TESTING YOUR GENESMany of us would like to blame our parents or our genes for our weight or health problems. It would
be easy to say that you have the genes for obesity or diabetes, that your parents and grandparents were
overweight or had diabetes or heart disease, so you do, too. But the world of genetics is much more
complicated than that.
Each of us has about 20,000 genes. Approximately 99 percent of those genes are identical to every
other human on the planet; the other 1 percent is what makes us unique. You have about 112 million
variations on those genes, called single nucleotide polymorphisms (SNPs for short), which influence
every function of your body, including your need for vitamins, your ability to detoxify, and your
tendency toward inflammation, heart disease, cancer, and much more. These SNPs also influence your
weight and metabolism and your ability to process or manage fat in your diet.
Every day we are learning more about these SNPs and how they influence our health. We know
enough today to start using genetic tests to help personalize our approach to health and nutrition. Soon
we will be able to take a swab of our cheek, send it in, and for a few hundred dollars know our
whole genome and match our food, supplement, and exercise needs to our own genes, optimizing
function and metabolism. Up to 40 to 50 percent of the variance in body weight among people may be
due to genetic factors, which is why different people respond differently to different diets.12For some of my patients, I order genetic testing to help guide me in personalizing
recommendations. There are some genes that help me tailor my approach for each person. These
specific genes are linked to obesity and the tendency to gain weight, and how cholesterol profiles may
respond to a high- or low-fat diet,13 metabolic rate, absorption of dietary fat, mobilization of fat from
cells, and the ability to burn fat for energy. There are genes that regulate dopamine receptors in the
brain, which control your likelihood of craving carbs and sugar, and genes that can predict levels of
insulin resistance, inflammation, cholesterol metabolism, and even how your body responds to
different types of exercise.
I’ve listed below some of the genes I test for (and that you can easily test for with a home test kit
—see www.eatfatgetthin.com for details):
FABP2: influences your absorption and metabolism of fat
PPARG: affects your insulin function, fat burning, and cholesterol levels
ADRB2: affects how your body mobilizes fat from fat cells for energy
ADRB3: affects how your body breaks down fat
APOA5: regulates your triglycerides
APOA2: affects the risk of obesity, cholesterol metabolism, risk of heart disease, and risk of
diabetes
MC4R: affects your energy intake and expenditure and appetite control
FTO: regulates appetite, temperature, and nervous and hormonal systems
TCF7L2: regulates blood sugar, including insulin secretion and action
ADBR3: affects your responsiveness to exercise and fat burning
PLIN: affects fat storage related to obesity
TNF-A: affects inflammation, which can affect blood sugar control and cholesterol abnormalities
LDL: removes cholesterol from circulation
CETP: regulates metabolism of HDL and the levels of blood cholesterol
APOA1: regulates the production of HDL (good cholesterol)
APOC3: plays a key role in cholesterol and triglyceride metabolism
APOE: plays an important role in the breakdown of triglycerides and cholesterol
DRD2: affects the dopamine receptors in your brain and your risk of addiction to sugar and refined
carbs
Since I am interested in this area, and because I have a strong family history of heart disease and
tend to have higher cholesterol, I wanted to see what my tests showed. Let’s go through my own
results so you can see how this can play a practical role in personalizing your own approach to
health.
On the whole, I discovered I was genetically very lucky. I had only one highly impactful gene that
put me at risk of being carbohydrate intolerant, called PLIN. This didn’t surprise me, since I notice
that if I eat refined carbs or sugar, I gain a bit of belly fat! I also have the MC4Rgene variation,
which makes me likely to overeat. I do in fact have to watch myself.
My triglycerides are a bit higher than I would have expected, given how clean my everyday diet
is. It was enlightening to learn that I have the APOA5 and APOA3 genes; it helps me know that I
should have more olive oil or MUFAs and fewer carbs in my diet.
As you progress through the program, don’t forget to listen to your body. How do you feel? Are
you losing weight? Is your energy dramatically increased? Are your aches and pains better? Is your
brain fog gone? Remember, your own body is the best barometer of what works and what doesn’t.
how to lose weight
MY OWN TRANSITION FROM FAT TO FITI went to medical school in the early eighties, in the heyday of the low-fat craze. I avoided fat and
recommended my patients do the same in order to lose weight and prevent heart disease. I became a
vegetarian, and for ten years I avoided any animal products except low-fat yogurt and egg whites. I
kept oils to a minimum and ate lots of bread and pasta (then promoted as a health food). I knew too
much sugar wasn’t that good for you, but I ate plenty of whole-wheat low-fat cookies and low-fat
frozen yogurt because I craved sugar and carbs. I was young and a runner, so I burned a lot of it off,
but as I got older I noticed my body change. I developed love handles, my belly got a little bigger, my
pant size increased two inches, and my body seemed flabby and less muscular. By the time I was
thirty-five, I’d gained fifteen pounds. I studied nutrition and followed a healthy balanced diet—the
same one I recommended to my patients—so I thought it was just normal aging. I didn’t eat junk food;
I never had soda or processed food. I ate a whole-foods diet rich in grains, beans, fruits, and veggies
and didn’t go overboard on sugar. I ate little fat. But my body just kept getting flabbier.
As the research started emerging on the dangers of sugar and refined carbs (even whole wheat
bread), I cut down on sugar and carbs. But still, I feared fat, especially saturated fat, which I “knew,”
as a doctor, was the cause of heart disease. If I exercised a lot (like riding my bike thirty-five miles a
day), I thought I could keep some of the excess weight off, but it wasn’t sustainable.
Then, over the last ten years, as the tide turned, I began to change my own eating habits and my
recommendations to my patients. I saw people lose one hundred or more pounds and reverse type 2
diabetes. I saw my patients get off insulin and optimize all their cholesterol levels not by eating lessfat, but by eating more fat.
The changes in my own body were remarkable. Not only did I have more mental focus and clarity,
but I lost the fifteen pounds, the love handles, and two inches off my waist, and at fifty-five years old I
am more muscular and fit than I’ve ever been, while working out less; I feel younger and more
energetic than ever.
Now I eat fat for breakfast without fear or guilt, with a big smile on my face and a deeply satisfied
tummy. Sometimes I have whole eggs cooked in grass-fed butter or extra virgin coconut oil (high in
saturated fat but super healthy), or a “fat” shake with a bunch of nuts, seeds, and coconut butter. For
lunch I have a big salad with fatty sardines or wild salmon, doused in olive oil and sprinkled with
fatty pumpkins seeds or pine nuts; and for dinner I might have grass-fed lamb without the fat cut off,
and three or four veggie dishes cooked in olive oil, lemon, and spices and salt.
When I traveled to Tibet in my twenties, I was invited into the yurts of nomads and fed salty yak
butter tea (actually it is dri butter—from the female yak), which was deeply satisfying and kept me
going for a long time at high altitudes. And sometimes now I have the American version created by
my friend David Asprey, Bulletproof Coffee—coffee blended with butter and MCT oil from coconut
(a super fat that is a super fuel for your brain and your body). One close friend in medical school was
an Arctic explorer who cross-country skied to the North Pole while living on sticks of butter for fuel.
He was remarkably healthy and way ahead of his time.
Eating a high-fat diet—especially a diet high in “dangerous” saturated fat—sounds crazy, and up
until ten years ago, I would have told you it was a health hazard. But my own body, my own blood
work, and thousands of my patients and tens of thousands of others who have followed this approach
in my online community all tell the true story. They all report the same benefits from welcoming fat
back into our diets. And the emerging research on fat and health, which we will nerd out on in this
book (sorry, I love the science… I can’t help myself!), supp
recommended my patients do the same in order to lose weight and prevent heart disease. I became a
vegetarian, and for ten years I avoided any animal products except low-fat yogurt and egg whites. I
kept oils to a minimum and ate lots of bread and pasta (then promoted as a health food). I knew too
much sugar wasn’t that good for you, but I ate plenty of whole-wheat low-fat cookies and low-fat
frozen yogurt because I craved sugar and carbs. I was young and a runner, so I burned a lot of it off,
but as I got older I noticed my body change. I developed love handles, my belly got a little bigger, my
pant size increased two inches, and my body seemed flabby and less muscular. By the time I was
thirty-five, I’d gained fifteen pounds. I studied nutrition and followed a healthy balanced diet—the
same one I recommended to my patients—so I thought it was just normal aging. I didn’t eat junk food;
I never had soda or processed food. I ate a whole-foods diet rich in grains, beans, fruits, and veggies
and didn’t go overboard on sugar. I ate little fat. But my body just kept getting flabbier.
As the research started emerging on the dangers of sugar and refined carbs (even whole wheat
bread), I cut down on sugar and carbs. But still, I feared fat, especially saturated fat, which I “knew,”
as a doctor, was the cause of heart disease. If I exercised a lot (like riding my bike thirty-five miles a
day), I thought I could keep some of the excess weight off, but it wasn’t sustainable.
Then, over the last ten years, as the tide turned, I began to change my own eating habits and my
recommendations to my patients. I saw people lose one hundred or more pounds and reverse type 2
diabetes. I saw my patients get off insulin and optimize all their cholesterol levels not by eating lessfat, but by eating more fat.
The changes in my own body were remarkable. Not only did I have more mental focus and clarity,
but I lost the fifteen pounds, the love handles, and two inches off my waist, and at fifty-five years old I
am more muscular and fit than I’ve ever been, while working out less; I feel younger and more
energetic than ever.
Now I eat fat for breakfast without fear or guilt, with a big smile on my face and a deeply satisfied
tummy. Sometimes I have whole eggs cooked in grass-fed butter or extra virgin coconut oil (high in
saturated fat but super healthy), or a “fat” shake with a bunch of nuts, seeds, and coconut butter. For
lunch I have a big salad with fatty sardines or wild salmon, doused in olive oil and sprinkled with
fatty pumpkins seeds or pine nuts; and for dinner I might have grass-fed lamb without the fat cut off,
and three or four veggie dishes cooked in olive oil, lemon, and spices and salt.
When I traveled to Tibet in my twenties, I was invited into the yurts of nomads and fed salty yak
butter tea (actually it is dri butter—from the female yak), which was deeply satisfying and kept me
going for a long time at high altitudes. And sometimes now I have the American version created by
my friend David Asprey, Bulletproof Coffee—coffee blended with butter and MCT oil from coconut
(a super fat that is a super fuel for your brain and your body). One close friend in medical school was
an Arctic explorer who cross-country skied to the North Pole while living on sticks of butter for fuel.
He was remarkably healthy and way ahead of his time.
Eating a high-fat diet—especially a diet high in “dangerous” saturated fat—sounds crazy, and up
until ten years ago, I would have told you it was a health hazard. But my own body, my own blood
work, and thousands of my patients and tens of thousands of others who have followed this approach
in my online community all tell the true story. They all report the same benefits from welcoming fat
back into our diets. And the emerging research on fat and health, which we will nerd out on in this
book (sorry, I love the science… I can’t help myself!), supp
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