Genes Times Habits
"Your genes are not your fate, they are your predisposition”
- Dr. Dean Ornish
Selling genetic testing kits and summary insights related to your genome is not a great business.1 Our genes do not change and their specific causal impact on our mind and body has been difficult to prove at scale without more controlled studies.
Selling habit formation, motivation and maintenance is a great business but extremely hard to do well. People often have a strong desire for habit change but a combination of biological and environmental factors make long-term habit change very difficult for most.
Do insights from genetic markers aid long-term habit change and efficacy?
With the dramatic reduction in the cost to map our individual genome / DNA in the last 20 years, a new tool has emerged for wellness practitioners like functional medicine doctors, naturopaths, coaches and others: genetic testing.
Their hypothesis is that understanding specific gene variations (aka single nucleotide polymorphisms or SNPs) increases the likelihood that certain habits can be more readily adopted, thus increasing the likelihood a desired intervention will be efficacious (e.g. the ability to wind-down and sleep, manage stress, maintain focus, increase immune system efficacy, burn fat mass, etc).2 Conversely, if a certain intervention, which is selected due to a genetic marker, leads to a near-term better quality of life, it would make sense that compliance for such habit change is easier to maintain.
Interestingly, most traditional MDs do not request a readout of your genetic markers which is in stark contrast to the standard practice of measuring your blood biomarkers regularly. This is primarily because:
1) There is not enough causal evidence to pinpoint specific genetic variants causing health issues (since non-genetic factors also play a key role as outlined below).
2) Testing can still be expensive for the average person.
3) There is widely believed quackery in selling genetic testing paired with supplements.3
That said, clinical studies are beginning to show meaningful correlation between gene variants and health outcomes.4
The single most misunderstood part of our genes?
Our genes can be turned ‘on’ and ‘off’ by environmental factors. This is called epigenetics. While our DNA and genes do not change, a chemical process called methylation can function to effectively turn on or off a wide variety of our genome.5 I define environmental factors here to include individual behaviors like nutrition, sleep and exercise as well as exogenous factors like exposure to chemicals (e.g. air pollution), sunshine, temperature, and nature.
Epigenetics explains why attributing either 100% nature (e.g. our genetics) or 100% nurture (e.g. our upbringing or current environment) to a particular personality trait or complex bodily function is near impossible. Scientists do not yet have the ability to accurately measure gene methylation down to the DNA level.6 However, studies of identical twins have shed light on how different environmental factors can impact DNA / gene expression in humans despite these twins having the same underlying DNA.7
To use an analogy, the DNA in our genes provides the “base programming code” for the human body to make new cells – about 4 million new cells are created every second.8 Think of that DNA code as a complex set of tree branches. Methylation, or the presence of methyl groups9 sitting on top of that DNA, acts like leaves selectively placed on that DNA tree branch. Both the branch and the amount of leaves attached to it impacts how the underlying code is actually written each second.
Why does gene methylation matter?
Abnormal gene methylation is associated with everything from the likelihood of cancer (i.e. a cell’s coding gone terribly awry) to the rate at which hormones are generated and cleared in our bodies. We also know that environmental factors *may* impact how genes are methylated.
As such, a “healthy” lifestyle may impact not just the observable body and mind, and not just the numerous biomarkers measured from a blood sample, it could impact the literal code that your DNA / genes use every millisecond to keep the trillions of cells in your body functioning properly.
What is unknown today is whether certain types of methylation i) directly cause unwanted gene expression or ii) are merely correlated with unwanted gene expression (and there is some other underlying cause).
Why should knowledge of genetic variations impact healthy habit formation?
Anyone who has dabbled with the litany of health and wellness podcasts out there knows that there is a deep rabbit hole of lifestyle changes to adopt for “optimal performance”.
I believe the most promising part of identifying specific, well-documented gene variations (or SNPs) is to help prioritize which habits to focus on. On the dinner menu of “Health & Wellness Habit Changes”, there are way too many options leading to analysis paralysis. People with more time and resources can continually experiment (see Trial and Error) but genetics may help provide an initial guide on where to focus for the more time-constrained.
I see a strong consumer value proposition for the following service. A trusted 3rd-party identifies certain genetic variants or SNPs related to a particularly important need state (e.g. people who consistently find it challenging to get high-quality sleep). Measuring genetic variants for chronotype, hormone regulation, and other information, the service clearly *prioritizes* certain lifestyle habits and offers convenient, efficacious products to maintain them.
23andme never quite nailed the habit prioritization and formation angle as it’s difficult to scale.10
Habit formation is about baby steps. There is a lot of value in thoughtfully identifying where to start and how to keep the snowball rolling.
I am talking primarily about 23andme. A business like Ancestry, which provides ongoing access to consumers to research familial trees is a better business.
In certain very select applications, some biotech companies are beginning to measure gene methylation in a specific part of DNA in a specific cell type like human T-cells (e.g. VC-backed Moonwalk Biosciences)
A chemical group consisting of one carbon atom bonded to three hydrogen atoms or CH3.
Instead, 23andme bet that their anonymized data would lead to a strong portfolio of novel pharmaceutical drugs with partner GlaxoSmithKline – which has not panned out yet.