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Genetic testing: Just a click away



By Mignon Fogarty
This article originally appeared in The Scientist, June 21, 2004, p.64.
 
You know a technology has hit the mainstream when people start using it for amusement. Remember when cell phones only made sense for physicians and realtors? Genetic testing had this niche aura; until recently only “serious” tests were available, and only through a genetic counselor or doctor. Today, genetic testing is heading the way of cell phones: it’s hip, entertaining, and commonplace. Consumers can order genetic tests online that shed ­ albeit limited --  light on ancestral ethnicity, on how the body processes prescription drugs, and how it handles foods and environmental toxins. This last type of testing, the kind I covet, is also called genetic nutritional profiling, and involves genotyping 19 genes that influence how your body metabolizes nutrients.

Thinking that I was a click and a cheek swab away, my excitement reversed course when I saw the price: $395. The recommended nutritionist consultation adds another $200. It’s this person’s job to convince us that having great “broccoli processing” genes doesn’t mean we’re free to swap florets for french-fries. Obviously, not everyone can afford to be privy to his or her own makeup. I may be a genetics groupie, but $395, let alone the $200 for the consult,
seemed steep for news that in all likelihood would advise me to eat more greens and avoid charred hamburgers. But still, I wanted it.

I also wanted to know if there were other genetics groupies out there. So I asked Carolyn Katzin, a nutritionist at the Center for Health Enhancement at St. John’s Health Center in Santa Monica who offers the testing as part of a complete nutritional analysis. According to Katzin, groupies fall into three categories: those whose family history includes a disease they
believe can be influenced by diet, such as cancer and heart disease; those who want the newest and latest (“We are in L.A. after all,” she jokes); and adoptees who lack their medical histories.

I nodded knowingly. My adoptee status has always fueled my obsession with genetics; such knowledge is an obvious way to fill in family medical history blanks. My mind was saying go for it, but the $395, plus consult, was still a factor.

I asked Katzin about the benefits, suspicious that I would learn nothing more than the basic health tips I already know by heart. Katzin explained that the outcomes are just one piece of the puzzle, like knowing somebody’s blood chemistry or weight. “I could still help them without that information; but by having it I can do more,” she says.

Hmmm. It sounded like these tests weren’t going to change my big picture much. Perhaps sensing my skepticism, Katzin continued, explaining how her own test results showed that she doesn’t process cigarette smoke toxins well, which makes her more diligent about avoiding second-hand smoke.

Now it made sense: The results deliver scientific knowledge, which motivates you to stick with the tried and true. Inspiration is something I can use. I was sold, but I still wanted to keep the price down. In the gadget industry, they say a product appeals to the masses only after it drops below the $400 point.

Since my genes aren’t going to change over time, a step-wise approach seemed workable. I could do the test for $395, and later take the results to a nutritionist if necessary. I’ve had cholesterol checkups without any medical interpretation and they were still useful. Katzin agreed that I’d incur no harm without a consultation, she simply pointed out that I might not get “the full benefit” of the results. For example, a variation in a vitamin D processing gene might indicate that I was at increased risk for osteoporosis, but my risk level also would depend on how active I was in my 20s, when I was laying down bone. A well-trained nutritionist can hunt down such distinctions. I noted the point for future reference.

As I clicked through the order form, I mused that I’ve never paid $395 for a cell phone, and weighed other options for spending the money. iPod? Heart rate monitor? Really nice tree? After much agonizing, I ordered the test.

I’m still waiting for the results; and I’m unsure whether knowing that I have a mutation in the PPAR-gamma2 gene, which would indicate that I have reduced insulin sensitivity, would get me to the gym more often. But, I’ve just invested $395 in the belief that it will.