For years, when asked to name the one strategy that would improve a person’s health, my response would be related to diet. I would advise the person to cut back on sugar, eliminate processed foods and follow a Mediterranean-style diet. Then, I might start explaining the importance of being active and having a positive attitude.
Today, however, my response is very different. It’s not that my earlier advice was wrong but the reality is that technology has given physicians—and in turn patients—a far more powerful arsenal. Precision medicine and more specifically genetic testing is the newest way to understand your unique needs related to nutrition, exercise, and risks of metabolic conditions including diabetes, high cholesterol, and obesity. Reviewing your test results with a healthcare provider is referred to as genetic counseling and understanding your profile increases the chances you’ll be able to successfully transform your lifestyle into a healthier one.
You might be inclined to think that if you found out you were genetically programmed for obesity you would probably just give up. In fact, the opposite is true! You don’t just throw in the towel and say you are doomed. Research shows that when patients find out they have the genes for obesity, they actually are more likely to make healthier lifestyle choices than if they had not received genetic counseling.
In fact, one of the biggest challenges in private practice is motivating patients to make lasting changes that positively influence their overall health. In the healthcare field, we often refer to this as patient compliance. For some people, the most challenging part is getting started while, for others, it’s sticking to those healthier behaviors over the long-term, choosing to make exercise a priority, and making sure they fill their kitchen with smart food options. With three growing kids of my own, I know how challenging it can be to keep the fridge and pantry stocked, but I have decided that this is a must for me.
As a physician, I spend most of my day telling patients what they SHOULD do, but you have to do the actual work after you leave your doctor’s office. Fortunately, genetic counseling helps and can make your work, if not more accessible, more focused. Many of my patients view the genetic counseling process as therapeutic. Some people have said they felt lighter, relieved, and even inspired.
This type of genetic profiling also provides valuable information about eating behaviors so we can further boost the likelihood someone will be successful with a healthy eating program. There are six behavior traits that can be evaluated and based on the results, we have developed a tool to allow us to provide targeted behavioral counseling. For example, if a patient displayed a variant associated with eating disinhibition, essentially a lack of restraint, then we would advise the person to measure his or her food and not eat from an open bag. Also, to avoid overeating, the person should have nutritious food available, especially when facing an emotional stressor.
When reviewing their genetic profiles, I often tell my patients that genetics (or nature) is about 30% of the equation, which is great news because that means 70% is environmental (or nurture), which is what can be influenced by your lifestyle choices. How you respond to emotional stressors, food signals and activity can all influence what happens to you. This is why a person can have the genes for obesity or diabetes but never actually become obese or get diagnosed with diabetes.
Another critical discovery is that genes can be “turned on” and “turned off.” This is a branch of genetics referred to as epigenetics. This is a very active area of research and scientists have already uncovered fascinating data. For example, while it has been generally accepted that green tea is healthy, specific studies are now examining how phytochemicals in the tea affect your genes.
There is no question that precision medicine will change the face of healthcare, especially in the area of targeted pharmaceutical therapies. But my emphasis has always been on prevention and lifestyle medicine. I coined the term “Precision Lifestyle Medicine” to specifically focus on the 70% of environmental factors that you can influence, once you are armed with your 30% genetic knowledge.
ADx Health is working to put this knowledge into people’s hands and in 2022, we’ll be releasing our GenoRisk test so you, too, can take health into your own hands.
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