Does DNA = destiny? Part 2

Some of you may recall a previous post related to my experience with genetic composition testing designed to “optimize your daily nutrition and exercise routine to help meet your fitness and health goals.” I learned some interesting things and honestly, I just find genetics a fascinating subject in general. So, it didn’t take much to convince me to dive in again when I received a discount for 23andme’s Ancestry and Health test kit. They were having a buy one, get one half off sale so my husband decided to do it as well. (He’s adopted and has little information about his birth family’s ethnicity or health history, so he thought this could provide some answers in that arena).

This decision once again brought up debate and discussion about how much one really wants to know about their genetic composition, and how it might influence one’s behaviors and actions. I am firmly in the “all in” camp as I believe the knowledge gained would positively influence my life. For example, one of the tests is for predisposition to late-onset Alzheimer’s Disease. If I discovered I had the genetic variant that indicated I was at high risk, it would prompt me to get going on my “bucket list” and do things NOW that I might otherwise put off until retirement. My husband was not quite as sure how he would respond to such information, so he let me go first and made his decision after I got my results.

The process and test was easy (for this one you have to provide a spit sample in a tube), and I received my results in less time than the company indicated it would take. The results are provided online through your password-protected account. You also have the ability to connect with other relatives via the 23andme website. I discovered a few (known) cousins who’ve done the test and also other “genetic” relatives in the local area (people whom I don’t know but apparently we share some common DNA. Who knew?).

Here are some highlights from my results:

Ancestry

All my life, I have always stated that I am 50% Italian (as my father’s parents/grandparents emigrated from Italy), 25% German (through my maternal grandfather) and 25% Irish (through my maternal grandmother). Turns out, that’s close but not exact. Genetically, I am about 31% Italian, 22% British and Irish, 8% German and then a smattering of other parts of Europe, Western Asia, and North Africa. I’m more of a melting pot than I thought! My parents are going to do the test as well, so I will be curious to see how their results compare to mine.

Health and Traits

I have to say that the health information is quite comprehensive, and the company does give you a choice upfront about which results you do and do not want to receive. I opted into it all. I should note that you also fill out a health history form and other optional survey questions when you register for the test, which I think ties into the “traits” section of the results. If I understand the algorithm correctly, I believe some of the traits are based both on genetics as well as people’s preferences as determined by the survey questions. For example, one of the questions you are asked is your preference for vanilla versus chocolate ice cream. I think they take the answer to that question across all participants and then compare it to the genetic info to determine that people with this gene tend to prefer chocolate (or vice versa).

Health Predisposition

The four major health conditions in this section that you have to opt in or out of include:

  • Breast Cancer (BRCA1/BRCA2 – selected variants)
  • MUTYH-Associated Polyposis (colorectal cancer)
  • Late-onset Alzheimer’s Disease
  • Parkinson’s Disease

There are some other interesting conditions such as Celiac Disease, Age-related Macular Degeneration and Type 2 Diabetes. My test indicated that “variant(s) not detected” for all of the tests except Hereditary Thrombophilia and Type 2 Diabetes. It indicated I have a “slightly increased risk” for developing blood clots as I have one of the two genetic variants they test for. I have “typical likelihood” of developing Type 2 Diabetes. Based on the 23andme database of participants, people of European descent with genetics like mine have about a 30% chance of developing diabetes between my current age and 80. Diabetes does run in my family on both sides and I have been acutely aware of how my eating habits, especially my sweet tooth, may impact my risk. I have done well in the last decade or so with reducing my sugar intake. I also try to eat a healthy diet and exercise regularly, so hopefully that will reduce my risk further.

I should note that there are disclaimers all over the website, both when you register and when you receive your results, emphasizing that these tests do not diagnose any health conditions. They also remind you about other factors, such as lifestyle, environment, and family history, that affect your chances of developing these conditions. I appreciated the fact that they provide suggestions about what to do with the data, such as share it with your personal physician to discuss the risks. They also discuss the potential need for genetic counseling if the results indicate you have the genetic variant(s) tested.

Carrier Status

This section indicates whether you have genetic variants that could affect your children’s health. The list of conditions included Cystic Fibrosis as well as Sickle Cell Anemia along with a host of others I have never heard of. My results indicated “variant not detected” for all of them, which is good news for my daughter (my husband had the same results, so she seems to be in the clear).

Wellness and Traits

The other two sections focused on how your DNA might affect your body’s response to diet, exercise, and sleep, as well as the genetics behind your appearance and senses. The Wellness section was similar to the testing I had done two years ago, and I found similar results regarding weight (predisposed to weigh above average) and muscle composition (I have one genetic variant commonly found in elite power athletes such as sprinters.) I still laugh at that latter result as I hate sprinting.

In my opinion, the Traits section has more lighthearted, “nice to know” vs. “need to know” characteristics such as the ability to detect the odor in your urine after you eat asparagus (I am “likely to smell”) and earlobe type (“likely detached earlobes” which is correct). I disagreed with some of the results in this section. For example, it indicated that I was more likely to prefer salty vs. sweet – nope, I tend to reach for sugary snacks when I have a choice. It also indicated I was likely to not have dimples. Wrong again – some people say they are one of my best facial features.

So, what’s the verdict?

Bottom line, I am glad that I did the test. The ancestry part is fascinating and has sparked an interest in exploring genealogy further. The health predisposition results were reassuring, although I absolutely acknowledge that these results do not mean I won’t develop any of those diseases. I do plan to talk to my physician about the blood clot predisposition as there is some family history with this problem and I want to determine if there is anything I can do to minimize my risk. Overall, I believe there is value in this information and that it could help many people change their behaviors to optimize their health and well-being.  

The Self-Care Debate

Those of you who know me well, know that I am a fervent proponent of self-care. I would go so far as to say it is the cornerstone of my health coaching practice – helping others find ways to prioritize day-to-day lifestyle choices that will optimize their health and well-being. Some people, particularly women, think it is selfish to focus on self-care. I have always argued the opposite – that it is one of the most selfless things you can do, as you can’t take care of others in your life if you are not feeling or functioning at your best. I often use the oxygen mask analogy from the airline safety protocol – put on your own oxygen mask first before assisting those around you. After all, you can’t help your family or fellow passengers if you are passed out – or in this case, burned out or close to it.

I recently had my ideas about self-care challenged at a Sunday service at the Unitarian Universalist Fellowship of Raleigh. We had a guest minister, Rev. Nate Hollister, preach a sermon titled “The Nonsense of Self-Care.” I have to admit that I found myself feeling defensive as soon as I saw the title. How dare this person cut down the work about which I am so passionate and have spent most of my life promoting as essential to health and well-being? However, I reminded myself to keep an open mind and hear what we had to say before making any snap judgments.

Rev. Hollister started off his sermon by acknowledging that we do need to take care of ourselves, but he challenged us to think about how we do so and why. He then addressed three points of contention with what he called the “reigning culture of self-care.” He suggested that we did not necessarily have to agree with his points but that he simply wanted to start a dialogue around the concept. I have outlined his three points as well as my thoughts about them.

Self-care is rooted in classism and consumerism
Rev. Hollister started with the notion that today’s concept of self-care is rooted in classism and consumerism, i.e., only people with time and money can afford to engage in the types of activities that are commonly associated with self-care. Think massages and other spa services. Splurging on a gourmet dinner. Activities that most “blue collar” workers don’t have the luxury of enjoying. He admitted that we all deserve to have access to nice things, but we head into “moral trouble” when taking care of ourselves means consuming material things – especially in a world that is becoming increasingly damaged due to overconsumption.

I would challenge his first point as, to me, self-care means different things to different people and thus, you can’t just lump it all into one generalized category. For example, he defined self-care as indulging in luxurious activities or services that take time and often cost a great deal. Although I agree that these activities can be part of self-care, to me self-care falls more in line with the little things we do (or should do) every day or every week to maintain our health and well-being.

I am more inclined to agree with the idea put forth by Tami Forman of Path Forward – that self-care is not an indulgence, but a discipline. As she so eloquently states, it takes discipline to “do the things that are good for us instead of what feels good in the moment.” She also reminds us that self-care is not something you do every now and then when life gets a little crazy. It’s about “taking care of yourself in a way that doesn’t require you to ‘indulge’ in order to restore balance. It’s making the commitment to stay healthy and balanced as a regular practice.” Thus, perhaps what is needed in our culture is a new image, a rebranding if you will, about the true essence of self-care that falls more in line with these daily habits that help sustain our health.

Self-care as the opiate of the masses
Rev. Hollister’s second point of contention with self-care was that its primary purpose is to “inure us to the injustices of our world” and desensitize us to the current structures of power. In his words, self-care could thus be considered the “opiate of the masses,” allowing us to escape from the harsh realities of the real world. He quoted Dr. Martin Luther King, Jr. who called for the need for “creative maladjustment,” wherein people refuse to normalize inequality and work continuously to expose injustice. Rev. Hollister argued that we are in terrible trouble when self-care keeps us resigned to the way things are, to accept the status quo rather than try to change things.

Anyone who is familiar with the UU faith knows that it is steeped in social justice. Thus, I wasn’t surprised when he made this argument – that for some, self-care is a way to cope with injustice rather than attempt to do something to change it. I’m willing to concede a little more on this point as I can see how some people could use what he defines as self-care activities as a way to soothe themselves when dealing with challenges in their day-to-day lives. It’s a lot easier to have a girls’ night out and complain about the state of politics in this country than it is to volunteer on a political campaign or – gasp – run for office yourself. I would propose that this goes back to my previous point of needing to redefine and broaden the definition of self-care, such as expanding the idea of self-care to include engaging in activities that serve a higher purpose. For example, one could volunteer at a local food bank or donate blood. Do something good for oneself as well as the community. For many people, it takes participating in these types of volunteer activities to truly open their eyes to the inequalities present in our society. After all, awareness is often the first step needed to bring about change – in ourselves and our communities.


Self-care promotes a culture of hyper-individualism
Rev. Hollister’s third and final argument was that the current approach to self-care is steeped in a culture of hyper-individualism, where it is “all about me” and has likely contributed to the recent epidemic of loneliness and separation in today’s society. You have probably heard that despite being more connected than ever through technology, humans in general report feeling lonelier and more disconnected than ever before. Rev. Hollister linked this back to the traditional American story of individualism – that you are essentially on your own and that you need to pull yourself up by the bootstraps in order to succeed. He noted however that this concept is relatively new, that most historical cultures and societies thrived on cooperation, not competition.

Rev. Hollister took a deeper look at this idea and challenged us to shift from the independent philosopher Descartes’ proclamation “I think, there I am” to the more interdependent African philosophy of ubuntu, which can be loosely translated as “I am because we are.” He wrapped things up by reminding us that yes, it is important to take care of ourselves but perhaps it is time to change the whole concept of self-care and move away from the perception that it is all about consumerism and being resigned to the status quo. In his closing words, he urged us to redefine self-care as taking care of one another, as we might survive on our own, but we can only thrive with each other.

By the end of the sermon, after making his final point, I found myself less in a place of defensiveness and more in a state of appreciation for having the opportunity to revisit my own ideas about self-care. Rev. Hollister made some compelling arguments for why we need to shift our perspective about self-care. For me, self-care is still about taking care of yourself so that you are able to take care of others – family, friends, colleagues and even strangers in your community. It is clear now that not everyone sees it that way, so I will do my part to try to help change perceptions about self-care. I am also more inclined to broaden what kinds of activities fall into my own self-care – and encourage others to do the same. Maybe next time I need a little break, it will mean picking up litter when I walk in my local park versus splurging on frozen treats at the local ice cream parlor. This way, I benefit from the walk and we all benefit from a cleaner environment. That’s a win-win situation.

(Note: Click here if you would like to listen to Rev. Hollister’s sermon on self-care.)

Hello World

Hey there.  I know what you’re thinking…not another “healthy lifestyle blogger”?!  I know, I know, it seems like we are a dime a dozen these days – BUT I encourage you to keep reading. You’re here already so you might as well stick around to see what I have to say, right?

Yes, there are many, many people in the “blogosphere” who write about health. Some are professionals or experts. Others are individuals who are passionate about health and wellness. They learn as much as they can about topics of interest and then share that knowledge with others. Where do I fall on the spectrum? I combine the best of both worlds – I took my passion for wellness and turned it into a professional career. The path was not straight and narrow, but I am incredibly excited that it led me here today.

So…why include me as a “go to” source for health-related information? Three reasons:

Credentials. I have a Master’s degree in Public Health with a focus on Health Behavior/Health Education from the UNC School of Public Health. I am a Certified Health Education Specialist (CHES®), a Certified Professional in Health Quality (CPHQ) and a Certified Integrative Health Coach (through Duke Integrative Medicine). I am also sitting for the brand new, national health and wellness coach certification exam in September so I hope to add one more credential as a National Board Certified Health & Wellness Coach. I realize that’s a lot of letters behind my name, but my degrees and certifications are all from accredited universities and reputable professional associations.

Experience. Throughout my career in healthcare, I have worked in and/or with most of the major types of facilities in our system including a rural health department, skilled nursing facilities, a large hospital system and a primary care physician practice. Even when my primary “paid” role did not include a focus on wellness, I found a way to get involved with prevention and promoting a healthy lifestyle. I am so grateful that my career path has led me to my current role of health and wellness coach, where I am privileged to partner with individuals on their journey to optimal health.

My personal health journey*. I’m a real person who deals with many of the same health issues and concerns as you. I have struggled with weight management, emotional eating, work-life balance, stress and anxiety, to name a few.  Have I nailed all of my healthy living habits? Heck no, but my point is that I can relate to many of the challenges you may face in taking care of your physical and emotional health.

Just one last thing – my promise to you is that I will be a trusted, credible resource for you on your journey. I will strive to share information that comes from reputable sources based on sound scientific research. If I do share anything that is more anecdotal in nature, I will state that upfront. No fake news – Girl Scout promise.

*For those of you who are interested, I have included details about my health journey in my next post.