Jeans or Genes

The hunt for the “disease gene” continues to suck the oxygen out of the room. The latest pass shows shared genetic variants between diabetes and heart disease, with overlapping loci that the press will inevitably brand as the root cause of both. The promise, as always, is a new generation of drugs that turn those genes off.

I have a few concerns about that framing.

First, it sets up the slippery slope of impossibly tight targets. Fasting glucose and A1c thresholds keep creeping down to a place most people cannot reach without medication. Blood pressure is the same story. There is nothing protective about taking an 80 year old with stiff non compliant arteries and forcing a pressure of 110 over 60. A broken hip and a hospital stay are not far behind.

Second, it shifts the prize back to the gene and away from epigenetics, which is where most of the action actually is. Most human disease is polygenic. You do not fix one gene and walk away. The gene that “causes” your disease almost always has a normal function elsewhere, in immunity, in cell growth, in heart development. Suppressing it has predictable consequences. Say it with me: side effects.

Third, there is the gene company gold rush. 23andMe has come back from the dead, with a small army of competitors. They are at least more careful now to remind you that what they find may not be all that meaningful. Progress, of a sort.

What is actually important

You are not your parents’ genes. You are a new combination of them, yours alone, in a body responding to the food, sleep, movement, and stress you put it through every day. That responsiveness has a name. Epigenetics. My working definition: epigenetics is where Mother Nature and the environment meet your genome.

Now, the part I have been saying for fifteen years.

• Fish oil influences the expression of more than 400 genes, including many implicated in heart disease and diabetes.
• Marine omega 3s improve insulin sensitivity by increasing glucose uptake into muscle and helping balance blood lipids.
• Vitamins that work, work by influencing gene expression. That is the mechanism. There is no other one worth talking about.

What you eat, how you sleep, what you supplement, and how you move matters far more than most people with letters after their name would like you to believe.

What to do tomorrow morning

Get your omega 3 status where it belongs. Take a well dosed multivitamin to backstop the nutrient gaps in modern soils and modern diets. Watch your fasting glucose, your A1c, your hs CRP, and your ApoB. These are the numbers that respond to behavior. They are also the numbers that map onto the genes the researchers keep waving in your face.

Big Pharma will keep selling the gene story because there is no other product for them to sell. You and I get to do something different.

The choice is yours. Make the right one.

Dr Dave

Further reading:
do Amaral CL et al. DNA methylation pattern in overweight women under an energy-restricted diet supplemented with fish oil. Biomed Res Int. 2014.
Lind MV et al. Genome-wide identification of mononuclear cell DNA methylation sites potentially affected by fish oil supplementation in young infants. Prostaglandins Leukot Essent Fatty Acids. 2015.
Epigenomic maintenance through dietary intervention can facilitate DNA repair process to slow down the progress of premature aging. IUBMB Life. 2016.

— Doc