Jeffrey Bland, PhD, recounts presenting at South by Southwest in Austin about functional and nutritional medicine and observing a millennial, health‑proactive audience interested in personalized, actionable health information. He highlights a paradigm shift from a disease model to a wellness/scientific‑wellness model, citing collaborations (e.g., Lee Hood/Institute for Systems Biology, Providence Hospital, AeroVelo/Pioneer 100) and examples where genetic variants (statin‑response SNPs, MTHFR C677T) guide personalized nutritional or supplement interventions (coenzyme Q10, 5‑methyl‑tetrahydrofolate) rather than simply predicting disease risk.
Chapters
Well, you'll notice that I'm wearing my south by Southwest badge and what an experience I had in Austin, Texas. This is quite a meeting of those of you who have never had the opportunity to attend. It's maybe a couple hundred thousand individuals. I would call it the high tech, high intelligence Mardi Gras. It really has all sorts of things going on from film to media, entertainment, music is all over the place and also tech and health. And I was there to give a discussion about obviously aspects of functional medicine, nutritional medicine, nutritional health. And it was really quite illuminating to me because the demographic is a very fascinating demographic. I would call it a lot of millennials, probably somewhere in the mid 30 age range and really proactive in individuals that are certainly activated towards healthcare and health and kind of, I would call it individual thinkers. So what did I take away from this? What I took away was that there is very powerful movement of people who are, I think for good reason, a little bit skeptical of what they hear. It's new. They want to be on the cutting edge. They want to be health proactive, they want to control their own information. They want to be part of the n of one experiment, the citizen scientist in which they're the subject that they're studying and they want to know real answers, things that deliver positive outcome to their life and that of their family and friends in terms of good health. So that leads us back to what's going on in the field right now. And as you know, there's this incredible movement that's happening right now that's revolutionary. And in fact, one example of that, just one, is this recent press release that just appeared. And the reason I find this an interesting example is my involvement with the Pioneer 100 program here in Seattle, Washington. And the title of this is a news erivol co founder Dr. Lee Hood and the Institute for Systems Biology affiliate with Providence Hospital System to catalog scientific wellness. Now, doesn't that sound like an oxymoron? A little bit. That a hospital system that has something like two and a half million lives that are enrolled under its care is connected to an Institute for Systems Biology, a high tech kind of genomics and informatics group, and this new business called Aerovol, that's a personalized healthcare, individualized healthcare around the construct of scientific wellness. Now that is really kind of a major paradigm shifting concept. So it really takes us back to our discussions that we've been having about what can you do with this new information. How is it going to empower people to make positive choices is all this information about our genes really just kind of that of scary risk about that you could die of the such and such disease because you have a certain gene, or is it really promoting health and wellness? And that then takes us back to the question, what good is a genetic test? And this is one of the things that I was talking about in our meeting at south by Southwest is I was indicating that there is more information about what we can do to promote our health than there is about risk to disease. If we just understand how to turn the equation around in terms of genetic testing. And let me use two specific examples that I think make the point. As you probably know, in the 23andMe genetic profile, they've added a recent new couple of SNPs into their interpretation. These have to do with statin risk. And they are SNPs that people have found that have certain kind of response to statins that are are including things like myopathies or muscle pain after taking statins. So that's one way of looking at a risk to adverse effects to statins. But the other way of looking at it is to say that One of these SNPs has to do with the way that our bodies make coenzyme Q10. And if you have this certain SNP, your body is less quickly able to make coenzyme Q10. So in that person, it may require more supplemental coenzyme Q10 in order to properly protect themselves against stress. Not just statins, but things that demand more oxidant exposure that would then create more need for antioxidants and more need for the body's protection against oxidative injury. So in this case, we turn that kind of SNP around to say it's not a ristostatin myopathy. It is an indication of unique need for coenzyme Q10 support and increasing susceptibility to oxidant stress. Let me give you another example. And that's Methylene tetrahydrofolate reductase. That's a big word, isn't it? Mthfr, another SNP that has been looked at quite a bit as a relates to folic acid need. And we say people who have a certain SNP, the CT677 SNP of MTHFR, and individuals who don't process folic acid as well, and therefore might require higher levels of folic acid or the preformed form of folic acid, which is called 5 methyl tetrahydrofolate. And so the question is, are these people at great risk? Well, the only way we really know that is to couple together. Whether you have that SNP with some aspect of the phenotype, is it expressing itself into your body in such a way that you are at risk? And how do we measure that? We measure that by looking at the blood at a biomarker called homocysteine. So if your homocysteine is elevated and you have this SNP for mthfr, that makes you a poor processor of folic acid, then what do you do? You take more folic acid or 5 methyltetrahydrofolate. It doesn't tell you you're at risk to early death. It tells you how to structure your diet, lifesty and your supplement program to provide optimal function and optimal health. So here is two examples of how genetic information can be used to empower us to personalize and be more precise about developing our own program for health. Not about the fear of death from a disease, but in promotion of health. And I think this is the theme that at the south by Southwest meeting seemed to be the most engaging for the individuals there. A very line, long line at the microphone of questions from the audience were really surrounding this specific issue of how do we produce an outcome in our bodies of good health, long life, not how do we just worry about the risk of disease, but actually proactivate health as a scientific experiment in our lives to produce a positive outcome. So we're really undergoing a tremendous change in thinking, a change in the paradigm moving away from a disease model to a wellness model. And I think these examples even of Araval and ISB and the Providence Hospital group are all indicating that this transition is occurring. It.
