The Failure of Decoding the Human Genome and the Future of Medicine

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THE DECODING OF THE HUMAN GENOME at the dawn of the millennium carried the hope and promise of the beginning of the end of human suffering. However, after more than a decade of intense exploration of the human genome the burden of human disease and suffering has only increased across the globe. Heart disease, cancer, and diabetes as well as allergic and autoimmune disorders have all continued to skyrocket. Hope has given way to disappointment as scientists have recognized that, other than in single gene disorders likes Down’s syndrome, your genes don’t determine your fate.

In November of this year a review on Genomics, Type 2 Diabetes, and Obesity in the New England Journal of Medicine(i) sadly reported on how little correlation exists between obesity, diabetes, and your genes. There are associated patterns that confer small risks, but the authors lament the lack of stronger connections between genetic makeup and the biggest disease epidemic of our time (obesity and diabetes) with refrains such as “modest effect size”, “relatively few successes”, “remains far from clear”, “poorly captured by existing biologic knowledge.”

The story of your health is much more complex than genetic programming. It is ultimately determined by the dynamic interplay of the environment washing over genes creating the “you” of this moment. The good news is that this has been the year of discoveries about “omics”—epigenomics, exposomics, nutrigenomics and microbiomics, and toxigenomics—that do, in fact, hold the key to unlocking our health and disease mysteries.

Science is now proving what we all knew intuitively—that how we live, the quality of our relationships, the food we eat, how we use our bodies, and the environment that washes over us and determines much more than our genes ever will.

The Epigenome: Bypassing Darwin and Evolution

More important than our collection of genes, it now appears, is how those genes are controlled by both internal and external factors—our thoughts, stress, social connections, what we eat, our level of physical and mental activity, and our exposure to microbes and environmental toxins. These factors are switches that turn genes on and off and determine which proteins are expressed. The expressed proteins, in turn, trigger signals of disease or health.

What’s even more striking is that if your DNA is tagged by an environmental factor, such as a pesticide, the impact this environmental factor has on your genes can be passed down through generations. The “epigenome” become inheritable. That means if your grandmother ate too much sugar, or smoked, or was exposed to mercury from too much sushi, the genetic modifications she incurred from this exposure could affect you. Her epigenome would carry an increased risk of disease that could be passed down from generation to generation. Interestingly, the Darwinian and Lamarckian worldviews are intersecting in 2010.

The Exposome: Environmental Influences on Health and Disease

In October 2010 Science magazine(ii) published an important paper that reviewed the notion of the “exposome”—the idea that the environment in which your genes live is more important than your genes themselves. What this suggests is that applying genomics to treat disease is misguided because 70-90 percent of your disease risk is related to your environment exposures and the resultant alterations in molecules that wash over your genes.

The question then is how do we measure and change our “exposome”—or the totality of the impact of the environment on your genes. We must address not just one factor but the whole collection of interacting factors that determine health and disease—toxins, food, microbes, internal chemicals including all the biologically active molecules that control inflammation, oxidative stress, gut flora, and other natural processes.

Emerging biomarkers and analytic techniques will soon allow us to map our exposome from a drop of blood, and measure change over time. Using novel treatments that help identify and remove known external toxins (like pesticides and mercury) and strategies that change the internal environment including diet, nutrients, probiotics, and detoxification would help you change your “exposome” and lower your overall disease risk.

Once this new paradigm of understanding how a lifetime of interacting exposures interacts with your genes to determine your chronic disease risk, once the gene-environment interactions are mapped more carefully, then the promise of the genomic revolution can be fully realized.

Nutrigenome: Eating Your Way to Better Genes

The most important thing you do to control your genes every day is eat well. Food; and the combination and quality of macronutrients (protein, fat, carbohydrate), micronutrients (vitamins and minerals), fiber, and phytonutrients (plant-based bioactive compounds); all wash over your DNA every day turning on or off, up or down signals from your genes. This field, called nutrigenomics,(iii) offers a powerful way for you to control your destiny.

Researchers have found, for example, that depending on your genes, you may respond better to different diets—some do better with more fat and protein and less carbs, others may not. One of the most important discoveries of the decade is how food—whether it is plant-based, nutrient-rich, phytonutrients-rich food, or processed, high sugar, nutrient-depleted food—changes your gene expression in real time over the course of weeks to months. Dr. Dean Ornish showed how this works in his seminal prostate cancer research.(iv) He was able to beneficially affect over 500 cancer-controlling genes simply by having his patients eat a plant-based, whole foods diet.

Microbiome: The Most Important DNA in Your Body is Not Your Own

The human body hosts 100 trillion microorganisms. The DNA of the bugs living in and on you, outnumber your own DNA by 100 times. This is called the microbiome.(v) Our bodies are simply a host environment for bacteria. They use us for their own purposes. The molecules produced by the DNA of these bacteria have significant impact on our health. This is called “metaproteomics”.

This microbiome, particularly the ecosystem of nearly 500 bugs that live in your gut, have been linked to everything from obesity, to cancer, to autoimmune and allergic disorders and even heart disease and diabetes. Our modern lifestyle and diet and the overuse of antibiotics has changed the population of bacteria living in our guts and it has made us sick.(vi) Which bugs we grow in our intestine determine whether we will be fat or thin, inflamed or healthy. The critical discovery of this microbiome and its implications for influencing many of the diseases of the 21st century will provide novel treatments involving changing our diets and the use of pre-and probiotics to shift the gut ecosystem into a health-promoting balance. We are only as healthy as our gut bacteria.

What the Future Holds

The giddy back-slapping decoding of the human genome, has given way to a more sober view of the limits of genomics and the remarkable understanding of what we all knew intuitively—that how we live, the quality of our relationships, the food we eat, how we use our bodies, and the environment that washes over us and determines much more than our genes ever will. The next decade will better characterize how the environment affects gene expression—the genome-exposome interactions—and our health, and provide us better ways to measure and improve those interactions and help us create the best expression of ourselves.

Now I’d like to know your thoughts on this subject.

Do you think your environment is as important as your genes in determining health or disease?

What actions do you plan to take to incorporate this new science into your life?

In the New Year would you consider changing your diet and lifestyle to improve your health? What changes do you plan to make?

Let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, MD

References

(i) McCarthy, M.I. 2010. Genomics, type 2 diabetes, and obesity. N Engl J Med. 363(24): 2339–50. Review.

(ii) Rappapport, S., et al. 2010. Environment and disease risks. Science. 330: 460–461

(iii) Grayson, M. 2010. Nutrigenomics. Nature. 468(7327): S1.

(iv) Ornish, D., Magbanua, M.J., Weidner, G., et al. 2008. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Natl Acad Sci USA. 105(24): 8369–74.

(v) Caesar, R., Fak, F., Bäckhed F. 2010. Effects of gut microbiota on obesity and atherosclerosis via modulation of inflammation and lipid metabolism. J Intern Med. 268(4): 320–8. doi: 10.1111 Review

(vi) De Filippo, C., Cavalieri, D., Di Paola, M., et al. 2010. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci USA. 107(33): 14691–6

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16 Responses to The Failure of Decoding the Human Genome and the Future of Medicine

  1. Thomas E. Jackson January 1, 2011 at 11:38 pm #

    I am reading with great interest: 86 years of age, diabetic, COPD, some memory loss, reasonavbly good shape for age..live on beach in Australia, Fruit veg diet but not fanatic..some meat fish etc. Believe we were created to live to healthy , sane, happy productive seniority..Hallellujah Acres fan

  2. Matt January 2, 2011 at 1:15 am #

    I love thinking of my health as a portfolio of investments: the only way to give myself the best chance of enjoying positive returns in a relatively low-stress way is to research what suits my needs, remain disciplined in my strategies, make modifications if something doesn’t feel right for me, diversify, and adopt a long-term approach. It takes a lot of discipline, but just like with your state of wealth, so many things in life depend on your state of health.

  3. Nick January 2, 2011 at 4:52 am #

    I agree with everything other than genes to determine health. But looking at myself and my family, I have to say genes play a large role. My father has good health despite bad treatment of his body, and my mother has bad health despite decent treatment. This has passed on to two of my siblings. I have good health despite bad treatment as well.

    I think health and physical ability are determined by genes. Two of my siblings have good energy level, whereas me and my sister are low energy naturally. No matter what, I just couldn’t keep up with my other brothers.

    • Michelle April 3, 2013 at 8:30 am #

      I feel that you are just lucky.
      Your bad treatment of your body will catch up with you.
      Have you considered how much more energy levels you may have if you treated your body with more care and respect.
      Your mother???
      Maybe her health is fragil from any sort of reasons, but her decent treatment has kept her alive longert than bad treament might have.
      All thoughts, but worth considering

  4. Jane January 3, 2011 at 12:14 am #

    Human civilizations have collapsed as a result of factors less noxious than the average American diet and the vast and toxic food and agricultural empires behind it. The American diet (and all that goes with it), has been ruthlessly exported to the rest of a gullible world. I live in a country where the rates of obesity and diabetes now match those of the USA, no little thanks to Corn and Coke and Fast ‘Food’ (sic).
    What concerns me is that we chiefly learn our habits of life from our mothers, and mother no longer “knows what’s best”. We must look to grandmothers or great-grandmothers for that wisdom, and most of them are gone. Turning this ship around requires a critical mass of young persons such as Matt appears to be, and whether the world can attain that mass is open to question. I fear we will hit the iceberg – or have we already done so?

  5. Eddie Ndlovu January 3, 2011 at 2:15 am #

    Amen Doc, you hit the Nail on the head, The “epigenome” is inheritable and that means Humans have a choice in creating healthy bodies.They used to say this in the 1960s “You can Shit in your own Nest, Only for so long before you are Nesting in your own Shit” I apologize to my French but your article needs to be taken very seriously and is calling for Humanity to act in its own best interest, if we are to create future healthy generations. Diabetes is not genetic and has come up tops in the last 50 yrs, if a young pregnant mother eats lots of sugar and happens to be carrying a baby girl, the unborn baby girl’s eggs become insulin resistant and gets born insulin resistant but this is not genetic , you have just exposed the baby girl to the harmful effects of sugar, Amen Doc.

  6. Darren January 3, 2011 at 5:07 am #

    Great piece. Love it. Thanks.

  7. Stacy Heatherly January 5, 2011 at 12:12 pm #

    Thank you for this article.
    I am working on a documentary film that will focus on auto immune disease. The research I am finding and the information being provided to me supports what is stated in this article.
    There should be no fear that once a mutated gene is turned on thatit can’t be turned off.
    What need to be the focus is the correct tests to determine the bugs living inside out bodies, the damage we have done through the eating of GMO’s, contaiminated water, pestisides and other unhealthy habits. Correct all of these and we are on the road to recovery.
    I am hearing from people whose bodies have really taken a hit. Is it too late for some? Is the damage too extensive to repair? These are intimate individual issues that have to be determined.

    My hope. Change our children’s future health outlook.

    Thank you!

  8. annemarie January 18, 2011 at 9:25 am #

    wow what an interesting article. having lost my mother and mother in law to cancer recently, I have been investigating healthier eating strategies and started the Dr Junger Clean program 10 days ago. I had never heard of metaproteomics though! Thanks for the information I will definitely keep coming back to browse your website.

  9. Holly January 22, 2011 at 1:56 pm #

    I truly belive that this is the way to go. I studied yoga and had a great holistic nutrition teacher. It’s good to know that we have a little more say in how we feel- mindy,body, and spirit. I personally suffered some serious effects from stress and depression and getting the the stess back under control has saved my life.

  10. susan February 12, 2011 at 2:26 pm #

    yes I believe environmental toxins and diet are more important than genes. Genes are not our destiny.

  11. Lu Dodson February 15, 2011 at 12:31 pm #

    I have been paying attention to what I eat for years and as a consequence,I notice what others around me eat or DON’T eat. Your article seems to back up about 12 years of causual observation (anecdotal,not hard science): people who eat a nutrient dense,colorful plant bsed diet combined with excercise have less chronic disease,take less medication,and seem happier. This is across age groups. I have come to believe that it is what you don’t eat or don’t eat in enough quantity that makes a huge difference in health ,cancer expression,disease occurrence.

  12. Sai Kit March 20, 2011 at 1:48 pm #

    This really confirm me of my belief! I think ultimately genes are information. Our next generation can become more beautiful, healthy, and long live because of what we do to our genes.

    I also believe that genes are spiritual! The quality of your relationship can also affect it? It’s long known that your friends/company can determine who you become in a few years.

    Some reports from Russia say that we can change our genes by verbal commands. What do you think?

    Maybe I can tell my genes to make me more handsome, to not let a hair drop (no male pattern baldness), and produces extra growth hormones!

  13. Lily Vinh May 21, 2011 at 5:46 pm #

    Flasing back….1935, “Man, The Unknown” by Alexis Carrel, a French surgeon, biologist who was awarded the Nobel Prize in Physiology or Medicine …stated, “Human is a stranger in the world that he has created…He has been incapable of organizing this world for himself… he did not possess a practical knowledge of his own nature…. Until 2009, “the Decade of the Brain”, we inched a bit more in Discovering Ourselves. Now, 2011, another decade, Human Genome failed to tell us… “our ignorance is profound”, stated Alexis Carrel1935. Now 2011, his remarks still valid. However, I do believe and agree with Dr. Mark that the next decade may shed some positive light when we are closer in knowing what relations exist between the activities in the environment, to our mental and cellular activities. Plainly to put, the different frequencies of energy in the environment have a powerful effects on our mental/human energy/cellular. Until we realize the simplicity of “what control us”, then we shall take little steps toward mastery ourselves. As in everything else, we must not be dubbed by the different frequencies….only when Man is the measure of all things. You are on the right track, we need more doctor like you dr. Mark. Thank you.

  14. Gerri Vandermark August 2, 2011 at 7:17 pm #

    I have been hearing about a botanical product that reduces oxidative stress. There have been 8 published clinical studies published on pubmed.com, so far. The company states oxidative stress (from our diet, environment) is a contributing factor to many disease processes…that are started by environmental/bad lifestyle choices. Thank you for all you have done for the Daniel Plan!

  15. Debbie Tejada August 30, 2011 at 6:07 pm #

    Dr Hyman, I’m just now reading Ultra Metabolism and decided to look over you web site. Do you know Bruce Lipton? I’ve read his books and he is VERY convincing that environment and perception affects our genes. He’s a cell biologist that was working with stem cells in the 1970s and made a lot of discoveries that traditional western medicine is having trouble embracing. He knows a lot about the genome project as well. My favorite book of his is The Wisdom of Your Cells, info here:

    I’m loving Ultra Metabolism, it all makes perfect sense and I’m gradually incorporating your food recommendations into my family’s diet. Now if I could get an appointment for my son to see you… (he’s 16, Type 1 diabetes for 10 years).

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