It's in the genes
Our analysis of technology’s impact on the Healthcare and Fitness industries has focused on devices, software and systems. In this post, we shift our attention to gene slicing as a tool to identify and prioritize personal health risks. This technology builds on the sequencing of the human genome, which is the complete sequence of nucleic acid encoded as DNA.
The initial effort to map the human genome, the Human Genome Project, was undertaken by a collaborative international team in the 1990s. The first draft covering 90% of the genome’s three billion base pairs was published in 2001. The full map followed in 2003[i]. It led to overly optimistic predictions of near term treatments and cures of many conditions and chronic illnesses. An alternative strategy sought to identify gene patterns that suggested individual vulnerabilities to a variety of illnesses and conditions such as cancer, diabetes and heart disease. This path, which is still in its infancy, is starting to bear fruit.
Mapping of the human genome took years of effort by an
international team of researchers. It was completed in 2003.
Companies like Health Nucleus use “cutting-edge technology and advanced whole genome sequencing” to analyze their clients’ DNA and gain insights into their health risks and likely response to various medicines. The resulting profiles are used to structure individual medical surveillances and preventive programs. These services suggest a near future where medical surveillance, prevention and treatment will be tailored to each person based largely on their genetic profiles, lifestyle, health and fitness levels.
For example, Type-2 diabetes is recognized as “a global health concern" that affects "approximately ten percent of the world’s population ... in their lifetime.[ii]” Genetic and environmental factors affect the probability of individuals becoming diabetic[iii] and thus genetic testing, near real-time blood glucose monitoring and dietary controls can be used to prevent it. Technologies that help identify the risks, and prevent or delay the onset of type 2 diabetes are already on the market, and new ones will expand on existing capabilities and ease of use. This is critically important because, in the United States alone, eighty-six million people are pre-diabetic and at risk of developing type 2 diabetes, and 90% of them don't know it! The costs of this largely preventable condition were estimated in 2012 at a staggering $322 billion dollars. On average, people with diabetes will experience 230% higher medical costs than those unaffected by the condition[iv].
Genome testing may also play a part in preventing sports-related brain damage and long term cognitive deficiencies. For example, studies of the Apolipoprotein E (APOE) gene, which influences the production of the apoE lipoprotein, suggest that it influences how quickly and effectively people recover from Traumatic Brain Injuries (TBI). This lipoprotein is “an important mediator of cholesterol and lipid transport in the brain, which is believed to play a key role in the repair of damaged neurons by mediating the recycling of cell membrane components from the debris of damaged neurons.[v]” Thus, genetic differences may help explain why some players in high impact sports such as American football demonstrate catastrophic cognitive damage as they age, while others remain largely asymptomatic. It’s likely this line of research will lead to the testing and screening of prospective players, beginning at a young age, as part of a comprehensive brain injury prevention strategy.
Genetic screenings, and real-time personal monitoring and analysis systems will play important roles preventing and delaying the onset of diseases and conditions, such as type 2 diabetes and TBI induced dementia. Machine learning and related analytical methods will carry out increasingly sophisticated evaluation and diagnosis of fast growing personal health and fitness data, and deliver results in user friendly, actionable formats. This process will likely shift early intervention and preventive care from higher cost healthcare providers to lower cost, more accessible, convenient alternatives, such as fitness clubs.
The potential social and economic benefits of these disruptive technologies include reduced mortality, improved quality of life and hundreds of billions in yearly healthcare related savings. In this context, our investigation suggests that technology and related fitness-centered services offer the best hope of slowing the escalating social and economic costs of traditional healthcare, without sacrificing the dramatic health and fitness benefits we've come to expect.
POSTS IN THIS SERIES
[i] An overview of the human genome project, National Human Genome Research Institute, accessed June 21, 2017, https://www.genome.gov/12011238/an-overview-of-the-human-genome-project/
[ii] Genetics of type-2 diabetes revealed in unprecedented detail, National Institutes of Health, July 11, 2016, https://www.nih.gov/news-events/news-releases/genetics-type-2-diabetes-revealed-unprecedented-detail
[iii] Mariana Murea, Lijun Ma, Barry I. Freedman, Genetic and environmental factors associated with type-2 diabetes and diabetic vascular complications, National Institutes of Health, May 10, 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448170/
[iv] The staggering costs of diabetes, American Diabetes Association, accessed June 24, 2017, http://www.diabetes.org/diabetes-basics/statistics/infographics/adv-staggering-cost-of-diabetes.html
[v] Xiao-chuan sun, Yong Jiang, Genetic susceptibility to traumatic brain injury and apolipoprotein E gene, Chine Journal of Traumatology (English Edition), August 2008, p. 248, http://www.sciencedirect.com/science/article/pii/S1008127508600516