Super Human Radio

Like any industry.. when an emerging technology arrives many use the consumers unfamiliarity with it to capitalize and profit. The same appears to be occurring with In-Home Genetic Testing. A recent undercover investigation of some of the most visible companies in this segment was performed by the General Accounting Office of the US Government .

Consumers are being told untruths about the extent in which genetic testing can provide a glimpse into future disease development as well as procedural issues. Some are being told to test others without their knowledge as a "gift" which would be a violation of privacy.

While testifying in front of the House Energy and Commerce Subcommittee on Oversight and Investigations, Gregory Kutz, a GAO investigator,detailed one such occurrence where a sales rep from Pathway Genomics suggested that a woman test her fiance's genes without the man knowing and offer it to him as a gift. The bride-to-be was actually a GAO undercover investigator. Secretive DNA testing is against the law in 33 states currently including the one the supposed fiance resided in.

While this is a violation of privacy the suggestion was some what innocuous compared to what an undercover investigator was told by a representative from Navigenics. When discussing the results of DNA testing to elucidate the risk of developing breast cancer, the woman was told that if her test results predicted  above-average she was "in the high risk of pretty much getting" breast cancer. This exact scenario was actually proven to be incorrect many years ago when original DNA testing studies predicted breast cancer development in some of the test subjects. A group of the high risk subjects opted for voluntary radical mastectomies as a preventative measure. The less reactive study participants who also tested in the high risk category did not have radical mastectomies and opted to watch with vigilance. And they did not develop breast cancer over their life time. As I've said numerous times on the show.. you are not a slave to your genetics. What you do with your genetics has more to do with the development of predisposed diseases. But accurate DNA testing can help guide you as to the what-to-do and what to stay clear of.

DNA testing is also quite foul-able. As with any test, collection of the specimen and exposure of the specimen to contaminants can alter the results as can the errors that take place in the assay process. Of the four companies that were investigated - 23andMe, deCode Genetics, Pathway Genomics, and Navigenics - all gave varying results for the same DNA specimen. For instance one company rated a donors risk of hypertension at "below average" while another rated it as "above average" and yet another said it was "average".

In some cases the predictive ability of the in-home test was in direct contradiction with an existing known abnormality or disease. As was the case in predicting that one donor had decreased risk of developing heart rhythm abnormalities yet he was already fitted with a pace maker due to Atrial Fibrillations.

DNA testing has its place. I'm not condemning it. What I am saying is that something as important as DNA testing should be done in a very controlled very specific environment by a skilled clinician. I called Dr. Peter Rouse who has appeared on SHR to ask his opinion since I know they do DNA test collection at his clinic AF Performance Center in Santa Monica California. He shared with me that there are many areas that in-home collection of the DNA sample can go wrong. One immediate factor is quite often "the swabs that are used for in-home collection are standard over-the-counter swabs" and are not suitable for this type of collection. They may not even meet the sterile requirements.

If you're going to get DNA testing get it done by a qualified clinic like AF Performance Center. If you have questions you can contact Dr. Rouse and he'll be happy to help. Don't skimp on this step or the information may be as meaningless as turning your decision over to the Magic Eight Ball.

The FDA announced that an advisory panel will meet this week to propose tougher regulations and tactics to oversee rouge MD's who over-prescribe long acting pain killers to their patients.

A Risk Evaluation and Mitigation Strategy (REMS) will be required for all long acting or extended release opioids. Drug maker would be required to create a plan to educate doctors about the risk of abuse., Huh?? Doctors don't already know this? OK....

And for the scary part of all of this.. the new proposed oversight would require a database of patient names who are being prescribed pain killers. Now they've lost me. I'm all for oversight of physicians who may be abusing their prescription rights and actually supplying patients with would-be-recreational drugs. Listing the patients is unnecessary and a violation of our privacy rights and possibly HIPA.

The FDA need only know how often a physician prescribes opioids and IF it is the same patient, the length of time a given patient has been prescribed. They do not need to know the names of patients to achieve this. This may also cause some patients who genuinely need to use pain killers to avoid the prescription so they don't end up on a governemt database!

Once again, a simple solution is styled to become a wide-sweeping over-reaching net to capture more informastion than needed and to compromise our privacy.. Its estimated that four million patients are prescribed long-acting or extended release opioids each year.. The advisory committee meeting comes about a month after new data showed that prescribed painkiller abuse now matches abuse of illegal drugs.

While I am all for punishing rouge doctors who would profit from Innapropriate prescribing practices, it should not be a legitimate reason for breaching the privacy rights of some seventy million legitimate chronic pain sufferers.

BMI - Body Mass Index - has been a flawed system of determining if a person is at a "normal" body weight range since its inception. BMI was created by Belgium statistician Adolphe Quetelet in the 1800's in an attempt to classify obese people.  BMI never took into account the amount of lean body mass - muscle - a person carries. BMI works like this: your body weight x 703 is divided by your height in inches squared. SO... lets use me as an example. I'm 6' 2" tall and I currently weight 224 pounds. We need to convert my height to inches - 74 inches - then square it (74 x 74 = 5476 ). Now divide my body weight  x 703 -  (224 x 703) / 5476 = a BMI of  28.8.

OK now lets look at this based upon the standard BMI rules. You're underweight if you're BMI is less than 18.5. You're obese if your BMI is 30 or over. Overweight is anything between 25 and 29.9 and if you happen to fall between 18.5 and 24.9 you're considered  "normal weight". So based upon MY BMI.. I'm overweight and pretty darn close to obese for my height. Oh yes.. and one more thing. BMI offers no variance for men and women. We are all lumped into the same group.

Doctors regularly use BMI to suggest that their patients loose weight to avoid metabolic syndrome.

Anyone with any common sense has been saying BMI is severely flawed for a long time.It does not take into account percentages of fat -vs- muscle.  Finally a group from the German Institute for Nutritional Research in Potsdam-Rehbrücke has offered their opinion as well. After through research they have suggested that the waist circumference plays a more important role in predicting the potential to develop diseases related to obesity like Type 2 Diabetes over BMI.

Visceral fat is an active type of fat that has been linked to greater risks of cancer, heart disease and diabetes. Waist circumference would allow physicians to identify otherwise "normal weight" individuals who meet the BMI for their height but are at greater risk of developing metabolic syndrome than their more muscular counterparts who are NOT at risk of developing metabolic syndrome yet DON'T meet the BMI for their height.

Its time to retire Quetelet's one-size-fits-all approach and adopt more intelligent methods of categorizing body types that really dose identify potential health risks.

Postmenopausal women not on hormone replacement therapy may do better to keep a little extra fat on their bodies to promote better cognition. A study performed by Diana R. Kerwin, MD and colleagues, of Northwestern University in Chicago found that women with higher BMI and apple shaped body types had better cognitive abilities than women with lower BMI's and pear shaped body types.

While the researchers were not able to point to a specific reason for this - I think I know why this is. Estrogen is created in fat cells by way of  the Aromatase Enzyme. Women with higher fat produce higher periphera levels of  estrogen. This has been proven in studies that look at obesity in women and the progression of estrogen de[pendant cancers.

Women with higher BMI's produce more estrogen and estrogen has been positively linked to brain function in women in numerous studies.

This does not negate the fact that obese women - pre or postmenopausal - run a greater risk for heart disease and cancer so if you are postmenopausal and don't want to spring for hormone replacement therapy - getting fatter should not be an option.

In my humble opinion this study indirectly point to the fact that estrogen is important for brain function and women who want to maintain cognitive acuity should absolutely consider hormone replacement therapy and not putting on weight.

Parkinson's Disease (PD) is a devastating disease that renders its victims unable to control their movement. Recent research has shed two important factors that can both help understand the onset and perhaps even stop the progression of the disease entirely.

A period known as the preclinical period - where the damage of the disease may be occurring but motor symptoms have not manifested yet - was always understood to occur around 6 years prior.  What was learned during a study performed by Rodolfo Savica and colleagues shows that the preclinical period may be as great as 20 years in advance of onset of motor symptoms. The indicators are not what one would look for or attribute to PD either,

Conditions such as constipation, anxiety disorders, rapid eye movement sleep behavior disorder (RBD) and anemia may be associated with the pre-clincal period of PD and may begin to occur as far out as 20 years prior to the onset of neuro-motor symptoms. Olfactory impairment and depression may also precede the onset of motor manifestations, but the lag time may be much shorter.

Recognition of non-motor symptoms may give clinicians better preclinical biomarkers when identifying the risk factors of PD.

What is more exciting however is that a study published in the Archives of Neurology has discovered  a link between vitamin D levels and the onset of PD. Paul Knekt and colleagues at the National Institute for Health and Welfare, Helsinki, Finland performed a longitudinal study over the course of 13 years with 3,373 men and women who were PD free at the onset of the study. Blood samples were drawn from 1978 through 1980 and frozen.

Over the 13 years 50 participants developed PD. The blood samples from all the participants was examined and a direct link between the lowest Vitamin D levels and the onset of PD was established. At the same time the individuals with the highest Vitamin D levels had a significantly reduced risk of developing the disease.

The results are consistent with the suggestion that high Vitamin D status provides protection against PD. The mechanism of action is unclear, however, we do know that there is a concentration of Vitamin D receptors in the Sunstantia Nigra and thus it may be that the activity and protection of dopamine producing neurons is some how linked to the availability of Vitamin D. More research is needed to better understand how Vitamin D influences the onset of PD.

In the mean time, if you believe that you have a risk of PD, it would be prudent to have your blood levels of Vitamin D tested regularly and supplement with Vitamin D to keep levels high.