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"Outsmart Your Genes" Aims to Simplify Genetics for the Lay Public, But Goes Too Far


Brandon Colby's interest in genetics started in the most personal manner — he was born with a genetic skin disorder. In an effort to understand his own DNA, he went on to medical school. Colby now runs a "predictive medicine" practice, based on the principle that patients need to explore their genes with their doctors. This is also the impetus behind Colby's book, Outsmart Your Genes, which advocates that patients take a proactive approach to their health by learning which gene mutations they may have that put them at risk for cancer, Alzheimer's, or other diseases, and by altering their behavior or environment to ameliorate any predicted risks. What Colby is essentially advocating is the empowerment of patients, a cause that few would disagree with.

However, because of its intended audience — the layperson that likely has little experience with, or knowledge of, genetics — Outsmart Your Genes falls into a trap laid for many self-help books: the subject matter is oversimplified. The book doesn't seem to acknowledge that there is still a lot of work and analysis left to be done, and therefore much uncertainty in the field. For example, when Colby talks about Alzheimer's disease and APOE, he says that if a person is found to have a variant of the gene, then that person can take steps to "delay or prevent Alzheimer's before it manifests." He seems to ignore research showing that no preventive measures can alter a person's risk or likelihood of suffering from the disease. Outsmart Your Genes was published in April, and in May, an NIH-sponsored review of previously published medical literature was released, which showed that nothing currently available works to prevent the disease. When he discusses obesity, Colby doesn't talk about factors other than genetic variants, such as the makeup of an individual's microbiome — the study of which, including its effect on obesity, is only just beginning.

Colby does, however, stress the importance of health care professionals' involvement in the process of figuring out an individual's genes. He also says that knowing which genetic variants a person has is only the beginning of the conversation people should be having with their doctors. At a point when scientists are often decried for not being willing to communicate with the public about their work, Colby is, at the very least, attempting to shed some light on a dense, difficult, and complicated subject. He could, perhaps, have better served his intent by writing a book aimed at physicians and at starting doctors down the path to thinking about genetics and genetic testing as a tool in their practices, instead of at patients who may be expecting too much from the field.

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