Nigerian carriers of two APOE4 alleles do not have an elevated risk for developing Alzheimer's disease.
Dietary protocol could come into play here, as APOE4 interacts with our low-density lipoprotein receptor (LDL receptor, or the receptor for "bad cholesterol"). The nigerian population's diet leads to low cholesterol levels which may alter gene expression in this specific case, nullifying the risk of carrying two APOE4 alleles. While it is completely speculative, hydrogen water has shown to positively affect cholesterol in both published studies⁵⁶⁷⁸ and others currently under review. Considering that only those with an APOE4 allele responded in the low-dose hydrogen water study on mild cognitive impairment (MCI)⁹ (dosage was around and even below the lowest observed beneficial threshold), there is potential the link to cholesterol comes into play. This MCI model saw an improvement despite being right around, even below, the minimum therapeutic dosage stated bu the IHSA. A more prominent effect, was observed in rodents, drinking the same concentration ad libitum, compared to humans consuming -300-500ml daily. Mice tend to drink around 10x what humans do, and the human subjects were drinking a small amount of hydrogen water, so comparative dose was separated by 60-100 or more times.
I've focused observed on APOE4 here, however there could be numerous problematic genotypes any individual could posses, with relevant lifestyle advice and data often widely available to minimize the risk. It matters less what your genes are in many cases, more how they are expressing themselves. Medicine in most ways has advanced greatly and changed dramatically over the last few centuries, but in one way is coming back full circle. Research was standardized to find what works for most people, most of the time, and these observations have led to longer, healthier and better lives for the vast majority of humanity. This came at the necessary cost of treating each patient, as statistical likelihoods needed to be employed to advance our knowledge. As our knowledge of genetics is advancing, drugs are being designed to target individuals. Individualized medicine is coming, and in many ways it is the future¹⁰. Having your DNA analyzed is NOT the same, not even close, but is along the same lines. Armed with more knowledge, you may be able to make easy adjustments to your lifestyle to minimize risks.
Importantly, before making any decisions based on your DNA analysis in regards to medications (as many of the tests come with scores on how you will respond to various classes of drugs), it is imperative to share the information with your prescribing practitioner and follow their advice. Do not stop taking a medication due to this information.
Personally, while I smirked and it confirmed my own observations, i didn't find use out of the analysis of my exercise capacities. I know many who likely would, with many friend's adamant on pursuing fitness goals that they clearly are not built for. For those of you struggling to achieve your goals, this could be useful information to refine your training, and exercise to maximize your genetic makeup.
Similarly, across the board I had a low risk of developing drug and alcohol addictions/dependencies. This was in no way surprising to me as at no time in my younger life when I indulged in a more hedonistic lifestyle was I not in complete control. Many are not as fortunate, and armed with the knowledge that a certain drug (including alcohol) may pose a greater risk of addiction, it may dissuade individuals from venturing down that path, before it's too late.
Having your DNA tested for health outcomes is not some sort of magic tell-all, but it provides valuable information to help make better choices. If the cost is not prohibitive, it's something I would recommend and endorse.
Next week, the DNA test I recommend and why
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