The gene genie

Keen to dodge your genetic fate? Helen Rumbelow trials a new gadget – a wristband that lets people choose food to suit their genes.

So, will it be the family weakness for Alzheimer’s or my granny’s cancer that gets me in the end? Our genes contain instructions for our death as well as our life, but they have always played dumb. Until now.

Now I can wear a wristband with my genetic vulnerability for fatal diseases coded into it. Which is by turns futuristic and kind of terrifying. For me, it’s like shaking hands with my heart attack scheduled for 2050: ‘‘Nice to meet you at last!’’

Weird, but I soon get used to it when I take the wristband shopping. It’s the opposite experience to taking a toddler, endlessly pestering for sweeties, to the supermarket. When I aim the tiny scanner of the ‘‘DNA Nudge’’ wristband at a packet of biscuits, it flashes red.

Remember your grandfather, it seems to tell me with this warning, dead at 56 from a heart attack? Or rather, remember why you don’t remember him? I know your genes and that’s coming for you. Another pack, allbutter shortbread, another red flash. It’s the Ghost of Christmas Future, showing me clutching at my chest. More red flashes. Other shoppers are starting to look now. No, not the salted crisps, with your DNA, are you suicidal or something?

Some prisoners, let out on probation, are forced to wear an electronic tag. This experience makes me realise we’re prisoners of our DNA. Does this British invention, with millions of pounds of funding behind it to launch in America, set us free or throw away the key?

‘‘This is like your DNA talking to you,’’ says the nice young man who helps to get me started in the new DNA Nudge shop in Covent Garden. ‘‘Your body doesn’t talk to you very well. Now it can.’’

The service is so new it is hard to describe: maybe the love child of Ancestry.com and Fitbit. I may well be pioneering the future of healthcare, when our diet, exercise, supplements and medicines will be tailored to our DNA. For £40 (NZ$80) you get an almost immediate genetic health analysis for factors such as heart disease, obesity and diabetes.

For another £80 you get that information coded into the wristband, which will guide you on diet and exercise through its in-built scanner and a motion sensor. Almost as soon as I enter the shop Chris Toumazou, the co-founder, pops up by my side. ‘‘Hey!’’ he says with a massive grin, and I would write that he has had too much espresso, except that I know now from looking at his DNA profile that he has the gene to process caffeine very efficiently. He just buzzes with energy.

Toumazou, at 57, looks like a younger Paul Simon and is the closest Britain has to a rock star of bio-engineering. In a more balanced culture, he’d be as famous as a rock star for his work on cochlear implants for deaf children, artificial pancreases for diabetics and wireless heart monitors, and

for his 750 research papers, 50 patents and 300 employees at his tech companies and at the Institute of Biomedical Engineering at Imperial College London.

He hangs about while the assistant helps me to swab my cheek cells with a large cotton bud, which then plugs into Toumazou’s fast DNA processor, which looks like a CD-player. Then Toumazou and I go into a room behind the shop to talk. My DNA results will be ready by the end of our conversation, quite the advance on the normal eight-week wait.

That gene-analysis technology was a breakthrough by Toumazou that won him the 2013 Gabor Medal of the Royal Society. It’s saving lives in hospitals by providing rapid analysis of superbugs instead of the usual 48-hour wait.

First off, Toumazou shows me his results on the DNA Nudge phone app. They break down into eight simplified categories in a grid. For instance, if you have a high genetic vulnerability to diabetes, the box marked ‘‘sugar’’ will be coloured red, and if you use the wristband to scan a high-sugar product it will refer you to a lower-sugar alternative.

Later, I will realise that Toumazou and I have a similar DNA Nudge profile: a high risk of heart disease – so we have red alerts for salt and saturated fat – and pretty average for everything else. Yet I certainly am not one of the few people in history to be appointed fellow of the elite institutions the Royal Society, the Royal Academy of Engineering and the Academy of Medical Sciences. One of us has certainly made the most of our genetic inheritance.

‘‘My mother’s mother died of a heart attack. My mother’s dad died of a heart attack,’’ he says. ‘‘So, you know, I’m not surprised that cardiovascular is my issue. What did surprise me is how I’ve changed my diet since using the app.’’

For example, he loves peanuts. He used to eat dry-roasted, thinking them a bit more wholesome. Then the app flashed red on them, diverting him to regular salted peanuts, which surprisingly have half the salt. Not a big deal for someone without his genetic flaws, but for him and me, over time, perhaps a very big deal.

‘‘This isn’t about the credibility of the science, it is already credible,’’ he says. ‘‘This is about the merging of science and behavioural science.’’

Toumazou was born in England to Greek-Cypriot parents who were in catering. He left school without any O levels. ‘‘I was pretty uneducated, due to go into running a Greek taverna.’’ But inventing always fascinated him. Somehow, against all the odds, a technician certificate was his route back into academia, where his ascent was steep. He took a two-year ordinary national diploma followed by a degree in engineering at Oxford Polytechnic, and then a PhD. After a postdoctoral position at Imperial he became its youngest professor at 33. ‘‘I was lacking depth,’’ he says of his non-academic start, ‘‘so I became more creative with breadth.’’

This was important when it came to the life-changing event that diverted the course of his career. His son, Marcus, lost both his kidneys at the age of 8. It was due to a genetic disposition to renal failure that his parents knew nothing about until it was almost too late. How Toumazou wished an early genetic test could have alerted them before his son came so close to death.

‘‘That made me think, ‘We’ve spent billions of dollars on technology. What if we could just apply a fraction of it to healthcare?’’’

Marcus was on dialysis for three years, ‘‘very difficult to manage’’, and would go on to have two transplants. ‘‘He’s 27. He’s fine now,’’ Toumazou says.

Meanwhile, Toumazou was on a new mission, determined to integrate genetics, engineering and practical medicine. He raised £40 million to found Britain’s first institute of biomedical engineering in 2005. ‘‘Naivety was key to success,’’ he says.

Toumazou’s inventions typically integrate elegantly with the body. He hated the way Marcus had to live with ‘‘wires all over the place, flapping about, it created a stigma’’. I ask if his DNA Nudge product will ever be an implant and he says ‘‘maybe’’, and that he already has a slightly different implant in testing. It is an alternative to a gastric band that eliminates the need for major surgery. It sets a tiny chip under the surface of the abdomen, dulling the hunger cues carried by the vagus nerve from gut to brain. Buy shares in Toumazou!

‘‘But my thinking has moved away from therapy to early detection and prevention,’’ he says. ‘‘Because I feel that’s where we can make a big difference.’’

He is sceptical, perhaps as any entrepreneur would be, about rival brands such as 23andme and Ancestry. com, that reel off reams of scary disease risks.

‘‘They’re giving you a problem without a solution,’’ he says. ‘‘We’re looking at very well-studied genes, and if we detect that you’ve got the predisposition to those medical conditions, then as a GP or a dietician would, we recommend the right nutrition for you.’’

So you’ve decided to tell people to avoid saturated fat rather than that they are at higher risk of a heart attack? ‘‘Absolutely. Because that’s what the consumer wants to know.’’

I really didn’t know what to expect of my results. The assistant in the shop, Joe, first shows me his; a grid of nearly all red alerts for fat, sugar, salt, calories, meaning he is at higher risk of obesity, diabetes, heart disease. I turn to look at him: a tall skinny young man.

‘‘That’s ridiculous,’’ I say, ‘‘you’re obviously naturally thin.’’ He shakes his head and laughs; he was severely obese for eight years.

When my results pop up on the app on my phone there is a moment’s thrill. It’s like a tarot reading. And, like a tarot, you immediately start joining the dots of its predictions. I’m suddenly sure my grandfather has bequeathed me his dicky heart.

Unlike Joe I score low risk for obesity, which I didn’t expect, given my tendency to puff up. If you have a spare £40 – it is priced for the mass market and will soon pop up in UK stores such as John Lewis and Waitrose – and are quite selfinterested, this test is totally fascinating. Also motivating.

I’m not so convinced by the wristband. It is entering an even more crowded market of wearable bands such as Fitbit and phone apps such as MyFitnessPal, which also has a food label scanning function, and a whole lot more new phone apps.

The unique twist to DNA Nudge is it knows your genes. That makes it interested in your future, not your present. At no point do you have to confess or track your BMI. It is also very forgiving. If you want crisps, it will not tell you off; rather it will gently nudge you to a better crisp for you. In the sweets aisle, it tells me I have a green light for Snickers (but red for a Bounty). I feel ridiculously shocked. What brave new world is this, with a green light to eat Snickers?

‘‘If you’re going to eat junk,’’ Toumazou says, ‘‘eat the best of the junk for your DNA.’’

Tracy Parker, a senior dietician from the British Heart Foundation, tells me that she is cautiously positive about the app. Yet it can’t control portion size and it can’t address myriad factors that affect your health. ‘‘It can only be one part of the picture,’’ she says.

There is a year-long trial at Imperial that has nearly finished, splitting a group of prediabetic people into three groups: those given standard healthy eating advice, those given the DNA Nudge test and those given the test and the wristband. Toumazou can only reveal the results ‘‘are looking very positive’’. But, I say, we all know what we have to do to be healthier, and it’s broadly the same for everyone.

‘‘Well,’’ he replies, ‘‘why have we got an obese population if those things have worked?’’