A Doctor Explains How a New Branch of Medicine Can Help You
Scientists used to think genes determined your future. They were hardwired and immutable, so if you had less-than-optimal parentage, too bad. Nothing you can do, so get over it.
An emerging field of medicine disputes this claim. Called Epigenetics (with sidelines in nutrition, “Nutragenomics”), this school of thought turns the past on its head. In fact, there’s quite a bit you can do to turn around poor genetic heritage. Your genes “bathe” in your environment, so you can choose good or bad ingredients for them.
“Your genes hold the gun, but your environment pulls the trigger,” explained Susan Scharf, MD, a Functional Medicine doctor (we’ll get to Functional Medicine in a bit). Everything in your personal ecology, from the air you breathe, the water you drink, the food you eat, to your exercise program (or lack thereof), past trauma, psychological state and spiritual beliefs can have a profound impact on your health. That means, in essence, it’s up to you whether you pull the trigger on a gene or not.
Diet. There are many examples of how epigenetics can work, especially through dietary changes. Cancer is the disease most commonly associated with adult nutrition and epigenetic modifications, said Dr. Scharf, who has a private practice in Manhattan. Compounds found in foods such as soy and green tea may provide protection against certain types of cancer. Garlic and cruciferous vegetables (like broccoli) have been associated with cancer prevention in clinical trials. Resveratrol (from the skin of red grapes), curcumin (from the spice turmeric) and green tea have anti-cancer capabilities in addition to being used as treatments for metabolic diseases.
Lifestyle. Stress and lack of sleep can release cortisol, which can lead to diabetes, weight gain, osteoporosis, cognitive impairment and damage to brain neurons. Exercise—and relaxation techniques like yoga and meditation—can counteract these effects by lowering cortisol, thus preventing these conditions.
SNPs. Another key discovery in the area of epigenetics is the existence of very small changes in gene sequences called single nucleotide polymorphisms or SNPs (pronounced “Snips”), that alter the function of a specific enzyme, making it more active or less able to function, but not completely obliterating its function. They occur commonly in at least 1 percent of the population. SNP testing is available for certain genes.
Many of these SNPs lead to differences in height or weight, food metabolism, food-gene interactions and disease susceptibilities such as Type 2 diabetes. “How these differences may be expressed depends upon environmental factors,” said Dr. Scharf. These SNPs opened the way for the emerging scientific discipline called nutragenomics or nutritional genomics.
The science of Nutragenomics is the study of how naturally occurring chemicals in foods can affect whether or not a gene fires. “Prevention is paramount. To start, we can all eat a diet rich in fruits and vegetables, maintain an appropriate weight for our height, moderate our consumption of alcohol, choose not to smoke, exercise regularly and develop and practice skills for managing our stress,” Dr. Scharf advised.
Lifestyle choices and dietary intake is not just about avoiding diseases but also gaining and maintaining optimal health and the avoidance of age-related disease. Dr. Scharf stressed that the benefits of some dietary choices are not the same for everyone, which is why it is best to have someone skilled in epigenetics and epigenomics working with you.
Functional Medicine views health from the viewpoint that you can offset bad genes by good behavior. A doctor in this specialty might prescribe a genetic test to see whether you have a predisposition for a disease, then take measures to help you avoid it. “Our genes are blueprints, but they don’t self-regulate, they don’t act on their own and they don’t make decisions. They don’t control anything. Blueprints are only effective if you have somebody who interprets the blueprint (the architect).”
A Functional Medicine doctor takes a lengthy, detailed health history, physical examination and laboratory testing to determine the underlying cause of problems. Then the physician develops a personalized, comprehensive plan for healing and prevention. Virtually every complex, chronic disease is preceded by long-term disturbances that can be identified and effectively managed, she declared.
“Functional Medicine practitioners address health issues at the root, which translates to resolution of the problem, not merely a band-aid,” Dr. Scharf explained.
Treatments may include combinations of drugs, botanical medicines, nutritional supplements, therapeutic diets or detoxification programs. They may also include counseling on lifestyle, exercise or stress-management techniques.
What about taking an epigenetic approach to life in your older years? “You can pursue the life you want, and make changes, even now. It’s in your hands more than ever,” stresses Dr. Scharf.