Genetic Magic

Genetic magic was announced last week. Researchers found that variants of two bits of DNA on chromosome 9 are associated with heart disease. What this means is made clear in a New York Times article: scientists will develop a test for these variants and if you have them you’ll be treated to “early interventions like cholesterol-lowering statins and methods to reduce blood pressure.”

You take a test. It tells you that you’ve got the genetic variant for heart disease. Early intervention prevents you from having a heart attack. Doesn’t that sound great?

But if you dig into the actual research, there’s much less to this discovery than the news suggests.

First, genetic scientists have yet to identify what this stretch of DNA does, which means they have no idea what biochemistry the two bits of DNA affect.

Second, these two bits of DNA aren’t associated with any of the standard risk factors for heart disease. So if you have them you’re a candidate for medication regardless of your levels of cholesterol or C-reactive protein or blood pressure or what have you. We’ve been critical of those standard risk factors. Could it be that this DNA variant is pointing to the real cause of heart attacks, a cause that has nothing to do with cholesterol-lowering and all the other conventional treatments?

Third, the two DNA variants are virtually absent in Africans. And while they’re present in African-Americans, there’s no association with heart disease. That is, these DNA variants are risk factors for European-Americans only, not for African-Americans. So in contrast to the last point, could it be that this DNA variant is pointing to some utterly superficial relationship to heart attacks?

Fourth, the risks involved are not dramatic. Each chromosome has two strands of DNA. If only one strand has the variants, your risk goes up by about 20%. If both DNA strands have the variant, your risk goes up by 40%. To put this in perspective, out of 1,000 people who lack the genetic variants, about 125 would have heart disease. Out of 1,000 people who have the variants on both strands of DNA (the worst case), 175 would have heart disease. That’s 50 additional people out of 1,000. However, most people with the DNA variants (825 to be exact) do not have heart disease. In other words, having these DNA variants is a very long way from a death sentence.

Let’s review some basic genetics. A gene does its work in response to a biochemical signal. The ultimate source of that signal is your environment, whether physical or social. Splashy news about a gene typically leaps over that chain of events. You have the genetic variation so you’re at risk so it’s off to the pharmacy for you. Not true. Your genes with their variations have to get the signal to launch the biochemistry that puts you at risk. No signal, no risk–at least not from that particular process. And the signal comes from your environment, which includes the food you eat, the physical activity you engage in, and the toxins to which you’re exposed.

It’s a safe bet that you want to stay out of harms way. That’s why the promise of science as magic is so seductive. But in fact it’s completely unhelpful. It threatens to steer increasing numbers of people into the same old tired routines that represent your body as possessed by evil spirits with drugs and surgical interventions as the exorcist.

News like this diverts our attention from what we can actually do to protect ourselves: change our exposure to the things that send the wrong signal to our DNA.