San Francisco Chronicle - (Sunday)
We must get past disease to science of wellness
America was sick before COVID19 struck. The pandemic has made our national sickness more acute and illustrated the critical importance of “wellness” in preventing disease and optimizing health. We know this because COVID disproportionately affected people with chronic illness and unhealthful lifestyles.
As a scientist who has worked at the leading edge of medicine, engineering and genetics for decades, I’m on a quest to give mind and body wellness the scientific rigor and urgency it deserves. No doctor, policy or breakthrough drug is as effective as “wellness” at minimizing disease and enhancing the length and quality of life.
From 1959 to 2014, America experienced a dramatic rise in life expectancy due to advances in medicine, nutrition, lifestyle, the environment, safety and economic wellbeing. Since then, life expectancy has declined four of the past five years, something we haven’t seen in a century.
Although COVID19 was a major factor in 2020’s life expectancy decline, it is only part of a bigger national health catastrophe. More than 45% of Americans suffer from at least one chronic condition, and 70% of all deaths in America are attributable to chronic disease.
Consistent with these grim statistics, the U.S. devotes 90% of its health care spending to treating patients with chronic physical and mental health conditions. Devastating chronic disease will be with us long after this pandemic recedes unless we make major changes in how we promote health and treat illness.
Our health care system is great at fighting disease retroactively, but it’s dismal at keeping people healthy proactively. Waiting to treat disease after it emerges is not the answer. Once heart disease sets in, cancer spreads or Alzheimer’s takes root, it’s too late. Shorter lifespans and diminished quality of life are the result.
In contrast, wellness is the absence of disease in the body, and the most power
ful force in human health. While “preventive medicine” seeks earlier detection of already established disease, scientific wellness gives medical providers a new way of treating patients based on a datainformed understanding of their personal health.
Each person’s genome, or genetic makeup, is unique. Other factors, including our epigenomes, blood analytes, microbiomes, environmental toxins, diet and lifestyle, contribute in complex but interrelated ways to disease susceptibility and overall health.
As an example, consider the gut microbiome, which consists of trillions of bacteria of multiple species that live in the gut. When functioning well, these bacteria regulate metabolism, bolster immune responsiveness and even promote cognitive health. Their diversity is essential to human health.
My research organization, the Institute for Systems Biology, did an experiment recently where we studied the gut microbiomes of 9,000 individuals across the entire adult human lifespan. We demonstrated that gut microbiomes in healthy people change markedly as they age. These healthy gut biomes individualize in unique ways, maintaining species diversity while deleting major bacterial species common in young people. These were surprising results.
We found that people in their 80s with less microbiome change were four times more likely to die than those with markedly changed microbiomes. Four times!
Why healthy microbiomes for the elderly differ from healthy microbiomes for the young is a fascinating research question. Answering it will increase our understanding of the aging process and lead to powerful new strategies for promoting lifelong health.
This is how we need big data and scientific wellness to work together. Starting in 2014, my organization has sequenced genomes and cataloged health measures of 5,000 patients. We were able to elevate individual wellness and extend its duration with individual analyses from the genome, blood and lifestyle reports, which led to actionable possibilities.
We have found striking blood signals long before disease symptoms can traditionally be diagnosed. That transformational research offers exciting opportunities to pursue interventions that delay or prevent the onset of disease.
Imagine the databased insights gained by studying the genomes and health measures of a million people. That is our goal. With that depth and breadth of understanding, we can significantly extend the lifespan and enhance the quality of life of every person living today.
In a system focused on wellness, physicians would spend as much or more time helping patients achieve healthy lifestyles as they currently spend treating patients for preventable or manageable diseases. Using a scientific approach to wellness, medical providers will be able to develop interventions based on each patient’s unique genome, blood, gut microbe, diet and digital physiology.
Leroy Hood, a member of the National Academies of Sciences, Engineering and Medicine, is a professor and cofounder of the Institute for Systems Biolog y and senior vice president and chief science officer of the Providence St. Joseph Health system. This story originally appeared in Los Angeles Times. Distributed by Tribune Content Agency LLC.