Is your life predetermined?

Is your life predetermined?

Awhile back, I heard a talk by Tom Blue, healthcare innovator, entrepreneur and Functional Medicine proponent, where he made the observation that we are moving from an era of pre-determinism to self-determinism in healthcare. I wanted to take some time to explore this concept further. 

Pre-determinism? Self-determinism? What does that even mean, you ask? More importantly, how will that help me on my baby-making journey? Hang with me and we’ll get there. 

Let’s start with pre-determinism, which is the idea that all events, including human actions, are decided in advance (or pre-determined, as it were). In the context of healthcare, it means that the development of individual health is predetermined by heredity. Basically, in the nature v. nurture debate, it puts all of the eggs in the “nature” category - you are born with a certain set of genes, those genes determine your destiny and there isn’t anything you can do about it. Pretty disempowering, huh? 

Genetic pre-determinism was the predominant theory of health for generations. However, with the sequencing of the human genome in 2003 and many other scientific and technological advancements, especially those in diagnostic testing and big data, our understanding has evolved significantly. In fact, Eric Lander, PhD, geneticist and one of the leaders of the Human Genome Project, so eloquently said: “The greatest danger is a mistaken sense of genetic determinism - that people will think that because genes play a role in something, they determine everything. We see, again and again, people saying, ‘It’s all genetic. I can’t do anything about it.’ That’s nonsense. To say that something has a genetic component does not make it unchangeable. Environmental factors play a huge role.”  Genes absolutely play a fundamental role in health, but they are not the whole story; frankly, they’re not even most of the story. 

That brings me to self-determinism, which essentially means that you have control over your health decisions and therefore your health outcomes. How much control? The latest research estimates that ~20-25% of the variance in health comes from genetics and the remaining 75-80% comes from environmental factors (including things like diet, exercise, stress, exposure to toxins, etc.).  In other words, the vast majority of your health outcomes are in your control.

How is that possible? Because our environment actually shapes how our genetics are expressed. 

Internal and external environmental factors (like stress, sleep, smoking, social connections and so forth) are like little switches that basically turn certain genes on and certain genes off; these “on-off” switches determine which proteins are expressed in the body and the expressed proteins then manifest as either health or disease. Moreover, if certain parts of your genetic blueprint are turned on or off by a certain environmental factor (say smoking, for instance) then the impact that this environmental factor has on your genes can also be passed down to your children and your children’s children. We now know that this “epigenome” (environmental influence over genetic blueprint) is inheritable. Therefore, it’s less about your genetic blueprint per se, but the interplay of your genetic blueprint and your environmental influences.

Taking a step back from the nitty gritty science for a moment, what this basically means is that your health (and by extension, the health of your children) is not set in stone; you can take actions, starting today, to improve your health and the health of your family for generations to come.
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