The Role of Genetics in Health and Longevity

You may have more influence over your genes than you think.

Remember that friend who could pick up a guitar and play well — with little effort? Or that kid on the track team who outpaced everyone in the 300 hurdles yet rarely showed up for practice?

Meanwhile, you struggled, even after hours of practice. 

Doesn’t seem fair, does it? And yet, if you kept at it, your musical ability improved, and you won a few track medals. 

It’s not that different with genetic diseases. “Genetics is not destiny; it is modifiable,” says Nicholas Borja, M.D., a clinical geneticist at Sylvester Comprehensive Cancer Center and the University of Miami Health System. “There is a lot of randomness in biology – genetics, lifestyle, exposures, luck – all play a role. The more we understand genetics, the more we realize that genetics and lifestyle aren’t separate; they interact.”

Anticipatory medicine can be a game-changer

By focusing on surveillance and early detection, Dr. Borja helps patients with genetic risk for cancer to lower their risk of developing the disease. This approach is particularly crucial for his pediatric patients born with rare genetic syndromes.

“Because many of these disorders can affect multiple organ systems, we aim to get ‘anticipatory medicine’ and therapies in place as early as possible,” says Dr. Borja. For a child at risk of kidney disease, for example, this might mean performing periodic blood tests and renal ultrasounds.

Help your body beat the odds

Traditional thinking says we can’t overcome our genes. While geneticists like Dr. Borja acknowledge the significant role genes play in determining health, he says that cultivating the right lifestyle is like “saving up for retirement.”

We can’t change our family’s medical history or the genetic cards we were dealt, but we can often improve the odds. Just as you can polish your musical skills through practice, you can sometimes prevent serious disease with a healthy lifestyle.

Simply by avoiding your father’s pack-a-day smoking habit, you significantly reduce your chance of developing the cancer that killed him. If heart disease runs in your family, you lower your risk of heart attack and stroke by maintaining a healthy weight, exercising, and eating right.

Patients genetically predisposed to high cholesterol that doesn’t respond to diet, exercise, or conventional medications may overcome this genetic obstacle by taking a PCSK9 inhibitor. This is the only drug shown to help lower elevated LP(a), a glycoprotein that increases our cardiovascular disease risk. “PCSK9 inhibitors were first conceived when patients were identified with dysfunctional PCSK9 genes causing abnormally low cholesterol,” Dr. Borja says. 

Sometimes, however, we just have to cope with our genetic inheritance. “For some individuals, it can be a tremendous relief to know when a condition has a genetic cause, particularly for parents who may have blamed themselves for their child’s condition,” Dr. Borja says.

How do genetics impact longevity?

We’ve all heard about the man with a daily cigar and whiskey habit who lives to be 102. 

Some people seem to win the genetic lottery, living long and strong despite their lifestyles. “Scandinavian studies corroborate that genetics contribute to about 20 to 30% of the overall variation in lifespan. No one single gene is responsible for this effect, but rather, it’s influenced by the contributions of multiple, different genes,” Dr. Borja says.

Unfortunately, the fountain of youth has always eluded humans. “There is no specific way of eating, or type of exercise, or hours of sleep that can guarantee you everlasting health. But a healthy lifestyle seems to encourage our genes to express themselves in a way that protects us from a host of chronic diseases all at once,” Dr. Borja says. That is why, if you follow a low-inflammatory diet to relieve arthritis symptoms, you also lower your risk of heart disease, cancer, and cognitive decline. 

There is still much to learn about genetics. “Despite all the unknowns,” Dr. Borja says, “more and more, medicine is shifting to understand human health and disease through a genetics lens,” Dr. Borja says.

Key takeaway

The realm of genetics is wonderfully complex, and there is excitement about the novel, gene-based therapies currently being developed for many serious or rare diseases. 

But while we wait, we can take advantage of the genetics/lifestyle connection. 

“Preliminary research on individuals with hereditary cancer susceptibility has suggested that they can not only benefit from lifestyle modifications but in some cases, may benefit even more than individuals who are not at risk. There is a lot that people can do for their own health,” Dr. Borja says.

Nancy Moreland is a regular contributor to the UHealth Collective. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.

Learn more about lifestyle medicine for cancer prevention at Sylvester Comprehensive Cancer Center.

Tags: Disease Prevention, Dr. Nicholas Borja, genetic disease, know your risk, Sylvester Comprehensive Cancer Center