Precision medicine. Sounds sleek, right? Futuristic. Empowering. It is none of those things. Mostly.
Today you can have your entire genetic code sequenced. All those A, C, G, T letters. For a thousand dollars. Cheap? Consider it a steal compared to the one hundred million it cost two decades ago. Partial sequencing is cheaper still. One hundred bucks gets you a partial glimpse.
“Direct-to-consumer genetic testing is ‘only a click away,’ like 23andMe”
You know the ads. Ancestry. Health. Love. But here is the rub. Many of these tests have not been properly validated. They might be useless. They might even be wrong. Flat-out false.
There is a hunger for this data. People want to know. But when researchers checked the work? An alarmingly high false-positive rate. Forty percent of the time. Specifically regarding the BRCA gene. You know the one. Angelina Jolie carried it. Tests flagged people as high-risk when they weren’t. Not close. Not borderline. Wrong.
Worse? They misclassified real variants as dangerous when they were harmless. Scary outlier results keep customers paying. They make the fee feel worth it. It sells. False alarms cause stress. They trigger unnecessary mastectomies. That is a heavy price for bad marketing.
We have identified thousands of genetic variants linked to complex diseases. Genes. Lots of them. But does that help?
“Nevertheless, the discovered gene variants do not markedly expand our predictive ability compared with what can be achieved by only information from long-known traditional risk factors ”
Look at type 2 diabetes. Fifty genes linked to the risk. Fifty. Yet obesity beats genetics. An obese person with low genetic risk is five times more likely to get diabetes than a lean person with high genetic risk. That is a brutal multiplier. A thin person with “bad genes” is safer than a fat person with “good genes.”
So what is the point? Who gets the message? It might lull the overweight into a false sense of security. Genetics do not change who needs lifestyle intervention. Everyone with excessive body fat needs to lose it. Regardless of your DNA.
What about that famous study on personalized nutrition? The one claiming blood sugar responses are so unique we need individualized diets?
Read the actual study. The model does not show high interpersonal variation. It is not better than current methods. Personalized advice does not beat standard advice.
Maybe knowledge motivates? The argument goes: show me the risk and I will act. It is a nice idea. Forlorn.
Researchers tried. They gave people expensive tests profiling risks for up to forty diseases. The goal: empower. The result? Nothing. No diet change. No lifestyle shift. Not in the short term. Not ever.
They randomized people into personalized nutrition groups. Tell them to eat greens. Lower cholesterol via genetics. At six months? No change. Not at three months either. No difference in weight. No drop in belly fat. Cholesterol stayed put. Biomarkers did not move.
Smoke if you must. The studies say knowing you are at high risk for lung cancer does not stop smokers. Telling people to exercise or eat well because of their DNA? It fails. Every time.
Why then the presidential push in 2015? “Empower individuals to take a more active role.”
Marketing. Pure marketing.
“It exploits the appeal… to generate political and public support… for an increasingly industrialized medical-industrial and scientific complex, which moves trillions of dollars around the globe”
Not a conspiracy. Just capitalism.
Healthy living threatens profits. Less sugar. Less meat. Healthy populations mean fewer doctors. Fewer drugs. Lower revenue.
“Healthy living directly threatens many powerful corporations …”
We ignore the evidence. We spend overwhelmingly on clinical care. We clean up the mess after we eat the sugar. We outspend other nations. We get worse outcomes.
Overrated promises. Vested interests.
Let’s go back to the start. Broccoli. Stairs.
Forget the 5.6 percent risk. Forget the 7.7. A sensible lifestyle beats the numbers. Every time.
