DNA, Destiny, Health, and Obesity
Let’s face it. Americans don’t like the idea of accepting a preordained destiny. Nope, we’ll have none of that. We choose our own destiny here, thank you. So naturally, if the New England Journal of Medicine tells us that DNA is not destiny when it comes to our risk of heart attacks, we love it.
There’s just one problem. The investigators counted obesity as a lifestyle choice. So in their calculations, someone with obesity who gets a heart attack more or less opted for that. Having obesity is equated with choosing to smoke, working out, and eating healthy.
Apart from that one fudge factor, it’s a solid study. The investigators looked at four large studies of coronary artery disease with a total of more than 50,000 participants. They identified individuals with high, medium, and low genetic risks for coronary disease.They found that high genetic risk nearly doubled the risk of a heart attack compared to people with low genetic risks. They found that healthy lifestyle factors roughly cut the risks in half for people with high genetic risks.
One of those healthy lifestyle factors was no obesity.
It’s not a bad message. Pull yourself up by your bootstraps. Follow a healthy eating pattern (“diet” is so last century). Work out five days a week. Don’t get born into a family where everyone has obesity.
Oops. That last one doesn’t fit.
Anyone who has contended with obesity since birth knows they didn’t choose the obesity lifestyle. Women who experience profound metabolic changes after childbirth or menopause don’t choose it.
It’s time to let go of the biased assumption that people with obesity have signed up for it. We don’t have to capitulate. DNA is not destiny. Everyone can indeed make choices to improve their health. We have to do the best we can with the bodies we receive at birth.
But wishful thinking doesn’t obliterate obesity. And bias makes it worse.
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
November 15, 2016