This DNA test might be worth the price if it can guide you to a healthier and longer life. On the other hand, it might bring the bad news that you have no hope. As a word of caution, this is a really long article.
'If I’m genetically predisposed to a horrible disease, I’d rather not live in fear, which is why I’ve never troubled a DNA testing firm with my spit. But FitnessGenes is different. The company — co-founded by the geneticist couple Dr Samantha Decombel and Dr Stuart Grice — doesn’t tell you if you are at high risk of breast cancer, Alzheimer’s or Parkinson’s.
It aims to help you understand aspects of health that you can improve through diet and exercise. So having identified genetic variants that influence, say, your propensity to gain weight, build muscle or suffer disturbed sleep — and crunched data such as your weight and activity levels — FitnessGenes provides personalised recommendations. “The whole picture is the lifestyle — where are you now? And the genetics — what risks can we see emerging in the future?” Grice says.
A full report costs £99 (about a fifth of what another company offering a less comprehensive service charges). Or just £39 if you have an existing DNA file, having already shared spit with 23andMe or ancestry.com, because they use the same sequencing technology. Plus, they offer a lifestyle analysis free of charge.
Let me at it. I receive my kit and send off my saliva sample for close to a million genetic variants to be analysed. Basic biology reminder: we inherit our genes from our parents, getting one copy of each parent’s chromosomes. Therefore, two sets of chromosomes and thus two alleles (or variants) for each gene that predispose us to this or that.
I also fill in a lifestyle questionnaire online. Essentially, I don’t struggle with my weight. In midlife I’m 47kg at 5ft 2in with body fat of about 24 per cent. (Though in the pandemic I ate a box of Maltesers daily and my fat percentage rose to 31.)
On an average day, I eat a lot, but not much is ultra-processed. Typically, coffee with cream, peanut butter on sourdough (no sugar or palm oil in either) for breakfast; homemade bean salad, tuna and avocado for lunch; fruit, dried fruit, Greek yoghurt, many nuts as snacks; bolognese or fish and rice or potato, some vegetables, then homemade flourless brownie for dinner. I’m fussy but won’t deprive myself — I love fish and chips, and chocolate. I don’t drink much alcohol (a glass or two a week). And I don’t smoke.
I swim about 12 lengths of my local 61m lido four or five times a week. I do a couple of online “yoga for strength” sessions weekly. I intermittently run (a feeble 3km slowly on the treadmill) or use the machines at the gym at their lightest setting.
Six weeks later, an email gives me my results. A hundred and fifty traits are provided (grouped into relevant categories such as inflammation, and blood sugar) and to paraphrase TV mob boss Tony Soprano, I have stinking, rotten, putrid genes. It’s surprising I don’t have to be winched out of bed by a crane.
FTO is the gene for appetite, and like just 14 per cent of people, I have inherited two copies of the “increased obesity risk” or, if I may, fatty-boom-boom A allele. Neuroimaging studies show that AA carriers’ brain circuitry reacts differently to high-calorie food and is more responsive to ghrelin, the hunger hormone.
APOA2 is the gene for your response to saturated fat intake. I, like an unlucky 7 per cent of the population, have two copies of the G allele, associated with “greater sensitivity to saturated fat intake”.
IGFBP3, a gene for regulating growth and development, brings more bad news. Like 43 per cent of the population, I have one C allele. “A copy of the C allele is associated with higher body fat risk. I’ve got the C allele,” I wail to my husband. “You’ve got the seal allele,” he replies.
I can’t argue. MC4R is a gene associated with overeating. I have one copy of the “increased uncontrolled eating” allele. My one “normal control over eating” allele is working overtime.
A few saving graces. My PPARA gene reveals two copies of the “fat-burning” G allele — “perfect for those undertaking endurance-related activities”. I also have two copies of the “reduced health risks when obese” allele (luckily).
However, I am slightly ruffled when I speak to Decombel and Grice on Zoom. Grice, 43, a biologist and former researcher at the Functional Genomics Unit at the University of Oxford, asks about my eating habits and tells me I have variants associated with risk. “But there are actions to mitigate the risk,” he says, “and you’ve actually just described several — moving to pulses and whole foods, being mindful of when the hunger is. Some genetic variants only confer risk if you eat lots of fat, or if you are inactive, or if you are overweight.”
Incidentally, this is why Tim Spector, professor of genetic epidemiology at individual’s College London and co-founder of Zoe, the personalised nutrition company, believes DNA testing is the “wrong approach” to optimising our diet. “Our genes are codes that exist but whether they are expressed or not to impact our health depends on our lifestyle, sleep, diet and movement,” he says. The Zoe app notes, “For some people, genes account for just 25 per cent of their predisposition to be overweight, while for others, the genetic influence is as high as 70-80 per cent.”
To be fair to FitnessGenes, their nutritional recommendations promote a healthy gut microbiome. And my lifestyle might be overriding my lousy DNA, but as Grice notes, this isn’t the case for everyone. I feel it’s useful to know these risk factors, and to understand why you might, for instance, auto-eat when stressed.
“If I’m having a stressful day, I’ll walk to the kitchen,’’ Grice says. “I’ll consume something without even noticing. It’s part of a dopamine reflex ‘oh I’m a bit stressed, I need to put something in my face hole’ reaction.”
It makes sense when he explains, “Over hundreds of thousands of years we evolved to, when there’s high- calorie food present, eat it as quickly as possible, because it was scarce.” Until recently, gene variants predisposing us to increased hunger or desire to eat in certain stress situations would be successful gene variants to have. “But now we live in the obesogenic environment, actually that causes chronic illness.”
Helpfully, FitnessGenes combines variants such as my FTO (AA) with thousands of others, plus my lifestyle data, and groups them into relevant traits and categories to give a holistic overview of my situation.
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For instance, I have 27 traits relating to fat loss, covering factors such as metabolism, hunger and lifestyle. “The use of lifestyle data enables us, for example, to highlight that your current behaviours around food are good,” Grice says. “Reviewing your genetic predispositions enables us to understand the many health risks that can build over time, such as accumulation of visceral fat or loss of muscle mass, and importantly, begin to mitigate that risk now.”
Annoyingly, I’m at risk of developing poor insulin function thanks to two copies of a “raised fasting glucose levels” allele. An “insight” is that following the Mediterranean diet lowers the impact of my uncontrolled eating allele. One recommendation is to drink green tea, found to keep sugar levels healthy and reduce inflammation.
Every piece of information and advice is backed by scientific research. For example, in my “building muscle’’ category, one of 20 relevant traits is “muscle strength, lifestyle” — and it’s noted that my behaviours are a good platform for improving muscle strength.
There are detailed “insights” as to how and why we lose or preserve muscle as we age. And 26 possible “actions”, eg “get plenty of leucine in your diet, through foods such as salmon, chickpeas and brown rice . . . an essential amino acid important for muscle protein synthesis . . .”. Citations are available to view. You can save each “action” (there are hundreds) for easy reference.
There’s a lot of exercise-related detail too. I was always picked third last for rounders, so no surprise that my body “is unable to produce the ACTN3 protein”, the “gene for speed”. A few variants support endurance activity, suggesting I could try harder.
As for biological ageing, while I have a gene variant linked with shorter telomeres, accelerating it, and another with “enhanced cell ageing” (which for a thrilling second I thought was a positive), I carry variants “linked with greater longevity and a reduced risk of critical illness in old age”.
My heart health-influencing genes are another mixed bag. There’s a variant linked to potential cardiovascular benefits from caffeine. I have one copy of an allele linked to “increased high blood pressure risk”.
My £99 also entitles me to fortnightly “trait releases” (the latest, “risk of raised liver fat levels”.). You can also buy a “genetically tailored” workout plan, starting at £29 — “the number of reps, sets, rest periods, all take into account your genetic results,” Decombel says. They offer four types (Get Fit, Build Muscle, Lose Weight, Get Lean) and you can choose your fitness level.
While my Get Fit: Starter schedule is a bit overwhelming (planks, push-ups, donkey kicks, squats, pelvic thrusts, lunges, and that’s just day one) I can understand why FitnessGenes is especially popular with people aged 35 to 55.
“Getting to that age where things start to creak,” Decombel says. I absolutely should be squatting and planking more now — but their advice does change as you age. For instance, Decombel says, “In the weight loss category, when we know you are perimenopausal, the recommendations alter slightly to take that into account.”
The pair (who’ve been together since they were teenagers and have two children) started out 12 years ago. Now their company, based in Oxford and London, employing a clinician, medical technician, biometrician, a sports scientist and a clinical nutritionist — aims to help anyone stay healthy longer, tuning recommendations according to clients’ age and sex, as well as lifestyle and DNA.
“We’re focused on preventative health and actionability,” says Decombel, 42, who has a PhD in genetics from the University of Birmingham. She put her expertise to valuable use when her mother mentioned she’d had high cholesterol for a decade.
Decombel told her to add oats, oat bran, flaxseed, soya products, tofu, edamame beans, garlic supplements, phytosterols and psyllium husk to her diet. In three months, her cholesterol dropped by 25 per cent. “We can do that for so many people, based on their risk factors,” Decombel says.
It’s good to be tipped off without being scared witless. It makes me determined to stay fit and get stronger (my ACTN3 TT allele is associated with lower muscle mass in older women). I will tweak my exercise routine to include more strength training. I also buy B and D vitamins, as I have a “high risk” of reduced absorption. I note that I can also increase my B12 levels by eating fresh tuna, salmon and eggs. Ultimately, I feel empowered.
Meanwhile, Decombel and Grace are well aware that some biotech companies focus on diagnostics, say, identifying the BRCA2 variant that is associated with increased breast cancer risk. But, Grice says, receiving such information with limited genetic counselling can cause panic.
“There’s a business case for us to go down that avenue. I don’t think there’s an ethical case. If we cannot solve the problem via fitness, nutrition and exercise,” he adds firmly, “we shouldn’t be telling people.”
https://www.thetimes.co.uk/article/dna- ... -lwzqx5qncWe make our world significant by the courage of our questions and by the depths of our answers.
