The Antidote

Counterspin for Health Care and Health News

Tuesday, January 09, 2007

Antidote Interview #1: Hsien-Hsien Lei

Dr. Hsien-Hsien Lei is a genetic epidemiologist and writer, and the brains - not to mention the wit - behind Genetics & Health. We've had a number of discussions about the intersection between genetics and public health, and she was kind enough to interview me for her blog a couple of months ago.
The interview format was such a good idea, and Hsien is such an engaging person, that I had to return the favor. If you haven't already, I'm sure you'll want to check out not only her Genetics and Health blog, but her other writing projects as well. I'd like to thank Hsien not only for this opportunity, but also for highlighting my blog early on in its life.


Hsien, what made you decide to start blogging about genetics and health? What's your goal in writing this blog? Is there a particular message or messages you'd really like to get across? And what else do you do in your writing life?

It wasn't too much of a stretch to start a blog about genetics and health, two areas that I've been passionate about since grade school. Seriously. My prize winning sixth grade science project was called "Heredity, Genes, and You." One of these days I'll have to dig up the dorky picture of me holding up my blue ribbon next to my poster board with the pipe cleaner DNA helices. I even made local TV for that project. Good times. ;)

My goal in writing the blog is to make genetics seem interesting and relevant to everyday life. So much of what goes on in research is out of reach for the average non-scientist and even scientists themselves are prone to losing touch with the bigger picture. My main message is: Genetics matters to everyone everyday.

As for my writing life, I am currently an editor at b5media.com - Science and Health as well as Family and Relationships. I also write a heart disease blog and a children's toy and book blog, PlayLibrary.com. I also keep a personal blog full of random nonsense that I want to keep in my online wunderkammer, Cottontimer.com.

What areas of genetics do you think hold the biggest potential for improving public health? Do you think genetics research is driven more by public health efforts or business concerns, and are these goals ever in conflict?


Genetics has already improved public health tremendously. For example, prenatal testing for Down's syndrome, pre-pregnancy testing for the Tay Sachs gene, and cancer screening for BRCA genes for breast and ovarian cancers. Beyond genetic testing, our understanding of genes and their function has opened up new areas of investigation into how our bodies work and provided new targets for drug treatments. If you consider crime part of the scope of public health, DNA analysis has helped us capture criminals and identify victims. Society is healthier and safer because of genomic technology.

One of the biggest potentials for the use of genetic information is in the area of personalized medicine. Each of us has a genetic make-up that determines how well we metabolize drugs. In extreme situations, some of us might develop severe side-effects to one treatment while that same treatment could save another's life. To be able to understand specific genes involved in drug safety and efficacy will not only improve our overall health, but also improve the efficiency of the healthcare we receive. Pharmaceutical companies will be able to develop more and better drugs with less waste, both money and resources. And we'll be able to tackle drug safety with more information.

As for the conflict between public health and business interests, it's the same for everything in life. Money doesn't always come along with ethical considerations or doing what's right. But without money, nothing would get done.

I'd like to ask you about one effort I heard a few years ago: individualized dietary supplement cocktails based on people's combinations of genetic polymorphisms. At the time, I raised an eyebrow, because I was skeptical that we knew enough about the effects of the polymorphisms, or of the benefits of the supplements, to come up with an effective drug. What are your thoughts on this?

I've written extensively about direct-to-consumer nutrigenetic testing (also known as nutrigenomics or nutritional genomics). I'm skeptical about their ability to give unique recommendations for each individual with regards to their diet and lifestyle. Most common sense nutrition and exercise tips will work for the majority of people. However, if a person has the money to spend on a nutrigenetic test, they may feel more motivated to adopt a healthier lifestyle. The information from these tests are vague enough that no one is going to think they can live forever by smoking 2 packs of cigarettes a day, eating only fried foods, and never getting off the sofa simply because the tests say they have one variant of this gene or another. So I don't think anyone is going to be harmed by nutrigenetic tests unless you're talking about their wallets.

FYI: Genetics and Health's previous posts on nutrigenomics.

I know your training is in epidemiology and genetics. Is genetic epidemiology a hybrid of the two disciplines, or is there more to it than that? And what's new and exciting these days in genetic epi?

I wouldn't say genetic epi is a hybrid of the two disciplines but more of an offshoot or an intermediary. There are statistical techniques that are unique to genetic epidemiology because it studies genetic factors in populations instead of individuals. (Meaning we take individual data and aggregate it to determine patterns.) I think genetic epidemiology is the most adept at teasing out genetic and environmental influences on a trait, whether it be cholesterol levels or diabetes. Genetic epi uses molecular techniques and different epidemiologic study designs to create a whole picture of a disease and its spread in the population. Very powerful and relevant.

Every time I talk about genetic epi specifically, I realize how much I enjoyed it as an active researcher.

I really admire the success and recognition you've achieved. Have you put a lot of time into publicizing your blog? On a larger but related subject, have you found blogging to be a useful mechanism for networking? Any stories you'd like to tell?

Thanks, Emily! When Genetics and Health was started in April 2005, I did go around and visit many blogs, leaving comments when I felt I had something to contribute. I still try to do that but have gotten busier with the addition of A Hearty Life so what I try to do instead of leaving comments is to read and trackback with my own posts, furthering the discussion that way. Publicity in and of itself is not something I devote myself to. Conversation is what I'm aiming for.

In terms of networking, I've met some wonderful people through my blogs, like you, who've engaged me intellectually and made me laugh when I needed it most. This is the next best thing to working in an office. Actually, it might even be better than having to slog in to work for 10 hours a day in a windowless cubicle or lab. :) I feel very fortunate to be a part of the blogging community as well as having the opportunity to share knowledge that I hope will improve people's lives.

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