For my birthday this summer, my wife bought me a personal genetic testing kit. Her motives were allegedly a mix of scientific and anthropological curiosity (although I have my doubts) and on these fronts the kit did not disappoint. The results allowed me to trace my genetic origins across Europe and the wider world – all uplifting and fascinating, even if I was bemused by the revelation that I have slightly more Neanderthal DNA than the average person.
There is a feature of these kits that I didn’t activate. Predictive diagnostics claim to inform the kits’ users of their predisposition to certain traits and health conditions. Anticipated advancements in this are a crucial potential tool for doctors to prevent conditions in patients – before they become patients – by recognising which conditions they have a higher risk of getting, and then modifying their lifestyles or prescribing treatments to minimise that risk.
The impact here on the way we eat and the prospect of ever more personalised diets was discussed this week at our latest Trends Breakfast on the Future of Food.
Will we move into an era where personalised diets are based less on faddish pseudo-science and more on a rigorous understanding of our genetic profiles?
A number a barriers exist at the moment:
- The accuracy of such predictions – the home testing kits are currently not sufficiently accurate to offer anything beyond an indication of predisposition, meaning those features have the possibility of doing as much harm as good as we could end up worrying over nothing. Key questions need to be answered here: how accurate does the science need to be?
- Individual choice – do we even want to know? Many would surely rather live in blissful ignorance of conditions they may or may not be disposed to, rather than spend their healthy lives concerned about a specific health event they may never experience. My family history suggests I have a good chance of going bald – but I’d rather live in hope than fear.
- Family responsibilities – one user discovering their risk factors is a personal choice, but if that user has siblings they are acquiring knowledge directly pertinent to their brothers and sisters as well. What are the ethical implications of this? If they don’t want to know, do we have a duty to tell them anyway?
If illness incidence can be suppressed by modification to lifestyles and diets, we are likely to see significant policy action and pressure from governments. Health services in the UK are already under severe financial pressure at the outset of a period of enormous demographic change: as society ages over the next 20-30 years we will see massive rises in the incidence of long term conditions such as cancer, diabetes and dementia as well as increases in the number of people living with co-morbidities (more than one long term condition).
The pressure on us to be healthy and to be considering our individual risks of ill health will be correspondingly greater – and relevant not just to public spending priorities but to commercial concerns in food service and insurance. Currently, our choices about food are driven primarily by a mix of practicality, and increasingly, enjoyment. In the future, the primary influence over what we eat may be our individual risks of far-off diseases.