How to improve your odds when genetics deals you a dud hand.
So you think you’re healthy yet you’re still prone to injury, high cholesterol or worse. Don’t be hard on yourself, there’s someone else to blame: your parents for starters — and their parents and their parents and so on.
The genes passed down from generation to generation determine many things from how likely you are to win a marathon to whether you should join the swim team. For some strange reason Mother Nature favours women so guys are far more likely to inherit a dud hand. But don’t despair. With a bit of knowledge there’s some great ways to beef up your genes through diet, exercise and the latest treatments.
THE PROBLEM: Heart defects.
Often the first indicator that you suffer a genetic heart problem is a heart attack. The lucky few get symptoms such as palpitations, shortness of breath, chest pain and blackouts. Dr. Christopher Semsarian Molecular Cardiologist at Royal Prince Alfred Hospital calls it a “time bomb” and says, “Genetic heart disease is the most common cause of sudden death in young people. There are over forty different heart diseases which are directly caused by gene defects”.
Somewhere between two and ten percent of all Australians have a genetic heart disease like irregular rhythms but here’s the kicker: “One in three will develop some form of heart disease in their lives,” says Dr. Semsarian. Heart disease is a dominant gene and that’s not good. “You have a one in two chance of passing on your defect to your children,” he says.
THE SOLUTION
”Live a healthy lifestyle to maintain general health: that means regular light exercise, a good diet, weight control, low cholesterol and avoid smoking,” says Dr. Semsarian. It’s common advice but worth repeating. “Up to 50 percent of sudden cardiac deaths in the young occur during, or immediately after, high level sports,” he adds, advising that people with a family history of heart attacks avoid competitive sports and sudden changes in heart pressure - that means no weights or bungie jumping. “Instead walk 30-40 minutes 4-5 times per week,” he says. Add a golf ball and hey presto, you’ve got sport. Oh, and swimming also works.
Thankfully there are a myriad of pills to control abnormal heart rhythms and implants are also available to zap your heart with electricity if it beats out of time. At the forefront of medicine is the new field of molecular cardiology which hopes to actually fix the faulty DNA - sparing generations of grandchildren years of heart ache.
THE PROBLEM: Poor vision.
Colour blindness is the most common genetic eye problem with up to eight percent of men suffering its effects. “It’s not dangerous, ” says Dr Peregrine Horton, one of Australia’s leading optometrists, “But it will affect you and your kids, career choice. Train drivers, electricians, pilots and firemen are all required to have accurate colour perception.” Struggling to see a red cricket ball on green grass means you’re probably not going to be the next Ricky Ponting. But if you don’t have it you won’t go colour blind - it’s with you from birth.
Short sightedness is thought to be part genetics, part environment and only starts showing up in teenage years - that’s when the eyeball takes it’s final shape. No matter what anyone tells you, scientists are still not sure what the environmental factors are. “The person who does will probably get a Nobel Prize,” says Dr. Horton.
The scary eye disease to look for in your family tree is glaucoma. “Glaucoma is damage to optic nerve, so signals don’t get to the brain properly. You develop tunnel vision and can go completely blind,” says Dr. Horton. It usually happens over years but sometimes can be as quick as a few days. “If you’ve got a relative with it, you’ve got about ten times the risk of contracting it as someone who doesn’t,” he warns. As a general rule, he says that the risk of eye diseases goes up three times for every ten years over the age of forty.
THE SOLUTION
“Regular exercise reduces the pressure in the eye slightly,” says Dr Houghton, explaining that it’s useful in preventing glaucoma. “It has virtually no symptoms in the early stages and once you’ve lost vision you won’t get it back,” he says. There are eye drops and, in more severe cases, operations to increase drainage from the eyeball. It’s serious stuff but better than going blind.
For short sightedness the solutions are many: glasses, contact lenses, laser surgery and more, but some controversial experimental drugs (not yet on the market) hold great promise. “They’re taken as the eye is forming, when you’re a child,” says Dr. Horton.
For the colour blind, tinted lenses can sometimes help specific sports. “Shooters wear red lenses to increase the contrast between the red target and green foliage,” he says. Whether they work is another thing altogether. “At an elite level a lot just comes down to confidence”, he says.
And now to debunk a long held myth: carrots will not significantly improve your sight. Dr. Horton claims, “It was a cover story for British pilots during world war two. They were far better at shooting down enemy planes in low light and said it was carrots helped them see - the real reason was the fact they had invented radar.”
THE PROBLEM: Skin disorders.
If your family snivel and sneeze their way through summer you’ve got more to worry about than running out of kleenex. According to Dr Stephen Shumack, Honorary Secretary of the Australian College of Dermatologists, you’re far more likely to get eczema. “While it’s not clear cut inheritance, if you come from a family with a history of eczema or asthma or hay fever then you’re four times more likely to get that condition.” He explains that they’re all an allergic reaction and around ten percent of Australians will suffer eczema at some stage.
While it’s not dangerous it is annoying and, like colour blindness, tends to change your lifestyle. “Some sports will make it worse, swimming a lot, sports that involve taking a lot of showers…Sweat itself isn’t a problem it’s washing it off on a regular basis that causes trouble,” says Dr Shumack. The soap and water remove the natural oils from the skin making it dry, sensitive and irritated.
Eczema and psoriasis are often confused. While eczema is a form of dermatitis, psoriasis is a partially inherited immune disease about which surprisingly little is known. “If you’ve got a family history of psoriasis, bad dandruff, scaly elbows or knees, your risk of getting it doubles from one in 40 to one in 20,” says Dr Shumack.
THE SOLUTION
Eczema sufferers have to suffer some more with cold showers. “Avoid things that de-fat the skin like soaps or detergents, even warm water will make it worse. Avoid hot long baths or showers. Use lots of moisturisers - and we say quantity rather than quality. Like sorbolene or vitamin E. If it’s particularly bad, some steroid cream will reduce the inflammation,” advises Dr Shumack.
Dermatologists treat psoriasis very differently. “Psoriasis responds to sunlight. So it’s one of the very rare conditions in dermatology where we tell people to get sunlight rather than avoid it. Obviously not enough to burn,” he says. Sunlight depresses the immune system, which alleviates the irritation. Another option: try some good old fashioned coal creams. Dr Shumack suggests being patient. “Eczema usually responds fairly rapidly to treatment but psoriasis takes weeks,” he says.
THE PROBLEM: Flat Feet.
“Very few of us have what you’d classically call a normal foot, ” says Dr Mark Gilheany, President Australasian College Podiatric Surgeons.” There are a lot of people out there with long noses and short noses and they don’t tend to cause any problem. Likewise with feet, they’re both inherited structural conditions but they don’t necessarily cause problems,” he says.
“As a general rule people tending towards a high arch foot have less ability to absorb shock,” he says, and that’s not good news for aspiring marathoners. High impact activities like running may produce shock-related symptoms like joint jarring and knee injuries. Oddly enough flat feet, he explains, tend to have more flex and are better for running than high arches - they certainly wouldn’t keep you out of the army.
A far more serious inherited problem is bunions. A whopping thirty percent of the population, he claims, have bunions. Of that sixty percent are women. “It’s got nothing to do with wearing high heels, it has to do with genetics. You see bunions in males and females in aboriginal populations the world over who have never worn a shoe,” he says. Bunions occur when the joint of the big toe slips out of alignment causing uneven wear of the cartilage. There’s no discomfort until it wears through - then it’s aaaarrrgh!!
THE SOLUTION
There are as many different remedies as there are shapes of feet. The challenge is finding the one that suits. There’s exercise therapy, shoes galore, a zillion different inner soles and, in extreme cases, surgery. If high arches are making sport difficult, Dr Gilheany advises pursuing something like cycling or swimming. For many the solution is as simple as a new pair of shoes. “Marathon runners go through a pair of shoes every six weeks or so,” he says, “because the shock absorption material wears out.” He doesn’t suggest simply handing your pay packet to the shoe store every month. “Fifteen years ago there was an immense difference between shoes. Now you just need to pay reasonable money for a brand name pair - and they don’t have to be 300 bucks. They’re all OK”. The important thing he says is for them to fit like a glove, er… shoe. “It should be comfortable in every dimension, not just length”, he says.
So if the shoe fits…well, you know what to do. If it doesn’t and the pain is unbearable new surgical procedures promise good results. “I have one patient who’s a footballer and his feet are so painful he had to pull out of the season,” says Dr. Gilheany. It seems like a career-ending operation but apparently not. “Baring complications, I’d look at having him running again in six weeks,” he says.
THE PROBLEM: High cholestrol.
High cholesterol has no symptoms and can cause a heart attack or stroke quicker than you can say LDL. A massive 40,000 Australians have inherited high cholesterol. Dr Maarten Kamp, an endocrinologist with Griffith University in Queensland explains that, left unchecked, roughly half the men will contract heart disease between the ages of 40 and 50.
If you’re family has a history of strokes or if their tickers stopped early you should definitely get tested. “Your HDL or good cholesterol should be above 1, and LDL or bad cholesterol less than 2.5,” says Dr Kamp. “If the total is between 7.5 and 9 every family member should be tested, including children.”
THE SOLUTION
”You’re not likely to be able to reduce your cholesterol any more than 20% with diet and exercise so if you figures are well outside the normal range you’ve probably got a genetic predisposition,” says Dr Kamp. Today’s drugs are far more effective but they’re not a replacement for healthy living.
Tone down the animal products (they’re full of saturate fats) and lay off the dairy and the salt. When you hear the words trans-fatty acids run a mile. They hide in processed foods and takeaway and will turn your arteries to stone. Go for fresh vegies more often.
It’s not all about deprivation. Nutrition Australia suggests if you already drink to keep it up. They claim that a low intake of alcoholic beverages (particularly wine) apparently reduces the risk of heart disease. Cheers to that!
THE PROBLEM: Diabetes.
Here’s some terrifying statistics from Diabetes Australia: 520,000 Australians are currently diagnosed with diabetes (another half million don’t know they have it); 65%-80% of people with diabetes will die of coronary heart disease. It’s also the leading cause of blindness in Australians under sixty.
“You can inherit a strong underlying risk on contracting type two [adult onset] diabetes but that risk is significantly modified by lifestyle factors,” says Griffith University’s Dr Kamp. The danger signs to watch for are blurred vision, skin infections, slow healing, tingling and numbness in the feet. Will your kids get it? “You’re children don’t face any greater risk of having type one or childhood diabetes but their risk of developing type two in their lifetime is certainly greater,” he says.
THE SOLUTION
The simplest solution is to stay slim. “Eighty to ninety percent of people diagnosed with type two diabetes are overweight or obese. By losing five to seven percent of your body weight and adopting healthy eating habits you can delay your risks by almost 60 percent,” says Dr Kamp. For children the solution is far simpler: “The best thing you can do to make sure your kids don’t get diabetes is set a good lifestyle example,” he says.
THE PROBLEM
Alcoholism
Most people enjoy a drink or two but according to Dr Stephen Jurd an addiction specialist based at Royal North Shore Hospital in Sydney, “Five percent of Australian adult males have diagnosable alcohol dependence.” He suggests a simple self-diagnosis. Are you’re defensive about how much you drink? Have other people complained about your drinking? Have you tried to cut down and failed? Do you feel guilty? Do you consume more than 26 standard drinks a week? Do you drink in the morning? Answer “yes” to any of these and you may have alcohol pulsing through your genes.
According to Dr. Jurd, “Nearly half of an alcoholic’s sons are likely to develop alcohol dependence.” That means more chance of all manner of grisly demises including suicide.
THE SOLUTION
Oddly enough a good preventative measure might actually be alcohol. “Some studies show that careful, culturally consistent exposure to alcohol, like in the Jewish Sabat ceremony or in Italian families will mitigate the risk,” he says. For adults the solution might be falling in love. “Alternative satisfactions,” Dr Jurd calls them. Relationships, work, sport - it doesn’t matter as long as they trigger the pleasure centers of the brain.
Dr Jurd explains that psychotherapy and drugs like naltrexone work best only in the short term. Long term help may have been there all along. “The scientific evidence for AA is beginning to add up. AA may not be overwhelmingly powerful…but it has a small to medium size effect and works in the long term. And that is what you really need in a chronic, relapsing, potentially fatal disease,” he says.
BOX
“People hear the word genetics and they think it’s all science fiction”, says Dr Kristine Barlow-Stewart, director of the Centre for Genetics Education at Sydney’s Royal North Shore Hospital. “They think it doesn’t apply to them, but there are some real applications that can benefit their health,” she says.
For starter’s there’s medicine’s Holy Grail: curing cancer. (Bowel cancer to be exact which affects one in seventeen men.) “If bowel cancer is detected early, in over ninety percent of cases it is able to be treated,” she says, so mapping your genetic family tree may well save your life.
Today’s medicine might seem medieval in years to come. “Currently everyone is prescribed the same amount of antibiotics, whereas we all have different genetic make up and differ in how we metabolise or use that drug,” says Dr. Barlow-Stewart, explaining that one day medicine will be tailored perfectly to individual patients.
For sportsmen the sky (and the law) is the limit. “There is a lot of concern about using gene doping to increase blood flow. You inject into the muscle the genes that code for the production of this particular protein that enhances the amount of haemoglobin in the blood,” she says. The result is a kind of human turbo-charging. She’s quick to add that no one has done it just yet - or at least admitted to it - but it’s a very real concern and the first athletes will certainly be human guinea pigs. With 30,000 odd genes yet to be tinkered with it really will be a brave (and sometimes foolish) new world.
Words by Adam McCulloch. Originally published in Men’s Health. The format has been altered to suit Tumblr.
