| | Predicting your health future and tailoring your treatment plan based on "functional assessments" and "genetic testing" Much of the "confusion" and contradiction within the realm of health and healthcare stems from trying to apply one diet or treatment to a wide range of people and expecting to get consistent results. While we can make some appropriate generalizations such as for a "basically healthy diet" and "exercise plan," until recently both doctors and patients have lacked the ability to assess and understand the subtle differences in physiologic function and gene expression that differentiate one patient from another and explain why some people are healthy and respond well to treatment while others have chronic health problems which are refractory to the usual interventions. Previously, this literal "lack of insight" into the molecular-biochemical uniqueness of each person has created frustration for doctors and has contributed to the reduced quality of life for many patients. Functional Medicine: assessment and correction of subtle physiologic function In the early 1990's a new branch of healthcare was born - Functional Medicine. This science-based approach to assessing, treating, and preventing a wide range of health conditions was a major breakthrough since it allowed, for the first time, the ability to assess for subtle variations in physiologic function that were previously invisible. "...a functional medicine approach would insist that alleviation of symptoms and prevention of illness are not sufficient goals in the practice of medicine. Medical goals must also include support of vitality and wellness in the patient's overall life experience."
Functional medicine has now merged with clinical genetics to produce a new field of healthcare: Genomic Medicine. Many of the earlier functional assessments were based at least in part upon detecting the end-products of faulty metabolism that results from gene-environment mismatches. Now, we are able to test for the genes themselves. Genomic Medicine: assessment of and compensation for genetic defects As of April 2002, the new frontier of healthcare has become available on a widespread basis. Previously only available in research centers for specific diseases, genetic testing is now available for all patients, for a wide range of conditions, and at a reasonable cost. Let's look at why these tests are valuable, and why they may be important for you. Virtually all-human diseases result from the interaction of genetic susceptibility factors and modifiable environmental factors, broadly defined to include infectious, chemical, physical, nutritional, and behavioral factors. Gene-Environment Interaction Fact Sheet Centers for Disease Control and Prevention, August 2000
We are all aware the "genes" and "heredity" play an important role in determining our susceptibility to certain diseases, and that this is why certain diseases such as heart disease and cancer tend to "run in the family." The problem in the past was that, even though we knew a person had such hereditary tendencies, we did not know how to intervene to help the patient modify his/her lifestyle to effect the greatest possible reduction in disease risk, especially when we were confronted with complex conditions such as cancer and heart disease, both of which are multifactorial (involving many different factors). Genes + environment* = health/disease
*environment = diet, exercise, social health, chemical exposures, vitamins, botanicals, medications, etc.
Environment | Genes (susceptibility) | Result: health or disease | healthy-optimal | healthy-optimal | perfect health | | healthy-optimal | average | excellent health | | average | healthy-optimal | good health | | average | average | average health: remember that "average" health in the US means facing a 33% probability of cancer and a probability of dying of heart attack. Average health is not desirable! | risky-unhealthy | average | poor health | average | risky unhealthy | poor health | risky-unhealthy | risky-unhealthy | poor health and early death |
The problem in the past was that we had no way of assessing which genes the patient had, so we therefore had no way of tailoring the environment-lifestyle-diet to the patient's specific needs for optimizing gene-environment interactions. The new genetic tests allow for patients to have specific and detailed insight into their heritage and their inherited tendency toward health and disease. With this information, doctors and patients can more effectively work together for the best possible health outcome for the patient. As exciting as this is for patients with established health problems, the potentials and possibilities are even greater for children, who can now be assessed for future risk of disease and begin to incorporate healthier diet, lifestyle, and treatments into their life at an early age, thus tremendously reducing the risk of future disease. 
Additional information about genes and genetic testing: looking for "snips" When we perform your genetic test, we are looking for genetic traits which will indicate that you are at higher or lower risk for certain diseases. We actually test for the gene defects themselves, which are called "snips" after SNP - single nucleotide polymophism, which basically translates into "singe gene defect." To put this in perspective, looking for a SNP is like looking for a single human being on the entire face of the earth. Even one bad gene can mean the difference between life.. or early disease and death. Even if only one gene is defective, it can alter the function of the entire body.
Genes code for amino acids in proteins. Proteins carry out the functions of cells. Therefore, if a gene is defective, its corresponding protein will also be defective, and the body will not function optimally unless the genetic defect can be compensated for, such as with therapeutic nutrition and botanical medicines. The new genetic tests allow for patients to have specific and detailed insight into their heritage and their inherited tendency toward health and disease. With this information, doctors and patients can more effectively work together for the best possible health outcome for the patient. As exciting as this is for patients with established health problems, the potentials and possibilities are even greater for children, who can now be assessed for future risk of disease and begin to incorporate healthier diet, lifestyle, and treatments into their life at an early age, thus tremendously reducing the risk of future disease.
http://starbulletin.com/2000/07/18/news/story4.html http://content.nejm.org/cgi/content/short/343/2/78 http://www.cdc.gov/genomics/info/books/21stcentury.htm Human Genome Epidemiology  Articles
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