Pamela Malo, MHS, RD, Arivale Coach
Co-author Niha Zubair, Arivale Clinical Research Scientist, PhD
With so many genetics companies out there, it can be difficult to decide which one to choose. Furthermore, you may receive different results and recommendations depending on which company you pick.
So, how to make the choice? It’s best to go with a genetics company that’s transparent in its methods and standards for reporting genetics.
But, first let’s discuss why a consumer might receive differing results and recommendations from company to company. Below are a few of the issues you may come across. (This is a long list, but it’s by no means exhaustive.)
Issue #1: The genotype for a genetic variant differs from company to company
Is your genotype an AA or a TT for a specific genetic variant? Did your DNA change between tests? Not likely.
Your DNA has two strands, and depending on which strand a company uses for reporting their genetic variant, you may be an AA or a TT. Regardless, it means the same thing and your DNA hasn’t changed. You can flip back and forth from AA to TT; it’s just a matter of choice. But, hopefully the company is keeping track of which strand they’re using in comparison to the strands used in scientific studies!
Of course, there is a small chance that discrepancies in genotype are actually due to technological differences, but this is rare.
In the end, if you want to compare your genotype from company to company, you need the complete information for the genetic variant in question, including the strand and the unique variant identification ID (rsID), not just the gene name and genotype. As an analogy, the gene is the zip code and the genotype is the color of the house, but without the street address, which is the rsID, you cannot find the right house. For example, in a report for the MTHFR gene, if you are only given the information that your genotype is CC, it’s not clear which of the 12,000 positions within the gene this genotype is for.
Issue #2: The genetic variants reported for a given trait differ from company to company
For a certain trait (higher weight or lower vitamin D levels, for example), there may be different variants reported from company to company. This can happen for two reasons. First, you have to ask whether the company curated the entire body of scientific literature and did they take the quality and quantity of the studies into account?
For some companies, a single positive paper on a genetic variant may be all it takes to add the variant to their report, even if there are multiple negative studies in the literature. For example, for an inflammation marker (CRP), one company may report on a variant in the IL-6 gene, while another reports on a different variant in the CRPgene. Why the difference? When looking at the overall body of evidence, the data for the variant in the IL-6 gene is conflicting, whereas for the variant in the CRP gene has an unconflicted body of evidence demonstrating its association with inflammation levels. In this example, the first company came to a conclusion without doing a thorough curation of the literature.
Issue #3: The trait of interest is not well-defined
The trait of interest needs to be well-defined and reported precisely to the consumer. For example, a variant in the CYP1A2 gene is known to impact the speed of caffeine metabolism. While it could be easy to assume this variant plays a role in jitteriness or another common side-effect from caffeine, there’s not enough science to support that claim. Rather, the science only consistently shows this variant is linked to the long-term risk of developing hypertension with regular caffeine consumption. If a company were to report the variant as related to “fast” or “slow” caffeine metabolism without elaborating, a consumer may not fully appreciate the variant’s potential impact on their health and could therefore miss the opportunity to make beneficial diet or lifestyle changes.
Another example we’ve seen is companies combining multiple traits into a single nondescript or broad interpretation. For example, a variant associated with cholesterol levels and a variant associated with weight gain from saturated fat may be combined into a single genetic insight titled “your sensitivity to saturated fat.” While it’s convenient to package variants into a single genetic insight, it can be confusing if not done correctly. In this scenario, what does it mean to be “sensitive to saturated fat?” What is the context? The insight combines variants from two different traits: weight gain and cardiovascular health. Unfortunately, the consumer may not clearly understand this distinction and could miss out on precisely how saturated fat affects their health. This single insight should be split into two insights, one for each trait.
Issue #4: The diet and lifestyle recommendations differ from company to company
Even if the same genetic variants are reported to the consumer, diet or lifestyle recommendations may differ from company to company. Companies may overinterpret the science to make these recommendations more consumer friendly. While it can be very satisfying from a consumer perspective to be told exactly what to do – “limit my total calories from saturated fat to precisely X% for weight loss,” for example –most of the time, unfortunately, there may not be studies backing up such precise recommendations.
More importantly, in the wellness space, recommendations shouldn’t be based on your genetics alone. Frequently, companies don’t take into account all your data, including blood biomarkers, blood pressure, weight, and personal and family health history. For example, a genetic variant may predispose you to have lower vitamin D levels, but do you actually need to supplement with vitamin D? Only your blood data can tell you this.
What makes Arivale stand apart
Before we dive into how Arivale addresses these specific issues, we wanted to highlight a weight-loss success story from one of our members who had also been a customer of another genetics company.
This member initially lost weight when she became vegan. While she wasn’t eating animal products, she was eating processed vegan alternatives that were high in fat. She became frustrated after hitting a plateau in her weight loss over the past year. This frustration led her to have her genetics done with Arivale and another company. Arivale’s results showed she actually had a higher genetic predisposition to gain weight from fat, whereas the other company told her the opposite. She decided to take advice from her Arivale Coach. She began tracking her food intake, aimed to limit her fat intake to 25 percent of her total calories, and focused on including more whole foods in her diet. Almost immediately she began seeing weight loss again. In fact, she’s lost 5 percent of her body weight over the course of her first seven months at Arivale. She credits Arivale for her results.
This member’s story highlights some of the differences one may experience when using different companies. She received essentially opposite diet advice from two companies, but clearly her genetics hadn’t changed. So, what gives? It stems back to the issues we presented above, which are becoming more common as the genetic wellness industry rapidly grows. How does the consumer navigate this uncharted territory?
At Arivale, we aim to be transparent in our methods and to back our results with science. We’ve developed guidelines and strict standards to review and report genetic variants. This provides consistency and accountability.
In addition, we provide diet and lifestyle recommendations based on the science. Importantly, these recommendations take into account data besides genetics, such as your blood markers, and are tailored and delivered by an Arivale Coach (a licensed Registered Dietitian or Certified Nutritionist). Our coaches also help you make the behavioral changes needed to implement and sustain these diet and lifestyle recommendations.
While at first glance Arivale may seem like another genetics company, genetics is only a part of what we do. We like to think of ourselves as a wellness program that takes a “systems approach” to both behavior and biology. That means we look at all of you – not just your DNA.