Recently, Vitaliy Husar received results from a DNA screening that changed his life. It wasn't a gene that suggested a high likelihood of cancer or a shocking revelation about his family tree. It was his diet. It was all wrong.
Illustration: Angelica Alzona/Gizmodo
That was, at least, according to DNA Lifestyle Coach, a startup that offers consumers advice on diet, exercise and other aspects of daily life based on genetics alone. Husar, a 38-year-old telecom salesman, had spent most of his life eating the sort of Eastern European fare typical of his native Ukraine: Lots of meat, potatoes, salt and saturated fats. DNA Lifestyle Coach suggested his body might appreciate a more Mediterranean diet instead.
"They show you which genes are linked to what traits, and link you to the research," Husar told Gizmodo. "There is science behind it."
DNA Lifestyle Coach isn't the only company hoping to turn our genetics into a lifestyle product. In the past decade, DNA sequencing has gotten really, really cheap, positioning genetics to become the next big consumer health craze. The sales pitch — a roadmap for life encoded in your very own DNA — can be hard to resist. But scientists are sceptical that we've decrypted enough about the human genome to turn strings of As, Ts, Cs and Gs into useful personalised lifestyle advice.
Indeed, that lifestyle advice has a tendency to sound more like it was divined from a health-conscious oracle than from actual science. Take, for instance, DNA Lifestyle Coach's recommendation that one client "drink 750ml of cloudy apple juice everyday to lose body fat".
"Millions of people have had genotyping done, but few people have had their whole genome sequenced," Eric Topol, a geneticist at Scripps in San Diego, told Gizmodo. Most consumer DNA testing companies, like 23andMe, offer genotyping, which examines small snippets of DNA for well-studied variations. Genome sequencing, on the other hand, decodes a person's entire genetic makeup. In many cases, there just isn't enough science concerning the genes in question to accurately predict, say, whether you should steer clear of carbs.
"We need billions of people to get their genome sequenced to be able to give people information like what kind of diet to follow," Topol said.
Husar stumbled upon the Kickstarter page for DNA Lifestyle Coach after getting his DNA tested via 23andMe a few years earlier. He wondered whether there was more information to be gleaned from his results. So six months ago, he downloaded his 23andMe data and uploaded it to DNA Lifestyle Coach. Each test costs between $US60 ($78) and $US70 ($91).
"I'm always looking for some ways to learn about my health, myself, my body," said Husar, who contributed to the company's Kickstarter back in 2015.
The advice he got back was incredibly specific. According to DNA Lifestyle Coach, he needed to start taking supplements of vitamins B12, D and E. He needed more iodine in his diet, and a lot less sodium. DNA Lifestyle Coach recommended that 55 per cent of his fat consumption come from monounsaturated fats like olive oil, rather than the sunflower oil popular in Ukraine. Oh, and he needed to change his workout to focus more on endurance and less on speed and power.
He switched up his workout and his diet, and added vitamin supplements to his daily routine. The results, he found, were hard to dispute: He lost 3kg, and for the first time in memory didn't spend Kiev's long harsh winter stuck with a bad case of the winter blues.
Image: A sample of a DNA Lifestyle Coach customer's fitness recommendations provided by a customer.
For now, DNA Lifestyle Coach's "interpretation engine" only offers consumers advice on diet and exercise, but in the coming months it plans to roll out genetics-based guidance on skin care, dental care and stress management. The company wants to tell you what SPF of sunscreen to use to decrease your risk of cancer, and which beauty products to use to delay the visible effects of ageing. Its founders told Gizmodo that eventually they envision being able to offer their customers recipes for specific meals to whip up for dinner, optimised for their genetic makeup.
DNA Lifestyle Coach joins a growing list of technology companies attempting to spin DNA testing results into a must-have product. The DNA sequencing company Helix plans to launch an "app store for genetics" later this year. One of its partners is Vinome, a wine club that for $US149 ($194) a quarter sends you wine selected based on your DNA. Orig3n offers genetics-based assessments of fitness, mental health, skin, nutrition and even — obviously unscientific — which superpower you are most likely to have. The CEO of the health-focused Veritas Genetics told Gizmodo that the company hopes to create a "Netflix for genetics", where consumers pay for a subscription to receive updated information on their genome for the rest of their life.
"It's not going to happen overnight, but we believe that DNA will become an integrated part of everyday life," Helix co-founder Justin Kao told Gizmodo. "The same way people use data to determine which movie to see or which restaurant to eat at, people will one day use their own DNA data to help guide everyday experiences."
Few would debate that our capability to decipher information from our genetic code is getting a lot more sophisticated. Just a decade ago, a bargain-basement deal on whole genome sequencing would run you $US300,000 ($391,491). Recently, DNA sequencing company Illumina announced plans do it for just $US100 ($130) within the next decade. Every day, researchers discover new links between our health, our environment and our genetics.
But much of this research is still preliminary, and many of the studies are small. DNA Lifestyle Coach's advice to drink 750ml of cloudy apple juice for fat loss, for instance, stemmed from a study of just 68 non-smoking men. Those results, while promising, still require much larger studies to confirm. Suggesting that the same regiment might work for consumers is a little like reading the leaves at the bottom of a tea cup — extracting meaning from patterns that aren't necessarily there.
Not to mention that the information our genes offer up is probabilistic, not deterministic. You may have run into this if you've done an ancestry DNA test and received results indicating that your parents are only "very likely" your parents. More often than not, many genes contribute to a specific trait — like taste — and how those genes all interact is a complex and poorly understood web. To complicate matters further, the expression of genes is often impacted by our behaviour and the environment. If you have a gene that raises the risk for skin cancer, but live in overcast Seattle and don't ever go outside, your chances of getting cancer are probably slimmer than someone who lives in Sydney and spends every day in the sun without slapping on some sunblock.
DNA Lifestyle Coach, though, wants to offer its customers simple, actionable advice, and so omits all this confusing grey area from its results. Instead, the recommendations are clear and specific, from how much Vitamin A to take to how many cups of coffee a day are most beneficial. It's a bit reminiscent of a long-term weather forecast spitting out predictions for sunshine or rain 30 days in advance — yes, such predictions can be made, but most meteorologists will tell you they're borderline useless.
Image: A sample of a DNA Lifestyle Coach customer's diet recommendations provided by a customer.
"We use a series of algorithms which rank studies by reliability of results," the company website explains. "Studies are then analysed for their relation to real-world dietary and nutritional needs, and the user is given straightforward recommendations."
Pressed on the questionable nature of that apple juice study, DNA Lifestyle Coach's founders responded that the "data is not as strong" as the the other studies it pulls from. "But it is a harmless recommendation," the company said.
When asked whether it was possible that DNA Lifestyle Coach's claims might have any validity, Topol laughed.
One day, he said, it's likely we'll have some genomic insight into what types of diets are better suited for certain people. But, he added, it's unlikely that we will ever accurately predict the sort of granular details DNA Lifestyle Coach hopes to, like exactly what SPF of sunscreen you should be using on your skin.
"There are limits," he said.
Image: A sample of a DNA Lifestyle Coach customer's diet recommendations provided by a customer.
DNA Lifestyle Coach was founded by a chemist and a business consultant who met over an interest in the biohacker scene, a subculture focused on ideas like DIY life extension. The company that runs DNA Lifestyle Coach, Titanovo, actually started as a blog. The name is meant to invoke superhumans. "It's like the rise of the titans," said Corey McCarren, the business side of the duo, when Gizmodo met with him at a health "moonshots" conference last month.
Their first foray into genetics was a home telomere length test, which launched in 2015 with help of $US10,000 ($13,050) raised on Indiegogo. Telomeres are little bits of DNA at the end of chromosomes. Each time a cell divides, its telomeres get shorter, and so they provide some insight into our biological age. Titanovo wanted to develop an easy test to tell consumers how long or short their telomeres were. The company initially pitched the test as a way to measure both longevity and health, but eventually was forced to clarify for customers that it is not at present possible to discern biological age from telomeres alone, after receiving emails from customers panicked about their own short telomeres.
Instead, they suggest, the $US150 ($196) telomere testing kit is a way to discern information about health. One finding from their data: Vegetarians and vegans who use the service have, on average, longer telomeres. The company recommends going veg if you find your telomeres are in need of a boost. Even this, however, seems like a stretch: Data on telomere length, like genomics, is not quite ready for public consumption. For every paper that finds a potential cause of telomere shorting, there's one that finds the opposite effect.
Undaunted by the rocky rollout of its telomere testing kit, Titanovo is now pressing forward into genomics. The Kickstarter campaign for DNA Lifestyle Coach wound up raising more than $US30,000 ($39,149). The company says it now has more than 1000 customers who either pay $US215 ($281) for the full DNA testing kit along with one panel, or the $US60 ($78) to $US70 ($91) to run panels with data from services like 23andMe.
While it might seem harmless to take part in a little science-based superstition and find out whether you're more Batman or Superman, such indulgence can have serious side effects. For years, we've been sold on DNA as the answer to almost everything. Decode the human genome, and decode the "mysteries of the human spirit". This gives companies like DNA Lifestyle Coach dangerous authority. If your DNA testing results say you're prone to obesity, why spend time exercising and eating right when your health seems beyond your control?
Joshua Knowles, a Stanford Cardiologist who studies applied genetics, told Gizmodo that he recently had a patient who was unwilling to try a certain class of drug based on their genotyping, even though they had a high risk of heart disease that might be drastically reduced by use of those medications.
"We're doing a poor job of educating patients on risk-benefit analysis," Knowles said. "In some cases, when it comes to genetics, we're placing a lot of weight on some things that have very small overall effects."
In 2008, an European Journal of Human Genetics article argued for better regulatory control of direct-to-consumer genetic testing, asking whether in the end, tests ran the risk of being little better than horoscopes that told people information they were already predisposed to believe.
It was these kinds of concerns that moved the US Food and Drug Administration to crack down on 23andMe in 2013, ordering the company to cease providing analyses of people's risk factors for disease until the tests' accuracy could be validated. The company now provides assessments on a small fraction of 254 diseases and conditions it once scanned for — it still processes the same information, but is restricted in what it can tell consumers. Where it once reported "health risks" alongside specific tips and guidance on how to reduce them, it now reports on your "carrier status", framing the results in terms of whether you might pass down a specific genetic variant to your offspring rather that whether you might develop the condition yourself.
Companies like DNA Lifestyle Coach have moved in to offer the sort of tips 23andMe no longer can.
"We have much too many companies doing nutrigenomics and other unproven things like that," said Topol. "That can give consumer genomics a really bad name. That's unfortunate."
Kao, of Helix, said that educating consumers on what these results really mean alongside actionable information will be the industry's greatest challenge — and what distinguishes it from just another pseudoscientific health fad.
"It's typically been very hard to interpret DNA information," Kao said. "DNA is most valuable with context, rather than as the only piece of the puzzle."
The industry, he argues, is young, but will get more accurate the more consumers use DNA-testing products. "Just as Netflix improves the more you rate shows you watch, so would many DNA-based products," he said.
Husar told Gizmodo that he got blood work done to confirm what he could about his DNA Lifestyle Coach results. The tests indeed confirmed that he was low on vitamins B12, D and E, as DNA Lifestyle Coach had suggested. Of course, Hussar still can't be sure his genes are responsible. It could be that he's simply not eating enough meat or cheese. Still, the blood work was enough to convince Husar that DNA Lifestyle Coach's analysis was worth taking seriously. And, for the most part, the results felt right — it made sense that a boost of vitamin B12 might counteract the emotional toll of winter, and that cutting out potatoes and saturated fats might be beneficial.
The tests's fitness results though, he did find a tad shocking.
"I was really surprised to learn that I'm not fast or powerful, but I have a high endurance," he said. "I can do Iron Man. This is what my genetics say. I'm trying to change my workout to see if that's true."
Husar may never be sure whether the advice divined from his genetics was really helpful. He can only hope it doesn't hurt.
Originally published on Gizmodo Australia.