Health notes: For your genes only
You’re more than the sum of your genes. Optimal health lies in fashioning your environment, nutrition and lifestyle precisely to suit them
We’re on the cusp of a major medical revolution, which was sparked by the coding of the human genome in 2003. Dr Jeffrey Bland, founder of the Institute for Functional Medicine (IFM) in the USA and author of The Disease Delusion (Harper Wave), admits in an essay titled The Age of Omics: Opportunities, Transformations and Paradigm Shifts that he isn’t a “typical citizen scientist”. He’s had his DNA sequenced three times in the past two years. He’s had quarterly blood tests to track a panel of biomarkers providing insight into how his lifestyle choices are affecting his biochemistry. He’s vowed to keep his Fitbit on at all times and stay active. His gut microbiome’s been analysed four times.
Sound like a chronic case of nosophobia? Bland thinks otherwise. “It’s evidence of a sea change in healthcare that’s based on personal empowerment, accessible digital technologies and the democratisation of data,” he says.
Just a decade ago, it would have been inconceivable to send your own buccal swab to a DNA testing laboratory and receive the results yourself 14 days later. Today, it’s available at a click.
In the not-too-distant future, Bland envisages a ground-breaking time, akin to the personal computing revolution, when big data and genomic testing merge with social media and wearable devices. The insights and advantages will be vast. Rather than the current onesize-fits-all approach, he says, the future is medicine that’s honed for the individual.
TAKING CHARGE OF YOUR HEALTH
An early player in the personal genomics and biotechnology sphere was American company 23andMe, co-founded by Anne Wojcicki, who had a vision of “a world of consumer-driven, affordable healthcare”. Today there are innumerable companies around the globe offering an array of genetic tests, from ancestry and paternity to health and fitness.
In SA, online company JOINCIRCLES (www.joincircles.com) has an inspiring personal component that’s informed its innovative approach. Co-founders Dr Heidi van Loggerenberg and Margie Doig-Gander have been lifelong friends. From partying as students to starting families, they’ve been through all of life’s stages together, including the shock of developing a dread disease in their mid-30s. “We both suffered from oestrogen cancer and we both found a solution. We wanted to take that solution to people and share what we’d learnt on our journey,” says Van Loggerenberg, JOINCIRCLES’ Medical Director. Currently completing a Functional Medicine Practitioner’s course at IFM, she holds a Master’s degree in homeopathy (MTech Hom) and principles of genetic counselling from the University of Cape Town. “We didn’t just want to offer tests, as other websites do,” adds Doig-Gander. “We wanted to offer the support and the application, because that’s where the value lies; that’s when you take action on your results.”
With over 15 years’ experience in the managed healthcare market focusing on the prevention of lifestyle-related chronic diseases, Doig-Gander says that after looking at their biomarkers, she and Van Loggerenberg realised they could have prevented their own cancers. “Our passion really lies in the fact that we’ve sat in the patient’s chair. We could see a big gap in healthcare for taking ownership of your own medical information and having access to it easily online,” she says. “We thought it would be hugely empowering to be able to go online and see specific tests that look at various biomarkers, genetic predispositions and biochemistry markers in real time, then purchase those tests yourself and drive your own healthcare process, in conjunction with consulting medical practitioners.”
CIRCLES OF SUPPORT
A major motivation for starting the company was helping patients who felt vulnerable and alone in the medical system. An online platform, JOINCIRCLES guides and supports each client through a journey to wellness. You order one of five DNA tests (diet, health, oestrogen, sport and skin) or bundles of tests (far less expensive) and the DNA swab kit’s delivered to your door. The courier delivers your sealed tube to DNAlysis Microbiology, a world-renowned, ISO-accredited laboratory at the forefront of DNA testing in SA.
All the tests the lab carries out are based on solid scientific research. “Our aim is to get this research into the public domain, so that people can make more informed decisions and practitioners can work with a patient’s DNA, instead of against it,” says DNAlysis Biotechnology founder Dr Danny Meyersfeld, who holds a PhD in molecular biology from the University of the Witwatersrand. “What made us a success was the science backing us. There are no wild claims or assumptions here.”
After two to three weeks you receive your results and book your one-on-one session with JOINCIRCLES. They will unpack your results in detail, provide their recommendations regarding biochemistry tests and refer you to a genetic counsellor or member of their Practitioners Circle, where necessary.
Doig-Gander, who has completed a Functional Medicine Wellness Coaching course at IFM and is currently sitting her Genetic and Genomics Certificate Program at Stanford University, is available to guide clients through their wellness journey, which can often be overwhelming. Another layer of support is provided through the online store, which is divided into neat categories so that you can shop for knowledge, tests, nutrition, environment and lifestyle. You can also shop by gene or brand, or even hit the “integrated shop” button and browse categories like stress, gut or oestrogen, that are aligned with your DNA results.
THE ROLE OF EPIGENETICS
Far from the fearful Gattaca-esque notion that our DNA is our pre-programmed destiny, scientists have discovered that epigenetics (the study of the biological mechanisms which can switch genes on and off) places us in a better position to shape our own health. Our genome is our entire genetic code, found in every single cell, and our epigenome is made up of molecules which attach like tags to the outside of the genome and change the signals or messages it receives from the outside world.
Learn.Genetics at the University of Utah, USA, explains this concept clearly: “Identical twins are genetic carbon copies. The genetic sequences are exactly the same. Yet physically, identical twins become increasingly different over time.” Their epigenomes are similar at birth and through the early years of life because they share the same environment. But their nutrition, environment and lifestyle choices may change as they age, so while one may smoke, eat processed foods and lead a sedentary lifestyle, the other may be a non-smoking vegetarian who exercises regularly. In this way, our lifestyle choices and environment can alter our gene expression patterns, potentially leading to premature ageing, weight gain or chronic illnesses such as diabetes and heart disease.
DNA TEST RESULTS UNPACKED
JOINCIRCLES recommends that I do a bundle of DNA tests, including health, oestrogen and diet. Each report shows the
“WE COULD SEE A BIG GAP IN HEALTHCARE FOR TAKING OWNERSHIP OF YOUR OWN MEDICAL INFORMATION AND HAVING ACCESS TO IT EASILY ONLINE.”
RATHER THAN THE CURRENT ONE-SIZE-FITSALL APPROACH, THE FUTURE IS MEDICINE THAT’S HONED FOR THE INDIVIDUAL.
gene name and description, followed by my specific result, an explanation of it and the associated risks, as well as dietary and lifestyle recommendations. It also identifies low, moderate and high priorities in each biological area. For the purposes of this article, we’re taking a closer look at the DNA health test.
This tests the following biological areas: lipid metabolism, methylation, detoxification, inflammation, oxidative stress, bone health and insulin sensitivity. Based on my family history (my late mother had arthritis and spent her last days in a wheelchair), I’m certain I’ll need to focus on my bone health. A few years ago I had a C4/C5 cervical herniated disc, which my mother had at exactly the same age, so I believe that’s my fate. Bone health, however, turns out to be a low priority. Van Loggerenberg points out that my mother could have had inflammation problems which affected her bone health if she wasn’t making the right lifestyle choices.
She’s spot on: my genotype combinations indicate that high-priority areas to focus on are inflammation and oxidative stress. These markers are apparently involved in every chronic disease. “If you address those two things, you stand a good chance of ‘switching off’ these genes – but you’ve got to make a real effort,” she cautions. “Every time you exceed your ideal weight, you start producing oxidative stress and inflammation. That’s good motivation for keeping your weight down.”
Inflammation advice: I need to manage my weight through a Mediterranean diet, which is beneficial in improving markers of inflammation. I should take in curcumin (the most active component of turmeric), ginger, omega 3 and oily fish. I should reduce my intake of omega 6 and avoid fast foods, chocolate, alcohol and red meat. Anything that’s a toxin drives up inflammation.
Recommended tests: the first is Hs-CRP – DBS. “It looks at inflammation in the body, particularly inside the artery walls, and is good for women as we grow older, as we always assume we’re not at risk of a heart attack,” says Van Loggerenberg. The second is the Fatty Acids Test. “This involves a finger prick and shows you your ratios of omega 3, 6 and 9. It’s not for everyone, but if you’re prone to high inflammation, it really helps you adjust your diet,” she explains.
Oxidative stress advice: Because I’m at an increased risk of poor antioxidant status, I need to “eat the rainbow”. My plate should look very colourful. I need to consume more vegetables than fruit and eat phytonutrient-rich foods and Brazil nuts (selenium is an antioxidant) every day. If I smoke, I should stop immediately (thankfully, I quit two years ago). Recommended test: The Dutch Comprehensive Urinary Hormone Test, which measures progesterone, oestrogen, testosterone, cortisol, DHEA and their metabolites, as well as measuring DNA damage. “If you can fix your adrenals, you can fix the preservation of progesterone and protect your thyroid gland, which regulates your whole body and helps indirectly with weight loss,” says Van Loggerenberg. Supplementation is advised in the form of Foundation 5, which combines a multivitamin, multimineral, phytomultivitamin, vitamin D, omega 3 and probiotics.