Do Your Genes Determine Your Destiny?
Fundamental laws of genetics
It is a fundamental truth that your genes interact with your environment to create who you are. Growing up I used to believe that we were born with a specific genetic code that determined everything in life for us. The truth is, while your DNA does provide the coding to everything that makes you who you are, its influence peaks at conception.
While it is true that your genes can predispose us to many health challenges, predisposition is not the same as predestined. We do not need to be rendered powerless by our family history of disease. In a recent interview, I sat down to talk about epigenetics and how our behaviour can influence which of our genes are turned on or off.
In this email I am going to outline a field in medicine called ‘genomics’ which is literally the study of all of a person's genes (the genome), including interactions of those genes with each other and with the person's environment.
With this specific information you can now have greater influence on your destiny and you can shape the life you want through diet, exercise and sleep interventions.
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Genomics Based Medicine
Genes control the function of every cell in your body. Some genes determine basic characteristics, such as the colour of your eyes and hair. Other genes can make you more likely to develop certain diseases, including Alzheimer's disease. Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of their clinical care (e.g. for diagnostic or therapeutic decision-making) and the health outcomes and policy implications of that clinical use. Already, genomic medicine is making an impact in the fields of oncology, pharmacology, rare and undiagnosed diseases, and infectious disease.
A decade ago, researchers were tentatively exploring the first reference human genome sequences, which cost over $1 billion to produce. Now, thousands of genomes from a cross-section of ethnic backgrounds have been sequenced. This explosion of activity has been enabled by unprecedented advances in sequencing technologies that can now sequence a person's entire genome — more than 6000 million bases — in days, at a cost of US$1000, with costs expected to fall further in coming years.
Watch this Instagram reel before you get into this section.
The most common gene associated with late-onset Alzheimer's disease is a risk gene called apolipoprotein E (APOE).
APOE has three common forms:
APOE e2 — the least common — reduces the risk of Alzheimer's.
APOE e4 — a little more common — increases the risk of Alzheimer's and is associated with getting the disease at an earlier age. Approximately 15% to 25% of the general population carries an APOE e4 allele.
APOE e3 — the most common — doesn't seem to affect the risk of Alzheimer's
But genes are not destiny. Not everyone who carries an APOE4 allele ( a gene variant) develops AD, and some AD patients don’t have any APOE4 variant in their genome.
This implies that lifestyle has a substantial effect too.
Most studies that try to quantify the risk of different APOE versions are retrospective — looking back. This means they start with genotyping people who already have dementia.
A prospective study on the other hand starts with people who do not have the condition and then follows them over several years.
In this study, scientists followed 12,978 healthy participants (70+ years of age) for around 4.5 years.
The APOE3/3 (one version from mom, one from dad) genotype is considered the neutral one. APOE3/4 has a higher risk, and APOE4/4 higher still.
The study’s participants were regularly tested for global cognition, episodic memory, language, executive function, and psychomotor speed. If there was a noticeable decline in these scores, additional assessments were conducted, including brain imaging and laboratory analyses.
Here’s the result:
Cumulative incidence of dementia to age 85 years was 7.4% in all participants, 12.6% in APOE3/4 and 26.6% in 4/4.
In the latest episode of TNE, we went over lifestyle interventions that can help delay the onset of Alzheimers Disease. You can listen to that here
Tumor Necrosis Factor Alpha (TNF-α) Gene
TNF-α is one of the most typical pro-inflammatory cytokines with both beneficial and destructive properties for the central nervous system. It is also an adipokine. As an adipokine, TNF promotes insulin resistance, and is associated with obesity-induced type 2 diabetes. As a cytokine, TNF is used by the immune system for cell signaling. If macrophages (certain white blood cells) detect an infection, they release TNF to alert other immune system cells as part of an inflammatory response.
Increasing evidences have demonstrated the important role of TNF-α in the development of ischemic stroke (IS). Stroke is one the leading causes of death in the world and a common cause of disability. IS is a multifactorial, polygenic, complex disease resulting from the combination of vascular, environmental and genetic factors. Inflammation and genetics are both prominent mechanisms in the pathogenesis of IS.
It has been demonstrated that an increased level of TNF-α is associated with greater neurological deficits and poorer treatment outcomes in IS patients. Based on previous meta-analysis results, it has been proposed that therapeutic strategies to decrease the circulating levels of TNF-α and increased levels of IGF-1 might be considered as a promising therapeutic target with potential neuroprotective effects for the treatment of IS.
Why do a Genetic Test?
Do you have genetics that make you need more choline, folate, or Vitamin D? Does your DNA make you very sensitive to gluten, dairy, refined carbohydrates, or saturated fat? When you test your genome you are able to pinpoint the accuracy of what you should be ingesting especially when it comes to supplements. Far too often people are reaching for supplements that aren’t needed to create the life they want.
Here is a Clip from the Episode I did with Wild Health
If you want to learn more about how to get started with genomics based medicine, check the message below!
Until next time,
Personalised Health Care
It's time to demand excellence from our healthcare and a new service called Wild Health is using the power of precision medicine & data to deliver truly personalized healthcare.
They combine an in-depth genetic analysis with extensive blood work and a lifestyle assessment to provide you with a fully comprehensive picture of your health like you’ve never seen it before. You’ll receive a 50+ page report covering everything from your optimal diet, exercise and supplement routine to your risks of chronic disease and prevention strategies. You also get paired with a dedicated doctor and health coach who will help you understand and apply the biggest opportunities for maximizing your health.
What I personally love is that they focus on brain health too - everything from dementia & Alzheimer's risk to overall inflammation.
They even look at specific genes around your circadian rhythm to help you optimize a sleep routine.
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