Genes: To Test or Not to Test?

Tim Caulfield is the author of The Cure for Everything, which was released in paperback this week.

We are continually told we are living in the midst of a “genetic revolution.” You hear this from politicians, leading scientists and the popular media. And there are innumerable new, direct-to-consumer companies trying to sell you a genetic test. The companies promise everything from improved mate selection to weight loss to a longer and healthier life.

So what is a person to do? Should we all embrace the revolution and get our genes tested? Can you really improve your dating, waistline and overall health by implementing a high-tech genetic solution?

In short: Nope. Save your money.

I like to break down the currently available tests into three categories: the clearly preposterous, the marginally pertinent, and the vaguely predictive (but still not terribly useful).

The clearly preposterous: These are the tests that are based on very little good science and offer a service for a complex trait, such as the testing companies that promise to find you a perfect and genetically matched romantic partner. I suppose you could pick a mate based on your genes, but it would likely be as random as basing your selection on the “chemistry” you feel when you meet someone at a bar.

All of the cosmetic and anti-aging services also belong in this category. Sorry, genetic testing isn’t going to make our wrinkles go away. Stay out of the sun, don’t smoke, and get lots of sleep.

The marginally pertinent: Some testing companies offer tests that are related to things like diet, exercise and athletic ability. While there is lots of interesting research on the areas — particularly around topics like the genetics of obesity — the science isn’t at a point where you can derive significant benefit from tailoring your workout or food intake to your genetic makeup. This is especially so since very few Americans currently satisfy the existing dietary and exercise recommendation. For most of us, tweaking our diet based on a genetic test is ludicrous. Simply eat better. No test required.

The vaguely predictive (but still not terribly useful): These tests include the services that are more comprehensive, science-based and aimed at the prevention of common diseases. These are also the services that have received the most attention from both the popular press and regulators.

I got my genes tested by the company 23andMe. What did I learn? Turns out that I am at slightly increased risk for a range of diseases (heart disease and colorectal cancer, for example) and at decreased risk for many others. I found the testing experience fun and interesting, and the presentation of the information by 23andMe was both engaging and sophisticated. But did I find out anything of value from a health perspective? Not really.

Don’t get me wrong. The health advice I got from the company was sound. It was, in fact, what we should all be doing already! Exercise, eat lots of fruits and vegetables, drink in moderation, keep my weight down, and don’t smoke. But I didn’t need a genetic test to tell me about this. And neither do you.

This is the problem with the current wave of genetic testing services, at least in the context of common chronic diseases. The information they provide isn’t terribly predictive. More importantly, it doesn’t provide information that is more valuable (despite their claims to the contrary) than the basic preventative strategies we have long known. This is why one recent study on the value of the current consumer tests concluded that they are unlikely to have “any significant impact on the health of the public.”

The bottom line is that many of these companies, particularly the ones that fall into the first two categories, are simply exploiting the legitimate excitement and profile of genetic research to market largely useless test.

Be active, eat well and ignore the high-tech hype.

Tim Caulfield on Twitter: @CaulfieldTim


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'The Cure for Everything: Untangling Twisted Messages about Health, Fitness, and Happiness' by Timothy Caulfield
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