Topic 1: Epigenetics

Before we dive into any discussion about lifestyle, we need to understand why it is important. We need to get out of this mindset that we are all genetically doomed to be sick. It puts us in a state of helplessness, hopelessness, and into a victim role. We need to understand how much power we have over our health destinies. To accomplish this we must explore the field of epigenetics.


"Research into epigenetics has shown that environmental factors affect characteristics of organisms. These changes are sometimes passed on to the offspring."

What does this even suggest? It says that there is a huge amount of data that supports the idea that the environment in which our genes are subject to, is as important as the coding of the genes we inherit. In fact we can pass this environmental baggage onto our kids if we aren't proactive.

I'm sure as a healthcare provider you ask about the "family history" in your H&Ps. As patients your doctor has likely asked if cancer, heart disease, diabetes, etc "runs in your family." Its obvious that many disease processes have a genetic link which is why the question is asked. But have you ever asked yourself, how much of this is a pre-disposition where you have no control? Well actually quite rare.

"Although specific genetic variants have been identified in rare Mendelian forms of hypertension, these variants are not applicable to the vast majority (>98%) of patients with essential hypertension." (Harrison's Internal Medicine, 18e)

Just to get this out of the way now, words like essential, primary, idiopathic, cryptogenic in medicine generally means we have no idea what causes these diseases. Over 98% of one of the most common problems in the U.S. have a complex multi-gene/epigenetic etiology or cause. Is this just an isolated disease process? What about the big D? No not diarrhea. I mean diabetes, and lets clarify type 2. Again lets go back to Harrison's. "The genes that predispose to type 2 DM are incompletely identified, but recent genome-wide association studies have identified a large number of genes that convey a relatively small risk for type 2 DM (>20 genes, each with a relative risk of 1.06–1.5)." So with the best research we have on genes, even if you are one of the unlucky few to a genetic predisposition to diabetes, you have an increased risk of 6-50%, thats if you just do nothing. Do we see a trend? 

So I am gonna talk about a little bit of molecular biology, biochemistry, so please stick with me.

Many molecular structures are being discovered to be important factors such as the histones. These proteins were always classically seen as just a way to save space inside the cell by tightly wrapping DNA around them. Research has proved it is not quite as simple as we would like it to be, imagine that. Depending on the chemical group they carry, if they are acetylated or methylated, they permanently activate or deactivate genes. What is scary is that the choices we make, seems to also be able to be passed on from generation to generation.

This appears to be just the tip of the iceberg, and it also appears to show that unlike a strict coding sequence that requires a mutation to change and complicated systems of DNA repair proteins to fix, because they are caused by the environment, we can repair these epigenetic changes, by changing the environment to one that is more favorable to the body. This is good news for us, because it puts the power back into our hands for our own personal health destiny and that of our children.

The most referred to study on this phenomenon was a study done in mice, Agouti mice. I am no expert on mice but apparently they typically are yellow, fat and are prone to diabetes and cancer. However, interestingly enough, if Agouti females are fed vitamin B12, folic acid and choline, directly prior to and during pregnancy, they give birth to mainly brown, slim and healthy offspring. And then when those offspring reproduce, hey in turn mainly have offspring similar to them.

The good news is, with the right lifestyle we epigenetically reverse or combat these defects and regain and retain our health and vitality.

To your health,

Dr. Peavler