What to Expect from 23andme’s Wellness Report
May 09, 2019
This is a description of my experience with 23andme’s wellness report, which covers nutrition, exercise and sleep.
As some of you may know, I often share my test results and findings (even though I take the right for privacy very seriously!) with the goal of starting the discussion on self-collected data and learning about other people's experiences. The links and screenshots of the results are available below.
23andMe is a personal genomics and biotech company whose mission is to help people access, understand and benefit from the human genome. 23andme had a previously fraught relationship with the US Food and Drug Administration (FDA), who ordered the company in 2013 to stop marketing its Saliva Collection Kit and Personal Genome Service. On October 21, 2015, 23andMe announced that it would begin marketing carrier tests in the U.S. again. It has since then received approval for many of the applications it has submitted to the FDA.
I ordered my test a few days after it was available on the market again in 2015. While the health and ancestry reports account for the majority of the results, I was mostly excited about the wellness section. I also checked back in eagerly every time I received an email about this section being updated with new results!
Here's How It Works
The DNA analysis requires a saliva sample; the consumer is provided with a box that includes a funnel lid, a saliva collection tube, a tube container, a specimen bag and an instruction manual. After you collect the saliva, you can be mail it back to 23andme in the same box. The results are then available within 6-8 weeks.
In my case, 23andme was not allowed to accept specimens collected from the state of New York; that has to do with NY state’s strict regulations regarding direct-to-consumer testing (one of the most asked questions at Fitnescity, since it’s a NY company!) As a result, I collected and mailed my specimen in New Jersey, and was able to complete the test.
About the Wellness Report
The current 23andMe wellness report includes a section for each of the following: genetic weight, saturated fat and weight, muscle composition, lactose intolerance, deep sleep, alcohol flush reaction, and finally, caffeine consumption.
The overall format of each report consists of the result, interpretation, a brief background on what is being tested, as well as other relevant information for each topic. There is also an expandable section for a more detailed explanation of the genetic variants being tested as well as the prevalence of that particular variant in other 23andme customers for comparison. Certain words that are underlined have definitions that appear when the cursor hovers over them, which makes the report easy to follow through. So overall, it’s very user-friendly.
Genetic Weight
My result for this part of the report informed me that I was genetically predisposed to weigh about average (which is not a bad thing...) This result was then followed with an important caveat: Lifestyle and environment may have just as much of an impact, if not more.
In the case of genetic weight, 23andme measured several DNA variants that had varying degrees of effect, and took that into account in the analysis. The report also compared my weight with that of other 23andme participants of European descent, which is the default for people of mixed ancestry. What was special in this section was that the report compared my result with that of other people with similar genetic predisposition and looked at their lifestyle, and how this might have affected their respective weights. This is great because you can get an overall picture of how people with similar genetic background are affected by environmental factors.
However, although this section was useful in theory, it did not provide any groundbreaking information: It showed that people who avoided fast food, limited red meats, ate vegetables, exercised, slept well, had the healthiest weights, which, well, made sense because they were living the definition of a healthy lifestyle. 23andme used the BMI of other participants of European descent to collect data on habits of people with ‘healthy weights,’ but had a disclaimer that differences in reported weight may be influenced by other lifestyle, demographic, and genetic factors, all of which were not included in the analysis.
Additionally, the report had a Genetics and Lifestyle Associations section, which summarizes how genetics could influence how much someone’s lifestyle can impact weight. This data is based on the BMI of other 23andMe research participants with different genetics and habits. For example, it seems that my genes have an average effect of 12.8% on my response to exercise.
Saturated Fat and Weight
The saturated fat and weight section is about my sensitivity to saturated fat in respect to my weight. My results showed that my weight was likely to be similar on diets high or low in saturated fat with the same number of total calories. That being said, 23andme does explain that this does not mean that I can (or should) eat large amounts of highly-processed foods. The report does a good job of reminding consumers who receive this type of result that saturated fat is associated with LDL Cholesterol, a risk factor for heart disease. So, the report still recommended that I limit my saturated fat intake, after all!
Muscle Composition
This is the section that I was really excited about. Power and endurance athletes differ in the composition and the capabilities of their muscles. These differences may be influenced by genetic factors, and this part of the report attempts to show that.
While it is clear that exercise is beneficial, it is not really clear how one should decide what to do to get and stay fit, and how someone’s genetics can (perhaps) be used to help guide their training. In June 2016, I talked about my experiment with different exercise choices at the Quantified Self Boston chapter. I (simplistically) put exercise into two buckets: power and endurance. I then decided to track my performance for each training regimen for a year by focusing on a single metric and watching its progress. At the same type, I tried to “double check” my findings with my 23andMe muscle composition results. Both my experiment and my 23andme results suggested that I show a propensity toward building fast-twitch fibers which allow for better performance at power, which as opposed to endurance, focuses on short, explosive activities, such as sprinting or weight-lifting.
My genetic variants showed that my composition is common among elite power athletes, since almost all of elite power athletes possess the same specific genetic variant. However, the big caveat is that research has so far only focused on elite athletes, and it’s not clear that those results apply to the rest of the population (like me!)
Moreover, the 23andme result did have an important disclaimer, which is that muscle composition and capabilities are influenced by both genetic factors AND training decisions. It was nice to see though that this report did caution that the contribution of genetics to muscle composition is minimal and explained that how we train might far outweigh the contribution of the genetic result at this marker.
My results were based on a genetic marker in the ACTN3 gene, which controls the production of a protein made by muscle cells. High levels of this protein production are apparently beneficial for at least the highest levels of power-based athletic activities.
Deep Sleep
The deep sleep section of the wellness report essentially tells you if you are a light/deep sleeper based on whether or not your brain produces certain waves of electrical activity, called delta waves.
This section was probably the most surprising one for me. Anybody who knows me knows that I am good sleeper. Not much can disturb my (straight) 8-9 hours of sleep :) However, my results indicated that, based on my genetics, “I am not likely to be an especially deep sleeper.”
In addition to the general information provided in the report, 23andme includes a small section on how caffeine can influence deep sleep, providing two studies with contradicting results. Nonetheless, the report makes a general recommendation to avoid caffeine later in the day to aid with sleeping at night (nothing new!)
Caffeine Consumption
This was also one of the reports I looked forward to reading. First, I’ll have to start by admitting that I drink 4+ cups of coffee per day (yes…)
Second, I have always thought that caffeine consumption was mostly determined by cultural and environmental factors, such as having a long day at work or not getting enough sleep. However, according to 23andme, genetics have a role in how much caffeine people tend to consume, too. 23andme tests for genetic variants around two genes – one that codes for an enzyme in charge of breaking down caffeine, and another that ramps up the enzyme’s activity. Based on that, it determines how quickly the body might metabolize caffeine.
My result said: “Laila, based on your genetics, you are likely to drink less caffeine than average, if you drink caffeine at all.” Interesting… but perhaps also a reminder that environment and lifestyle can influence those results... a lot.
The report also had a small section on how caffeine affects performance, suggesting that it could be an "illusion" and individuals can actually develop withdrawal symptoms that can worsen their productivity. It transitions beautifully into what is considered excessive caffeine intake as well as other factors that can affect its consumption, such as other undiscovered genetic variants as well as culture and history.
Overall thoughts
23andMe provides a fun and user-friendly interface for each trait and its associated genetic variant(s). It includes scientific evidence and explanations to support each section. Although it was definitely interesting to learn about certain genetic predispositions, such information should be taken with a grain of salt. There are still many unknown genetic variants that are not taken in account in each trait. Moreover, environmental factors have a major role in the expression of certain genes.
In summary, the experience was entertaining (I’ve heard some people in the industry call it “genetic entertainment”), relatively informative, and mostly very exciting.. at least for me! As someone with no background on the topic, I’ve certainly learned a lot. It was also a good “first-hand” perspective on the relationship between genetics and nutrition/exercise, and how this field is still a (very) nascent one.
My overall impression is that the findings can (unfortunately) be of little impact for the consumer as of today. This obviously does not take into account that consumer data is currently being used for research, which in turn could make their results more useful one day. It’s hard to miss that each section basically reminds consumers of the importance of lifestyle and environment in improving their overall wellness. I personally think this type of results can be helpful, but only for individuals who are fully aware of (and already following) basic and well-studied aspects of nutrition and exercise (e.g. eating more greens, drinking more water, following a healthy macronutrient breakdown, getting enough physical activity, etc.)
Have you taken the test (or any other similar ones)? Let me know your thoughts!
