Control your genes

FIRST, the bad news. Fat genes do exist. If you're the sort who seems to put on weight just by looking at food, it's not your imagination. By the same token, the skinny person who eats like there's no tomorrow but doesn't expand sideways has a more effective fat-burning gene than you do.

The good news is that you don't have to live with the genes you're born with. According to a growing field of research called nutrigenomics, it is possible to adjust your diet to keep your genes from showing their bad sides and making you sick, fat or worse.

Ever since scientists managed to map out the entire genome code around 2003, researchers have been studying how genes affect people's propensity to develop life-threatening diseases such as cancer. In the process, they also identified genes that determine an individual's health blueprint. These genes determine one's ability to deal with issues such as metabolism, insulin sensitivity, inflammation and so on.

General practitioner Joseph Soh, medical director of aesthetics centre Firma Medical, was your typical unhealthy, food-loving Singaporean before he stumbled upon nutrigenomics. Firma Medical now offers the Nutri-G programme to analyse patients' DNA and formulate appropriate diets based on their test results.

"I did my own DNA test and it came up with a lot of 'reds'," he explains, referring to the traffic light-inspired colour codes that refer to each gene's "expression". His results showed a strong inclination towards inflammation and cancer, plus a poor body repair system which meant that long distance running and other strenuous sports would do him more harm than good. If he continued to eat char kway teow every day without engaging in short-duration, resistance training, it would be a matter of time before he succumbed to a heart attack or other life-threatening diseases.

But armed with the results of the test, he could identify specific areas he was deficient in, and boost himself with supplements to compensate for the deficient genes. Nobody can change the genes they're born with, emphasises Dr Soh. But you don't have to give them the ammunition to do their damage. For example, your body is supposed to produce cytokines - molecules that direct cells to inflamed areas of the body to fight off the sources of damage and heal them. How well your body fights off inflammation is determined by the genes you have. So, if your genes are weak in this area, and you don't support them with good nutrition, but instead overload your system with sugar, trans fats and the like, your body doesn't stand a chance against all the nasty inflammatory invaders.

Now, Dr Soh has a supplement and exercise regime that helps to give his body an edge, such that he can have that plate of char kway teow knowing that his body has enough defences built up to fight off the antagonists. He offers a car analogy as an explanation. "One's capacity to operate depends on one's genes. You can be a one litre engine, a 1.5 litre or even a two litre. If you're lucky enough to be a two-litre engine, that's great. But if you're just one litre, you need a turbo booster with the right nutrition to help you burn fat and control inflammation."

Nutrigenomics is still relatively new in Singapore with few offering DNA testing and nutritional guidance. Besides Firma-Medical, COMO Shambhala conducts a selection of DNA tests targeting very specific areas of interest. Under the guidance of clinical nutritionist Josephine Ng, you pick from four categories according to your needs: weight management, hormone balance, overall health check and sports performance.

Regardless of the programme you pick, each involves doing a DNA swab of your inner cheek which is sent to labs in the US for assessment. Results take about a month, after which they are analysed and a nutritional plan designed for you.

COMO Shambhala's weight management plan, for example, costs S$940 and tests 13 genes linked to obesity risk and weight loss. The results will tell you whether you're susceptible to weight gain; how well your body processes and burns fat and carbohydrates; are you prone to inflammation or binge-eating. "Some people are more sensitive to fat and others to carbohydrates so the test helps us to decide if you are better off on a low-fat or low-carb diet," explains Ms Ng. "If you are insulin-sensitive, eating refined carbs will activate the fat cells and make you put on weight. The type and amount of fat also plays a part. Some people are better at converting fat into energy, and for others, adrenaline-producing exercises don't work as well for weight loss as weight-bearing ones."

The results will also tell you if you are at a high risk of getting type 2 diabetes.

Armed with this information, Ms Ng is able to advise you on which diet works best - low-fat, low-carb or Mediterranean - and comes up with a diet and exercise plan, along with lifestyle recommendations. She is so detailed that she even notes down the weights of the meat or fish that you should eat (a rather paltry 130gm to 150gm a day). If you have other issues besides weight, the DNAOestrogen plan tests 10 genes involved in the "biosynthesis and metabolism of oestrogen". In turn, DNASport tests the genes of the athlete to see if he or she should aim for a power or endurance sport, while DNAHealth (S$980) tests 28 genes to assess your risk of coronary heart disease and diabetes.

In turn, Firma Medical tests 38 genes as part of a 10-month long programme that costs S$3,500 - which sounds hefty initially but includes regular reviews and separate blood tests to assess your current health condition and subsequent progress.

"Even though your genes may be bad, the blood test monitors the actual state of your health," explains Dr Soh. The test measures your levels of insulin, homocysteine, high-sensitivity CRP (which measures heart attack risk) and vitamin D - which are not always included in medical screenings because "it's costly". For example, the DNA test may indicate genes that are weak at neutralising free radicals, but the blood test may show that you don't have too many bad free radicals in the first place. "Showing how the genes have manifested themselves or whether they have been triggered helps in our diagnosis of how much supplementation you need."

Of the DNA test, he says: "We don't test disease-specific genes because there is nothing we can do about it." (As in the case of actress Angelina Jolie who underwent a double mastectomy after finding out she had a high risk of breast cancer). "We test functional genes which describe the capacity of your health support systems. By knowing this we can focus on specific weaknesses."

His boosters include an arsenal of supplements from broccoli sprouts for anti-cancer and inflammation protection, concentrated vitamin B for cell repair to high potency fish oil. Over-supplementation is as bad as under-supplementation, Dr Soh cautions. People who overdose on vitamins "suppress their bodies' own ability to fight disease and is more damaging. It's better to have supplements that boost the body's ability to produce its own antioxidants. So it's crucial to know where and what to supplement." This is also why superfoods and vitamins work well for some people but not for others because "your body's requirements differ from others".

Tests aside, one may well argue that the results do point to the same common sense direction: that everybody will benefit from a healthy diet that is largely Mediterranean with an emphasis on lean pasture-raised meat, lots of vegetables and low-glycemic fruit. Still, these tests function like a personality test - giving a scientific affirmation of the suspicions you already had about your health. For example, if you always wondered why you're always suffering from water retention (poor genetic ability to process sodium); why you have such a sweet tooth (there's a gene for that); why you feel lousy after a long run (your body can't repair stress as well as others); why it's so hard to lose weight (you don't burn fat well) - now you know.

One consolation about the high cost is that DNA tests need only be done once in your lifetime. But after that, your health destiny is in your hands. Which then begets the question: what price health?