What taking health tests taught me about our future | David Ewing Duncan | TEDxMIT

Key Concepts

• Personal Genomics: Sequencing and analyzing an individual’s entire genome.
• Biomarkers: Measurable indicators of a biological state or condition (e.g., caffeine metabolism gene, immune health age).
• Systems Biology: Studying the interactions between components of a biological system as a whole, rather than in isolation.
• Predictive Healthcare: Utilizing data to anticipate and prevent disease before symptoms appear.
• Synthetic Biology: Designing and constructing new biological parts, devices, and systems.
• Entropy: A measure of disorder or randomness in a system; life’s constant battle against entropy.
• ACE Inhibitor: A medication used to treat high blood pressure.
• mRNA: Messenger ribonucleic acid, a molecule that carries genetic code from DNA to ribosomes for protein synthesis.
• Nucleotide: The basic building block of DNA and RNA.

From Sick Care to Well Care: A 25-Year Journey of Self-Experimentation

This presentation details a 25-year exploration into the speaker’s own biology, driven by a desire to understand the shift from reactive “sick care” to proactive “well care.” Beginning with participation in the Human Genome Project in 2001, the speaker, a science writer, has undergone extensive testing – accumulating 70 terabytes of data – to map and interpret the complex interplay of factors that define individual health.

The Genesis: The Human Genome Project & Early Biomarkers (2001-2017)

The speaker’s journey began with an assignment for Wired magazine covering the nascent Human Genome Project. In 2001, sequencing an individual’s genome was a novelty. The initial data, as shown in a slide, was limited, focusing on a handful of genetic markers to assess risk for diseases like hypertension. The speaker’s own genome revealed a potential future risk for hypertension, a prediction that materialized 17 years later, requiring treatment with an ACE inhibitor. This experience underscored the potential of predictive healthcare, catching diseases early to mitigate damage to organs like the heart and kidneys.

Expanding the Data Landscape: From Biomarkers to Systems (2013-2018)

As technology advanced, the scope of testing broadened significantly. The speaker underwent a vast array of tests, including blood analysis (toxin levels, proteins, mRNA), brain EEGs, MRI scans, and data collection via wearable devices. Around 2013-2014, the advent of advanced computing allowed for the layering of this data, revealing correlations and predictions previously unattainable. The number of biomarkers analyzed increased from single digits to “dozens, hundreds, even the low thousands.”

A particularly compelling example from 2008 involved a heart attack risk assessment costing tens of thousands of dollars. The prediction hinged on weight gain: gaining half a pound per year resulted in a 70% chance of a heart attack within 20 years, while maintaining weight yielded only a 2% risk. This highlighted the individual sensitivity to specific factors and the potential for personalized preventative measures. Notably, the speaker has remained heart attack-free for the 17 years since this prediction.

The Immune System as “The Mother of All Systems” (Recent Developments)

The speaker’s testing evolved further to encompass a holistic assessment of the immune system. A recent test at Yale University, part of a study involving only a few hundred participants, provided an “immune health age.” The speaker’s score indicated an immune system functioning at a level 20 years younger than their chronological age. This represents a shift from predicting individual disease risks to evaluating the overall health and resilience of a complex biological system.

Synthetic Biology and the Future of Personalized Medicine

The presentation concluded with a glimpse into the future of personalized medicine through synthetic biology. The speaker recounted a 2018 conversation with George Church at Harvard, where they explored the possibility of creating a synthetic human chromosome. While a full synthetic genome remains impractical, they successfully synthesized a functional version of the speaker’s Y chromosome, engineered to be resistant to viruses. This demonstrates the potential to proactively enhance biological defenses through genetic modification.

The Philosophical Underpinning: Fighting Entropy

The speaker framed this entire endeavor within a broader philosophical context, emphasizing that life itself is a constant struggle against entropy – the natural tendency towards disorder. The goal of healthcare, therefore, is to maintain an equilibrium of good health, proactively identifying and addressing imbalances before they manifest as disease.

Notable Quote: “Life on Earth for four billion years, we managed to keep things at an equilibrium of life. So, that's what this data is all about.”

Data & Statistics Mentioned

• 70 Terabytes: Approximate amount of data accumulated over 25 years of testing.
• 25%: Percentage of North Americans who can drink coffee before bed and fall asleep (caffeine fast metabolizers).
• 70% Heart Attack Risk: Predicted risk if the speaker gained half a pound per year, based on 2008 data.
• 2% Heart Attack Risk: Predicted risk if the speaker maintained their weight, based on 2008 data.
• Immune Health Age: Speaker’s immune system functioned at a level 20 years younger than their chronological age.

Conclusion:

The speaker’s 25-year self-experimentation serves as a compelling case study for the transformative potential of personalized medicine. By embracing a data-driven approach and shifting the focus from treating illness to maintaining wellness, we can move towards a future where healthcare is proactive, preventative, and tailored to the unique biological profile of each individual. The journey highlights the increasing complexity of biological data, the power of systems biology, and the exciting possibilities offered by emerging fields like synthetic biology.