I have long sounded an alarm about the potential "dark side" to the otherwise glowing promise of genomics: counting on genes, to account for what ails us, may cause us to dither while waiting for answers we don't yet have, and squander those we do, along with the clear and present opportunities to promote health through better living those answers provide.
How nature might one day hone the cutting edge of biomedical advance, in other words, might blunt our application of nurture. The lens through which I view the world does, indeed, show exactly that view -- and has for quite some time.
But while my 'dark' view of genomics was limited to the threats of distraction and delay, a report just published by the Bioscience Resource Project goes considerably further. Their dark view -- which is predicated on the concession by premier geneticists that if there are genes that meaningfully account for common diseases, they are hiding in the dark matter of our DNA, whatever that is -- suggests that genomics is one part boondoggle, one part conspiracy by the military-industrial establishment.
What you should make of this truly dark view of dark DNA, I leave to your own judgment. I merely suggest for now that you read the report and reflect accordingly.
My own hope for genomic advances lingers, I confess. But at its best, that hope was and is a small flicker in comparison to the luminous promise of lifestyle. As I have noted before, feet, forks and fingers are the master levers of medical destiny and can rewrite our fate at the very level of whatever genes we harbor. Avoiding tobacco, eating well and being active could, by themselves and across a backdrop of genetic variation, eliminate something close to 80 percent of all chronic, degenerative disease. No Nobel Prize ever conferred -- in genetics or any other field -- was for an advance of this potential scope and impact.
It remains to be seen what promises genomic medicine will keep. It remains to be seen what insights might illuminate the dark matter of our DNA, if it exists. It remains to be seen if there is a genie of great power in our genome. It remains to be seen what we can do if genetic nature becomes malleable to us.
But the stunning power of nurture is a bird in hand. It is at your disposal right now. It only remains to be put to good use.
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Studies of gynaecological problems where there is a clear distinction between injuries to autonomic nerves sustained by multiparous women as a consequence of labor, and, nulliparous women with many years of straining during defecation, offer clear neurological explanations for benign gynaecological conditions including endometriosis, adenomyosis and fibroids (www.endometriosisexplained.com ). Each body cavity (thorax, abdomen and pelvis) carries a central autonomic nerve plexus (cardiac, celiac and hypogastric) from which nerves stream to every internal organ through intermediary plexi over different distances, before distributing in varied patterns in solid and hollow organs. Their injury results in organs enlarging, failing to function, being susceptible to unusual infections, alcohol, tobacco and drugs, as well as pain that persists after their surgical removal (www.western-diseases.com ).
Previously unexplained injuries to autonomic nerves (the “autonomic denervation view”) occur in every organ from our nose (acute allergic rhinitis) to our anus (anal fissures) as well as in our renal arteries in some forms of hypertension, and, in our myocardium in some arrhythmias. We know that straining during defecation, straining during labor, direct trauma and surgery are clear causes of injuries to autonomic nerves; we are looking for further sources of autonomic injury resulting from Western diets and lifestyles.
I regret that few of them result from genetics or genomics.
1. The haptoglobin protein helps clear heme iron, a powerful oxidant, from lysed red blood cells in the circulation. People with HP 2-2 genotype have reduced ability to clear heme iron. Although earlier studies did not show a benefit of vitamin E supplementation on cardiovascular risk, recent re-evaluations found significant benefit of 400IU vitamin E daily in individuals with the HP 2-2 genotype. For more details, see http://www.ncbi.nlm.nih.gov/pubmed/20415560 and http://talkingnutrition.dsm.com/en_US/public/pages/blog/20111105VitE_Stroke.jsp;jsessionid=9B92C019523003FED28AB3C6649DAFC2?DCSext.src=search
2. Beta-carotene is an important source of vitamin A for many people. New evidence finds that humans can vary by 45% in conversion of beta-carotene to vitamin A (http://www.fasebj.org/content/23/4/1041.full). A failure to randomize people to treatments according to this genotype may explain why earlier beta-carotene supplementation studies were not beneficial. It could be that only one genotype needs much higher beta-carotene intakes to benefit.
Clearly, everyone needs to do all they can today to maintain health. However, I am optimistic about genomics. If reliable tests were available to personalize IOM Estimated Average Requirements with known influential SNPs, it would be helpful.