“One Test for All” Is a Myth
A patient comes to the consultation room carrying a thick folder containing 50 pages of DNA test results she has just taken, somewhere. She puts it on the desk and asks enthusiastically: “Doctor, with a genetic test this expensive, what are the results doc, am I aging faster? Did my diet last month roughly succeed or not doc” The doctor falls silent for a moment, then answers: “Ma’am I am very sorry, this many test results cannot answer even one of your questions” Basic DNA testing does not see your body’s condition today. It only reads the genetic heritage that has existed since you were born and will not change until you die. This is not the patient’s fault. This happens because of marketing that equates all types of genetic testing as if there is one magical test that can answer all questions. In fact, there are two types of genetic tests that work very differently, for different questions as well. If mistaken, we will only waste money.
Hard Drive vs Software: Two Tools, Two Functions
Basic DNA Testing is a test to examine your hardware, which is your own DNA. This DNA is a blueprint that you inherit from your parents and will never change. If you take this test at the age of 5 years or 80 years, the results will be identical. A DNA test can map the potential and vulnerability of hereditary diseases, and only needs to be done once in a lifetime. Biological Age (Epigenetic) Testing is a test to assess the epigenetics in your cells. Epigenetics is like an operating system on top of hardware. It does not read static genetic code, but reads how your lifestyle changes the way genes work. Its examination is done by detecting markers called DNA methylation. Your lifestyle is recorded here, whether you lack sleep, are often stressed, have a poor diet, exercise or not, and many more.
This is the test that must be done periodically, for example once a year, to monitor whether your body is biologically aging faster or slower than calendar age. Both of these tests are not rivals, but complement each other. Both answer different questions and both are needed to describe your body’s condition comprehensively. This is why the patient scenario at the beginning ended up unpleasantly. She bought a tool that answers questions about her genetic future, but used it to answer questions about her body’s condition today. Two completely different things. The danger is, someone can feel safe just because seeing their gene profile is safe, but not realize that their biological age has actually far exceeded their ID card age. And vice versa, someone with a high genetic risk can have a biological age much younger than average because they know and act earlier.
Three Things That Can Only Be Answered by the Right Test
- Who is More Accurate in Predicting Diseases? Hillary et al. (2021) in Clinical Epigenetics compared the two directly in a large population. The results: epigenetic measurements independently predict the emergence of major chronic diseases, including heart disease and diabetes. Epigenetic testing turns out to be much more accurate than congenital genetic scores alone. The reason is because epigenetics captures the real damage from a lifestyle that has been going on for years, something that cannot be detected in basic DNA testing.
- Can a Healthy Lifestyle Be Proven Molecularly? This is the question most frequently asked by patients and the answer can only be found in a biological age test. Waziry et al. (2023) in Nature Aging studied CALERIE trial participants who underwent long-term calorie restriction. The results revealed that their DNA test results did not change at all (because indeed they cannot), but their epigenetic test results showed a quite significant slowdown in aging. So, only a biological age test can prove whether your diet has had an impact down to the cellular level or not.
- How Do Both Work Together? Ferrucci et al. (2020) in Aging Cell emphasized that precision longevity medicine requires both in the right order: a basic DNA test at the beginning to map congenital vulnerabilities and formulate prevention strategies, then periodic biological age tests to measure whether those strategies truly work and slow down body aging. A basic DNA test shows the terrain you have to face. A biological age test shows how well you face it.
What Do You Actually Need Today?
Before choosing a test, first determine the question:
- Want to know the risk of hereditary diseases and how your genetics respond to specific nutrients? -> Basic DNA Test. Do it once, make this test result a long-term map for your body.
- Already undergoing a health program and want to know whether your cell aging is truly slowing down? -> Biological Age Test. Do it periodically, make it a progress indicator. Two tools, two questions, two different moments. Do not buy a weather report if what you need is a road map and vice versa.
REFERENCES
- Hillary, R. F., et al. (2021). Epigenetic measures of ageing predict the prevalence and incidence of leading causes of death and disease burden. Clinical Epigenetics, 13(1), 115.
- Waziry, R., et al. (2023). Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. Nature Aging, 3(3), 248-257.
- Ferrucci, L., et al. (2020). Measuring biological aging in humans: A quest. Aging Cell, 19(2), e13080.
