A Health & Wellbeing Interview with Health Expert Dr. Comite [Podcast]
Personalized Genomics & Living Your Best Life
Dr. Florence Comite is an endocrinologist and founder of the Comite Center for Precision Medicine & Health in New York City and the personalized health app, QUANTIOME. She also wrote the bestseller, Keep It Up! Connect with her on Instagram and Facebook.
In this article:
What Are Personalized Genomics?
Personalized genomics is an emerging science that looks at an individual’s DNA to assess health and provide personal guidance on disease risk. It looks at lifestyle factors such as your metabolism and your exercise response. For example, do you have genes that make you endure marathons, or are you better at running fast? Issues like that.
Wouldn’t it be great if we could spit in a tube or take a blood test to figure out exactly how to live our best life for the longest time possible? That’s the idea behind personalized genomics.
Many companies offer genomics testing, from sequencing the whole genome to simple tests. Simple tests study only a few or particular genes such as BRCA screening for breast cancer or colon cancer risk.
There’s an increase in colon cancers in younger people, so this is the kind of thing we should take seriously.
We Don't Hear About Personal Genomics Often. Why Don't Doctors Use It More Widely?
From my perspective, the problem lies with the translation of the data rather than the data itself.
I’ve been anticipating personal genomics medicine as a way of thinking about health. Not just testing, but also integrating and interpreting individualized data to control your health trajectory for decades.
For example, your metabolism, hormones, family history, and lifestyle – the way you sleep, work out, or don’t do those things – all affect gene expression.
No one is studying this and seeing how it all integrates. It’s been my work and passion for the last few decades. First at Yale, and now my work at the Centre for Precision Medicine & Health.
How do we connect the dots to understand what it means if we have the same gene, but we express it very differently? And why? We’re still struggling with these issues, yet, it hasn’t begun in academic centers. The focus is still mostly on disease and disease states.
What Do You Say to People Who Think Personal Genomics Is Just a Waste?
I just mentioned the rapid increase in colon cancer diagnoses at a younger age. Genomics may indicate your risk for colon cancer.
Instead of waiting until 50 to get your colonoscopy, you might do it at 40, or even sooner. Because cancer grows slowly, this could be helpful.
Although I used to think family history was a poor man’s genetic test, now I believe it’s much more valuable. Family history is significant because it reveals how our DNA expresses itself, how it reacts.
I regularly look at my clients’ DNA in a process called whole genome sequencing. If considered in the context of an individual’s health, a genetic test provides understandable, actionable data. That’s what’s missing from many companies because this kind of research isn’t widespread.
I’m hoping to publish my research shortly, because I’ve been monitoring people for a decade or two, and I have the data that connects some of these dots.
Most of the genome and epigenetic research that goes on at Yale, Harvard, Hopkins, and other institutions, revolve around disease signatures. For example, gene expressions in tumors and therapeutics that would remedy that. But, nobody is looking at the genomics of sprinter muscles versus marathon runners and what that means for muscle maintenance with aging.
While a test may tell me I have sprinter’s muscles, it doesn’t tell me I should be sprinting, or that I may have a health factor that predisposes me to shin splints, tendon tears, or stress fractures.
I would also need more information on how to be healthier. For instance, I react to magnesium, but 90% of the population needs magnesium. That’s a crucial factor.
In other cases, a person might be malnourished and underweight, and shouldn’t be sprinting at all. There are many variables to consider.
Will Things Like ancestry.com and 23&Me Help Personal Genomics Become Mainstream?
That’s where all the money is going. And, that’s what most people want, they want to know who they are.
Many people have mixed ancestry. Or somebody who grew up thinking they were German now finds out they’re Irish. And that’s great.
I hope personal genomics becomes mainstream, and it’s getting there because it’s exciting.
I’ve been anticipating personalized genomics medicine as a way of thinking about health for many years. Not just testing, but also integrating and interpreting individualized data to control your health trajectory for decades.
But, I think we’re at least a decade or two away from making it a reality for most people.
I’m currently working on an app that scales what I’ve built over the years as a digital platform. The app takes details you complete and uses technology to help scale advanced medicine.
The numbers we read every year when you get your annual, the information in your biomarkers… They’re there for the taking, and that’s what I’ve been doing.
The NIH is on a roll to it in their “All of us” trial. People should look that up at joinallofus.org. It’s going to take another ten years and a million participants.
It will take a significant shift in academic medicine, education, training doctors, and how we think about health, disease, and research. Insurance companies will need to get involved, for personal genomics to become mainstream as well.
Should I Get a Genetic Test or Not?
That depends on your family history and lifestyle. I believe in it, but I’m biased.
I encourage anyone who wants to undergo genetic testing to do their homework first. Speak to somebody like us here at Comite Center, to understand the benefits.
Then, speak to your family and find out more about your family history, that’s the best way to get an indication of future issues. If you talk to your family, you take a significant step because your family is an indicator of how your genes will express.
As we learn more about the genome and other omic sciences, I hope to start publishing the data we’ve collected and explain how to put those factors together.
Even simple lab tests like the metabolism you express, your complete blood count (CBCs), and your hormones will give us insight into who you are and the state of your health.
I encourage people to start with ancestry because buried in some of that are clues to a healthy life, and that’s the most valuable insight you can get.
I want to live life in the best health until the last possible moment, and maybe getting your genome is like buying a book in a language you’re not fluent in yet. It may still be a few years before we can make sense of all the data, but it’s still valuable.
What are your thoughts on personal genomics? Let us know in the comment section below!