Last autumn, my husband and I purchased two DNA analyses by 23andMe. Well, I purchased them and goaded him into trying it with me. I'd heard Robb Wolf speak at a Farm-to-Consumer Legal Defense Fund event we both attended. He's a compelling speaker, fascinating with an intensely science-based approach, he mentioned DNA analysis by 23andMe as a way to approach ancestral health and gain a fuller understanding of your own personal genetics. It intrigued me.
So in November of last year, I finally placed my order online. Our packages arrived, we read the instructions and dutifully swished, swished and spat into their tubes. Sealed them up, and sent them off. And then we waited, and waited, and waited. And waited until mid-January when 23andMe finally posted our results online.
23andMe Ancestry Report
It's a fascinating thing to see your genes splayed out in graphs and charts, and I imagine it's particularly fascinating for Americans, mutts that we are, to finally see ancestral lineage so very clearly. And while I can see the results very clearly in the chart above: 29.3% British and Irish, 7% French and German on down the line, what I miss are the stories. It's a cold, but fascinating, calculation to see your genetic story dialed down to numbers, and I'm left wanting, still for the history of the people who made me.
For me, the ancestry composition provided reinforces some of the stories I was told about my heritage: namely, that my forebears who emigrated to the United States in the mid- to late-20th century were Irish, English and German.
In addition to Ancestry Composition, 23andMe also provides information on haplogroup, or very deep ancestry that links your genes to ancestors who migrated from Africa, allowing you to essentially retrace the migratory routes of your most ancient ancestors. For women, only reporting on maternal haplogroup is available though for men reporting on both maternal and paternal haplogroup is accessible through 23andMe. It's through the analysis of the haplogroup that 23andMe links your genetic lineage to probably distant ancestors. For example, my report on maternal haplogroup indicates that I likely share an ancient ancestor with Marie Antoinette and Napoleon Bonaparte. Not particularly actionable, and of trivial interest.
As part of our ancestral reports, we also learned about our Neanderthal ancestry; that is the average person of European heritage has about 2.7% Neanderthal DNA. I learned I have 2.1% Neanderthal DNA and my husband has 2.7% which, again, is trivially interesting but not particularly actionable or informative.
23andMe Health Report
We were fortunate that we ordered our DNA analyses just before the FDA forced 23andMe to stop providing the service (though the company still offers ancestry reports and raw genetic data for you to analyze on your own). While the ancestral reports are fascinating, the health reports on health risks, drug response and inherited conditions are more valuable because they represent talking points to provide to your health care provider or in approaching your own health through lifestyle choices.
Some people may not wish to know about their genetic predisposition to certain health issues, but others find it fascinating or at least helpful. For reasons of privacy, I won't share the details of my health reports or those of my husband, but it's important to note that the health reports only analyze likelihood of developing any given condition, and that they're not diagnostic; that is the report provides you information on your individualized risk (as it relates to your genes) compared to the general population. And, in this way, the information is not particularly actionable; rather, it provides information to discuss with your health care provider in relation to your overall health. Genes play a role in the likelihood of developing disease, but so, too, do lifestyle factors, environment and choice. And even if an individual's risk is lower (or higher) it is still just a risk, not a diagnosis.
23andMe also provides information on likely drug response which could be critically valuable in a medical setting. While I don't take prescription medication, having no need, if my doctor were to prescribe certain medications to which I may have increased or reduced response to, the information could be helpful in helping him to ascertain the best dose or to choose the best medication for me.
Lastly, 23andMe provides information on carrier status for various inherited conditions like cystic fibrosis, tay sach's disease, hemochromatosis and many, many others. While you probably are already aware of the potentiality of being a carrier for various inherited conditions depending on how well you know your family's health history, the information can be very valuable especially as you and your partner look to have children, or, again, when discussing your health with a medical professional.
23andMe and the FDA and Other Criticisms
As many of you are aware, the FDA and 23andMe have been embroiled in a bit of a battle over the accessibility of health information: namely risk of certain diseases. Having viewed my own health reports, and those of my husband, I think it's a bit of a stretch to imply that the work of 23andMe is diagnostic or prescriptive. It simply provides slightly more individualized risk levels associated with various conditions, which is, of course, not a diagnosis - it's simply statistics. Further, the likelihood of developing many disease is not only related to genetic predisposition, but also lifestyle factors which can't be included in 23andMe's report of relative risk. And the closest recommendation provided to me from 23andMe was the recommendation to eat plenty of fruits and vegetables, fish and nuts and to not smoke. Couldn't we all benefit from those general recommendation for a healthy lifestyle?
Further, 23andMe simply provides information on ancestry, relative health risks as they relate to genetics, and, as such, is simply a tool providing people perspective on their general health. Any actionable steps, outside of general choices to lead a healthier lifestyle, would and could only be taken under the guidance of a health care professional.
Keep in mind that another concern is the relative accuracy of the health risks presented by 23andMe, with fear being that users will attempt to take action (or fail to take action) based on results that could be inaccurate. A New York Times writer tried several different genetic tests and found them each to yield slightly different results when it came to the relative risk of developing various diseases. You can read more about her results here.
For my part, I think it's foolish to entirely base health care decisions off of the results of a spit test you ordered from the internet; yet, it could be helpful (or at least interesting) to look at those results in the context of lifestyle, and under the guidance of a doctor should you need to take action.
Putting it All Together
For us, it's been a fascinating approach as we've looked to the ancestral component of the 23andMe reports - and it encouraged me to re-read Nutrition and Physical Degeneration, a book which describes the native culinary traditions of peoples all across the world, paying great attention to the peoples of the outer Hebrides since their heritage most closely resembles my own, as well as to take a deeper look at the traditional foods of Ireland, England, France and Germany. And while it's health reports are informative, though not diagnostic or prescriptive, it provides a reminder to engage in a healthy lifestyle: physically activity, stress reduction and eating lots of whole foods.
Participating in 23andMe
The cost of analysis by 23andMe is $99, expensive but not ridiculously so. While 23andMe can only provide ancestry reporting, and not the health reports I received to new subscribers, you will receive your full genetic details and you can conduct further research on your own. If you choose to order through this link, I'll earn a small referral bonus which doesn't influence my thoughts on the service; rather, it simply helps to support the continued maintenance and development of this site.